Stroke care has evolved dramatically since I started practicing emergency medicine almost 25 years ago. What remains a constant, however, is that time is critical. Delays in seeking care can be catastrophic, as would have been the case here. I’ve witnessed time and again the miraculous recovery after a stroke victim arrives paralyzed on one side of the body and is treated with tissue plasminogen activator(tPA). For patients who seek care within 3 hours of a stroke, this life-altering, clot-busting medication helps open up a clogged artery in the brain responsible for loss of function.

My friend’s experience impressed upon me how important it is for patients to recognize that stroke care no longer stops at 3 hours. Fortunately, for his dad,  a regional Thrombectomy Capable Stroke Center was nearby. As the human brain is exquisitely intolerant of diminished oxygen flow from a stroke, he was expeditiously transferred to the regional facility where specialized doctors called neuro-interventional radiologists used a small artery to tunnel a catheter into the arteries in his brain and retrieved the blood clot. Thanks to the skill of those specialists at that advanced stroke center, he recovered almost immediately and today, you would never know he was almost left with what would have been a disastrous, life-altering deficit.

The data is irrefutable. People are waiting too long at home to seek emergency care when needed, for fear of COVID. We as emergency physicians are witnessing devastating strokes, heart attacks, infections, diabetic complications and many other preventable illnesses because of delays in seeking medical help during this pandemic. The reality is that COVID isn’t contracted in hospitals, but out in the community when we let down our guard(and our masks). Yet heart attacks and strokes lack the courtesy to wait out the pandemic.
Here’s what you can do to ensure the best possible outcomes for yourself and your family during these trying times:

• Plan ahead by knowing where the closest Thrombectomy Capable Stroke Center is located to you and your loved ones.  Tri-City Medical Center is a Thrombectomy Capable Stroke Center and is located at 4002 Vista Way in Oceanside. 
• Recognize the symptoms of a stroke with the acronym F.A.S.T.-Facial droop, Arm weakness, Speech difficulty, Time to call 911.
• Know the symptoms of a heart attack: Chest discomfort with our without jaw or neck pain, shortness of breath, sweating, nausea and weakness.

Most of all, stay strong Oceanside. The vaccine is imminent, and we can finally see the light at the end of the tunnel. Together, we’re going to beat this and be with our friends and families again.

About The Author
Dr. Gene Ma has served as an emergency department physician at Tri-City Medical Center for over 19 years and is Tri-City’s Chief Medical Officer.

by Tina F. Edwards, MD, World of Wellness, Healing Care

When you pay for something you expect to get something out of it. But, are you getting anything from the Healthcare you are buying for your employees? Are they healthier? Do they get good care? Do they have fewer sick days? Does any benefit accrue to you, the employer, for paying for this increasingly expensive service?

Why are you paying for healthcare, anyway? When did employers become responsible for their employees health and why? Essentially, it was an accident of history and a change in the tax code. During World War II, one way to attract laborers to essential war-time factory work was to offer better fringe benefits. One of those was health-insurance. In 1943, the IRS decided that employer-based-healthcare would be tax free—and thus the standard of employer funded health-insurance was born.[i]

Today, you probably pay a monthly amount for each of your employees to cover their health-insurance. That insurance, in turn, covers some or all of their health expenses. Usually, to keep costs low, you use a Health Maintenance Organization (HMO), perhaps with a large co-pay for each visit, or a PPO with a very large deductible. For that, they can potentially see their doctor after making an appointment for 1-2 weeks in advance. Maybe, if they are lucky, they can see some other provider that day or the next day if they are actually sick—and when do they call their doctors for an appointment? When they are well?  The focus is rarely on preventing illness, but rather responding to it, maybe with pills, or hospitalization, or expensive testing. For each of those, they will pay a co-pay, usually ranging from $15 to $70 dollars, or more, for an ER visit when they can’t get in to see a regular doctor or urgent care.

What, you may ask, is the alternative? There is a new movement among primary care doctors and their patients today called Direct Primary Care (DPC). Born of the idea that it is Primary Care that is the real driver of health, a growing wave of doctors have decided to opt out of the insurance game, and take their services directly to the patient.

DPC patients pay a monthly fee to their doctor, usually less than $99 a month and averaging $50-$70/monthly, per patient, for most practices. Fees are usually based on age and family size. A DPC doctor limits their practice to less than a thousand patients, sometimes as little as three or four hundred. DPC doctors are available for same and next-day visits, texting, phone conversation, twitter messages, Facebook messages and even video chatting. DPC doctors can spend 30 minutes or an hour with patients, and can take all the time needed to do the right thing.

DPC doctors recognize that the current insurance model for Primary Care doesn’t serve the doctor or the patient. Insurance companies derive their revenue from the stream of payments from employers and insured. It is to their benefit to see that patients get as little care, in as little time, as possible, so that they can keep the most money for the company. They have to build nice buildings and offices to house all the administrators and rule-writers they have to pay to decide what patients can and can’t get from their doctors. In short, they get between the doctor and the patient, and they make money doing it.

DPC doctors know that good primary care can take care of 90%, or more, of everything patients need, and primary care is where the real work of health and wellness occur.  What prevents this level of care in most traditional insurance-based doctors’ offices?  First, the doctors have no time. To support the staff they need to comply with insurance and Medicare regulations, doctors have to have panels of 3000-5000 patients. That means they need to see thirty or more, patients, per day. That is why appointments are limited to seven to ten minutes on average, and doctors don’t listen to their patients. Second, they’ll do what they get paid to do. What they get paid to do is write their chart in such a way that their coders can code it “correctly” to get the most money out of the insurance company.  They get paid for referring to specialists; they don’t get paid for listening to the patient long enough to figure out what is going on without that expensive referral.

It sounds strange, but it’s true. Nothing in the current structure actually pays the doctor to sit and listen to the complex human beings that are their patients, and try to help them.  Doctors don’t get paid to talk about grief, isolation or anxiety.  They don’t get paid to talk about diet and exercise, and their role in not just being healthy, but feeling healthy. They don’t get paid to talk to patients about their goals and aspirations, and how doctors can help.  In short, doctors aren’t being paid to do what their patients really need them to do, which is help them to live healthy and fulfilling lives.

Direct Primary Care is a way to return to the roots of medicine, when the local doctor was a local resource for all kinds of health issues, not just strictly for handing out pills and referrals to other doctors. DPC doctors can help your business by keeping your employees healthy, fit, and energized. A healthy workforce is a productive workforce. If you’re among the growing number of employers who self-insures, DPC can help you keep those costs down by limiting referrals, expensive studies and ER visits to what is really needed, not just to what is convenient for the doctor overwhelmed by more than 30 patients a day.

When one ER visit for a simple problem can cost your employees thousands of dollars, DPC pays for itself just in avoiding those expensive visits. When DPC doctors focus on your employees’ health, and getting them to work, ready to work, and keeping the contagious away from work, DPC pays for itself in productivity. When you combine DPC with a health-care-sharing program like Liberty Health Share, or low-cost policies that cover hospitalization and more catastrophic costs, DPC pays for itself by saving you money directly on employee health costs. Finally, when you are able to offer your employees excellent primary care for themselves and their entire family, at very low costs, DPC pays for itself by making you a more competitive employer.   

If you are frustrated by the current Health-care insurance system and looking for an alternative for yourself and your employees, look into Direct Primary Care.  You can change your business to a better model, one that works for you and your employees.
Information Resources:
http://www.dpcfrontier.com/
http://www.businessinsider.com/direct-primary-care-a-no-insurance-healthcare-model-2017-3
http://www.aarp.org/health/health-insurance/info-08-2013/direct-primary-care.html
http://www.heritage.org/health-care-reform/report/direct-primary-care-innovative-alternative-conventional-health-insurance
Local DPC practices
World of Wellness, Dr. Tina F. Edwards, www.wowhealingcare.com,
reevoMD, Dr. Gordon Luan,  www.reevomd.com,
Encinitas Personal Healthcare, Dr. Marty Schulman, http://www.martyschulmanmd.com


[i] Accidents of History Created the US Health System. Blumberg, Alex. Davidson, Adam, http://www.npr.org/templates/story/story.php?storyId=114045132

Last Thursday marked the Oceanside Chamber’s 11th Annual North County Health Fair at the Oceanside Civic Center Plaza. Hundreds of residents, along with visitors and members of the local business community came together to enjoy a beautiful day in the sun.

The event, presented by Tri-City Medical Center, offered community members an opportunity to get connected to the wide variety of health care resources that are available in Oceanside and surrounding communities. Dozens of exhibitors were on hand to provide information about the services offered by their businesses. Event sponsors included Scripps, Kaiser Permanente and Primary Care Associates/Cassidy Medical Group, Part of OptumCare.

On October 13th, the Chamber’s Oceanside Senior Expo event will take place at the same venue. For more information on the Chamber’s upcoming events, visit our Special Events page.

by Carrie Chacon
 
Here it comes, Holiday Deliciousness! I love everything about the holidays, the food, the weather, the friends and family, everything that makes this time of year special. Running around, eating on the go and hugging everyone I see fills me with joy… and taxes my immune system. I say “Humbug” to colds, sniffles and fatigue! I don’t want to forgo hugs and hot chocolate to stay healthy, so I take a few precautionary steps during the holidays to keep myself and my family healthy (well as healthy as possible, colds can be sneaky bugs!)

by Carrie Chacon,

Did you ever wonder how to use, really efficiently use the crisper drawers in your fridge? I did and I have figured it out! 
 
Here is a simple look at how to safely store produce and get a little more life from those veggies.  

The high humidity drawer is good for produce prone to moisture loss.  Think of the moisture as what shapes these foods. If they loose their moisture they will dry out wilt, shrivel and doop. And who wants to eat that? Not any 5 year old I know!

Gotta love this simple food! Eggs, have been eaten since the dawn of human time.  And what a gem of a find! When the first person ate that perfect protein filled egg, they stumbled upon one perfect food.  Eggs, once considered the cholesterol-raising villain, have finally been seen for the wonderful food they are. Even the egg yolk is getting some love! 90% of an egg’s calcium and iron are found in the yolk, and the white of an egg is almost all protein. It really is the perfect snack.

Protein is the super-star nutrient in an egg. But we have to give props to Vitamin K and the mineral Selenium both found in our oval friend.  Vitamin K is an element vital in the bone building processes and selenium is essential for healthy thyroid function. Also showcasing in eggs is Lutein, an antioxidant that helps prevent free radical damage in the eyes.

When back to school commercials start popping up on TV, my kids freak out! They know summer is coming to end.  I, on the other hand, do a little happy dance. Back to routine!  Back to uninterrupted workdays! But the start of school does bring back the one task I do dread- School Lunch Packing! But this year lunch packing is quite literally “In The Bag!”  So here are my 6 tips for successful school lunch packing.

1)     Pack what you know your kids will eat. Seems very obvious, but in an effort to pack a healthy lunch, we often times pack a lunch they won’t even eat.  Remember healthy lunches are only healthy if…the food is eaten.  So packing that PB&J everyday it is ok! And the less food kids toss; the less they waste.