May Your Holidays Be Happy, Healthy & Safe!

May Your Holidays Be Happy, Healthy & Safe!

Happy holidays!

For many of us, the holiday season really is the most wonderful time of the year.  It’s an opportunity to spend time with family, give thanks, watch football, exchange gifts, enjoy holiday parties and marvel at the magical effect Christmas has on children.

All of this activity can be a lot of fun – it can also be exhausting and stressful.  Privia Medical Group North Texas physicians want you and your family to have a special and memorable holiday season, and that starts with looking out for your health and safety first.  Here’s our seven keys to staying safe and healthy this holiday season.

  1. Get Your Flu Shot

If you haven’t already had your flu shot, do it now! Flu season started in October and flu cases begin to spike in December.

“The last thing you want in the middle of the holiday season is to be down for a week or two with the flu,” says Dr. James Parker, an internal medicine physician.  “Everyone six months and older should receive an annual flu vaccine, which are available at most Privia Medical Group primary care offices, as well as most pharmacies.”

  1. Wash Your Hands Often

Just as flu season picks up around the holidays, so does the likelihood of an upper respiratory infection, such as the common cold.  “The best safeguard against colds and other illnesses is frequent and proper hand-washing,” advises Dr. Parker.  “When we touch anything that others have touched, such as money, a handrail on a staircase or a credit card machine at a retail checkout, we’re putting ourselves at risk of a cold.”

The U.S. Centers for Disease Control and Prevention (CDC) provides the following instructions for proper hand-washing:

  • “Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
    • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
    • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
    • Rinse your hands well under clean, running water.
    • Dry your hands using a clean towel or air dry them.”

Hand-washing is always preferable, but it’s a good idea to keep a bottle of hand sanitizer that has at least a 60 percent alcohol content nearby.  This is a good fallback you when you can’t use soap and water right away.

  1. Safety First

Holiday decorating should be fun, not dangerous.  Here are a few important holiday safety tips:

If you’re putting up a live Christmas tree, always keep the water basin full.  If the tree dries out, it can become a fire hazard.

When putting up Christmas lights, take a few safety precautions.  First, check your lights carefully to see that the wires are not frayed or damaged and that the bulbs are not broken.  If lights are damaged in any way, they are a fire and electrocution hazard – throw them away.  Follow instructions on how many strands you can safely connect and take care not to create a circuit overload.

One of the most common household injuries involves ladders.  If you’re hanging outside lights and it involves a ladder, it is best to hire an insured professional to do the job.  Falling off a ladder is one of the more common household injuries and can be quite dangerous.  “Breaking your leg or suffering a head injury isn’t a risk worth taking,” says Dr. Robert Reddix, Jr., an orthopedic surgeon.  “We’ve seen too many of these types of injuries from ladder falls.”

Safety extends to meal preparation, as well. If you prefer your holiday turkey to be fried, order it from a restaurant, ready to serve.  Every year, there are reports of home fires as a result of a turkey-frying project gone awry.  In some cases, this method of turkey preparation has caused explosions and severe, life-threatening burns.  “Our advice on deep-frying a turkey at home: don’t,” says Dr. Uzoma Ben Gbulie, a plastic surgeon.

  1. Enjoy the Food – Just Not Too Much of It 

Undoubtedly, one of the best parts of the holiday season is the great meals we get to enjoy.  While Thanksgiving dinners and other holiday foods may tend to be on the rich side, much of the traditional holiday food is not terrible for you, in and of itself.

“The problem with holiday dining is that we tend to simply eat too much fat, sugar and salt,” explains Dr. Errol Bryce, an internal medicine physician.  “Having some turkey, mashed potatoes with gravy and a reasonably-sized slice of pumpkin pie isn’t going to cause devastating weight gain.  The problem tends to be that we simply eat too much of all this good food.  We load an excessive amount of food on our plates and maybe go back for seconds, also.”

If you have a chronic health condition, such as diabetes or high blood pressure, there are some simple things you can do to ensure the holiday season doesn’t mean an unhealthy intake of sugar or salt.  If you’re doing the cooking, it’s easier to know the foods you’re serving aren’t loaded with ingredients that adversely affect your health.  If you’ll be dining at a relative’s or friend’s home, it’s best to let them know of any dietary restrictions before you come (and if you’re a host, it’s always a good idea to ask your guests this question beforehand).  You can also always bring your own side or desert to a holiday gathering – you’ll help out the host, while ensuring you’ve got something healthy to eat.

  1. Easy on the bubbly

For people who drink alcohol, moderate consumption is an important part of staying healthy.  That means no more than one drink per day for women and two for men.  It’s especially important to remain mindful of this around the holidays, when people can have a tendency to over-indulge.

Just as eating too much will result in an unhealthy calorie intake, so will drinking too much – all alcoholic drinks contain calories that can lead to weight gain and they provide none of the nutrients that food contains.

The dangers of drinking too much alcohol go far beyond the calories.  “Drinking in excess can lead to intoxication and will leave you dehydrated and possibly nauseous for several hours after you stop drinking,” says Dr. Joseph Milne, an orthopedic surgeon.  “The most dangerous part of drinking to intoxication is that your judgement and motor skills become impaired. You might lose your balance and fall, suffering a broken bone or head injury.”

And of course, drinking too much and then getting behind the wheel can lead to a lethal outcome.  The National Institutes of Health reports that two to three times as many people die in alcohol-related traffic accidents over Christmas and New Year’s, compared to the rest of the year.  Additionally, 40 percent of traffic fatalities over Christmas and New Year’s involve a driver who is alcohol-impaired, compared to 28 percent for the rest of December.

If you’ve been drinking, don’t drive, ever.

  1. Keep Moving

 

It’s important for our overall health that we get at least 30 minutes of physical activity a day, five to seven days a week.  That’s true year-round and it’s important to keep up an exercise routine around the holidays, when it’s especially needed to burn those extra calories.

“Given how hectic the holiday season can be, some may be tempted to put their exercise routine on hold – promise yourself you won’t do that,” advises Dr. Lindsay Breedlove Tate, an obstetrician and gynecologist.  “You need to stay with your exercise routine to burn calories and also help clear your head from your endless holiday to-do list.”

If your holiday plans include travel, pack your walking or running shoes and make time to get in some exercise when you’re on the road.

  1. Find Your Stress Reliever

While the holiday season is supposed to be joyful and fun, the reality for many people is that it can be stressful.  Between the decorating, cooking, baking, shopping, travel and entertaining, some try to cram too much into a few short weeks.

“If you find yourself feeling overwhelmed, that’s a key sign you need to ease up on yourself,” says Dr. John Briscoe, an internal medicine physician.  “Make time for yourself and do something that relieves your stress – read a book, watch a movie or go for a walk.  Remind yourself that everything does not have to be ‘perfect’ – you, your family and friends will enjoy the holidays the most when you’re relaxed, rested and at ease.”

Having a happy and joyous holiday season starts with putting your health and safety first.  By taking time to ensure you’re protecting your health, minimizing stress and getting rest, you’ll better enjoy this special time of year and your family and friends will enjoy their time with you.  So slow down, give thanks for what you have and take care of yourself!

From all of us at Privia Medical Group North Texas, we wish you

Happy Holidays and a healthy and safe New Year!

Healthy Holiday Gift Guide

Healthy Holiday Gift Guide

Are you making your list and checking it twice?  If your holiday shopping list includes family or friends who spend a lot of time in the kitchen, enjoy exercise and fitness or love the latest high-tech gadget, there are a lot of clever, health-oriented gift ideas for you to consider.  And if you fall into one of those categories yourself, maybe you can use this gift guide to drop some hints to your family and friends!  Here are some of our favorite gift ideas for those who are interested in focusing on health, wellness and fitness.

Kitchen Gadgets

For people who enjoy cooking, a new kitchen gadget or tool is often the perfect gift.  Many food-oriented gifts can also serve a healthy purpose.

Blenders: Blenders are hardly a new item, but there are now a greater variety of sizes and price points on the market than ever before.  For someone who may be interested in blending healthy smoothies or shakes to start their day or for a post-workout meal, consider a small blender/smoothie-maker that yields an individual-size smoothie in no time at all.

“Not only is making a smoothie or shake at home much cheaper than buying one on your way to work, you can also ensure that your smoothie isn’t loaded with sugar or fat,” explains Dr. Scott Ewing, a cardiologist.

Think about what types of produce you’ll be blending and buy one that is up to job.  For example, if someone likes a smoothie made from hard produce, such as apples or carrots, make sure the blender is rated well for pureeing that type of food.

Kitchen scales: for an inexpensive, yet useful gift, consider a kitchen scale.  Not only is this helpful to the cook who has to figure out how much of an ingredient to put in a recipe, it’s especially beneficial for those interested in cutting back how much food they are preparing and eating.  If someone is trying to get their meat portions down to the recommended four ounces per serving, a kitchen scale is a foolproof way of getting there.

Air Fryers: Deep-fried food may taste good, but it can be rough on your waistline and cholesterol levels.  Air fryers are designed to create crunchy food as though it has been fried, but they don’t use the frying oil that can be so unhealthy.  In fact, air fryers don’t really fry food at all.  They circulate heat around the food, similar to a convection oven.  This helps to crisp the food without frying it.

Healthy Cookbooks: “A cook never minds getting a new cookbook,” says Dr. Timothy Jones, an obstetrician and gynecologist.  “There are plenty of cookbooks for sale that emphasize healthier eating and have creative recipes that taste good and are good for you.”

Fitness Trackers & Smart Watches

Smart watches and activity trackers have become all the rage over the last few years.  These smart devices can do a lot – they keep track of the steps you’ve walked, how fast you have run, how many flights of stairs you climbed, your heart rate and how much sleep you’re getting.

“We should all get at least 30 minutes of physical activity a day, 5-7 days per week,” says Dr. Katherine Kane, a vascular surgeon.  “Many activity trackers and smart watches will keep track of your steps and other movements, so you can see if you are meeting that 30-minute goal.”

If you’re thinking of buying a fitness tracker for someone on your shopping list, consider what they will use it for.  If it’s someone who has a moderate exercise routine, a device that tracks steps will probably be sufficient.

But some trackers and smart watches will do much more.  If you are shopping for an avid runner, swimmer or triathlete, consider a training tracker that does it all.  Many include a GPS function, enabling the user to can easily track the route and distance walked, run or biked.

Some trackers contain a gyroscope that can tell if you’re sitting or standing – with periodic reminders to stand or move about.  They can also determine if you are running, swimming or on a bike.

Others will also monitor your heart rate, so you can track it throughout the day and know if you’re hitting your target heart rate during workouts.  Even others can track your perspiration and breathing.

“Virtually all fitness trackers and smart watches will sync data with an app on your smartphone, which makes it easy to check how many steps you have taken or what your heart rate got up to on the last run,” says Dr. Ronald Blair, a pediatrician.  “These apps can also sync with smart bathroom scales, so that your body weight is automatically transmitted into the app.  However, our professional medical advice is that you don’t buy anyone a bathroom scale as a gift!”

Other Fitness Gifts

There are plenty of other good gift ideas for the fitness-oriented person on your list, at a variety of price points.

“If you have someone who goes to the gym or runs regularly, you can never go wrong with new exercise shorts, running shoes or other workout attire,” says Dr. Caren Reaves, an obstetrician and gynecologist.  “I know I always appreciate getting new gear for my workout routine.”

For those who like to listen to music while they exercise, consider upgrading their headphones.  Many people enjoy having wireless headphones or ear buds that connect with their phone via Bluetooth – this frees them from having a wire extending to their phone and makes movement during exercise easier.

And if they need some new material to listen to while running or hitting the weights, you could always buy them a subscription to a digital music service or some audio books.

For those who travel frequently, you might buy them some low-tech exercise equipment they can take on the road.  “Resistance bands make a great gift for someone who travels a lot – they’re compact, lightweight and easily fit into a suitcase,” says Dr. Emil Tajzoy, an obstetrician and gynecologist.  “Resistance bands help facilitate an easy strength training workout in a hotel room. Jump ropes and yoga mats are also good gifts for the road warrior.”

Expand Their Fitness Horizons

A good fitness-oriented gift doesn’t necessarily have to come in a box.  If you have someone on your list who is looking for a new exercise routine or workout challenge, consider buying them a membership for a Pilates studio, a dance studio or a gym.  If you’re not sure they’ll stick with it, look for short-term or trial membership options.

Finding a new activity does not have to involve a pricey membership, however.  Community colleges, including Tarrant County College and the Dallas County Community College District, offer inexpensive, non-credit fitness classes, available to any resident of the county.  These include cycling, kickboxing, yoga, swimming and a variety of sports.  If you have someone on your list who is interested in a new challenge, one of these classes may be the perfect gift for them or for both of you to take together.

And for someone who enjoys spending time in the great outdoors, consider a Texas State Parks Pass, available for $70 from the Texas Parks and Wildlife Department.  This pass grants entry for one year to the pass holder and anyone else in their vehicle to any one of Texas’ 90 state parks, including several convenient North Texas locations.  The Parks Pass provides limitless opportunities for hiking and other outdoor activity.

Don’t Forget the Stocking Stuffers!

“If your family’s tradition includes stuffing stockings, cut back on the candy canes this year and throw in some useful items such as hand sanitizer, a personal first aid kit and sunscreen,” suggests Dr. Isha Mannering, a pediatrician.

Good luck with your shopping and gift-giving!

From all of us at Privia Medical Group North Texas, have a safe and happy holiday season!

This article contains information sourced from:

Consumer Reports

Open Enrollment Information 2018

PRIVIA MEDICAL GROUP NORTH TEXAS ANNOUNCEMENT

OPEN ENROLLMENT FOR EMPLOYEES WILL BEGIN 11/01/2018 through Close of Business day 11/30/2018
There will be four open enrollment benefits meetings for PMG NTX -THC staff and two meetings for PMG NTX Dallas clinics.
(Privia clinical offices in Dallas should check with their office managers for participation and dates.)

 

This is the only time of year that full time eligible staff can update (change, enroll or terminate) coverage for an eligible benefit for yourself and/or family members. Please review the dates and times listed below to find the meeting you would like to attend. Then you may click the link to sign up.

YOU WILL NEED A PASSWORD TO REGISTER FOR A MEETING. PLEASE REFER TO YOUR 10/12/2018 THC Employee Newsletter for password.


Location 1 – 11/06/2018 Tuesday -Hilton Inn – Garden Center, 912 Northton Street, Fort Worth, Texas 76106, 6:00 – 7:00 PM

Location 2 – 11/08/2018 Thursday – Hulen Movie Tavern, Hulen Mall, 4920 South Hulen, Fort Worth, Texas 76132, 6:00- 7:00 PM

Location 3 – 11/12/2018 Monday -Hilton Inn – Garden Center, 912 Northton Street, Fort Worth, Texas 76106, 6:00 – 7:00 PM

Location 4 – 11/13/2018 Tuesday – Hulen Movie Tavern, Hulen Mall, 4920 South Hulen, Fort Worth, Texas 76132, 6:00- 7:00 PM

Higginbotham and Associates will conduct the 2019 Benefits Overview providing our New Employee Benefits Guide and provide online Enrollment Instructions for our new web based benefits platform “Benefits in Hand”*. You will be paid for the one hour company paid event(s). — Employee Benefits Guide will also be available upon conclusion of the 11/13th meeting and made available on the company’s Google Drive (PMGNTX THC Benefits Open Enrollment)

Contact Cindy Wooley or Sara Funchess at 817/740-8400 for meeting registration assistance.

*Open Enrollment will close 11/30/2018


Open Enrollment OPENS 11/01/2018

Last day for online enrollment will be 11/30/2018

All requested changes will be effective 01/01/2019.

Thanks!-Cindy

Is it Time for a Health Insurance Check-up?

Is it Time for a Health Insurance Check-up?

With the end of the calendar year approaching, this is the time for many people to take a look at their health insurance coverage and determine if any changes or updates are in order.  Health insurance plans provide what’s known as an “open enrollment” period, during which time people can change plans.  For many people who have employer-based coverage, Medicare or Health Insurance Marketplace coverage, this period occurs toward the end of the calendar year.  However, some employer-based plans will offer an open enrollment period during another part of the year, so be sure to check with your human resources office to find out when your open enrollment period takes place.

Why Have Health Insurance?

No one ever wants or plans for a tornado to hit their home, but we have a homeowner’s insurance policy so that we can repair or rebuild, if needed.  We need health insurance for the same reason: because we never know when we will need it.  People don’t plan on a gallbladder removal, open heart surgery or cancer treatment – but at some point in our lives, we may have to confront a significant medical event.  And when that day comes, we don’t want it to bankrupt us – that’s why it’s important to have health insurance.

Just as with homeowners or auto insurance, the premise behind health insurance is one of “spreading risk.” By having many customers, insurance companies collect premiums from a broad base and then use a portion of those funds to pay policyholders’ claims.  For many people, those claims aren’t any more expensive than a routine check-up or physical once a year.  However, other medical needs are much more expensive, such as delivering a baby, treatment for cancer or various types of surgery.  Commonly-used diagnosis and screening tools, such as an MRI or a CT scan, can also be costly.

“Not all health insurance plans are created equal,” says Dr. Yevgeniy Ostrinsky, a gastroenterologist.   “Understanding the various pros and cons of different types of health plans is important to ensuring you and your family have the right coverage to get the health care you need.”

The ABCs of Health Insurance

The world of health insurance seems to have its own language.  Here’s a look at some of the common health insurance terms and acronyms every consumer should familiarize themselves with:

  • HMO: Health Maintenance Organization. HMOs are insurance plans in which enrollees can only see providers who are part of the HMO’s network.  A visit to an out-of-network provider will not be covered, except in cases of medical emergency or if the insurer has agreed in advance that it is a medical necessity.
  • PPO: Preferred Provider Organization. This type of health insurance plan allows enrollees to see out-of-network providers, though usually at a greater out-of-pocket cost.  There are also fewer restrictions on seeing specialists without a referral from a primary care provider.
  • EPO: Exclusive Provider Network.  This plan has some characteristics of both HMOs and PPOs.  As with an HMO, there is generally no coverage for out-of-network providers.  But like PPOs, EPOs do not require you to first get a referral from a primary care doctor before seeing a specialist.
  • In-network: Insurance plans have a group of health care providers they refer to as a “network.”  These are providers, such as physicians, hospitals and labs, with which the insurer has a contract that stipulates what the provider will be paid by the insurance company.  The bottom line for the patient is that it’s cheaper to see a doctor or go to a hospital that is in-network.  Sometimes, however, it is not always practical.
  • Out-of-network: This refers to providers who are not in your insurer’s plan.  You may pay more to see providers who are out-of-network.  Some patients will choose to see a provider out-of-network if they believe that’s the best health care available for their situation.  In other instances, such as a medical emergency, it may not be practical to get to an in-network provider in a timely manner.
  • Premium: This is the amount you pay each month to maintain your health insurance coverage.
  • Deductible: This is the sum you pay out-of-pocket before your insurance company begins to pay your claims. It is generally a fixed dollar amount each year.
  • Co-pay/co-insurance: This is the amount you pay at each visit to a health care provider. This is a fixed dollar amount, or in some cases, a percentage of the total bill.  There are co-pays for visiting a doctor, a specialist, getting an x-ray, having lab work done, filling a prescription, getting hearing aids, using an ambulance and going to an urgent care clinic or emergency room.
  • PCP: This is the abbreviation for primary care provider, often a doctor of family medicine, internal medicine or obstetrician/gynecologist. PCP is an important term for insurance purposes; your insurance company will want to make sure you have one and will sometimes require a referral from your PCP before you can see a specialist.
  • EOB: This is the “explanation of benefits” your insurer will send you after you’ve used your health insurance. The EOB will explain what the total charges were, how much your insurance covered and what amount, if any, you may still owe to the provider.  The EOB is not a bill.
  • Prior Authorization: In some cases, you or your physician may need to obtain prior authorization for a medical procedure, screening or prescription drug. In these cases, the procedure or prescription in question may not automatically be covered and your provider (or you) has to explain to the insurance company why it is medically necessary and why it should be covered.
  • Preventative Services: This is a category of health care services that are available to consumers and do not require a co-pay or co-insurance; they are fully covered by the insurance plan. This includes services such as flu vaccines, some screening tests and wellness visits.

Where do you get health insurance?

People obtain health insurance in a variety of ways:

  • Your employer: This is the traditional way most non-seniors in America have health insurance.  You select a plan offered by your employer and you pay a premium that is deducted from your paycheck, before taxes.  Generally, the employer pays a share of the employee’s coverage and in some cases, a share of the employee’s family members’ coverage.
  • The Health Insurance Marketplace: The Marketplace was established by the Affordable Care Act and is an option for American citizens under 65 to purchase health insurance.  People generally use this option if coverage is not available through their employer.  Some plans have low premiums and high deductibles, which could make sense for younger, healthy people who don’t have a lot of medical needs.  Other plans are more expensive but cover more, which make sense the older you get.  Some enrollees may qualify for a federal income tax credit when they enroll, depending on income. Open enrollment in the Marketplace runs from November 1 to December 15, 2018. Visit healthcare.gov for more information.
  • Association Health Plans: AHPs may be an option for small businesses to band together and offer coverage to their employees as an employer group or business association. They are generally formed when businesses in a like industry or geographical area work together to offer coverage.  The U.S. Department of Labor issued new guidelines in 2018 intended to expand the availability of AHPs.
  • Medicare: This is the federal health insurance program for American citizens age 65 and older.  People who are approaching the age of 65 should visit gov for enrollment information.  Some people are automatically enrolled at age 65, while others need to enroll themselves.  There are three main components of Medicare:
    • Medicare Part A is known as hospital insurance, covering hospital stays and some long-term care needs.
    • Medicare Part B is medical insurance, covering physician visits and medical screenings and labs.
    • Medicare Part D is a prescription drug insurance program.

Some people choose to delay enrollment in Medicare Parts B and D if they have health insurance through an employer that they prefer to keep while they are still working.  However, a late enrollment penalty may apply.

  • Medicare Advantage: These are private plans that some seniors choose to purchase to supplement the coverage provided by Medicare.  Medicare Advantage plans are offered by private companies but must be approved by Medicare.  Those with a Medicare Advantage plan still have Medicare coverage, but they receive their benefits through the plan directly, not traditional Medicare.

 

The purpose of Medicare Advantage plans is to provide additional coverage beyond that provided by traditional Medicare.  These added benefits may include dental, hearing and vision coverage.  Out-of-pocket expenses vary between Medicare Advantage plans, as do the provider networks they offer. For these reasons, it is important to compare Medicare Advantage plans just as you would employer-based plans, taking into account a variety of factors.

Important Note: For Medicare Part D and Medicare Advantage, you can make changes to your plans and switch plans during an open enrollment period that runs from October 15 – December 7, 2018.  You can also disenroll from a Medicare Advantage plan between January 1 – February 14, 2019.  

  • Veterans Administration: Veterans of the United States Armed Forces may be eligible for varying degrees of health benefits through the VA, depending on a variety of factors, including length of time served, discharge circumstances, income and service-connected disability. For more information, visit gov.
  • Tricare: Tricare is health insurance for active-duty military personnel, as well as some military retirees. For more information, visit mil.
  • Medicaid and CHIP: Medicaid and the Children’s Health Insurance Program (CHIP) primarily serve lower-income families.  In Texas, Medicaid eligibility is usually limited to children and women who are pregnant.  CHIP is available for some families who earn too much to qualify for Medicaid.  Visit healthcare.gov or the Texas Health & Human Services Commission.

Selecting a Plan

If you have employer-based health insurance or will be shopping for insurance in the Health Insurance Marketplace, you will likely have a few options to choose from.  You may have a choice between an HMO, a PPO or an EPO.  Carefully evaluate the differences between these options.  An HMO may be less expensive but may also provide fewer benefits or not allow you as many provider options.  On the other hand, if you are relatively young and healthy, a less-expensive plan may be right for you.  Similarly, on the Health Insurance Marketplace, you will find a variety of plans at varying costs.  These plans are named after metals – bronze, silver, gold and platinum.  You’ll pay the least for bronze and also get the fewest benefits; at the other end of the scale, platinum is the most expensive but provides the most comprehensive overall coverage.

When comparing costs on any plan, be sure to consider three separate cost factors:

    • Premium: the amount you pay each month to maintain coverage.
    • Co-pay/co-insurance: the amount you will pay each time you visit a provider or get a prescription filled.
    • Deductible: the amount you must pay out-of-pocket each year before your health plan begins to cover the cost of medical services.

You may find an inexpensive plan but later discover you have to meet a high deductible before you benefit from any coverage from the plan.  You may also find that your co-pay for each visit, procedure or prescription is higher than you expected.  For some people, these low premium/high-deductible plans work just fine; just make sure you have all the facts before making a decision.

An additional tool some employers offer for people who opt to enroll in a high-deductible plan is a health savings account (HSA).  This is essentially a medical savings account that people can contribute pre-tax income to and then spend later to cover deductibles and other out-of-pocket costs.

Understanding Networks

Understanding an insurer’s network is critical to making a decision about a health insurance plan.  No matter what type of plan you select, you will pay higher out-of-pocket costs to see a provider who is not in your plan’s network.  Whenever possible, you want to stay within your network to keep costs down and you certainly want to ensure that your primary care provider and any specialists you see are in your plan’s network.  Privia Medical Group North Texas providers are in-network for most major insurance plans in North Texas.

All insurance plans, including HMOs, PPOs and EPOs, are required to maintain adequate networks for their customers.  Network adequacy in Texas is regulated by the Texas Department of Insurance (TDI).

There are several requirements that insurers must meet, according to TDI:

      • “These plans must provide a network with enough qualified doctors and hospitals to make sure that covered services are reasonably available and that you have choice, access, and quality care.
      • General doctor and hospital care must be available within 30 miles (within 60 miles in rural areas for PPOs and EPOs).
      • Network specialty doctors and hospitals must be available within 75 miles.
      • Emergency hospital care (including general, specialty, and psychiatric hospitals) must be available 24 hours a day, seven days a week.
      • Nonemergency urgent care must be available within 24 hours for medical and behavioral health conditions.”

If you believe your insurance provider is not meeting these or other requirements, you can file a complaint with TDI.   (Note: TDI regulates the private health insurance market in Texas and does not have jurisdiction over Medicare, VA, Tricare or most aspects of the Health Insurance Marketplace).

At the Doctor’s Office

When you make an appointment to see a doctor, you will give the office staff your insurance card and they will verify your coverage is active.   You may also have filled out an information sheet before your visit.  The doctor’s office will collect any co-pay you owe for the visit.  After your visit, the physician’s office will bill your health insurance provider directly.  You will later receive the EOB from your insurer, explaining what they covered for the visit.  If there is an amount that you still owe the provider, you will receive a bill directly from the provider later.

“Health insurance can be extremely confusing, even for those of us who deal with it every day,” says Dr. Larry Tatum, CEO of Privia Medical Group North Texas.  “Our providers have experienced administrative staff who work hard to facilitate insurance benefits on behalf of our patients.  To better serve our patients, we have in-network agreements with most of the major health plans in North Texas.  That’s a big advantage for both our patients and our physician members.”

Breast Cancer Awareness

Breast Cancer Awareness

October is Breast Cancer Awareness Month, one of the highest-profile health observances of the year.  The pink ribbons that have become synonymous with breast cancer awareness can be found everywhere in October, one indication that our society increasingly understands and embraces the need to raise awareness about a disease that affects more than 12 percent of all women.  Apart from skin cancers, breast cancer is the most common type of cancer to affect women.  Breast cancer is possible – but extremely rare – in men.

Breast cancer is most frequently diagnosed in women ages 55-64, with a median diagnosis age of 62.  The National Cancer Institute, a division of the National Institutes of Health, estimates that more than 266,000 new cases of breast cancer will be diagnosed in 2018, representing slightly more than 15 percent of all new cancer cases and 30 percent of all cancer diagnoses in women.  It also projects that nearly 41,000 women will die from the disease this year, accounting for 6.7 percent of all cancer-related deaths.

“The fact breast cancer represents 15 percent of all cancer diagnoses but less than 7 percent of cancer-related deaths is proof that many women can beat breast cancer through early detection and treatment,” says Dr. Douglas Decker, an obstetrician and gynecologist.  “The five-year survival rate for breast cancer is nearly 90 percent, a significant increase from 1975, when it was only 75 percent.  In other words, nine out of ten women diagnosed with breast cancer today will live at least five years after their diagnosis and many will live much longer.”

“The key to beating breast cancer is early detection through awareness and screenings,” explains Dr. Lindsay Breedlove Tate, an obstetrician and gynecologist.  “Treatment for breast cancer has also improved, helping more women overcome this disease.”

Awareness, Screening and Detection

Changes or abnormalities in the breast can be detected in a variety of ways:  through a mammogram or other imaging test, a clinical breast exam and through “breast self-awareness.”

Mammograms

The mammogram, which is an x-ray image of the breast, is usually the most effective way to screen for breast cancer.  Because treatment is most effective when the cancer is at an early stage, periodic mammograms increase the odds of successful treatment.

The American College of Obstetricians and Gynecologists (ACOG) updated its guidelines for breast cancer screenings in 2017:

  • All women age 40 and over should be offered mammography screenings beginning at age 40 and women who have a normal risk of breast cancer should consider having a mammogram screening every year or every other year beginning between the ages of 40-49.
  • All women age 50 and older should have a mammogram every one or two years.

These are general recommendations, and your physician will make specific recommendations for screenings based upon your medical history and risk factors.

“Mammograms have saved countless lives,” says obstetrician and gynecologist, Dr. Joseph Kilianski. “Every woman is different and instead of relying on a one-size-fits-all approach to screening, your physician will consult with you so you can make the best decision on when to begin mammograms based upon your medical history and any known risk factors.”

A mammogram allows the physician to spot abnormalities, including cancer.  In some cases, a mammogram may be inconclusive, in which case the physician may order an additional diagnostic imaging exam, such as a 3-D mammogram, an ultrasound or an MRI to make a better assessment.

Your physician can order a mammogram for you as part of a well-woman exam, or as needed.  There are also various community clinics and other resources that offer mammograms.  The vast majority of insurance plans cover the full cost of mammograms with no co-pay or deductible for the patient.

Clinical Breast Exams

For women with normal risk who are too young for mammograms, your physician may suggest a clinical breast exam as part of a regular check-up or well-woman exam.  This is a physical examination at the doctor’s office in which the physician examines the breasts for any abnormalities.

ACOG’s guidance on clinical breast exams is:

  • They may be offered for women with normal risk at ages 25-39, every 1-3 years.
  • They may be offered annually for women age 40 and older.

Breast Self-Awareness

Finally, a key component of early detection is what is known as breast self-awareness.  The goal of breast self-awareness is for a woman to be able to recognize any changes in the appearance or feel of her breasts.  ACOG reports that a substantial percentage of breast cancers are initially detected this way – about half for women age 50 and older and more than 70 percent for women younger than 50.  Breast self-awareness is recommended for women of all ages.

It’s important to note that many women have lumps in their breasts which are unrelated to cancer.  Cysts and fibrocystic breast condition are two common causes of non-cancerous lumps.  What’s most important is that a woman can recognize a change in her breast, such as a lump that was not there before.  If you notice a change in the appearance or feel of your breasts, see your physician right away.

Risk Factors

Many of the risk factors associated with breast cancer are outside anyone’s control.  The major risk factor is getting older, as the greatest incidence of breast cancer is in women over age 50.  Some other risk factors associated with breast cancer include:

  • Family history of breast cancer: a woman who has a history of breast cancer in her family, especially a first-degree relative such as a mother, sister or daughter who has had the disease, is at elevated risk.
  • Genetic mutations: Inherited gene mutations, such as BCRA1 and BCRA2, known as the breast cancer genes, increase risk.
  • Early menstruation/late menopause: women whose periods began before age 12 or who begin menopause after age 55 are at a slightly higher risk of breast cancer.  In both cases, the woman is exposed to estrogen hormones for a longer period of time, increasing risk.
  • Late pregnancy or never having been pregnant: becoming pregnant for the first time after age 35 or never having a full-term pregnancy can increase risk.
  • Dense breasts: women with denser breasts – those with more connective tissue than fatty tissue – are at elevated risk.

“While some risk factors are outside anyone’s control, there are other known contributing factors to breast cancer that can be managed, mitigated or eliminated through lifestyle changes and working in partnership with your health care provider,” explains Dr. Emily Maas, an obstetrician and gynecologist.  These risk factors include:

  • Hormone replacement therapy: Taking hormones to replace estrogen and progesterone during menopause may increase breast cancer risk.  Your physician can help advise you on the best course of action when considering hormone replacement therapy.
  • Oral contraceptives: Some, but not all, types of birth control pills may contribute to breast cancer risk.  Again, this is something to ask your health care provider about.
  • Weight: Women who are overweight or obese after menopause are at a greater risk. Maintaining a healthy weight helps to reduce risk.
  • Alcohol consumption: The more alcohol consumed, the greater the risk for breast cancer.  Consume alcohol in moderation, if at all.
  • Smoking: Smoking cigarettes is a known cause of many types of cancer, as well as heart disease.
  • Sleep: Inadequate nighttime sleep can increase the risk of breast cancer. Get a good night’s sleep each night, and if you are having trouble sleeping, see a doctor.
  • Breastfeed your babies, as breastfeeding has been shown to reduce the risk of breast cancer.

Symptoms

Breast cancer often produces no noticeable symptoms initially, which is the key reason that following recommended screening schedules is so important.  The following may be symptoms of breast cancer:

  • A new lump in the breast or armpit area
  • Pain in any part of the breast
  • Thickening or swelling of part of the breast
  • Irritation or dimpling of breast skin
  • Redness or flaky skin in the nipple area or the breast
  • Pain in the nipple area
  • Nipple discharge other than breast milk, including blood
  • Any change in the breast’s size or shape

Having one or more of these symptoms does not necessarily mean cancer is present, but is reason to see a doctor right away.

Diagnosis & Treatment

If a mammogram indicates an abnormality that may be cancerous, the patient will be referred to a breast specialist or surgeon.  Additional imaging tests, such as an MRI or ultrasound may be conducted, and a biopsy may be performed to take a sample of tissue or fluid from the breast to examine it for cancer.

“A breast cancer diagnosis is understandably frightening for the patient and her family.  This is an issue that has touched me personally, since my mother fought advanced stage breast cancer and has now been cancer free for 16 years,” says Dr. Rachel Lusby, an obstetrician and gynecologist. “Your physician and your health care team will be with you every step of the way in your fight.  We want you to know you’re not alone in this battle.  Your health care providers are here to help you navigate this journey with the right medical treatment and the emotional support needed.”

“Treatment for breast cancer varies based on how advanced the cancer is, the patient’s medical history and other factors,” explains Dr. Joseph Heyne, a breast oncology surgeon.  “Treatment often involves a combination of surgery to remove the cancer, as well as chemotherapy or radiation therapy to shrink and kill remaining cancerous cells.”

The scope of surgery to treat breast cancer varies from patient to patient and will depend in part on how advanced the cancer is, as well as if and how much it has spread.  In breast-conserving surgery, the cancerous tumor and surrounding tissue are removed from the breast.  In other cases, the entire breast must be removed, a procedure known as a total mastectomy.   Finally, in a modified radical mastectomy, the breast is removed, as well as some of the lymph nodes under the arm and lining of the chest muscles.  Chemotherapy may be employed before surgery to first shrink the cancerous tumor.

Additional treatments include hormonal therapy, which blocks the cancer cells from getting the hormones they need to grow and spread, as well as biological therapy, which helps the body’s immune system fight cancer cells and/or cope with side effects from chemotherapy and radiation treatment.

In the event the treatment involves a mastectomy,  breast reconstruction surgery is sometimes performed as part of the same surgery.  In other cases, breast reconstruction may take place at a later time.

Make an Appointment Today

If you are over age 40 and have not visited with a doctor about the right time to begin mammograms, make an appointment with your physician today.  If you don’t have a physician, contact one of Privia Medical Group North Texas’ obstetricians & gynecologists, internal medicine, family practice or primary care physicians.

A respected North Texas resource is the Andrews Women’s Hospital at Baylor All Saints Medical Center in Fort Worth, a facility that provides comprehensive health care services for women, including breast screenings and imaging. Privia Medical Group North Texas physicians helped found Andrews Women’s Hospital and continue to practice there today.

This article contains information sourced from:

The American Congress of Obstetricians and Gynecologists

The National Cancer Institute, National Institutes of Health

The U.S. Centers for Disease Control and Prevention

THC Privia Partnership

Attention THC Patients:

The doctors of Texas Health Care (THC) have partnered with Privia Medical Group – North Texas. This partnership will allow your physicians to continue to offer superior care. We proudly remind our patients that we are fully contracted with BCBS, UHC, Aetna, Cigna, as well as other North Texas payers. In addition, we are not limited in our affiliation with any particular hospital system. We have physicians who participate with Baylor, THR facilities (HFW, HSW, Huguley, Alliance), Medical Plaza, Methodist Mansfield, JPS and others in our area. Please contact your physician if you have any questions.

2017 Top Doctors

44 Texas Health Care/Privia Medical Group North Texas Physicians Named to Magazine’s Prestigious List

The April cover story of Fort Worth Texas: The City’s Magazine features the publication’s annual “Top Doctors” list and once again, Texas Health Care/Privia Medical Group North Texas physicians are featured prominently on the prestigious list: 44 of its members across 17 specialty areas have been recognized as tops in their fields by their peers.

To select the physicians who are included in the “Top Doctors” list, the magazine sends an annual survey to more than 4,500 Tarrant County physicians, asking them to list the colleagues they believe to be the best in a variety of practice areas. The list includes doctors in Fort Worth and the greater Tarrant County area.

Eight of the 2017 Texas Health Care honorees are members of the John Peter Smith (JPS) Hospital surgical division. The public-private partnership between JPS, Tarrant County’s only Level I Trauma Center, and Texas Health Care affords patients some of the best surgical care in North Texas, delivered in a public hospital setting. At the same time, Tarrant County taxpayers benefit from the unique value that Texas Health Care/Privia surgeons deliver to the hospital.

“Texas Health Care members have always been committed to providing exceptional care for every patient, every time,” said Dr. Larry Tatum, the group’s CEO. “Now, with our new partnership with Privia Medical Group, a nationally-recognized health care leader known for innovations in population health, we’re poised to play an even bigger role in health care delivery for North Texas. Having 44 of our physician members on the 2017 ‘Top Doctors’ list is added proof of that.”

Texas Health Care has 219 providers in North Texas and surrounding areas.

The Texas Health Care/Privia Medical Group North Texas 2017 Top Doctors are:

Breast Oncology Surgery

Anita W. Chow*

Joseph Heyne*

Cardiac/Thoracic Surgery

Reza Khalafi*

Cardiology

Scott Ewing

Mohan Sathyamoorthy

Colon/Rectal Surgery

Jason Allen

Edward Castillo

Lori Gordon

Glen D. Hooker

Female Pelvic Medicine & Reconstructive Surgery

Michael England

General Surgery

John Mark Bayouth*

John L. Birbari

Scott Bloemendal

Antonio Castaneda

Mark Collins

Rajesh Gandhi*

Domingo Tan

Gynecology

Larry D. Tatum

Gynecology & Obstetrics

Cynthia A. English

Jay Herd

Beatrice G. Kutzler

Elisabeth Wagner

Robert Zwernemann

Internal Medicine

John Briscoe

Jason S. Ledbetter

Amber Lesley

Craig L. Dearden

Orthopedic Surgery

Donald Dolce

Joseph Milne

Brian Tobias

Torrance Walker

Orthopedic Back Surgery

James Brezina

Orthopedic Hand Surgery

Nathan Lesley

Ryan Reardon

Eric Wroten

Otolaryngology

Phillip Anthony

Yadro Ducic

John L. Fewins

Todd E. Samuelson

Jesse E. Smith*

Pain Management

Christopher C. Pratt

Plastic/Reconstructive Surgery

Larry E. Reaves*

Sports Medicine

Steven Meyers

Vascular Surgery

James E. Anderson*

*Denotes THC member who is part of the John Peter Smith Hospital surgical unit

Forty Texas Health Care Physicians Named 2015 “Top Doctors”

Once again, Texas Health Care physicians are featured prominently in Fort Worth Texas: The City’s Magazine’s annual list of “Top Doctors.” This year’s list, which will appear in the April issue of the magazine, features 40 Texas Health Care physicians.

To select the physicians who are included in the “Top Doctors” list, the magazine sends an annual voluntary survey to more than 4,500 Tarrant County physicians, asking them to list the colleagues they believe to be the best in a variety of practice areas. The list includes doctors in Fort Worth and the greater Tarrant County area.

Twelve of the Texas Health Care physicians who have been recognized for 2015 are members of the John Peter Smith (JPS) Hospital surgical division. The public-private partnership between JPS and Texas Health Care affords patients some of the best surgical care in North Texas, delivered in a public hospital setting. At the same time, taxpayers benefit from the unique value that Texas Health Care surgeons deliver to the hospital.

“We could not be more proud of our Texas Health Care members who have been recognized as 2015 Top Doctors. Each and every one of these physicians is committed to providing the best care to their patients, and it’s great to see their work honored by their peers,” said Dr. Michael Korenman, a Texas Health Care board member.

Texas Health Care has 150 physician members in 33 different specialties across Tarrant County and surrounding areas.

The Texas Health Care 2015 Top Doctors are:

Breast Oncology Surgery

Anita W. Chow*

Cardiac/Thoracic Surgery

James E. Anderson*

Reza Khalafi*

Cardiology

Scott Ewing

Colon/Rectal Surgery

Jason W. Allen

Lori L. Gordon

Glen D. Hooker

Paul R. Senter

Britton R. West*

Female Pelvic Medicine & Reconstructive Surgery

Michael J. England

General Surgery

John Mark Bayouth*

John L. Birbari

Scott Bloemendal

John Crawford

Rajesh Gandhi*

General/Family Practice

Lynne R. Tilkin

Gynecology/Obstetrics

Cynthia A. English

Beatrice G. Kutzler

Larry D. Tatum

Internal Medicine

Alan Davenport

Jason S. Ledbetter

Amber Lesley

Craig L. Dearden

Nephrology

Carlos S. Bahrami

Ophthalmology

Harry Rosenthal

Orthopedic Surgery

Stephen Brotherton

Nathan Lesley

Ryan Reardon

Eric Wroten

Otolaryngology

Ricardo Cristobal*

Yadro Ducic

John L. Fewins

Todd E. Samuelson

Jesse E. Smith*

Pain Management

Christopher C. Pratt

Thomas M. Ratino

Plastic/Reconstructive Surgery

Larry E. Reaves*

Vascular Surgery

James E. Anderson*

Harshal S. Broker*

David L. Stroman*

*Denotes THC member who is part of the John Peter Smith Hospital surgical unit

Texas Health Care physicians recognized as 2014 “Top Doctors”

Record Number of Texas Health Care physicians recognized as 2014 “Top Doctors” in Fort Worth, Texas: The City’s Magazine

Texas Health Care is proud to congratulate a record number of its members who have been recognized as 2014 “Top Doctors” in the April edition of Fort Worth, Texas: The City’s Magazine. This year a total of 43 Texas Health Care physicians, spanning 15 different specialties and practice areas, have received the “Top Doctors” honor.

To select the physicians who are included in the “Top Doctors” list, the magazine sends an annual voluntary survey to more than 4,500 Tarrant County physicians, asking them to list the colleagues they believe to be the best in a variety of fields. The list includes doctors in Fort Worth and the greater Tarrant County area.

Fourteen of the Texas Health Care physicians who have been recognized are members of the John Peter Smith (JPS) Hospital surgical unit. The public-private partnership between JPS and Texas Health Care affords patients some of the best surgical care in North Texas, delivered in a public hospital setting. At the same time, taxpayers benefit from the unique value that Texas Health Care surgeons deliver to the hospital.

“We congratulate all of our members who have been recognized as 2014 ‘Top Doctors,’” said Michael Korenman, M.D., one of Texas Health Care’s Board members. “Each and every one of our physicians is dedicated to providing excellent care to their patients, and it is gratifying to see their work recognized by our peers,” he added.

The Texas Health Care 2014 “Top Doctors” are:

Breast Surgery

Anita Chow*

Joseph Heyne*

Cardiac/Thoracic Surgery

James Anderson*

Reza Khalafi*

Cardiology

Scott E. Ewing

Colon/Rectal Surgery

Jason Allen

Eduardo Castillo*

Lori Gordon*

Glen Hooker

Paul R. Senter

Britton West*

Cosmetic Surgery

Yadro Ducic*

Larry Reaves*

Jesse Smith*

General Surgery

John Mark Bayouth*

John Birbari

L. Scott Bloemendal

Antonio Castaneda

Mark F. Collins

John Crawford

Travis Crudup

Gynecology/Obstetrics

Cynthia English

Bea Kutzler

Jennifer Motley

Larry Tatum

Internal Medicine

Charles Carlton

Norman A. Davenport

Craig Dearden

Jason Ledbetter

Amber Lesley

Nephrology

Carlos Bahrami

Ophthalmology

Harry Rosenthal

Orthopedic Surgery

Stephen Brotherton

Nathan Lesley

Ryan Reardon

Eric Wroten

Mark Wylie

Otolaryngology

Ricardo Cristobal*

Yadro Ducic*

John Fewins

Todd E. Samuelson

Plastic/Reconstructive Surgery

Larry Reaves*

Sports Medicine

Steven J. Meyers

Vascular Surgery

James Anderson*

Harshal Broker*

David Stroman*

*Denotes THC member who is part of the John Peter Smith Hospital surgical unit

Texas Health Care Honored with “Spirit of Community” Award for Charitable Giving

We’re proud to be recognized for our role in The Greatest Gift Catalogue Ever, which helps raise money for area non-profits. Texas Health Care was recently honored with the “Spirit of Community” award by the Shared Community Benefit Foundation for supporting the group’s communications efforts through the catalogue – a guide connecting area non-profits with prospective donors. THC is the fourth recipient of the “Spirit of Community” award – a group that includes Ted Blevins, Chris Robinson, and the Lena Pope Home.

Elliot Goldman, one of the founders of The Greatest Gift Catalogue Ever, said the “Spirit of Community” award is the people’s choice from Tarrant County’s charitable community. Goldman said of THC: “A lot of people know that Texas Health Care is group of caring and committed physicians. But not everyone is aware of their charitable giving and contribution to the local non-profit community.”

In its fifth year of supporting the charitable-giving catalogue, THC physicians and employees have had a significant impact on its success, Goldman said. Texas Health Care was the catalog’s first non-conventional distribution partner and one of the first large business groups to support the organization when it was founded. Texas Health Care President and CEO Larry Tatum, MD went to his board with the idea to place the catalog in member physician reception areas.

At the time, the catalog could not afford to advertise, so Texas Health Care’s participation was instrumental to its early growth. It has paid off in a big way: in just four holiday seasons, the catalog has resulted in a $2.5 million impact to local charities. Last year, the catalogue’s beneficiaries included: Boys and Girls Clubs, Meals on Wheels, Kids Who Care Inc., Catholic Charities, Ronald McDonald House, and the Tarrant County Women’s Center, to name a few.

“We’re delighted and honored to receive the award. But, honestly, we participate in the catalogue program because we see the impact that this charitable giving is having on our community and we’re proud to participate in any way that we can,” Dr. Tatum said.