Dr. Sharyl Truty

About Dr. Sharyl Truty

http://drtruty.com

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‘Flat-Fee Primary Care’ As A GOP-Friendly Way To Provide Routine Health Care

Back in the day, people paid for routine, primary medical care on their own and only used insurance when something serious came up. Some primary care doctors are betting that model can thrive again through a monthly subscription for routine care and a high-deductible insurance policy to take care of the big stuff.

But the changes raise questions about whether that approach really leads to more effective and efficient health care.

Article written by Michelle Andrews

It's easy to understand the appeal of Direct Primary Care, as it's called, for doctors and patients. Doctors charge a monthly fee, generally from $50 to $150, to provide routine clinical care and consultation, sometimes including basic lab work and tests. Patients who need other care, an MRI or surgery, for example, would be covered by their insurance policy, if they have one.

Freed from having to devote time and money to managing insurance claims, doctors say they can accept fewer patients and spend more time with them without focusing on the question of which services are paid for.

Patients, meanwhile, may get more personalized care. They also may save money on insurance if they can pair their primary care plan with a cheaper, high-deductible policy.

Although only a fraction of primary care doctors practice this way, the proportion has grown from 2 percent to 3 percent in the past year, according to data from the American Academy of Family Physicians, which supports this type of practice.

Advocates of direct primary care believe their prospects are bright because the new Republican administration favors market-driven approaches to health care. The plan introduced by Health and Human Services Secretary Tom Price when he was in Congress would allow people to pay monthly fees for direct primary care with funds from health savings accounts. A bipartisan bill introduced in January for consideration by the current Congress would amend Internal Revenue Service rules to permit that.

William Bayne, a commercial real estate developer in Las Vegas, joined MedLion, a direct primary care company, last October. For $300 a month, Bayne gets routine primary care for himself, his wife and their five children. "It's great for the little stuff that comes up with five kids," says Bayne, 41. They also have a comprehensive family insurance plan.

"Advocates of paying a family doctor a flat monthly fee for office visits and some lab work, say it saves patients money when coupled with a high-deductible insurance plan"

When Bayne's 8-year-old son woke up with what looked like a big pimple on the side of his eye one morning, they called MedLion and made an appointment for 12:30 that afternoon. But their family physician, Dr. Samir Qamar, called before that, having seen their names on the schedule, and asked for a photo of the boy's eye. Qamar said it looked like an oil gland in an eyelid was clogged and suggested they wait a day before coming in, because it would probably clear up on its own. It did.

Qamar used to have a high-end concierge practice in Pebble Beach, Calif., where he provided on-call primary care services. When the Great Recession hit in 2007, he says, he and his wife, who was a physician with a traditional primary care practice, decided to offer concierge-style primary care at a lower price point. They moved to Las Vegas and opened MedLion, which is now available in seven locations in the Las Vegas area and works with 429 affiliated physicians in 25 states.

Like many direct primary care practices, MedLion has shifted its focus from individuals to the employers who offer the service as a benefit. Workers typically pick one of their company's regular insurance plans and add the Direct Primary Care service if they wish to. The company pays the monthly fee for those who choose the option and may or may not pass that cost along to workers.

In perhaps the largest effort of its kind, the state of New Jersey recently kicked off a pilot program with Philadelphia-based direct primary care provider R-Health that aims to enroll at least 60,000 state employees in the first three years.

Not surprisingly, the program is particularly appealing to people with chronic conditions, says Mason Reiner, CEO of R-Health.

"Those are the folks who really need and can benefit from relationship-based primary care," he says. "It can make a big difference for them and for the state, since so much of the cost of care is driven by these folks."

Improving access to primary care is important, says Dr. A. Mark Fendrick, an internist who directs the Center for Value-Based Insurance Design at the University of Michigan. But he cautions that while direct primary care doctors who get a flat monthly fee aren't motivated to provide unnecessary, low-value care, patients don't have the same incentive. For patients, an "all you can eat model" may encourage them to get care they don't need.

"By removing fee-for-service [payments], this model is positive on the provider side," Fendrick says. "But it isn't nuanced enough on the patient side to get the system where we need it to be."

Dr. Sharyl Truty is a Direct Primary Care & Integrative Medicine doctor in Ponte Vedra Beach, FL.  Her innovative approach puts you in charge of your health, free from onerous insurance and health systems’ mandates and protocols. Her practice provides more time per appointment, a doctor who listens and respects your time, knowledge and instincts; and a doctor that puts prevention and lifestyle changes before pills. For more information about Dr. Truty and her unique approach to healthcare call 904-930-4774 or visit www.BalancedPhysicianCare.com

 

sources

Michelle Andrews, Kaiser Health News

heart health

Heart Health Risk

February is Heart Health Month. At hospitals across America you will see a host of "Red Dress" events raising awareness for the importance of heart health in women. Most of us may not realize that Cardiovascular Disease still remains the main cause of mortality among men and women.

However, what most women don't realize is that signs of a heart attack may be different in women than in men. Men will typically get a crushing, heavy chest pain in the front and middle area of the chest, but women can get a different type of pain. Pain in the upper stomach area that "may seem like heartburn" in fact be angina or heart pain. Pain that is also located middle of the back right behind the heart can also be a sign of chest pain.

So, how do you know?

If you have any concerns, go see your doctor right away, so they can help you to decide if you need to get your heart checked further with tests such as and ECG or Stress test.  Having said this, there are several wellness markers you can evaluate today to get a good understanding of your personal risk.

1) Get Your Cholesterol Checked

2) Know Your Blood Pressure and eliminate cigarette smoke from your environment

3) Know not only your BMI, but your Waist to Hip Ratio

4) Evaluate how much salt you eat on a daily basis.

5) Ask your parents about your Family History.  Who had a heart attack and how old were they?

6) Ask Your Doctor to Evaluate your Framingham Risk Score and know the number.

7) Consider getting your homocysteine and cardiac CRP levels checked.

8) Decide if advanced lipid testing is right for you.

Your cholesterol levels, blood pressure, age and smoking status are all used to calculate your Framingham Risk Score.  This is one of the most popular scores that helps doctors to determine your 10-year risk of heart disease.  We also know that an increased BMI (especially over 30) and an increased waist to hip ratio above 0.85 for women and above 0.90 for men {calculated as waist measurement divided by hip measurement (W ÷ H)} puts you at greater cardiovascular risk as well.  Any family members who were diagnosed or had heart attacks before the age of 50, increases your risk.  Reducing your intake of sodium below 2500 mg can help lower your blood pressure which is an independent risk factor for heart disease, so keeping tract of how much to take in on a regular basis will help you know your risk.  Finally, there are some "advanced" blood tests that further help you to understand your risk. 

Some of these are controversial, but worth considering. 

Your homocysteine level and cardiac c-crp levels are markers for inflammation in your blood vessels and since one of the fundamentals of developing plaque in your arteries is inflammation, knowing your overall body inflammation may help you to assess your risk.  Finally, medicine is finding that the "size" of your cholesterol particles is also important in determining your risk, so there are cholesterol panels available to check this; however, they can be expensive and may not change our recommendations for your treatment by much.  Also, cholesterol particle size is largely due to your genetics, so before considering the test, ask yourself if knowing this information will motivate your to change your behavior or just make you more anxious. 

Celebrate your heart this month.  Take time to understand your heart and what it needs to keep you healthy.

If you feel like you need more information on how screenings exams and checkups can benefit your heart health then you owe it to yourself to contact us at Balanced Physician Care today (904-930-4774). Dr Sharyl Truty has the time to truly analysis your symptoms, find the root cause of your issues, and get you back on the path wellness.

acupuncture-for-sports

“Sticking It” to Injuries

I have treated multiple athletes and weekend warriors with injuries. In the past, I would often describe traditional therapies for acute injuries, such as intermittent icing, wound compression and the use of anti-inflammatory agents.

However, recent research by the Academy of Sports Medicine suggests we may have over-treated injuries with excessive use of anti-inflammatory agents such as ibuprofen.

The concern is that in trying to control swelling, we may actually impede the bodies' natural response to heal. However, it's important to note that excessive swelling could be harmful if it causes pain or decreases blood flow. There are also the potential side effects that can occur from anti-inflammatory agents such as ulcers, internal bleeding and kidney dysfunction.

With this in mind, I decided to change my tactic for treating many athletic injuries. For the last 10 years, I have turned to acupuncture. Most people believe that acupuncture only offers pain relief. This is true, but, more importantly, acupuncture helps facilitate injury repair and wound healing by accessing energy pathways called meridians. The placement of the acupuncture needles on these pathways improves energy flow, which speeds healing.

I am continually amazed at the responses in my patients who use acupuncture. I have treated multiple athletes who have sustained acute strains and sprains with acupuncture. They returned to exercise in almost half the time it normally takes. The beauty of acupuncture is that there are little, if any, potential side effects.

Acupuncture is also a great treatment for chronic musculoskeletal issues like tendonitis, bursitis and arthritis by improving energy flow over these inflamed regions. Again, the common treatment has been prescribing anti-inflammatory medication and, if that is not successful, steroid injections. These have serious potential side effects, including possible tendon rupture. With acupuncture, healing is facilitated without a medication which makes it a "natural" remedy.

Additionally, it should be noted that acupuncture can also be useful for energy replacement. This is a concept that is difficult to comprehend from a typical Western eye, but many Eastern medical therapies (such as acupuncture) are designed to reinvigorate an individual and help with excessive fatigue. As every athlete knows, it is imperative to have as much energy as possible to reach your peak performance.

It is important to note that an individual needs to be ruled out for obvious causes of fatigue such as anemia, uncontrolled blood sugar, and low thyroid or overtraining syndrome before using acupuncture for energy replacement.

Acupuncture may not be for everyone, especially those with a needle phobia. Consult your physician and consider acupuncture therapy for the treatment of the following injuries:

Acute strains and sprains
Acute and chronic arthritis
Tendonitis and bursitis
Low back pain
Low energy

 

Dr Sharyl Truty MD is board certified in Family Practice and Sports Medicine and has completed a physicians course at UCLA Helms Acupuncture Training and Certification as well as acupuncture training in China.  If you would like to schedule an appointment with Dr Sharyl Truty, please call 904.930.4774 and ask about the New Patient Special, 3 visits for $199, available at Balanced Physician Care.

Sources:

Acupuncture: "Sticking it" to Injuries
By Stephen Brewer, MD, AAFP

yoga+sunrise

Rejuvenate

Rejuvenation…2 Simple Places to Change on the Path to Optimal Health

Keeping a broader definition of health and rejuvenation in mind, there are two areas of wellness that are simple and very cost effective, but yet the provide each of us a very powerful tool to optimize our wellness in the new year. 

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Renewal

Renewal

Renewal.

The beginning of the year marks a shift and a time for change. A time to focus on establishing new behaviors that will help meet goals in the year ahead. When it comes to our health, the new year is a great time for renewal and reflection.

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Sharyl Truty

Why I became a Physician

christmas-stress-mom

Holiday Havoc on Your Body

 

The Holiday season is undoubtedly a very special time of year.  From the tree, to the gifts, to the time spent with family, it’s a widely anticipated season that always seems to sneak up fast.  

Though we don’t want to admit it, we all go through different waves of emotions at this time and these emotions can effect your body.

Your body responds to the way you think. When you feel stressed, anxious, or upset, your body reacts in a way that might tell you that something isn’t right. High blood pressure, stomach ulcers, or even headaches might be physical signs that your emotional health is out of balance.

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sickbug

Cold & Flu Bug, Be Gone

 

Most of us enjoy the seasonal change at this time of year.

What most of us don’t appreciate is that our bodies also go through change, adjusting to the outside around us. Often times this can make us vulnerable to catching a cold virus or a flu virus.

There are some common, natural herbals that have solid medical studies behind them and are easily available at any your local stores.

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doctor-patient-time

“900 seconds, That’s It Doc”?

You took the afternoon off. You arrived 15 minutes early. You ended up waiting 25-30 minutes in a small, crowded waiting room before having the opportunity to wait another 10 minutes in another smaller room.

When the doctor finally walks in, he “hid” behind his computer screen for another 2 minutes before getting down to business. Ten minutes later you walked out with a prescription and a receipt for a $40 copay.

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