"Doc, I've got sinus" is a phrase I often hear as we begin to interview a patient in my Otolaryngology (ENT) practice at ENT Associates of Alabama office at Grandview. And while I understand the patient's colloquial use of "sinus,” to an ENT doctor, sinusitis is a specific problem affecting the paranasal sinus' (air-filled bone spaces that surround the nasal cavity) as opposed to rhinitis, which involves inflammation and /or infection in the nasal cavity. So I want to take the opportunity to explain the differences between the two terms and how we treat each entity.
The 21st Century Cures Act is a landmark bipartisan healthcare innovation law that went into effect on April 5, 2021. Cures includes provisions to promote health information interoperability and prohibit information blocking by “Actors,” which include health information networks, HIEs, health information technology developers of certified health IT, and health care providers.
As a cardiologist, I have become accustomed to diagnosing and treating patients with congestive heart failure (CHF), seeing their leg edema, prescribing lasix, doing an evaluation en route to hopefully watching their recovery.
Diabetes is the epitome of “an ounce of prevention is worth a pound of cure.” That was the driving force behind our division’s advocacy efforts that led to a change in Medicaid coverage requirements for continuous glucose monitors (CGM) for children with type 1 diabetes.
Drug testing is increasingly becoming an important part of responsible prescribing practices. Drug testing can alert medical providers to indications of drug abuse or misuse, as well as allow them to monitor for patient compliance with prescription regimens. However, while the medical utility of routine drug testing is becoming apparent, it is important to understand that many of its methodologies were initially developed for forensic and employment-testing applications. Accordingly, traditional approaches to drug testing do not always meet the demands of the clinical context.
Drug testing is increasingly becoming an important part of responsible prescribing practices. Drug testing can alert medical providers to indications of drug abuse or misuse, as well as allow them to monitor for patient compliance with prescription regimens. However, while the medical utility of routine drug testing is becoming apparent, it is important to understand that many of its methodologies were initially developed for forensic and employment-testing applications. Accordingly, traditional approaches to drug testing do not always meet the demands of the clinical context.
After a painful odyssey of more than 20 months, the one thing all Americans can agree on is that the CORONAVIRUS-19 pandemic has disrupted every facet of life. Everything from the global supply chain to the educational system have been forced to adapt.
Fall has arrived, and with the cooler temperatures, many of us want to get outdoors and enjoy the weather, including taking to our local hiking trails. But, as peaceful as a Saturday afternoon hike can be, this activity does come with risks – read on to learn about the six most common hiking injuries and how Southlake Orthopaedics can help if you are experiencing an injury from your favorite fall pastime
Through ongoing advancements in healthcare technology, healthcare providers and patients can now access broader communication applications thanks to advances in data storage. These advancements have improved collaboration, increased communication outlets and have transformed the way data is stored and shared.
Not that long ago, before phones with GPS, it was fairly common to become lost in a different city (or even a different part of your own city) and help was needed to become “un-lost.” We could keep driving or stop and ask for directions.
For years, medical professionals have discussed the need to transform the healthcare system, while also keeping it available to all people. There are many different ways of doing this including government programs, fee-for-service, Medicare programs, waivers, etc.
For many physicians, the practice retirement plan can result in providing one of their most significant assets to be used after retirement. These plans are called qualified retirement plans because they fall under requirements of IRS Internal Revenue Code and are eligible to receive certain tax benefits, unlike non-qualified plans. These plans are governed by the Employee Retirement Income Security Act (ERISA).
Obesity is no longer considered a cosmetic issue caused by overeating and a lack of self-control. The World Health Organization (WHO), along with national and international medical and scientific societies, now recognizes obesity as a chronic progressive disease resulting from multiple environmental and genetic factors.
In its latest report, the Centers for Disease Control and Prevention (CDC) estimates that 42.4 percent of U.S. adults were obese with 9.2 percent of these severely obese, which is the highest incidence ever recorded in America.
A pediatric oncologist colleague of ours from Cornell Medical Center in New York posted a question to Facebook on March 23, 2020: How would the new COVID-19 pandemic impact the pediatric cancer population? We were asking ourselves the same question here at Children’s of Alabama. As social distancing and virtual meetings became the norm, we put our heads together – nearly 1,000 miles apart – to figure out how best to provide ongoing care for our oncology patients.
The result is the Pediatric COVID-19 Cancer Case (POCC) Report, a national registry of pediatric cancer patients diagnosed with COVID-19. It’s designed to better help our fellow clinicians provide vital care during an evolving pandemic.
It is back to school time. Although it is still hot outside, many schools have opened, we have taken first day of school pictures, and football practice is underway. As we enter this new season, it’s a good time for physicians to review some practice fundamentals. To that end, I offer ten reminders about regulatory compliance fundamentals that can help to avoid legal liability and an unwanted invitation to Montgomery.
Hernia is a problem which has plagued humankind since the beginning of written history. From the Greek word “hernios” meaning “bud” or “offshoot”, it was originally thought to be a problem that was created and exacerbated by coughing. Treatments originally consisted of stooping and bending, which were erroneously thought to reduce the bulging and improve the symptoms. Surgical fixation was poorly understood and attempts to perform surgery were messy affairs that were frequently fatal.
Because of the stress we have all been under in the past year, this is a good time to take stock of your mental health. I want to provide information that may help you or someone you love.
Why do physicians leave their employment with a practice group?
There’s no single reason for such a separation. A physician's leaving might be planned well in advance, or might be an unplanned, precipitous event.
[This is the first of a three-part series. By the end of the series, I hope to have covered national, regional, local, and personal realities of the medical malpractice market so that the reader (especially physicians, practice administrators, office managers, and hospital executives) has a sense of the current disturbing developments they may be experiencing.]
Mogul, mogul, mogul, drop off. It didn’t take long for the widowmaker, a black diamond trail on Snowshoe Mountain, to send me to the emergency room of Pocahontas Memorial Hospital. Snowshoe Mountain in West Virginia has some of the best snow east of the Mississippi and as a first-time
Children’s of Alabama marks an important milestone with the celebration of its Asthma Clinical Pathway’s 10th Anniversary. The quality improvement initiative began in March 2011 with an aim to reduce inpatient asthma length of stay through the delivery of evidence-based excellent acute asthma care.
Multiple Myeloma is a hematologic cancer of the plasma cells, which are found in the bone marrow. Early symptoms of Multiple Myeloma include fatigue, back pain and bone pain. Because these symptoms are non-specific, patients often go first to their primary care physician which can delay diagnosis, resulting in a more progressive disease. This year alone, the American Cancer Society predicts 34,920 new cases and 12,410 expected deaths from Multiple Myeloma.
The physician owners of Alabama Allergy & Asthma Center and Clinical Research Center of Alabama have partnered with an investment group and have received an infusion of growth capital leading to the creation of AllerVie Health, a national network of board-certified allergists and immunologists. Alabama Allergy & Asthma Center locations will be rebranding to AllerVie Health this fall. At present, Clinical Research Center of Alabama will not be rebranding and will retain its name as an affiliate of AllerVie Health.
With the imminent emergency of the Covid virus subsiding, discussions have shifted from the physical dangers to concern about its lasting psychological effects. Healthcare organizations report alarming levels of stress, burnout, anxiety, and depression in employees, especially clinicians. This sharp rise should bring another equally troubling issue to the conversation: substance use disorders and addiction among healthcare providers and professionals.
When the Birmingham Medical News asked me to write a blog, they told me I could write about anything. Anything? Anything.
What a year we’ve had. This time last year, we were starting to transition out of stay-at-home orders, attempting to find balance between a return to work and life, and trying to keep ourselves and loved ones safe. In a year’s time, Alabamans lost 11,043 friends and loved ones. Many also lost jobs, personal connections, and much more. Now, vaccines are widely available, giving us all an opportunity to regain some normalcy. All over the country, individuals aged 12+ can be vaccinated, which allows us to protect ourselves, but also others.
As many as one out of three women experience urinary leaking with cough, sneeze, exercise or certain activities that increase abdominal pressure. Until the mid-1990’s, most treatments had either poor success rates or increased morbidity with complications like urinary retention, severe postoperative pain or protracted recovery. In 1996, the Tension-free Vaginal Tape (TVT), also known as the midurethral sling, was introduced to treat stress urinary incontinence (SUI). These devices offered physicians a resource to treat SUI in the context of a procedure that could provide high success rates (95 percent) and low risk rates (one percent).
Imagine a gently winding forest path stretching out before you, in sight of a place that feels friendly and familiar. Subtle sounds provide the soundtrack as you take slow, steady steps through the path’s vibrant color, light and shadow, followed by a deep inhale.
As we all know, 2020 was a difficult year in the healthcare due to the COVID pandemic. Now, with a large number of people vaccinated, there is hope that things will stabilize.
In the past year, most physicians have been so busy with all the complications and changes in approach to care that resulted from the pandemic that they haven’t had time to examine aspects of their practice that aren’t part of the daily work. If you haven’t performed a recent review of the potential threats to your practices’ financial health, I recommend doing that, starting with your commercial insurance plan.
Partnering with an experienced agent who specializes in the healthcare arena can provide you with multiple carrier options to compare while helping you negotiate more favorable terms than some companies will offer to clients who work directly with the carrier only. Let’s take a look at a few of the items my team is focused on for our healthcare clients and the emerging threats that are continuing to impact more medical businesses.
In recent years, we have seen robust growth in the use of orthobiologics for a number of orthopedic injuries. Orthobiologics are organic materials, including cells, tissue, blood components and growth factors, that are used to replace lost tissue, stimulate regeneration and healing, reduce pain and inflammation and/or improve joint function.
Most medical practices have permitted key business partners to access critical IT systems remotely. This is usually done to provide fast and efficient support of these systems. It could be an EMR vendor that needs to access a database, or perhaps a third-party IT service provider that will access systems for updates. Regardless of the requirement, every form of remote access that is provided to an outside party is a potential risk.
It took a trip to a textile store… yes, a textile store. It was late 1940s, and Michael DeBakey (who would later become the most innovative and most distinguished cardiovascular surgeon in the world) was thinking how to address a major clinical need for a deadly disease – ruptured aortic aneurysm.
Albert Einstein just died of one, with echoes of his sudden death reverberating in the world and in the medical community. Einstein consulted doctors, including DeBakey, but no treatment options existed at that time.
Currently, Alabama ranks toward the bottom in the country in regard to the number of citizens receiving the vaccine on a per capita basis. Why does Alabama seem to be trailing behind the rest of the country in vaccination rates?
Patients and friends often ask me if the pain in their hand could be from carpal tunnel syndrome. I find that, while many people have heard of carpal tunnel or have known someone who has dealt with it, there is a lot of misinformation about the condition and how it is best treated.
It is the most complex cardiothoracic surgery performed in newborns, one in which surgeons literally construct a new, larger aorta for babies born with hypoplastic left heart syndrome (HLHS). Called the Norwood procedure, it must be done within the infant’s first week of life, followed by a second surgery when the baby is three to six months, and a third at age four or five.
The journey toward mental health parity began in 1961, when President Kennedy directed the Civil Service Commission (now known as the Office of Personnel Management) to implement mental health parity. The Strengthening Behavioral Health Parity Act (“SBHPA”), which was signed into law on December 27, 2020 as part of the Consolidated Appropriations Act of 2021, represents a major milestone in that journey by adding ERISA plans to the plans that are covered by the Mental Health Parity Act of 1996 and by working to achieve parity in physical and mental health care management processes.
The Food Allergy Treatment Center is offering continuing education through the Medical Association of the State of Alabama. This continuing education virtual webinar is designed to provide physicians and other health care staff with a practical and timely overview of the important developments in food allergy and treatment options. The course will cover a review of food allergy diagnosis, management, including anaphylaxis management, and available treatment options. Adequate time after each session will permit time for questions and discussion. This educational activity is designed for those who evaluate, diagnose, and manage patients with food allergies.
It has been a difficult 2020 with the ongoing presence of COVID 19 exhausting frontline healthcare entities and stalling the outpatient services. The pandemic has been a devastating historical event, but it has brought sweeping changes for 2021.
Because of COVID-19, many of us will be more alarmed than usual when we hear a sneeze or a cough this allergy season. The truth, however, is that seasonal allergies are very common so it is important to be able to tell the difference between COVID-19 and seasonal allergies.
Gastroesophageal Reflux Disease (GERD) Awareness Week occurs annually around the week of Thanksgiving and is intended to increase awareness about GERD and its potential health risks when left undiagnosed or untreated, potential adverse effects of long-term proton pump inhibitor (PPI) medication use, and the links between chronic heartburn and adenocarcinoma, the most common type of esophageal cancer in the U.S.
Many practices are currently leveraging Microsoft Office 365 for e-mail, file storage, and internal collaboration. Unsurprisingly, the number of threats targeting this information (phishing attacks, compromised credentials, etc.) continues to grow at a rapid rate.
Everyone should have a developed, thoughtful, and unique financial plan. However, newly practicing physicians face more unique financial challenges than most recent graduates due to many having considerable accumulation of student loan debt. Once physicians begin earning income, there are pressures to play catch-up with peers who have had longer to establish their careers and savings accounts.
October brings many welcome changes, including cooler temperatures, colorful leaves and the return of fall sports. As a breast-specialized radiologist, I look forward to October events designed to promote breast cancer screening awareness. Public campaigns, corporate promotions and community awareness events all contribute to this effort. I’m always happy to see those annual mammography patients who have established themselves as “October regulars” as a result of these efforts.
Annual mammography has been shown to decrease breast cancer death by at least 40 percent.
Breast pain is one of the most common symptoms in patients undergoing breast imaging tests. Known clinically as breast mastalgia, breast pain is a frequent ailment in women regularly affecting their quality of life. In the mainstream, especially in the media and on the internet, breast pain is often associated as a symptom of cancer. However, breast pain can develop from a variety of different conditions.
As we enter into the last few months of this challenging year, many practices will be looking to perform a HIPAA IT Security Risk Analysis. When considering the approach to this year's analysis, it's important to consider any changes that may have been made to critical IT systems as part of the practice's response to COVID-19.
Throughout training, physicians are taught how to prescribe medications. How does the medication work within the body? Which patients will benefit? What is the appropriate dose? What are the side effects? The cost? We spend years honing our expertise on how to prescribe medications safely and correctly. Great care is taken to prescribe the best medication for each situation in each patient. We become comfortable prescribing medications early in training. Over the course of a patient’s lifetime, the number of these medications can build, leading to polypharmacy.
September is Atrial Fibrillation (AF) Awareness Month, which reminds us that even in the midst of the pandemic, cardiovascular and other diseases progress unabated. As a result, we welcome this opportunity to review some of the important approved developments in AF therapeutics and assess their validity when subjected to scientific scrutiny.
September is National Childhood Cancer and Sickle Cell Awareness Month. This year’s observance comes as we continue to learn more about COVID-19 and its effects, and we are fortunate that our pediatric hematology-oncology patients have not been severely impacted. Two of our faculty members, Julie Wolfson, MD, MSHS and Emily Johnston, MD, MS are involved in a national research effort to collect information on pediatric cancer patients infected with the virus.
The COVID 19 pandemic has thrown a wrench into all of our day to day routines, including going to work, taking our children to school, running household errands, exercising, and even going to see our doctors or dentists.
Oral Immunotherapy (OIT) for food allergies is a life changing medical treatment that re-trains the immune system to become desensitized to food allergens through regular ingestion of food proteins at increasing doses. Alabama Allergy's Food Allergy Treatment Center provides OIT to patients who are at risk for anaphylactic reactions to peanut, tree nuts, milk, egg, soy, sesame seed, and wheat. This treatment is guided by Sunena Argo, MD Board Certified Allergist and Erin Cuzzort, CRNP.
When Children’s of Alabama performed its Community Needs Assessments in 2013, 2016 and 2019, mental and behavioral health were found to be among the top priorities for pediatric health.
Over the past few years, you may have heard about companies, app makers, and service providers launching two-factor verification or two-factor authentication.
The importance of a having well-designed website and creating an online presence is crucial to your medical practice now more than ever, regardless of how the pandemic affects your marketing outcomes. You don’t want to risk deterring new and current patients from using your practice.
In 1968, the Green Bay Packers won the Super Bowl, the first Hot Wheels toy car made its debut, and Richard Nixon was elected President of the U.S. It was also the year that the first knee replacement surgery was performed. Today, more than 600,000 total knee replacements are performed in the U.S. each year to help relieve pain and decrease disability in people with knee problems.
Pediatric office visits have declined by half during the COVID-19 pandemic, according to the American Academy of Pediatrics (AAP). Not only are children missing well-child checks, but also the vaccines that are given during these visits. Manufacturers are reporting a decline in vaccine orders and vaccine doses distributed through the Vaccines for Children program.
In this day and age of advanced technology, physicians have access to abundant clinical information at their fingertips. Electronic medical record (EMR) systems can provide physicians with the data they need to care for their patients at virtually any time or place (whether or not these systems are user-friendly is another story).
Eric Wallace, M.D., the medical director of UAB eMedicine, and Curt Carver Jr., Ph.D., vice president for Information Technology, both at the University of Alabama at Birmingham, were appointed by Governor Kay Ivey to serve on the Broadband Working Group to provide input and guidance on how to allocate funding from the federal Coronavirus Aid, Relief and Economic Security Act.
Potential complications of both surgery (carotid endarterectomy or CEA) and conventional stenting (accessed from the groin) for stroke prevention in patients with carotid artery disease occur during or after the procedures. Studies have shown a higher risk of stroke during conventional stenting as compared to surgery and a higher risk of heart attack and wound complication with surgery as compared to conventional stenting.
Obesity is a growing disease both in the US and around the world. It is a major cause of many diseases including diabetes, hypertension, heart disease, cancer, cerebrovascular disease and stroke, gastroesophageal reflux disease, bone and joint damage and respiratory disorders. It also places individuals at increased risk of developing serious complications from COVID-19.
Never before in history have we been so limited in our ability to be freely active, to compete, or simply to spectate the sports we love. The devastating effects of Covid-19 are at the front of our collective consciousness, and we have nothing to distract us. Though fall football may be a fan favorite, spring, it can be argued, is one of the best stretches in sports with March Madness, The Masters, Major League Baseball’s opening day, and the ramp up to NBA and NHL playoffs. While we struggle with the frustration as fans without a team to watch or games to attend, my greater sympathies reside with all of the senior athletes, both college and high school, whose final steps on the field, court, green, or rink were never realized.
Approximately every 40 seconds someone in the United States has a stroke and roughly every four minutes someone dies of a stroke. It causes about one in 20 deaths annually – making it the fifth-leading cause of death – and the primary reason for long-term disability. Moreover, Alabama has the second-highest stroke mortality rate in the United States, behind Mississippi, according to the Centers for Disease Control and Prevention (CDC). This high incidence of stroke has earned Alabama a spot in the stroke belt, dubbed so by the medical community.
This is not business as usual, and it is a great time of uncertainty. We are faced with one of the greatest challenges of our lifetime and your services are more critical than ever.
There is still a great deal of uncertainty regarding the coronavirus. Although researchers are studying several pharmaceuticals that may have positive effects on the virus, we still don’t have a definitive antidote. This is why it is important to do what we can to flatten the curve, and social distancing is one of the most effective remedies. This limits the spread of germs between people so that fewer people become sick and it buys our nation time to strengthen our healthcare forces.
The Brookwood Baptist system recently incorporated state-of-the art Cardiac Magnetic Resonance (CMR) imaging for diagnosis patients with complex cardiovascular conditions. The technique allows for the acquisition of three-dimensional multi-planar moving images of the heart, blood vessels and associated organs without the need for ionizing radiation in about one 15-minute session.
The National Institute of Standards and Technology has published a bulletin that provides several key reminders for people who have had to shift to working remotely as a response to COVID-19. The guidance, which can be found in full at the link below, summarizes previous NIST guidelines for working safely when out of the office.
Observed annually on the fourth Tuesday in March, Diabetes Alert Day is a wake-up call to inform the American public about the seriousness of diabetes – an illness that affects millions of Americans of all ages, particularly when diabetes is left undiagnosed or untreated. This year, Diabetes Alert Day falls on March 24, and it’s especially imperative that the people of Alabama take note considering our state has among the highest prevalence of diabetes in the United States.
Valentine’s Day was last month, and as usual, stores were filled with candy hearts while customers snapped up flowers and greeting cards. With Valentine’s Day now in the rear view mirror, while thinking about the holiday, I realized that we tend to overlook the opportunities we have every day to genuinely impact someone else. I found myself wondering how I could turn the seasonal attempts to show someone appreciation into a day-to-day routine. If I carried this mentality with me throughout the year, what downstream effects would follow? How would this impact not only my personal life, but my career and the culture of my organization?
In winter, the combination of colder temperatures, dry air, and turned-up thermostats can wreak havoc on your respiratory and immune system. One of the best ways to reduce your risk for infection is to start using a humidifier. Although humidifiers can help to relieve sinusitis, moisturize dry skin, protect vocal cords, and halt the spread of flu germs, they can also promote bacteria and mold growth if not cleaned properly. Clean your humidifier by doing the following:
Each year, the landscape for physician practices has experienced seismic shifts in the areas of reimbursement, regulatory requirements, technology, and competition. Meeting the challenges of such a shifting landscape is a formidable task for even the most sophisticated of physician practices. Doing so requires a keen eye on what’s ahead and careful planning. So, let’s look at a couple of trends that should be considered in the planning process for 2020.
Over the last four decades, there has been a tremendous reduction in mortality of patients with cardiovascular diseases. This applies to the entire spectrum of disease, including patients with acute myocardial infarction, heart failure, atrial fibrillation and arrhythmia.
We live in a three-dimensional world, where many physicians and surgeons diagnose, treat and operate on patients using flat images, but that is not the case at Children’s of Alabama. Seven years ago, I helped open Children’s first 3-D laboratory, which provides cutting-edge technology through advanced visualization. We help our medical staff provide a clearer, less invasive and more realistic view of joints and organs. With this type of information, doctors can also give patient families a clearer vision and understanding of their child’s condition.
I have a meniscus tear, now what?
Many patients who come to my clinic with an MRI that shows a meniscus tear are looking for advice on what to do next. Another physician may have told them that they need surgery because the MRI is abnormal. Some people just want another opinion. Not all meniscus tears need surgery.
I first want to understand the patient’s symptoms, and I look to see if the knee is locking, catching, or if it feels unstable. Meniscus tears that are unstable create these problems, which may indicate that more damage is being done to the articular cartilage in the rest of the knee. An additional concern here is that the knee could give way at a bad time, causing a fall or buckle leading to another injury. Be careful.
I am an Associate Professor of Pathology at UAB, and was surprised when, shortly after moving to the Birmingham are in 2013, I was diagnosed with leukemia. As a researcher of diabetes and cardiovascular diseases, I had no idea how many advances had been made in the world of oncology. However, owing to the discovery of tyrosine kinase inhibitors, like Gleevec and Sprycel, and the outstanding medical care I received at the O’Neal Comprehensive Cancer Center and Kirklin Clinics, I was quickly cured. However, not all have been so lucky, and that is why I have now put my love of running to help put an end to blood cancer for others.
As 2020 approaches and people begin to contemplate their New Year’s resolutions, weight loss is often at the top of the list. There are two excellent options available for dramatic weight loss: the gastric bypass procedure and gastric sleeve procedure.
Breaking a bone is often the first sign of osteoporosis. Approximately one in two women, and up to one in four men age 50 and older will break a bone due to osteoporosis. Osteoporosis causes bone to become brittle and weak, which allows them to fracture with relatively low impact. We typically refer to an osteoporotic fracture as a fragility fracture.
With more healthcare organizations moving to VoIP (Voice-over-Internet Protocol) for their phone and communication needs, it’s important to understand the technology and how to make it work for your business needs. So let’s start with the basics.
Saliva is produced by three paired “major” salivary glands in the head and neck – Parotid, Submandibular, and Sublingual as well as ~400 “minor” salivary glands throughout your oral cavity and oropharynx. Saliva is usually plentiful (your mouth makes between one pint and one liter per day) and is important in the enzymatic digestion of food, providing an immunologic barrier for dental protection, and to foster ideal oral mucosal health. Salivary glands may be affected by several different disorders that disrupt their important normal function:
The effects of a stroke are unique to each patient and everyone’s path to recovery will look different. However, there are inherent truths to stroke treatment that should guide clinical decisions on the best care for patients.
Are you struggling to keep your employees engaged? Are you aware of the factors that impact engagement in the workplace? Often, we assume that if employees like their jobs, they will be fully engaged at work, but in reality, healthy workplace engagement extends beyond job satisfaction. Engaged employees not only enjoy their jobs, but are also motivated to work toward a common goal aligned with their company’s vision. It’s a big-picture formula that involves both the organization and management.
During your first visit as a new patient to our fertility clinic, the American Institute for Reproductive Medicine, you will undergo a series of lab tests. These tests are critical in determining the right treatment plan. We focus on eight common lab tests.
As the new division director of the Pediatric Hematology-Oncology and Blood Marrow Transplantation program in the University of Alabama at Birmingham (UAB) Department of Pediatrics and Children’s of Alabama, my top priority is to build a well-rounded program; a program that is not only strong in its clinical mission – to provide the best treatment possible for children with cancer and blood diseases – but one that also has a strong research base, which includes clinical, basic and translational research.
Seasonal affective disorder (SAD), which as its name implies, is a disorder related to the change in seasons. The earlier sunsets cause less daylight exposure which can impact mood and, subsequently, cause depression for many people. Further, SAD occurs like clockwork as the seasons change with certain people exhibiting the first warning signs in the fall which, consequently, worsen in the winter. During this time people with the disorder feel depressed, lethargic and irritable to the point that it interferes with their daily functioning.
Most people associate allergy season with the Spring, but just because the pollen isn’t present doesn’t mean the sniffles aren’t.
Hay fever, despite its name, actually has nothing to do with hay. Ragweed is a common cause of hay fever/allergic rhinitis. Ragweed begins to pollinate in mid-August and will continue provoking allergy symptoms through the fall until a hard freeze. Allergy shots, sublingual allergy drops or dissolvable ragweed tablet are beneficial for patients who struggle with ragweed, helping to build immunologic tolerance to pollen.
According to the Medical Group Management Association (MGMA), the fourth most challenging issue in practice management is collecting from self-pay and high deductible patients. With patient payments representing a growing portion of practice revenue, re-engineering how patient collections are approached is crucial to practice success.
Just as it’s common for our families to have “Dr. Mom,” it’s also common for one spouse to serve as the family’s Chief Financial Officer (CFO). The family CFO takes the lead in paying bills, making investment decisions, selecting insurance policies and employee benefits, etc. This division of labor is common because one spouse may have more interest in financial matters, and the set-up works fine - as long as both spouses are physically and mentally healthy.
Transcatheter aortic valve replacement, or TAVR, is a minimally invasive alternative to open heart surgery for patients who require replacement of their aortic valve due to severe aortic stenosis. Although previously available only to patients at high or intermediate surgical risk, in August the Food and Drug Administration approved both of the latest-generation TAVR valves for use in patients at low surgical risk. This is a large group of patients who are typically younger and/or more active than those at higher risk. Until now these patients' only option was open heart surgery.
Influenza, commonly known as flu, is a virus that can be spread by droplets. It can occur anytime of the year, but the majority of cases occur in December through March. Flu vaccines are the single best way to protect yourself from getting the flu. It is best to be vaccinated in early fall, as it takes two to four weeks to build up immunity. You can still develop the flu after being vaccinated, but cases are generally milder than for those that have not been vaccinated.
VoIP is a game-changer for the healthcare industry’s communication landscape, allowing for quicker, more reliable communication. However, it also brings with it a multitude of HIPAA concerns that can be confusing to navigate.
Yesterday, I received a text from my eye doctor informing me that I have not scheduled my yearly exam and need to make an appointment. The notification was an electronic version of the Annual Patient Postcard reminders. But unlike the old postcards, the text included links to automatically call the office or direct me to visit self-scheduling. Booking that appointment has been on my to-do list for weeks, but I seem to only remember to do it after the office has closed. Yet, with one click and about two minutes of my time, the mission was accomplished. That’s when it dawned on me – healthcare is going “Amazon.”
The Psychiatric Intake Response Center (PIRC) at Children’s of Alabama has completed its inaugural year of operations, assisting more than 5,000 patients and callers seeking mental health expertise for children, adolescents and their families in central Alabama. The PIRC, established in March 2018 as a collaboration between Children’s and the Anne B. LaRussa Foundation of Hope, is one of only three centers of its kind in the U.S. We are dedicated to identifying the right care at the right time and at the right place.
As financial advisors, we help our clients to consider and plan not only for their own goals, but also for some of life’s serious “what ifs.” What if you want to retire early? What if you want to buy a vacation home? What if your child is planning to attend graduate school? What if you need long-term care? What if you are raising a young family and you get cancer?
There is no one simple solution that will eliminate all business security risks. However, organizations can build a robust internal culture of security that can profoundly decrease those risks. This approach starts from the top down.
The “just right” theme repeated in the classic fairy tale of Goldilocks and the Three Bears hits close to home at Children’s of Alabama’s Pediatric Imaging Center (PIC), where services are tailored especially for kids. Every inch of the PIC, located at Children’s South Pediatric Outpatient Center in Birmingham, is designed with children in mind to ensure their experience is “just right.”
One of the most common operations in orthopaedics and sports medicine is surgery for a torn meniscus. I get a lot of questions about what this surgery involves, how long it takes to recover, and when it should be done.
Sound processes are essential to the success of any business. This is even more important in healthcare, where the ever-changing environment makes process improvement vital in order for a practice to prosper.
Recently, a friend in the pharmaceuticals business asked me about SGLT-2 Inhibitors. He wanted to know what a nephrologist thought of the drugs, and I expressed strong misgivings about potential complications.
Arrhythmias are abnormal heart rhythms that are often under recognized cardiac problems and can lead to dangerous consequences if ignored or not treated appropriately. Typical symptoms can mimic those of other cardiac conditions like a heart attack, and often include palpitations (abnormal sensation in the chest, feeling like your heart is racing or beating abnormal). Sometimes symptoms may be associated with chest discomfort, shortness of breath at rest or with exertion, dizziness, near passing out or passing out, and/or fatigue.
As the temperatures spike this summer, the risk of heat-related injury such as heat stroke and heat exhaustion also rise. While the temperatures are hard to avoid, there are ways to recognize symptoms and prevent heat-injury. People who tend to be more at risk are young children and infants, people over the age of 65 and those who are overweight or have a preexisting illness. It is important to note that some medications can also make you more sensitive to sun exposure and heat.
Millions of patients around the world wear contact lenses to correct their vision.1In fact, research suggests that contact lenses provide patients with benefits such as better perceived cosmetic appearance, better social acceptance, and a better ability to play sports compared to glasses.2-4While most contact lens wearers use soft contact lenses for cosmetic reasons, some patients wear specialty hard contact lenses because they are the only way that they can achieve functional vision without undergoing surgery to correct a visually debilitating eye disease like keratoconus (a degenerative disease that results in an irregularly shaped cornea).5In other cases, patients who suffer from moderate to severe dry eyes wear specialty contact lenses because they have the ability to make their eyes comfortable enough to effectively function.6While there is more than one type of specialty contact lens that can help patients with these conditions, scleral lenses have emerged over the past few years as the contact lens treatment of choice for these difficult-to-treat patients.7
Teen Health Week, a global campaign to raise awareness of the unique health issues adolescents and young adults face, is observed every year during the first week of April. However, raising awareness is an everyday reality for the University of Alabama at Birmingham (UAB) Division of Adolescent Medicine at Children’s of Alabama, where our team of specialists provides a comprehensive array of services to help patients transition into a healthy adulthood.
As our society transitioned to mobile phones, a frequently overheard question and related advertising theme was “Can you hear me now?”
Check-ups, tests, and results. Doctors provide, measure, and deliver data to patients every day, often with profound implications. Financial advisors, at least the diligent ones, offer the same to their clients. Much of our data focuses on helping people have confidence that they can do what they want to do and not run out of money at the same time. Approaches and technical tools may vary, often with significant differences in degrees of sophistication. It has been common practice for advisors to use these tools to help project a portfolio’s ability to provide income for retirement. Rates of return are calculated, spending requirements input, withdrawal rates assumed, and end-of-life portfolio values projected.
What if a microscopic amount of food protein you accidentally ingested quickly resulted in life threatening symptoms such as hives, swelling, vomiting, diarrhea, coughing, wheezing, or difficulty breathing? This is a serious reality for patients with food allergies and results in a constant anxiety and fear of accidental ingestion. Many are never able to eat out at restaurants, go to baseball games, fly on planes, attend movies, or simply have the option to eat at any table in a cafeteria without fear. This not only affects the patients, but their families as well.
Over the past several years the healthcare industry has become the number one target of cyberattacks. These attacks have exposed tens of millions of customers’ identities worldwide, costing an estimated $1 billion USD in losses.
The Apple Watch and other wearables are now able to monitor your heart rhythm. The Apple watch can detect irregular heart rhythms, and if it does so five times, it will prompt you to record your rhythm. In that way, it can also be used to diagnose atrial fibrillation.
One of the more common complaints evaluated by health care providers on a daily basis is Sciatica which is described generally as pain in the lower back or buttock that radiates into the leg and the foot along the path of the sciatic nerve. Patients will sometimes complain of associated numbness, tingling and even weakness in their lower leg with difficulty sitting. Symptoms can appear suddenly or gradually, and with or without a preceding precipitating event such as lifting or other back straining activities.
Like customers in most other industries, patients are turning to the internet to learn about physicians before seeking treatment. The following tips will help your practice manage your physician’s online identity in order to maximize the benefit and reduce the risks associated with online information.
The numbers tell the story.
Atrial fibrillation (AFIB), a condition in which the heart fires so rapidly that the upper chambers quiver instead of beating in a normal rhythmic pattern, is the now most common arrhythmia condition worldwide and is recognized as a global health problem with its burden of morbidity and mortality resulting from embolic stroke. AFIB is expected to double by 2030.
Vince Lombardi once said football is not a contact sport. Dancing is a contact sport. Football is a collision sport. He was right. And when you or your family members are involved in collision sports like football (or soccer, wrestling, basketball, mountain biking, etc.) your shoulders may pay the price. Contact injuries to the shoulder are a common cause of down-time and occasionally result in surgery. What is the best management for these injuries?
Peripheral arterial disease, or PAD, is a disease process in which plaque buildup causes the arteries to narrow, resulting in reduced blood flow to the limbs. This can lead to a variety of medical emergencies: Claudication, stroke, uncontrolled hypertension, and possibly amputation.
In 2012, Transcatheter Aortic Valve Replacement (TAVR) became commercially available in the US to treat high-risk patients with severe aortic stenosis. It offered effective, minimally invasive, and often lifesaving treatment to tens of thousands of patients who previously had no option for aortic valve replacement surgery.
A recent global study by the Ponemon Institute finds that the financial damage caused by a data breach has risen by 6.4 percent in the last year and now costs companies an average of $3.86 million each.
When I speak with a patient regarding knee replacement or hip replacement surgery, he/she often asks in detail about the post-surgical rehab. In my specialty of orthopaedics, rehabilitation is critical to the success of the surgery. However, one of the major risks, although uncommon, facing surgery patients is the formation of a blood clot within a deep vein. This complication is often overlooked, and can be fatal when symptoms are ignored.
January 14, 2020 is a special day for Microsoft Corporation (you know that little company that controls 82.88 percent of the computer software market share). On that date, Microsoft will end the life of some of the major software that businesses use. End of life means that the manufacturer will no longer support the product. This list includes:
The Department of Justice designated 12 federal prosecutors across the country as part of the Opioid Fraud and Abuse Detection Units. These Units are assigned to areas where the most opioid drug-related deaths have occurred: California, Nevada, Alabama, Central Florida, East Tennessee, West Virginia, North Carolina, Kentucky, Ohio, Pennsylvania, Michigan, and Maryland. Members of these Units also includes numerous federal, state, and local law enforcement and governing entities including the DEA, FBI, HHS, and other federal and state agencies (Medicaid Fraud Control Units, FDA, IRS, State Pharmacy Boards, etc.). These Units have a specific mandate to target physicians, pharmacists, and ancillary services (addiction treatment centers, etc.).
Two years ago, the Children’s of Alabama Community Healthcare Education Simulation Program, or COACHES, launched with a mission of improving pediatric care in community hospitals throughout Alabama.
During my 30 years in healthcare consulting, I have seen several reform initiatives come and go.
In many cases, the initiatives have enhanced the ability of consumers to access insurance coverage and ultimately healthcare. In 1993, President Clinton proposed legislation that led to growth in Health Maintenance Organizations (HMOs) and also the HIPAA privacy standards which are still in place today. In the 2000s, President George Bush proposed changes to the Medicare program that led to the implementation of Medicare Part D coverage.
Earlier sunsets and dropping temperatures can lull us all into the false sense that the sun isn’t as intense and therefore, not as damaging in the fall and winter months. Because of this, many choose to forgo the most important skincare product of all- sunscreen. In fact, the clouds only slightly lessen one of the two UV types that cause skin damage and skin cancers, UVB. UVB causes sunburn and damage that leads to cancers, but ironically, in the absence of this warning sign, people can be less aware that they’ve had too much sun.
Peripheral angioplasty is a minimally invasive procedure that can be performed now in an outpatient setting under local anesthesia for the treatment of peripheral artery disease (PAD). Medical technology has played a significant role in furthering this trend. PAD is a common circulatory problem in which the narrowed arteries reduce blood flow in the legs causing leg pain, numbness and/or discoloration.
With the Halloween season upon us, it is a good reminder to bring up the discussion on the dangers of cosmetic contact lens abuse. Today, nearly 41 million adults in the U.S. (16.7%) wear contact lenses as an option for their vision correction. There are also options available for patients who, in addition to wishing to correct their refractive error, can change the look of their eyes with cosmetic contact lenses.
On Sept. 6, representatives of Children’s of Alabama, the University of Alabama at Birmingham (UAB) Division of Pediatric Rehabilitation Medicine and the Lakeshore Foundation gathered to cut the ceremonial red ribbon for the grand opening of Children’s at Lakeshore – the latest chapter in a partnership among the institutions.
A 2016 report from the Centers for Disease Control and Prevention (CDC) found that 20 percent of Medicare participants 65 or older don’t take their blood pressure medicine as directed.1 Additionally, 20-30 percent of prescriptions for chronic health conditions are never filled and roughly 50 percent are not taken as recommended.1
How often do you walk into a room and completely forget why you went into the room? Or do you struggle with remembering someone’s name a few seconds after they introduce themselves to you? It seems that these “senior moments” occur more frequently as we all get older. As a clinical neuropsychologist, I am often asked if this is normal aging or if it is a sign of a bigger problem such as Alzheimer’s disease. The field of neuropsychology is uniquely skilled to answer this very question. Clinical neuropsychology is a sub-field of psychology which examines the relationship between the brain and behavior. It uses neuroscience, neuroanatomy, cognitive psychology, cognitive science and clinical psychology to understand the structure and function of the brain in relation to behavior and the information processing aspects of the mind. Neuropsychologists help to assess, diagnosis and treat individuals with neurological, medical, developmental or psychiatric conditions across the lifespan. Neuropsychological testing can aid in understanding how different areas of the brain are working. Neuropsychologists use various standardized tests to objectively examine a person’s strengths and weaknesses in all areas of thinking or cognition. Tests may be paper-and-pencil, answering questions, computer-based or task oriented. Areas of cognitive impairment or deficit can be identified and placed within the context of the individual’s medical and psychological history in order to determine what condition may be impacting a person’s functioning and thinking.
It’s been more than twenty years since the 1997 revisions to Evaluation and Management guidelines, which focus mainly on physical examination. The 2019 proposed changes provide practitioners a choice in the basis of documenting E/M visits; alleviate the burdens, and focus attention on alternatives that better reflect the current practice of medicine. The implementation of electronic medical records has allowed providers to document more information, yet repetitive templates, cloning, and other workflows have pushed the envelope on compliance in documenting the traditional elements of the visit.
As the summer months are a time when many people take vacations, it is a good time to get veins treated. So, today, we are decoding the facts about one of the latest minimally invasive technology offerings at the Alabama Vein Center: VenaSeal™ closure system.
One of the most frustrating things PC users can experience is slow performance or freezing while using their normal programs. It can make even the simplest tasks take several times longer and greatly slow down your work day, which impacts patient care as well. While it will sometimes mean there could be hardware issues and your PC needs an upgrade, there are several steps that you and your IT support can take to speed up the performance of your PC through cleanup tools, anti-virus and anti-malware scans, or optimizing settings.
Venous ulcers of the lower extremities can be a frustrating disease process for clinicians. Do I send them to wound care center (WCC), do I need to order specific studies, are they venous or arterial?
Atrial Fibrillation (AF) is the most common abnormal heart rhythm which can cause adverse clinical outcomes such as stroke and heart failure. An estimated 2.7 to 6.1 million people have AF in the United States. As the prevalence of AF increases with increasing age, with an aging population, prevalence of AF is expected to double in the next 2-3 decades. People above the age of 40 years have a 1 in 4 chance of developing AF in their lifetime. Patients with AF are 6-7 times more likely than general population to suffer from a stroke.
Many Alabama providers participated in the Quality Payment Program in 2017, under MIPS (Merit Based Incentive Program). A handful participated in a MIPS APM (Alternative Payment Model), which is a baby step towards alternative payments, but still left the participants free from downside risks. As we pass the half-way point for the 2018 performance period, exploring risk bearing programs is on the rise.
Is your EHR application in the cloud or are you considering moving to a cloud based provider? If so ensuring that you know the providers processes for data backup, disaster recovery and overall security are extremely important.
Children’s of Alabama in collaboration with the Anne B. LaRussa Foundation of Hope launched a new service in March 2018 targeting patients, families and providers who seek better access to mental health care resources. The Psychiatric Intake Response Center, or PIRC, located in Children’s Emergency Department, is staffed by licensed mental health clinicians who, via telephone or in person, assess a child or adolescent’s mental, emotional and behavioral needs, and recommend the best treatment options.
Dr Beth Malizia and Alabama Fertility Specialists are thrilled to announce the first pregnancy in the state of Alabama from a new technology that allows for the intra-vaginal culture of embryos. This new technique using a device (INVOcell) cultures embryos within a patient’s vagina rather than utilizing the complex incubators of an IVF laboratory.
I find it intriguing that physicians are one of the only professionals who pledge an oath before practicing their craft. Other notable “oath” moments in our country focus mainly on Nationalism and Service (Military, Law Enforcement, Public Servants and Naturalization among others). How different might some professionals behave, if included in their daily duties, was the acknowledgement that they are working under an assumed set of values and principles that help guide their tasks? For CERTIFIED FINANCIAL PLANNER™ professionals this exists, not in an oath form however; but within principles expressing ethical and professional ideals.
“We’re all wearing our team colors, but colors don’t matter when it comes to concussion,” says Dr. Jimmy Robinson, University of Alabama lead team physician. This year, at the Children’s of Alabama Annual Concussion Summit, a special science, vision, and engineering breakout session featured the insight of Dr. Robinson and others in the trenches of Division I sidelines. Led by UAB’s director of medical athletics, Dr. Heath Hale, and UAB Team Eye Doctor, Dr. Kathy Weise, lead team physicians and scientists from Alabama, Auburn, Florida and Clemson joined forces to weigh in on UAB’s advancements in concussion expertise. What if a contact lens could determine how much the eye sloshes around in the orbit to predict how much the brain moves in the skull when exposed to impact? What if retinal blood flow could predict cerebral blood flow following concussion? What if an objective pupil test could help predict prolonged concussion recovery?
Fraud. It’s an ugly thing and it’s everywhere, the medical industry is no exception. When most people think about fraud, they think about white collar criminals stealing millions of dollars from big name companies, or the “dark web” where most of our social security numbers and credit card numbers are floating around just waiting for a buyer. The truth is most businesses will experience some type of fraud during their operation. It is so important for owners and business managers to be constantly vigilant to protect their practices.
Those of us who live in the South are pretty familiar with hot weather, but as we get into the dog days of summer, the heat can become excessive and oppressive. All the normal rules for heat and sun safety apply, but as temperatures soar, you may need to take more extreme measures to stay cool and safe.
Where are the old (and not so good) days when a patient with myocardial infarction was staying in hospital bed for a week?
Other than skin cancer, prostate cancer is the most common cancer in American men. Although it is common, it is still one of the least well-known cancers and a diagnosis can cause confusion about treatment, symptoms, and potential side effects. In search of a minimally-invasive treatment for your prostate cancer? Through our partnership with Vituro Health, Urology Centers of Alabama is the first and only in the state to offer High Intensity Focused Ultrasound, or HIFU treatment.
Malware are created with the intent to damage or disable our mobile devices, computers or servers. These attempts can include disrupting computing or communication operations, trying to steal sensitive data, accessing our private networks, or hijacking our systems to exploit their resources. With the tremendous growth in email and internet use over the last couple of decades, we have seen a corresponding explosion of growth in malware
I recently visited a specialty practice at a major health system. As I approached the registration desk a posted sign directed me to a standing kiosk to sign in. The family member I accompanied to the visit was unable to stand at the kiosk, so I provided the needed information and signed her in. Although it was a quick and seamless process, I was concerned because if I needed assistance, there were no employees to ask. Many practices have implemented kiosk sign-ins and have someone to assist a patient with the process if needed. Practice administrators have made the decision to implement kiosk to assure verification of the current insurance policy and prompt the patient to pay any out of pocket expense before they see the doctor. Many of the kiosk solutions allow a pre-registration via email to allow the patient to populate data and upload information from their own device at their convenience. Benefits of Kiosk Sign-ins include: reduction in the staffing at the front desk, decrease in patient wait time, and most impressively is the increase of time of service collections.
One of the greatest challenges healthcare organizations face today is clinical application interoperability – the communication between computer systems, applications, or software to allow them to work in conjunction with one another.
Medical advancements through specialized programs and essential personnel are vital to the continued growth of the University of Alabama at Birmingham (UAB) Division of Pediatric Neurology at Children’s of Alabama. Expansion is underway while the unremitting needs of patients are met.
The CDC estimates that 1.2 million people in the United States have chronic Hepatitis B (HBV) but two-thirds do not know they are infected. These unaware patients can have clinically silent infections for decades until developing cirrhosis, end-stage liver disease, or hepatocellular carcinoma (HCC). HBV is transmitted by percutaneous or mucosal exposure to blood or body fluids of an infected person, such as from an infected mother to her newborn during childbirth, through close personal contact within households, through unscreened blood transfusion or unsafe injections in health- care settings, through injection drug use, and from sexual contact with an infected person.
"I believe it was divine intervention that I was sent to Aspire Physical Recovery Center at Cahaba River. The therapy team brought me back to myself."
The question is often asked, at what point should a patient and his or her physician begin to consider a total joint replacement?
It is especially important for smaller practices to be mindful of Electronic Protected Health Information (ePHI) security regulations – a breach of ePHI can lead to costly notification requirements and potential monetary penalties under the HITECH Act. Managing physicians of small independent practices hold many responsibilities, including the duty to comply with the Security Rule within HIPAA regulations. This article provides a brief overview of federal ePHI compliance safeguards required in a practice. While not meant to be a comprehensive discussion of all requirements, it highlights legal considerations and safeguards a practice must implement to comply with HIPAA ePHI regulations. The federal Security Rule under HIPAA requires a health care provider (typically known as a Covered Entity) to have the minimum ePHI safeguards, listed below.
Mitral valve regurgitation has been described as a very common cardiac valvular abnormality which is under recognized and under treated even in industrialized countries
As today’s healthcare drive pushes practices even further down the path of pay for performance versus the older models of pay for volume, administrators and executives throughout healthcare are researching and implementing ideas to provide an overall better experience for patients.
Pelvic organ prolapse (POP) is the descent of one or more parts of the vagina and/or uterus. Woman may experience displacement of the anterior, posterior or apex of the vagina, and often there is a combination. This is referred to as a cystocele, rectocele and enterocele.
According to a recent study by the Cleveland Clinic, more than one-third of physicians are in a silent battle with professional burnout. Physicians dealing with mental, emotional and physical exhaustion become less able to provide quality care to their patients and find themselves leaving the medical profession altogether…or worse. It’s the “or worse” scenario that worries Dr. Debbie Kolb of Madison.
More than 10 million people in the United States are affected by Peripheral Artery Disease (PAD). About one in every twenty Americans over the age of 50 has PAD. Smokers are four times more likely to develop the condition. Peripheral Artery Disease is a strong indicator for potential heart attack and stroke. Most people are aware of coronary artery disease but few know the symptoms of vascular disease. The most common symptom of PAD in the lower extremities is a painful muscle cramping in the hips, thighs and calves when walking or exercising. Other symptoms to be aware of are leg numbness, skin discoloration of the legs or toes & loss of hair on the lower legs.
Are you sleeping well? One in three Americans suffer from sleep-related issues. If you or someone you know suffers from a sleep disorder, there has never been a better time to find a solution. Lack of good sleep can be detrimental to one’s quality of life in many aspects. Untreated sleep disorders make it difficult to control other health conditions such as migraines, anxiety, depression, pain, and more. Poor sleep due to a disorder such as sleep apnea can also have negative effects on your social life, as you are too tired to participate in social activities. People who snore could also interrupt the sleep of their bed-partners! Finally, sleep issues can lead to poor concentration, job performance, and lack of productivity.
In 2012, I read this article that made me question much of what I thought I knew about my profession of serving clients as a guide for their financial decisions. The designation following my name for which I had worked so hard at obtaining? Good, but not enough. The incredible technology –from complex financial forecasting to automated investment management? Lacking.
On Friday, January 19, 2018, the Department of Health and Human Services (HHS) issued a proposed rule that will complicate the issues healthcare providers face in providing treatment to LGBTQ patients.
According to the Ponemon Institute – www.ponemon.org - the average cost of a data breach was $3.62 million dollars. This breaks down to $141 dollars per stolen record. International Data Corporation – www.idc.com – estimates that globally data storage will grow ten-fold by 2025 total of 163 zettabytes (a trillion gigabytes) by 2025. Data is stored in a vast range of devices including your smart phone, laptops, notebooks, workstations, tablets and even on your smart TV. Most businesses focus on the technical aspects of how to avoid data breaches (firewalls, anti-virus, security patches, etc.) and often how physical technical assets are destroyed at the end of their life are often overlooked or do not have a set process in place.
Lipedema (Lip- fat, edema- swelling) is a disease of abnormal and disproportionate adipose tissue deposition almost exclusively occurring in women1. While the disorder was originally described in 19402, lipedema remains under-recognized and underdiagnosed in the United States3. This article aims to elucidate the salient features of lipedema toward the goal of raising awareness among the medical community.
Almost everyone has seen the ads for the new anticoagulants at this point. However, many Americans still remain in the dark regarding what atrial fibrillation (Afib) is and it’s potentially devastating consequences. Despite increasing efforts to improve the awareness for atrial fibrillation, many still do not know it’s signs and symptoms or that it is a progressive disease. Afib is the most common arrhythmia in the world affecting 3-6 million Americans with projections of up to 16 million by the year 2050.
2018 marks 23 years since Children’s of Alabama entered the primary care market, expanding our footprint and brand awareness outside of our main campus on Birmingham’s Southside and strengthening our relationship with doctors who care for kids.
A rare cancer of the eye known as uveal melanoma has affected a specific demographic, mainly women, who attended Auburn University in the late 1980’s and early 1990’s. Uveal melanoma is the most common cancer in the eye, but overall its incidence is extremely low, known to affect only 4.3 per 1 million people in the US. While these cancers are uncommon, they can lead to unfortunate outcomes including total removal of the eye, and even aggressive cancers spreading throughout the body, making it crucial to catch them early.
Birmingham, AL – Behavioral Health Systems, Inc. (BHS), a Birmingham-based corporation administering national behavioral health programs since 1989, will be hosting a national economic and legislative forum on Wednesday, April 18, 2018 at The Club in Birmingham, from 8:00 am to 5:00 pm.
In the past few years, when we discussed patient satisfaction it pertained only to patient surveys and results. Some managers believe surveys are utilized by specialties, such as, plastic surgery who primarily practice on a cash basis. Consumerism is here to stay! Cost and quality will create a level playing field in healthcare. When working with a practice, I love to sit in the waiting room to see operations from the patient’s point of view. I also search the specialty online to review the competition and the effectiveness of the practice’s website; I may also see online reviews.
When most people think of Spring they think of flowers blooming, birds chirping and sunny day ahead, but for millions… their thoughts turn to congestion, runny noses, itchy eyes or endless sneezes. They have what are known as seasonal allergies. Allergy symptoms are caused by a hypersensitive response to an otherwise harmless substance and not all allergies are the same.
If you surveyed managing physicians and office managers from the Birmingham area about their business continuity plans, how confident do you think they would be with their Disaster Recovery solution? Do they feel prepared? Have they even thought about it?
Physicians and other medical care professionals spend years studying, training and preparing themselves to provide best possible care to their patients. In many instances, these professionals spend the bulk of their attention and energy on treating their patients and meeting the day-to-day challenges that come with providing the best care possible. Unfortunately, practicing in today’s economic climate within a medical industry undergoing a vast transformation has forced many medical professionals to place equal value on business issues that effect their practice. Often times, the business of operating a medical practice is never discussed in medical school. Instead, many healthcare professionals are forced to learn fundamental business principles on the fly in private practice. With the emergence of electronic medical records and coding, many healthcare providers and practices are spending a substantial amount of time concentrating on the business of healthcare in addition to patient care. Of all the business issues that must now be prioritized by the medical industry, medical billing and managing account receivables can bear the most burden of all.
Between phone calls with clients on another day in the financial trenches at Raymond James & Associates, I brainstormed for a good topic to pontificate upon to the readers of this fine publication, and I hope you’ll agree I found it.
Treatment for a pinched nerve in the neck (cervical radiculopathy) that has failed to improve with non-operative care has traditionally been treated with an anterior cervical discectomy and fusion (ACDF). Originally explained in 1958, this procedure achieves success by eliminating nerve root compression by removing the disc, replacing with bone graft via a fusion to prevent recurrent or pinched nerves and maintain stability. However, not only does this increase restricted motion to the spine (which is increased with multilevel fusions), but it also transfers force stresses to other levels or levels above and below the fusion which has been shown to increase symptoms/degeneration at other levels.
Over the last year or so, cryptocurrencies and blockchain technology have grabbed the attention of global markets and its participants.
Until recently, sufferers of chronic or recurrent sinusitis were limited to two treatment options: medication therapy or aggressive sinus surgery. Fortunately, advances in medical science have opened new doors.
If “Varithena” sounds like the latest Marvel or DC superhero, there’s good reason. When it comes to treating varicose veins, such an idea isn’t so far fetched!
Physicians serve on the frontlines of our healthcare system, and by extension the many social programs guaranteed by the Social Security Administration. It’s a large responsibility and we owe them a debt of gratitude. These dedicated care providers, across many areas of practice and at varied levels within our medical system, help more than 57 million children and adults who live with disabilities across the United States.
We hate to break it to you, but there's a HIPAA requirement you’re more than likely doing wrong. The Department of Health & Human Services’ Office for Civil Rights (OCR) is cracking down on requiring a true Healthcare Security Risk Analysis.
When Michele Kong was a little girl growing up in Malaysia, she knew the world was filled with both wonder and danger. She surprised herself and her family when she managed to kill a not-so-small python that slithered into their home. She laughs now remembering the incident, but she said someone had to do it to protect her family, and she had the shovel.
Most companies assume their cyber security is pretty good… until a breach happens and then you find out where the holes were. We often find that apathy and a lack of being proactive may cost you lots of money. An annual security audit is a necessity for all medical practices and companies in todays ever changing world of technology. It is a vital part of protecting your digital assets and cyber security plan for your organization. It’s not just about discovering any vulnerabilities or shortcomings, rather it’s about opportunities to strengthen your network security.
Q: Could you tell us about Norwood Clinic Ophthalmology?
A: We’re a part of Norwood Clinic, which is the oldest and largest multi-specialty medical group in the Birmingham area. At the ophthalmology location, we offer comprehensive ophthalmology services. This includes routine adult and pediatric eye exams; medical and surgical treatment for diseases of the eye and eyelids; and screening for ocular manifestations of systemic diseases such as diabetes.
We also have certified ophthalmic technicians and an optician to assist with the dispensing of glasses and contact lenses.
We all recognize that healthcare is evolving at a rapid pace. With this evolution, the need to share patient information to positively impact quality care, provide a seamless patient experience, plus save time for your staff to coordinate care is of critical importance. By making the most of new technology, today’s office equipment can easily and securely, help you do just that.
A couple should consider seeking help from a fertility specialist after attempting to conceive for three months, six months, a year—there really is no right answer. Infertility could be due to a single factor, or multiple factors, and fertility treatments vary in complexity. One factor in particular has become more prominent nowadays in couples who are trying to conceive: age, which effects both the husband and wife, has become a threat to fecundity as society pressures couples to start a family later in life.
Every year, new hearing aid technology is introduced to the market. New technology in hearing aids boasts updates and changes in directional microphones, sound processing algorithms, noise reduction features, amplitude and frequency compression, and audio data transfer between hearing aids, just to mention a few. What is often forgotten however, is that the primary objective of a traditional hearing aid fitting is to ensure that the patient is receiving the appropriate amount of amplification for their hearing loss at each frequency.
Noncompliance (non-adherence) to medical recommendations can have a significant impact on a patient’s overall health quality, resulting in decreased opportunities for prevention, delayed diagnosis, and incomplete or ineffective treatment. There may also be significant liability and financial risks to a responsible healthcare professional treating this patient, particularly as patient outcomes increasingly become connected to quality indicators and reimbursement.
The Alabama Center for Childhood Cancer and Blood Disorders at Children’s of Alabama actively works toward the goal of a total cure through research and development of innovative therapies. More than a dozen prominent pediatric hematology, oncology and blood and bone marrow physician-scientists provide exceptional programs in patient care, education and research. Currently, the Center provides care or treatment for 90 percent of the pediatric hematology-oncology patients in the state.
Two million Americans suffer from plantar fasciitis every year and 10 percent of the population will experience it in their lifetime. It has become recognized as one of the most chronic and, often times, most difficult foot problems to treat.
Healthcare professionals are all well aware of what a clinical trial is, how they work, and the possibilities that are provided to those who participate. However, the majority of Americans have not participated or heard about opportunities to participate in clinical research. According to a survey conducted by Research!America in partnership with Zogby Analytics (2017), fewer than 10% of Americans actually participate in clinical trials. Digging further into the reasons why, 55% of those surveyed stated that they were not aware or lacked information regarding clinical trials (Research!America, 2017).
Just because you’re getting older doesn’t mean that it’s too late to get in shape. In fact, research shows that older people who have never exercised can still benefit from physical conditioning. By starting a regular exercise program, you can help prevent coronary artery disease, high blood pressure, stroke, diabetes, depression and some cancer. Physical fitness reduces the effects of osteoporosis and arthritis — two conditions which can severely limit an older person’s lifestyle. Being in good shape physically can help you remain independent as you age and improve the quality of your life.
As we finalize 2017 participation in the Merit Based Incentive Program, most of us focused on improved performance in quality since the category carried the highest weight of 60%. Those who had previous success in Meaningful Use found the Advancing Care category easy to address. The Practice Improvement category is new and somewhat vague, but many practices were already performing tasks that qualified as an improvement activity. It is important to document the approach to improvement and track success because this category is subject to audit in the future.
Approximately 12 million Americans suffer from peripheral artery disease (PAD), yet general awareness of the disease is at 25%. Patients over the age of 50 with a history of smoking, high cholesterol, diabetes, hypertension, and heart disease are at the greatest risk. A staggering 50% of PAD patients have unrecognized symptoms that may progress directly to severe disease.
An estimated 3.5 million people in the United States are infected with Chronic Hepatitis C Virus (HCV). Many of these people do not know they are infected and are not receiving care or treatment. The CDC estimates that while Baby Boomers (born 1945-1965) comprise only 27% of the US population, they account for approximately three fourths of all HCV infections. Therefore, they are at greatest risk for hepatocellular carcinoma and other HCV-related liver disease. HCV is now the leading cause of liver transplantation and liver cancer in the US.
Parkinson’s is recognized as the second most neurodegenerative disorder right behind Alzheimer’s. An estimated 7 to 10 million people have Parkinson’s disease worldwide, with 60,000 new cases of Parkinson’s being diagnosed just in the U.S. every year. Parkinson’s is known as a progressive condition and symptoms will affect patients differently. Typically, people diagnosed with Parkinson’s will portray some degree of difficulty with shaking or tremor, slowness of movement or bradykinesia, stiffness in movement or rigidity of the arms, legs and trunk and gait imbalance. Because of the loss of dopamine producing brain cells, patients will see their movements become slower and smaller, creating risk for falls and impairing their quality of life.
Robotic assisted surgery has seen an explosion since it was first introduced about 20 years ago with over 4 million procedures performed. Although minimally invasive laparoscopic surgery has been around longer, certain limitations existed within this field. Laparoscopic surgical instruments lack wristed movement, essentially forcing surgeons to operate with chop sticks. The effect was difficulty performing certain procedures and working at difficult angles. Robotic surgery allows wristed action of the instruments, better optics (depth perception), surgeon control of the camera, and better ergonomics. While there is not any significant change in long term outcomes, there are studies suggesting decreased pain and shorter hospital stays.
Your business' data could be compromised by the most unlikely of sources -- your own IT manager.
Over the past couple months, I’ve encountered multiple chilling examples of IT staff gone rogue. Of course, this isn't happening every day. But when it does, it's especially damaging to organizations with a one-person IT department. These lone IT managers often hold the keys to the kingdom. No one person - IT expert or not - should ever have complete control over passwords, access, processes, etc. Why? Consider these two recent incidents:
Full scale recruitment is under way for the Alabama Genomic Health Initiative (AGHI), a partnership of the University of Alabama at Birmingham (UAB), HudsonAlpha Institute for Biotechnology and Children’s of Alabama. Funded by a $2 million appropriation from the Alabama legislature to UAB, the AGHI is one of the nation’s first statewide efforts to use genomic analysis to identify those at high risk for genetic diseases.
The state’s first spine procedure using the Mazor Robotic System in conjunction with intraoperative imaging was performed by neurosurgeons with Neurosurgical Associates, PC at St. Vincent’s Birmingham.
Venous reflux in the lower extremity is when blood from the foot which should travel towards the heart reverses downwards due to gravity.
There is a lot of confusion about SSDI and SSI, the two types of disability benefits that can be received from Social Security. The definition of disability is the same under both programs, but that is where the similarity ends. The following is a very basic description of the disability programs provided under the Social Security Act, titles II and XVI.
What is myopia?
Myopia is a condition that results in distant objects appearing blurry to a patient when not being corrected with glasses or contact lenses.1 Myopic blur typically results from the eye being too long for its optical focusing components (cornea and crystalline lens), which causes distant objects to be in focus in front of the retina (back of the eye) instead on the retina, a requirement for the eye to be able to see clearly.1 About one third of Americans have myopia, and its prevalence is likely increasing because of factors associated with living in a developed country (e.g., decreased time outdoors).2-5 With that said, the scientific community only has a vague understanding of how genetics and the environment influence the development and progression of myopia.1 While myopia’s visual affects can be a costly nuisance and strain on the health care system,6 myopia also places the affected individuals at a greater risk for developing vision-threatening conditions like cataracts, retinal detachments, and glaucoma.1 Once present, myopia cannot be cured; therefore, preventing it or even reducing the amount of myopia that a patient develops is an upmost priority for the scientific community.7
No matter the size of the business, a successful business must be paid promptly and in full. However, often a business, including a medical practice is dealing with numerous overdue accounts receivables. Such a financial position can be commonplace in today’s business environment. Although this financial condition is often perceived as “normal” or “accepted” business practice”, savvy business owners should collect promptly and protect their rights in resolving overdue receivables with the proper policy and procedures in place. Effective policy and procedures generally begin with utilizing a new patient form and/or the credit application.
For 2017, The American Cancer Society has estimated that around 252,710 new cases of invasive breast cancer will be diagnosed in women and 2,470 diagnosed in men, around 63,410 new cases of Carcinoma in situ(non-invasive and the earliest form of breast cancer) will be diagnosed, and approximately 40,610 cases will be fatal.
Over 36 million American adults have some degree of hearing loss.
That is over 4 times the amount of people who live in New York City.
As of September 30, 2017, the Department of Health and Human Services Office of Civil Rights (OCR) has received notices of 237 breaches. 46% occurred as result of hacking or IT security incidents; many at the business associate level. Ransomware is rampant and projected to increase 670%. As a covered entity, although a breach occurs at your business associate, under HIPAA, you are responsible for your protected health information and responding to the breach. OCR has been clear that breaches of 500 or more records will be investigated. Given the significant increase in breaches over the past few years, advance preparation is critical and can reduce the cost and burden of breach response.
An Oklahoma physician agreed on August 28, 2017 to pay the government $580,000 to resolve allegations that he violated the False Claims Act by submitting claims to the Medicare program for services he did not provide or supervise. According to the government, the physician allowed a company that employed him and in which he had an ownership interest to use his NPI numbers to bill Medicare for physical therapy evaluation and management services that he did not provide or supervise. The government further alleged that after he separated from the company and deactivated his NPIs associated with the company, he reactivated those NPIs so that the company could use them to bill Medicare for services he neither performed nor supervised.
Most people are aware that atherosclerosis can cause blockages in the coronary arteries, resulting in chest pain or heart attack, or in the carotid arteries, precipitating a stroke. But atherosclerosis can lead to another serious but often under-diagnosed condition: peripheral arterial disease (PAD). Defined as atherosclerotic obstruction of the arteries to the lower extremities, PAD causes leg pain and is associated with other cardiovascular disease. Although lower extremity PAD affects an estimated 12 to 20 million people in the United States, only four to five million of them are experiencing symptoms.
Did you know that prostate cancer is the second most common cancer among American men? In fact, an average of 480 American men are diagnosed with prostate cancer every day - that’s one every 3 minutes.
It has now been two years since the implementation of ICD-10, everyone survived! While denials have been minimal, the goal of implementing ICD 10 to acquire more specificity and a complete picture of health has not been fully achieved. Physicians and managers have created a new set of shortcuts to assure payment of claims, relying on paper superbills or inappropriate conversions from ICD 9 to ICD 10.
Every caregiver strives to expand the services they provide to their patients, while also improving quality of care and safety. These are certainly our goals at the Children’s of Alabama orthopedic clinic.
As a hand and upper extremity Orthopaedic surgeon, I see many patients that present to my office with pain in their elbow and forearm. For a certain subsets of these patients, I ultimately diagnose them with lateral epicondylitis, or tennis elbow. Oftentimes, their reaction is the same. They say, “Doc, I don’t even play tennis, how could I have tennis elbow?!” Unfortunately, many people assume that lateral epicondylitis will only affect those individuals that are active in racquet sports, when in reality; tennis elbow can affect both men and women regardless of their hobbies.
Bang, bang, bang! If you experience your heart banging against your chest or skipping beats you may be experiencing an arrhythmia. An arrhythmia is an irregular rate or rhythm of the heartbeat, where your heart can beat too fast or slow. Most commonly, this is caused by atrial fibrillation (AFib), when disorganized electrical signals cause the heart’s chambers not to beat in sync or fibrillate. Millions of Americans are affected by this disease and the number increases each year. AFib is the most common abnormal heart rhythm in America.
"Aspire Physical Recovery Center at Cahaba River is proud to offer its guest use of the OMNIVR system. The OMNI is a virtual reality augmented rehabilitation system that allows trained clinicians the opportunity to work with guests in novel, yet functional ways.
Tumor Treating Fields or TTF as it is more commonly known is a recently developed method by which malignant brain tumor cells are prevented from reproducing. Shelby Baptist Medical Center and Generations Radiotherapy & Oncology PC has begun therapy on its first patient using this entirely new approach in the treatment of malignant brain tumors with the Optune TTF system.
Prostate cancer is the second most common cancer diagnosed in American men and the second leading cause of cancer death. While a majority of men will be diagnosed after the age of 65, younger men do need to consider screening for prostate cancer, especially if risk factors are present such as African American heritage or a family history of prostate cancer.
Most all medical practices are preparing a MACRA project this summer. Our healthcare team has had the opportunity to speak to many physicians and managers regarding preparation for the transition from volume to value based medicine and reimbursement. A large project can be overwhelming for any practice but this is more than a project, it is a culture change!
Between 2000-2015 the number of Americans with hearing loss has doubled, bringing it close to 48 million. With the aging baby boomer population, that number will continue to climb in the coming years.
Hard-to-heal wounds can be a problem for many people. One way that Medical West is offering treatment is through hyperbaric oxygen therapy at the Advanced Wound Center.
Hyperbaric oxygen therapy is the application of 100% oxygen that is applied to a patient under pressure. The therapy is used for decompression sickness, for infections, air pockets in blood vessels, and for diabetic wounds that won’t heal.
With the addition of two more physicians in the coming months, Children’s of Alabama will soon be able to expand the care we provide to pediatric patients with liver disease.
The internet is a necessary part of the healthcare world today. This forces us to deal with the issue of managing employee Internet usage which can be a drain on your organizations productivity. This holds true in the healthcare industry whether you run a small clinic, large practice or hospital.
TUSCUMBIA – When you walk into Dr. Suzanne Blaylock’s office at the Helen Keller Pavilion, there’s a medical journal on her desk, paused and waiting for her to return to continue reading the most recent article. On the wall behind her chair are framed reminders of why she choose anesthesiology as her specialty – awards recognizing her from the Peer Reviewed Professionals, the Consumers’ Research Council of America as one of America’s Top Anesthesiologists, and the Consumers’ Research Council of America’s Top Physicians. Dr. Blaylock always knew she’d have a career in medicine, but what she got was so much more.
The AAOS (American Academy of Orthopaedic Surgeons) has recently sponsored some remarkable multimedia public service campaigns. You may remember the recent “Decide to Drive” initiative about distracted driving /texting. Well, their newest is “Painkillers are easy to get into. Hard to escape.” Included in the AAOS statement, the U.S. Department of Health and Human Services reports on an average day in the U.S., more than 650,000 opioid prescriptions are dispensed and 78 people die from opioid-related overdose. It is considered an “epidemic.” We all have relatives, friends, and patients who have been caught up in and succumbed to the detrimental effects of drug addiction.
For years now, I have seen patient after patient frustrated with stubborn fat in areas that do not respond well (or quickly) to diet and exercise. Their concerns are very common, and certainly not something of which to be ashamed. Patients also frequently ask me for my recommendations on non-invasive cosmetic treatments designed to address these issues, like CoolSculpting®, Sculpsure®, Vanquish™ or Zerona™.
Birmingham Heart Clinic physicians are now utilizing a new approach to reduce atrial fibrillation stroke risk and eliminate the need for blood thinners over time.
Summer is quickly approaching, a season that usually comes with warmer weather and, for many of us, vacation time. Vacations come in a variety of forms. You may prefer a staycation where you simply stay at home and avoid emails for a week. You may favor an once-in-a-lifetime trip to a place like Iceland, or you might head to the southern Alabama coast to catch some sun at the beach. While the travel possibilities are nearly endless, a contact lens wearer needs to be prepared for every situation.
Hearing loss is a common problem. 15% of American adults aged 18 and over report trouble hearing. Over the age of 65, one third of the population has significant hearing loss. Most people with Hearing Impairment suffer some social, psychological and physical problems. Social consequences of hearing loss include reduced social activity and problems communicating with family and at work. Particularly in the elderly Hearing Loss can be isolating.
A family medicine doctor is someone you can always feel comfortable voicing your concerns to and leave an appointment feeling as though you were really listened to. They will help you to become an informed and active member of your healthcare decision-making process.
MONTGOMERY – Boyde Jerome “Jerry” Harrison, a family practitioner from Haleyville, was formally installed as president of the Medical Association of the State of Alabama during the 2017 Inauguration, Awards Presentation and 50-Year Physician Recognition Dinner on Friday, April 14.
You may have thought that a sports orthopaedic center would be a place to go only after a catastrophic sports injury—something breaks or tears or starts hurting so badly you can’t physically use it.
“Most athletic injuries seen in sports clinics are indeed overuse injuries that have reached a point of taking the patient out of the game,” said Dr. Ricardo Colberg of Andrews Sports Medicine & Orthopaedic Center. “Although 85% of sports injuries do not require surgery, many patients wait until they are unable to compete to start correcting their issues.”
As pediatric medicine becomes more specialized, the demand for specialists grows. One need look no further than the Division of Pediatric Neurology at the University of Alabama at Birmingham (UAB) for evidence of this trend.
Recycling electronics is a great way to help conserve and reuse valuable resources and materials found in many gadgets, including glass, plastics, and various metals such as copper, gold, palladium, and silver. Many electronics, especially computers and televisions, contain toxic materials such as cadmium, lead, and mercury. Recycling and reusing electronics helps to keep these toxic materials out of our landfills and water supply.
As we women age, we do not always know what is coming next. We think we do, but we may not. We all know the stereotypical changes that happen with menopause, and of course, chronic diseases such as diabetes, heart disease, etc. that can occur with age. I can tell you that many women in their late 40s to late 70s are not expecting pain with intercourse, vaginal pain and discomfort, or both. It is honestly a surprise. And not a good one at that. It can make a healthy sexual relationship go sour very quickly, which not only hurts the woman’s quality of life, but her partner’s as well. This can affect the relationship as a whole, and both parties’ overall health, which can then lead to other medical issues. In our practice, we traditionally have treated men for erectile dysfunction and other sexual issues, but we understand that female sexual health is important as well.
MONTGOMERY – On March 29, officials from the Medical Association of the State of Alabama participated in a proclamation signing ceremony declaring March 30, 2017, the Second Annual Doctors’ Day in Alabama formally recognizing Alabama’s nearly 17,000 licensed physicians serving millions of residents through private practice, in hospitals, in research, and in other health care facilities.
A colonoscopy is an endoscopic examination of your large intestine. The primary indication for the procedure is colon cancer screening. However, it is also an effective diagnostic tool for the evaluation of chronic intestinal symptoms including abdominal pain, diarrhea and rectal bleeding as well as unexplained anemia.
2 pounds asparagus 1 spring onion or scallion (thinly sliced) 1/4 cup extra virgin olive oil 4 hard boiled eggs (chopped) 1/4 cup toasted breadcrumbs 1/4 grated parmesan
Moving a medical practice can be a daunting task. A medical office move can be a result of needing a bigger space, physician retirement, or practice acquisition. While making patients aware of a major change is most certainly a priority, it is equally important to make sure their documents and all office data and service equipment survives the move as well.
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