Tag Archive for: healthcare

Medicare cuts

Medicare cuts coming in Jan. Why you should pay attention.

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On Nov 1st, the Federal government issued a final ruling that’s going to result in Medicare cuts of 4.5%. In an already dysfunctional and overcrowded healthcare system – this is going to be a problem for you (the consumer) – and here’s why…

Healthcare is ultimately a business. And its goal is to make a profit. Revenue and profit come from things like procedures, tests, images, and surgery – not from disease prevention and keeping people healthy.

What does that mean for you?

Health care specialities such as orthopedic surgery, neurology, and gastroenterology (for example) – those that are procedurally-driven – generate higher revenues and get paid more for their services.

On the flip side – disciplines like primary care physicians, rehab therapies (like physical therapy), and endocrinologists (those that manage chronic conditions like diabetes and osteoporosis) – get paid less.

The consequence is that the disciplines who actually need more time with you- so they can get to know you and your lifestyle – because that’s what is required to give you a good strategy for disease and injury prevention- are forced to do more work for less.

Eventually, something has to give…

Family medicine doctors have to see patients every 10 minutes and that’s if you can even get in to see them in a timely fashion. Physical therapists have to see multiple patients per hour, resulting in 12-16 patients per day.

These caseloads and demands are not supportive of a health care practitioner truly getting to know you as a person, what your concerns are, or what your particular lifestyle and burdens are. (A recent commentary by Shirlene Obuobi, MD in the Washington Post illustrates this dilemma quite well.)

These are all critically important factors if you want to get effective treatment and advice that’s going to match your needs and deliver the outcome you want.

The consequence is sub-par preventative care. And you risk unnecessarily getting shuffled off to the “specialist” who uses fancy tests and procedures (instead of getting to know you and asking questions) to make (often costly) decisions about your health.

Now, my intention here is not to paint specialists who use procedures and tests as their norm of examination as the “bad guys”.

The problem is you, the patient, is getting pawned off on them too soon because the people who are meant to protect you and help you defend against disease and injury are getting crushed (and not valued) by the health insurance companies.

Medicare tends to be the leader and everyone else follows suit. If these 2023 cuts go through, commercial insurers will be next.

So what can you do?

First, you must do everything in your power to become educated about health and wellness. Then, you can prevent disease and injuries on your own.

This may require hiring certain, key, preventative health care professionals to guide you – such as getting your own dietician, your own physical therapist, and your own mental health professional. Ironically, we already do this without even thinking about it when it comes to our dental care.

Why wouldn’t we want to do this with other aspects – like digestive, mental, and musculoskeletal health?

Health insurance companies add red-tape when it comes to accessing these services. An example is requiring a referral. Referrals that our already overburdened primary care physicians don’t have time to give. This leads me to my second recommendation. Start thinking outside the box. Be willing and able to invest in the health care you both desire and need.

Going outside of insurance and paying out of pocket for preventative care services is not as expensive as you think. Your options could open up exponentially. Especially if you budget and plan for it. At some point, it’s not going to be in your favor to rely on your health insurance to fund all your healthcare needs anymore. It’s clear they’re not interested. Instead, look at your finances and start budgeting.

One of the best ways to do this is to open up a health savings account. If your health plan doesn’t allow for that, then open up a separate savings account to save on your own. More and more practitioners are ditching insurance – if not leaving their respective professions altogether. Do you want to stay out of the hospital? Or big corporate health care systems and see someone private who has the time to care about you? You will have to pay. Personally, I believe this is the way to go but I understand it’s not for everyone.

However, with some planning and foresight, it could be.

I hope things do eventually change for the long-term. Stay educated, take control over the administration and funding of your health care in the short term. This is a far better alternative than heading to Washington and fighting Congress on your own.

Are you local to Portsmouth, NH? CLICK HERE to request a Free Discovery Session with us – we’ll ask you what’s been going on – and see if we’re the right fit to help you.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

work out

Why More People are Paying out of Pocket for Healthcare…even during an economic downturn

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More People are Paying out of Pocket for Healthcare…even during a recession

If you’ve ever had an injury or dealt with chronic pain, you’ve probably followed a pretty traditional course of action to address it that might have looked like this:

  • You went to your primary care doctor and they sent you to the lab for x rays, prescribed medication, or both.
  • You may have gotten a referral to a specialist or even a surgeon.
  • You went to that appointment and were either told that you needed surgery or that you needed to modify your physical activity and avoid certain activities in order to not exacerbate the problem.

Basically, you were thrust into the assembly line that has become “modern healthcare”.

But did you know that you could bypass all of this hassle – and get faster results – by going directly to a physical therapist?

Physical therapists are trained to diagnose your problem and provide a fully customized treatment option. One that doesn’t involve prescription medications or procedures.

In almost all states (including NH) you don’t even need a prescription to see a physical therapist.

The problem is that for many people, traditional physical therapy has not produced the results they are looking for.

Physical therapy DOES work. But what often doesn’t work is the model of care.

There have been many limitations insurance companies have placed on reimbursement over the years. Most traditional physical therapy clinics (those that take insurance) have been forced to see more patients. Just so they can pay the bills and keep the lights on!

Additionally, insurance companies and healthcare have essentially taken over your care.

They decide who you can see, what type of treatment you will get, and how many visits you are allowed to have.

These decisions are being made by someone who’s never even spoken to you, met you, or actually looked at you.

Because of this, “physical therapy” has gotten a bad reputation and a lot of people find that it’s a waste of time, or that it consists of just a bunch of exercises.

It’s not the physical therapist’s fault, it’s the insurance company’s fault.

The good news is that you’ve got options and alternatives when it comes to taking care of your back or knee pain.

You don’t want to be prescribed medication and you don’t want to deal with procedures like injections or surgery. Or you don’t want to go to traditional physical therapy and feel like you’re wasting your time. The answer is to go outside of your insurance and pay out of pocket.

This is known as going “out of network”.

More people are doing it because they are fed up with the traditional models. Models of healthcare and physical therapy that don’t give them the results they are looking for.

But isn’t that expensive? Not at all, and it really depends on what you value.

For me, and for most of the folks that we work with, it’s far more costly to live with chronic back pain. You have to miss out on activities you love, and end up with a surgery you never even wanted.

It’s also far more costly to spend years going to weekly chiropractic and massage therapy appointments. Just so that you can function and manage your pain.

When it comes to musculoskeletal problems, you NEED a physical therapist in your corner and as part of your healthcare team.

But it can’t be the traditional kind where all you get is cookie cutter treatment plans. Physical therapists who don’t contract with insurance companies are able to spend more time with you. Allowing them to create a truly customized plan of care.

We focus on getting to know you and your body. Not what paperwork needs to be filled out for your next healthcare insurance authorization.

Our clients like this model because they get long-term success instead of short-term pain relief. Our therapists like this model. They are free to use their brains and actually do what they were trained to do.

Everyone should have their own, personal physical therapist to call and come see anytime you need. Just like you would a chiropractor, dentist, doctor, or massage therapist.

The only way to do this, is to go outside your insurance. If you are curious about whether or not this model of physical therapy is right for you just give us a call!

It’s not for everyone, but more and more people are finding that it is.

Most of the folks we meet and work with say: “I wish I had found you first”.

If this is something you are interested in – or are seeking more information on – CLICK HERE to speak to one of my specialists.

They will give you all the information you need to make the BEST decision for YOUR health. Whether that’s working with us or not!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

Why You Need an Accountability Team

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The Importance of Accountability

Lately I’ve been feeling like there are just not enough hours in the day to do everything I need to do, and to be honest, it’s thrown me off track a bit! We have so many awesome things going on here at CJ Physical Therapy and Pilates, and despite how exciting our development and growth has been recently, it can be stressful to stay on top of everything.

However, I need to remind myself how lucky I am to have good, supportive people around me who I can rely on as my “accountability team.” They’re the people who will hold me accountable for the things I really need to be doing, redirect my focus if I’m pouring all my energy into less crucial tasks, see things I’m not seeing, and sometimes to simply give me the thumbs up (or down). For me – that’s my husband and my AMAZING team at CJPT and Pilates (many of whom you’ve had the awesome chance to meet)!

The lovely ladies of CJPT & Pilates!

Strangely enough, this topic has been coming up A LOT lately with our clients too!

I can’t tell you how many times someone comes into my office stressed out and worried because they didn’t get to do their exercises this week, they didn’t do them exactly right – or worse – they try to delay or put off getting help because they don’t have time to do the exercises…

Helping you help yourself

First – getting help for a back, neck, or knee problem that’s been lingering for awhile – or that you’ve been putting off for awhile – isn’t just about doing exercises. That’s actually where most people are confused and get it wrong (if it were that simple – well, frankly – I’d be out of a job!).

Where I help people the most is by becoming a part of their support and accountability team! Often when I first meet with someone, it starts with getting to know what’s going on in their life. How busy are they? Do they spend most of their time in a plane or car because of work? Do they have three little kids, or grandkids, they’re trying to keep up with? Do they have one or two really energetic dogs that have them running around the house or yard all the time?

I want to know what your real life is like. That way we can come up with a realistic plan that will set you up for success. Expecting you to suddenly go to the gym every day when you don’t even have a membership is kind of ridiculous. So is expecting you to NEVER bend over when you’ve got two little kids at home, for example. It’s important that you are working with someone who understands you, your life, and is prepared to be part of your support and accountability system. You don’t need someone who is just going to make life more difficult for by recommending unrealistic treatments or imposing demands that simply won’t work (or more importantly LAST) with your individual lifestyle.

Here for the Long Haul

Now, being a physical therapist in the traditional sense, it would be very easy for me to do some manual work on the table for each of my clients, and even go through some therapeutic exercises that I know will get rid of their pain quickly. BUT… does that actually get you through a physically and mentally strenuous week? Does a quick fix really help in the long run?

No – and that’s why having a support and accountability team – especially when it comes to your health – is absolutely vital.

Don’t work with people who simply put bandaids on the problem in the form of drugs or quick fixes. Work with someone who is willing to dig in and find a real solution, support you along the way, and hold you accountable for the time and energy that you need to invest in your health as well!

If you’re interested in adding a specialist physical therapist (and/or Pilates instructor) to your accountability team, you can reach out anytime or even request a time to talk to one of our specialists for FREE. Thanks for reading – and for holding ME accountable to sharing this advice with you!