Children with smoking parents may not be as healthy as they appear.
A study presented at the American Thoracic Society International Conference shows that although children of smokers may not exhibit respiratory problems, they may still be suffering from damage to their airways.
Some researchers claim that children of smokers are more likely to have respiratory problems such as puffing, wheezing, and cases of pneumonia.
However it is unclear if there is impairment in children who have no respiratory complaints or diagnosed problems.
The study consisted of 244 children ages 4 through 12 who had no history of lung or airway ailments. Based on the smoking patterns of parents, the children were separated into four groups:
(1) never smokers
(2) smoking after birth but not during pregnancy
(3) during pregnancy but not after birth
(4) before and after both. Children of smoking parents were found to have reductions in lung function similar to that in smokers.
Smoking after birth contributed more to lung impairment than smoking during pregnancy alone.
Researchers believe that, with the growing number of outdoor smoking bans, there may be an increasing trend for parents to smoke inside the home. While no ill effects of passive smoking have been demonstrated from outdoor smoke, if such a trend proves to be true, children exposed to indoor smoke could see diminished lung function over time.
It remains controversial whether personal smoking habits go beyond affecting the health of a single individual, and whether outdoor smoking bans make any sense from a scientific standpoint..
Friday, May 9, 2008
Wednesday, May 7, 2008
A look back to Workplace Injury Stats in 1992
Most Americans between the ages of 22 and 65 spend 40 to 50 percent of waking hours at work. Every year millions of Americans suffer injuries and thousands experience deaths in our workplaces. Yet little effort has been made to estimate either the extent of these injuries, deaths, and diseases or their cost to the economy. Thus, important questions about workplace safety and the economic resources expended due to workplace health problems remain unanswered.
In this study, we address these questions by presenting estimates of the incidence, prevalence, and costs of workplace-related injuries, illnesses, and deaths for the entire civilian workforce of the United States in 1992. We also consider controversies surrounding cost methodologies, estimate how these costs are distributed across occupations, consider who pays the costs, and address some policy issues.
Our major findings are as follows:
Roughly 6,371 job-related injury deaths, 13.3 million nonfatal injuries, 60,300 disease deaths, and 1,184,000 illnesses occurred in the U.S. workplace in 1992.
The total direct and indirect costs associated with these injuries and illnesses were estimated to be $155.5 billion, or nearly 3 percent of gross domestic product (GDP).
Direct costs included medical expenses for hospitals, physicians, and drugs, as well as health insurance administration costs, and were estimated to be $51.8 billion.
The indirect costs included loss of wages, costs of fringe benefits, and loss of home production (e.g., child care provided by parent and home repairs), as well as employer retraining and workplace disruption costs, and were estimated to be $103.7 billion.
Injuries generated roughly 85 percent whereas diseases generated 15 percent of all costs.
These costs are large when compared to those for other diseases. The costs are roughly five times the costs for AIDS, three times the costs for Alzheimer's disease, more than the costs of arthritis, nearly as great as the costs for cancer, and roughly 82 percent of the costs of all circulatory (heart and stroke) diseases.
Workers' compensation covered roughly 27 percent of all costs. Taxpayers paid approximately 18 percent of these costs through contributions to Medicare, Medicaid, and Social Security.
Costs were borne by injured workers and their families, by all other workers through lower wages, by firms through lower profits, and by consumers through higher prices.
Our study appears to be the first to use national data to produce estimates on costs for occupational injuries and illnesses. Prior studies have underestimated costs by ignoring nondisabling injuries, deaths, and workplace violence, by taking inadequate account of diseases, and, most importantly, by relying on only one or two sources of data.
The Annual Survey of the Bureau of Labor Statistics (BLS) provides the most reliable and comprehensive data on nonfatal injuries. However, it misses roughly 53 percent of job-related injuries. This omission, in part, is due to the exclusion of government employees and the self-employed and also, in part, due to illegal underreporting by private firms.
Contrary to the Annual Survey data, we find small firms have exceptionally high injury rates.
Occupations contributing the most to costs included truck drivers, laborers, janitors, nursing orderlies, assemblers, and carpenters. On a per capita basis, lumberjacks, laborers, millwrights, prison guards, and meatcutters contributed the most to costs.
Occupations at highest risk for carpal tunnel syndrome include dental hygienists, meatcutters, sewing machine operators, and assemblers. Among well-paid professions, dentists face the highest risks.
Any of the major sources of data, such as the Bureau of Labor Statistics, National Institute for Occupational Safety and Health, workers' compensation systems, or National Health Interview Survey, by themselves underestimate the numbers of injuries and illnesses.
Greater efforts need to be directed toward gathering data on job-related injuries and illnesses. The United States needs a comprehensive data bank for fatal and nonfatal injuries and all illnesses. Future researchers should not have to investigate the over 20 sources of primary data and 300 sources of secondary data that we investigated.
In this study, we address these questions by presenting estimates of the incidence, prevalence, and costs of workplace-related injuries, illnesses, and deaths for the entire civilian workforce of the United States in 1992. We also consider controversies surrounding cost methodologies, estimate how these costs are distributed across occupations, consider who pays the costs, and address some policy issues.
Our major findings are as follows:
Roughly 6,371 job-related injury deaths, 13.3 million nonfatal injuries, 60,300 disease deaths, and 1,184,000 illnesses occurred in the U.S. workplace in 1992.
The total direct and indirect costs associated with these injuries and illnesses were estimated to be $155.5 billion, or nearly 3 percent of gross domestic product (GDP).
Direct costs included medical expenses for hospitals, physicians, and drugs, as well as health insurance administration costs, and were estimated to be $51.8 billion.
The indirect costs included loss of wages, costs of fringe benefits, and loss of home production (e.g., child care provided by parent and home repairs), as well as employer retraining and workplace disruption costs, and were estimated to be $103.7 billion.
Injuries generated roughly 85 percent whereas diseases generated 15 percent of all costs.
These costs are large when compared to those for other diseases. The costs are roughly five times the costs for AIDS, three times the costs for Alzheimer's disease, more than the costs of arthritis, nearly as great as the costs for cancer, and roughly 82 percent of the costs of all circulatory (heart and stroke) diseases.
Workers' compensation covered roughly 27 percent of all costs. Taxpayers paid approximately 18 percent of these costs through contributions to Medicare, Medicaid, and Social Security.
Costs were borne by injured workers and their families, by all other workers through lower wages, by firms through lower profits, and by consumers through higher prices.
Our study appears to be the first to use national data to produce estimates on costs for occupational injuries and illnesses. Prior studies have underestimated costs by ignoring nondisabling injuries, deaths, and workplace violence, by taking inadequate account of diseases, and, most importantly, by relying on only one or two sources of data.
The Annual Survey of the Bureau of Labor Statistics (BLS) provides the most reliable and comprehensive data on nonfatal injuries. However, it misses roughly 53 percent of job-related injuries. This omission, in part, is due to the exclusion of government employees and the self-employed and also, in part, due to illegal underreporting by private firms.
Contrary to the Annual Survey data, we find small firms have exceptionally high injury rates.
Occupations contributing the most to costs included truck drivers, laborers, janitors, nursing orderlies, assemblers, and carpenters. On a per capita basis, lumberjacks, laborers, millwrights, prison guards, and meatcutters contributed the most to costs.
Occupations at highest risk for carpal tunnel syndrome include dental hygienists, meatcutters, sewing machine operators, and assemblers. Among well-paid professions, dentists face the highest risks.
Any of the major sources of data, such as the Bureau of Labor Statistics, National Institute for Occupational Safety and Health, workers' compensation systems, or National Health Interview Survey, by themselves underestimate the numbers of injuries and illnesses.
Greater efforts need to be directed toward gathering data on job-related injuries and illnesses. The United States needs a comprehensive data bank for fatal and nonfatal injuries and all illnesses. Future researchers should not have to investigate the over 20 sources of primary data and 300 sources of secondary data that we investigated.
Tuesday, May 6, 2008
Asthma Worsened by Obesity
In asthma patients, dynamic hyperinflation, following a test measure airway hypersensitivity, is greater in obese individuals than in their nonobese counterparts, which helps explain why asthma is perceived to be more severe in patients with a higher body mass index (BMI), investigators in New Zealand report.
A BMI is the ratio between height and weight, and is used to classify people as underweight, overweight or normal weight.
"The greater dynamic hyperinflation means that obese individuals lose the ability to inhale as deeply or exhale as fully as normal weight individuals," Dr. D. Robin Taylor explains in an American Thoracic Society statement.
Taylor's team at the University of Otago in Dunedin studied the changes in airway expansion and lung volume that occur with acute constriction of the bronchial tubes in a group of 30 adult women with asthma. Ten women each were classified as normal weight, overweight, or obese, and lung volumes were measured.
The degree of bronchial constriction following the airway sensitivity test did not vary by group, the team reports in the American Journal of Respiratory and Critical Care Medicine. The only significant difference among the subjects was a decrease in vital capacity that significantly corresponded with increasing BMI.
Lung volume measurements also showed that the volume of air retained in the lung following exhalation was significantly higher as BMI increased, while the amount of air that could be inhaled was lower.
These variations "were significantly greater in relation to BMI" after taking into account the effects of "airway hyperresponsiveness, the severity of airflow obstruction, and lung volume measurements, indicating the effect of BMI was an independent one," the investigators note, meaning that BMI alone was associated with the severity of asthma.
This puts obese individuals at greater disadvantage due to enhanced gas trapping, they point out, a significant contributor to difficulty in breathing.
Taylor and his associates also noted that conventional lung function tests "may have limitations when used to evaluate symptoms in obese patients with asthma, with the potential for misinterpretation" in the absence of lung volume measurements.
A BMI is the ratio between height and weight, and is used to classify people as underweight, overweight or normal weight.
"The greater dynamic hyperinflation means that obese individuals lose the ability to inhale as deeply or exhale as fully as normal weight individuals," Dr. D. Robin Taylor explains in an American Thoracic Society statement.
Taylor's team at the University of Otago in Dunedin studied the changes in airway expansion and lung volume that occur with acute constriction of the bronchial tubes in a group of 30 adult women with asthma. Ten women each were classified as normal weight, overweight, or obese, and lung volumes were measured.
The degree of bronchial constriction following the airway sensitivity test did not vary by group, the team reports in the American Journal of Respiratory and Critical Care Medicine. The only significant difference among the subjects was a decrease in vital capacity that significantly corresponded with increasing BMI.
Lung volume measurements also showed that the volume of air retained in the lung following exhalation was significantly higher as BMI increased, while the amount of air that could be inhaled was lower.
These variations "were significantly greater in relation to BMI" after taking into account the effects of "airway hyperresponsiveness, the severity of airflow obstruction, and lung volume measurements, indicating the effect of BMI was an independent one," the investigators note, meaning that BMI alone was associated with the severity of asthma.
This puts obese individuals at greater disadvantage due to enhanced gas trapping, they point out, a significant contributor to difficulty in breathing.
Taylor and his associates also noted that conventional lung function tests "may have limitations when used to evaluate symptoms in obese patients with asthma, with the potential for misinterpretation" in the absence of lung volume measurements.
Monday, May 5, 2008
Healthy Trust Occupational Health Clinic
Healthy Trust Occupational Health Clinic serves as your companies ‘team doctor ’
Challenging government regulations and rising workers’ compensation premiums may make navigating through a workplace injury daunting to an employer. Having a health care partner completely dedicated to the health and safety of your employees not only results in a productive work force, it is also vital to the bottom line.
Healthy Trust Immediate Medical Care, a locally owned and operated occupational medicine clinic, is comprised of trained and certified professionals striving to ensure worker health and safety in the Chicago North Shore suburbs.
Along with skilled treatment of job-related injuries, Healthy Trust Immediate Medical Care can provide your company with drug and alcohol testing, respirator mask fitting, audio testing, immunizations, diagnostic services, customized wellness plans, preventive screenings, and other health services. Many of these services can be provided at your worksite or office.
An occupational medicine physician is similar to a team doctor for a sports team. The ultimate goal is to get the employee (athlete) healthy and back into the workplace quickly. In the past, occupational medicine was thought to only be practical for the industrial corridor—construction and manufacturing companies, refineries and other industrial organizations.
Today, representatives from all businesses, industrial and professional, are recognizing the benefits of a strong working relationship with an occupational medicine provider.
Healthy Trust Immediate Medical Care serves as the company’s medical department, providing health care services to employees. With proper testing, Healthy Trust providers may spot pre-existing medical conditions that otherwise have gone unnoticed.
Healthy Trust Occupational Health Clinic can also assist in the development of a drug and alcohol testing program in an effort to monitor a safe work environment. “Employers can increase the productivity of their employees,” says Medical Director Dr. Boris Gurevich. “Whether it’s flu shots or wellness programs, there is a substantial return on each dollar spent.”
Time is a major factor in the workplace today. Many companies now operate outside of the traditional 9 to 5 workday and need a health care provider to accommodate the odd-hour schedules of their employees. Healthy Trust Occupational Health Clinic makes this easy.
Extended hours help to alleviate the stress of taking time out of the workday to receive necessary health care services.
The physicians and other clinical providers at Healthy Trust Immediate Care are trained in occupational health issues and are ready to provide reliable and professional services for all segments of business and industry.
Healthy Trust Occupational Health Clinic serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Challenging government regulations and rising workers’ compensation premiums may make navigating through a workplace injury daunting to an employer. Having a health care partner completely dedicated to the health and safety of your employees not only results in a productive work force, it is also vital to the bottom line.
Healthy Trust Immediate Medical Care, a locally owned and operated occupational medicine clinic, is comprised of trained and certified professionals striving to ensure worker health and safety in the Chicago North Shore suburbs.
Along with skilled treatment of job-related injuries, Healthy Trust Immediate Medical Care can provide your company with drug and alcohol testing, respirator mask fitting, audio testing, immunizations, diagnostic services, customized wellness plans, preventive screenings, and other health services. Many of these services can be provided at your worksite or office.
An occupational medicine physician is similar to a team doctor for a sports team. The ultimate goal is to get the employee (athlete) healthy and back into the workplace quickly. In the past, occupational medicine was thought to only be practical for the industrial corridor—construction and manufacturing companies, refineries and other industrial organizations.
Today, representatives from all businesses, industrial and professional, are recognizing the benefits of a strong working relationship with an occupational medicine provider.
Healthy Trust Immediate Medical Care serves as the company’s medical department, providing health care services to employees. With proper testing, Healthy Trust providers may spot pre-existing medical conditions that otherwise have gone unnoticed.
Healthy Trust Occupational Health Clinic can also assist in the development of a drug and alcohol testing program in an effort to monitor a safe work environment. “Employers can increase the productivity of their employees,” says Medical Director Dr. Boris Gurevich. “Whether it’s flu shots or wellness programs, there is a substantial return on each dollar spent.”
Time is a major factor in the workplace today. Many companies now operate outside of the traditional 9 to 5 workday and need a health care provider to accommodate the odd-hour schedules of their employees. Healthy Trust Occupational Health Clinic makes this easy.
Extended hours help to alleviate the stress of taking time out of the workday to receive necessary health care services.
The physicians and other clinical providers at Healthy Trust Immediate Care are trained in occupational health issues and are ready to provide reliable and professional services for all segments of business and industry.
Healthy Trust Occupational Health Clinic serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.
Walking While Working
On the heels of research finding that fat-burning enzymes shut down while sitting, Mayo Clinic researchers believe they may have the cure for inactive 9-to-5ers chained to their desks: walking workstations.
According to experts, the walkstations, which resemble treadmills with computers attached, represent a bold new step by the medical community in an effort to fight the rising obesity epidemic.
James Levine, an endocrinologist at the Mayo Clinic, came up with the walkstation idea about three years ago while talking to an ABC producer about new obesity research; it indicated that people with obesity fidget less and are more likely to sit than people who aren't obese.
During the conversation, Levine gave her four ideas to revolutionize offices. Six weeks later, he began putting them into action as part of his NEAT (non-exercise activity thermogenesis) initiative to transform offices into gyms.
"Support from the Mayo Clinic was unbelievable. People at Mayo said this is very important," Levine said. "They literally assigned 50 to 60 builders to do this, night and day. I would show up at 3 in the morning, people would be there painting walls, designing desks."
Fifteen years of research at the Mayo Clinic has shown that sitting all day long at the office is actually quite harmful to human health and that people who are obese tend to be seated two hours more than leaner people, according to Levine.
We're chair-based. People being seated all day is crucial to why obesity occurred," he said.
Levine first tested the newly designed office with his own research staff for six to 10 weeks. Then he approached Steelcase to collaborate and develop walkstations that can now be integrated into any office.
"They call it a walkstation, I call it a dream for my patients," he said. "One can write manuscripts, talk on the telephone while walking one mile per hour. Patients with weight problems are burning 100 to 150 calories more per hour, potentially 1,000 more per day. That number is profoundly important."
In offices with walkstations, employees can also hold conferences on the move. Levine's research team even developed "Meeting in Progress" stickers that indicate that a person is not to be interrupted as they're walking.
A month ago, Deb Bailey, director of corporate communications at Steelcase, began to use one of the walkstation units available at her office.
"I walked by a couple of times [and] saw other people using them," she said. "I was shocked at the way they were sending e-mails, checking e-mails while on the treadmill. Then I thought, why not be multitasking in a healthy way?"
Bailey now uses the walkstation daily.
"I jump on it for an hour. In the morning, I check e-mails; it's a nice period of time," she said. "I think I'm more productive [throughout the day as a result. It gets the adrenaline pumping."
She is quick to dismiss criticism of the new units.
"People will say it's a treadmill. It's not like I'm trying to talk and run. I keep it at a 1.3 miles per hour gait," she said. "It's very much regular activity. The only thing I do differently is bring a pair of walking shoes. It's not designed to be strenuous. It's the same thing you would be doing if you were on campus walking from building to building."
She also adds that the walkstation is an excellent remedy for the midafternoon post lunch sugar slump.
"We only look at a change in posture as a good way of adding energy. Why not stand up and do this? Or a 30-minute conference call, do it from a walkstation," Bailey said.
Growing Trend?
Four walkstations are currently in use at Wal-Mart's corporate offices in Bentonville, Ark., and at Salo, a financial outsourcing firm in Minneapolis, according to Bud Klipa, president of Details, a Steelcase company. Hundreds of walkstations have already been reserved for customers, including some Fortune 500 companies.
The walkstations are also extending into some schools. Traditional school desks are removed from classrooms; kids are then free to sit on the floor with their laptops, stand or move around as they're listening to their teachers.
Student behaviors in those schools improved substantially, according to Levine.
The response from the scientific community the walkstations has been largely positive.
"Often in science when you come up with ideas that are offbeat, the standard response of many scientists is very skeptical. Sometimes it's unhelpful because it makes people think scientists argue all the time," said George Brooks, a professor in the Department of Integrative Biology at the University of California at Berkeley. "When I sent an e-mail to NIH[National Institutes of Health] [about the whole project], no scientist was opposed to it. They said, "How can we be involved?' It's fantastic. It's been incredible, quite amazing."
Brooks believes that the walkstations are an important step in the fight against obesity.
"Physical activity is gone from our jobs, as a consequence people are overweight, diabetic, and it's even leading to some forms of cancer. We need to be active at least one hour a day," he said. "The walk stations are a revolutionary step in terms of putting physical activity in the workplace in a way people are still effective at their jobs."
Brooks insists that investing in workplace fitness has great benefits for employers, despite financial costs.
"If organizations try to implement it, we'll see if people will do it. I think people will resist it mightily," he said. "But people who will do it will be healthier, more effective, and happier."
According to experts, the walkstations, which resemble treadmills with computers attached, represent a bold new step by the medical community in an effort to fight the rising obesity epidemic.
James Levine, an endocrinologist at the Mayo Clinic, came up with the walkstation idea about three years ago while talking to an ABC producer about new obesity research; it indicated that people with obesity fidget less and are more likely to sit than people who aren't obese.
During the conversation, Levine gave her four ideas to revolutionize offices. Six weeks later, he began putting them into action as part of his NEAT (non-exercise activity thermogenesis) initiative to transform offices into gyms.
"Support from the Mayo Clinic was unbelievable. People at Mayo said this is very important," Levine said. "They literally assigned 50 to 60 builders to do this, night and day. I would show up at 3 in the morning, people would be there painting walls, designing desks."
Fifteen years of research at the Mayo Clinic has shown that sitting all day long at the office is actually quite harmful to human health and that people who are obese tend to be seated two hours more than leaner people, according to Levine.
We're chair-based. People being seated all day is crucial to why obesity occurred," he said.
Levine first tested the newly designed office with his own research staff for six to 10 weeks. Then he approached Steelcase to collaborate and develop walkstations that can now be integrated into any office.
"They call it a walkstation, I call it a dream for my patients," he said. "One can write manuscripts, talk on the telephone while walking one mile per hour. Patients with weight problems are burning 100 to 150 calories more per hour, potentially 1,000 more per day. That number is profoundly important."
In offices with walkstations, employees can also hold conferences on the move. Levine's research team even developed "Meeting in Progress" stickers that indicate that a person is not to be interrupted as they're walking.
A month ago, Deb Bailey, director of corporate communications at Steelcase, began to use one of the walkstation units available at her office.
"I walked by a couple of times [and] saw other people using them," she said. "I was shocked at the way they were sending e-mails, checking e-mails while on the treadmill. Then I thought, why not be multitasking in a healthy way?"
Bailey now uses the walkstation daily.
"I jump on it for an hour. In the morning, I check e-mails; it's a nice period of time," she said. "I think I'm more productive [throughout the day as a result. It gets the adrenaline pumping."
She is quick to dismiss criticism of the new units.
"People will say it's a treadmill. It's not like I'm trying to talk and run. I keep it at a 1.3 miles per hour gait," she said. "It's very much regular activity. The only thing I do differently is bring a pair of walking shoes. It's not designed to be strenuous. It's the same thing you would be doing if you were on campus walking from building to building."
She also adds that the walkstation is an excellent remedy for the midafternoon post lunch sugar slump.
"We only look at a change in posture as a good way of adding energy. Why not stand up and do this? Or a 30-minute conference call, do it from a walkstation," Bailey said.
Growing Trend?
Four walkstations are currently in use at Wal-Mart's corporate offices in Bentonville, Ark., and at Salo, a financial outsourcing firm in Minneapolis, according to Bud Klipa, president of Details, a Steelcase company. Hundreds of walkstations have already been reserved for customers, including some Fortune 500 companies.
The walkstations are also extending into some schools. Traditional school desks are removed from classrooms; kids are then free to sit on the floor with their laptops, stand or move around as they're listening to their teachers.
Student behaviors in those schools improved substantially, according to Levine.
The response from the scientific community the walkstations has been largely positive.
"Often in science when you come up with ideas that are offbeat, the standard response of many scientists is very skeptical. Sometimes it's unhelpful because it makes people think scientists argue all the time," said George Brooks, a professor in the Department of Integrative Biology at the University of California at Berkeley. "When I sent an e-mail to NIH[National Institutes of Health] [about the whole project], no scientist was opposed to it. They said, "How can we be involved?' It's fantastic. It's been incredible, quite amazing."
Brooks believes that the walkstations are an important step in the fight against obesity.
"Physical activity is gone from our jobs, as a consequence people are overweight, diabetic, and it's even leading to some forms of cancer. We need to be active at least one hour a day," he said. "The walk stations are a revolutionary step in terms of putting physical activity in the workplace in a way people are still effective at their jobs."
Brooks insists that investing in workplace fitness has great benefits for employers, despite financial costs.
"If organizations try to implement it, we'll see if people will do it. I think people will resist it mightily," he said. "But people who will do it will be healthier, more effective, and happier."
Sunday, May 4, 2008
Urgent Care In Tucson
A surgeon and a physician assistant who took care of injured troops in Iraq and Afghanistan are now using their emergency treatment skills at a new urgent care cetner they’ve opened in north central Tucson.
Dr. David Orringer, a surgeon, and Davidson Hall, a physician assistant, partnered to open Velo Med Urgent Care in a 6,400-square-foot building at 50 E. Croydon Park Road, off North Stone Avenue a block south of River Road. The urgent care business is using 4,400 square feet of space and Orringer and Hall plan to rent the remaining 2,000 square feet to a tenant.
Although trained as a surgeon, Dr. Orringer said he had never considered getting involved with an urgent care facility until after treating wounded military personnel.
"A lot of what you get in the field is bare bones operations," Dr. Orringer said. "You’re treating people with few resources and so you have to be prepared to see anything and everything — and you have so many guys depending on you. So urgent care is the same except in a little more of a controlled environment, with better equipment and better resources and a fully trained staff."
Orringer believes his military experience now serves him and Hall well as they see "pretty much anything and everything." He realized while in Iraq and Afghanistan that handling emergency treatment never gets boring and has a component of excitement about it that he thrives on.
The building was designed by Edward Marley, of Swaim Associates LTD Architects. Orringer said Marley, like himself, is a cycling enthusiast and the clinic’s reception area has been designed in the pattern of a bicycle.
An accomplished classical pianist and opera singer who once considered that as a career, Dr. Orringer achieved the rank of major and served as the medical director for the Air Force’s Combat Search and Rescue mission in Iraq and Afghanistan for four months each location before leaving the Air Force in 2007. Hall was a combat medic in Iraq during Desert Storm and also served with the 82nd Airborne and as a Special Forces Medic.
Orringer was awarded the Sikorsky Rescue Award, given to those involved in the rescue of someone in combat.
According to the Sikorsky website, the Winged-S Rescue Award Program was created in 1950 to honor all those who perform rescues flying a Sikorsky helicopter. "Through this award, we gratefully acknowledge the humanitarian efforts of all pilots and crewmembers who put themselves in harm’s way to save others and fulfill company founder Igor Sikorsky’s vision of the helicopter as a unique and powerful life-saving instrument," the website says.
Orringer and Hall met while practicing at another urgent care facility in Tucson and decided to open Velo Med Urgent Care facility.
The facility, which employees 16, including two other part-time physicians, has five exam rooms and a sixth which also is used for minor surgical procedures. There also is an X ray suite, a lab and a limited onsite pharmacy.
The clinic specializes in sports or work injuries, physical exams, lacerations, sprains, rashes, allergies, colds and coughs and sore throats and walk-ins are encouraged.
Originally from New England, where he studied classical piano at Dartmouth, Dr. Orringer said he "really fell in love with Tucson" and decided to stay here. Because there are not enough primary care physicians and emergency rooms are overcrowded here in Tucson, Dr. Orringer said he felt that his new clinic could offer a good intermediate solution for patients.
His sole disadvantage in Tucson is that he doesn’t get much opportunity to use his classical piano and opera training. "It’s mostly just singing in the car," he laughed.
Dr. David Orringer, a surgeon, and Davidson Hall, a physician assistant, partnered to open Velo Med Urgent Care in a 6,400-square-foot building at 50 E. Croydon Park Road, off North Stone Avenue a block south of River Road. The urgent care business is using 4,400 square feet of space and Orringer and Hall plan to rent the remaining 2,000 square feet to a tenant.
Although trained as a surgeon, Dr. Orringer said he had never considered getting involved with an urgent care facility until after treating wounded military personnel.
"A lot of what you get in the field is bare bones operations," Dr. Orringer said. "You’re treating people with few resources and so you have to be prepared to see anything and everything — and you have so many guys depending on you. So urgent care is the same except in a little more of a controlled environment, with better equipment and better resources and a fully trained staff."
Orringer believes his military experience now serves him and Hall well as they see "pretty much anything and everything." He realized while in Iraq and Afghanistan that handling emergency treatment never gets boring and has a component of excitement about it that he thrives on.
The building was designed by Edward Marley, of Swaim Associates LTD Architects. Orringer said Marley, like himself, is a cycling enthusiast and the clinic’s reception area has been designed in the pattern of a bicycle.
An accomplished classical pianist and opera singer who once considered that as a career, Dr. Orringer achieved the rank of major and served as the medical director for the Air Force’s Combat Search and Rescue mission in Iraq and Afghanistan for four months each location before leaving the Air Force in 2007. Hall was a combat medic in Iraq during Desert Storm and also served with the 82nd Airborne and as a Special Forces Medic.
Orringer was awarded the Sikorsky Rescue Award, given to those involved in the rescue of someone in combat.
According to the Sikorsky website, the Winged-S Rescue Award Program was created in 1950 to honor all those who perform rescues flying a Sikorsky helicopter. "Through this award, we gratefully acknowledge the humanitarian efforts of all pilots and crewmembers who put themselves in harm’s way to save others and fulfill company founder Igor Sikorsky’s vision of the helicopter as a unique and powerful life-saving instrument," the website says.
Orringer and Hall met while practicing at another urgent care facility in Tucson and decided to open Velo Med Urgent Care facility.
The facility, which employees 16, including two other part-time physicians, has five exam rooms and a sixth which also is used for minor surgical procedures. There also is an X ray suite, a lab and a limited onsite pharmacy.
The clinic specializes in sports or work injuries, physical exams, lacerations, sprains, rashes, allergies, colds and coughs and sore throats and walk-ins are encouraged.
Originally from New England, where he studied classical piano at Dartmouth, Dr. Orringer said he "really fell in love with Tucson" and decided to stay here. Because there are not enough primary care physicians and emergency rooms are overcrowded here in Tucson, Dr. Orringer said he felt that his new clinic could offer a good intermediate solution for patients.
His sole disadvantage in Tucson is that he doesn’t get much opportunity to use his classical piano and opera training. "It’s mostly just singing in the car," he laughed.
Thursday, May 1, 2008
Georgia Tackling the Plight of the Un, and Under Insured
For those hoping state leaders will find a way to help pare down the number of uninsured Georgians, the doctors are in.
Whether their diagnoses and cures are the right ones depends on who you listen to. Among the major proposals in front of lawmakers is a move by Gov. Sonny Perdue to embrace high-deductible health care plans and accompanying health savings accounts. Also getting attention is a pair of proposals from Lt. Gov. Casey Cagle, one that would give a financial boost to free clinics and another that would provide more information to health-care consumers. Rounding out the bunch is a proposal by Insurance and Safety Fire Commissioner John Oxendine to force health insurance companies to get his approval before they can raise premiums.
Critics question how valuable some of those free-market ideas might be and focus on efforts to expand what they see as tried-and-true government programs, such as the joint state-federal Medicaid health insurance plan for lower-income Georgians.
All of the ideas are aimed at trying to get at least some of an estimated 1.7 million uninsured Georgians onto an insurance plan, or to at least tame costs so they can afford one if they choose.
Though legislative leaders haven't necessarily rallied behind a single idea yet, some are just happy the issue is being mentioned.
"We're just elated that this is on the table to figure out how to start addressing this," said Jimmy Lewis, the CEO of HomeTown Health, an organization of small and rural hospitals.
THE CHEAPEST PRODUCT ON THE MARKET
Mr. Perdue's major initiative is an effort to promote high-deductible health-care plans. Those plans don't provide as much coverage of routine visits to the doctor or other small medical costs. Instead, patients have to pay a more sizable deductible than under other plans, one usually met only because of a long-term illness or a major accident.
In return, they pay less in monthly premiums than for more traditional and comprehensive coverage.
Supporters say the high-deductible plans often bring in many workers who would otherwise be unable to afford health insurance.
"This will be the cheapest product on the market," said Rep. Mickey Channell, R-Greensboro, a key legislative voice on health-care issues and a sponsor of the House version of Mr. Perdue's proposal.
The governor's idea, which Mr. Oxendine has recently said was largely taken from his previous proposals, would exempt premium payments for the high-deductible plans from the state's premium tax and allow Georgians to claim the payments as deductions on their state income taxes if they're not already doing so on their federal taxes.
And it would change state laws that some read as barring rewards for healthy behaviors that many high-deductible plans use to help members build up their health savings accounts.
Those accounts allow members to save the money they need to cover the small-ticket medical costs until they reach the deductible.
Critics aren't sure the plans will work.
"The problem is that they don't really address the bulk of the uninsured population," said Timothy Sweeney, a senior health-care analyst at the private Georgia Budget and Policy Institute, which advocates more funding for social programs.
Even the high-deductible programs are financially out of reach for many lower-income families trying to find health care, critics say, and some who could already pay for insurance but don't because of the current high prices.
"A certain number of people might be able to get insurance," said Alan Essig, the institute's executive director. "But then there's a question of whether they could have afforded it anyway."
Mr. Channell counters that 30 percent to 35 percent of those who sign up for the plans nationwide are uninsured when they do so.
OTHER IDEAS
Both of Mr. Cagle's ideas seem to enjoy fairly broad support among those who follow health-care issues. One proposal would give grants of up to $30,000 toward planning a free clinic and up to $150,000 for existing clinics that work with lower-income patients.
The idea is that those clinics could provide some of the less-urgent and preventative care that would keep uninsured patients out of the emergency room, where the cost of care is far higher.
Mr. Sweeney cautions against seeing the clinics as a cure.
"Free care at a clinic certainly does not replace health insurance," he said.
A separate measure by Mr. Channell would give doctors a $25-an-hour tax credit for working at one of the clinics.
Mr. Cagle would also create a Georgia Health Marketplace, which would help consumers shop around for various health-care options.
Mr. Sweeney and Mr. Essig argue that the state might already have the best solution for its uninsured residents: Medicaid. Raising the eligibility rate could bring thousands of new people into the system, with the federal government picking up 60 percent of the costs.
"That may be a more effective way of enrolling people, getting people health care, than some of the more individual ways that we're talking about now," Mr. Essig said.
Some say there are problems with that approach. Expanding Medicaid would be expensive -- even with federal help -- and would likely rankle some of the free-market conservatives in the GOP-controlled Legislature. Mr. Channell said he thinks it is unlikely to pass.
Mr. Lewis of HomeTown Health said expanding Medicaid would exacerbate another problem. Hospitals now complain that they lose 15 cents for every dollar they spend treating Medicaid patients because of low reimbursement rates.
"It would just accelerate the demise of a number of providers and force them out of business," he said.
Whether their diagnoses and cures are the right ones depends on who you listen to. Among the major proposals in front of lawmakers is a move by Gov. Sonny Perdue to embrace high-deductible health care plans and accompanying health savings accounts. Also getting attention is a pair of proposals from Lt. Gov. Casey Cagle, one that would give a financial boost to free clinics and another that would provide more information to health-care consumers. Rounding out the bunch is a proposal by Insurance and Safety Fire Commissioner John Oxendine to force health insurance companies to get his approval before they can raise premiums.
Critics question how valuable some of those free-market ideas might be and focus on efforts to expand what they see as tried-and-true government programs, such as the joint state-federal Medicaid health insurance plan for lower-income Georgians.
All of the ideas are aimed at trying to get at least some of an estimated 1.7 million uninsured Georgians onto an insurance plan, or to at least tame costs so they can afford one if they choose.
Though legislative leaders haven't necessarily rallied behind a single idea yet, some are just happy the issue is being mentioned.
"We're just elated that this is on the table to figure out how to start addressing this," said Jimmy Lewis, the CEO of HomeTown Health, an organization of small and rural hospitals.
THE CHEAPEST PRODUCT ON THE MARKET
Mr. Perdue's major initiative is an effort to promote high-deductible health-care plans. Those plans don't provide as much coverage of routine visits to the doctor or other small medical costs. Instead, patients have to pay a more sizable deductible than under other plans, one usually met only because of a long-term illness or a major accident.
In return, they pay less in monthly premiums than for more traditional and comprehensive coverage.
Supporters say the high-deductible plans often bring in many workers who would otherwise be unable to afford health insurance.
"This will be the cheapest product on the market," said Rep. Mickey Channell, R-Greensboro, a key legislative voice on health-care issues and a sponsor of the House version of Mr. Perdue's proposal.
The governor's idea, which Mr. Oxendine has recently said was largely taken from his previous proposals, would exempt premium payments for the high-deductible plans from the state's premium tax and allow Georgians to claim the payments as deductions on their state income taxes if they're not already doing so on their federal taxes.
And it would change state laws that some read as barring rewards for healthy behaviors that many high-deductible plans use to help members build up their health savings accounts.
Those accounts allow members to save the money they need to cover the small-ticket medical costs until they reach the deductible.
Critics aren't sure the plans will work.
"The problem is that they don't really address the bulk of the uninsured population," said Timothy Sweeney, a senior health-care analyst at the private Georgia Budget and Policy Institute, which advocates more funding for social programs.
Even the high-deductible programs are financially out of reach for many lower-income families trying to find health care, critics say, and some who could already pay for insurance but don't because of the current high prices.
"A certain number of people might be able to get insurance," said Alan Essig, the institute's executive director. "But then there's a question of whether they could have afforded it anyway."
Mr. Channell counters that 30 percent to 35 percent of those who sign up for the plans nationwide are uninsured when they do so.
OTHER IDEAS
Both of Mr. Cagle's ideas seem to enjoy fairly broad support among those who follow health-care issues. One proposal would give grants of up to $30,000 toward planning a free clinic and up to $150,000 for existing clinics that work with lower-income patients.
The idea is that those clinics could provide some of the less-urgent and preventative care that would keep uninsured patients out of the emergency room, where the cost of care is far higher.
Mr. Sweeney cautions against seeing the clinics as a cure.
"Free care at a clinic certainly does not replace health insurance," he said.
A separate measure by Mr. Channell would give doctors a $25-an-hour tax credit for working at one of the clinics.
Mr. Cagle would also create a Georgia Health Marketplace, which would help consumers shop around for various health-care options.
Mr. Sweeney and Mr. Essig argue that the state might already have the best solution for its uninsured residents: Medicaid. Raising the eligibility rate could bring thousands of new people into the system, with the federal government picking up 60 percent of the costs.
"That may be a more effective way of enrolling people, getting people health care, than some of the more individual ways that we're talking about now," Mr. Essig said.
Some say there are problems with that approach. Expanding Medicaid would be expensive -- even with federal help -- and would likely rankle some of the free-market conservatives in the GOP-controlled Legislature. Mr. Channell said he thinks it is unlikely to pass.
Mr. Lewis of HomeTown Health said expanding Medicaid would exacerbate another problem. Hospitals now complain that they lose 15 cents for every dollar they spend treating Medicaid patients because of low reimbursement rates.
"It would just accelerate the demise of a number of providers and force them out of business," he said.
Subscribe to:
Posts (Atom)