When am I going to see the doctor? ”Nurse: “Oh, you don’t see the doctor anymore.

A man sits in an exam room.  His appointment is with a specialist to help with his serious and chronic condition.  After a few minutes a nurse walks into the room.  The nurse asks him the standard list of intake questions and puts the information into a laptop.  When she is finished, she leaves the room and tells the man she will be right back.  Ten minutes later the nurse returns to the room.

Nurse: “Mr. Johnson, here is your prescription and an order for an MRI.  You can schedule your MRI when you check out as well as another follow up visit in the next 6 weeks.  Do you have any questions?”

The man is a bit confused and says, “Well yes.  When am I going to see the doctor?”

Nurse: “Oh, you don’t see the doctor anymore.  You see we found it to be much more efficient and profitable if we just put your information into our new care delivery algorithm.  The computer will tell us what you need.  But don’t worry, a doctor signs off on every chart.  This is so much more efficient.  Why yesterday one of our doctors signed off on over 25,000 charts in one day!”

Patient: “But wait.  That means the doctor only spent about 1 second reviewing each chart before signing off.”

Nurse: “I didn’t say he “reviewed” the charts.  I said he signed off on them.  You see, this is much more efficient than spending the time to review the charts.  But don’t worry, we have the utmost faith in the new computer algorithm.”

Patient: “So a computer is actually practicing medicine now and telling me what care I can get?”

Nurse: “Oh no. Of course not.  That would expose us to liability.  You can get whatever care you want.  We are not limiting the care you can get.  We are only telling you what our computer recommends.  It’s up to you if you want to follow that recommendation or not.   The other interesting thing is right after we got our new MRI and started making money on MRIs the computer started ordering them on every patient.  It’s almost like the computer is programed to do what is good for our bottom line and not necessarily what the patient needs.   You have a great day Mr. Johnson, and I will see you again in 6 weeks.”

So, I ask you, how is this different than what the payers are doing when denying care?  I will tell you how it’s different.  One is immoral and illegal and the other is just immoral.

Sound therapy may ease concussion symptoms - ScienceBlog.com

New research indicates that acoustic stimulation of the brain may ease persistent symptoms in individuals who experienced mild traumatic brain injury (concussion) in the past.

The study, which is published in Annals of Clinical and Translational Neurology, included 106 military service members, veterans, or their spouses with persistent symptoms after mild traumatic brain injury 3 months to 10 years ago. Participants were randomized 1:1 to receive 10 sessions of engineered tones linked to brainwaves (intervention), or random engineered tones not linked to brainwaves (sham control). All participants rested comfortably in a zero-gravity chair in the dark with eyes closed and listened to the computer-generated tones via earbud-style headphones. The primary outcome was change in symptom scores, with secondary outcomes of heart rate variability and self-reported measures of sleep, mood, and anxiety.   The results indicate that although acoustic stimulation is associated with marked improvement in postconcussive symptoms, listening to acoustic stimulation based on brain electrical activity, as it was delivered in this study, may not improve symptoms, brain function, or heart rate variability more than randomly generated, computer engineered acoustic stimulation.Among all study participants, symptom scores clinically and statistically improved compared with baseline, with benefits largely sustained at 3 months and 6 months; however, there were no significant differences between the intervention and control groups. Similar patterns were observed for secondary outcomes.

Conclusions

Participating in a study involving approximately 10 cumulative hours of resting comfortably in a zero-gravity chair in the dark with eyes closed and listening to computer-generated acoustic stimulation is well tolerated and is associated with clinically and statistically significant improvement in postconcussive symptoms. However, the results of this study do not suggest that in a primarily active duty group with postconcussive symptoms listening to acoustic stimulation based on one's own brain electrical activity reduces symptoms, or improves brain function or heart rate variability, more than randomly generated, computer engineered acoustic stimulation. In addition, ongoing work indicates that the combination of acoustic stimulation and microelectrical stimulation of the scalp, also based on brain electrical activity, may have greater power to improve postconcussive symptoms. Future studies will determine if the gains seen in this study can be improved (i.e., greater symptom improvement with fewer treatment sessions) using the combination of acoustic and microelectrical stimulation in a similar noninvasive neurotechnology intervention.

“Postconcussive symptoms have proven very difficult to treat, and the degree of improvement seen in this study is virtually unheard of, though further research is needed to identify what elements are key to its success,” said corresponding author Michael J. Roy, MD, MPH, of Uniformed Services University and the Walter Reed National Military Medical Center, in Bethesda.

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Sound therapy may ease concussion symptoms - ScienceBlog.com

Neuroplasticity in Stroke Recovery

What is Neuroplasticity?

Neuroplasticity, also known as neural plasticity or brain plasticity, refers to the brain’s ability to adapt or change (1). Neuro refers to the neurons, the nerve cells that are the building blocks of the brain and nervous system, while plasticity refers to change

The brain rewires itself through neuroplasticity. Brain cells send messages, which are the neural connections around the brain. However, when an individual experiences a stroke, the stroke damages some of the connections inside the brain in addition to the connection between the brain and the rest of the body (4). Rehabilitation activities help the brain in making new neural connections in the healthy parts of your brain. More neural connections can improve your brain’s ability to control your body and perform daily activities. Every time you take an extra step, say a new word or do an exercise, it helps the brain make new connections (4).
The brain rewires itself through neuroplasticity. Brain cells send messages, which are the neural connections around the brain. However, when an individual experiences a stroke, the stroke damages some of the connections inside the brain in addition to the connection between the brain and the rest of the body (4). Rehabilitation activities help the brain in making new neural connections in the healthy parts of your brain. More neural connections can improve your brain’s ability to control your body and perform daily activities. Every time you take an extra step, say a new word or do an exercise, it helps the brain make new connections (4).

Physical Benefits:

• Speeds up all-around stroke recovery

• Recovers strength

• Improves balance

• Increases walking speed

• Boosts the ability to perform daily routine activities

• Prevents the recurrence of strokes

Mental Benefits:

• Reduces depression and enhances mood

• Boosts brain health

• Relieves stress

• Helps in increasing a sense of self-worth and self-reliance that can decrease after a stroke

• Gives patients a sense of purpose and a goal to work towards

• What is the Ipsihand?

References:

https://positivepsychology.com/neuroplasticity/#stroke-neuroplasticity (1)

https://www.ncbi.nlm.nih.gov/books/NBK557811/ (2)

https://www.verywellmind.com/what-is-brain-plasticity-2794886 (3)

https://www.stroke.org.uk/effects-of-stroke/neuroplasticity-rewiring-the-brain (4)

https://www.flintrehab.com/neuroplasticity-after-stroke/ (5)

https://tactustherapy.com/neuroplasticity-stroke-survivors/ (6)

https://www.stroke.org.nz/sites/default/files/inline-files/Your%20Guide%20to%20Exercise%20after%20a%20Stroke%202017%20%281%29.pdf (7)

https://www.scielo.br/j/anp/a/JL9mMt9QKWp8g85shXndnWs/ (8)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266302/ (9)

https://www.neofect.com/us/blog/the-ultimate-guide-to-stroke-exercises (10)

https://strokerecoverybc.ca/wp-content/uploads/2011/11/GRASP_All_3_levels11490.pdf (11)

https://ninkatec.com/nutrition-and-fitness-for-stroke-recovery/ (12)
Seek out a qualified rehabilitation counselor.
Is Ipsihand covered by insurance? Not yet
How much is Ipsihand? The Neurolutions IpsiHand system is a qualified medical expense under a heath savings account (HSA) or flexible spending account (FSA). Please verify youreligibility by checking with your individual physicianNeuroplasticity in Stroke Recovery

My Medication Rights | Medication Instructions that Patients Understand

Tell the FDA you want a Patient Friendly Format that’s standardized, with instructions that are clear, easy to understand, and proven to help patients comprehend important medication information. Now is the time to act. 

Proposed Formant

FDA Format

Which one would you read?

TAKE ACTION

My Medication Rights | Medication Instructions that Patients Understand

How can you use active listening to help your patients

Active listening is a cornerstone of effective patient care. It goes beyond simply hearing words; it involves a genuine effort to understand the patient's concerns, emotions, and perspectives. In healthcare, where accurate diagnosis and empathetic communication are crucial, active listening builds trust and fosters a strong patient-provider relationship. It's not just a skill; it's a manifestation of respect and compassion, essential for delivering patient-centered care. As a healthcare professional, mastering active listening is akin to unlocking a door to better patient outcomes and improved overall well-being.

How can you use active listening to understand healthcare policy more comprehensively?