Recent research sheds light on our early ancestors, illuminating aspects of Neanderthals dental plaque. At the University of Liverpool two researchers with tenacity have claimed to sequence DNA from calcified calculus. They have worked at this project for over many years and only recent improvements in ancient DNA analysis have opened up new insight to diet and eating habits including possible self-medicating for a tooth abscess. Stories like this are why anyone can love history! http://www.nature.com/news/neanderthal-tooth-plaque-hints-at-meals-and-kisses-1.21593
I believe widely dispersed smaller primary care medical practices hold a big part of the answer for a lower cost and access solution for America health care. A recent article lays out how the model for the physician and practice would work and IS working. The article presents in part Linnea Meyer, MD, a physician in Boston, who uses the direct pay model. Dr. Meyer states “This kind of practice is why I went into medicine, and that feels so good.” Quite different from what you usually read about physician’s unhappiness with contemporary medical practice. Dr. Meyer has patients paying her $25 to $125 a month depending on age to cover their primary care. It is called direct care and she gets to focus on the care of her patients. “Getting that third party payer out of the room frees me up to focus on patient care” she says. A substantial part of the recent riveting health care debate focused on the costly nature of various government programs and also how to help all citizens have affordable primary care. Here is one part of a possible solution: 1) focus policy on enabling smaller primary care practices (not on encouraging ever larger physician – hospital group practices), 2) foster for those citizens meeting needs based criteria direct to physician financial payments made on the patient’s behalf. Read: In a Direct Primary Care Practice, It’s Just the Doctor and Patient, by Melinda Beck, 2/27/2017 Wall Street Journal
In my view, one of the most important parts of a vital life, at any age, is staying mentally engaged. For those people that reach the point of retiring from their chosen career or job many have what has been called, unretired brains. These seniors seek intellectual stimulation and new knowledge and undoubtedly include many with advanced professional training, doctors, lawyers and professionals of all kinds. In the recent article, Seniors Seek Intellectual Buzz, by Leslie Brody, WSJ, 3/10/2017, Henry Nusbaum a senior learner at age 103 goes and audits a college class on Medieval History, sitting in the front row no less! He is a prime example of a deep interest in learning. The article goes on to indicate the interest in more formal endeavors noting that the National Center for Education counts 66,000 people over age 64 enrolled in degree granting postsecondary institutions in 2013. The article notes some universities are responding and providing access to audit classes and the library. But you can be sure that baby boomers with advanced education will press for more meaningful engagement. One option: not just traditional auditing a course here or there or the other extreme of high commitment full on enrollment, but a mid-ground with a formalized structured certificate programs in various college departments to give a new lease to later life.
As the PPACA repeal, replace or something else debate continues, I’ve been listening for voices that advocate first for starting any change with an assessment of what would meet real people’s health care needs today. There is a lot of concern about access and more concern for those who face immediate to chronic conditions, for aging issues,
concern for those who might lose insurance and more. But at this juncture I don’t hear much on starting anew with an overall design to manage a very large system of health care. Right now there are lots of piecemeal policy and funding discussions that surface from various sources and also legislators continuously air their views on government’s role. But, a back to basics assessment based on needs and coupled with a coherent business plan market based design, that seems to be missing.
Debt is approaching an all-time high. According to a recent report by the Federal Reserve Bank of New York and reported by the Wall Street Journal, total household debt climbed again in the last three months of 2016 and is nearing the high of $12.7 trillion. Consider this a warning to closely monitor patient financial arrangements. Also doctor’s should carefully watch their own family and business debt. The last time debt approached this level the whole banking and financial sector was adversely impacted, that was 2008.
On Friday March 10th at 7pm CST there is a webinar panel titled “Evaluating the Dental Products Panel of the US Food and Drug Administration Scope and Effectiveness” hosted by Loyola University of Chicago School of Law Institute for Health Law and Policy. I am moderating, the panel participants are:
- Dean Joel Berg, University of Washington,
- Professor Jon Suzuki, Temple University Kornberg School of Dentistry, and Chair of the Dental Products Panel, and
- Professor Marjorie Jeffcoat, University of Pennsylvania Dental School and a Dental Products Panel member and past Chair.
Complementary CLE credit is being offered by Loyola for attorneys attending the webinar.
If you are interested, please register in advance. Webinar attendance is Free: http://luc.edu/law/centers/healthlaw/events/seminar_series.html.
Login Information: Once you are registered the only information you will need to login on March 10th to the webinar is your name and e-mail address. Here is the link to use on March 10th for the webinar: http://tinyurl.com/loyolahlss . As a suggestion, you may find Firefox or Internet Explorer is helpful to log in.
You are welcome to message me or call 800-999-8121 if you have comments or questions.
Randall K. Berning, JD, LLM
Given the still rampant scourge of childhood carries in some populations a break through is needed that is both cost and time effective. One possibility to slow child decay may be present in the form of flavored tablets containing live probiotic bacteria. A study conducted from 2012-2014 by researchers at the University of Copenhagen and reported in BMC Oral Health, Effect of Pr
obiotic Chewing Tablets on Early Childhood Caries – A Randomized Controlled Trial seems to offer some hope, although the long term effects on the health of the child of administering the probiotic is not known. The study was published September 24, 2015. Interesting to note that the tablets were from a US company Oragenics of Tampa Florida.
Doctors nearing retirement take note, health care costs are rising. In recently available research, the Retirement Health Care Cost Estimate by Fidelity Investment, as discussed by PlanAdviser, a healthy couple planning to retire this year at 65 should anticipate spending $245,000 over the course of their retirement. Why the increase? Longer life expectancies and increases for care and prescriptions.
Superb mini article, Dentist to the Dead, Scientific American, October 2015,
opens a window on the work of Christina Warinner, an anthropologist at the University of Oklahoma who studies Vikings and Stone Age farmer’s teeth. In my view, this is an article to copy and provide to patients for fun and education! Her work and that of other scientists indicates that fossilized plaque is “the richest source of DNA in the archaeological record.” According to the work done to date, plaque “carries between 100 and 1,000 times more nucleic acids per milligram than another other known source.”
Randall Berning is President of Berning Affiliates, Inc., a publisher, consultant and health care attorney. He has provided dentists and dental specialists with publications and specific practice plans to implement vision, practice growth, profitability and practice transition for more than 30 years. His current focus it turning many of the forms and materials he has used in his practice into products so that doctors and their advisors can gain from his successful experience. Go to the BerningAffiliates Webstore www.berningaffiliates.biz to see the products. Mr. Berning is the co-author of two ADA top selling publications Associateships, A Guide for Owners and Prospective Associates and Valuing A Practice, A Guide for Dentists, the co-author of AAO materials on valuation and practice financing and the Editor and Publisher of The Smart Doctor CEO Interactive Newsletter TM and the Expert Series for Dentists TM. A frequent speaker, he has presented at numerous Annual Sessions. He is past Adjunct Professor of Dental Jurisprudence and Director of Practice Administration at the University of Illinois, College of Dentistry and adjunct faculty at UCSF School of Dentistry and the University of Maryland Baltimore College of Dental Surgery. Prior to entering private practice Mr. Berning served as an Assistant Attorney General for the State of Illinois.