BMN Blog

AUG 14
Percutaneous Left Atrial Appendage Occlusion in Patients with Atrial FibrillationBy Nirman Bhatia, MD, FACC, RPVI Interventional/Structural Heart Cardiologist with HeartSouth Cardiovascular Group, PC in Clinical

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.

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AUG 13
The Benefits of Occupational and Physical TherapyBy Melody Cook, OT/L with Alabama Bone & Joint Clinic in Clinical

What is the importance of occupational and physical therapy rehabilitation? Each discipline has its own unique benefits for clients of all age ranges with varying diagnoses and various settings. A common misconception regarding therapy in general is that treatment will elicit pain and discomfort. However, one of the primary goals of both occupational and physical therapy is to control pain in order to increase daily function and skill.

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AUG 07

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.

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JUL 30
EHR in the Cloud? – Make sure the I’s are Dotted and the T’s are CrossedBy Curtis Woods President at Integrated Solutions, LLC in Technology

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.

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JUL 26
PIRC helps communities navigate mental health care system By Jesse Tobias C. Martinez Jr., M.D. UAB Assistant Professor and Medical Director, Psychiatric Intake Response Center and Consultation-Liaison Psychiatry at Children’s of Alabama in Clinical

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.

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JUL 25
Growing Embryos in the VaginaBy Beth A. Malizia, MD with Alabama Fertility Specialists in Clinical

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.

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JUL 23
The Hippocratic Oath and the Fiduciary StandardBy Jeris Gaston, CFP® with Bridgeworth Financial in Business

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.

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JUL 18
ConcussionsBy Katherine Weise, OD, Professor of Optometry Director, Pediatric Optometry Services at UAB in Clinical

“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?

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JUL 11
Combatting fraud in the Medical IndustryBy Sarah Propper, CPA with Pearce, Bevill, Leesburg, Moore, P.C in Business

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.

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JUL 10
How connectivity Powers Rural Care and TelehealthBy Theresa Dudley, Healthcare Programs with Spectrum Enterprise in Technology

One of the greatest challenges facing the healthcare industry isn’t a political issue, it’s a geographic issue. What if I told you that approximately 50 million Americans (17 percent of the total population of the US) have limited access to high quality healthcare because they live in rural communities? Rural healthcare has a unique set of challenges including not only geographic but also economic and lifestyle factors.

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JUL 09
Can you go blind from diabetes?By Lindsay A. Rhodes, MD Assistant Professor of Ophthalmology at UAB in Clinical

Unfortunately, yes! Diabetes is the leading cause of new cases of blindness in adults ages 20-74 in the U.S.  African Americans are two times more likely to have diabetic eye disease than Caucasian patients. Despite the risk of vision loss, only about half of people with diabetes follow the recommendation to receive a dilated eye exam every year.

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JUL 03
6 Tips for Dealing with Extreme HeatBy Total Skin & Beauty Dermatology Center in Clinical

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.

 

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JUL 02
Lifelong Limb Preservation: An Update on Peripheral Artery Disease By George Hipp, MD, RPVI with Alabama PVD Center in Clinical

Over 10 million people in the Unites States and over 200 million worldwide have peripheral arterial disease (PAD).1 Critical limb ischemia (CLI), defined as ischemic rest pain or tissue loss resulting from arterial insufficiency, affects approximately 1% of the adult population, or 10% of patients with PAD.2 Further increasing the impact of CLI is the poor prognosis it carries. Major amputation occurs in 33-67% of patients with ischemic tissue loss at 4 years.3,4 Mortality at 2 years in CLI patients is as high as 40%, and appears to be even higher in those with tissue loss. The vast majority of these deaths are due to cardiac events, cardiovascular disease, and cancer, rather than PAD.4,5

 

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JUN 26
Outpatient, and Radial Access Evolution in Interventional CardiologyBy Jan Skowronski, MD with Cardiovascular Associates in Clinical

Where are the old (and not so good) days when a patient with myocardial infarction was staying in hospital bed for a week?

 

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JUN 20
Prostate Cancer: Understanding Your Treatment OptionsBy Bryant Poole M.D. & Andrew Strang M.D. with Urology Centers of Alabama, P.C. in Clinical

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.

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JUN 14
Malware Detection and Prevention: the never-ending battleBy Ron Prevatte, Director of Sales and Business Development with Integrated Solutions in Technology

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

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JUN 11
Front Office Transformation – First Impressions Are EverythingBy Tammie Lunceford, CMPE CPC, Healthcare Consultant with Warren Averett in Business

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.

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JUN 07
Work-Arounds are Jeopardizing Your Patient DataBy Christina Southern with TekLinks in Technology

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.

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MAY 30
Pediatric neurology division continues growth By Leon Dure, M.D. UAB Professor and Director, Division of Neurology & William Bew White, Jr. Chair in Pediatric Neurology in Clinical

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.

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MAY 23
Hepatitis B: Screening in Primary CareBy David M. Fettig, MD, Birmingham Gastroenterology Associates in Clinical

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.

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MAY 22

"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."

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MAY 17
Total Joint Replacement By Daryl Dykes, MD with Alabama Bone & Joint Clinic in Clinical

The question is often asked, at what point should a patient and his or her physician begin to consider a total joint replacement?

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MAY 16
ePHI Safeguards Requirements and Small Practices: What Physicians Need to KnowBy Hayley Scheer, J.D., LL.M. Health Law Attorney, Cabaniss, Johnston, Gardner, Dumas & O’Neal LLP in Regulatory

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.[1]  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[2]) to have the minimum ePHI safeguards, listed below.

 

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MAY 15
Mitral Valve Regurgitation By Hosakote Nagaraj M.D. with Heart South in Clinical

 Mitral valve regurgitation has been described as a very common cardiac valvular abnormality which is under recognized and under treated even in industrialized countries

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MAY 10
Annual Wellness Visits By Carrie Gulledge RHIA, Director of Electronic Health Records and Jennifer Woodward, Director of Operations with MediSYS in Business

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.

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MAY 08
Understanding Pelvic Organ Prolapse By Drs. Nicole Massie and Paula Rookis with Urology Centers of Alabama. in Clinical

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.

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APR 30
Burnout Proof – Healing the HealersBy Lori M. Quiller, APR Director of Communications and Social Media Medical Association of the State of Alabama in Business

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.

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APR 19

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.                                                                                                                                    

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APR 18
Are you sleeping well?By Sunil Goli, MD sleep medicine with Medical West in Clinical

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.

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APR 16

In 2012, I read this 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. 

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APR 04
UPDATE - HHS Proposes New Rule Affecting LGBTQ PatientsBy Rhett Owens, Attorney with Hall Booth Smith, P.C in Regulatory

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.

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APR 03

According to the Ponemon Institute –   - the average cost of a data breach was $3.62 million dollars. This breaks down to $141 dollars per stolen record. International Data Corporation – – 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.

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APR 02

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.

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MAR 28
Atrial Fibrillation Awareness and Progression PreventionBy Macy C. Smith, Jr., MD, FACC, FHRS with Cardiovascular Associates in Clinical

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.

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MAR 27

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.

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MAR 26
Where’s Your Patient Data Hiding?By Robbie Morris, Teklinks in Technology

They were surprised, and you likely be will, too. Of the hundreds of healthcare organizations I’ve helped document HIPAA and meet compliance requirements, most are unaware that their Patient Health Information (PHI) is exposed in some way. If a cyber attacker took advantage of this situation, it could cause damage to your patients, bring giant HIPAA fines, and a loss of reputation.

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MAR 22
Ocular Melanoma: What You Don’t Know CAN Hurt You!By Elizabeth A. Steele, OD, FAAO with UAB Eye Care in Clinical

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.

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MAR 22
The Tax Cuts and Jobs Act: An Overview for PhysiciansBy Mark Baker, Principal, Jackson Thornton CPAs and Consultants, January 9, 2018 in Business

The new tax reform law — commonly referred to as the "Tax Cuts and Jobs Act" (TCJA) — is the most significant tax legislation in decades. Although the law was passed only a few weeks ago, the impact on the economy and business outlook cannot be overlooked as the stock market rally continues and both individuals and businesses appear the most optimistic in quite some time.

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MAR 21

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.

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MAR 20
Affordable Care Act UpdateBy Leonard J. Nelson, III, Professor Emeritus Cumberland School of Law Faculty Member, M.S.L. and LL.M. programs in Health Law and Policy in Regulatory

At the core of the Affordable Care Act (ACA) is the three-legged stool: (1) insurance reforms; (2) the individual mandate; and (3) premium and cost-sharing subsidies. Removal of any one of these legs could destabilize the ACA. The ACA established insurance marketplaces in every state to provide access to ACA compliant private health insurance coverage (Qualified Health Plans) in the individual and small group markets. The ACA provides premium subsidies on a sliding scale for persons with incomes up to 400% FPL for the purchase of an individual policy on the marketplace exchange. It also provides cost-sharing subsidies for persons with incomes below 250% FPL. Prior to the implementation of the ACA, manual rating was typically used by insurers for rate-making in the individual and small group markets and exclusions from coverage for pre-existing conditions were common. Age-based rates were typically 5:1. The insurance reforms in the ACA are largely directed at the small group and individual markets (e.g., guaranteed issue/renewal, no preexisting condition limitations, adjusted community rating capped at a 3:1 ratio for age). Standardization of benefits is achieved by requiring coverage for ten essential health benefits (EHBs) and certain preventive services which in the latter case services must be provided without cost-sharing.

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MAR 19
Patient Satisfaction- What Is It Worth?By Tammie Lunceford, CMPE CPC with Warren Averett in Business

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.

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MAR 15
Understanding AllergiesBy ENT Associates of Alabama in Clinical

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.

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MAR 14
Confidence in the face of disaster – Are you ready?By Drew Braden Senior Technology Consultant with Keep IT Simple in Technology

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?

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MAR 13
It’s Not Just Stress: Removing the Cloak of AnxietyBy Minerva Amputch Young, LPC, NCC with West Neuropsychology, LLC in Clinical

In a world of rapidly accelerating technology, our lives have become a 24hr sprint of endless tasks to be completed within a certain timeframe. Doctor offices are inundated with patients many young in age presenting symptoms such as high blood pressure, racing heartbeat, headaches, chest pain, random sweats, insomnia, and gastrointestinal problems. With the increased volume of patients and the demanding time constraints experienced in physician offices, these physical symptoms are often treated individually. The physician may prescribe medication, make recommendations on possible lifestyle changes, yet the symptoms remain. Effective treatment has to go deeper. These patients could be simply suffering from stress or they could be dealing with a more problematic subset of mood disorders: Anxiety Disorders.

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MAR 12
Medical Billing Practices in the Modern Era of Medicine By William A. "Drew" Ellis, Esq. at Cloud Willis & Ellis, LLC in Regulatory

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.

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MAR 09
Calmness in the stormBy Patrick Mullins AAMS® with Raymond James / Private Client Group in Business

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.

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MAR 06

The assessment of patient compliance is very difficult. Many patients may not want to disappoint their physician and will not be completely accurate about their degree of compliance. Other patients are not able to accurately evaluate or do not know their degree of compliance. In one study, 10% of patients reported that they were 100% compliant with their medication use. Using pill count methods, however, the use of the prescribed medications ranged from 2% to 130% of the prescribed pills.

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MAR 06
To Fuse or Not to Fuse: The Argument for Spinal Disc ReplacementBy Christopher Heck, MD-Spine Surgeon Southlake Orthopaedics Sports Medicine & Spine Center, PC in Clinical

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.

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MAR 05
Cryptocurrencies, Blockchain & the Value of TrustBy Matt Dennis, National Bank of Commerce in Business

Over the last year or so, cryptocurrencies and blockchain technology have grabbed the attention of global markets and its participants.

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FEB 27
10 Commandments of Gastrointestinal HealthBy Christopher P. Shaver, MD, Birmingham Gastroenterology Associates in Clinical
  1. Control all of your “other” medical conditions.  Many chronic diseases negatively influence your intestinal tract: think poorly controlled diabetes, undertreated cardiovascular diseases, thyroid disorders, obesity, and so on.  There is a synergistic relationship between intestinal health and your other organ systems. 
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