November 2018
Northerners- welcome back, fall weather is here!

Hello everyone!  

It is a bit past due for me to communicate with all of you.  I appreciate everyone's patronage and we look forward to keeping you healthy and strong this season.  I am sure many of you have had your flu vaccines; if not, contact my staff and arrange a vaccination appointment soon. It is offered as part of your membership. Sorry coupon shoppers, unlike CVS or Publix I won't be offering you a coupon to entice you into the office <smile>. 

A quick business update is to inform everyone that due to the success of our membership practice model, I have placed a physician ad to our local medical society bulletin and various other avenues.  I am approaching full capacity for my capabilities and expected level of service for my patients.  I am planning to add doctor power so we can continue and expand this exceptional way of practicing medicine in Fort Myers. 

The business, political and health benefits landscape is changing for the better.  Due to my involvement as president of the Independent Physicians Association of Lee County, I have been approached and engaged with individuals on the health insurance, health sharing and employer/employee benefits side of the healthcare market.  There are benefits brokers and third party administrators trying to move us to more cost effective and fiscally appropriate models of helping people mitigate damage from unexpected health expenses.  I welcome their efforts and for the past 3 years have anticipated this opportunity for patients and doctors. 

Recently our IPALC association moved to dissolve and in place of this entity we have now started a regional chapter of the Free Market Medical Association called the Florida Southwest Chapter of the Free Market Medical Association.  Come like us and join our facebook page.    I will link free market and other newsworthy health information on this page. 

If any of us still feel that socializing healthcare (Medicare for All) is a worthy cause, I would like to point out Venezuela as the real life example of this heartfelt but untenable method of political economics.  Our practice model is a prime example of what a free market can accomplish in regardings to value and choice in the market.   It is only a matter of time that my peers and others in health care will be forced into the free market.  People will walk with their feet, votes  and their pocketbooks as the present bloated, status quo tries to force them into "mandated" portal messaging for appointments and other blind, non caring policies and procedures for accessing your doctor or hospital. 

Dispensary and Prescription Update

This past weekend (October 21), I reviewed the dispensary utilization.  It appears this program is a very popular value-added service for our patients.  Personally, I know I love the convenience of our dispensary.  The average monthly dispensed prescription medications provided to our patients is 236!   On a Direct Primary Care doctors Facebook page I noted that some new physicians are planning to offer 6-8 "commonly" prescribed generics.  From our experience these doctors are going to find very quickly that they will need to purchase and offer tens of different prescription medications. 

The news remains loaded with  ongoing examples of how the health insurance companies are leveraging entities called Prescription Benefit Managers to arrange "pay for play" exclusive contracts to get lower priced medications- FOR THE INSURANCE COMPANY.  Unfortunately this isn't helping the customer patients get less expensive medications at the point of dispensing.  It appears these lower prices achieved stay "in house" with the PBM or the health insurance company itself. 
Years ago I began to understand that insured patients (especially Medicare) were paying out of pocket copays that exceeded cash prices for generic medications.  Additionally, the insurance pool is getting charged additional multiples for these same medications.  This observation coupled with the PBM's refusing my cost effective generic prescription recommendations is when I decided to take action for all of us.

It isn't an easy task to set up a proper dispensary. Patients are saving a lot of money with this service -often significantly defraying the cost of membership in the practice. This is a tremendous value that I am proud to offer our patients. 

There were unexpected costs included monthly software payments, expensive printer functions and labels and of course staff time.  We are dispensing medications at wholesale cost (exactly what I am paying to get the pills in the door)  plus a standard fill fee which covers these additional expenses.  

Another important and big news achievement is working with the Elation record system and updated pharmacy platforms, I am now able to electronically fulfill controlled substance prescriptions.  This means we won't need to inconvenience people with counterfeit-proof printed prescriptions any longer.  

Finally, new regulatory legislation for Florida (based upon additional national recommendations) will result in some changes in procedures in the office as it relates to controlled substance prescriptions.  If you are a scheduled/controlled prescription we have to check a state website for any controlled prescriptions at office visits and prescription refill requests.  Additionally we will be screening urine for drug compliance and safety.  This is for patient safety and I appreciate everyone's cooperation in this area. 
The Free Market Approach to Health Benefits
I recently have posted to the Doctor K ordonowy social media posts about a novel and potentially useful benefits association   With the help of Sadera Health Sharing, MPowering Benefits Association  incorporates many cost saving and health improvement incentives while maintaining MEC required insurance with HSA qualification.  While this program isn't allowed to be offered to Medicare patients and it may not be right for everyone, I truly believe this could be useful to many individuals and small business owners who have found health insurance coverage unattractive and unaffordable. 

Close-up Of Doctor Holding Mobile Phone With App For Health
Alternative to Traditional First Dollar Health Insurance

The link below shows you a programed priced at a discount for using the DPC membership model (my practice) option.

Health Sharing Is Another Alternative To Health Insurance 

In March of this year I submitted a review as well as proposals to improve health costs.  We don't need more support for or subsidies to the present status quo health insurance market.  We need competition and alternatives to the present low supply, high cost access that we are suffering from. 

Here is an excerpt from the beginning of the piece linked above: 

" It is fear of becoming bankrupt from an unforeseen health care event and its unexpected costs.  The prospect of short term financial difficulties is what keeps individuals "strapped to" the first dollar insurance model.   This course of inquiry leads to an additional question (and an answer).  What if people had the tools to allow alternative high cost event payment with terms allowing repayment at manageable costs over time?   This is what credit is all about.  The average person can easily arrange a car loan.  Why can't we have access to capital for a health consumption event?"

In my blog policy submission I mentioned Health Sharing as one of the current competitive alternatives to the UnAffordable Care Act that our federal government passed as the "law of the land".   I also made a unique recommendation that the credit industry openly compete with the health insurance industry to help free people from the constraints of health insurance networks and behind-the-door deals forced under the leverage of large hospital corporations, insurance and big pharma. 

There are many physicians trying to help guide policymakers towards rules that will make Health Saving Accounts available to all tax paying citizens regardless of whether they have an health insurance policy, health sharing or just paying the old fashion way for their medical expenses.  Why should only those buying health insurance benefit from the tax deferment that a health savings account allows?  Also why are Medicare beneficiaries kept trapped in an ever worsening health care system and payment method?  Imagine the possibilities if a HSA deduction was available to Medicare patients!

Carrot-Ginger Soup

This is a low glycemic hot fall/winter soup that is sure to be a hit for lunch or as part of your evening meal.  The 21 Day Sugar Detox Cookbook is a great way to get yourself off your high carb/addictive diet if you are in this trap. 

Dill replaces the parsley in this carrot ginger soup

  • 1 tablespoon butter or other cooking fat 
  • 1 celery stalk diced (1/2 cup)
  • 1/2 small yellow onion, diced (1/2 cup)
  • sea salt and pepper
  • 1 teaspoon minced garlic
  • 1 teaspoon minced fresh ginger
  • 6 extra large carrots, chopped (4 cups)
  • 3 cups bone broth chicken or vegetable broth
  • sprigs of dill for garnish 
  • Optional for "kick"- dry chile flakes 1/4 teaspoon, or chile garlic sauce (1/2-1 teaspoon)
In a large pot and over medium heat:
  • melt the butter/cooking fat
  • cook the celery and onion with a dash of salt and pepper until tender and translucent (5 minutes) 
  • stirn in the garlic and ginger and cook for one minute 
  • add the carrots and bone/vegetable broth
  • reduce heat to medium low and simmer until carrots are soft through (10 minutes) 
  • Transfer all to a blender or food processor in 3-4 small batches. If blender used you will need to vent the process by removing the "valve/center" of the cover and avoid splatter with a clean towel
  • Transfer your batches back to the pan and season further if desired, stirring to consistency.
Serve in soup bowls and garnish with dill.  Enjoy!

Raymond Kordonowy MD 

Call us for you medical needs.