Market your practice

Practical advice

Is the kiwi a magic fruit?Read what makes

them special

When medicine meets artHow one doctor mixes science and emotion

Med MonthlyMay 2011 | Vol. 1 Issue 1

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Want to know more?Call John Nowak at 1.704.681.1703, or e-mail john.nowak@bankofamerica.com. Mention Priority Code ADMJN11A. You can also visit us online at www.bankofamerica.com/practicesolutions.

* All programs subject to credit approval and loan amounts are subject to creditworthiness. Some restrictions may apply.** Banc of America Practice Solutions may prohibit use of an account to pay off or pay down another Bank of America account. Bank of America and Banc of America Practice Solutions are trademarks of Bank of America Corporation. Banc of America

Practice Solutions is a subsidiary of Bank of America Corporation. © 2011 Bank of America Corporation

At Banc of America Practice Solutions,, you can rely on our industry leadership. Our financing professionals understand the challenges of managing and growing a practice. Let us help you succeed.

◆ New office start-ups — get started with up to 100% project financing,* including design, construction, equipment and working capital.

◆ Practice sales and purchases — our team of experts can provide the experience and industry knowledge you need for buying and selling.

◆ Business debt consolidation**— to improve your cash flow.

◆ Office improvement and expansion — remodel, refurbish, or expand.

◆ Commercial real estate — choose from a suite of comprehensive real estate loan options to buy, refinance,* or relocate, terms up to 25 years.

◆ Equipment financing*— choose from a variety of options and flexible terms tailored to meet your needs.

What kind of financing do you need?You’ll find it here – and much more.

Product Features:*

◆ Terms up to 15 years on:

– Practice sales and purchases

– Office improvement and expansion

◆ Loans up to $5 million

◆ Flexible repayment options

04.11_Nowak_AllProducts_Med_2.indd 1 4/13/11 9:54 AM

contents

30

16 MARKETING YOUR PRACTICE Practical advice from a doctor who’s done it

18 ART IMITATES LIFEA doctor releases his emotions through painting

20 ACCOUNTABLE CARE ORGANIZATIONSNew rules on ACOs released

22 DENTAL PRACTICE BLOGGINGMarketing advice for the tech savvy

24 CAREERS IN HEALTH CARE MANAGEMENTWhat they make, how the make it and how you can make it too!

22 DO’S AND DON’TS Of medical practice marketing

34

research and technology8 TECHNOLOGY AND MEDICINE9 PHARMACEUTICAL RESEARCH 10 CHEMICAL SUBSTANCE LAWS

finance12 PHYSICIAN LOANS14 HEALTH RISKS OF IDENTITY THEFT

healthy living26 BENEFITS OF TAI CHI29 MEDICAL ALERT SYSTEMS

the kitchen30 IS THE KIWI A MAGIC FRUIT?33 TEA, FOR A HEALTHY DIET

the arts34 SOOTHING THE MIND THROUGH ART

features

in every issue6 editor’s letter36 top nine

38 for sale42 write on

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editor’s letter

I can’t think of a better time of year to launch a new magazine than spring. As all of the trees and flowers slowly come to life it is the per-fect time to introduce a new project. We are so thrilled here at Med

Monthly to be bringing a completely new way of thinking and reporting on what is exciting in the medical and health care industry. Each month we will be profiling interesting physicians, innovative practices and cut-

ting edge technol-ogy.

This month in our premier issue we have high-lighted the incred-ible talents of Dr. M. Osman. In addition to being board certified in Family Practice and Geriatrics Dr. Osman is an accomplished artist whose work has been profiled in Australia, France and Africa as well

as in galleries throughout the U.S. His success as an artist is evident in his work and his personal story is compelling in its own right.

Our writers here at Med Monthly will use their vision and creativity to bring stories from triumph to technology in the medical field. We are thrilled to present Alice Osborn, who joins our staff and brings years of writing and editing experience to our team. Alice will be writing about everything from hot topics to cool doctors and everything in between.

This month’s issue highlights some healthy living tips we could all use, as well as how to blog about your dental practice and information on protecting children from harmful chemicals. Next month we will focus on the importance of marketing your practice, how to make it more profitable and using the latest trends in social media.

We are enthusiastic about providing an informative and exciting issue for our readers. I personally want to thank everyone who has contrib-uted to make this premier possible and welcome our valued readers!

Enjoy our first issue,

Managing Editor

Suzy Buck

Med Monthly

Publisher

Managing Editor

Creative Director

Contributing Editor

Contributors

Advertising Director

Philip Driver

Suzy Buck

Courtney Flaherty

Alice Osborn

Ashley Austin Kimberly LicataShauna Smith Duty

Bill Turner

Med Monthly is a national monthly magazine committed to providing

insights about the health care profession, current events, what’s

working and what’s not in the health care industry, as well as practical

advice for physicians and practices. We are currently accepting articles to

be considered for publication. For more information on writing for Med Monthly,

check out our writer’s guidelines at medmontly.com/writersguidelines.

May 2011

Subscription InformationSubscriptions are $69 for one year or $89 for two years. Individual copies are $5.95 each. To subscribe call 919.747.9031 or

visit medmonthly.com

P.O. Box 98313Raleigh, NC 27624

medmedia9@gmail.com

Online 24/7 at medmonthly.com

6 | MAY 2011

Philip Driver

Suzy Buck

Courtney Flaherty

Alice Osborn

Ashley Austin Kimberly LicataShauna Smith Duty

Bill Turner

8 | MAY 2011

research & technology

With technology advancing at such a rapid rate, the medi-cal field has seen tremendous

improvements to the equipment used in surgeries. Medical facilities around the country, such as the Dwight Illinois hospital, have seen that the new kinds of equipment are easier to use, and often have been created to continue to reduce the side effects that patients may experience after surgery - such as irritation or infection. Physicians are being trained daily on new types of equipment that will advance medicine as well as work alongside medical staff to guarantee the best results possible.

One major innovation that has been used in hospitals lately is a machine called the da Vinci robot. What exactly is this robot? How does it work? Well, the robot is used primarily for prostate surgery. Often, open surgery to remove a malignant prostate can be uncom-fortable - requiring a large incision and can lead to a substantial amount of blood loss. With the new, state-of-the-art robot, a lot of these drawbacks can be fixed. The robot is operated by the surgeon and it is less invasive than typical prostate surgeries. With the robot and surgeon combination, a more precise result often occurs. And instead of many drawbacks, patients often see less pain and blood loss. Since it is not open surgery requiring a large incision, the scarring is far less significant and the risk of infection is lowered. All of this will result in a shorter time spent at the hospital as well as a speedy recovery!

Of course, you will also be treated by the best doctors and nurses around!

The great thing about these advances in technology is that it will enhance the terrific skills that surgeons and doc-tors learn throughout their training, and continue to learn on the job. It is combining the best of both worlds to give patients the absolute best results. The amalgamation of these two will only serve to advance the treatment of patients in all areas of the medical field. Surgeons can use their advanced skills and knowledge along with the robot’s capabilities to operate and possibly give patients shorter recovery periods, a positive situation for all involved.

And across the country in places such as Dwight hospital, technology will continue to advance the medical field along with surgeons and doctors in every field. And regardless of where you live, these impacts will be felt by

everyone. Advances in medicine only increase the chances of successful outcomes to surgeries and other types of treatment. For all involved, these advancements are very promising and exciting.

And with hospitals nationwide simi-lar to Dwight hospital either using or considering the use of a da Vinci robot and other technological advancements, you will know that you are in good hands the next time you visit your local hospital. And with hospitals and facilities across the US, your health and comfort come first. From the state-of-the-art technology to every staff member - the patient comes first.

— Courtesy of EzineArticles.com/?expert=Alice_Lane

Technology and Medicine Advancing procedures and recovery

By Alice Lane

MEDMONTHLY.COM | 9

Why does drug research cost so much money? That is the question on the minds of al-

most everyone, from patients and doc-tors to the media and the government. Over the last several decades advances in pharmaceuticals have transformed health care on many different levels. Today, more health problems than ever before can be prevented, cured, and even managed for years with the help of prescription drugs. In fact, for some people, the use of prescription pharma-ceuticals can even prevent even costlier health care in the long run.

With more than 90% of senior citizens and almost 60% of

non-elderly adults needing prescription medications

on a regular basis, the pharmaceutical

industry is boom-ing. However,

only a modest part of the total health care spend in the United States relies on medications. Despite this, the cost implications of drug research and health care loom over the wallets of the general public, insurance companies and the government alike.

The drug industry’s profits over the years have become fodder for some of the most heated debates to date. In fact, the pharmaceutical industry is one, if not the, most profitable industry in the country. So, why is this industry boom-ing and why does research and develop-ment cost so much? There is no simple answer except stating that several factors have come to influence the increased spending on drugs and drug research.

The primary reason is the complex-ity of drug discovery and regulatory approval. Drugs often take anywhere from 4 to 20 years to go from cocept, to execution to clinical trials to regu-latory approval and market launch. The process is excruciatingly slow and expensive. Only one out of thousands of drug concepts and early trials actually makes it to market. On top of that even those that make it to market have to be recalled at times, resulting in major

losers for drug companies. These reasons drive up drug costs.

Also, over the last decade the demand for prescription drugs has increased exponentially

compared to the population. This means that with the devel-

opment of more medications, the demand for each drug rises. With

more treatments available it only makes sense that this will happen. This

increase in drug options has influenced pharmaceutical companies to compete and develop alternate options for their consumers - the patients.

The cost of drug research is also influenced by the types of prescrip-tions written. Because most of the more popular medications are newer, they are also higher priced. These newer, more expensive drugs often replace older, cheaper solutions. With the develop-ment of these new drugs also comes price hikes in the retail sector.

The cost of drug research is also affected significantly by the advertis-ing and marketing dollars spent. After years of trying to create a drug and get approval to market to customer, pharma companies must go all out to convince customers of the benefits of the drug. Such propaganda often takes years of advertisements in mainstream channels to establish a drug in the market and recoup development costs. Substantial investments are made on marketing to the doctors and patients alike. These marketing schemes will directly affect patient demand and physician usage. Along with branding of these drugs, patent laws also contribute to the cost.

— Courtesy of EzineArticles.com/?expert=Erick_Coval

Why does big pharmaceutical research cost billions?By Erick Coval

ABPS American Board of Physician Spe-cialities, is the leading provider of specialized medical board cer-tifications for physicians such as Emergency Medicine Certification.

research & technology

10 | MAY 2011

The U.S. is not doing enough to protect kids from exposure to potentially dangerous chemicals,

pediatricians said in a new statement released today.

The policy paper from the American Academy of Pediatrics explains that a

law meant to inform the public about the risks of different chemicals, and to give the government the right to intervene to keep dangerous chemi-cals off the market, has largely failed to achieve those goals.

 And, writes Dr. Jerome Paulson,

part of the AAP’s Council on Envi-ronmental Health, the consequences of that may hit kids the hardest, and in unpredictable ways.

 “Children are not little adults,” Paulson, of Children’s National Medical Center in Washington, D.C.,

By Genevra Pittman

The American Academy of Pediatrics says that a law meant to inform the public about the risks of chemicals has largely failed to achieve its goals.

Chemical substances need stricter laws, pediatricians say

research & technology

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told Reuters Health. “Their bodies are different and their behaviors are different. That means that their ex-posures to chemicals in the environ-ment are different, and the way their bodies (break down) those chemicals are different.”

 Kids may be especially vulnerable to chemicals during important periods in development, when their brains and bodies are changing quickly, Paulson added.

 He said the goal of the report is to include the voice of pediatricians in current discussions about the need to update the Toxic Substances Control Act, passed in 1976 with the intention of protecting the public against exposure to hazardous chemicals.

 That law has only been used to regu-late five chemicals or types of chemicals, Paulson writes.

 That’s because it gives the companies that make chemicals an easy out, accord-ing to the report, not requiring them to research chemicals for safety before those chemicals go on the market.

 And without safety data, the En-vironmental Protection Agency can’t prove that any of the 80,000 chemicals used in the U.S. are risky enough to require regulation.

 Paulson said that even without more stringent laws on chemical use, the lack of information about just how risky different chemicals are makes it hard for people to avoid those poten-tial risks.

The reality is, we live in a chemical world, and some of them are benign and some of them aren’t, and we don’t know” which are and which aren’t, Paulson said.

 “The reality is, we live in a chemical world, and some of them are benign and some of them aren’t, and we don’t know” which are and which aren’t, Paulson said. 

“It makes it impossible for us to understand what people should do to try to protect themselves or their children.”

Noting recent surges of concern about bisphenol A in baby bottles and flame retardants, Paulson said that “we can’t really deal with these kinds of issues one chemical at a time. We need a better system for screening chemi-cals before they’re introduced into the marketplace, trying as best we can to identify ones that could be problem-atic ... while at the same time monitor-ing those that do come on the market.” 

Michael Wilson, who studies chem-ical policy at the University of Califor-nia, Berkeley, said he was “thrilled” to see the new policy paper and that “it’s

a powerful statement, it’s overdue and also timely.”

 A few weeks ago, New Jersey senator Frank Lautenberg introduced for the second time a bill that would reform the Toxic Substances Control Act.

 “The problems that we’re experi-encing today that are very concrete problems ... all of those problems are going to broaden and deepen in coming years,” Wilson, who is not connected to the AAP’s council, told Reuters Health.

 A spokesperson from the Ameri-can Chemistry Council told Reuters Health in an e-mail that the chemi-cal company representative agrees that the Toxic Substances Control Act needs to be updated, and that the chemical industry is also working with the government to protect kids’ health through other means. 

Reform of chemical laws would “send a whole new signal to the in-dustry” that the health impacts of its products, especially the impacts on vulnerable babies and kids, are just important as their function and price, Wilson said. 

Then, the council pointed out, com-panies would have incentives to pro-duce safer products, instead of having incentives not to measure health and safety risks at all. 

— Copyright 2011 Reuters US Online Report Health News

MEDMONTHLY.COM | 11

Physician loans, commonly called doctor loans, are programs devel-oped by lenders to specifically target

doctors only. They offer a great number of advantages to those who spend a significant amount of time and money to serve society as a doctor. Very often such loans are the only option available to phy-sicians to finance large purchases, such as a house or a car. While physician loans are mostly available to medical doctors, such as Doctor of Optometry, Doctor of Podiatric Medicine, Doctor of Ophthal-mology, Doctor of Dental Science, Doc-tor of Osteopathy, some of them are also geared towards students and residents in these programs as well.

Doctor loans are great when it comes to terms and rates

While loan features differ, depend-ing on state of residency, lender, and credit score of the borrower, they have a lot in common and are most widely used to finance home purchases. Doc-tor home loans feature amounts as high as $750,000 with some requiring no down payment. Mortgage loans with 100% financing also feature no mortgage insurance and low EMI, making monthly payments affordable.

Physician loans An excellent way for doctors to save money on borrowing

finance

By Mary Wise

Doctors loans have ad-vantageous features when compared to generic loans, such as:

● 100% financing - no need for down payment ● Waved loan insurance for qualified candidates ● Flexible credit score requirements ● Option for adjustable rates ● Low EMI

Physician loans at a glance

Mary Wise is a personal loan consultant who has been associated with bad credit loans and has more than thirty years of experience in finances. She has helped a lot of people to ob-tain fast unsecured loans and many other products regardless of their credit situation. If you want to learn more about Personal Loans you can visit her at BadCreditLoanServices.com

Qualification criteria are basic and the benefits are excellent

Once again, physician loans are only available to doctors, and also have some other requirements. Loan applicants need to be U.S. citizens or resident aliens, and general credit score requirement is 720 on FICO scale, even though some lower credit scores may qualify. Apart from excellent loan terms, physician loans offer additional benefits to doctors, such as free check-ing accounts, debt consolidation ser-vices, and free loan consultations.

Doctor loans come with fixed rates as well as in adjustable rate packages. Fixed rate physician loans feature repayment periods from 15 to 30 years. Adjustable rate packages come in form of 3/1, 5/1, and 7/1 loans with 30 year repayment. Special underwrit-ing services are provided and no PMI is required.

Finding physician loans Is a matter of simple Google searchThe internet is the best place to start your search for doctor loans. There is a number of well-known lenders, such as Physician Loans, Carteret mortgage, and Doctor Loan USA. The first two offer loans to students and residents as well as to full pledged doctors. Doctor Loan USA has stricter requirements and only offers financing to doctors with a minimum credit score of 720 with no refinanc-ing options. They do, however, have an excellent reputation and offer great deals on physician loans.

12 | MAY 2011

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14 | MAY 2011

You make healthy choices throughout your lifestyle, from eating a diet low in fat and salt to getting plenty

of rest and 60 minutes of vigorous exercise every day. You even take care of your mental health, avoiding excess stress and spending as much time as possible with loved ones.

But how often do you consider your financial well-being, and how it could affect your overall health if something compromises it?

Financial matters are major stressors for many Americans, especially as the economy continues its slow climb out of recession and unemployment rates remain high. While you work to pre-

serve your physical and mental health, it makes sense to take steps to protect yourself from one of the most disturb-ing and increasingly common types of financial problems — identity theft.

Nearly 12 million people experi-enced at least one attempted or suc-cessful incident of identity theft in the last year, according to the Bureau of

finance

Preventing the (financial) health risk of identity theftGive your financial well-being a workout

‘‘Justice Statistics. Of that group, more than 2 million people rated the ex-perience as severely distressing, the bureau reports. And having damaged credit could make it difficult to secure and pay for the services that help you preserve your physical health.

While nothing can ever guarantee you won’t be a victim of identity theft, you can take steps to minimize your risk. Give your financial well-being a workout with these identity theft prevention tips:

● Monitor your credit report. Many identity theft prevention experts agree that checking your credit once a year isn’t enough. Consider using an identity theft protection product, like ProtectMyID, which monitors your credit, scans the Internet for your information, and alerts you to more than 50 indicators of fraud that may be a sign your identity has been compro-mised. The product also provides $1 million in insurance and assistance from identity theft resolution agents in the event your identity is compromised

while you are a member.

● Shred documents before disposing of them, including pre-approved credit card offers, convenience checks, bal-ance forward checks, and anything that contains personal or financial informa-tion. Going through trash is still one of the most common ways identity thieves gain access to information.

● Safeguard your Social Security num-ber. Never carry your SS card in your wallet, and never have the number imprinted on your driver’s license, personal checks or any other card.

Be wary of who you give the number to. When an individual or company requests your SSN, you do not have to automatically share it. Ask them why they need it and if they will accept an alternate identifier.

● Mail theft is another common tool of identity thieves; that is why ProtectMy-ID alerts members when a change of address action is taken. Use a locked, secure mailbox or P.O. Box for sending and receiving mail. When paying bills, consider paying online through your bank or the creditor’s secure websites.● Do not respond to unsolicited e-mails and never click on a link sent to you in an unsolicited e-mail. Use a fire-wall and up-to-date antivirus software on your home PC and laptop.

Taking care of your physical and mental well-being just makes sense - and so does protecting your overall health and financial fitness by taking steps to prevent identity theft.

— Courtesy of ARA content

While you work to preserve your physical and mental health, it makes sense to take steps to protect yourself from… identity theft.”

16 | MAY 2011

Is there any doubt? Private medical practices are scampering to fight off the medical practice competi-

tion from many sources. The urban overload of doctors doesn’t leave much room for new doctors starting out. Your patients are gradually being ab-sorbed by managed care enterprises.

Destitute hospitals are struggling to survive by buying up or contract-ing local medical practices for more patients. Are you aware of the increas-ing para-medical health care services that are “borrowing” your patients for services you want to provide your own patients? All are actively marketing for

How to market your medical practice without losing time and money

marketing

By Curtis G. Graham

• To keep your practice growing.......if it levels off you are already in the pro-cess of losing the practice---fact! • To remain profitable with income appropriate to your life style.....not easy to do since fees are restricted by law and by you know who.

• Able to hire top quality employees who know your business talents.....it implies

stability and long duration of employment.

• Any business today will fail if marketing is never in-volved.....and medical prac-tice is a true business in every sense of the word.

• Early retirement from medi-cal practice requires more income faster and loads of new patients from the start right up to the end.....how to do that? Marketing.

Reasons for actively marketing your medical practice

Practical advice from a doctor who’s done it

increasing their patient load. Are you?Being a physician myself you’ll

never convince me you aren’t con-cerned about impending solo or even group practice competition!

Whether you realize it or not, if your medical practice isn’t taking in a continuous flow of new patients, your practice is fading out to the competi-tion.

What I know and will tell you• Will make your life as a physician easier and more enjoyable. • Will remove the important financial

practice worries and stresses. • Will enable you to take guiltless time with your family. • Will actually double your practice income in a year.

You see, I’ve been where you are, felt the same stresses, made mistakes that I’d like to go back and fix, and slowly lost my medical practice because of my marketing ignorance. Now, I’m a heap smarter and want to share that wisdom with you.

What marketing strategies will do for you• Build your reputation as a doctor who teaches patients, not just treat them and send them out the door. • Allow you more ways to be available to your patients without compromising your personal time. • Improve your communication meth-ods that save time and effort. • Eliminate the patient perception you run a health care mill. • Re-instill patient trust in what you say and do. • Motivate you to over-deliver con-cerning patient care, which few doc-tors presently take time for. • Learn what your patients need and want from you---and it’s a lot more than just routine medical care. • Discover persuasive ways to get pa-tients to comply with your advice. • Enable you to see more patients more efficiently with fewer no-shows.

MEDMONTHLY.COM | 17

Oh yes, you’re smart. I’m sure all of these advantages have entered your mind at one time or another, but have you taken the time to implement any of them----or do you even know how? Which ones work the best? Ever taken a seminar on medical business func-tions? What about all those benefits that aren’t even mentioned here?

Wake up doctors!Medical school didn’t teach me

anything about the business side of running a medical office business let alone marketing it.......it was by trial and error. A few medical schools are now beginning to catch on to the need for preparing medical students to run their office business and are actually doing something about it. The Univer-sity of Pennsylvania School of Medi-cine is adapting the Wharton Business School into their medical curriculum.

Beyond that is a large field of re-quired marketing knowledge to start, maintain, and profit from any business. But, don’t let that thought scare you away. It’s a lot easier than memorizing all the origins and insertions of every muscle in the human body.

Most medical doctors are quite defi-

cient in knowledge of effective busi-ness practices, let alone the marketing process. How many websites do you see on Google that give you the skinny on medical practice marketing, what to do, and how to do it?

This deficiency becomes glar-ingly obvious when your practice flow decreases along with your monthly income. It’s the same time your medi-cal office staff wants a raise in salary in spite of having less work to do. No-tice how you can’t afford the luxuries you always dreamed of and may have promised to your soul mate and family.

If the statistics are true about “late retirement” of doctors, 90% arrive at retirement with very little money to show for all those years. A well funded retire-ment requires constant marketing of your medical practice all the way to retirement.

My recommendation for prepar-ing to start easy and go hard with your own medical practice marketing projects is to start right here and now to begin to effectively increase your patient load, your practice income, and your personal value to your patients.

When you can afford to invest a rea-sonable amount in the future of your

medical practice just go to my website and latch on to the single program that is designed for professionals in busi-ness and is just the ticket for medical practice marketing.

Discover how much more profitable and enjoyable your medical practice could be with simple marketing strategies. Visit marketingamedicalpractice.com for the newest effective ways to do it.

©Copyright 2008, Curtis Graham, M.D., L & C Internet Enterprises, Inc.,

All Rights Reserved.

Curt Graham, M.D.,is an experienced physician, au-thor, and marketer with expertise in medical practice marketing strategies. He is an expert author and motivator for medical profes-sionals in the business world who need help with improving their business, using marketing. He’s an expert Guide in Health Education on SelfGrowth (the elite website for self improvement), author with EzineArticles, and is published in Modern Physician.

Being available to patients

and improving communication with them are just a few ways to grow your

practice!

18 | MAY 2011

MEDMONTHLY.COM | 19

Three screaming children in M. Osman’s picture“Unheard Agonies” have mouths that are almost bigger than their heads. This African born physician has painted hundreds of haunting images, many of them illustrating painful medical condi-

tions, both physical and mental. They often reflect what life was like in the villages of Somalia where he saw so many people dying of preventable illnesses. He believed he could reduce their suffering by becoming a doctor.

In his words, “What I create communicates with our spiritual, aesthetic, psychosocial aspects and sense of human being…It conveys a multitude of strong messages. They are deep in thought and content. They tell a history.”

His interest in artwork began when he was a child. The eldest of 12, Dr. Osman started designing and making furni-ture out of necessity. An Italian architect once complimented his work, and the notion of becoming an artist took hold. Years later he received a scholarship to the Kalinin State Medical Institute in the former Soviet Union. The National Gallery was across the street from his medical school. Dr. Osman became exposed to the great Russian painters and other classical artists.

Upon completion of his residency, Dr. Osman spent three years in Kenya and then moved home. He became director of a U.N. medical clinic overseeing a 2,000 member staff. However five years later, in 1989, his wife and daughter were caught in crossfire. His four year old suffered cuts and

trauma. Dr. Osman decided to relocate his family away from the intense violence. The Omans escaped and lived in Toronto as refugees. They scraped by on welfare while Dr. Osman finished his qualifying medical exams.

At this point his painting became a form of therapy. Expe-rience with his own patients along with the memories of his homeland gave him inspiration. He uses strong themes, bold strokes and bright colors to help “bring understanding and compassion to [people’s] situations.”

This self taught artist has had many exhibitions in both the U.S. and Europe, such as ones at the African Art Mu-seum and the Pratt Art Gallery. Scotland Yard borrowed some of his paintings for meetings devoted to immigrants. Dr. Osman has also been given several awards and has been published in multiple magazines, including the covers of Vi-sion Magazine and Kaiser Permanente Medical Journal.

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Dr. M. Osmancurrently lives in NC with his family. He owns and prac-tices at Primary Care of St. Pauls, where his paintings fill the walls. To see more of Dr. Osman’s artwork, please visit osmanart.net.

Inspiration abounds in the artwork of a worldly doctor

Edited by Ashley Austin

20 | MAY 2011

At long last, the much an-ticipated federal regulations setting the ground rules for

forming Accountable Care Organiza-tions (ACOs) arrived on the eve of April Fools. ACOs are no laughing matter, however. The regulations and other governmental guidance issued concurrently provide many pages of rules and information about ACOs from the perspective of the govern-ment’s largest payor, the Centers for Medicare and Medicaid Ser-vices (CMS), the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS), the Internal Revenue Service (IRS), the Department of Justice, and the Federal Trade Commission (FTC). If the mention of so many government agencies has not convinced you that ACOs as a concept are of key impor-tance to the Obama Administration’s reform of health care, keep reading to see just how important ACOs may be to health care. ACOs mark the dawn of a new age for health care. Are you ready to seize the day?

ACOs promise change in how health care services are delivered and how they are reimbursed. The de-livery of health care services will be different in that coordination of care, preventive care, disease management, and efficiency of services are of criti-cal importance. Health care providers who decide to participate in an ACO must be “accountable” or responsible for the quality, cost, and overall care

of assigned Medicare fee-for-service beneficiaries. If the ACO achieves savings as judged from an ACO-spe-cific benchmark level and if certain quality standards and reporting requirements are met, then the ACO (and its participants) are entitled to “share” in the achieved savings in the form of bonus payments. For many physicians, ACOs will mean payment for the activities they already do to maximize the health of their patients.

What are some of the rules that the many government agencies are set-ting for ACOs?

Form of ACOs ACOs will not all look the same

and could take the form of various structures, from heavily integrated delivery systems, networks of individ-ual practices of ACO professionals, joint ventures or other arrangements with hospitals, among others. The rules discuss certain organizational requirements for the ACO governing body and other areas of the ACO.

Size of ACOsThe size of an ACO is driven in

part by the requirement that an ACO manages the care of at least 5,000 beneficiaries. Many estimate that a successful ACO will manage more like 20,000 to 40,000 lives to achieve true savings. The government itself requires only 5,000 beneficiaries and proposes a process to penalize ACOs

who fall below the minimum num-ber. Any interesting side note is that the proposed rules allow an ACO to drop, but not add

Kick-Off DateACOs will start offering services

every January 1st for a three-year period once CMS approves them with performance (and therefore savings payments) measured on a yearly basis.

Beneficiaries Beneficiaries will be assigned only

to one ACO, on the basis of their historical patterns of primary care utilization, and they will not receive advance notice of their ACO assign-ment. Physicians and other ACO par-ticipants must post signs and give the beneficiaries the heads up on their assignment. CMS has said it expects 5 million Medicare beneficiaries to receive care from an ACO.

Financial RiskThe government has had shared

savings programs in the past that required providers to assume the risk for losses as well as savings generated under the programs. This resulted in a number of providers losing money since by the time start-up costs were recouped, the program was nearing its end. This time the government wants to give ACOs time to get their acts together by insulating ACOs

Can you become an Accountable Care Organization and do you want to?

By Kimberly Licata

New guidelines and regulations released

your practice

MEDMONTHLY.COM | 21

from the risk of losses for beneficia-ries’ care that is the same or higher than the benchmark goals for the ACO. The government envisions two tracks for ACOs: one that has two years no risk for the ACO with a third year at-risk (one-sided model) and a second that has the ACO at risk for losses and gains (with a higher re-ward) from the beginning (two-sided model). Groups that are highly inte-grated today may be well-positioned to choose the two-sided model. Physi-cians and groups that are just starting out will likely prefer the one-sided model. The one-sided model permits a successful ACO to share in a sav-ing payment, but does not require an “unsuccessful” ACO (one that does not reduce costs to the benchmarked level) to pay back any money to the government.

Payments The shared savings payment will be

in addition to the FFS payment a pro-vider already receives. To receive any payment at all, the ACO must meet certain quality standards and organi-zational requirements. A big negative is that ACOs that choose the two-sided model will be subject to a 25% without of shared savings to offset future losses, which will be returned at the end of the three year period.

Data Use and ReportingACOs will need to use, report,

transfer, and otherwise manipulate

Kimberly Licata is an attorney at Poyner Spruill, who practices health law and partici-pates on the Firm’s Emerging Tech-

nologies and Privacy and Information Security teams. She may be reached at kli-cata@poyner-spruill.com or 919-783-2949.

information about their patients and ACO participants to create better outcomes, coordination of care, and cost savings. Meaningfully using an EHR program in place is required for 50% of an ACO’s PCPs. Data that is reported must be certified as to its accuracy, truthfulness, and complete-ness, and ACOs must be open to audits of their data.

The good news is that the govern-ment is working together to make the ACO program as successful as possi-ble and is very enthusiastic about the possibilities. The regulations issued at the end of March are proposals only and CMS, the FTC, the OIG, and IRS are all seeking public comments on the program. Remember, if you do not comment, the government will not change the proposals. Work with your professional societies and associations to prepare comments on how you think the program ought to be structured.

No doubt every provider will be thinking about ACOs and decid-ing whether to create one, join one, or buck the trend entirely (for the time being). It’s time to be an edu-cated consumer about ACOs. Shared savings programs and value-based purchasing programs that stress qual-ity over quantity in health care have become more prevalent. Some form of cost-saving programs and reim-bursement reform are inevitable (even necessary?) to protect the federal pocketbook from escalating health care costs. What does this mean for physicians? Get involved. Learn about the various shared savings programs involve and which suits your practice style best. Whatever you do, do not run and hide. If you don’t like the government’s proposed shared savings program, prepare comments to CMS as provided in the recent regulations found on the Shared Savings webpage.

Editor’s note: These comments are not intended to establish an attorney-client relationship and are not intended to be legal advice.

Learn more about Jaime’s skin cancer story atwww.aad.org/PSA

“Mothers who allow their daughters to tan are putting them at a huge risk.

My daughter, Jaime, spent time in the sun and frequently used tanning beds. I didn’t know how dangerous they were.

One person an hour dies from melanoma.

Jaime’s hour was at 1:00 p.m., Friday, March 16, 2007.

I hope no one else has to mark his or her hour.”

-Donna Regen

“No mother should have to visit her daughter in a cemetery.”

22| MAY 2011

Teach your old blog new tricks! SEO, backlinks,

commenting and social networking

can all increase blog traffic.

22 | MAY 2011

has written and edited numer-ous websites, articles, ad-vertisements, and blogs. She is President and C.O.O at Modern Den-

tal Practice Marketing, an internet marketing company that caters to the dental and medical com-munities. Learn more about Duty at moderndentalmarketing.com.

What will a blog do for you?I can’t tell you what any

old blog will do for you, be-cause the results depend upon many factors, including how often you blog, your keywords and SEO, backlinks and comments, social networking interaction, and the quality of your blogs.

I can, however, tell you what a Dental Practice Marketing blog will do for you. It will:

● Get you more new patients…the right new patients● Define your image in your commu-nity and online● Increase your return on investment from internet marketing investment

Likewise, our client dentists con-sistently tell us that they’re getting referrals from their MDPM blog or website. Also, we regularly assess our clients’ Google Analytics, so we know how many people are visiting a blog or website, where the people live, and which pages or posts they’re reading. We can see where to make changes for greater effectiveness.

I’m Shauna Duty, and I’ve been a writer for over a decade. I worked as Director of Copywriting for a dental website firm for four years, and I’ve been the editor of a successful dental news website. Now I’m a partner at Modern Dental Practice Marketing. I tell you this so that you can know, I

understand dentistry. I know what’s going on in the industry. I under-stand dental procedures, as well as dental patients. All of this knowledge, I impart on my team of talented den-tal copywriters.

In addition, I understand search engine optimization, and I stay on top of the latest initiatives from Google. For instance, metatags are not as important as they once were. If you want to rank high on search engines, according to Google Caf-feine (launched in April, 2010), you need to associate your dental practice with news on the Internet. Blogs are considered news. Thus, you need a dental blog.

At MDPM, we have a global view of dental marketing. Instead of focus-ing on merely writing and posting blogs, we get involved with our client dentists’ branding and overall mar-keting strategy. Understanding your office’s unique goals helps my team develop the right kind of blogs, and the right image, for your practice. We use proven techniques in copywriting and graphic design to draw a defined target market.

Here’s an example: Let’s say that you don’t see children, you want to focus on big restorative cases, and you place dental implants. Your office has been in a suburb of San Francisco for 20 years. You have a website, you advertise in a local health magazine,

and you depend on word-of-mouth referrals for most of your new pa-tients. This marketing strategy isn’t bringing you enough new patients to thrive and grow as you would like.

From this information, and of course with more conversation, I would begin to see that we need to target baby boomers in and around your community. We need to get in-volved with Facebook and make sure that your website, blog, and Facebook links are published in your magazine advertisements. Then, we need to cre-ate a blog website that appeals to our target audience, post Baby Boomer -appropriate blogs once or twice each week, and build a fan base on Face-book. From there, the sky’s the limit.

Everything you need to know about dental practice blogs

By Shauna Smith Duty

Shauna Smith Duty

And the necessity to have one in today’s world

your practice

MEDMONTHLY.COM |23

24 | MAY 2011

The Do’s and Don’ts of Medical MarketingWhat you need to know about marketing your practice

By John Whites

your practice

In order for your medical practice to succeed and grow, you must nur-ture it through medical marketing.

Although many doctors cringe at the thought of having to promote their practices as if they were businesses, they must promote themselves if they want to continue attracting new pa-tients, increasing revenue, and perhaps even opening new office locations.

However, doctors have to be careful not to be too aggressive in their medi-cal marketing approach. Without even realizing it, a doctor could be break-ing several state and federal laws by marketing and advertising aggressively. Nevertheless, doctors don’t have to abandon direct-to-consumer market-ing and advertising completely, as long

Don’t wait for patients to find you. Put yourself out there to grow your practice

as they are careful not to break any laws. Here is a list of medical market-ing do’s and don’ts that will help you stay on the right track.

DoDevelop a thorough marketing plan

with specific goals and objectives in mind. Make sure that you also have a tracking system in place that will help you determine what is enabling you to meet your goals and what isn’t. Edu-cate your target audience, whether it consists of referring doctors, patients, or the community. Educating and helping others is the key to success in modern medical marketing.

Give away small gifts and services as

incentives in your marketing program, but never cash or anything that could be converted into cash. The retail value of gifts cannot exceed $10 per recipi-ent. Make sure that all of the marketing materials you use are straightforward, accurate, and not deceptive. You also have to be certain that your employees and marketing consultants understand that the marketing materials used have to be clear and not create unjustifiable expectations.

Review the Office of Inspector Gen-eral (OIG) guidance materials regard-ing medical marketing before planning your marketing campaign. The OIG has issued opinions about medical marketing arrangements and the of-fering of items, goods, and services to beneficiaries of federal healthcare programs.

Promote the delivery of preventive care services. As long as the delivery of preventive care services is not tied to Medicaid or Medicare reimbursable services, you are allowed by law to give incentives to promote the delivery of preventive care services such as pre-natal services or post-natal well-baby visits. Consult a health care attorney to ensure that your medical marketing ef-forts do not violate any state or federal laws.

Don’tWaive coinsurance or deductible

amounts because you can violate several laws by doing so. For ex-

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ample, a physician can face fines of up to $10,000 for offering a waiver to sway the decision of a Medicaid or Medicare-eligible person to choose him over another physician. There are exceptions to this rule, however. As long as the waiver is not offered as part of an advertisement or solicitation, the physician does not regularly offer waivers, and the physician only offers the waiver after determining that the patient is in financial need, no laws would be violated.

Wait for patients to find you. You may be a great doctor but most pa-tients won’t hear about your practice unless you put yourself out there. Be proactive and use medical market-ing methods to attract more people to your practice. Expect to see results overnight. Medical marketing takes time and the results will take a while to manifest. If you are patient, you’ll see your efforts bear fruit.

Use medical terminology or il-lustrations that are difficult for the general public to understand in your marketing materials. Make sure all of your marketing materials are read-

ily comprehensible. Use deceptive, high-pressure advertising tactics that create unrealistic expectations. Make unsolicited phone calls to Medicare and Medicaid beneficiaries. In order to call them, they must have been your patient in the last 15 months and you must have their permission to call.

Say in your advertising that patients will not have out-of-pocket expenses and that Medicare or insurance is accepted as payment in full. In addi-tion, you should avoid saying that you provide discounts to beneficiaries of Medicare. Provide discounts for servic-es if the patient commits to purchasing another item or service at a specific price. Offering contingent discounts is a violation of state and federal laws.

Compensate your employees and marketing consultants based on the success of their marketing efforts. Make sure that the fee you pay them is fixed in advance.

Conclusion To avoid breaking rules and to achieve optimal results in your medical mar-

John Whites is a medical marketing expert who works full time with health care providers to increase their visibility on the web space to get people connected with the Medical Professionals.

keting campaign, consider working with a medical marketing firm. A med-ical marketing company can help you with everything from graphic design to copywriting to analytics, ensuring that your campaign runs smoothly from beginning to end. Ultimately, your medical practice is a brand, and you need to make the effort to build a strong brand image and reputa-tion through your medical marketing efforts. A professional, experienced medical marketing firm can help you develop a powerful presence both on-line and offline while making sure that you aren’t breaking any laws.

— Courtesy of EzineArticles.com/?expert=John_Whites

26 | MAY 2011

‘‘With Tai Chi,we may be able to treat [depression] without exposing [the elderly] to additional medications.”

MEDMONTHLY.COM | 27

Tai Chi beats back depression in the elderly, study shows

By Mark Wheeler

The numbers are, well, depressing: More than 2 million people age 65 and older suffer from depression,

including 50 percent of those living in nursing homes. The suicide rate among white men over 85 is the highest in the country — six times the national rate.

 And we’re not getting any younger. In the next 35 years, the number of Americans over 65 will double and the number of those over 85 will triple.

 So the question becomes, how to help elderly depressed individuals?

 Researchers at UCLA turned to a gentle, Westernized version of tai chi chih, a 2,000-year-old Chinese martial art. When they combined a weekly tai chi exercise class with a standard depression treatment for a group of depressed elderly adults, they found greater improvement in the level of de-pression — along with improved quality of life, better memory and cognition, and more overall energy — than among a different group in which the standard treatment was paired with a weekly health education class.

 The results of the study appear in the current online edition of the American Journal of Geriatric Psychiatry.

 “This is the first study to demonstrate the benefits of tai chi in the management of late-life depression, and we were encouraged by the results,” said first author Dr. Helen Lavretsky, a UCLA professor-in-residence of psychi-atry. “We know that nearly two-thirds of elderly patients who seek treatment for their depression fail to achieve relief

with a prescribed medication.” In the study, 112 adults age 60 or

older with major depression were treated with the drug escitalopram, a standard antidepressant, for ap-proximately four weeks. From among those participants, 73 who showed only partial improvement continued to receive the medication daily but were also randomly assigned to 10 weeks of either a Tai Chi class for two hours per week or a health education class for two hours per week.

 All the participants were evaluated for their levels of depression, anxiety, resilience, health-related quality of life, cognition and immune system inflam-mation at the beginning of the study and again four months later.

 The level of depression among each participant was assessed using a common diagnostic tool known as the Hamilton Rating Scale for Depression, which involves interviewing the individual. The questions are designed to gauge the severity of depression. A cut-off score of 10/11 is generally regarded as appropriate for the diagnosis of depression. 

The researchers found that among the Tai Chi participants, 94 percent achieved a score of less than 10, with 65 percent achieving remission (a score of 6 or less). By comparison, among par-ticipants who received health education, 77 percent achieved scores of 10 or less, with 51 percent achieving remission.

 While both groups showed improvement in the severity of

depression, said Lavretsky, who di-Lavretsky, who di-rects UCLA’s Late-Life Depression, Stress and Wellness Research Program, greater reductions were seen among those taking escitalopram and partici-pating in tai chi, a form of exercise that is gentle enough for the elderly.

 “Depression can lead to serious consequences, including greater morbidity, disability, mortality and increased cost of care,” Lavretsky said. “This study shows that adding a mind-body exercise like tai chi that is widely available in the community can improve the outcomes of treating depression in older adults, who may also have other, co-existing medical conditions, or cog-nitive impairment.

 “With Tai Chi,” she said, “we may be able to treat these conditions without exposing them to additional medications.” 

Other authors on the study included Lily L. Alstein, Richard E. Olmstead, Linda M. Ercoli, Marquertie Riparetti-Brown, Natalie St. Cyr and Michael R. Irwin, all of UCLA. 

Funding for the study was provided by the National Institutes of Health, the General Clinical Research Centers Pro-gram, the UCLA Cousins Center at the Semel Institute for Neuroscience and Human Behavior, and the UCLA Older Americans Independence Center. 

The authors report no conflict of interest. 

— Courtesy of UCLA Newsroom, newsroom.ucla.edu.

healthy living

Can a 2,000 year old Chinese martial art help?

What’s your practice worth?When most doctors are asked what their practice is worth, the answer is usually, “I don’t know.” Doctors can tell you what their practices made or lost last year, but few actually know what it’s worth.

In today’s world, expenses are rising and profits are being squeezed. A BizScore Performance Review will provide details regarding liquidity, profits & profit margins, sales, borrowing and assets.

919.846.4747bizscorevaluation.com

MEDMONTHLY.COM | 29

Medical alert systems have been helping seniors stay living in their homes lon-

ger knowing that if they should fall or have any other type of emergency they would be able to push their medical alert pendant and notify 911 of their predicament and also notify their loved ones.

No longer does a family mem-ber have to worry about mom, dad, aunt or uncle worry about whether their loved one might be lying in the middle of the floor yelling, “Help I’ve Fallen,” and not be able to reach the phone for help. It is difficult for a relatives living a distance to be com-fortable with their parents staying at home alone when they fear that they could have a heart attack, stroke or just fall due to an emergency and lay on the floor... sometimes for days.

Back in the late 1970’s medical alert systems were crude systems that had a non-waterproof large heavy bulky pendant worn around the neck that could not be taken into the shower or the tub. As time progressed by the 1980’s, as all technology does, the medical alert pendant transmitter started to shrink in size and weight. But still, the pendant transmitters were not waterproof. Usually a hook was hung low near the tub or shower so that if a senior should fall and not be able to get up, the help button would still be within reach.

From the 1970’s till the early 1990’s these medical alert systems were sold for $1000 to $3000. They were mainly sold directly in the home by salesman

who worked on commission. Some companies were very honest but oth-ers would not leave the elderly seniors alone until they were worn down and purchased the medical alert systems. On top of the purchase there was a medical monitoring device service fees that ranged from $15.00 to $49.00 per month depending on the program the seniors chose. Some of these had contracts that made it very difficult to be released from the obligation.

Today, medical alerts are usually not purchased; they are rented for the cost of the senior medical monitor-ing service. And today medical alert systems are waterproof and are meant to be worn in the shower or tub. Even more importantly today’s medical alerts have a voice-to-voice channel that allows the senior to speak up and back with the medical monitoring center without the senior ever having to touch the phone. The client can be heard by the operators and they can hear the operators in a three-story home. The pendant transmitter can be picked up outside the house as far as 400 feet depending on the surround-ings (although outside of the house the medical monitoring service knows they are in trouble but are unable to speak to the senior directly), in this case, the monitoring center assumes that the client is in trouble and dis-patches the local 911 first responders.

If the senior is capable of talking they may tell the operator through the speaker box that they do not need the paramedics they may have simply fallen and request that their neighbor

or friend be called to help them up. The choice is theirs. If the monitor-ing center cannot hear them help is immediately sent and the family or whoever is on the call list is notified.

The average age of a senior using a medical alert system has risen from an average age of 70 all the way up to the 80s. More seniors are electing to stay in their own homes where their wonderful memories are because they can get help when they need it.

In a nutshell, the elderly live longer and feel peace of mind with the pro-tection of a personal alarm known as medical alert systems.

The most important issue in choos-ing a good medical alert company is making sure there are no long term contracts and that their monitoring center is at a minimum UL Listed and certified and has a redundant backup monitoring center in another location.

Be sure to check your gut instincts when you talk to different medical alarm companies. Don’t let them pres-sure you. Don’t let them scare you. If they speak badly or warn you about other companies, put them in the suspicious category. There are many good companies out there that won’t pressure you, won’t stick you with a contract that cannot be canceled and aren’t easily dealt with when your sys-tem needs servicing. Take your time, read everyone’s brochure and make sure that your instincts tell you that the company is a good one.

— Courtesy of EzineArticles.com/?expert=Jeffrey_C_Mi

Medical Alert Systems

By Jeffrey C Miller

History, pricing and choosing the best medical alert systems

healthy living

30 | MAY 2011

the kitchen

The first time you saw a kiwifruit in your grocery store did you think it was a lemon gone wrong? Or perhaps you thought it was a new, smaller, odd-

looking variety of pear. The truth is the kiwi-fruit isn’t just a fruit, it’s one of nature’s most perfect foods - and if your family hasn’t yet discovered the taste, versatility and nutrition-al punch of kiwifruit, it’s time to give it a try.

Kiwifruit has a history every bit as unusual as its appearance. Discovered in ancient China, the berry (which grows on vines like grapes) was known as Chinese gooseberry by the mid 1800s. The kiwi arrived in California in the early 1960s and was nicknamed “ki-wifruit” because it was imported from New Zealand. Today, fewer than 300 family farms produce more than 98 percent of all the kiwi-fruit grown in the U.S. You can view a video about kiwifruit, how it’s grown and how to select, ripen and eat it at www.kiwifruit.org.

Nutritionally, kiwifruit packs a powerful

Secrets of the amazing kiwifruit

Fuzzy, fun and family-friendly

1 1/4 cups flour1/3 cup powdered sugar, di-vided1/2 cup butter or margarine1 cup sugar2 California kiwifruit, pared and pureed

2 eggs, beaten1 teaspoon lime juice1/2 teaspoon grated lime peel1/2 teaspoon baking powder

Try this kiwifruit recipe to introduce

your family to this fuzzy, fun, family-friendly fruit:

Directions:

Combine flour and 1/4 cup powdered sugar. Cut butter into flour mixture until mixture looks like cornmeal. Pat into 9-inch square pan. Bake at 350F for 15 minutes. Combine sugar, kiwifruit, eggs, lime juice, lime peel and baking powder. Pour over baked crust. Return to oven. Bake for 25 more minutes. Cool and sprinkle with remaining powdered sugar. Cut into 16 squares.

California Kiwifruit Squares

30 | MAY 2011

wallop. Low in calories and naturally fat free, kiwifruit offers:

● Two and a half times the recommended daily allowance of immune system booster vitamin C.

● More fiber (in two kiwis) than a bowl of bran cereal.

● More potassium than a banana.

● Nearly 10 percent of the recommended daily allowance of folate, a nutrient vital to fetal development and maternal health before, during and after pregnancy.

● Vitamin E, a powerful antioxidant that is found in just a handful of fat-free sources like kiwifruit.

The California Kiwifruit Commission offers a few helpful hints for enjoying kiwi:

● Kiwifruit should be smooth-skinned (but slightly prickly), without wrinkles, bruises or blemishes.

● Like many fruits and vegetables sold in su-permarkets, kiwifruit come in varying stages of ripeness. When you plan to eat your kiwi-fruit will determine what degree of ripeness you choose. If you’ll be eating your kiwifruit after three or more days, choose fruit that are firm to the touch. If you plan to eat them in just a day or two, select softer fruit. If you want to eat your kiwifruit right away, choose ones that give easily when gently pressed.

● To eat your kiwifruit, practice “slooping.” First, slice the kiwi in half lengthwise, and then scoop out the sweet flesh with a spoon - slooping. You can receive a free slooper from the California Kiwifruit Commission by visit-ing their website.

● Kiwifruit are great in a wide variety of recipes and dishes, from delectable summer smoothies and fresh salads to pies, puddings and even cocktails.

For more interesting facts, nutritional in-formation and recipes, and to view the video, visit www.kiwifruit.org.

— Courtesy of ARA content

California Kiwifruit Squares

©2010 Raymond James Financial Services, Inc., member FINRA/SIPC 10-BDMKT-0319v RW 03/10

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MEDMONTHLY.COM | 31

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A physician’s Q&A Tasty and healthy recipes Interesting practice profi les

The latest on health care trends Ideas for marketing your practice Helpful classifi ed section

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Are kiwis a magic fruit?Read what makes

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When medicine meets artHow one doctor mixes science and emotion

Med MonthlyMay 2011 | Vol. 1 Issue 1

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Eating right is often easier said than done. You like what you like, so breaking old eating habits is never easy. That’s why

sometimes it can be easier to slightly modify your diet instead of giving it a complete overhaul.

The good news is subbing in health-ier substitutes doesn’t have to make your food taste less flavorful. Here are five healthy substitutions to try on your journey to better health:

Make things wholeConsider what type of bread, pasta, flour and rice you are regularly eating. Switching to the whole grain versions of these foods not only helps you cut down on calories, but also add nutri-tion to your diet. Whole grain foods are also packed with fiber, which helps you feel full and aids in digestion.

Consider beveragesDid you know the average can of soda contains about 150 calories and no nutrients? On the other hand, try opting for tasteful beverages that have a neutral, or even a positive effect on your health. For example, natural teas can provide added health ben-efits — oolong tea can help lower your cholesterol and green tea can help boost your metabolism. Like soda, tea can also be quick, easy and refreshing - cold-brewed tea from brands such as Teawan come in packages that can be brewed in minutes.

Watch where you start in the kitchenCooking more at home is a sure-fire way to reduce the calories you take in, but your cooking methods can be another place to make gains in eat-ing healthier. Instead of using butter, vegetable shortening or lard, consider using olive oil, peanut oil or canola oil, which contain less saturated fat.

Creamy substitutesWhen a recipe calls for heavy cream, try substituting half and half or milk. Or use yogurt instead of sour cream. These simple substitutions can provide great taste for a fraction of the calories and fat.

Modify your meat intakeYou don’t have to suddenly become a vegetarian, but try a stir fry using only veggies or substitute ground turkey for ground beef in your favorite recipes. By making a similar substitution once a week or more, you’ll consume less calo-ries and fat, and possibly discover some tasty variations on your go-to dishes.

You may find that some substitutes actually make your diet more inter-esting and give you more options for healthy eating. As you work toward eating healthier, you ultimately have to find options you enjoy to achieve sustainable and nutritious diet.

— Courtesy of ARA content

Five simple substitutes that lead to a healthier dietBegin your journey to better health

Med Monthly

SUBSCRIBE TODAY!

Med Monthly offers insights about the health care profession, current events, what’s working and what’s not in the health care industry, as well as practice advice. Don’t miss out on this exciting opportunity to get a subscription today!

A physician’s Q&A Tasty and healthy recipes Interesting practice profi les

The latest on health care trends Ideas for marketing your practice Helpful classifi ed section

Market your practice

Practical advice

Are kiwis a magic fruit?Read what makes

them special

When medicine meets artHow one doctor mixes science and emotion

Med MonthlyMay 2011 | Vol. 1 Issue 1

Subscribe and Save!YES! I want to subscribe to Med Monthly!

In every issue we offer:

One year for only $69

Two years for only $89 Best Deal - A 38% Savings!*

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the kitchen

34 | MAY 2011

MEDMONTHLY.COM | 35

Martha Pettywas born in Atlanta, Georgia and moved to Florida when she was three. She attended East Carolina University and received a MFA in 1989. Her work has been shown at gal-leries across the country.

the arts

Soothing the mind through artHow anxiety and depression were healed with stormy weather and art

By Suzy Buck

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As a child Martha Petty was mesmerized by nature and the forces it creates. At three years old the artist’s family relocated to Florida and she witnessed the dark blue-purple storm clouds that formed in the afternoons. She remembers hearing the wind whistle during the

many tropical storms that skirted the coast and seeing the palm trees thrash in the wind. It was her fascination with these torpedo shaped forces that has stayed with her and shaped her career as an artist.

“It has become part of my core and perhaps as an offshoot of my anxiety, tornado imagery appears in my work,” Petty said.

In 2000, Petty began working in encaustic (a medium in which pigment is combined with beeswax and dammar resin) and continued to use the tornado image. She then continued to experiment with drawing in charcoal on the wax surface of the painting. Some of Petty’s work has returned her to the theme of architecture an interest of hers since graduate school. By using the encaustic medium it allows the creation of layers of paint that record the history of the marks that have formed on the surface. Petty feels that she benefits from her art by feeling more grounded and relaxed after a stressful week.

Her artwork can be found on display at the Law School at University of North Carolina and Southern Progress Corporation, MedMedia 9 offices and at exhibits throughout the Southeast. For more information about Petty and her work visit www.marthapetty.com.

36 | MAY 2011

9 Strange facts about BotoxBy Andrew Stratton

Sure, maybe paralyzing your muscles voluntarily doesn’t sound that appealing, but it’s hard to deny the influence Botox has had on the

public and cosmetic surgery community. While many advocates will try and assuage naysayers’ fears about the product, it’s impossible to deny

that Botox is a bit, well, strange. Here are some odd facts and tidbits about this popular wrinkle eraser that you may not have heard before.

1 Botox is a marketing name for the much more difficult to pronounce botulinum. It is considered toxic, and is in fact one

of the strongest currently known. It’s actually a protein that is created from a bacterium.

2 You probably have heard of botulism be-fore, an illness that most commonly can be contracted from handling contami-

nated food. However, it can also be acquired by other means. Botox is commonly confused or thought to create this illness. While made of the same protein, the means through which Botox is injected and the amount used is not nearly significant enough to cause the illness. The toxin is purified so while it creates similar effects to that of botulism (muscle paralysis) it is not dangerous.

3 Cosmetic corrections are only a fraction of the scope of what Botox can do for patients. People suffering from muscles

spasms, including such debilitating problems as a weak bladder, can benefit from injections. It can help ease movement and relieve pain for those with muscle problems.

4 It is a permanent way to solve your sweat-ing problems. Many people suffer from overactive sweat glands, causing them

to perspire constantly and heavily even if they don’t feel particularly hot, stressed, or anxious. By injecting Botox into the sweat glands, they are effectively blocked and excessive perspira-tion is temporarily relieved.

top nine

MEDMONTHLY.COM | 37

5 There are more deaths attributed to the use of the “fake” treatment than there are to the true substance. In

the past twenty years, less than fifty deaths have been recorded and none of these have been related to cosmetic use. Using other substances as a substitute for Botox that has not been medically approved, however, can cause serious injury, complications, and even death.

6 It is is fairly safe for most people. However, those who are pregnant or who have egg allergies should not

undergo treatment as potential risks are greater.

7 Less than five percent of patients who receive injections have any serious side effects. The ones that do might experi-

ence bruising, swelling, nausea, cold or flu-like symptoms, and some minor bleeding at the injection site. Even these side effects, however, are temporary and subside within a few days’ time.

8 Not ready to commit to a facelift? It can be used in combination with der-mal fillers to help lift and tighten sag-

ging facial features and eliminate wrinkles. Sometimes this is referred to as a “liquid facelift.” It is significantly cheaper and less painful than the traditional surgical proce-dure.

9 Practically anyone with a medical license is allowed to buy and admin-ister the injection. However, you’ll

want to find someone with experience and skill. Dermatologists, plastic surgeons, and other specialists who deal with the face and skin are probably the safest bets. Beware of Botox “parties” and other events that may not be the most reputable.

— Courtesy of ezinearticles.com

Classified

North Carolina

To place a classified ad, call 919.747.9031

North Carolina (cont.)

the sales

Occupation Health Care Practice located in Greensboro North Carolina has an immediate opening for a primary care physician. This is 40 hours per week opportunity with a base salary of $135,000 plus incentives, professional liability insurance provided and an excellent CME, vacation and sick leave package. Send copies of your CV, NC Medical License, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. B ox 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physiciansolutions@gmail.com Family Practice physician opportunity in Raleigh North Caro-lina. This is a locum’s position with 3 to 4 shifts per week re-quirement that will last for several months. You must be BC/BE and comfortable treating patients from 1 year of age to Geriatrics. You will be surrounded by an exceptional, experi-ences staff with beautiful offices and accommodations. No call or hospital rounds. Send copies of your CV, NC Medical License, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. B ox 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physiciansolutions@gmail.com

Methadone Treatment Center located near Charlotte North Carolina has an opening for an experienced physician. You must be comfortable in the evaluation and treatment within the guidelines of a highly regulated environment. Practice operating hours are 6:00 a.m. till 3:00 p.m. Monday through Friday. Send copies of your CV, NC Medical License, DEA certificate and NPI certificate with number to Physician Solu-tions for immediate consideration. Physician Solutions, P.O. B ox 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physiciansolutions@gmail.com

Family Practice physician is needed to cover several shifts per week in Rocky Mount North Carolina. This high profile practice treats pediatrics, women’s health as well as primary care patients of all ages. If you are available for 30 plus hours per week for the remainder of the year, this could be the perfect opportunity. Send copies of your CV, NC Medi-cal License, DEA certificate and NPI certificate with number to Physician Solutions for immediate consideration. Physician Solutions, P.O. B ox 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physiciansolutions@gmail.com

Cardiology practice located in High Point North Carolina has an opening for a Board Certified Cardiovascular physician. This established and beautiful facility offers the ideal setting for an enhanced life style. There is no hospital call or invasive procedures. Look into joining this 3 physician facility and live the good live in one of North Carolina’s most beautiful cities.

38 | MAY 2011

Send copies of your CV, NC Medical License, DEA certificate and NPI certificate with number to Physician Solutions for im-mediate consideration. Physician Solutions, P.O. B ox 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physician-solutions@gmail.com

Family Practice Physician needed for full time employment in established primary care practice in High Point, North Caro-lina. Salary with full benefits and production incentive for an energetic Board Certified FP. The ideal candidate can begin practicing as early as June 2011. Please send a copy of your current CV, North Carolina medical license, DEA certificate and NPI certificate with number along with your detailed work history and CME courses completed to; Physi-cian Solutions, P.O. Box 98313, Raleigh, NC 27624. E-mail: physiciansolutions@gmail.com or phone with any questions, PH: (919) 845-0044.

Board Certified Internal Medicine Physician position is avail-able in the Greensboro, North Carolina area. This is an out-patient opportunity within a large established practice. The employment package contains salary plus incentives features. Please send a copy of your current CV, North Carolina medical license, DEA certificate and NPI certificate with number along with your detailed work history and CME courses completed to; Physician Solutions, P.O. Box 98313, Raleigh, NC 27624. Email: physiciansolutions@gmail.com or phone with any questions, PH: (919) 845-0044.

Locum Tenens opportunity for Primary Care MD in the Triad Area, North Carolina. This is a 40 hour per week on-going assignment in a fast pace established practice. You must be comfortable treating pediatrics to geriatrics. We pay top

Physicians needed Physicians needed

Med Monthly● Need a physician?

● Selling your practice?● Equipement for sale?

Place your ad in Med Monthly!To place a classified

call 919.747.9031 today!

To place a classified ad, call 919.747.9031

MEDMONTHLY.COM | 39

Urgent Care opportunities throughout Virginia. We have con-tracts with numerous facilities and 8 to 14 hours shifts are avail-able. If you have experience treating patients from Pediatrics to Geriatrics, we welcome your inquires. Send copies of your CV, VA Medical License, DEA certificate and NPI certificate with number to Physician Solutions for immediate consider-ation. Physician Solutions, P.O. Box 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physiciansolutions@gmail.com Pediatric Locums Physician needed in Harrisonburg, Danville and Lynchburg Virginia. These locum positions require 30 to 40 hours per week, on-going. If you are seek-ing a beautiful climate and flexibility with your schedule, please consider one of these opportunities. Send copies of your CV, VA Medical License, DEA certificate and NPI certificate with number to Physician Solutions for immedi-ate consideration. Physician Solutions, P.O. B ox 98313, Raleigh, NC 27624, and PH: (919) 845-0054, E-mail: physi-ciansolutions@gmail.com

Virginia

Physicians needed Practice sales

IndianaPain Management Practice located in Indiana is now listed for sale. The main practice has been serving the community with two satellites located about 30 miles from the main practice. All three practices are being offered for $785,000 with the main practice building offered for $950,000. The two satellite practices being leased for a very reasonable monthly rent. If you are interested in a Pain Management practice that will generate impressive profits from month one, this could be your opportunity. Contact Medical Practice Listings at (919) 848-4202 for more information. View additional listings at; www.medi-calpracticelistings.com

North CarolinaImpressive Internal Medical Practice in Durham, The City of Medicine. Over 20 years serving the community, this practice is now listed for sale. There are 4 well equipped exam rooms, new computer equipment and a solid pa-tient following. The owner is retiring and willing to con-tinue with the new owner for a few months to assist with a smooth transition. Contact Medical Practice Listings at (919) 848-4202 for more information. View additional listings at: www.medicalpracticelistings.com

Modern Vein Care Practice located in the mountains of North Carolina. Booking 7 to 10 procedures per day, you will find this impressive vein practice attractive in many ways. Housed in the same practice building with an Internal Medicine, you will enjoy the referrals from this as well as other primary care and specialties in the community. We have this practice listed for $295,000 which includes charts, equipment and good will. Con-tact Medical Practice Listings at (919) 848-4202 for more information. View additional listings at: www.medical-practicelistings.com

Family Practice located in Hickory North Carolina. Well established and a solid 40 to 55 patients split between an MD and physician assistant. Experienced staff and outstanding medical equipment. Gross revenues aver-age $1,500,000 with strong profits. Monthly practice rent is only $3,000 and the utilities are very reasonable. The practice with all equipment, charts and good will are priced at $625,000. Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or E-mail: medlistings@gmail.com

Internal Medicine Practice located just outside Fayette-ville North Carolina is now being offered. The owning

Classified

wage, provide professional liability insurance, lodging when necessary, mileage and exceptional opportunities. Please send a copy of your current CV, North Carolina medical li-cense, DEA certificate and NPI certificate with number along with your detailed work history and CME courses completed to; Physician Solutions, P.O. Box 98313, Raleigh, NC 27624. E-mail: physiciansolutions@gmail.com or phone with any questions, PH: (919) 845-0054.

North Carolina (cont.)

MEDICAL PRACTICE LISTINGSMedical practice sell - buy

View national practice listings or contact us for a confidential discussion regarding

your practice options.

919.848.4202medlistings@gmail.com

medicalpracticelistings.com

in-house practice experts and attorney

ClassifiedTo place a classified ad, call 919.747.9031

the sales

Practice for sale

North Carolina (cont.)

South CarolinaLucrative E.N.T. practice with room for growth, located three miles from the beach. Physician’s assistant, audiol-ogist, esthetician, and well-trained staff. Electronic medi-cal records, Mirror imaging system, established patient and referral base, hearing aids and balance testing, es-thetic services and Candela laser. All aspects of Otolar-yngology, busy skin cancer practice, established referral base for reconstructive eyelid surgery, Botox and facial fillers. All new surgical equipment, image-guidance sinus surgery, balloon sinuplasty, nerve monitor for ear/parotid/thyroid surgery. Room for establishing Allergy, Cosmet-ics, Laryngology & Trans-nasal Esophagoscopy. All the organization is done, walk into a ready-made practice as your own boss and make the changes you want, when you want. Physician will to stay on for smooth transition.

physician is retiring and is willing to continue working for the new owner for a month or two assisting with a smooth transaction. The practice treats patients 4 and ½ days per week with no call or hospital rounds. The schedule accommodates 35 patients per day. You will be hard pressed to find a more beautiful practice that is modern, tastefully decorated and well appointed with beautiful art work. The practice, patient charts, equip-ment and good will is being offered for $415,000 while the free standing building is being offered for $635,000. Contact Medical Practice Listings for additional informa-tion. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or E-mail: medlistings@gmail.com

Primary Care practice specializing in Women’s care. The owning female physician is willing to continue with the practice for a reasonable time to assist with smooth ownership transfer. The patient load is 35 to 40 patients per day, however that could double with a second provider. Exceptional cash flow and profitable prac-tice that will surprise even the most optimistic practice seeker. This is a remarkable opportunity to purchase a well-established woman’s practice. Spacious practice with several well-appointed exam rooms, tactful and well appointed throughout. New computers and medi-cal management software add to this modern front desk environment. This practice is being offered for $435,000 per year. Contact Medical Practice Listings for addi-tional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or E-mail: medlistings@gmail.com

Hospital support is also an option for up to a year. The listing price is $395,000 for the practice, charts, equip-ment and good will. Contact Medical Practice Listings for additional information. Medical Practice Listings, P.O. Box 99488, Raleigh, NC 27624. PH: (919) 848-4202 or E-mail: medlistings@gmail.com

Practice for sale

South Carolina (cont.)

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40 | MAY 2011

P.O. Box 98313, Raleigh, NC 27624

phone: 919.845.0054 fax: 919.845.1947e-mail: physiciansolutions@gmail.com

www.physiciansolutions.com

Physician Solutions MD STAFFING Locum tenens Permanent placement

When your physician can’t work tomorrow do you have a plan B?

With an extensive network of health-

care providers and over 20 years of

years of experience in physician staff-

ing, Physician Solutions is a leader in

the industry. We specialize in primary

care and place doctors in facilities such

as familly practices, urgent cares, pedi-

atrics offices and occupational health.

Short term or long term, Physician Solutions has your covered

Hi, I’m Alice Osborn from Raleigh, North Carolina, and I’m the featured writer for Med Monthly. It’s great to be here and I can’t wait to share my stories with you. I’ll bring you stories about

passionate healthcare professionals who love what they do, along with stories lurking under the headlines that at first you may easily miss. I’ve

been a longtime freelancer for both national and regional publications and I’m the author of two books of poetry, Unfinished Projects (Main Street Rag Publishing Co., 2010) and Right Lane Ends (Catawba Publishing, 2006). In addition, I’m the owner of Write from the Inside Out where I offer editing, writing workshops and mentoring to writers who want to get published. When I am not editing, writing or coaching, I teach blogging, editing,

memoir, fiction and poetry classes both in person and online.Since I was in the fourth grade, I’ve wanted to be a writer. However, I didn’t seriously jump into a writing career until eight years ago when I found my voice through poems, journals, and stories. Writing poetry helps me examine the intricacies and ironies of life and relationships through sound, words, and images. I enjoy writing narrative-image poems in free verse (many of my poems spring from my childhood) that honor history and irony. When I’m not working, I enjoy researching notable people on Wikipedia, listening to singer Rob Thomas, hiking with my husband Keith, and spending time with my two kids, Daniel age 8 and Erin age 3. My favorite city is Charleston, South Carolina, where I lived for four years in the late 1990s. My favorite food is anything I don’t cook and I’m a white wine connoisseur. On my nightstand you’ll find books I review for my blog, along with a few nonfiction notables such as In Cold Blood by Truman Capote and Into the Wild by Jon Krakauer. Favorite films range from classics like High Noon and All About Eve to The Empire Strikes Back and Finding Nemo. I’d love for you to visit my website at http://aliceosborn.com to delve further into my obsessions.

Meet Our Featured WriterAlice Osborn

write on

Our staff members all have an interesting back-ground. Check out some of the hightlights from Alice’s bio:

Married? Yes, to husband KeithChildren? Two. Daniel, age 8 and Erin, age 3Favorite city: Charleston, SCFavorite movies: Anything from high Noon to Finding Nemo

Alice Osborn at a glance

42 | MAY 2011

“I’m not afraid to be the pale girl in the bathing suit. It doesn’t bother me anymore.”

“I have friends who use

tanning beds or lie out in the sun.

I tell them about Jaime.

Jaime was in her early 20s

when she was diagnosed with

melanoma, and she died right

before she turned 30.

One person dies from

melanoma every hour.

After Jaime’s death, I completely

walked away from tanning.

People think it’s safe. But

I know it’s not. You could die -

just like Jaime did.”

-Amanda Asplin

Learn more about Jaime’s skin cancer story at www.aad.org/PSA

IMAGINE THAT!Have products or services to sell but no buyers?

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