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Thursday, August 23, 2012

Why You Should See Me for Physical Therapy Rather Than An Office That Accepts Your Insurance


Anyone in New York who has received a referral from their medical doctor for physical therapy can relate to the following scenario: you have a high co-pay, anywhere from $15 to $50 for someone in-network, or you pay out-of-pocket until your $2000-$5000 deductible is met and then you’re responsible for about 30% of the billed charges. You get evaluated and treated and see your physical therapist for a total one-to-one time of about 5-15 minutes. The rest of the time is spent waiting with a hot or cold pack along with some electrical stimulation in which an aide sets you up with on whatever part of the body you are being treated for. And then you spend the rest of the time doing exercises in their gym being watched by the aide or even a personal trainer. You’re scheduled for 2-3 times a week of this for about 4-8 weeks.

The Problem

What you may not be aware of is that the physical therapist has his/her hands tied behind their back as it is the insurance companies that dictate what they can or cannot do. Health insurance is a business and as a business, the bottom line is profits. Every year they make it more difficult for providers to make a decent living as a therapist by 1) lowering reimbursement rates, 2) denying charges for treatments after a certain period of time regardless of medical necessity, 3) increasing the patient’s responsibility with higher co-pays & deductibles/out-of-pocket expenses, and 4) did I mention lowering reimbursement rates. It’s as if they change their rules every year and make it difficult for the provider to collect their charges. Because of this, the therapist has to over-book patients per hour in order to pay the rent and make a profit. It is common, if not standard, to schedule 3-6 patients per therapist an hour (I once worked in a local practice part-time that routinely scheduled me up to 8 patients an hour). As a patient, you may get annoyed and/or frustrated that your therapist is unable to spend more time with you and that your treatment is not improving your condition. In some practices, the patient may see a different therapist each visit. And of course, that 5-15 minutes with the therapist is because he/she is seeing 3-4 other patients at the same time as you.

For some patients, this is not an issue and they’re satisfied with this type of care since it works for them. This blog post is for those that can see through the ridiculousness and can smell the bullshit of the whole healthcare chaos/mess. As long as the provider is accepting health insurance within a distorted, profit-driven health-care industry, they are slaves to the system and slaves to the insurance companies. In other words, they don’t mind bending over and getting raped by the insurers.

The Solution

Presently, I wear two hats where I work a few days a week in an insurance-driven  medical practice providing physical therapy, chiropractic, and limited medical services in Forest Hills, New York and the other two days of the week, I see private, cash-paying clients in my home office in Howard Beach, New York. I don’t know how long I will be in Forest Hills, but for now the way I see things is in order to change the “game”, one must be within the “game” where Forest Hills is in the heat of the battlefield and I can at least soften the damage of the casualties of “war” by giving each patient I see the best treatment I can for the very limited time I am able to see them without getting sucked into the stress of the crazy “game”.  In my home office, patients pay me $150/hour and get my full Attention and thus get very significant results that they may have never achieved in an insurance-driven practice or if they did, would’ve have taken a much longer time (rare). For most cases, the insurance-driven practice is sufficient, but there is an alarmingly increasing number of patients with complex situations that medical doctors and therapists have no idea what to do with them and they’re sent to one specialist after the other, each with their own referred diagnostic tests that still tell them nothing that can help them achieve results. Frustrating? Obviously. Hopeless? No. 

I’m not saying I’m a miracle worker but I can truthfully tell you what I think may be going on with your situation based upon my thorough initial assessment which I base your treatment program upon where every session is an assessment & treatment at the same time and not some “one size fits all” protocol. I am not enslaved by the insurance companies so I will utilize whatever treatment modality I see fit for your condition. I’ve been doing this long enough to confidently state that I can help you feel better within 2-5 treatment sessions for the majority of cases where other more complex cases may take some more time (and commonly, the “simple” cases begin to unravel more complexities as one receives attentive care). Some cases, such as post-operative conditions will take several weeks to months – although, much more functional and effective results than conventional therapy.

The Bottom Line On Why It’s Worth Seeing Me As A Private Client:
1) Results. And not just any results but Better Results. And not just Better Results since there is always Hope, the Greater Awareness you will learn about your body and your “condition”, is quite simply,…Priceless.

Thursday, August 9, 2012

The Dirty Side of Howard Beach

So it's been exactly one week since I posted about the garbage on the Joseph Addabbo Bridge in Howard Beach towards the Rockaways. I did manage to email Senator Joseph Addabbo, Jr. on a Thursday in which he (or an intern) responded back to me on the following Monday writing that he will get the Department of Transportation and the Sanitation Department to take care of the mess. Of course, I'm not holding my breath waiting for this to happen but this is more of a test to see how fast our city's politicians respond to a quality of life issue such as pollution from a single, yet relatively unknown, tax-paying, law-abiding citizen, and most importantly, a registered VOTER (this would be me of course).

So today I took my baby girl for our morning walk towards the Addabbo Bridge and wasn't surprised to see that much of the same garbage from last week was still there and there was even more new trash dumped as well. Below are the latest pictures I took on my walk on the late morning of Thursday, 8/9/12 around 11 AM:

Good old McDonald's bag

Same illegally dumped couch from last week

Someone decided to dump an old rug on the sidewalk

Lovely view down the sidewalk with garbage everywhere

View from the bridge of the beach below-gets worse every week

Thursday, August 2, 2012

Hey Congressman Addabbo, How About Cleaning Up Your Bridge?

Walking South towards the Addabbo Bridge
Usually on Thursdays, since it's my day off, I get to take care of my two kids and one of the things I enjoy is to take a walk with my 6 month old daughter through the neighborhood I grew up in and love, Howard Beach. Like any other neighborhood, Howard Beach has its bright side to it as well as its dark side. This particular morning I decided to take another route towards the Joseph P. Addabbo Bridge going towards the Rockaways. I haven't been down this route in awhile but the first thing I noticed was the illegal garbage dumping all throughout the sidewalk path. And if that wasn't enough, as I approached the bridge, looking West towards the Jamaica Bay, by the beach underneath the bridge was  even more washed up garbage and the scavenger seagulls having a feast with the trash. It reminded me of a scenery I am familiar with whenever I travel to South America and beyond the "cleanliness" of the richer neighborhoods, are the filthy, mountains of garbage in the "slums" or outskirts of the heavily populated cities.

The beach underneath the Addabbo Bridge
Here's a sign of our times where we accumulate more than what we need and it is quite disheartening to see in the neighborhood I was raised in and the place where I choose to raise my children that such disregard for the Land, the very soil in which our houses are built upon, where what we call our Homes, are garbage dump mountains in the making. What went wrong? Does everyone else in Howard Beach aware of this? Does anyone in Howard Beach care?

They should care. We all should care.

Excess garbage breeds excess parasites/scavengers which breeds disease which infiltrates our soils and water supply. Of course, on the micro-scale of things many would reply, "what's the big deal?", considering the city has sewage treatment centers and our water is filtered and treated with fluoride and other chemical treatments to sterilize the water. True, but only a partial truth. What do you think will happen if no one does anything about the accumulating garbage on the beach and surrounding areas by the bridge??? Ever watch the Pixar movie Wall-E where we Humans in the Future have to leave the Earth and live in spaceships because we fucked up our planet and made it into a planetary dumping ground?

Walking North away from the Addabbo Bridge. Someone felt the need to dump an old couch on the sidewalk.
What's really going on? I don't have the answer to that but we can all agree it's about Responsibility. In this case, not taking Responsibility for our actions. Those who choose to dump their garbage wherever they want are disrespecting others who also share the land with them. In fact, no one truly owns Land. That is an illusion. You may be able to "buy" property, but did you Create it? The Truth of the matter is that we are merely Stewards of this Land and as Stewards, it is our Responsibility to take care of it. We may satisfy our egos to think that we own land because we paid money for it but that doesn't necessarily mean we "own" it. It's like the way the Native American Indians, before the Conquistadors "conquered", or "bought", them believed the Land in which they lived was a gift and it was their Responsibility to take care of it in an interdependent relationship. They believed that if you kill the land, you kill your people. And isn't that what's going on with illegal garbage dumping and the neglect to clean it up? Maybe many people are too distracted from their own little "big" worries of Life to even care about this but I think Awareness is a great initial step to effect change. Quite possibly, if more people were aware of the effect of their actions, maybe they wouldn't be so irresponsible and disrespectful towards others and thus themselves.

And finally, what if someone dumped their junk all over your place. How would you feel? The "it's not my problem" attitude is getting a bit thin since some of the shit is hitting the fan much closer to Home....Meditate on that.