Sunday, October 26, 2014

Wake Up and Smell the Cafe Au Lait! A Story of Co-Pays and a Cash Based Service

Yum!  Here in New Orleans we really love our Cafe au Lait.  Even though I have changed the hot steamed milk for coconut milk these days, but I digress.

I work in two settings.  Two days a week I work in a busy orthopedic setting where I see a patient every 1/2 hour.  I have a waiting list of people to see me there for a few weeks.  Why?  Because I get results quickly.  However, this isn't about me per se.  This is about billing, co pays and the McKenzie Method® Mechanical Diagnosis andTherapy® (MDT): evidence based assessment, diagnosis and treatment for the spine and extremities.  Two days a week I work in my solo practice at Grimm Physiotherapy.  I really love working in both settings.

Here is the rub.  In the busy orthopedic setting we accept and bill insurance (a team of people are responsible for billing and collections). We don't accept every insurance but just a few plans.  If you have a co-pay of $75.00, $85.00, $95.00 or more ( I have seen the spectrum), you are expected to pay this for every visit.  Sometimes we spend part of your 1/2 hour debating the co-pay, but it really isn't up to us.  This just cuts into the allotted time we have to spend on your healthcare.  You may or may not get the opportunity to see me, a credentialed MDT physical therapist, but you may see one of our Physical Therapy Assistants, or have our Physical Therapy Technician help you with a few exercises, just like other traditional PT clinics.
Grimm Physiotherapy
"Everyone Deserves a Good Mechanical Evaluation and Treatment Plan!"


Now at Grimm Physiotherapy  the first visit runs $120.00 for evaluation, and $60.00 for one-half hour follow up care.  You get me, a credentialed MDT physical therapist, one on one for your entire visit.  There are 30 - 60 minute appointments available depending on your needs but generally follow up visits run about 1/2 hour.  I do not use aides, technicians, or assistants to manage your care.  I don't double book or dove tail treatment sessions.  You get to see me every appointment to improve the continuity of your care.  

Back to the dollars or numbers...If you see me at Grimm Physiotherapy 5 visits you would pay $360.00 (+ or -) out of pocket and you possibly could get reimbursed by your insurance company or apply it to your deductible.  If you elect to see me in the orthopedic clinic and you have a high co-pay, you may have to pay  $ 475.00 (+ or -) out of pocket and you may or may not get to see me for your treatments.  Are you getting the drift now?  This doesn't even include all of those appointments you paid cash for including massage therapists, chiropractors, and wasted time with other non-MDT clinicians. Imagine the cost of going to other non-MDT chiropractic and physical therapy clinics who book you 3 times a week for at least a month.  Imagine how much money that would be out of pocket.    

Do you want effective inexpensive healthcare?  Do you want to see your healthcare practitioner one on one for an hour?  This is what you get  at Grimm Physiotherapy.  I know, it is the way healthcare used to be, but with all the regulations, paperwork, and red tape you have to go through in a traditional settings this is getting to be rarer and rarer these days.  

You know what I am going to say..."Everyone Deserves a Good Mechanical Evaluation and Treatment Plan!"  Call 504-228-0524 or visit grimmpt.com to set up yours today. 


Sunday, October 19, 2014

Low Tech vs. High Tech Treatment Options for Pain

Let's just say that my practice is as low tech as it gets... So when you are done with the High and Low Tech treatments that don't fix the problem, then check out the McKenzie Method® Mechanical Diagnosis and Therapy® (MDT).  MDT is evidence based assessment, diagnosis and treatment for the spine and extremities which is the preferred practice here at Grimm Physiotherapy.  MDT equally well in rural communities that don't have the high tech treatments listed below.  

Just for fun, let's look at just a few high tech ways to diagnose and treat low back, neck and extremity pain in the greater New Orleans area...

High Tech

Platelet Rich Plasma Injections
Lumbar Transforaminal Epidural Steroid Injections
Lumbar Medial Branch Blocks
Cervical Facet Medial Branch Blocks
Lumbar Facet Radio-Frequency Denervation
Cervical Facet Radio-Frequency Denervation
Cervical Interlaminarl Epidural Steroid Injections
Cervical Transforaminal Epidural Steroid Injections
Caudal Epidural Steroid Injections
Ultrasound Guided Injections
Electrical Stimulation
Ultrasound
Iontophoresis
Diathermy
Transcutaneous Nerve Electrical Stimulation
Discography
Sacroiliac Joint Arthrogram
Magnetic Resonance Imaging
X-rays
CT Scans
Surgery
 Flexeril (Cyclobenzaprine)
Zanaflex (Tizanidine)
Lioresal (Baclofen)
Soma (Carisoprodol)
Tramadol (brand names Rybix, Ryzolt or Ultram)
Medrol dose packs  (methylprednisolone)
Cymbalta (duloxetine)
 Lyrica (pregabalin)
Neurontin (gabapentin)
 Elavil (amitriptyline
 Pamelor (nortriptyline)
Celebrex
 Voltaren (diclofenac)
 Mobic (meloxicam)
 Relafen (nabumetone)
Vicodin
Tylenol with codeine
Oxycodone

Yikes!  Do I need to go into the side effects and complications from these procedures and medications?  Probably not, since most of them are discussed at length in TV commercials for medications and lawyers.  

No wonder our healthcare system is bankrupt!


Now for a few examples of:

Low Tech

Accupunture
Dry Needling
Manipulations
Massage
Taping
Rest
Ice

You know these all feel good. I enjoy them all on occasion, but they just don't get to to the root of the problem like the McKenzie Method® Mechanical Diagnosis and Therapy® (MDT) does.

You know what I am going to say..."Everyone Deserves a Good Mechanical Evaluation and Treatment Plan!"  Visit grimmpt.com  or call 504-228-0524 to schedule your assessment today.

Sunday, October 12, 2014

Do Your Hands Go Numb When You Sleep?

Here is a great review of why your hands may go numb at night MD-Health.com

They list several possibilities including:

Wrong Sleeping Position
Ulnar Nerve Entrapment
Stroke
Carpal Tunnel Syndrome
Cubital Tunnel Syndrome
Cervical Spondylosis
Alcoholism
Seizures
Low temperatures
Type 2 diabetes
Raynaud's disease
HIV/AIDS
Transient ischemic attack
Vitamin B-12 deficiency
Spinal cord injury
Amyloidosis
Neck injury
Enlarged blood vessels
Tumors
Broken shoulder blade
Ganglion cysts
Multiple sclerosis
Lyme disease
Sjogren's syndrome
Vasculitis
Syphilis
Side effect of chemotherapy/radiation therapy


It is very difficult to diagnose yourself over the Internet. The most common reason your hands go numb is the first one listed.  Sleeping posture.  Now it isn't easy to change anyone's sleeping positions, because you can't control anything once you fall asleep.  But you can change your sleeping surface.  The easiest recommendation is simply to change your pillow.  Pillows are supposed to support your head and neck.


I recommend a down pillow because it is easily mold-able to fit the natural hollow or curves in your neck without letting the head tilt to far to the side or too far forward.  If you sleep with too many pillows you
may be sleeping with your head in a prolonged "forward head" position which can cause pressure on the nerves to your arms.



Memory foam pillows are not adjustable and might be the wrong fit for your neck.  
A very inexpensive solution is the  McKenzie Cervical Roll.  It is designed to support the curves of your neck whether you are lying on your sides or your back.  It slides right inside your pillowcase to keep it in place.  You may purchase one here.

For more information on correcting sleeping postures I recommend you read Treat Your Own Neck by Robin McKenzie.  This may be all you need to stop the numbness in your hands at night.  You may purchase the book here.    Let me know how it works for you.  If the numbness continues and you have a stiff neck or neck pain as well, give me a call.

You know what I am going to say, "Everyone Deserves a Good Mechanical Assessment and Treatment Plan!"  Visit grimmpt.com  or call 504-228-0524 to schedule your evaluation today.  

Monday, October 6, 2014

Woo Hoo! Pain Can Be Retrained!

Here they are again, saying it better than I ever could!  





If you are experiencing chronic pain, learn how to take a more active approach at Grimm Physiotherapy.  A good mechanical assessment, lifestyle modifications, diet and the right exercise just might be the answer to a pain-free lifestyle.  I am fond of saying that once we get the mechanical problems off of the table, then we have a good idea of what we are working with which will make it easier to treat chronic pain.

You know what I am going to say!  Everyone deserves a good mechanical assessment and treatment plan.  Visit grimmpt.com or call 504-228-0524 to set up your evaluation today.