Thursday, May 27, 2010
'Doctor for hire' insurance would complement traditional insurance

By Dr. Anthony Policastro

Last week's Seaford Star had an article entitled, "'Doctor for hire' bill is alternative from traditional health insurance." It indicated that the proposal would be overseen by the Board of Medical Practice. As a member of the Board of Medical Practice, I have had a chance to review the bill. There are some things that the article did not include which are relevant. The perception created by the headline was that you could use this type of insurance instead of traditional health insurance, which is not the case. The article indicates what services would be available under a doctor for hire system. These services would include office visits, lab services and x-ray services. However, there are many other things it would not cover. For example, there is no mention of surgery, hospitalization or emergency room visits. These are the kinds of things that most people have medical insurance to cover. This insurance plan would be in addition to current medical insurance. The rates for current insurance might be lower because some services are not covered. However, overall there would not likely be a significant out of pocket cost to the individual. The second thing is that the article indicates that patients would not have to pay things such as co-pays or deductibles. That may be true. However, what they are substituting for those is an up front, out of pocket cost. If you use a lot of medical services you may pay less with the new plan. However, if you do not use many services, the out of pocket costs will be higher with the new plan. You pay whether you use the services or not. An issue not mentioned in the article has to do with the fact that doctors participating in plans like these take on less patients. This allows them to give better access to their remaining patients. However, a physician who currently sees many patients and then joins this plan will see less patients. What the article did not say is who will see the patients that the doctor no longer sees. As I indicated in my article on health care reform a few weeks ago, having more insured patients will increase the doctor shortage. There will be more patients trying to see the same number of doctors. If some doctors shed patients by using a plan such as this, then those released patients will need to find a new physician. This will worsen the doctor shortage in places like Sussex County. Other issues are related to the oversight by the Board of Medical Practice. The plan is for the Board to review all contracts. Currently, the number of contracts reviewed by the Board is zero. The number of people on the Board with contract reviewing expertise is zero. The bill calls for the Board to review contracts on individuals that they have no jurisdiction over. These include individuals such as chiropractors and nurses. Many things carry unintended consequences. The list provided here highlights some potential unintended consequences of the proposed legislation.

Free directory of services Looking for an assisted living facility, adult day care, home health care services or caregiver support group in your community?Would you like to locate one of Delaware's many nutrition program sites or find providers of assistive technology devices? You'll find these resources and much more information in the 2010-2011 Guide to Services for Older Delawareans and Persons with Disabilities.The widely used free directory is a publication of the Delaware Division of Services for Aging and Adults with Physical Disabilities' Aging and Disability Resource Center. The 300-page guide was expanded to incorporate services for persons with disabilities that were previously published in a separate directory. The 2010-2011 services guide is available for viewing or downloading on the division's website,, or by calling the division toll-free at 1-800-223-9074 for printed copies. A Spanish language edition of the publication will be available in print and on the website at a later date.

Mentoring program launched HealthCorps - a proactive health movement with an in-school educational and mentoring program in 50 schools in nine states announces the launch of its curriculum in two Delaware schools - McKean High School in Wilmington and Laurel High School in Laurel. Nemours, owner and operator of the Alfred I. duPont Hospital for Children, is a founding sponsor of this initiative in Delaware. The program, led by a full-time salaried health coordinator, will make its debut in the stateat the start of the 2010-2011 school year this fall. HealthCorps was founded by Dr. Mehmet Oz, the host of the nationally syndicated talk show, "The Dr. Oz Show," and vice-chair and professor of Surgery at Columbia University Medical Center.

In 2003, he conceived the program in New York City after finding himself operating on patients in their twenties who were in need of heart surgery because of poor lifestyle choices. He set out to save a generation of youth from sustaining shorter life spans than those of their parents. HealthCorps is focused on three priorities - educating the student body; achieving community outreach through "FitTown" - an initiative to connect and empower citizens and organizations to bring about awareness and affect change through local projects and initiatives; and advocating for policy shifts across all levels of government that put health and physical education back into the core curriculum of the American education system. As part of the organization's mandate, the school program extends to the community through health festivals and liaisons with local health resources and non-profits who share HealthCorps' mission.

Bereavement support group Compassionate Care Hospice, The Wellness Community-DE and Nanticoke Memorial Hospital will collaborate to present a monthly bereavement group, The Next Step. The group focuses on issues of loss that continue beyond the early stages of grief. Mary Van House, bereavement coordinator, will facilitate the group at 10 a.m. on the third Tuesday of each month, at the Nanticoke Cancer Care Center, second floor conference room. To register, call Lisa at 629-6611, ext. 2378.

Depression Support Group There is a free bimonthly Depression Support Group meeting in Laurel on the second and fourth Wednesday evenings from 7 to 8:30 p.m. Any person who has signs and symptoms of depression and is under the care of a professional counselor/MD is welcome to attend. To register, call 302-465-6612.

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. The program is facilitated by Nanticoke Memorial Hospital Cancer Center professional staff - Terri A. Clifton, MS, NCC, Cancer Care coordinator; Mary Brown, RN, DSN, manager Cancer Care Center; and Wendy Polk, nutritionist - with assistance from Lois Wilkinson, DBCC special projects manager, who helps facilitate the program at Bayhealth. Together, they answer questions, help calm fears, and share information about resources that are available at Nanticoke, through DBCC, and other organizations within the local community. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Man to Man support group Nanticoke Memorial Hospital offers a Man to Man support group meeting on the fourth Wednesday of each month. Man to Man helps men cope with prostate cancer by receiving information and peer support. Man to Man is a forum for men and their support network to learn about diagnosis and treatment options through presentations, written materials and videos. Specialists share information such as side effects and how to cope with prostate cancer and its treatment. News and information about nutrition, general health, research and treatment, as well as messages from men living with prostate cancer and other Man to Man activities, are offered to assist in the recovery process. Pre-registration is not required for this free support group. For more information, contact Larry Skala (337-3678) or Grafton Adams (628-8311).

Cancer support group The Wellness Community-Delaware offers a free general cancer support group for people affected by cancer and their loved ones at Nanticoke Memorial Hospital in Seaford. The monthly support group meets in the second floor conference room of the Cancer Care Center on the third Monday of each month from 4:30 to 6 p.m. The Wellness Community is dedicated to helping people affected by cancer enhance their health and well-being through participation in a professional program of emotional support and hope. All facilitators of these groups are trained mental health professionals. Call 645-9150 for information or to register.