Personal Injury Lawsuit Funding

To understand the concept of Personal Injury Lawsuit Funding, you first need to understand the concept of Personal Injury. Consider a situation when you find yourself thrown out of your job without notice, or harassed at the workplace or facing discrimination. Alternatively, you may be a victim of an automobile accident and suffering either major or minor injuries. These are some the examples of personal injuries. There are others that include medical or legal malpractice.

A person finding himself or herself in such a situation has two recourses: one is to fight a legal battle and the second is to opt for an out-of-court settlement. Now, if you wish to agree to an out-of-court settlement, chances are that you may give in to pressure and opt to settle for an amount less than what you would have received had you taken the case to court.

To take a case to court, you need adequate finances. Also, you would require money to see you through the days until you get the settlement amount. To get the required finances, you can opt for Personal Injury Lawsuit Funding.

Personal Injury Lawsuit Funding is a relatively new concept that is steadily gaining a foothold in the field of financing. If you are a claimant for a Personal Injury lawsuit and do not have the funds to fight your case, you can approach one of these lawsuit financing companies. These companies, in a way, purchase a part of your future settlement. They advance you a loan to fight your legal case. This loan is a non-recourse loan, meaning that you have to pay it back only if you win the case. If you lose, the company also loses the advanced cash amount. Given the high risk involved, these companies charge you a very high fee for their services. This fee can be either a flat fee or a recurring fee. Flat fee means that you have to pay a percentage amount at the time of the settlement verdict. Recurring fees means that you need to pay a certain monthly amount until the loan is repaid.

Conflict Resolution For Bullies

An article on MSNBC website on July 9, 2008, "Hospital bullies take a toll on patient safety," cited how a lack of emotional intelligence affects the quality of medical care, and health care costs. Hospitals today are stressful workplaces and most of the healthcare professionals within them work hard to save lives and provide compassionate care. However, studies have found that a small percentage of clinicians acting in an arrogant, intimidating manner can have major impact within the healthcare system.

As in the business sector, a lack of emotional intelligence affects staff morale and turnover among healthcare workers. But in health care, there's growing evidence that disruptive behaviors are tied to costly medical mistakes. An article published in the spring journal of Obstetric, Gynecologic & Neonatal Nursing finds links between disruptive behavior and adverse outcomes, and patient mortality.

The article focuses on doctors, who are often seen as the "higher authority," as being the major contributors to abusive, bullying behavior. However, bad behavior can also covers nurses, pharmacists and other clinicians.

Also of note is that there is evidence that ignoring bad behavior has potentially serious consequences for patients. The article cites a 2004 study of workplace intimidation by the Institute for Safe Medication Practices (ISMP) in Horsham, Pa., which found that 40% of clinicians avoided talking to an intimidating colleague about improper medication. In these cases, the incorrect medication or dosage is allowed to continue.

I have worked in two hospital administrations, and I know how this intimidation works. For example, a pharmacist tells a doctor that he has prescribed the wrong dosage. The doctor gets furious at the pharmacist and maybe tells the Medical Director that this pharmacist has an attitude problem. The next time the doctor prescribes incorrectly, the pharmacist decides to let it go.

As you can see, lack of emotional intelligence on the part of both the bullies and the bullied contribute dearly to adverse outcomes in hospitals. A hospital regulatory agency, The Joint Commission (JCAHO), is concerned enough to be taking action by creating new requirements to take place in January of 2009.

Bullying occurs in all environments, not just hospitals. What do I recommend?

Training and coaching managers in emotional intelligence will help to minimize the problem. The bullies themselves need to be confronted with the bad outcomes of their behavior. They don't really get away with it. Patients suffer. They are more liable for malpractice suits. In all industries, their relationships with others deteriorate.

The victims of bullies need training in confrontation skills. Most people shy away from confrontations in part because they don't believe they can do it right. They fear they will just make matters worse. But with training, they can step up to confront bullies and make their point. For example, the pharmacist can tell a doctor that his prescription dosage is not right. If necessary, the victim will have the courage to appeal to a higher authority.

Managers need training in how to handle these cases of bullying. Good performance management practices are required for the bullies. Also the managers need to be able to encourage everyone to step forward and expose the bullies. That means the managers have to instill trust. That includes convincing victims that they will be safe in whistle blowing, with no repercussions.

ACA Reforms: Affordable Care Act Seeks to Regularize Health Insurance

ACA reforms seek to correct many malpractices that have seeped into the American healthcare insurance sector over the decades. It should be noted that the effect of ACA reforms is growing. This is a gradually moving process where some of the reforms were introduced in 2010 and going ahead, it seems that insurance landscape will witness a more consumer-centric transformation. It is just a matter of time before the entire health insurance sector will witness a revolution with the arrival of state exchanges.

The exchanges will behave in a matter similar to the online travel deals market where there is loads of competition, fair price practices prevail and the emphasis is on providing the consumer the maximum for every dollar spent. This is why many people have compared the state health exchanges to an Expedia.com, referring to the similarities between online marketplaces for health insurance and travel deals. Some of the most significant aspects of the ACA reforms have been listed below for your reading purposes.

Ever since 1998, premiums have been on the rise without substantially raising the quality of care. While millions of Americans suffer without the presence of adequate coverage, millions continue to suffer from sudden hikes in the plan rates which are usually not regulated by the state authorities. The market seems tilted heavily in the favor of insurers who realize that most people have no option but to seek health care enrollment of some sort. These are major conglomerates that have acquired some of the latest insurance software solutions that can decode the smallest of clerical mistakes made when filing a Medicare application or when filing a claim. The idea is to decline the claim or coverage on the flimsiest of excuses. Some industry analysts argue that the premium increases have resulted due to the higher cost of medical care.

However, most research studies opine differently where it is clearly visible that health insurance costs have outstripped the spending capabilities of people and not provided the best in medical care that the dollar can buy. Under the ACA mandates, premium hikes would have to be justified by the insurers who plan to sell their health plans on the exchanges. This basically means that every time a significant premium hike is sought by the insurer, the percentage increase would have to be explained where the insurer needs to provide proper statistical data to justify the hike. The insurance companies cannot continue to overpay their executives, absorb losses and pass them on to the consumer as the state exchange authorities have been given the liberty of holding audits into the functioning of the insurers.

The efforts of the ACA to liberalize the health insurance market and to ensure that typical issues like problems faced by seniors when seeking information about Medicare eligibility enrollment is underlined by the process in which the ACA was created. Much time and money was spent on collecting reports, seeking public opinions, publishing articles, investigating claim history of insurers and analyzing the growth of profit margins of insurers before the mandates were rolled out.

The ACA seek to cut the lengthy process through which the insurers can wriggle out of the claim. The reforms seek to create a much more transparent market where the premium hikes are based upon reasonable and solid evidence. However, this doesn't mean that the insurers are being victimized by the health reforms. Proper rate reviews will be executed to ensure that the health costs are covered profitably for the insurers but in accordance with the 80-20 split where the insurers need to ensure that 80 cents out of every dollar earned are diverted towards providing benefits to the consumer or towards improving the medical care and coverage facilities.

The Standard of Care in Anesthesia - Don't Be So Sure!

Depending on who is asking the question of what constitutes a standard of care, and further depending on who replies, a standard of care is a fluid thing, with the standard for some things becoming more difficult to identify than others.

The practice of anesthesia is a unique example. The basic issues regarding monitoring, procedures and various technical aspects of the delivery of anesthesia are much agreed upon when it comes to a "standard" within the community of anesthesia providers. Fiercely disputed however, is who should practice that standard and when. No where else in medicine does state law determine a standard of care more than in the practice of anesthesia. And nowhere else in medicine is state law ignored as much as possible in a fight aimed at creating separate standards of care for the same health care. The American Society of Anesthesiologists (ASA) and the American Association of Nurse Anesthetists (AANA) have very different ideas regarding who may execute the fundamentally agreed upon treatment standards. This has created a battle not over the right or wrong way anesthesia procedures should technically be done, but rather over who may do them. This in spite of a 100 year history of Nurse Anesthetists and Physician Anesthesiologists safely administering anesthesia, and even creating a model of safety that is the envy of every medical and nursing specialty.

Professional associations do not determine the standard of care. Rather, it is determined by expert witness testimony in court. Recent court rulings have defined who may testify to these standards and increasingly it must be someone specifically trained in the very profession being examined. For instance, a physician may be barred from testifying as to what a nurse should or should not do. The ASA has created a standard among its members that only a physician may administer a spinal anesthetic. However, the AANA provides that spinal anesthesia is an integral part of the practice of a nurse anesthetist. A physician anesthesiologist would not be stating the standard of care if he or she were to testify that only physicians should administer a spinal anesthetic. For one thing, the ASA's own members do not follow their "standard" and often work with nurse anesthetists whom they encourage to administer a spinal.

This example show the difficulties in using a single source, no matter how authoritative they might seem, as a final determinant of what constitutes a standard. The ASA practice guidelines are inconsistent with state nurse practice laws and actually have the effect of putting the anesthesiologist at risk for litigation. Yet lawyers, insurance companies, risk managers and "experts" often use them as a benchmark for the practice of anesthesia by nurse anesthetists, much to their own peril. Recently, a case in Maryland illustrated the pitfalls the ASA has created for their own members.

Dr. Steven Bernstein, a John's Hopkins trained anesthesiologist was recently brought before the Maryland Board of Physicians following a complaint from the physician son of a patient. The complainants' elderly mother underwent surgery after fracturing her hip. Dr. Berstein was on duty in the department of anesthesia along with two nurse anesthetists. There were two procedures being done simultaneously, the hip fracture an an appendectomy. Dr. Berstein did the appendectomy, while one of the nurse anesthetists administered the anesthesia for the hip replacement.

The complaint alleged that Dr. Berstein failed to provide the standard of care by not supervising the nurse anesthetist (who had 30 years of experience) appropriately. The Board of Physicians agreed, and issued a sweeping reprimand which detailed multiple violations which were based on the ASA Anesthesia Care Team position statement. Despite their findings creating a supervision standard contrary to the Maryland Nurse Practice Act, the Board commented that they did not rely on laws governing nurses to determine the medical standard of care. Had the case been in a courtroom in a malpractice action, the standard of care for supervision would have been defined very differently. Had the case been before the Board of Nursing, a different conclusion would also have been reached. It all depends on who asks, and who answers the question.

National Health Care

More than 45 million Americans go without health care. At 14% of the gross domestic product, national health care spending is at an all time high. Health care issues and prescription drug costs continue to gain increasing attention during election campaigns, and many Americans are calling for the need to provide national health coverage as a universal service to all residents.

The government already provides healthcare to 28% of Americans. Medicaid programs cover medical treatments for people who are of low income and limited resources. Medicare provides healthcare coverage to U.S. citizens over the age of 65, and to certain people under the age of 65 with specific disabilities. While neither of these systems are perfect, advocates call for the expansion of similar national health care products to service all U.S. citizens. Although 61% of Americans have private health insurance, usually through a group employer, proponents of national health care coverage believe that only government reforms and mandates can control rising healthcare costs and make coverage available to all citizens.

Among physicians who support a national medical care system, a single-payer system is seen as the only solution capable of providing coverage to the uninsured or underinsured, while also controlling the skyrocketing health costs due to drug pricing, malpractice suits, and long-term care. Under a single-payer system, the government would finance healthcare, but delivery of services to the consumer would be managed by private parties. How to integrate this in a cost-efficient manner, without breaking our current system, continues to be a source of much debate.

The call for a universal health care system began under the Theodore Roosevelt administration, and was a major issue and topic of debate during the Clinton administration. During this time, First Lady Hillary Clinton was appointed by President Bill Clinton to head the Task Force on National Health Care Reform, making national health care her primary concern. The system reforms she proposed were too complex for many Americans to understand and they were defeated in Congress. In 2003, President George W. Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act. This was done to overhaul and expand a system which had become antiquated.

Despite this, many experts believe Medicare will run out of money as the baby-boomer generation requires greater, more intensive healthcare, and suggest national health insurance as the only solution. Many proponents of national health care point to the face that the United States, which is vastly rich in its resources, should be capable of providing the same type of national medical coverage that is universally offered in other modern, industrialized nations. National healthcare systems have been in practice for some time in many European nations. Those systems don't provide the same independence of choice that individuals in the U.S. demand.

The Cosmetic World and Neck Liposuction

When beauty is anything but skin-deep, it soon falls under the boundaries of wants and needs. Liposuction for many odd but sensible reasons is becoming a necessity of sorts for some. The neck for some reason is one unpublicized area where this procedure can be done. Neck liposuction allows patients to lose the chin jowls and even slightly return them to a more youthful appearance. Unlike other cosmetic surgeries, this procedure does not require the patient to stay overnight at the hospital. As an outpatient, they can return home only a few hours after the operation has taken place.

The results of neck liposuction last for about five to ten years. The duration depends on a patient's general health, skin care, weight changes and genetics. If the patient takes good care of his or her health, a decade of successful procedure is highly likely. When too much weight is lost or too much fat is removed then skin could sag. Other patients opt to have a follow-up surgery done by taking out the excess skin, in a sort of neck lift procedure making it appear more taut and firm. Genetics also play an important part since in some ways it dictates the healing process of the patient and the degree of scarring after surgery.

A neck liposuction does not come cheap though. Be prepared to shell out about US$2,000 to US$4,500 for the procedure alone. Patients will still have to settle other expenses such as hospital fees, doctor's professional fees, check-ups, medicines, etc. This is also why a greater numbers of cosmetic surgery patients come from well-to-do countries.

Now that that's settled, here comes the issue of choosing the right doctor to do the procedure on you. This is one of the most crucial points to consider because a skilled surgeon leads to a successful operation. Moreover, a patient will be leaving his or her welfare in the doctor's hands. Malpractice can lead to infections and complications that may pose a great threat to one's health. It is important to keep the risks of anything going wrong to a minimum, if not nil. Choosing a qualified neck liposuction surgeon is a matter to be taken seriously. A cosmetic doctor's eligibility relies on his or her qualifications: a medical degree, board certification from a medical board of plastic surgery, fellowship in cosmetic surgery societies, surgical history and success rate. Popular surgeons may not always be the best choice. It would be best to consult your general practitioner first if he or she could recommend a highly qualified and eligible cosmetic surgeon for you. If not, ask friends or families who have had cosmetic procedures done in the past and whether their doctors seem fitting.

The neck liposuction procedure may last between 45 minutes to a couple of hours. Patients need not check in to the hospital after that; however it is recommended that someone responsible accompanies the patient home since sedation is administered. After the operation, he or she will need to have follow-up appointments so the doctor could examine the progress of the patient's recovery process.

Personal Injury Lawyers

Personal injury is defined as any wrong or damage done to a person or his property, rights or reputation. A personal injury can occur at the workplace, in a road accident, from a faulty product or repair, because of improper medical treatment, etc. Personal injury can be classified as physical or psychological. Personal injury occurs due to the negligence or unsafe actions of the person or organization that otherwise should have provided you ordinary care and caution. Examples of personal injury cases are professional malpractice, wrongful death, slander, trespass, and nuisance.

Most personal injury lawyers provide free consultation and give you the opportunity to talk in detail about the case before you hire them. You can get an idea of a compensation amount as well the time frame required. Personal injury lawyers are generally hired on a 'contingency fee' basis. This means that if you do not receive any compensation from the case, you need not pay any fees to the lawyer. But if a settlement is reached, you are required to give a percentage of the amount to the lawyer. Regardless of this, you need to pay for any expenses incurred while pursuing the case. It is advisable to sign an agreement with the personal injury lawyer before handing the case to him. Clear communication with your lawyer at all times will help you get the desired results.

Good personal injury lawyers generally deal with catastrophic injuries and help in dealing with insurance agents. They help in assessing the worth of the personal injury claim, and explain to you the pros and cons of the case. So it is better to get hold of a reputable lawyer for your case, and check his credentials before hiring him. There are associations and societies of lawyers that provide lists of professionals in your area to help you locate the right attorney. Checking with acquaintances can also help you find a good personal injury lawyer.

Asset Protection for Entrepreneurs

As a small business owner, you have assets to protect. Usually associated with high income individuals and medical professionals, asset protection planning is just as necessary for owners of start-ups and small businesses.

Unfortunately, asset protection is often ignored or lost in the long list of things to do when starting or building your business. This mistake can cost you and your family when you least expect it.

What's Involved in Protecting Your Assets?

Asset protection planning is a simple concept. First identify all of your personal and business assets, such as bank and brokerage accounts, personal property and real estate, etc. Next you identify possible financial threats and then you insulate yourself from threats using a combination of different legal entities (trusts, corporations, limited liability companies, etc.) and insurance.

Properly done, this will help protect your current and future assets from loss due to the hazards of everyday life, such as lawsuits, business failures, and creditor claims.

To create an asset protection plan, you'll need to review your potential exposure to financial loss, assess the different types of protection available, evaluate potential tax issues involved and analyze your ongoing personal financial needs, such as qualifying for mortgages and easily accessing assets when required. You should work with competent financial and legal advisors who are familiar with asset protection strategies.

Small Business Owners Beware

As a small business owner, there are several areas that warrant your concern. The first is to take financial liability issues into account when you choose the type of legal structure for running your business (corporation, limited liability company, etc.). Once established, take care to follow the legal requirements of the entity you choose, so that you don't jeopardize your personal assets. Some examples of this are not mixing business and personal expenses, not treating your business bank accounts as personal piggybanks, keeping necessary records, having the proper corporate officers and establishing a Board of Directors in corporations.

Personal guarantees are another common source of financial exposure. Lenders, landlords and leasing companies often ask for a personal guarantee from the owner of a small business. This means exactly what it says; you are providing a personal guarantee of repayment. If your business can't make the payments the creditor can and will go after you and your personal assets.

Many entrepreneurs use personal credit cards and credit lines to get started. This may give you the credit you need, but it is ultimately a personal obligation. So if your business doesn't have the cash flow to pay the bill, you'll have to deal with these credit balances yourself. And the hefty finance charges can add up fast. Use extreme caution when leveraging personal credit for business use.

And then there is insurance. Small businesses often under insure to keep overhead expenses low. This is risky. Losses do happen and they can quickly put an under-protected company out of business or hamper it severely. Be realistic when evaluating the type (liability, property, malpractice, etc.) and the amount of insurance you carry.

Be Safe, Not Sorry - Protect Your Assets Depending on your individual situation, there are a variety of asset protection tools from which to choose ranging from the relatively straightforward, such as insurance, to the extremely complex involving off-shore trusts and multiple legal entities.

Seek the advice of financial planners and attorneys who specialize in this area. It is an investment in your financial security. Once you are on the wrong side of a lawsuit, it is too late to protect your assets.

You and I Live in the 21st Century, Healthcare Is Back in the 19th

Everyone complains about health care, but the real problem is healthcare. As two words, health care is a service offered by trained professionals to people known as patients. As one word, healthcare means the system in which the professionals work and where patients receive care.

The healthcare system is broken. It doesn't work because healthcare still thinks like the 19th century, but we live in the 21st.

In the 19th century, there was a direct relationship between the doctor and the patient. The doctor delivered both the baby and the bill. The patient received the new child and paid the doctor for his services.

Today, health care is provided by a team. When I asked my mother-in-law who was her doctor, she responded, "Northwestern University Hospital." She could not identify an individual with a name.

Patients do not pay their bills today. Insurance policies - via private companies or government agencies - pay our medical bills. The lack of a direct, fiduciary relationship between doctor and patient prevents the free market from functioning.

Micro-economic disconnection shows how separating or "disconnecting" supply and demand - the free market forces - produces an ever-rising, unsupportable cost spiral. Because the patient doesn't pay the bill, he or she has no reason to economize. Because the doctor wants "everything done," and knows that insurance is paying the bill, the doctor has no incentive to economize. The insurance company certainly does economize. Under the current system, they make money by not spending it, so they deny or delay our medical care.

The phrase "moral hazard" describes how freely we spend money when it is not our own. We have no hesitation going to the Emergency Room - spending $500- for our child with a fever instead of going to the pediatrician and spending $40. Because of the moral hazard, it makes no difference to our wallets so why should we economize?

Harmful consequences of disconnection extend well beyond money. Many people use the word fiduciary to refer solely to financial relationships. However, a fiduciary is someone who temporarily accepts power or authority from one person to use for the benefit of that person. A patient gives power to the doctor - in the role as fiduciary - to cut the patient open and operate. If any other person did what the doctor does, it would be classified as attempted murder.

In today's disconnected (patient-to-doctor) world of medical teams, third party payers and malpractice lawyers, the fiduciary relationship is gone and with it went our faith in doctors. Though today's doctors can do so much more for patients than doctors could in the 19th century, we no longer trust them. They have fallen from God, passed through fiduciary and are now approaching "perp" (perpetrator) status.

Nineteenth century scientists developed laws or rules in physics, chemistry and mechanics. They could precisely predict events like where a planet would be or how much bicarbonate we get each time when we add H20 to CO2. As medical capabilities dramatically improved over the years, patients continued to expect the same degree of predictability in medicine as in physics or math. We thought they could guarantee a specific outcome to a specific patient.

In the 20th century, Werner Heisenberg enunciated the uncertainty principle and showed that we couldn't predict or guarantee anything at all. Nevertheless, healthcare stayed with Newton's mechanical predictable world. Today, instead of accepting a bad medical outcome as misfortune, unavoidable human error or limitations on medical knowledge, healthcare blames the doctor, cementing his or her 21st century status as a perp.

In the 19th century, the highest measure of success was efficiency. The quicker and cheaper you did something, the better the result. The person who makes the most widgets during the workday is the best. So today, if the best doctor is the most efficient, then the best doctor sees the most patients per day and therefore spends the least time with each patient. But wait! That is not right. That is not what patients want nor is it the way to practice high quality medicine.

Right now, my hospital expects me to be efficient, meaning that I see 4.2 patients per hour. This translated to 14 minutes per patient, seven of which are consumed with paperwork. This is how 19th century thinking produces what are called perverse incentives. The system rewards the very behaviors we don't want.

If you want a healthcare system that works, drag it up from the 19th century into the 21st.

Looking For Dr House: Finding A Diagnostician, Part I

DIAGNOSTIC MEDICINE

So, I wanted to find House, MD (the king of diagnostic physicians on TV) in my local area. I research online to find out there is no Diagnostic Specialty. Although this seems ludicrous, I continue. My search leads me to find that most doctors believe they are diagnosticians. And they are, to some extent. Most doctors will take a history, declare that you have a cold or a bruise or a pain or worse and send you to a local specialist in the region/system of your body that is affected.

This redirection to specialists doesn't speak to finding a doctor with diagnostic ability. Only that you are being directed to someone else whose credentials you don't have. Shouldn't each doctor have a diagnostic rating, if the medical system doesn't include this as a specialty? How about a rating on a scale of 1 to 10 for level of diagnostic skill set? A peer-rated system would work well, alongside a customer rated system. Delving, deducing, concluding and having the ability to integrate and pull from vast knowledge in infection, degeneration, heredity, mental and environmental health require a special skill. So, why not have a separate specialization and definitive certification in Diagnostic Medicine? If we wait a few years, for political correctness, Internal Medicine will probably be called Diagnostic Medicine with no change in requirements.

THE DOCTOR IS IN THE PATIENT'S EMPLOY

On this search, we must start out by putting roles into perspective. WE, THE PATIENTS, are the employer, by hiring the doctor. Unfortunately, the demand for competence and diagnostic skill is higher than the supply. So, we forget our roles, for the most part, and consider ourselves lucky when the employee allows us to hire her/him. Bottom line: when we are in need of doctoring, our perspective changes and we lose focus.

Even though we usually forget, we, in the role of employer, can monitor, direct and impact the behavior of the doctor, in the role of employee, to some extent. True, each doctor delivers service in her/his own way and has the right to do so. But, we have the right to ask questions, extend our time of service if we need it, be satisfied that we have been well attended to and terminate employment of the doctor, if we are not satisfied. Hint: talk to the doctor, and don't be shy. Doctors like to clarify.

In many cases, although doctors have taken an oath of service, they may feel the need to act pompous and ego-filled. This may be a result of their wanting to wear on their sleeve the blood, sweat, tears and coin they expended to complete medical school. It happens. It's a natural occurrence when you learn a great deal that the pride and the skill can leak out arrogantly. It's bad manners; it's not always; it's human and what's a little insecurity among fellow humans who save lives? Bottom line, doctors, usually, do not think of themselves as YOUR employee or YOUR servant.

Because of caseloads, rising malpractice insurance costs, "allowable amount" cuts from insurance companies, increased sickness; doctors, typically, spend less time their patients because their roster has grown along with expense. Typical consumers do not pay for "exclusive" care. The concierge doctor set-up is a great option, resulting from an overstock of patients or from consumers' dissatisfaction with five-minute-only appointments with doctors. Choosing to pay double or ten times the fee for the security of a 20-, 30- or 60-minute appointment is part of our free enterprise system. Long live it!

DOCTOR CREDENTIALS

We are told to research internists, that they are the closest thing to a diagnostician. But should we have to become customers before we do our research or in order to do our research? Should we have to pay to interview our employee? Should we have to purchase a service we know nothing about? Shouldn't we have open online access to a central, non-fee based doctor information system where we can find all the credentials on one page, or a spec sheet, like the MSDS, (materials safety data sheet) for manufacturing?

Let's go back to my term "doctor." I have been using this term to mean anyone who does doctoring. I am not using the words "anyone who practices medicine" because I don't subscribe to the word "practice," in this usage. I want someone who already has the knowledge, not someone who needs to practice to get the knowledge.

Yes, we learn by experience, but doctors must be doing, not practicing, if I have the choice. I'm the first one to say that you can receive guru care from someone with less or different training from the doctor who got the best grades or went to the best medical school. The truth is that training dearly impacts the student, which means that someone with less formal education but passion and a brilliant teacher, can result in becoming a better-skilled doctor than the straight A-student with no passion who memorizes, so long as exams are passed and a skill test is administered.

So why are these credentials left to our research and not listed, as a general rule? Is it because, at any time, a patient can complain, and a doctor would rather have no credentials or reviews, than deal with negative reviews?

We should have full access to the primary medical school and board certification expiration date of all doctors who hang a physical or internet shingle. Strangely, these data are NOT commonly offered. Is it fear of judgment? Or is it to create a demand for this information so that service associations, often owned by doctors, can charge for the gathering of the most up-to-date information?

Should doctor information be mandatory, like nutritional labels? And, what about the diagnostic rating system? I believe in disclosing ingredients as I believe in disclosing who is a great diagnostician and what method of measurement was used to decide.

A free site I have used for researching hospitals and doctors is www.healthgrades.com. Whichever service you use, you want to make sure that the doctor you are checking is not able to pay for nice, positive comments to be placed in the comment section.

DIAGNOSTICIAN CONCLUSION

Finding a diagnostician is not easy. We have briefly touched upon the concepts of credentials, ratings, med schools, research. These issues are prerequisites to the search. It is not enough to place a suffix after your name without credentialing your suffix. If that, we could all emulate Frank AbagnaIe, Jr., who impersonated a doctor (whose life was played by Leo DiCaprio in Catch Me If You Can).

In the next article, we will look at common traits of a diagnostician and look at how they exist in a specialty that does not exist, Diagnostic Medicine.

Ohio Personal Injury Lawyers

If you are involved in either an auto accident, an injury resulting from a dangerous or defective product, aviation disaster, professional malpractice, wrongful death, workers compensation, pet attacks, home accidents, toxic exposure, or anything similar in the state of Ohio, you may be able to file for personal injury damages.

Should you hire a lawyer or not?

Most personal injury cases can be settled out of court. However, if you are inexperienced and lack the knowledge to defend yourself, insurance companies will try to compensate you with an amount lower than what you are supposed to actually receive.

This is why it is advisable to seek the help of an Ohio personal injury lawyer in collecting claims for damages. Claims can include medical bills, lost wages (including possible overtime pay), costs related to pain and suffering, costs of physical disability, deformities, permanent scars, emotional stress, embarrassment, loss of love and affection and enjoyment, property damage, and other expenses you may have incurred due to the injury. Your lawyer will make sure to protect your rights and ensure that you receive the claims and entitlements you deserve.

An Ohio personal injury lawyer will focus on helping you collect the maximum amount of compensation that you can claim and will make sure that your best interests are protected. He will make sure your case is filed before the statute of limitations occurs.

An Ohio personal injury lawyer can help you prove - beyond a shadow of a doubt - that the fault lies with another person so that you can get a substantial amount compensation. If there is a possibility that you were at fault for the injuries that happened to you, the claim that you may be able to collect would be significantly reduced. A lawyer can help prevent this from happening.

Small Business Marketing Strategy - A Blink Lesson Part 1

This is Article one of six in a series of lessons for small business marketers from Malcolm Gladwell's Blink.

Six articles may seem a bit much to review one book, but Blink is worth it. Malcolm Gladwell's newest book is about first impressions--specifically, about the first Two Seconds a person encounters new data.

Because Blink deals with First Impressions, learning the mechanisms behind a 'blink' can have huge payoffs for the small business marketer. As Gladwell writes (p. 241):

"This is the gift of training and expertise--the ability to extract an enormous amount of meaningful information from the very thinnest slice of experience. To a novice, that incident would have gone by in a blur. But it wasn't a blur at all. Every moment--every blink--is composed of a series of discrete moving parts, and every one of those parts offers an opportunity for intervention, for reform, and for correction."

The above quote describes an encounter between a police officer and a young man with a gun. The police officer is the person who has the "training and expertise", but when we look at our customers we see that all their so-called "snap decisions" about purchasing a product from you--or not purchasing a product from you--are also the results of their own 'blinks'.

Those of you who've read our articles before know how much we enjoy and admire Gladwell's first book, The Tipping Point. But why spend six articles examining this new work? The answer is simple: each section of Blink reveals vitally important lessons for the small business owner and marketer.

Consumers are generally very adept at buying and sorting through advertising hype. Much of Blink examines the ability of experts to make extremely good decisions or arrive at spot-on conclusions in those first two seconds.

You probably see elements of this skill of the specialist in your own industry. Doesn't your accumulated experience sometimes enable you to evaluate certain aspects unique to your field in a blink? Products and procedures that were mysterious when you were a rookie in the industry now make sense and have become such a part of your experience that you don't even think about how you process some of your decisions.

Well, consumers have been buying their whole lives--they are experts at it. The more we can learn about how our customers make decisions, the more we can adjust our own small business marketing efforts to fit their style of evaluating.

Chapter One in Blink explores a mental process called 'thin slicing'. As you read this book--and we emphatically encourage you to go buy it and read each chapter and then look at some of our comments--please understand Gladwell's definition from page 23: ""Thin-slicing" refers to the ability of our unconscious to find patterns in situations and behavior based on very narrow slices of experience."

OK, it's a good definition, and a catchy phrase. But you may ask yourself--'How do I use this in my small business?'

Well just a few pages later, on p. 32, Gladwell details how an expert, John Gottman, has discovered that one factor--Contempt--is the #1 predictor if a marriage will survive or not. Later, Gladwell supplies us with another example drawn from the medical and legal professions; a single factor--A doctor giving respect to patients--is the key determinant of whether or not a patient will sue their doctor for malpractice. And there is a dominant indicator that shows if the doctor gives respect to the patient: tone of voice.

These are two powerful examples of how experts who have enormous experience with a certain set of human behavior have been able to discover one small yet critical indicator of how people will behave.

And it's really no different for your small business. As you read through Blink you'll see several examples of how the experience of experts can uncover key indicators that can then be taught to people who aren't specialists. These non-experts can become very good at thin slicing a particular behavior, because they know what traits or indicative behaviors to look for. Even a casual observer can tell if a person's tone of voice is respectful or domineering.

Many small business owners find it almost impossible to pass on to their employees all their experience--but how could they? It's taken you years to really learn your industry, and your customer. But if you can teach your staff how to identify the really important signals a customer sends, and then how to react to those signals to either make the sale or service the customer, you'll arm your people on the frontlines with a powerful weapon in the war against lost sales and unhappy customers. If you can teach your employees what elements of the client purchase process are most important to thin slice, you will gain an edge over your competition.

Remember: Brand (who you are) + Package (your Face to the Customer) + People (customers and employees) = Marketing Success.

© 2006 Marketing Hawks

5 Benefits of Implementing EMR Software

Are you still trying to decide if EMR software (speaking of Electronic Medical Records applications) is practical for your business? We are living in uncertain times and you are correct in thinking that minimizing pointless expenses is imperative. However, the facts show that electronic health record software makes you more money in the long-run. Here are 5 considerations that are hard to ignore.

1. Elimination of Paper

By eliminating paper with your EMR system, you save on office space, save on employee payroll (since filing is a non-issue) and save a great deal of wasted time. Computerized patient charts also save you time, money and a great deal of headache as you no longer have to worry about illegible writing or lost documents. It's all stored in the system.

2. Increased Revenues and Faster Accounts Receivable Cycle

You streamline your accounts receivable process and ensure that you get all the money that you have coming to you. How many times have you lost money because of errors made by staff in managing daily charges? By reducing missing charges, as well as denied claims (that result because of errors) you are actually increasing your income.

3. The Safety of Patients

Nothing is more important than the safety of your patients. Errors that result from human imperfection can be life-threatening and very costly. E-prescriptions (which are highly accurate compared to calling in a prescription the old fashioned way) are saving practices thousands of dollars, as they literally save thousands of lives in the United States alone. With an EMR system, you can also prevent medication errors and get automated alerts warning about possible drug reactions or unsafe drug combinations. This feature alone could potentially save your practice from a lawsuit.

4. E-Prescription

Did you know that a Physician can save $15,700 per year by using the ePrescribing feature of a good EMR Software? Sound too good to be true? Well it is, and it doesn't cost you any more time or money when you select the right EMR Software with an up to date and fully integrated ePrescribing function that virtually does it all on automatic pilot while you're examining your patients.

5. Improved Reimbursements and Reduced Insurance Premiums

Accuracy of certified EMR and certified EHR programs is so trusted that many malpractice insurance companies are now offering discounts to doctors who use full software systems. In addition, practice management software can also greatly improve your reimbursement rates as they will ensure your office claims are compliant with insurance company drug formularies and other policies.

These are just a few reasons why electronic medical record software can save you money-even in times of economic recession!

What the Clinically Depressed Need From Church

Having had some personal experience with depression, yet without any experience with clinical depression, I am grateful for the lessons I'm learning, as a minister of God, regarding how the church can support the clinically depressed.

Grief-induced depression, or depression induced due to change etc, i.e., non-clinical depression, is very far removed from clinical depression. These two are poles apart. And whilst the former person might be encouraged by words from the Bible, the latter - the people who have struggled with severe depression - may inevitably feel condemned because they are misunderstood. They are, therefore, so far as the church is concerned, misrepresented. For, the church exists to speak into the hearts of suffering people as these, by a compassion beyond words.

THE CHURCH AND ITS ROLE IN MINISTERING TO THE CLINICALLY DEPRESSED

The church has a very specific role when it comes to ministering to the clinically depressed. The church is no snake oil healer, nor is it a place where someone might be diagnosed. Anything other than supporting a person with clinical depression, by just journeying non-judgmentally with them, treads the fine line of ministry malpractice. The reason being, those who are clinically depressed are so home to feeling condemned, due to their experience and indeed even within their own thoughts. The only thing that defeats such mindsets of condemnation is an eternal commitment to compassion; no matter what. Besides, the church and its ministers are unqualified to do anything other than to support - but they're perfectly qualified to do that, because they're invigorated by the compassion of the Holy Spirit.

We ought to know that the church, in the present context, exists to be the hands and feet of Jesus.

Yet, that becomes too clichéd. Too often we find the church knows the right words to say but there is an emptiness of compassion; the words lack sincerity and they lack meaning, and as a function, Christ loses credibility - even when God is the only credible overall Guide.

As a church, and as ministers, there is sometimes a role for facilitating the right level of medical support, if required (i.e., helping connect people with proven [caring and competent] medical and health professionals). I've heard some who have been clinically depressed say to me that they felt that the biochemical balance had to be restored first and foremost, before any real spiritual work could be done (which they, alone, are to be masters of, with a minister's support). As ministers, and as encouragers, we are to ensure that we validate the need to achieve biochemical balance - the need for pharmaceuticals to restore physiological balance to the body and mind.

More than anything else what we can do, within our churches, is to unconditionally accept those who have suffered, and continue to suffer, clinical depression. It must be a safe place to come to, where all vagaries of mood are accepted and never judged. We are to offer compassion.

What we cannot understand or explain needs only compassion.

© 2012 S. J. Wickham.

What Makes a Great LASIK Surgeon?

A great LASIK surgeon ...

1. Has quality training and keeps up with new developments

When LASIK first became available after being approved by the FDA in the late 1990s, there was a rush for it, and lots of LASIK centers suddenly opened and offered it. Not all these centers were well run, or hired properly qualified eye surgeons.

A great eye surgeon:

· Is a fully qualified ophthalmologist, certified by the American Board of Ophthalmology

· Has training beyond the original medical degree

· Belongs to at least one professional organization, such as the American Academy of Ophthalmology, or the American Society of Cataract and Refractive Surgeons (ASCRS) - this keeps the eye surgeon in contact with his peers, which in turn apprises him of new ideas and better methods

· Has a clean record at the state Board

· Has never had malpractice insurance coverage denied

· Has never had their license revoked, restricted, or suspended

2. Has lots of experience

· Has been performing LASIK procedures for at least 3 years or so

· Has done at least 500 procedures

· Has done at least 100 of the same type of procedure recommended for you

3. Puts quality before cost-saving measures

Every person's eyesight is precious. The best eye surgeons take extreme care of their patients' eyes and provide the best in everything, rather than cut costs. For instance, they:

· Lease or purchase the best quality laser and microkeratome - these are both expensive items for the surgeon, but there's a big difference between the quality of vision correction possible with cheaper tools and that possible with the best tools.

· Hire office support staff who are not only kind and sympathetic people but also highly trained in the techniques they perform

4. Does your pre-op and post-op visits himself

Some LASIK eye surgeons delegate important work to people who aren't necessarily properly qualified. Besides doing the actual surgery, the best ones will:

· See you initially and determine if you're a good LASIK candidate - an excellent outcome isn't possible if you're not a good candidate to begin with, and the best surgeons screen their patients carefully

· See you for all your post-op visits, to check on your healing progress and how you're feeling about the results

5. Runs a very organized facility

Vision correction is meticulous work, and meticulousness should be evident throughout the facility. The surgeon sets the standards. If the staff misplaces your records, forgets your name, writes down the wrong appointment time, gets your phone number wrong, etc., then what is the surgeon doing with your eyesight? Most LASIK complications are the result of "human error", which is a name for carelessness.

6. Keeps the surgical tools well-maintained

Some LASIK centers try to process as many patients as possible, cutting corners to keep costs down, and offering those "$499 per eye" deals. One of the corners that's often cut is quality maintenance of the LASIK equipment.

A great LASIK surgeon will:

· Calibrate the laser before each procedure - this isn't mandatory but it helps keep the laser at its peak level of accuracy

· Keep the laser in a room that has the correct temperature and humidity

· Have good battery backup in case of power outages

· Have professional preventive maintenance done on the microkeratome - this is the instrument used to cut the little corneal flap so that the laser can do its corrective work on the underlying corneal tissue. Many LASIK complications are related to faulty flaps.

7. Offers Custom Wavefront LASIK

This is an upgrade over traditional LASIK surgery, and uses a far more precise method of mapping your eyes, so that your treatment will be far more exact and customized for you. This type of LASIK treats the higher order aberrations (glare, starbursts, double vision etc.) as well as the lower order aberrations (near- and far-sightedness and astigmatism).

8. Will respond quickly to any complication or emergency situation

The sooner a problem in any surgery is addressed, the more likely it is to be well corrected. A great LASIK surgeon is equipped and staffed such that he can respond immediately to any problem, whether it occurs during surgery, or just afterwards, or in the recovery period.
Follow-up visits are a part of a good LASIK treatment, so that if you do experience a problem in the period following your surgery, you can quickly see your surgeon and have it resolved.

9. Feels and shows genuine concern for each patient

Eye surgery can be an alarming prospect. The best surgeons understand this, and take care to inform and reassure their patients, and answer all their questions. Some also offer relaxing medication such as Valium, if necessary.

Part of genuine concern is honesty. The best LASIK surgeons will not:

· Guarantee 20/20 vision -- because each person is unique and though many LASIK patients do achieve excellent vision, some still must wear glasses, and others run into some rare complication which can probably be remedied, but sometimes not

· Claim to have "special" technology - the LASIK technology is widely available, and if a new technique comes along it will have to be tested over time before it can be trusted

· Offer extraordinarily low prices - because LASIK procedures are best done using the best equipment and staff, which eliminates bargain basement prices. As with so many things, you get what you pay for in vision correction.

Why Should You Hire a Compensation Lawyer?

A Compensation Lawyer helps you to claim the compensation amount in a court of law when you have failed to do it yourself. There have been various occasions when a person has suffered losses and have faced hindrances for no fault of his own. In such cases he is free to claim compensation amount from the other party. And if he fails to do so by negotiation, which is often the case, then hiring a Compensation Lawyer is a mark of prudence as he is well versed in the laws that facilitate claiming compensation and can get you the best possible claim amount.

  • Medical Compensation Lawyer: A Medical Compensation Lawyer is someone who helps you to claim compensation from a hospital or other medical centers. It should be mentioned that you cannot simply claim compensation just because your illness was not treated because sometimes the nature of the illness is such that it cannot be treated. However, if you come to know about malpractices in the hospital, if you have been wrongly diagnosed and over charged for your treatments, or if you come to know that the hospital deliberately kept you back in spite of lacking in facilities and equipments, then you are free to claim compensation and Compensation Lawyer will guide through it.
  • Work Accident Compensation Lawyer: On a number of occasions a worker is injured in the workplace. This is especially common in factories where outdated equipments are used and under trained and inexperienced workers are employed to maximize profit for the employers. And for a single individual it is not possible to stand against a huge organization. A Compensation Lawyer will present your case in the best possible light and will help you to get the maximum claim amount from the employer. He will gather the evidences and other witnesses and present them before the court to prove the need of the compensation. If the worker has been heavily injured, the compensation amount is likely to go up even higher.
  • Criminal Injury Compensation Lawyer: A Criminal Compensation Lawyer helps the victim while claiming compensation in case of violent physical or mental abuse which can be rated as criminal offence. And he is well equipped to represent the victim who may have suffered more of mental trauma, along with the physical injuries. In case of a homicide, the lawyer represents the victim's family. Criminal offences involve a lot of investigation and a good lawyer will be able to provide all the information to prove the crime of the offender.
If you want to press further charges then you should hire a prosecuting lawyer, since a Compensation Lawyer only negotiates and does not stand in trial cases usually.

How Much is a Human Life Truly Worth?

We need to include tort reform as part of our health care reform. This would help to lower the cost of health care by decreasing the cost of malpractice insurance and legal fees for health care professionals. Nobody should be able to sue a doctor or any other member of the medical profession for millions and millions of dollars. A reasonable cap should be set on punitive damages (in addition to cost of medical care, etc.), even in the cases of severe injury or death. In addition, the health care professional who is found to be responsible for the damages should no longer be able to practice medicine, and he should be subjected to the penalties for any criminal activities which are already established in our legal system.

So what is a reasonable cap for determining what a human life is worth? Of course, a human life is priceless, but when presented with the ugly task of trying to place a monetary value on life, here are some suggestions from the Bible:

In Leviticus 27:1-8, we see a list of various amounts for the equivalence of "dedicating persons to the Lord." The highest of these amounts was for "a male between the ages of twenty and sixty," which was fifty shekels of silver, or about 1.25 pounds. At today's price of silver of about $14 per ounce, this would be about $280. This is obviously too low for today's standards.

Then, in Matthew 20:9, we see that a day's wages was a denarius, which was a silver coin weighing about 4.5 grams, or about 0.16 ounces. Again, at today's price of silver, this was about $2 for one day's wages. So, we see that the $280 from Leviticus 27 would equate to several months' wages. and it would even be fair to say that this was approximately one years' wages. In today's world, we might say that this would be one years' worth of wages for whatever the injured party's annual salary is, or we might choose an average number, maybe $30,000 to $50,000, or maybe even a more generous number of $100,000. However, this still seems too low to us for what a human life is worth.

Then in Genesis 29:18, we read the story about Laban working for seven years for Jacob, in return for Jacob's daughter Rachel (i.e., for her hand of in marriage. From this we might conclude that a life is worth seven years' wages. Using the numbers from above, one could argue that this might place the value of a human life somewhere between $200,000and $700,000, with a more generous amount being about $1,000,000.

A (priceless) human life is certainly worth more than one million dollars. However, is this amount a reasonable cap for punitive damages for what a human life is worth in our legal system? Yes, I think this is fair. The average man or woman could easily live on the interest on this amount, which, at 5% would be $50,000 per year. If the person is wealthy, and accustomed to living on a much larger amount, then they would still be able to get by simply because they are wealthy. It's a tough decision that nobody wants to make, but it needs to be done.

Dr Phil, Dr Clueless, and Dr Any Day Now

Have you ever been to a restaurant with lousy service? Even though the
food is good, you won't go back because you refuse to be treated poorly.
Have you ever stopped frequenting a retail establishment because you
became tired of lousy service by a workforce that has no work ethic and
perhaps give off those signals that they're doing you a favor? Think
about an establishment that no longer has your business because the way
they do business is just plain terrible.

Let me ask you this....Did your doctor's office come to mind? Probably
not. Why is it that if a restaurant or a retail establishment gives us
poor service we walk away, inform management, or fill out customer
comment cards? When our doctor's office gives us poor service we go
back for more; over and over again?

Over the last couple of months I have listened to several people
verbalize some negative things about their doctor and the inefficiencies
at the office. They all have the same doctor. I've heard comments like
you can't get an appointment, they pawn you off on a physician's
assistant or a different doctor, or the staff is just rude and will let
you sit and wait and wait and wait and not tell you what is going on.
Now the first thing that comes to my mind is 'why the heck do you keep
going back for more'. New physicians are graduating medical school every
year; new physicians who are perhaps more current with technology and
protocols.

Oh coincidentally, the doctor receiving the complaints is mine as well.

So I asked all three of these people what they have done about changing
the situation. Have they said anything? Have they talked to the doctor
about what they are experiencing? Don't they think it is important that
the physician know what is going on? Or were they just going to whine
about the waiting, the shuffling, and the poor service, only to be
frustrated again next time they pick up the phone or enter the office? I
shared my thoughts on how things will not change unless someone says or
does something. The response from all three was along the lines of it
won't matter; nothing will change, why bother, and I don't go to the
doctor that often. Which is amazing; most businesses really do want to
hear from their customers. Many actually implement changes when they
hear from customers. A doctor's office is a business, isn't it? Sorry to ruin your day if you thought otherwise.

Well last week was my turn. I needed to see the doctor. He was not
available. I was referred to his associate who had lots of openings. Of
course she did, she's clueless. When I needed shots for my trip to
Africa last year I accepted an appointment with her. I figured it
wouldn't matter; it was just shots. When I arrived she wanted me to tell
her what shots I needed; what protocols I needed. I informed her that
she was the doc and that the office staff knew why they were scheduling
me. She said she would have to research it and she would get back to me.
Hooray! I got to pay a $25 co-pay for someone to tell me they will do
research. I digress.

So when the receptionist offered me an appointment with Dr. Clueless, I
declined. I was given an appointment with Dr.
I-Could-Care-Less-How-Long-You-Wait-For-Me. I arrived and waited forty
minutes watching everyone else being called through the Doorway to
Better Health. I finally asked if I was forgotten. I was informed that
he was running late and that it would be another hour. I informed them
that it would not be another hour and perhaps I should bill them for
wasting my time. Dead, uncomfortable silence. Hey, like I said, you
gotta have a little fun. They offered me Dr. Clueless. I chuckled and
told them my two ten month old puppies could do a better job diagnosing
my problem. They told me they would note my file that I am not to ever
see her. Those words came out of the receptionist's mouth so fast, as if
this was not the first time this has happened. I walked out. That
evening I also faxed them an invoice for an immediate refund of my
co-pay; with a "threat" of a collection agency. Just having my sadistic
fun.

Let me tell you why I originally selected this doctor. I do not do
medication - it is the last alternative. It is that simple. This doctor
doesn't just prescribe medication. It was a match made in heaven. As a
matter of fact several years back he sent me for Reiki when I was having
a little period of anxiety. He was young when I found him. His practice
was new. I am relatively healthy. I do not need to see him regularly; I
was even told that is why I couldn't be slotted in on an emergency basis
last week; because I have not seen him in over a year. Boy, it sucks to
be healthy

Now when I walked out I started thinking about those three other
patients. I made a decision right then and there. I was going to let the
doctor know that I walked out of his office and most likely for the last
time. I thought about the feedback I receive at the end of most
presentations or workshops that I give. That feedback makes be better.
(It also makes me feel good too!) I decided the doctor needed a
confidential evaluation of his office. I thought about the number of
times an audience member or a reader of my newsletter challenged
something I said or did. It got me thinking. Perhaps it gets me to
change something. But most importantly, I usually know I struck a nerve
- which is what I enjoy doing. When I strike a nerve I know I am getting
people to think, stand up for themselves, or begin to make some great
change in their life. I decided it was time to strike a nerve with the
doc and this was on behalf of all people here in the United States who
have experienced "managed care!"

So I wrote Dr. Phil a letter, yes his first name is Phil. I reminded him
why I originally came to him. I also shared my frustration with his
office. I let him know that people in the community are not saying nice
things about him. I told him I understand that might feel that he is at
the mercy of the insurance agencies, HMO's, and malpractice issues. I
told him I understand his predicament. I also reminded him of the people
who were there when he started his practice. I apologized for not being
sick enough to visit him on a regular basis and told him I would
probably not see him again; but am available to talk to him about my
letter if he so chooses.

Will my letter make a difference? I don't know. I have nothing to lose.
I can't get in to see him anyway, even if I make an appointment. But
maybe, just maybe he might stop for a moment and do some thinking.
Maybe, just maybe, I am the first to let him know what is going on; and
why he is losing a patient. Maybe he has been losing many patients and
not knowing it? Maybe he wants to know? Somebody has to be first.

But here is your take-away...There are businesses that you choose
for reasons that are important to you. Likewise, people are choosing you
and your business for particular reasons as well. Do you know what they
are? Is it worth revisiting your core values and beliefs every so often,
as an employee, employer, business owner or staff member? Have you ever
played customer for one day at your business? Where do you need to speak
up? Don't think it will make a difference? Will it make a difference to
you?

Remember to have some fun today!

Here's a Health Care Plan For You!

Everyone pretty much agrees that "SOMETHING" needs to be done to reform our current health care system.
The question is "what", and "how soon"?

Well, I'm sure most will agree that "the sooner, the better".

The problem is that too many are "rushing into" all kinds of "major surgery" whereas I believe a series of corrective operations need to be performed. There are too many policies, rules & restrictions in place which prohibit cost-effective operation of the current system. Here are just some of the steps needed which will give you a sense for the necessary way we need to make corrections in our Healthcare System.

First, we need to transfer ownership of all health insurance plans directly into the hands of the individual. That means eliminating control of employer-held policies for their employees. Employers simply PAY their employees for whatever costs they are now paying. This will force individuals (employees) to now "comparison-shop" for the BEST policies, thereby introducing the "competitiveness" element into the health care marketplace! Enrollment requirements for group policies would be modified or eliminated.

Second, we need to allow individuals the freedom to purchase ONLY the coverage that they need (want) and can afford. For instance, if one wanted coverage for a pregnancy, it would certainly cost less than one with all the other "bells & whistles". Likewise, there is no reason that a non-smoker, drinker or drug user would need to pay for coverage which would include alcohol and drug abuse, etc. (unless, of course he or she just wanted it).

Third, we need to eliminate many of our "built-in" cost producing restrictions. Examples are: Many reasonable healthcare services can be handled by qualified nurse-assistants (practitioners) instead of requiring the more expensive visit to a higher paid physician; adopt a "loser-pays" system for malpractice suits; re-vamp FDA restrictions and availability of drugs....including availability of more reasonable "over-the-counter" drugs; deny federal medical funds to any organizations (including states) who restrict competition in the medical field; modify laws requiring Emergency Rooms to treat ALL persons regardless of condition; i.e. prevent free-loaders from using emergency rooms for non-emergency injuries (colds, abrasions, etc.), and there are many more!!

Fourth, we need to allow tax-free Medical Savings Plans for all "Citizens"

Fifth, we need to eliminate coverage for illegal aliens.

Sixth, we need to adopt the FAIR TAX H.R. 25 & S 296

The Ethical Challenges of Working With Older Adults

Marie Jones is a 73-year-old woman who lost her husband last year after almost 50 years of marriage. Her complaints are memory problems, poor appetite, and low energy. Mrs. Jones told her physician that her children think she should move into a retirement community, but she is hesitant to give up her home. If Mrs. Jones or someone like her was referred to your practice, would you be prepared to treat her? If you are like many other providers in the helping community, the answer is most likely no. As the 20th century draws to a close American society is graying. Life expectancies have increased dramatically during the past 75 years, and the number of community dew willing seniors is steadily rising. The stressful associated with aging, such as environmental changes, retirement, loss of partners, and coping with Illnesses are all issues that could be addressed in psychotherapy. Yet very few graduate programs offer training opportunities in clinical gerontology.

Even when training is available, ageism may lead some therapists to assume that emotional growth and change among seniors is limited, and therefore not worth professional pursuit. Counter transference, often based on personal fears of aging or family issues with parents/grandparents, can also pull people away from treating seniors. Whether the reasons are personal or professional, treating older adults when you are I'll prepared leaves the door wide open for ethical dilemmas and potential malpractice.

*Before the Work Begins*
Psychotherapy is an intensive exploration of personal values. Understanding your own value system and how it Impacts your work is the cornerstone of ethical practice. Your beliefs drive the counseling process forward, even in the most non directive of therapies. As Christians, it is easy to underestimate the Importance of values clarification. Loving God, loving our neighbors as ourselves, and believing in the healing power of Christ are all values that would appear to be self-evident within the Christian counseling community. But there is tremendous diversity within the Body of Christ as we will as many different understandings of health, healing, pathology, and change.

Assessing and articulating your values in the field of gerontology will involve prayerfully considering difficult questions. For example, what are your beliefs regarding the ending of life? If your client wanted to die by stopping painful medical treatment, how would you decide what to do? Would your decision be different if your client was 65 or 85? Would your behavior place you in conflict with accepted community standards of practice or with state regulations and laws? Values guide us, and they guide our clients. Once you have taken the time to identify your values about the aging process and about older persons, you will be better able to see how thesis will Impact your work. Being aware, being clear, and being open respects both the process of therapy and the individual client. It also helps you steer clear of many ethics-related pitfalls.

*Common Ethical Dilemmas in Gerontology*
Mrs. Jones has now been referred for counseling by her family physician. He is concerned about her memory problems and wants a second opinion. He also thinks that Mrs. Jones is isolated and could benefit from talking to someone about the relatively recent loss of her spouse. Are you the appropriate referral? Even with the limited information we have about Mrs. Jones, there are many clues that can direct her mental health treatment. Her complaints may indicate the onset of a dementia, but they can also suggest other problems, such as depression, uncomplicated bereavement, failing health, or even elder abuse. Psychological assessment, individual therapy, and family therapy may all be appropriate parts of her treatment plan. As a provider, you must first evaluate your own level of training and expertise. Just as you would not think of treating children without adequate training, the same standard applies to gerontological practice. If you feel that you are under trained, you will need to access old_resources such as supervision, continuing education, and consultation to assist your work. The most ethical decision may be to refer this client to a colleague and take the time you need to develop your skills.

*Consent to Treatment*
Many older adults are unfamiliar with the process, demands, and expectations of psychotherapy. Although the senior community is rapidly becoming more psychologically sophisticated, there are many older persons who believe that counseling is only for really crazy people. They may be more comfortable with a traditional doctor/ patient relationship and may not know what to expect from a therapist or from therapy Itself. Once you have decided you have the skills to treat Mrs. Jones, she must be fully informed about the process of therapy, including your therapeutic style, fees and billing practices, confidentiality, and the risks and benefits of treatment. She may need additional information about potential recommendations such as psychological testing, bereavement groups, or a medication consultation. Once Mrs. Jones is given the information she needs to understand your work with her, she will then be better prepared to give informed content. If you have any doubts about her competence to give consent, further evaluation will be needed before you begin treating Mrs. Jones. This is Important for the provision of ethically sound therapy and for the clients own safety. If Mrs. Jones does not appear to understand the therapeutic contract, she may have problems outside the therapy room that need to be quickly addressed. Memory loss or decreases in functioning do not equal incompetence, but they can serve as red flags for a comprehensive assessment.

*Release of Information*
You have been meeting with Mrs. Jones for about two months when her son comes to visit from another state. He is very impressed with the Improvements he sees in his mother's mood and self-care but continues to wonder whether his mother should move into a care facility. He also believes that some of his mother's problems relate to the physical abuse she endured during most of her married life. He calls and leaves you this information and asks that you return his call without telling his mother he has been in touch. This phone message presents many problems for you. First, Mrs. Jones has yet to mention that her husband was abusive. She has presented her marriage as happy and stable. Second, Mrs. Jones decided not to sign releases of information for her children, because they worry enough about me and this would just make it worse. Her son learned about her therapy from the family physician, who reported to the son that Mrs. Jones memory problems and depression seemed to be decreasing. When faced with this turn of events, you must remain focused on your client. You do not have access to Mrs. Jones son, as much as he would like to be helpful. In addition, you now have Important therapeutic information that must be sensitively addressed with your client. Honesty within the therapy demands that you let her know what has happened and work with her to reach a plan of action.

*Limits of Confidentiality*
When told about her sons call, Mrs. Jones states that her husband had been an active alcoholic for most of their marriage. During that time, he was physically abusive. His eventual failing health led to his sobriety, and they spent the last 10 years of their lives together in a peaceful and relatively happy relationship. Mrs. Jones also reveals that her youngest son, who lives next door, is also an alcoholic and sometimes becomes so angry that he hIt's her. An essential aspect of ethically sound gerontological practice is having a thorough understanding of elder abuse. It is possible that some of the depression and cognitive problems observed in Mrs. Jones could be attributed to the abuse she has been experiencing. The shame associated with being abused by their children leads many adults to keep the violence hidden, but the stress and trauma are often exhibited indirectly. It is your responsibility to know the laws in your state regarding the limits of confidentiality and the reporting requirements for suspected elder abuse. This information should be shared with your clients when treatment begins, so they have the power to decide when and how to share this information with you. Online Christian Counseling is a nice way to get suggestions.

*In Closing*
The best way to avoid ethical problems in psychotherapy with any population is antecedent control. Recognizing the limits of your training, participating in continuing education, making sure you have safety nets in place to assist your practice, and staying in touch with colleagues are all Important safeguards against ethical violations. As Christian therapists, we have made a commitment to be Gods instruments of healing in a broken world. This demands not only that we practice with the highest ethical standards of our profession, but that we constantly remain open to the work that God can do through us. Knowledgeable, we will-trained, and self-aware clinicians who know their values, strengths, and limits are going to be best equipped to meet this higher standard of care.

Bariatric EHR - Know the Advantages of Using This System

Computers are a necessity today. They not only simplify our lives but also help make our work easier and save us unnecessary wastage of time. The medical industry is now realizing the importance of technology and is focusing on doing away with cumbersome files, loads of paper, and hand written records. The shift is now towards using computers to keep a track of medical records.

In a normal scenario when an individual approaches his doctor with some ailment the doctor seeks a whole lot of information from the patient about his medical history, previous medical conditions, radiological images if any, laboratory results and other such details. The doctor uses this information as well as details of some tests he may order to diagnose your problem and provide a course of treatment. Things are different today. What the doctor now does is put all the information you provide in a digital format. This digital format is also known as an electronic health record. In the case of bariatric patients these records are known as bariatric EHR (Electronic health records)

Be it a regular EHR or a bariatric EHR, these systems have some advantages and disadvantages. The advantages of having an Electronic health record are:

1. Effective documentation: Doctors are known to have illegible handwriting and this can very often lead to information being misunderstood by some other health care provider. If you go in for ehr this problem will disappear.

2. Cost effective: The use of EHR will lower costs in the long run and help you save resources. Information is easily available and the patient's sick period is reduced as information is easily available at the click of a button.

3. Storage: Files and paper documents take a lot of space and a backup needs to be created to take care of calamities such as fire. On the other hand a lot of information when stored in a digital format can take up very little space and creating a back-up is not too difficult as well.

4. Insurance companies usually reduce the malpractice premium for hospitals that use an EHR system. This is because they have access to documentation that is legible and accurate as compared to notes that are scribbled by your doctor. In case there is litigation it becomes easier to follow an information trail in the case of institutions that use an EHR system.

5. The care that is provided to a patient is also improved as the health care provider can easily access the patient's medical information.

Lawsuit Funding - Leveling the Lawsuit Playing Field

Are you a plaintiff or an attorney involved in a lawsuit and need more money to continue your case? Lawsuit funding may be the way to go. Since this service has only been available for a few years now, most attorneys and hardly any individuals are aware of the fact that they can receive cash advances for pending lawsuits.

What Is Lawsuit Funding? Lawsuit funding - often referred as lawsuit loans, litigation financing, and legal finance - is a new segment of the cash flow industry. But, it is growing very quickly. Essentially, a funding company provides a cash advance to a plaintiff in a lawsuit against the favorable outcome of the case.

In other words, based upon the strength of the lawsuit, the lawsuit funding company will provide an advance (normally, in the range of 10-15%) on the amount of money the plaintiff is expected to receive, should he win his case. This advance is non-recourse. This means, that should the plaintiff not win the case, he does not owe the funding company any money in return. Lawsuit funding is not a typical loan because the money does not have to be paid back, unless the case is won or settled.

Why Lawsuit Funding? It levels the lawsuit playing field. Typically, lawsuit defendants (insurance companies, large manufacturers, banks, etc) have deep pockets. The plaintiffs are normally average, ordinary citizens. These large companies tend to string the process out, hoping that the plaintiff will run out of money and quickly settle the case for a small sum of money.

Take for instance, slip and fall cases and auto accidents. These cases account for more than 3 million injuries each year in the US. Many result in job loss, severe injuries, paralysis, and head traumas; some are permanent and irreversible. Many require continual, expensive medical care - the cost of which can easily bankrupt a family. This is where lawsuit funding can help.

A lawsuit cash advance will allow the plaintiff to pay his or her medical bills, mortgage payments, and other household bills. The problem is: Most lawsuit plaintiffs do not know they can get a lawsuit loan. They can qualify for funding, ranging from $250 to over $1M for an individual case and up to $10M for a commercial case.

How Does Lawsuit Funding Works? It is very simple and straightforward: The plaintiff fills out an application and submits it to the lawsuit funding company. The company contacts the plaintiff and his lawyer and asks background questions about the case. The funding company sends the plaintiff a contract, the plaintiff signs and the company transfers the money into the plaintiff's bank account or FedEx's the funds directly to the plaintiff (whichever the plaintiff chooses).

Advantages of Lawsuit Funding. Lawsuit funding offers many advantages: it is confidential, prompt and discreet; there is no risk to the borrower; applications are free, and without obligation; there are no upfront fees, nor any processing or monthly fees; there are no credit or employment checks; bad credit - even no credit - is okay; the underwriting process is quick - as little as 6-8 hours; a client can have money in hand the very same day; funds can be for any purpose; plaintiff pays back the advance, only if he or she wins; if the client loses the case, he or she owes nothing; all information is kept confidential; you do not need your attorney's approval; and its available for all types of civil and commercial lawsuits.

Who is eligible for Lawsuit funding? If you are involved in any type of lawsuit, such as: personal injury, product liability, auto accident, patent infringement, malpractice (medical, legal, construction), employment discrimination, fraud, breach of contract, Mesothelioma, negligence, workers compensation, class action, civil rights, whistle blower (qui tam), workers compensation (not in all states), wrongful death, commercial litigation etc.; and you are represented by an attorney, you may qualify.

Spread the word! You can get an advance against your lawsuit. If you have a friend, family member or business associate going through a lawsuit, let them know about this new service.

An Alternative to Traditional Physician Jobs

You've spent years in medical school and residency dreaming about the time when you could care for your patients and start settling down into a regular life. For many people, working in traditional physician jobs is the perfect solution for enjoying life outside of medical school. For other doctors, however, who find that graduating from medical and completing their residency is a completing liberating experience, the prospect of being tied down to a full-time job just isn't a thrilling idea. Many new doctors who have been stuck inside a classroom or doing residency inside a hospital for years may be ready to break out of the traditional mold and see a little bit of the world.

For these doctors who find traditional physician jobs unappealing, a job as a locum tenens doctor may be the perfect solution. Locum tenens doctors are traveling positions who work on a contract basis to cover for full-time doctors when they go on vacation or take another type of leave of absence from their positions. Their services are vital to hospitals, medical centers, and even family practices that otherwise would not be able to care for patients adequately when members of their medical staff are away for an extended period of time.

Most professionals working as a locum tenens doctor will find employment options through a servicing company, which can negotiate your compensation package, and make your travel and housing arrangements for each of your jobs. Often the compensation received for locum tenens services are superior, and many medical facilities will cover housing, travel, malpractice insurance, and even licensing fees. These jobs are available for doctors who have chosen not to specialize such as family practice physicians as well as others who have specialized in any number of areas, including surgical specialties. The jobs are a great way for doctors to travel and see different parts of the country while still working in their profession.

Searching For The Shovel In Texas - The Young Are Digging Themselves Out Of The Healthcare Crisis

Perhaps it shouldn't feel like suffering a personal wound when learning about the state of healthcare coverage in Dallas, Houston and throughout Texas, or anywhere else in this country – but it does. In fact, for most of us, it really does.

It tends to shatter the ideals we were taught as American children—that everyone is equal, no one suffers unwillingly, and working hard will get you somewhere—when we learn that approximately 18,000 uninsured individuals ages 25 to 64 suffer “excess" deaths annually.

Health insurance premiums have increased by 15% per year over the past five years, more than triple that of the inflation rate, 2.5% . Medical costs are through the roof, quality of it often below sewage level, and an average citizen might feel that he/she has to overwork him or herself into a coronary just to get it.

One third of firms did not even offer health insurance coverage to their employees in 2004 , most of them citing high premium costs. It does not seem a coincidence then, that one-third of uninsured adults did not fill at least one prescription, and/or receive at least one recommended test, due to cost .

In Texas alone, 9,787 deaths in 2002 were attributed to lung and bronchus cancers, arguably the most preventable cancers with proper screening and smoking cessation programs. Perhaps it shouldn't be personal, but when young adults consider the reality of an impending personal health crisis, or their children not receiving the absolute highest quality of care available because of poor or non-existent coverage—and perhaps not even knowing the difference—yes, it tends to chafe. This is a biologically-based life, after all, and those lungs and hearts keep us in the game.

In order to address the problem, it is important to attempt to understand why this is happening. It's not just that premiums are increasing; it's that the economy is shifting. Texas and the rest of the United States is no longer manufacturing-based; it's service-based, and small businesses – which cannot afford large, corporate healthcare packages – in turn, cannot offer coverage to their employees. Three-fifths of all workers provide their labor to small businesses, and less than two-thirds of these companies offer health benefits .

Even if they could, their employees might not be able to afford group health insurance; employee spending for healthcare coverage increased 143% between 2000 and 2005 . To many, it's simply unrealistic. So what we have, without exaggeration, is a healthcare crisis—lack of or inadequate coverage, which leads to lack of or inadequate healthcare.

But let's not be entirely gloom and doom about this, shall we? After all, whiners with no solutions are a bit like well diggers in the desert with no shovels. We can analyze the situation for days at a time ("yep, that's a lot of sand") —but then, of course, we die of dehydration. There are, in fact, solutions, and perfectly logical options at that.

(1) Introduce revamped, affordable health insurance plans addressing the uninsured's actual needs.

Sounds obvious, right? Well, evidently not. Approximately 58% of uninsured adults in 2004 reported having changed or lost their jobs in 2003 , while only 7% of the unemployed could afford COBRA insurance (an extension of former employers' health plans), at an average of $700 per month, per family. While it's also easy to blame insurance companies for high premiums, they, too, are absorbing higher hospital and clinic bills, the consequences of malpractice suits, and a surge of baby boomers growing older. It may be more productive, for now, for the public to demand new plans that are reflective of today's needs, than to try to tear apart the industry as a whole. This is not at all unrealistic, and pushing for such changes could make a big difference.

Many of us, for instance, need affordable interim or basic coverage while we build our careers, and would gladly pay a reasonable premium for a reasonable policy. We need these policies to cover the millions slipping through the cracks—students, entry-level workers, those in between jobs, on leave of absence, or those just starting out in their professions (and who may not be able to afford buying into group health insurance). Similarly-crafted policies need to also address the growing number of workers in contract, freelance, self-employed, and full-time positions, in which benefits are self-provided through individual health insurance plans.

These plans need to be accessible and affordable to the increasingly independent, young individual with middle and lower-middle class budget constraints. Obviously, the market is there.

(2) Purchase "portable" individual health insurance plans.

Considering the majority of the uninsured in 2004 had changed or
lost their jobs, and considering that there are many who stay in their current
positions simply for the health insurance coverage, individual health insurance may make more sense, as they are "portable," that is, they can follow a worker from job to job. With individual health insurance policies, workers are no longer tied to a position just for the sake of health insurance, nor do they need to worry about the exorbitant cost of COBRA in the case of job loss. Many companies, in fact, are willing to offer an allotment to cover all of their employees for the purpose of purchasing individual health insurance. In this way, insured individuals can relax, knowing they will still have coverage if they switch, or lose their jobs, even with pre-existing conditions.

(3) Increase coverage of preventative care.

According to the American Cancer Society, an individual's risk of getting, or dying from, cancer greatly decreases with prevention, early detection, and proper screening programs. Smoking alone causes 30% of all cancer deaths, and lifestyle changes can also dramatically reduce cancer risks . Yet, those lacking insurance receive less preventative care, are diagnosed at more advanced stages of disease, and tend to have higher mortality rates than the insured . Even many of the insured do not have access to these programs. Obviously, standardizing affordable packages that offer preventative services would not only reduce incidences of disease, but also dramatically reduce treatment costs. Even basic plans need to include an allotment for preventative care, in addition to some version of basic dental and eye coverage—like annual exams.

So, yes, my sense of good citizenship has been a bit wounded by the current state
of healthcare coverage. We used to worry about the retirees and children who could not provide their own health coverage; now we worry about almost everyone. Most of us are hard-working, helpful members of society who would pay a reasonable premium if we had access to it. But, if this system is to be revamped, citizens must speak louder for the necessary changes. We may be in the desert of healthcare, after all, but we are not without shovels.

If you’re interested in high-quality individual health insurance at affordable rates, specifically created for young, healthy individuals, you should take a look at Precedent. Visit our website, [http://www.precedent.com], for more information. We offer a unique and innovative suite of individual health insurance solutions, including highly competitive HSA-qualified plans, and an unparalleled “real time" application and acceptance experience.

With Brainswitching the Brain Can "Lose" Its Depression

In the early 1990s, when brainswitching, was first proposed as a cognitive behavioral method to halt a depressive episode, there wasn't much scientific research to support it. Anti-depressants were touted as the best solution.

Also there was the little matter, of which not everyone is aware, that anti-depressants were the treatment of choice for depression according to the DSM IV. This is the legal standard for the diagnosis and treatment of mental illness. That meant if a psychiatrist or medical doctor did not prescribe medication for depression, they could be subject to a malpractice suit for having made that "contrary" decision. Contrary as far as the DSM IV was concerned.

However, because of new questions raised this year about the efficacy of anti-depressants, there may be some changes in the DSM IV when it morphs into the DSM V at the next publication. Newsweek's cover story on February 8, based on the research of Irving Kirsch and Guy Sapirstein of the University of Connecticut, claims that placeboes are just as effective as anti-depressants in the treatment of depression,

Kirsch and Sapirstein saw that patients did improve on anti-depressants. "This improvement," says Newsweek, "demonstrated in scores of clinical trials, is the basis for the ubiquitous claim that antidepressants work. But when Kirsch compared the improvement in patients taking the drugs with the improvement in those taking dummy pills-clinical trials typically compare an experimental drug with a placebo-he saw that the difference was minuscule."

Brainswitching was ahead of its time in recommending mind exercises over anti-depressants. There is now much more support for brainswitching, and other alternative methods, in the research of the last 5 years. For instance, Rafael Malach and Ilan Goldberg of the Weizmann Institute of Science reported in 2006 that the "self-related" function of the brain, that part of the brain involved with introspection, actually shuts down during an intense sensory task.

Or, another way to put it, the brain can actually "lose itself," lose its power of self-focus, when engaged in some demanding task. The research involved getting subjects to classify animal picture cards, or name selections of musical pieces, while at the same time indicating whether or not they had a strong or weak emotional response to what they were classifying.

The researchers found that the regions of the brain involved with processing something in the environment, such as classifying the animal or music, was distinctly different from one's introspection about it, whether or not one felt strongly or neutral about one animal or the other, or one piece of music or the other.

The parts of the brain activated during either the classifying or emotional response to the animals or music were quite distinct and segregated. To make this judgment, the researcher used magnetic fields and radio waves to scan blood flow in the different brain areas, which would indicate brain activity going on in the different parts of the brain.

The conclusion of the research is that the self-focused "observer" doesn't seem to be present when one is involved in some intense task. Or, you could say, as the researchers did, the brain actually switches off "self." This research is very support of the cognitive behavioral techniques involved in brainswitching.

In the first place, in order to be depressed, a person has to think their depression. The person has to be self-focused on the pain they are feeling. The "observer part,"" the "self" of the brain must be present and functioning in order to experience the pain of the depression. Brainswitching, like the experiment of Malach and Goldberg, actually separates the message from one part of the brain to the other that depression is being produced. Some relief is immediate.

The whole idea of brainswitching is to do some intense mental task, such as thinking a nursery rhyme like row, row, row your boat over and over. The point being that the brain, in concentrating on thinking the thought repetitively, loses the "observer" of the depression. The observer disappears, the "self" disappears, it goes "offline," and therefore the depression cannot sustain itself.

Depression depends upon anxious thinking to produce the stress chemicals that cause the chemical imbalance that causes depression. When the depressed person uses a simple brainswitch exercise first, to separate the message from one part of the brain to another that depression is ongoing, and then immediately gets intensely busy with chores or work, the person's brain temporarily "loses" the "self" that was suffering with depression. The chemical imbalance now has a change to stabilize.