End of Year Thoughts

As we wind down 2014 and look forward to the new year, a few thoughts come to mind. It has been a good year for me personally and for the our family medicine practice. Health care is changing and our practice and the people that work here are changing to adapt to it. We have been a Patient Centered Medical Home Practice for over 5 years now. We attested for Meaningful Use Certification for our second time. We have begun the transition to ICD-10 coding/billing readiness and are on-track for the October 1st 2015 deadline. We have done our PQRS reporting for Medicare for a second year as well. The affordable Care Act (aka Obamacare) has arrived and the walls are still standing... What the heck does all of that mean???

It means the practice of medicine has become more centralized. No longer can we function as an island of health care, disconnected from the hospitals and the insurance payers. No longer can you be an island of your own. It means your health is being monitored by other people so that we, as a population, can live longer, healthier, more productive lives. There is a sacrifice to be made. You are not just an individual who can take or leave health care. It means you are part of a greater whole. You are helping to take care of other people you will probably never meet...and they are taking care of you and your family too. You were paying for their health care long before Obamacare, you just didn't know it.  By not smoking and getting your vaccinations and eating healthy and getting out to exercise, you are not only helping yourself, but others. Policies are being made that will make it possible for generations of Americans to have basic health care and I think it's, overall, a good thing...but it means change, and that can be a little stressful. My word of advice for 2015 is, RELAX, because I'll bet there will be a 2016 too.

Happy Healthy New Year!
-Dr. Ronan and staff
www.lakelansingfamilypractice.com

Healthy Habits for Weight Loss Program

I'm very excited about our Healthy Habits For Weight Loss Program at Lake Lansing Family Practice. We are in week 2 of a 22 week program designed around Dr. Wayne Andersen's concepts for healthy living and weight loss www.drwayneandersen.com
This is our first group medical visit utilizing a team approach to address the health hazards of obesity within our practice. So often diet, exercise, and weight are mentioned as an afterthought when treating Diabetes or Heart Disease or even Arthritis, but rarely do we discuss it as the primary reason for an office visit. Our program utilizes a team approach which includes a Registered Dietitian, Nurse Practitioner/Program Director, Physician Medical Director, Health Coach, and Personal Trainer/Group Fitness Instructor. Initially meals are planned through MediFast www.lakelansingfamilypractice.tsfl.com but meal plans can be custom designed for each patient in attendance according to their fitness goals and nutritional needs. We had 14 people attend tonight and I hope we can keep the momentum up through all 22 weeks and beyond.
Nice job tonight Team!

Optimal Health

We will be offering our patients a 22 week program focused on weight loss starting in 3 weeks. Often times weight is discussed as an afterthought or in addition to and acute problem or multiple other chronic disease processes that we are trying to manage. I find that the weight and how it got to where it is now is the underlying problem leading to most of the other complaints during the visits.  We have decided to make weight its' own health topic and not lump it in with the Diabetes or the Hypertension or the Coronary Heart Disease or the Hip, Back and Knee pain.  The habits that led to the weight gain is what led to the acceleration of all of those other problems. Addressing them won't fix the weight.
Health is dependent on many things, some we can control and others we cannot.  We can choose to smoke or not smoke. We can choose the food we consume. We can choose to be active or not. You can't do much about age and genetics, but Lifestyle we can control.
The core foundation of our program is based on Dr. Wayne Scott Anderson's book, Discover Your Optimum Health.  It is a "guide to taking control of your weight, your vitality, your life."
22 weeks seems like a long path, but I'll bet that after doing something consistently for 22 weeks you will build habits that should last a lifetime.www.lakelansingfamilypractice.tsfl.com

Are you there yet?...hopefully, you have a long road ahead of you.

-Dr.Ronan

Check That Filter!

I noticed my furnace blower was a little noisy this morning while I was working out, so I turned off the blower and yanked out the air filter and... it was due for a change. With 2 dogs in our house we seem to need to replace these every month or two. I think not replacing these filters has led to a burned our motor at least twice for our household over the past 12 years. I usually buy about 3-4 at a time when I'm at Home Depot or the hardware store. Make it a routine to check these at home and at work (we have 4 furnaces at my office), so you don't go without heat or air conditioning this year.

Pet Therapy

This is my dog Max. He was in the clinic today due to family travel plans. One of my staff volunteered to take care of him and our other dog Josie over the weekend. My wife was coming in to pick him up at lunch time, so Max got to make patient rounds with me this morning. He's a pretty docile 13 year old dog who is very familiar with the clinic, unlike my younger lab/retreiver mix, who is a bit of a loose cannon. He kind of just follows me around and lays down in each room I visit. I always ask if patients are ok with a dog in the room before entering and if they prefer no dog, I park him outside the door. He likes to hit the pharmaceutical reps up for pats on the head and the occassional snack if they have any edibles. On vacation, I often miss bringing the dogs, since they are so much a part of our morning and evening routines. I think pets help kids learn how to care about other things besides themselves and to be responsible. I think being a dog owner has made me a better doctor in some ways. It is hard to watch him get old.
As Max says: drink plenty of water, walk a lot and get plenty of rest.

Food For Thought

Food For Thought  after the Holidays-

Well,we are just coming off the longest eating stetch of the year and I’ve noticed the gym is packed each night with post holiday New Years resolutionaries. I’ve talked to several dieticians and nutritionists over the years and the secret to losing weight is not in the exercise you do, but in the amount of food you eat. The ratio is 80 diet and 20% exercise. You will not exercise your weight off nearly as easily as you will calorie restrict your weight off.

That being said, I like to eat. I also like a good beer (good beer, not a lot of beer). We have always enjoyed good food and drink at family functions over the years, but I’ve noticed that a few tricks help keep the bulge off the holidays.

There is no magic food. All food contains calories. When you eat more calories than you need, you gain weight. When you eat fewer calories than you need, you lose weight. In order to lose a lot of weight, you need to consistently eat fewer calories than you need EVERY DAY for an extended period of time. You are what you ate last month/year.  Healthy weight loss is about 1-2 lbs per week. So, if you want to lose 30lbs, at 1lbs. per week, it’s going to take you 30 weeks or about 6 months. The good news is that this long period of time should do something transformative to you. It should nearly permanently change your eating habits so that you are not “dieting” anymore, you are just eating the way you eat to maintain a healthy weight.  The holiday eating is an exception, not how you live and eat normally. The other 48-50 weeks of the year is what you really are.

I don’t particularly like tofu, fish, wheat grass or cod liver oil, but there are plenty of lean healthy foods that I do like that I enjoy every day, and I keep my weight pretty well in check most of the time.

The book series, Eat This, Not That and Cook This, Not Than by David Zinczenko and Matt Goulding are great resources. I also like Clean Eating Magazine and refer people to their web site for affordable, delicious, low calorie-dense food.

Have some strawberries dipped in dark baking chocolate (South Beach Diet recommended) and enjoy a massage or pedicure instead of cheesecake. Go for a walk on a nice day. Watch a sports event while on a piece of home exercise equipment instead of the couch and try to drink one water for every beer or glass of wine you consume.

Don't do what you want to do in this cold...stay in!

With temperatures at -19 Fahrenheit this morning and a windchill at -33 F, it was downright painful to walk across the parking lot this morning. Over 15 inches of snow fell in our area over the past 2 days making driving difficult. My wife and kids kept wanting to use the day off of school and work to do "normal" winter activities, like go sledding, shopping, skiing, or go out for dinner, but I had to remind them and myself that the schools, banks, state government and my office were all closed for a reason...it was dangerous outside!
I plowed my driveway 3 times and when the temperatures dropped below zero, my hands turned red, swelled up and hurt that last time. I thought about doing more of the sidewalk or back porch, but thought better of it and went inside to warm up. My wife did go out to the grocery store the day before and stocked up on basics like bread and milk and eggs, so we had plenty of food. She wanted to do some shopping, but I told her that just because the driveway was clean didn't mean our street was and all the side roads were still pretty icy. Tow trucks were pretty busy, so if you needed one, you better be prepared to wait. The kids wanted to sled, but we chose to watch movies and eat popcorn instead. After being outside a couple of times, even the dogs knew being inside was the way to go. They just would not go out after a while. Funny how animal instincts are more dependable than people's.
Don't follow your instincts to go out, stay in and stay warm.