Empty Nest - March 2024

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Competition is high between Medicare Advantage plans

Brought to you by - Jay Looft, Senior Source Medicare

Over the past 10 years, the Medicare Advantage Program has experienced exponential growth. According to the Kaiser Family Foundation, more than half of Medicare beneficiaries are now receiving their Medicare benefits through Medicare Advantage, otherwise known as the privatesector version of Medicare.

With this level of popularity for the program, you can imagine there are a lot of insurance companies that want a “piece of that pie”.

If you go to Medicare.gov and input a North Atlanta zip code, you will find there are 10 different Medicare Advantage companies. That’s a lot!

Some of these companies you’ll recognize, some you will not. Some are large carriers, some are small. Because there are so many companies involved in the program now, the plans are becoming better for the consumers!

Here are some of the features we are seeing drastic improvement in: Dental Allowance, Over-The-Counter Allowance, Grocery Allowance, Gym Networks, Hearing Aid Allowance, Elderly Assistance,

and lower Medical Maximum-Out-OfPocket limits.

These features are getting stronger and stronger each year, but it requires analysis of these plans or a check-in with your Medicare insurance broker each year. We would be happy to be that insurance broker for you if you don’t already have one.

You may have been with one of the large insurance carriers for years, and there is nothing wrong with that, but could that carrier have a better plan? Or if you are willing to try out one of the smaller carriers, it could offer more benefits if you’re willing to forgo name recognition.

Keeping an open mind about all the insurance carriers in the marketplace could put you in a better plan for your needs. It’s never too early to start thinking about your next Medicare insurance plan.

We are not currently in an active enrollment period, but depending on your situation, there might be a plan you can switch to right now. Check with us about your Medicare insurance options or ask for a plan review of your current plan today! Call us at (770) 913-6464 or through our website at www. SeniorSourceMedicare. com.

On Occam’s Razor, Hickam’s Dictum and Crabtree’s Bludgeon

Brought to you by – Dr. Brent Taylor, Premier Dermatology and Mohs Surgery of Atlanta

Arriving at a correct diagnosis is not a simple matter. With the exception of the occasional conspiracy theorist (Is Elvis alive?), most people gravitate to the least elaborate explanation to a question – the explanation that makes the fewest assumptions to fit available data.

Indeed, this approach is known as “Occam’s razor” and is the most famous rule of diagnosis taught in medical school. Within medicine, this rule is sometimes abbreviated to mean that a doctor should seek one single unifying diagnosis that explains all of a patient’s complaints instead of trying to explain five complaints with five diseases. For example, if a patient has a tick bite, rash, fever, headache and confusion, perhaps a single tick-borne illness explains all the symptoms and the patient can be treated accordingly rather than delaying treatment and introducing risk to perform spinal taps, MRIs or other investigations to search for second, third or fourth diseases.

Occam’s razor might sound like obvious and sage advice. Unfortunately, it proves wrong often enough that a Dr. John Hickam, former departmental head of medicine at Indiana University, felt the need to remind students that Occam’s Razor is sometimes wrong. He coined Hickam’s Dictum, which states “patients can have as many diseases as they [darn] well please.” (Dr. Hickam used the other D word, but we may have children in the audience.)

How often is Occam’s razor wrong?

In my physical diagnosis class in medical school, a professor taught us that there was a study of inpatients admitted at a university hospital in which the researchers looked at how often at least two diagnoses were necessary to account for the patient’s chief complaint. The result? One third of the time at least two diseases were to blame. Hickam’s dictum counterbalances Occam’s razor and reminds us of not becoming nearsighted or prematurely triumphant upon reaching a plausible single diagnosis. Sometimes two or more diseases are to blame. Sometimes, the patient in respiratory distress has the flu and covid.

A third rule, Crabtree’s Bludgeon might be my favorite. Who doesn’t love a good bludgeon? (You can tell I am a father of boys). Crabtree’s bludgeon says that a motivated individual will figure out an intelligible method of explaining away a set of contradictions, no matter how contradictory they are and how wrong they might be. This rule hints at the extent to which we humans often doggedly stick to a certain conviction or belief despite all the evidence to the contrary. New evidence says we might be wrong? No problem. We simply reason out elaborate new rules and exceptions that fit

our previous beliefs and account for the new evidence. Never underestimate the ability of people who are wrong to invent reasons not to admit it and to figure out how the new evidence actually further proves that they are right. (Think Flat Earthers)

Sometimes, a doctor can cling to an erroneous diagnosis far too long when what the patient needs is a complete reassessment. This is one of the most compelling arguments for patients receiving second opinions.

One of the most interesting cases that I have encountered in my medical career occurred when I spent a month studying at Stanford University. A patient presented to Stanford’s dermatology clinic with a tumor near her optic nerve and with certain birthmarks of her skin. She was sent by the ophthalmology department to the dermatology department for an opinion on whether the eye tumor was related to the birthmarks.

The stakes were high. If the eye tumor was deemed connected to the skin findings, then the ophthalmologists planned on watchful waiting and observation of the tumor. If not, then they planned surgery which could result in blindness in that eye. I spent hours researching the embryology of her findings and discovered reasons to believe that the patient’s tumor was very likely an atypical presentation of a disease called segmental neurofibromatosis. I concluded that the tumor and the birthmarks were very likely part of a single syndrome.

When I presented the case at Stanford’s dermatology grand rounds, Occam, Hickam, and Crabtree all showed up. Great debate ensued. The first professor to speak argued for the optic nerve tumor being unrelated to the birthmarks. Other professors found my evidence for a syndrome convincing. When the first professor found herself outnumbered, she doubled down and bludgeoned her way into arguing that the data was not only weak but actually backed her argument.

How did things turn out? The patient chose observation instead of surgery. My visit to Stanford ended, but I corresponded with a professor there, and the last update that I received was that the patient was doing well with no further growth of the tumor on subsequent MRIs.

I hope that you enjoyed this peek into diagnosis within medicine. For readers with children or grandchildren, I suggest that the lessons to be learned from Occam, Hickam and Crabtree are worth sharing and have relevance far beyond the field of medicine.

If you or a loved one has a possible skin cancer or any medical or cosmetic skincare need, please consider Premier Dermatology and Mohs Surgery of Atlanta. Dr. Brent Taylor, Kathryn Filipek, PA-C and our wonderful staff are honored to take care of you and your family.

Dr. Brent Taylor is a Board-Certified Dermatologist, a Fellowship-Trained Mohs Surgeon, and is certified by the Board of Venous and Lymphatic Medicine in the field of Vein Care.

He is an expert in skin cancer and melanoma treatment, endovenous laser ablation, minimally invasive vein procedures and cosmetics procedures such as Botox and injectables.

Kathryn is a certified physician assistant with over 18 years experience as a Dermatology PA. We are excited to welcome her, as she brings with her experience in general dermatology and cosmetic dermatology.

Her specialties include general dermatology such as acne, eczema, rashes, hair loss, full body skin exams, abnormal growths etc. Kathryn also specializes in cosmetic dermatology including lasers, injectables, micro-needling, PRP, facial peels, sclerotherapy for spider veins and at home skin care.

Competition is high between Medicare Advantage plans

Brought to you by - Jay Looft, Senior Source Medicare

Over the past 10 years, the Medicare Advantage Program has experienced exponential growth. According to the Kaiser Family Foundation, more than half of Medicare beneficiaries are now receiving their Medicare benefits through Medicare Advantage, otherwise known as the privatesector version of Medicare.

With this level of popularity for the program, you can imagine there are a lot of insurance companies that want a “piece of that pie”.

If you go to Medicare.gov and input a North Atlanta zip code, you will find there are 10 different Medicare Advantage companies. That’s a lot!

Some of these companies you’ll recognize, some you will not. Some are large carriers, some are small. Because there are so many companies involved in the program now, the plans are becoming better for the consumers!

Here are some of the features we are seeing drastic improvement in: Dental Allowance, Over-The-Counter Allowance, Grocery Allowance, Gym Networks, Hearing Aid Allowance, Elderly Assistance,

and lower Medical Maximum-Out-OfPocket limits.

These features are getting stronger and stronger each year, but it requires analysis of these plans or a check-in with your Medicare insurance broker each year. We would be happy to be that insurance broker for you if you don’t already have one.

You may have been with one of the large insurance carriers for years, and there is nothing wrong with that, but could that carrier have a better plan? Or if you are willing to try out one of the smaller carriers, it could offer more benefits if you’re willing to forgo name recognition.

Keeping an open mind about all the insurance carriers in the marketplace could put you in a better plan for your needs. It’s never too early to start thinking about your next Medicare insurance plan.

We are not currently in an active enrollment period, but depending on your situation, there might be a plan you can switch to right now. Check with us about your Medicare insurance options or ask for a plan review of your current plan today!

Call us at (770) 913-6464 or through our website at www. SeniorSourceMedicare. com.

Paige Gorman Agent

Living with guilt vs. Living with gusto!

Brought to you by - Alice D, Hoag, EdD, LPC, Summit Counseling Center

A few years ago, I intercepted one of my sons as he was descending the staircase and heading outside. He explained, with a guilty expression on his face, that he was going to go outside to smoke a cigarette. Ever since I was my grandmother’s companion during her final months of life as she went through chemo and radiation treatments for lung cancer after her 50 years of smoking cigarettes, I’ve not been a fan of cigarette smoking. And he knew this. I stopped him and challenged, “Either do it with gusto or don’t do it at all.” I went on to encourage him, “Fully enjoy inhaling and blowing smoke rings or whatever you do. Get the most out of whatever it is that you do. Choose wisely, then do it with no guilt. If you cannot enjoy it fully, then don’t do it at all.”

In the decade since that first statement just slipped out of my mouth on its own, I’ve reflected on that sentiment. I believe it is a way of living life to its fullest. “Either do it with gusto or don’t do it at all.”

Guilt and anxiety. Neither is a good option to live with as a way of life, yet I interact with so many people who do live in a constant state of guilt and/ or anxiety! It’s their default mode; it just happens without even thinking. Every action and thought carries with it

either a sense of guilt or anxiety.

“Being my best self” is a way of life that I attempt to live by every moment of every day. While I may not hit the “best self” goal all the time, I can certainly choose the “better self” more often than not. It’s an element of being a good steward of what I’ve been given. And we’re all called to good stewardship of everything we’ve been given: time, talent, energy, body, mind, actions, motives, finances, relationships, and on and on.

It is not an easy task to choose our better self (or best self). It requires that we surrender the easy path, the selfish or self-protective default mode in each of us. However, as we do, we become more intentional. When we choose our actions intentionally to be consistent with our best self, we end up being less guilt-driven. And when we act intentionally, there is less anxiety. There’s actually less emotional involvement at all. Acting intentionally requires that we observe the options from several angles, then choose the best version of ourselves to move forward in a direction. This results in freedom, contentment, and joy. That’s living with Gusto!

If you’d like guidance and encouragement on choosing joy and living with gusto as your better self, The Summit would love to come alongside and walk with you on your journey.

It’s allergy season in Atlanta!

Brought to you by – Comprehensive Internal Medicine

What are allergies?

Allergies are your body’s reaction to a foreign particle, usually a protein. These proteins can come from pet dander, molds, pollens, or from trees and grasses. If you develop an allergy to a particular protein, your body’s defense system (immune system) reacts to it and the allergic reaction creates allergy symptoms.

What is an allergic reaction?

An allergic reaction is the way your body responds to an allergen, usually a protein.

You may feel itchy, watery eyes, a runny nose, sinus or ear fullness, a hoarse voice, a scratchy throat, or trouble breathing. You may even develop a skin rash.

These symptoms can be treated with over the counter or prescription allergy medication or immunotherapy (allergy shots) can be tailored specifically for you.

What is allergy testing?

To perform allergy testing, small pinpricks or scratches are made in the

skin and a very small amount of allergen is placed to test your body’s response. If you react to the allergen, we have identified a trigger that is causing your allergy symptoms.

What is immunotherapy?

Immunotherapy is a treatment used to desensitize your body to the allergy trigger.

In this treatment, the results of your allergy testing are used to create a very personalized formula of medicine that is used to slowly treat your immune system in a way that stops reacting to your allergy trigger. Immunotherapy medicine is given by injection (allergy shots) and is administered twice weekly. The first injection is given in the doctor’s office.

Comprehensive Internal Medicine uses an advanced formulation and instruction that allows you to then give the injections at home. This saves the twice-weekly visits to the doctor’s office. You return to Comprehensive Internal Medicine every 6 weeks to progress the therapy and at the end of one year, allergy testing is repeated. Often, a second year of treatment is advised, following which, most allergies are cured.

Comprehensive Internal Medicine has been serving the Alpharetta community for 20 years, celebrating this milestone anniversary in

The medical practice offers a very comfortable environment and serves a medical home where patients are seen for their wellness examinations (checkups) and for the management of multiple medical problems. Same-day appointments are always available.

We welcome new patients, take most insurance plans and discounts for self-pay patients.

Jeffrey Obiora, M.D.

Dr. Obiora has a special interest in managing medical issues such as diabetes, high blood pressure and high cholesterol. He also specializes in diabetes prevention and weight loss.

In addition, he brings expertise in allergy treatment and managing allergic rhinitis, sinusitis and asthma, and can schedule allergy testing to determine the best way to treat allergy symptoms.

Jacqueline T. Pearson, M.D., M.S.

Anju Bhushan, M.D. Arezou Fatemi, M.D.

Ryan Bozof, M.D. Shima Mansouri, P.A.-C Laurae Carpenetti, M.D.

Carol Hector, M.D.

Sumera Pervaiz, M.D. Sudeshna Nandi, M.D.

Petula Gunn, APRN

Raphael Lopez, M.D.

Alexis Buelow , MSN,APRN,FNP-C.

ISTOCK

What factors contribute to acne?

Acne is influenced by a combination of factors, including genetics, hormonal changes, excess oil production, and the presence of acne-causing bacteria on the skin. Lifestyle factors like diet, stress, and certain medications can also play a role. Understanding these factors is crucial in developing an effective acne management plan. How can I treat my acne?

Treating acne involves a multifaceted approach. Over-the-counter products with ingredients like salicylic acid or benzoyl peroxide can help, but for more severe cases, consulting a dermatologist is essential. Dermatologists can prescribe topical or oral medications tailored to your skin’s specific needs. They also provide personalized advice on skincare routines and may recommend procedures like laser therapy or chemical peels for more severe cases. Partnering with a dermatologist ensures that your treatment plan is effective, minimizing the risk of scarring and promoting long-term skin health. It’s a collaborative effort to find the most suitable solutions for your unique skin conditions.