January Edition 2021
Inside This Issue
Resolution Refresh: Three Ways to Hit Reset on Your Health By Punit Chadha, M.D., Texas Oncology South Austin
Convincing Patients Not to Delay Necessary In-Person Care During COVID-19: Top 5 Tips See pg. 9
INDEX Legal Matters....................... pg.3 Oncology Research......... pg.4 Mental Health...................... pg.6 Healthy Heart....................... pg.8
Preventive Measures for staying Healthy See pg. 12
E
ach New Year’s Eve, millions of Americans bid farewell to the past year and look forward to a fresh new start on January 1. This year, however, ringing in the new year was radically different as many of us celebrated long-held traditions virtually – or not at all – and braced for post-holiday spikes in COVID-19. The pandemic has indefinitely changed how we live, work, communicate, and interact with one another. Now, more than ever, it’s time to take a comprehensive approach to health and wellness. Here are three ways to hit reset on your health – and there’s no better time to start than now. Prioritize your emotional and physical health. The National Institutes of
Health reports that the emotional impact of living with a cancer diagnosis and treatment, fear of recurrence, and the daily stress of living with physical symptoms can create new or worsen preexisting emotional distress for cancer patients. Furthermore, in a survey by the American Society of Clinical Oncology (ASCO), nearly half of cancer patients surveyed – 45% – said the COVID-19 pandemic has negatively impacted their mental health. Talk to your physician if you or a loved one are experiencing depression or anxiety during the COVID-19 pandemic.
Consider whether getting counseling or mental health care, including via telehealth, would be helpful. When it comes to physical health, preventative screenings are the single most effective way to detect cancer early, often before signs or symptoms occur. Yet, cancer screenings dropped dramatically during the pandemic, leading to delayed or missed diagnoses. ASCO reported in October 2020 that two-thirds of Americans surveyed delayed or skipped a scheduled see Resolution Refresh... page 14
UT Austin Receives Some of Texas’ First COVID-19 Vaccines to Protect Healthcare Staff Serving the Region
U
T Health Austin, the clinical is among the first in Texas to receive practice of Dell Medical School the long-awaited first shipment of at The University of Texas at Austin, COVID-19 vaccines. The vials arrived by ground and were immediately placed in sub-zero temperature storage. The 2,925 Pfizer vaccine vials received are the first of two doses earmarked to protect UT Austin’s front-line health care workers, including faculty, staff and students who are actively involved in clinical care delivery to patients in the Austin community. Vaccine distribution will begin Tuesday and will continue for nine days. The second doses are expected in early
January 2021. “This has been a long haul for everyone, but especially for the health care providers who have been putting their own lives at risk in taking care of COVID-19 patients on the front lines,” said Amy Young, M.D., Chief Clinical Officer of UT Health Austin and Vice Dean of Professional Practice at Dell see UT ... page 14
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Legal Matters No Steak, No Wine? OIG Cautions Against Physician Speaker Programs
By Asher D. Funk, J.D. Dayna C. Laplante, J.D. Polsinelli, PC
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n a recent Special Fraud, the Department of Health and Human Services Office of Inspector General (HHS-OIG) raised significant fraud and abuse concerns with companies offering or providing remuneration in connection with physician speaker programs. Speaker programs typically involve one health care professional presenting to others on a company’s drug or device, or a disease state relevant to the company’s products, in exchange for a speaker honorarium. While speaker programs may have
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some legitimate purposes, HHS-OIG warned of risk the programs create, if one purpose is to induce or reward federal health care program referrals. Because the HHS-OIG rarely issues Special Fraud Alerts and has not done so in over six years, this guidance warrants the attention of health care providers along with a review of health care entities’ current practices. In the Fraud Alert, HHS-OIG identified the following non-exhaustive list of “suspect characteristics,” which may be present in speaker programs and increase the risk of liability under the Anti-Kickback Statute: • Little or no substantive information is presented at a company-sponsored speaker program; • Alcohol is available or free, or a meal greater than modest value is provided to attendees; • The program’s setting is not conducive to the exchange of educational information (e.g.
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restaurants, sports or entertainment venues); A company sponsors a large number of programs on the same or similar topic, particularly where there is no recent substantive change in relevant information; No new medical or scientific information, or a new FDA-approved or clear indication for the product, has occurred in a significant period of time; Health care professionals attend the same or substantially similar programs more than once; Program attendees do not have a legitimate business reason to attend (e.g. significant others of the health care professional attendee, employees of the speaker’s medical practice, others with no use for the information, etc.); Sales or marketing personnel influence the selection of speakers or the company selects speakers or attendees based on past or expected revenue they will generate by ordering company products; and, Compensation the company pays health care professionals for speaking is more than fair market value or takes into account the
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volume or value of past or potential business generated. HHS-OIG emphasized in the Fraud Alert that many investigations and enforcement actions under the federal False Claims Act and Anti-Kickback Statute included one or more of the characteristics listed above. HHS-OIG also acknowledged the nearly $2 billion that drug and device companies reported as being paid to physicians for speaker-related services in the last three years. A recent settlement between Medtronic USA Inc. and the Department of Justice highlights these enforcement efforts and the importance of properly
see Legal Matters...page 14
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Oncology Research Is It Important to Screen For Prostate Cancer? By Dee Dee Grays It is important to have a discussion with your health care provider to see if screening for prostate cancer is right for you
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esticular cancer and prostate cancer are two of the most important health issues that males face. In a two-part series, Grady “Sam” Hogue, MD, FAAFP, interim head in Department of Primary Care and Population Health at the Texas A&M University College of Medicine, discusses the importance of screening for these two diseases. Read the importance of screening for testicular cancer here. “You’re going to do what?” is a common phrase that I have heard uttered when I have suggested a Digital Rectal exam (DRE) as a screening test for prostate cancer. Other than skin cancer, prostate cancer is the number one cancer among American men, and about 1 in 9 men will be diagnosed with prostate cancer during his lifetime. Knowing the warning signs and the risk and talking to your physician about weighing the pros and cons of getting screened are all
important measures to take. It is a fact that you are at a higher risk of getting prostate cancer due to three factors: age, family history and race. Studies show that up to 46% of men in their 50s will have cancerous cells, and up to 83% of men in their 70s will. You are at a higher risk if a man in your family has had prostate cancer, and African American men are also at a higher risk. However, there are issues surrounding early screening for prostate cancer. Prostate cancer screening recommendations for early detection have changed, with less emphasis on routine screening than before. The PSA (prostate-specific antigen) test, approved by the Food and Drug Administration (FDA) in the late 1980s, combined with a DRE was, at the time, felt to be the best practice for screening men. However, health officials have found the PSA test may not reduce the chance of dying from prostate cancer, and may give false-positive or false-negative results. With time, it has become evident that most prostate cancers are non-aggressive or slow-growing, and
men usually die due to other causes besides prostate cancer. In fact, the risk of dying from prostate cancer is only 3 percent. Many times using the PSA test could cause overdiagnosis or overtreatment, which often leads to unwanted side effects, such as lifelong sexual dysfunction and loss of urinary bladder control. The diagnosis by biopsy of the prostrate has infection and significant pain risk as well. Studies also show that the benefits of screening have not been completely transparent.
Currently the most common recommendation is for males, based on their age and life expectancy, to have a discussion with their health care providers regarding the risks versus the benefits of early screening for prostate cancer. The most important thing is to have a conversation with your physician, as it is unclear if the benefits of early screening outweigh the risks for men and depend greatly on his personal situation.
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Mental Health Top 5 Strategies to Cultivating Your Mental Health By Lindsay Israel, MD,
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odern life keeps us very busy. We find ourselves ignoring the fundamentals like our health, family, friends, community etc. All that neglect causes dysfunction in our lives. We try desperately to fix the problem after it becomes a significant issue. In other words, we are attempting to reverse the damage once it has already become a disorder. As a physician, this neglect is something I see among my patients every day. It is important to remember that prevention is a big piece to eradicating depression and anxiety. Yes, there are some things that are simply unavoidable such as genetics and certain life stressors, such as a death of a loved one or a lay-off from a job. However, if we focus on areas of our lives we can control, then we would
psychiatric practice, compared with 10% to 18% of adults in the general U.S. population. It is a chicken or the egg dilemma. Do mental health disorders cause sleep disturbances or does insomnia trigger a cascade of symptoms leading to a mental health problem? The basic answer is both can occur. Neuroimaging and neurochemistry studies suggest that a good night’s sleep helps foster both mental and emotional resilience, while chronic sleep disruptions set the stage for negative thinking and emotional vulnerability. In 2010, the American Medical Association along with the American Academy of Sleep Medicine recognized insufficient sleep as a serious health risk amongst adolescents. It is not too surprising that sleep issues in our teen years can persist into adulthood. The brain likes patterns; repetition, routine. If it receives signals on a regular basis, even unhealthy ones, it will lock into that pattern.
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January 2021
have a much easier time coping with events that are out of our control; the “curveballs” of life. Though the word “habit” can have a negative connotation, it more accurately describes a behavior done repetitively as a routine. A habit can be a choice, and a healthy habit is a healthy choice. These lifestyle amendments are time-tested and clinically proven to be effective in preventing the symptoms associated with anxiety and depression. Here are 5 simple strategies we can incorporate into our day-to-day routine to lay a healthy foundation and maintain our mental wellbeing. 1. Protect Your Sleep, Your Life Depends on It! This is perhaps the most important intervention to our mental upkeep. Chronic sleep problems affect 50% to 80% of patients in a typical
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Good sleep hygiene is of the utmost importance in preventing sleep disorders which can lead to other comorbid psychiatric illnesses. 2. Maintain a Balanced Diet Our eating habits can play a large role in our mood regulation throughout the day. Big carb loads can lead to big carb crashes which can cause fatigue, concentration issues and irritability, symptoms that are also apparent in depression. Protein, healthy non-saturated fats, fiber and some simple carbohydrates should all be represented in our meals. Moderating our food intake will give us the best chance of having a good day. 3. Get Regular Exercise Any activity that induces our heart rate to increase is considered see Mental Health...page 13
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Healthy Heart
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Go Ahead and Ditch The Grand New Year’s Resolution By American Heart Association
Dr. Jen n i fer A shton, A BC ’s c h ief medical correspondent and American Heart Association national volunteer, talks about easy, free, and fast ways to improve health – one month at a time.
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t the dawn of every year, many of us resolve to shed some pounds and get in shape. But by the middle of January, we’ve dropped the barbells and stepped off the treadmills — returning to unhealthy habits. After seeing that routine play out year after year, Dr. Jennifer Ashton, a board-certified Ob-Gyn, bestselling author and ABC’s chief medical correspondent, and American Heart Association volunteer expert for Go Red for Women, tried a different approach.
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even five minutes of activity. She recommended that people mix it up, incorporating a variety of activities. In the same spirit, Ashton swapped red meat for fruits and veggies. Focus on adding plant-based foods rather than eliminating meat, she recommended, noting that there are hundreds of varieties of beans, fruits, and vegetables available on store shelves. Finding restaurants and home-delivery services that offer plant-based meals can also help to ease the transition. “It’s about being deliberate with the way I live my life and being proactive about health, wellness and disease prevention,” said Ashton, who has volunteered for the American Heart Association for nearly seven years. “Heart disease is the No. 1
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Never a fan of making lofty New Year’s resolutions, Ashton committed to smaller challenges every month for a year. She focuses on things nearly anyone can do anytime, anywhere and at no expense. “They literally take seconds or minutes instead of hours,” she said. “The barrier to entry is almost nonexistent. As much as I love a self-challenge, doing one massive thing is too daunting, because if you don’t nail it, you feel like a failure.” During the process, she discovered how easily something could become a habit and how little it took to make a positive impact on health and well-being. Doing the challenges, however, also showed her there was room for improvement. The daughter of a cardiologist, Ashton made heart-healthy changes such as taking more steps and doing more aerobic exercise. Something is better than nothing, Ashton said, advising people to start with January 2021
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killer of women.” She also remembered the importance of mental health, challenging herself to meditate, laugh more, and do better with the three s’s. “Stress, poor sleep, and social disconnectedness have been linked with heart disease,” Ashton said. “I’m trying to encourage our society to focus on the neck up as much as we do the neck down.” The message is that anybody can take small steps to improve their health and well-being. The approach is for the fit and the couch potato; old and young; men or women. “In 2021, be as compassionate and nonjudgmental of yourself as you are with others. It’s okay to take a break, take a deep breath, reset, renew, and reconnect with what feeds your soul,” said Dr. Julia Andrieni, Senior Vice President of Population Health and Primary Care at Houston Methodist.
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Convincing Patients Not to Delay Necessary In-Person Care During COVID-19: Top 5 Tips Chad Anguilm, MBA, Vice President, In-Practice Technology Services Medical Advantage Part of the TDC Group of Companies Although the COVID-19 pandemic has spurred innovations throughout healthcare, many medical practices are wrestling with a stubborn trend: Due to anxiety about potentially contracting the virus, many patients are putting off in-person appointments. According to the Centers for Disease Control and Prevention (CDC), by June 30, 2020, an estimated 41 percent of U.S. adults had delayed or avoided medical care, including urgent/ emergency care and routine care, because of concerns about COVID-19.
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s patients’ fears intensify with the current surge in COVID-19 cases, many practices are presented with a three-fold problem: Patients not getting the care they need, a decline in revenue from in-person appointments, and potential liability risks presented by patients who experience adverse events because of a delayed diagnosis—
the number one cause of medical malpractice suits. Despite these challenges, practices nationwide have developed strategies to enable their in-person operations to remain safe for patients and profitable for the practice. In advising healthcare providers on operations during COVID-19, practice consultants from Medical Advantage, part of the TDC Group of companies (TDC Group), have compiled the following top five tips for encouraging patients to come in for necessary in-person visits during the pandemic: 1. Educate patients about the dangers of ignoring critical health issues. Emphasize to patients that ignoring critical health issues can be more harmful than potentially being exposed to the COVID-19 virus, and that medical facilities can be some of the lowest risk places to visit during the pandemic due to strict sterilization. A recent study determined that 225,530
excess deaths (the gap between observed and expected deaths) occurred in the U.S. between March 21 and April 11, 2020. About two-thirds of these excess deaths were related to COVID-19, but the other third was the result of other conditions. The study further demonstrated that states with the highest death rates from COVID-19 also had the largest proportional increases in deaths from other underlying causes, including diabetes and cardiovascular disease. In other words, where the COVID-19 disruptions were largest, diminished access to medical care and/or fear that medical care would be dangerous in a COVID-19-intense environment were
causing patients to not get care that they otherwise would be getting for diseases not related to COVID-19. Additionally, the National Cancer Institute predicts an excess of 10,000 deaths due to breast cancer and colorectal cancer because of missed screening in the year 2020. Therefore, patients with heart conditions—or even those experiencing symptoms of heart conditions—should not wait until their conditions worsen and potentially become life-threatening. The same can be said of patients with diabetes, those see Top 5 Tips..page 13
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Study Suggests That Losing Fat Mass, But Not Lean Mass, Is Key for Heart Health in Obese Patients with Type 2 Diabetes
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educing the level of body fat and waist size are linked to a lower risk of heart failure in patients with type 2 diabetes, a study led by UT Southwestern researchers indicates. The findings, reported today in Circulation, suggest that all weight loss isn’t equal when it comes to mitigating the risk of heart disease. The burden of diabetes is increasing, with an estimated 700 million adults worldwide predicted to have this disease by 2045. The vast majority of cases are type 2 diabetes, characterized by insulin resistance, an inability for cells to respond to insulin. Type 2 diabetes doubles the risk of cardiovascular events such as heart failure and heart attacks. Being overweight and obese are strong risk factors for both type 2 diabetes and heart disease, and patients are often counseled to lose weight to
reduce the likelihood of developing both conditions. However, not all weight loss is the same, explains Ambarish Pandey, M.D., senior author of the study and assistant professor of internal medicine at UTSW. “We have long counseled patients to lower their body-mass index into the ‘healthy’ range. But that doesn’t tell us whether a patient has lost ‘fat mass’ or ‘lean mass,’ or where the weight came off,” Pandey says. “We didn’t know how each of these factors might affect patients’ risk of heart disease.” Fat mass accounts for fat in different parts of the body while lean mass is mostly muscle. Understanding the relationship between heart disease and body composition has proven especially challenging, Pandey explains, because there hasn’t been an easy and inexpensive way to evaluate body composition. The
gold standard of determining fat mass and lean mass is to measure it directly with tools like dual-energy X-ray absorptiometry (DXA), a scan that’s cumbersome, expensive, and exposes patients to radiation. To help answer how different types of weight loss can affect cardiovascular disease, Pandey and his colleagues used data from the Look AHEAD (Action for Health in Diabetes) Trial, which investigated the effects of either an intense lifestyle intervention focused on weight loss and physical activity or diabetes support and education in more than 5,000 overweight or obese adults with type 2 diabetes. The study collected information on the volunteers’ weight, body composition, and waist circumference at the baseline and again one and four years later. It also tracked the incidence of heart failure in this group over a 12-year period. The Look AHEAD Trial determined body composition with DXA. But Pandey and his colleagues used a new equation that incorporates age, sex, race/ethnicity, height, body weight, and waist circumference to estimate fat and lean mass – producing results that closely matched those from DXA scans.
Among the 5,103 participants in the Look AHEAD Trial, 257 developed heart failure over the follow-up period. Pandey and his colleagues found that the more these volunteers lowered their fat mass and waist circumference, the lower were their chances of developing heart failure. Just a 10 percent reduction in fat mass led to a 22 percent lower risk of heart failure with preserved ejection fraction and a 24 percent lower risk of heart failure with reduced ejection fraction, two subtypes of this condition. A decline in waist circumference significantly lowered the risk of heart failure with preserved injection fraction but not heart failure with reduced ejection fraction. However, a decline in lean mass didn’t change the risk of heart see Diabetes ..page 13
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Age Well, Live Well Preventive Measures for Staying Healthy By Ully Wagner Texas Health and Human Services
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s you age, your immune system can weaken and have a harder time fighting off infections, such as influenza (seasonal flu), pneumonia and shingles. Without a robust immune response, these diseases can lead to severe complications or long-term illness. If you have a chronic condition like diabetes and heart disease, receiving a vaccine is even more important. Vaccines can help you, your family and others in your community stay healthy. Visiting your health care provider for preventive services like vaccines can help you avoid disease or identify it early on to receive treatment. Some people with specific conditions should not receive certain vaccines or should wait to get them. Talk to your health care provider about which vaccines are right for you. Shingles Vaccine Shingles is caused by the same virus that causes chickenpox, the varicella-zoster virus. Current data suggests that nearly 1 in every 3 Americans will develop shingles sometime in their life.
The shingles vaccine is recommended for adults 50 years and older. Seasonal Flu Vaccine Flu season happens every year, typically from October through May. During this time, adults 65 years and older make up more than 60 percent of influenza-related hospitalizations. The seasonal flu vaccine is recommended for people 6 months of age and up, and receiving the vaccine when you are older can be even more important. Pneumonia Vaccine Pneumococcal disease is caused by a common germ that can infect different parts of the body, such as the lungs (pneumonia), the bloodstream and the brain. The PPSV23 vaccine is recommended for adults 65 years and older. An additional vaccine, the PCV13 is recommended for some older adults that may be at increased risk. Healthy Aging Resources In addition to receiving these vaccines, you can also bolster your chances of staying healthy by regularly visiting your health care provider, eating nutritious foods and maintaining an appropriate level of physical activity. The following resources can help support
older Texans with healthy aging. Age Well Live Well Age Well Live Well has resources to help individuals and communities stay healthy, connected and informed. Visit hhs.texas.gov/about-hhs/community-engagement/age-well-live-well for more information. Texercise Texercise, an HHS health promotions initiative, offers free resources and programs to engage adults 45 years and older in regular physical activity and a good diet. Visit texercise. com to learn more about healthy aging and to request a free copy of the Texercise handbook. Area Agencies on Aging Every community in Texas
is covered by one of 28 AAAs. They offer no-cost services, such as home-delivered meals, homemaker assistance, and evidence-based health and wellness interventions for people 60 and older. Visit txregionalcouncil.org/ regional-programs/health-and-humanservices/area-agencies-on-aging to find an AAA that serves your area. SNAP SNAP provides assistance to help put healthy food on your table. Visit yourtexasbenefits.com for more information on what SNAP offers and how to check your eligibility and apply. Information in this article comes from vaccines.gov and cdc.gov/ vaccines.ď ľ
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Continued from page 6 exercise. For substantial health benefits, adults should do at least 150 minutes a week of moderate-intensity exercise, which equates to about 20 minutes a day. Yes, we all have very busy lives, but we can all find a way to carve out 20 minutes for ourselves for this very important task. In fact, healthy diet and exercise will circle back up to improving our sleep. If we engage in habits #1-3, our bodies will certainly thank us. 4. Get Involved in Your Community Whether it is through a community center or a church or temple, surrounding ourselves with people who have similar goals as us can have
Top 5 Tips
Continued from page 9 who find symptoms of cancer, those who need to participate in a regular cancer screening, those who experience certain infections, and those with other potentially serious conditions. 2. Update safety practices, workflows, and precautions. A cornerstone of any strategy to encourage patients to come in for necessary visits during the COVID-19 pandemic is patient safety. Temperature and health questionnaire screenings, mask mandates, sanitation and social distancing policies, and PPE for staff are all familiar, excellent steps, but represent only the beginning of a cohesive patient safety plan that minimizes virus hazards and ensures patient peace of mind. One of the most effective ways to ensure patient safety is by focusing on patient triage. Patients who need COVID-19 tests can call or text from their cars, eliminating the need for them to be in the waiting room. Patients coming in for other issues can be screened on the phone and in the parking lot before directly entering the exam room. Other workflow adjustments can increase patient safety protections even further. For example, scheduling
Diabetes
Continued from page 10 failure at all. These findings provide important insights, says Kershaw Patel, M.D., study author and former UTSW cardiology
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a profoundly positive impact on our mental wellbeing. The Patient-Centered Outcomes Research Institute has helped fund studies investigating this very topic. Donating our time towards a community project, or simply socializing is a quality way to help our self-esteem and build a network of support. Interacting with fellow human beings reminds us we are not alone and gives us an outlet to share our thoughts and feelings. Community can be the forum in which topics such as depression and anxiety can be discussed freely. 5. Find a Hobby Lack of motivation and anhedonia defined as decreased pleasure in pleasurable activities are classic hallmark symptoms of depression. Finding an enjoyable activity serves a preventative role in combating
the onset of depression and anxiety, as it can be a healthy outlet at the end of a stressful and can be a positive distractor from any negative thoughts. Engaging in an activity that brings us pleasure and enjoyment has a physiologic effect on our brains, triggering a release of neurotransmitters such as dopamine, serotonin and newly discovered brain-derived neurotrophic factor, which is our ammunition in fighting depression and anxiety. Hobbies such as crafting, boxing, book clubs, gardening and many others will also circle back up to emphasizing the importance of socializing and being around others, as isolation can be a trigger for depression and reinforce anxiety. Remember, activity “activates” us all. The Next Step Which of these items are easiest
for you to implement? Take out your phone and enter them into your calendar as nudges to getting started. Including these fundamental activities in your day-to-day will change your life for the better. Your positivity will also begin to affect everyone around you. By following these 5 lifestyle choices, we put ourselves in the best position possible to prevent the onset of depression and anxiety. Though typically we are trying to “kick” habits, these are 5 healthy habits we should all try to “kick” into gear for a better way of living.
staff and patients strategically keeps the number of people in the clinic low, reducing the risk of virus transmission. In addition, staggering scheduling allows practices to dedicate their limited in-person resources to patients with priority needs, while using telehealth and other solutions for less at-risk populations. One idea is to have senior hours or at-risk hours, a dedicated one-to-two-hour block of appointments each morning for those most at risk. 3. Bolster marketing efforts to communicate new COVID-19 measures to patients. Communicate patient safety policies clearly to patients. Whether you’re reaching patients in person, through your website, or via a phone or telehealth connection, being clear and transparent about the steps your practice is taking to offer safe care during the pandemic will boost patient peace of mind. On-site at your practice, this can mean signage inside and outside pointing out distancing and sanitation measures. Some practices have used color-coding systems to clearly signal to patients which areas, like exam rooms and waiting areas, have already been disinfected before their visit—and the schedule for cleaning. Patients coming into the practice in person represent an opportunity for practice staff and physicians to verbally communicate the
new safety procedures, as well as create a sense of precaution by leading by example and adhering to patient safety practices during the appointment. Text, email, patient portal messaging, social media, and website campaigns are all places where you can educate and reassure patients about extra precautions your practice is taking. Showing and communicating with patients that their safety is being prioritized with protective, pandemic-adapted policies gives patients increased peace of mind, making them more likely to come in for any necessary in-person visits. 4. Shore up patient outreach efforts to triage at-risk populations. By proactively targeting certain at-risk and chronic care management (CCM) populations, usually via phone, practices have successfully continued delivering these patients the in-person care they need, even during the pandemic. This means reaching out to patients who are older or have underlying conditions. Practices can utilize nurse telehealth appointments to triage patient needs and ensure CCM patients are following medical advice, diet recommendations, and taking medications as prescribed. In this way, providers can take care of all or most of the check-up remotely, and reserve
in-person space for patients with priority needs. Create a strategy, have a plan, pick up the phone, and drive appointments. Many patients are spending their days at home and are more likely to pick up a call when they see that it is from their healthcare provider. 5. Leverage telehealth to take the pressure off in-person operations. One dilemma medical practices face during the pandemic is how to enact social distancing policies while still providing patients the in-person care they need. For this reason, telehealth has become a critical tool for allowing healthcare providers to offer basic care remotely while freeing up appointment and office space for patients who need in-person care. Medicare and Medicaid compliance codes have been relaxed during the pandemic, allowing practices to deliver certain services via telehealth that had previously been reserved for in-person visits. Using telehealth services to bridge the gap while reserving in-person care for patients with priority needs is a crucial part of any plan to keep patients coming in for necessary visits during the pandemic.
fellow who is now a cardiologist at Houston Methodist Hospital. “We showed that reductions in specific, not all, body composition parameters are linked to heart failure,” Patel says. More studies are needed to determine if reducing fat and retaining or increasing muscle may be more effective
at decreasing the risk of heart failure, research that’s facilitated with the new equation to estimate body composition, Pandey adds. In the meantime, he says, patients may benefit from incorporating strategies toward this goal – such as resistance training – into their weight loss efforts.
“Our study suggests that simply losing weight is not enough,” Pandey says. “We may need to prioritize fat loss to truly reduce the risk of heart failure.”
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Austin Medical Times
Resolution Refresh
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Continued from page 1 cancer screening as a direct result of COVID-19. Skipping screenings can adversely impact your long-term health. Make a commitment this year to schedule and keep your annual screenings and wellness check-ups. Don’t underestimate the power of a healthy diet. With more time at home during the pandemic, many people have discovered, or rediscovered, a love of cooking. Some have also discovered the convenience of grabbing extra snacks throughout the day. Stock your pantry with healthy staples and make it a point to plan meals on the weekends to set yourself up for a healthy week ahead.
Keep your meal rotation fresh by trying a new recipe weekly and bulk up your soups and salads with hearty vegetables. Your body and your mind will thank you. Commit to staying in touch with family and friends. Among the challenges of living with cancer are feelings of loneliness and isolation. Cancer patients and those with weakened immune systems are at higher risk of complications from viruses, like COVID-19, adding layers of social separation that may magnify loneliness. Eight in 10, or 81% of people with cancer, and 60% of Americans have limited their contact with others
to reduce their risk of contracting the virus, according to ASCO. Reach out to a loved one and ask for regular phone calls or video chats. Everyone is going through this together. By finding the strength to reach out for help, you may learn that others in your social circle are struggling too. We are living in an unprecedented time – but there remains hope and anticipation for good things to come. As oncologists, we are constantly inspired by our patients’ strength and courage as we join them in their fight against cancer. We wish good health and happiness to all in the year ahead.
Centers for Disease Control and Prevention’s guidance, which prioritizes health care personnel as well as for other high-risk groups. Receipt of the vaccine is an especially meaningful milestone for UT Austin. Earlier this January, molecular
biologist Jason McLellan, Ph.D., made one of the key discoveries that was essential to the development of Pfizer, Moderna and other vaccines to fight the global pandemic.
Legal Matters
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January 2021
Web Development Lorenzo Morales Distribution Brad Jander
Office: 512-203-3987
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reporting payments made to physicians. On October 29, 2020, Medtronic agreed to pay over $9.2 million to settle allegations that Medtronic violated the Anti-Kickback Statute and False Claims Act by holding and paying for over 130 events at a restaurant owned by a neurosurgeon. Given the risks attendant to speaker programs and HHS-OIG’s skepticism, the Fraud Alert highlighted alternative means for drug and device companies to educate health care professionals about their products. Those suggestions include the provision of online resources, the package inserts for drugs or devices, third-party educational conference and medical journals. What Providers Should Know • The Special Fraud Alert warns that all participants in speaker programs – drug or device companies and health care professionals that
Senior Designer Jamie Farquhar-Rizzo
Accounting Liz Thachar
UT
Medical School. “Having the vaccine finally gives us hope for a future without COVID, and that really is an extraordinary step forward,” she said. UT’s protocols for equitable vaccine distribution align with the
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present at or attend those events – health care professionals. may be subject to an enforcement • The factors HHS-OIG identified action if the programs violate the as suspect are not surprising (e.g. Anti-Kickback Statute and, by the level of speaker compensation, extension, the False Claims Act. value of meals provided, program • While the Special Fraud Alert setting or identity of attendees), but does not prohibit speaker there may be other characteristics programs outright, risk under of suspect programs that health care the Anti-Kickback Statute is a providers had not contemplated fact-specific inquiry and the Fraud and warrant consideration for any Alert is one tool health care future speaker events. entities can use when assessing • Given the highly infrequent use of their risk. Special Fraud Alerts by HHS-OIG, • Health care providers that offer providers should view the or attend speaker programs HHS-OIG’s guidance as a warning should carefully assess whether shot preceding future investigations current practices align with the and enforcement actions. Through identified suspect characteristics the Fraud Alert, HHS-OIG has and determine whether changes signaled that speaker programs are warranted. This includes the are a priority area for enforcement evaluation of alternatives to speaker which requires health care entities’ programs which offer education full attention. without providing remuneration to
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Looking for a way to jump-start some healthy habits? Build up your baseline of positivity with #21DaysofGratitude! Participating in this challenge can set you up for success, so you can be Healthy for Good. Follow along and share your progress on social!
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