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A Primary Goal

Looking for a doctor? The Bartlett Medical Clinic and Wellness Center won’t accept your insurance. Heather Bartlett, M.D., the clinic’s founder and owner, sees a hidden health care crisis in America, one which led her to establish Columbus’ first Direct Primary Care (DPC) medical practice, an alternative payment model with a flat-rate monthly fee and [...]
Laura Dachenbach

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Looking for a doctor?

The Bartlett Medical Clinic and Wellness Center won’t accept your insurance.

Heather Bartlett, M.D., the clinic’s founder and owner, sees a hidden health care crisis in America, one which led her to establish Columbus’ first Direct Primary Care (DPC) medical practice, an alternative payment model with a flat-rate monthly fee and no third-party billing.

“Nobody’s talking about it,” Bartlett’s said, referring to physician burnout—the anxiety and depression leading to suicidal thoughts, the disengagement, the general malaise that has ticked upwards in the profession by 25 percent over the last four years according to some studies. She tells me about closed Facebook groups for physicians looking for side work, rental income or MLMs to escape clinical work.

“We’re not getting to practice medicine any more. We’re becoming data entry clerks,” Bartlett lamented.

As a young doctor in Seattle working under an insurance model, Bartlett describes how she was trained to limit her patients’ issues to just one or two a visit, maximizing the number of patients seen per day, since insurance companies won’t reimburse a physician or practice for the time spent with any one patient.

“These were people that were coming in that were lower socioeconomic class, that were laborers who had bosses who were jerks. They were already losing income by being there. They were losing income by waiting. Then they lost income with their copay. Then they lost income with anything that I ordered.”

Follow up care would often become unaffordable. So Bartlett always worked through the list of complaints her patients would bring her, disregarding the “rule” to prioritize concerns for the sake of time.

“I couldn’t do it,” she explained, shaking her head. “It wasn’t within my resolve.”

So in February 2016, in the midst of political battles over insurance, Bartlett opened her no-insurance clinic and returned to the type of work she loves to do—primary care. Being a pioneer in the field isn’t easy, but she was convinced that providing affordable access to primary care, along with the time to adequately counsel patients, was the right thing to do.

“There’s a difference between being miserable and struggling. Struggling is being an entrepreneur and taking a risk. And that’s okay because that can change,” said Bartlett. “Even when I had moments of doubt, it was my patients’ feedback that kept me going; to say, ‘Okay I’ll figure out how to keep the clinic open for another month, and another month, and another month.’”

Bartlett shows me her exam room, what medicine looks like when the bureaucracy is removed. The vintage cabinets and wooden blinds call back an era before health insurance became commonplace (and virtually necessary) to healthcare. Bartlett even has a small pharmacy stocked with frequently prescribed drugs (most of them generics and 50 to 80 percent cheaper) and supplies such as braces and splints. Here is where she spends two hours with a patient during an initial exam. And what does she do with patients for that amount of time?

“I’m going to get to know them,” Bartlett explains, adding that current medical records consists mostly of yes or no questions designed around ease of billing, rather than getting an accurate medical history or description of a current illness. “First of all I say, ‘I see your history, but I’m going to let you start. Where do you want to start with your health history?’ You need to know the history of the patient. You need to know the story. It’s a story.”

To Bartlett, it’s all about trust, or in her words, “knowing that someone’s got your back”—which stems from genuine relationships with patients as well as financial transparency. Her billing is by “membership plan,” ranging from $149 a month to $59 a month. Fees for labs are available on her website. All plans include the ability to call/email/text/telemed with Bartlett. That means you can take a picture of that thing on your foot, email it, and get a same or next day answer without being forced to make an appointment, taking time off work, or trying to self diagnose on WebMD. You can video conference. Or you can text with urgent concerns.

“A patient was vacationing in Costa Rica…and he was having some side effects [from medication]. So he was able to email me, ‘Hey, this is going on.’ “ Bartlett answered the email and followed up the next day. “He didn’t go to an ER. He didn’t go to an Urgent Care. He didn’t screw up his vacation with his family because of something that I was familiar with and I could guide him.”

Bartlett feels lucky to have escaped the world of doctors on the “hamster wheel,” forced to process huge numbers of patients in an unreasonable amount of time and foresees an exodus of primary-care physicians, already threatened in numbers, leaving the field of medicine, and leaving patients, insured or not, without health care providers. DPC doesn’t mean less work for Bartlett, but it does mean more professional satisfaction.

“There’s a difference in going home tired and frustrated versus being tired and fulfilled,” Bartlett said. “So I’m happy.”

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Health & Fitness

Truth or Trend: Do lemons help with digestion?

Becca Kirian RD, LD, CNSC

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Lemons have been used for years in cooking to add acidity to foods, but is there actually a health benefit to using lemons in your food regularly? According to this social media post below, yes. The post alleges that lemons are a key to improving digestion due to their pH.

But, let’s stop there and explore whether or not there’s any truth to this claim.

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First of all, yes, lemons are acidic and have a low pH, and our gastric fluids or stomach acid is also acidic with a normal pH range being 1.5-3.5. So, lemons and our gastric juices do have similar pHs, and the acidity of stomach acid is vital for correct digestion processes. Thus, one might think lemons would be great to eat every day to keep our stomach acidic and digestion flowing,

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However, it’s not common for stomach acid to get out of normal range. Our bodies have a strong capability to maintain homeostasis, meaning if things get outside “normal” levels, our bodies will try to correct it from within. If your stomach acid is not in the normal range, that could be indicative of other health conditions that lemons may not be able to cure.

Take-Away: Continue to use lemons in your foods for acidity, flavor, and color, or if you really enjoy eating them—they do count as a serving of fruit! But, there is no need to force yourself to add more lemons to your diet for digestive purposes. Our bodies work hard to keep us stable, and if your gastric juices are out of range, visiting your doctor is the only thing that will help.

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Health & Fitness

Truth or Trend: Pregnancy Fit Tea

Becca Kirian RD, LD, CNSC

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We don’t have to be a woman to know that pregnancy can be difficult time, so a tea that helps with the nausea and discomfort seems like a great idea, right?

Wrong.

While many herbal teas are safe for the general public and pregnant women, there are some concerns.

First, some of the “beneficial” ingredients in the Flat Tummy tea above are not supported by any real evidence, let alone by information stating that they are safe to consume while pregnant. One of those ingredients is Rooibos (asparlathus linearis), which is touted as a “digestive aid” for pregnant women. However, this claim is not corroborated by a single study on The U.S. National Library of Medicine’s PubMed database.

Ginger is yet another ingredient present in the tea that has not been proven undeniably healthy for pregnant woman.

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“Although several studies have found no evidence of harm from taking ginger during pregnancy, it’s uncertain whether ginger is always safe for pregnant women,” according to the National Institutes of Health.

Not only is ginger a questionable ingredient for a child-bearing woman to consume, the Flat Tummy tea fails to specify exactly how much ginger was used to make it.

Take Away: Please do not fall for the schemes of these “Fit Teas.” If you are pregnant, please be cautious of all ingredients you put in your body and discuss with your healthcare provider before starting any supplementations.

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Health & Fitness

Medical marijuana arrives in Columbus next week

Mike Thomas

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Got your card? Terrasana – central Ohio’s first dispensary for medical marijuana – will open to patients in Ohio’s medical marijuana program this Tuesday, March 26th.

https://www.instagram.com/p/BpJ7V7gFgau/

The dispensary which also has plans for locations in Cleveland, Fremont, and Springfield Ohio will open at 656 Grandview Avenue.

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According to the company’s website, Terrasana’s goal is to connect high quality cannabis to patients in need with a doctor-driven approach focused on education.

Prices for the dispensary’s products start at 40 dollars per unit, though it’s unclear what that equates to in quantity or dose at this time.

Will you line up to be a day-one patient in Columbus’ growing MMJ scene? Let us know your thoughts in the comments

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