RE: Prevention in a factory setting

[Guest guest]

From Joanne in Drain, Oregon Dear Members: I need help and ideas. A local factory is asking me to meet with them and their insurance company about creating for them a system of preventive management of disease for their employees. The company has about 50 employees who are ageing now (many in their fifties) and they find their insurance costs are going up very high. A few years ago the factory manager started a concentrated preventive program for accidents including planning all the work stations with an eye to stopping both accidents and excessive strains: their accident and lost days rate have dropped and their insurance rates have dropped notably. He is hoping to have the same thing happen if they start a preventive program and have an incentive

program attached to it. We mentioned smoking cessation; obesity, diet and exercise (he is very interested in this), hypertension management. Does anyone have any suggestions: are there published programs, or flow charts, or systems previously established? Of course there are. I just have to find them and thought someone out there could keep me from having to rediscover the wheel. I am very excited, because this was exactly why I thought working as a solo MD in a very small town could be very productive. Here, one could make a real difference in a whole community. This company is one of three largish companies that support this town; the rest is all small business with one or two or no employees. Drain, by the way, has 992

people. Just think: if we can get local 50 working people doing diet and exercise, then all their families will be affected by that; maybe another 165. That will be nearly a quarter of the town. We could change what foods the local store carries for sale. Joanne Holland DVM/MD __________________________________________________

[Guest guest]

From Joanne in Drain, Oregon Dear Members: I need help and ideas. A local factory is asking me to meet with them and their insurance company about creating for them a system of preventive management of disease for their employees. The company has about 50 employees who are ageing now (many in their fifties) and they find their insurance costs are going up very high. A few years ago the factory manager started a concentrated preventive program for accidents including planning all the work stations with an eye to stopping both accidents and excessive strains: their accident and lost days rate have dropped and their insurance rates have dropped notably. He is hoping to have the same thing happen if they start a preventive program and have an incentive

program attached to it. We mentioned smoking cessation; obesity, diet and exercise (he is very interested in this), hypertension management. Does anyone have any suggestions: are there published programs, or flow charts, or systems previously established? Of course there are. I just have to find them and thought someone out there could keep me from having to rediscover the wheel. I am very excited, because this was exactly why I thought working as a solo MD in a very small town could be very productive. Here, one could make a real difference in a whole community. This company is one of three largish companies that support this town; the rest is all small business with one or two or no employees. Drain, by the way, has 992

people. Just think: if we can get local 50 working people doing diet and exercise, then all their families will be affected by that; maybe another 165. That will be nearly a quarter of the town. We could change what foods the local store carries for sale. Joanne Holland DVM/MD __________________________________________________

[Guest guest]

From Joanne in Drain, Oregon Dear Members: I need help and ideas. A local factory is asking me to meet with them and their insurance company about creating for them a system of preventive management of disease for their employees. The company has about 50 employees who are ageing now (many in their fifties) and they find their insurance costs are going up very high. A few years ago the factory manager started a concentrated preventive program for accidents including planning all the work stations with an eye to stopping both accidents and excessive strains: their accident and lost days rate have dropped and their insurance rates have dropped notably. He is hoping to have the same thing happen if they start a preventive program and have an incentive

program attached to it. We mentioned smoking cessation; obesity, diet and exercise (he is very interested in this), hypertension management. Does anyone have any suggestions: are there published programs, or flow charts, or systems previously established? Of course there are. I just have to find them and thought someone out there could keep me from having to rediscover the wheel. I am very excited, because this was exactly why I thought working as a solo MD in a very small town could be very productive. Here, one could make a real difference in a whole community. This company is one of three largish companies that support this town; the rest is all small business with one or two or no employees. Drain, by the way, has 992

people. Just think: if we can get local 50 working people doing diet and exercise, then all their families will be affected by that; maybe another 165. That will be nearly a quarter of the town. We could change what foods the local store carries for sale. Joanne Holland DVM/MD __________________________________________________

[Guest guest]

Wow! What a wonderful opportunity! Although

I have no knowledge in this area (and can’t therefore help), I really

admire what you’re doing and can’t wait to see how things develop.

Good Luck!

Re:

Prevention in a factory setting

From Joanne in Drain, Oregon

Dear Members:

I need help and ideas.

A local factory is asking me to

meet with them and their insurance company about creating for them a

system of preventive management of disease for their

employees. The company has about 50 employees who are ageing now (many in

their fifties) and they find their insurance costs are going up very

high.

A few years ago

the factory manager started a concentrated preventive program for

accidents including planning all the work stations with an eye to stopping both

accidents and excessive strains: their accident and lost days rate have

dropped and their insurance rates have dropped notably. He is hoping to

have the same thing happen if they start a preventive program and have an

incentive program attached to it.

We

mentioned smoking cessation; obesity, diet and exercise (he is very

interested in this), hypertension management.

Does anyone have any

suggestions: are there published programs, or flow charts, or systems

previously established? Of course there are. I just have to find

them and thought someone out there could keep me from having to rediscover the

wheel.

I am very excited, because

this was exactly why I thought working as a solo MD in a very small town could

be very productive. Here, one could make a real difference in

a whole community. This company is one of three largish companies that

support this town; the rest is all small business with one or two or

no employees. Drain, by the way, has 992 people. Just

think: if we can get local 50 working people doing diet and

exercise, then all their families will be affected by that; maybe another

165. That will be nearly a quarter of the town. We

could change what foods the local store carries for sale.

Joanne Holland DVM/MD

__________________________________________________

[Guest guest]

From Drain: Thanks for your feedback and great ideas for what to focus on in a prevention program. About being paid: yes, I think so. We haven't talked money, just ideas. I think I will be contracted in some way. The manager told someone in his church he would like to support keeping a local MD here, and was thinking about contracting me to do the initial workup on his workman's comp cases. What he actually told me yesterday was "I think we could come up with something that would be helpful to both of us." I'd probably do it for nothing, except that would be wrong in this medical environment. What I came back into medicine to do was to change the health care system: and we are doing that, aren't we? I just have this image of coming into an underserved area and striking a blow for good medicine that would

cleave the system wide open. I am feeling "up" today, because I cought an early appendicitis and got her into the hospital with the appropriate documentation 7 hours after her first symptom struck: and also caught a previously undiagnosed asthmatic in an exacerbation and reversed it in the office between patients. Both of those people would have been in the ER at midnight tonight. This was done by me and my exploited family member working alone, while seeing my usual 8 other patients. Joanne in Drain, Oregon lawrence lyon wrote: congratulations! that's

terrific!... prevention and screening... how to know when to see the doctor.... natural history of common diseases.... integration of prevention, screening, lifestyle and common diseases, into acting out healthy choices on a daily basis.... LLjoanne holland wrote: From Joanne in Drain, Oregon Dear Members: I need help and ideas. A local factory is asking me to meet with them and their insurance company about creating for them a

system of preventive management of disease for their employees....... We mentioned smoking cessation; obesity, diet and exercise (he is very interested in this), hypertension management....... Does anyone have any suggestions? .... I am very excited. Joanne Holland DVM/MD __________________________________________________

[Guest guest]

This is cool. It is just a meeting however and it is with an

insurance company.

Things that you can do really is finding and treating htn, colon

screening , immunization update, est if needed, psa, mammogram, lab

screeing.

Smoking cessation along w pfts.

Obesity and diet will be difficult, especially w those in their

50's.

I would try to get them to pay for an annual health review and yearly

lab, ekg if needed, colonscopy every 5-10 years, psa, stool guiac,

mammgoram, periodic pap. You could discount your part if they

simplifed process.

You could go to plant and give annual flu shot for them.

You could get the employer to pay for memberships to the local gym

for all if possible.

Brent

>

> From Joanne in Drain, Oregon

>

> Dear Members:

>

> I need help and ideas.

> A local factory is asking me to meet with them and their

insurance company about creating for them a system of preventive

management of disease for their employees. The company has about 50

employees who are ageing now (many in their fifties) and they find

their insurance costs are going up very high.

> A few years ago the factory manager started a concentrated

preventive program for accidents including planning all the work

stations with an eye to stopping both accidents and excessive

strains: their accident and lost days rate have dropped and their

insurance rates have dropped notably. He is hoping to have the same

thing happen if they start a preventive program and have an incentive

program attached to it.

>

> We mentioned smoking cessation; obesity, diet and exercise

(he is very interested in this), hypertension management.

> Does anyone have any suggestions: are there published

programs, or flow charts, or systems previously established? Of

course there are. I just have to find them and thought someone out

there could keep me from having to rediscover the wheel.

>

> I am very excited, because this was exactly why I thought

working as a solo MD in a very small town could be very productive.

Here, one could make a real difference in a whole community. This

company is one of three largish companies that support this town;

the rest is all small business with one or two or no employees.

Drain, by the way, has 992 people. Just think: if we can get local

50 working people doing diet and exercise, then all their families

will be affected by that; maybe another 165. That will be nearly a

quarter of the town. We could change what foods the local store

carries for sale.

>

> Joanne Holland DVM/MD

>

>

> __________________________________________________

>

[Guest guest]

Hi Joann,

Neat opportunity. You might get some

ideas and at least ‘parts of the wheel’ from my local Teller County

Public Health. They were one of very few counties across the country to get a

grant to help get the population’s health improved. They have gone to

workplaces and helped them organize their wellness programs, and also focus on

obesity, exercise, diabetes, tobacco cessation and asthma. Check out their

website: www.tellersteps.org. Mail: POBox 928, Divide,

CO 80814,

phone .

Good luck!

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From: [mailto: ] On Behalf Of joanne holland

Sent: Friday, June 02, 2006 11:20

AM

To:

Subject: Re:

Prevention in a factory setting

From Joanne in Drain, Oregon

Dear Members:

I need help and ideas.

A local factory is asking me to meet with them and

their insurance company about creating for them a system of

preventive management of disease for their employees. The

company has about 50 employees who are ageing now (many in their fifties) and

they find their insurance costs are going up very high.

A few years ago the factory

manager started a concentrated preventive program for accidents including

planning all the work stations with an eye to stopping both accidents and

excessive strains: their accident and lost days rate have dropped and

their insurance rates have dropped notably. He is hoping to have

the same thing happen if they start a preventive program and have an incentive

program attached to it.

We mentioned smoking cessation;

obesity, diet and exercise (he is very interested in this),

hypertension management.

Does anyone have any suggestions: are

there published programs, or flow charts, or systems previously

established? Of course there are. I just have to find them and

thought someone out there could keep me from having to rediscover the

wheel.

I am very excited, because this was exactly

why I thought working as a solo MD in a very small town could be very

productive. Here, one could make a real difference in a whole

community. This company is one of three largish companies that support

this town; the rest is all small business with one or two or no

employees. Drain, by the way, has 992 people. Just

think: if we can get local 50 working people doing diet and

exercise, then all their families will be affected by that; maybe another

165. That will be nearly a quarter of the town. We

could change what foods the local store carries for sale.

Joanne Holland DVM/MD

__________________________________________________

[Guest guest]

Hi Joann,

Neat opportunity. You might get some

ideas and at least ‘parts of the wheel’ from my local Teller County

Public Health. They were one of very few counties across the country to get a

grant to help get the population’s health improved. They have gone to

workplaces and helped them organize their wellness programs, and also focus on

obesity, exercise, diabetes, tobacco cessation and asthma. Check out their

website: www.tellersteps.org. Mail: POBox 928, Divide,

CO 80814,

phone .

Good luck!

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From: [mailto: ] On Behalf Of joanne holland

Sent: Friday, June 02, 2006 11:20

AM

To:

Subject: Re:

Prevention in a factory setting

From Joanne in Drain, Oregon

Dear Members:

I need help and ideas.

A local factory is asking me to meet with them and

their insurance company about creating for them a system of

preventive management of disease for their employees. The

company has about 50 employees who are ageing now (many in their fifties) and

they find their insurance costs are going up very high.

A few years ago the factory

manager started a concentrated preventive program for accidents including

planning all the work stations with an eye to stopping both accidents and

excessive strains: their accident and lost days rate have dropped and

their insurance rates have dropped notably. He is hoping to have

the same thing happen if they start a preventive program and have an incentive

program attached to it.

We mentioned smoking cessation;

obesity, diet and exercise (he is very interested in this),

hypertension management.

Does anyone have any suggestions: are

there published programs, or flow charts, or systems previously

established? Of course there are. I just have to find them and

thought someone out there could keep me from having to rediscover the

wheel.

I am very excited, because this was exactly

why I thought working as a solo MD in a very small town could be very

productive. Here, one could make a real difference in a whole

community. This company is one of three largish companies that support

this town; the rest is all small business with one or two or no

employees. Drain, by the way, has 992 people. Just

think: if we can get local 50 working people doing diet and

exercise, then all their families will be affected by that; maybe another

165. That will be nearly a quarter of the town. We

could change what foods the local store carries for sale.

Joanne Holland DVM/MD

__________________________________________________

[Guest guest]

Great opportunity Joann.

I've reviewed an article for publication describing an employer based

health care program that reduced total health care expenditures by 17% (a

whopping drop for most employers). The article is in press so

I'm not allowed to share yet, but you can look into their info on:

http://www.quad-med.com/about/

The basic premise of success in the QuadMed example is: effective primary

care.

They cut the typical primary care panel size in half, made each

appointment at least 30 minutes, put the docs on salary, and then grew

other programs to help support wellness in the workplace.

This is one of the core points we're setting out to prove in our Ideal

MicroPractice project: better primary care lowers overall health

costs.

My suggestion: in addition to thinking about wellness programs, consider

the power of an ideal primary care home that has eliminated the barriers

to access and has implemented the core components of the ideal micro

practice model.

Let us know how it goes as we all gain from such experiences.

Quantify what you can so that others may benefit.

Gordon

At 01:52 PM 6/3/2006, you wrote:

Hi

Joann,

Neat opportunity. You might get some ideas and at least ‘parts of

the wheel’ from my local Teller County Public Health. They were one

of very few counties across the country to get a grant to help get the

population’s health improved. They have gone to workplaces

and helped them organize their wellness programs, and also focus on

obesity, exercise, diabetes, tobacco cessation and asthma. Check

out their website:

www.tellersteps.org.

Mail: POBox 928, Divide, CO 80814, phone .

Good luck!

A.

Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park,

CO 80863

From:

[

mailto: ] On Behalf Of

joanne holland

Sent: Friday, June 02, 2006 11:20 AM

To:

Subject: Re: Prevention in a factory

setting

From Joanne in Drain, Oregon

Dear Members:

I need help and ideas.

A local factory is asking me to meet with them and

their insurance company about creating for them a system of preventive

management of disease for their employees. The company has about 50

employees who are ageing now (many in their fifties) and they find their

insurance costs are going up very high.

A few years ago the factory manager

started a concentrated preventive program for accidents including

planning all the work stations with an eye to stopping both accidents and

excessive strains: their accident and lost days rate have dropped

and their insurance rates have dropped notably. He is hoping

to have the same thing happen if they start a preventive program

and have an incentive program attached to it.

We mentioned smoking cessation;

obesity, diet and exercise (he is very interested in this),

hypertension management.

Does anyone have any suggestions: are

there published programs, or flow charts, or systems previously

established? Of course there are. I just have to find them

and thought someone out there could keep me from having to rediscover the

wheel.

I am very excited, because this was exactly why

I thought working as a solo MD in a very small town could be very

productive. Here, one could make a real difference in a whole

community. This company is one of three largish companies that

support this town; the rest is all small business with one or two

or no employees. Drain, by the way, has 992 people.

Just think: if we can get local 50 working people doing diet and

exercise, then all their families will be affected by that; maybe

another 165. That will be nearly a quarter of the

town. We could change what foods the local store carries for

sale.

Joanne Holland DVM/MD

__________________________________________________

[Guest guest]

Great opportunity Joann.

I've reviewed an article for publication describing an employer based

health care program that reduced total health care expenditures by 17% (a

whopping drop for most employers). The article is in press so

I'm not allowed to share yet, but you can look into their info on:

http://www.quad-med.com/about/

The basic premise of success in the QuadMed example is: effective primary

care.

They cut the typical primary care panel size in half, made each

appointment at least 30 minutes, put the docs on salary, and then grew

other programs to help support wellness in the workplace.

This is one of the core points we're setting out to prove in our Ideal

MicroPractice project: better primary care lowers overall health

costs.

My suggestion: in addition to thinking about wellness programs, consider

the power of an ideal primary care home that has eliminated the barriers

to access and has implemented the core components of the ideal micro

practice model.

Let us know how it goes as we all gain from such experiences.

Quantify what you can so that others may benefit.

Gordon

At 01:52 PM 6/3/2006, you wrote:

Hi

Joann,

Neat opportunity. You might get some ideas and at least ‘parts of

the wheel’ from my local Teller County Public Health. They were one

of very few counties across the country to get a grant to help get the

population’s health improved. They have gone to workplaces

and helped them organize their wellness programs, and also focus on

obesity, exercise, diabetes, tobacco cessation and asthma. Check

out their website:

www.tellersteps.org.

Mail: POBox 928, Divide, CO 80814, phone .

Good luck!

A.

Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park,

CO 80863

From:

[

mailto: ] On Behalf Of

joanne holland

Sent: Friday, June 02, 2006 11:20 AM

To:

Subject: Re: Prevention in a factory

setting

From Joanne in Drain, Oregon

Dear Members:

I need help and ideas.

A local factory is asking me to meet with them and

their insurance company about creating for them a system of preventive

management of disease for their employees. The company has about 50

employees who are ageing now (many in their fifties) and they find their

insurance costs are going up very high.

A few years ago the factory manager

started a concentrated preventive program for accidents including

planning all the work stations with an eye to stopping both accidents and

excessive strains: their accident and lost days rate have dropped

and their insurance rates have dropped notably. He is hoping

to have the same thing happen if they start a preventive program

and have an incentive program attached to it.

We mentioned smoking cessation;

obesity, diet and exercise (he is very interested in this),

hypertension management.

Does anyone have any suggestions: are

there published programs, or flow charts, or systems previously

established? Of course there are. I just have to find them

and thought someone out there could keep me from having to rediscover the

wheel.

I am very excited, because this was exactly why

I thought working as a solo MD in a very small town could be very

productive. Here, one could make a real difference in a whole

community. This company is one of three largish companies that

support this town; the rest is all small business with one or two

or no employees. Drain, by the way, has 992 people.

Just think: if we can get local 50 working people doing diet and

exercise, then all their families will be affected by that; maybe

another 165. That will be nearly a quarter of the

town. We could change what foods the local store carries for

sale.

Joanne Holland DVM/MD

__________________________________________________