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Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
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- Frustration over limited time spent with patients. - Inordinate amounts of time inputting required data. - Side effects including high levels of stress. The patient? Herself. The remedy? “I did the research and found direct primary care,” said Anderson-Elder of Windsor. And in June she joined Dr. Frank Morgan at Balance Health in Greeley, a direct primary care clinic he founded four years ago in Greeley. Leaving her family practice at UCHealth Medical Clinic in Windsor after seven years wasn’t an easy decision, she said, but it was the right decision for her. Many physicians — from all specialties — share Anderson-Elder’s frustration and levels of stress incurred while working in insurance-based health care systems. In the 2018 Medscape National Physician and Depression Report, 42 percent of family physicians admitted to having burnout or depression, listing “too many bureaucratic tasks (charting, paperwork)” and “too many hours at work” as the leading factors in burnout. Although direct primary care has been around for some time, it is just now gaining a toehold with both physicians contemplating the switch to a different way of providing care and patients willing to give it a shot, so to speak. In 2017, there were more than 600 direct primary care clinics in the U.S., 10 percent of those in Colorado, according to the Colorado Independent. Anderson-Elder said in her research she found 1,000 out of the 80,000 family doctors practicing in the U.S. have gone the direct primary care route. DIRECT PRIMARY CARE What is direct primary care? And why the interest? First and foremost, the major difference is that direct primary care does not accept insurance. Patients instead pay a monthly membership fee that includes unlimited visits, calls and emails, along with many routine services and access to prescriptions and lab work at a reduced cost. For the physician, it means quality time spent with patients and no more time filling out paperwork to satisfy health insurance company regulations. What the monthly fee is varies from clinic to clinic. At Balance Health, it is $99 for adults, $180 for couples and $30 for children. Those who sign up for direct primary care are asked to sign an annual contract but can be released from it with 30 days’ notice, Anderson-Elder said. “We want to be accessible to our patients. We don’t want them to go to urgent care or ER if they don’t have to,” she said. And yes, that includes calls at 3 a.m., but if it can wait till morning, the patient is worked into that day’s schedule. Anderson-Elder typically sees eight to 17 patients per day, depending on whether it’s cold and flu season. And she spends as much time as needed with them. At her previous practice, she was limited to spending 15 to 20 minutes per patient. “People service their cars,” she said. “They should do the same thing with their bodies. You should be looked at and tuned up.” While most people think of going to the doctor only when they don’t feel well or need a physical for work or school, Anderson-Elder said she likes to see patients even when they feel healthy so she can check in on their well-being and talk about proper nutrition. “Oftentimes patients think they’re healthy, but then we do an exam and sometimes find things,” she said. Direct primary care works best when combined with a high-deductible health plan, Anderson-Elder said, for those times when unexpected surgeries are scheduled and for patients who suffer from chronic illnesses. But she said about one-third of her patients have no health insurance at all. She also noted direct primary care should not be confused with concierge medicine, which also provides direct access to providers for a flat fee but still bills insurance companies for services provided. Another key distinction between the two is direct primary care is mentioned in the Affordable Care Act as an acceptable option for receiving medical care without insurance, while concierge medicine is not, according to the American Academy of Family Physicians. And last year, Colorado Gov. John Hickenlooper signed Colorado HB17-1115, which establishes that direct primary health care can operate without regulation of the division of insurance. Windsor Republican Rep. Perry Buck was a primary sponsor of the bill. Patients at Balance Health also can tap into other healthy-living services for additional fees. Dr. Dana Morgan, a family care physician, specializes in bioidentical hormone replacement therapy. Balance Health also has a small fitness gym replete with trainers and classes. Wellness coaching also is offered. Leaving her practice in Windsor, though a hard decision, has been the right prescription for her, she said. “I no longer take paperwork home,” she said. “I’m happier and less stressed.” ___ Information from: The Tribune of Greeley, Co, http://greeleytribune.com
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Windsor doctor joining direct primary care movement.


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A team of 20 doctors, including surgeons, neurosurgeons, anesthesiologists and nurses, will be deployed to the region of Marche in central Italy for two weeks, Italian ambassador to Ukraine, Davide La Cecilia told Reuters. “The national health service in our country is very stressed. So we badly need medical personnel and are very happy that Ukraine is sending this humanitarian aid,” said La Cecilia at Kiev’s airport, before the medical mission’s departure. Ukrainian Interior Minister Arsen Avakov, who accompanied the ambassador, said Kiev would send more medical aid and disinfectant to Italy in the coming days. “It is an honour for us to help Italy during such tough times. We know that many Ukrainians live and work in Italy. By helping Italy, we are helping our citizens,” said Avakov. Ukraine’s health ministry has reported 1,096 cases, including 28 deaths since March 3, when the first case was recorded. But as thousands of Ukrainians have recently returned home from abroad, the ministry expects a much bigger outbreak ahead. The daily tally of new cases increased to 154 on Saturday from 138 on Friday, up from 62 last Monday. The head of the Ukrainian medical mission, neurosurgeon Andriy Miroshnichenko, said that all the team members volunteered to work in Italy. “After they come back home, they will be able to treat patients and work having practical experience and knowledge about the disease,” said Miroshnichenko. Asked whether the Ukrainian doctors were not afraid to catch the virus themselves Glib Bidyukov, a nurse, said it was “a consciously made choice”. “When you choose healthcare, you understand that you put yourself in some danger… Each of us made a choice a long time ago,” Bidyukov said.
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Ukrainian doctors fly to Italy to help combat coronavirus.


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The possibility that the coronavirus spreads in a mostly stealthy mode among a population of largely young, healthy people showing no symptoms could have major implications for U.S. policy-makers, who are considering how and when to reopen the economy. It also renews questions about the extent to which U.S. testing of just the people suspected of being infected is actually capturing the spread of the virus in the United States and around the world. The Navy’s testing of the entire 4,800-member crew of the aircraft carrier - which is about 94% complete - was an extraordinary move in a headline-grabbing case that has already led to the firing of the carrier’s captain and the resignation of the Navy’s top civilian official. Roughly 60 percent of the over 600 sailors who tested positive so far have not shown symptoms of COVID-19, the potentially lethal respiratory disease caused by the coronavirus, the Navy says. The service did not speculate about how many might later develop symptoms or remain asymptomatic. “With regard to COVID-19, we’re learning that stealth in the form of asymptomatic transmission is this adversary’s secret power,” said Rear Admiral Bruce Gillingham, surgeon general of the Navy. The figure is higher than the 25% to 50% range offered on April 5 by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a member of President Donald Trump’s coronavirus task force. Defense Secretary Mark Esper, speaking in a television interview on Thursday, said the number of asymptomatic cases from the carrier was “disconcerting.”   “It has revealed a new dynamic of this virus: that it can be carried by normal, healthy people who have no idea whatsoever that they are carrying it,” Esper told NBC’s “Today” morning show. Such data present challenges to the Pentagon, which is deployed around the world, sometimes in confined environments like submarines, ships and aircraft. Testing the entire military is not yet feasible, given still-limited testing capacity, officials say, and detecting enough cases without tests is impossible if most cases are asymptomatic. The U.S. coronavirus death toll - the highest in the world - surged past 31,000 on Thursday after doubling in a week. It also claimed the life of a sailor from the Theodore Roosevelt this week. Five other members of the crew are hospitalized. Still, the case of the Theodore Roosevelt offers a case study for researchers about how the virus spreads asymptomatically in a confined environment among mostly younger adults. That cohort has been somewhat underrepresented in the epidemiological data so far, said William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. “The findings are of enormous interest because the proportion of people who are asymptomatic is just simply not known,” Schaffner said, when asked about the Navy’s data. Vice Admiral Phillip Sawyer, a deputy chief of naval operations at the center of the Navy’s coronavirus response efforts, presented the 60% figure in a call with a small group of reporters on Wednesday. But he declined to speculate about the implications. “I don’t know if we’re proving something different,” Sawyer said. “I do agree that we are providing some data that some other organizations might not have.”
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Coronavirus clue? Most cases aboard U.S. aircraft carrier are symptom-free.