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.

- 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
Windsor doctor joining direct primary care movement.

Coaches around the league are taking preventive measures to help deal with the grind and stresses of a long NBA season. That hasn’t always been the case. Now, the NBA Coaches Association provides guidance to its members on everything from diet and exercise to sleep and mental health. “Well, we’re trying. We all are trying, we all are conscious of it,” Clippers coach Doc Rivers said. “I don’t think we’re very good at it, honestly. I know I’ve tried. It’s still very hard to accomplish. The game consumes us. It consumes me at least, and it should, if you love it. And it’s just hard to turn off. It’s important. We have to do it. We should have been doing it.” After a late arrival in Bay Area last month, it was after 10 p.m. when Rivers had the team tissue therapist work on his body, including knees and ankle — “and my brain.” He has consulted a sleep doctor, too. In Los Angeles, Walton is being proactive by encouraging every staff member to stay physically, mentally and emotionally healthy. The advice is to recharge when necessary, in whatever way is best. “It’s a priority,” Lakers assistant Mark Madsen said. “It’s important because think about all the late nights. We’ll get into cities at 4 in the morning sometimes. You have to stay on top of it.” As a youngster, J.B. Bickerstaff knew there were a couple of hours in the afternoon on game days his father needed for himself. Bernie Bickerstaff took a power nap that allowed him to be fresh for a long night on the NBA bench. J.B. Bickerstaff now does it the same exact way as coach of the Memphis Grizzlies. The coaches’ association is providing support and guidance like never before, and many coaches are making a point to openly discuss wellness strategies and share ideas. There’s also a close-knit support system within this crop of NBA coaches that Dallas’ Rick Carlisle, the coaches’ association president, considers special. “We also have a unique group of head coaches right now, guys that are extremely competitive but have great respect for one another and provide a high level of support for each other,” Carlisle said. “Guys who are going through tough times with health and even things like losing streaks. We’ve got a very high character group.” For example, Clifford so appreciated a call he got last season from Kerr, each having gone through his own challenging health ordeal that kept him from the bench for an extensive stretch. Clifford, then coaching the Charlotte Hornets, missed more than five weeks dealing with agonizing headaches that after a battery of tests were deemed to be caused by sleep deprivation. Kerr has endured some of the most high-profile absences. He missed the initial 43 games of the 2015-16 season — including a record 24-0 start — dealing with painful and confounding symptoms following a pair of back surgeries. Kerr was sidelined again for 11 games during the Warriors’ 16-1 postseason in 2017 before returning to the bench for Game 2 of the NBA Finals the Warriors wound up winning in five games against LeBron James and Cleveland. Kerr had undergone a procedure to repair a spinal fluid leak on May 5, 2017, at Duke University but was not well enough to return until June 4. He made it through last year’s repeat run to a title. “My advice to coaches who are coming into the league: Don’t get back surgery,” Kerr quipped. “That’s my main advice. Sorry, bad joke. Luke Walton, when he took the Laker job, we talked a lot about that. He told me his whole staff is really on a conditioning program and a health-wellness program. I think it’s really smart, something that every staff should try to do is just make sure you’ve got people looking after you and looking after each other.” Kerr practices regular yoga and can often be seen on the elliptical machine after practice in a corner of the gym, getting loose on a foam roller or stretching with the assistance of an athletic trainer. Trail Blazers coach Terry Stotts appreciates the points of emphasis and information provided by the coaches’ association “whether it’s diet or things to alleviate stress.” He watches what he eats and works in exercise whenever he can, saying those two things are “the remedy for everybody.” “A lot of it is just common sense that everybody has to deal with to take care of yourself,” Stotts said. “It’s not just coaches, obviously, it’s everybody, a lot of middle-aged men need to be doing the same, and some like me, beyond-middle-aged men. The fact that our lifestyle, if you give in to it, it can be a detriment, and everybody needs to be aware of it.” Clifford is in Orlando now, and he understands better than ever the importance of taking care of himself and monitoring his own health in a business where keeping your job depends largely on winning. He took significant steps to improve his sleep patterns and overall health, this after a previous heart scare as well. The 57-year-old Clifford deeply appreciated Kerr’s call. “It was great,” Clifford said. “He was one of the guys who reached out and obviously we had the health issue in common. It was a terrific gesture.” Last season, former Cavaliers coach Tyronn Lue dealt with anxiety and needed a mental and physical break. “Wellness isn’t just physical. It’s mental as well,” Portland guard Damian Lillard said. “I think the position we’re in as professional athletes and with coaches in the social media age, it’s a little more difficult. That takes it to a much higher level from physical and mental ... when you’ve got people talking about you all the time, on Twitter bashing you. People just have so much more access to you. It becomes a more stressful job, much more pressure on your job and so many more eyes.” Coaches are also realizing they can’t always do it alone, relying on experts to stay healthy. Golden State hired Rick Celebrini this past offseason as director of sports medicine and performance. “If you can find some help, somebody to give you a little guidance,” Kerr said, “like we have here with Rick and Drew Yoder, I think it’s a big help.” The coaches’ association sends a regular newsletter with guidance from nutrition consultant Stacy Goldberg, who also is always available for 1-on-1 conversations. She attends coach association meetings, too, offering healthy food and snack choices. “Often, coaches are so focused on taking care of the players that they are not always focused on taking care of themselves,” said Goldberg, founder and CEO of Savorfull. “This is especially true when it comes to their nutrition.” Added Carlisle: “We view this as important as anything else we do with the NBA coaches association.” ___ More AP NBA: https://apnews.com/tag/NBA and https://twitter.com/AP_Sports
NBA coaches’ new play: tending to health to cope with grind.

A 'suicide kit' is seen during a Reuters Interview in London May 7, 2009. REUTERS/Stefan Wermuth The state’s House of Representative passed the bill on Monday to ban the products. It must now be considered in the state Senate, which passed similar legislation in May. Sponsors say the bill would in no way impinge on a landmark 1997 state law legalizing physician-assisted suicides for terminally ill individuals in Oregon. Washington is the only other state with such a statute on the books. The newly passed Oregon bill was sparked by notoriety surrounding an elderly California woman who sells self-asphyxiation kits through a mail-order business, and the December suicide of one of her customers from Eugene, Oregon, 29-year-old Nicholas Klonoski. Sharlotte Hydorn, 91, a retired science teacher and great-grandmother who lives near San Diego, says her product is intended to help people with incurable, fatal illnesses end their lives with dignity in their own homes. The kits, which sell for $60 including shipping, consist of a plastic hood that closes around the neck and tubing that connects the hood to a tank of helium or other inert gas the patients supply themselves. Critics, including Klonoski’s brother, have faulted Hydorn for not screening potential buyers of her kits, which they say she peddles indiscriminately to customers who may be emotionally fragile, rather than terminally ill.   Klonoski’s family said he suffered from depression but was otherwise healthy when he used one of Hydorn’s kits to take his own life around Christmas time. “We don’t want somebody coming into Oregon making a profit off this kind of thing,” Representative Jeff Barker, a Democrat and sponsor of the bill, told Reuters. Oregon Governor John Kitzhaber, a Democrat and former emergency room physician, has taken no position on the bill, a spokeswoman said. The bill would make it a felony, punishable by up to 10 years in prison, for a person to sell “any substance or object that is capable of causing death to another person for the purpose of assisting the other person to commit suicide.”   Supporters stressed the measure would leave intact Oregon’s Death with Dignity Act, which allows physicians to prescribe life-ending medication to terminally ill patients, though the patients must be physically capable of administering the drug to themselves. State records show that 525 Oregonians have ended their lives under the statute since 1997. Hydorn has said sales of her product, which she calls “exit kits,” jumped sharply as a result of media attention stemming from Klonoski’s death and reaction to it in Oregon. She said much of her recent business has come from Oregon. Armed federal agents raided her home last month and seized cartons of documents, computers and sewing machines under a search warrant Hydorn said accused her of conspiracy, mail fraud, tax evasion and the “sale of (an) adulterated or misbranded medical device.”

Oregon votes to outlaw sale of suicide kits.