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The Joys and Challenges of Being a Country Vet

Wed, 03 Jun 2026 14:00:00 GMT

The Joys and Challenges of Being a Country Vet

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Rural Veterinarian Shortage
Impacting Communities

Your day begins well before dawn and stretches well past sunset. You make house calls miles from your clinic, treating a wide range of small and very large patients, assisting with difficult births, and performing surgery.

Most days, you love your job. You’re a rural vet.

The United States has lost 90% of its rural veterinarians since the end of World War II. While this shortage is not new, it is growing. Fewer students are choosing to enter the profession overall, but the dearth in those pursuing rural practice is even greater.

According to the College of Veterinary Medicine at Iowa State University, 60% of the state’s veterinary clinics seeking to hire practitioners are in communities with fewer than 10,000 people.

The challenges of rural practice are significant (physical demands, emotional stress, and financial constraints typical of agrarian settings), but so are the joys, particularly the unique sense of fulfillment in serving close-knit communities. (See sidebar below, “No Place Like Home.”)

What motivates someone to assume this demanding role, and what keeps them going despite the odds?

No Place Like Home

A 2024 cross-sectional survey of more than 2,000 rural and nonrural veterinarians, published in the March 2025 issue of the Journal of the American Veterinary Medical Association (JAVMA) revealed that rural practitioners were more attached to their communities .

Specifically, rural practitioners:

Felt more at home, connected to, and interested in their communities

Would be sorry or regretful to leave their communities

Believed their communities were an important part of their personal history

And felt their community was an ideal place for families to live.

Source: JAVMA

Not Your Daily Grind

A country veterinarian’s daily schedule is highly unpredictable; they never know exactly what each day will bring, even with a full schedule of appointments.

They perform a wide array of tasks, ranging from routine vaccinations and health checks to emergency surgeries and animal birthing support. No two days are alike, which keeps the job interesting.

The diversity is what appealed most to Dr. Tyler Feldhacker of Sioux Center, Iowa. Once he became a part of the community, he was hooked.

“There’s just something when you’re on a farmer’s place working with their livestock. You build great relationships not only with their animals but with them and their whole system. You know everything about their families. You make great relationships with your farmers.”

- Dr. Tyler Feldhacker, Sioux Center, IA

Rural veterinarians function as both practitioners and educators, instructing their clients about animal health and responsible care. Every day is a new adventure, requiring both medical expertise and a strong commitment to the communities they serve.

Demand Performance

The daily challenges of a country vet can be motivating, but they can also lead to fatigue and burnout.

Prolonged and frequent on-call hours (often 10 out of 14 days) and long-distance travel between clients—coupled with the physical demands of handling animals weighing over a thousand pounds—can be exhausting. As with all medical practitioners, there’s also the emotional toll of losing a patient. For vets, euthanasia can be a particularly heart-wrenching responsibility. In addition, the demanding work environment can be disruptive to work-life balance.

Finally, there are significant economic challenges. With veterinary student loan debt averaging $185,000, practicing in underserved rural areas where salaries are lower can be financially daunting.

But those who remain steadfast in their dedication to providing essential veterinary care to agrarian communities often find that rural America offers a unique and rewarding lifestyle.

Proposed Solutions

Addressing the challenges of rural veterinary practice is essential for attracting new graduates into the field. To this end, the USDA’s five-part Rural Veterinary Action Plan focuses on both immediate and long-term solutions to strengthen veterinary services in underserved communities by:

Expanding financial support for the Veterinary Medicine Loan Repayment Program and Veterinary Services Grant Program to help veterinarians manage student debt in exchange for serving in shortage areas. (The Iowa Farm Bureau Federation launched a similar loan repayment program in March 2025.)

Simplifying the process for veterinarians to access grants and loan repayment opportunities.

Partnering with universities, veterinary schools, and professional associations to encourage students to consider rural practice.

Providing continuing education, mentorship, and telemedicine tools to support veterinarians working in remote locations.

Improving coordination between federal, state, and local agencies.

--Article Continues Below--

Recruitment Strategies

What can rural clinics do to attract new veterinary school graduates? Iowa State researchers offer the following suggestions:

Make sure your practice has a dedicated website. This is the first place today’s students go to find out about the clinic and the community.

Engage students early by offering shadowing opportunities, internship programs, externship programs, and scholarships.

Offer financial incentives such as special pay rates, tuition reimbursement, or recruitment bonuses.

Sell the advantages rural communities: a more relaxed pace of life, low cost of living, less traffic and noise, recreational offerings, and a general feeling of safety.

Make sure potential candidates are aware of available technologies and affiliations with regional institutions and practices that offer networking and educational opportunities.

Worth the Sacrifice

Most rural vets thrive on the urgency, variety, and unpredictability of their practices and wouldn’t want to do anything else for a living. As Dr. Carol Hillhouse of Panhandle, Texas, recently explained, “There have been financial, professional, and personal sacrifices; however, not many people can say that they still love their job after thirty years.”

Sources:

Featured Image: Adobe, License Granted

Sioux Center News

Being Like

Iowa Agribusiness Radio Network

Iowa State University

USDA

I Want to Be a Veterinarian

The Rural Roots of Tobacco Use

Thu, 07 May 2026 14:31:18 GMT

The Rural Roots of Tobacco Use

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Small-Town America Still Lighting Up

America’s rural population is disproportionately impacted by tobacco use.

A 2024 Surgeon General’s report found that, while national smoking rates continue to decrease, tobacco use remains high in rural communities: 15.4% among rural adults, compared to 10.1% among their urban counterparts. Rural Americans also smoke more heavily (15 or more cigarettes per day) than urban smokers.

Moreover, rural residents often face structural barriers to tobacco cessation services, including lower rates of insurance coverage and the relative scarcity of health care providers.

Tobacco’s Deadly Consequences

The effect of tobacco use on America’s rural populations is sobering:

People living in rural areas have 18% to 20% higher lung cancer death rates than urban residents, 90% of which is caused by cigarette smoking.

Rural residents are less likely to receive recommended cancer prevention and screening. As a result, many of them have already reached a later stage of the disease at the time of diagnosis.

Four of the five leading causes of premature death for people in rural areas (heart disease, cancer, chronic respiratory disease, and stroke) can be associated with tobacco use.

Starting Young

Compared to urban and suburban youth, children from rural areas typically start using tobacco at a much younger age and are more likely to use it daily.

How Iowa Compares

According to the Iowa Department of Health and Human Services , 14.7% of Iowan adults smoke cigarettes, most of whom are between the ages of 25 and 65. Iowa’s smoking rate is 3% higher than the national average.

Here’s how it compares to neighboring states:

Illinois: 10.8%
Missouri: 15.3%
Minnesota: 12.2%
Wisconsin: 12.0%
Nebraska: 12.1%
South Dakota: 15.2%

In addition, the American Lung Association’s 2025 report has given Iowa the following grades for tobacco control efforts:

According to the CDC, e-cigarettes are the most widely used tobacco product among all U.S. middle school and high school students. But vaping is particularly prevalent among rural adolescents. In addition, these youths are more likely to use other tobacco products as well, including cigarettes and smokeless tobacco (“snuff,” “dip,” or “chew”).

Chew On This

Use of smokeless tobacco is twice as common in rural communities as in urban or suburban areas, particularly in the Midwest. As with rural youth, it is not uncommon for rural adults to use more than one type of tobacco product (such as both cigarettes and chewing tobacco).

The appeal of smokeless tobacco to rural Americans is partly due to targeted marketing. Product packaging and strategically placed retail displays feature cowboys, hunters, and race-car drivers, aiming to engage young men in rural areas.

In addition, tobacco companies frequently sponsor fishing, rodeo, and baseball events in rural areas, where up to 30% of the attendees are under the age of 18.

Understanding Rural Culture

One of the reasons anti-tobacco campaigns have been largely unsuccessful in rural areas is that they fail to consider the unique characteristics of rural culture. Such as:

The conventional attitudes of independence, self-reliance, and protection of personal liberties that stem from relatively isolated living.

A tendency toward conservative ways of approaching life, resulting in more careful and considered decision-making.

The awareness that others within their small communities are very interested in their lives; this lack of anonymity or privacy often results in pressure to conform.

The deep roots of tobacco use within rural social environments, where many role models (such as family members) are tobacco users.

The values of simple country life, and appreciation for hard manual labor and the outdoors.

As a result, most government-sponsored anti-tobacco campaigns do not resonate with rural Americans.

--Article Continues Below--

On a Rescue Mission

In response to this problem, one innovative marketing agency has developed an anti-tobacco initiative specifically targeting rural teens. Rescue Agency designed its “ Down and Dirty ” ready-made campaign to help government agencies and nonprofits drive healthy behavioral change within this vulnerable population.

Down and Dirty takes the highly successful social branding model that the tobacco industry has employed for decades and turns it on its head to counter market these messages. The campaign uses relatable anti-tobacco role models to break the association between rural culture and tobacco use.

Here's an example of the types of messages used in the Down and Dirty campaign:

So far, this program has been successfully implemented in more than a dozen states. The data gathered by the Rescue Agency from these initial campaigns has been used to refine its messaging and delivery methods.

To learn more about this innovative approach to breaking tobacco’s hold on rural youth, check out “ Rural Teen Vaping, Chew, and Smoking Prevention.”

Sources:
Featured Image: Adobe, License Granted
State of Tobacco Control 2025
American Lung Association
CDC
JCO Oncology Practice

How Much Do You Know About the Benefits of Laughter?

Wed, 08 Apr 2026 15:00:00 GMT

How Much Do You Know About the Benefits of Laughter?

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Test Your Knowledge
With Our Humor Quiz

For the past 50 years, the month of April has been designated as National Humor Month.

Established in 1976 by author and humorist Larry Wilde to promote the therapeutic benefits of laughter, the annual observance serves as a reminder to embrace joy and introduce more levity into our lives.

How much do you know about the therapeutic effects of humor and laughter? Take our quiz and find out.

#1. “Laughter therapy” incorporates humor into clinical settings. Who is credited with pioneering this approach?

Norman Lear created and produced many popular and groundbreaking 1970s sitcoms, including “All in the Family,” “Maude,” and “Sanford and Son.” Norm Macdonald was a Canadian stand-up comedian and “Saturday Night Live” cast member.

Norman Rockwell was an American painter and illustrator, most famous for his cover illustrations of everyday life for The Saturday Evening Post. Norman Fell was an American actor who was best known for his comedic portrayal of landlord Stanley Roper on the 1970s hit TV show “Three's Company,” for which he won a Golden Globe Award.

#2. Humor and laughter are medically documented to induce multiple physical health benefits. Which of the following is NOT one of them?

#3. Which of the following humor styles typifies the late comedian Rodney Dangerfield?

Self-defeating humor is used when attempting to please others by poking fun at oneself. Affiliative humor entails cracking jokes and engaging in banter to bond with others and recognize the humor in everyday life. (Think Jerry Seinfeld.) Aggressive humor uses sarcasm, teasing, criticism, and ridicule at the expense of others. (Think Don Rickles.) Self-enhancing humor laughs at oneself or at the absurdity of a situation in a constructive way, ala Jon Stewart.

[Curious about which category best describes your sense of humor? Check out this quiz .]

#4. Patch Adams, a medical doctor portrayed by Robin Williams in the eponymous 1998 film, believes that laughter is an integral part of the healing process. What’s the name of his non-profit healthcare organization?

Child’s Play is a charity that provides games, toys, and gaming consoles to about 200 hospital pediatric wards worldwide. Clowns Without Borders is an international organization that visits communities in crisis (such as natural disaster areas and refugee camps) to entertain and lift the spirits of suffering people.

Kidding Around is an international yoga organization dedicated to promoting the benefits of yoga to children. Patch Me Up is the name of two different companies, one is a clothing repair platform, and the other produces wellness patches.

#5. What is laughter yoga?

A. Activation of the abdominal muscles that naturally occurs when laughing

B. Laughing at people attempting yoga poses

C. Laughing instead of crying when you contort yourself into a difficult and painful yoga pose

D. A form of exercise that encourages participants to laugh for no reason

E. There is no such thing.

Answer D. Developed in 1995 by Indian physician Dr. Madan Kataria, laughter yoga is based on the belief that the physical body cannot distinguish between simulated and spontaneous laughter. Therefore, forcing oneself to laugh provides all the same benefits as reflexive laughter. Practiced in more than 110 countries, laughter yoga incorporates laughter exercises with yoga breathing techniques.

#6. The American Medical Association offers several suggestions for incorporating humor within a clinical setting. Which of the following is NOT one of them?

A. Adding humorous reading material to your waiting room

B. Playing funny TV shows in your reception area

C. Demonstrating comical pratfalls

D. Displaying humorous photos of your kids or pets in your office

E. Placing funny signs in public areas

Answer: C. While the AMA encourages humor in clinical settings, it draws the line at demonstrating pratfalls. All the other suggestions are AMA-approved.

Laughter Heals

If laughter is the best medicine, then the prescription is simple: make space for humor. Take time out of every day to simply yuck it up; your body and mind will thank you. The following video clip should get you started:

Sources:
Featured Image: Adobe, License Granted
Other Image: Designed by Freepik
Science News Today
Psychology Today
Gesundheit! Institute
Laughter Yoga International
AMA Journal of Ethics

The Personality of Debt

Wed, 11 Mar 2026 04:00:00 GMT

The Personality of Debt

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How Personality Impacts
Financial Health

Our unique personalities shape our spending and saving habits, impacting our financial health.

Although personality alone does not determine financial behavior, it does significantly influence the way individuals manage their money. For instance, research studies have identified a definitive connection between certain character traits and the probability of accumulating debt.

Mapping Personality Traits

When correlating personality traits with financial health, most psychologists employ a widely accepted model known as the “Big Five.” This method describes personality in terms of five broad dimensions: Openness, Conscientiousness, Agreeableness, Neuroticism, and Extraversion. Each of us possesses a unique combination of these traits, influencing our behavior and reactions to various situations.

These traits exist on a spectrum, and individuals differ in the degree to which they express each one. For example, a person may be very extraverted, somewhat extraverted, or not at all extraverted.

Linking Personality Traits and Debt

For each of the Big Five, there is a definitive correlation between the individual trait and the likelihood of accumulating debt:

Openness

Openness to experience is associated with creativity, curiosity, and a willingness to explore new ideas and perspectives. Some studies suggest that individuals with high levels of openness are more willing to assume debt for novel experiences or to invest in personal growth.

Conscientiousness

This personality trait is associated with responsibility, organization, and a desire to achieve goals. Research indicates that individuals with high levels of conscientiousness tend to be better at budgeting, planning for the future, and controlling their spending habits, making them less likely to accumulate debt. On the other hand, people with very low levels of conscientiousness tend to be impulsive, acting without considering the consequences. Such consumers are often driven by a desire for immediate gratification and struggle with self-control when it comes to spending.

--Article Continues Below--

Agreeableness

Agreeableness as a personality trait is associated with cooperation and kindness. However, one of the few drawbacks to this trait is in the domain of personal finances. Highly agreeable people tend to perform worse on various key financial metrics, including lower savings balances, lower incomes, and greater economic hardship (e.g., debts, insolvency). Agreeable people may also be more easily manipulated into making irresponsible spending decisions.

Neuroticism

Neuroticism is characterized by emotional instability, anxiety, and a tendency toward negative perceptions. Individuals with high levels of neuroticism may use spending as a coping mechanism to deal with stress and painful emotions. They may also be more prone to making impulsive financial decisions because of their emotional reactivity.

Extraversion

Extraverted individuals are outgoing, sociable, and assertive. Studies of this personality trait have yielded mixed results regarding debt accumulation, with some suggesting a positive correlation (possibly due to a desire for material possessions or social status) and other studies finding no significant relationship.

Type vs. Trait

Personality types and traits both aim to describe human behavior, but they do so in fundamentally different ways.

Personality types refer to the classification of individuals into distinct categories based on specific patterns of behavior, thought, and emotion. Types are often seen as qualitative categories; you either fit into a type or you don’t. They provide a broad framework for understanding motivations and behaviors.

Personality traits, on the other hand, are enduring characteristics or qualities that reflect consistent patterns in an individual’s thoughts, feelings, and behaviors. Traits are typically measured on a continuum, such as the Big Five personality traits.

In other words, types are categorical (e.g., introvert vs. extrovert), while traits occur on a spectrum (e.g., varying levels of extraversion).

Source: Personality Types

Debt Personalities

In addition to the Big Five personality traits , financial psychologists have identified distinct personality types with respect to how consumers manage and perceive debt. (See sidebar, “Type vs. Trait.”)

Let’s take a look at the five most common “debt personalities” recognized by financial behavior experts:

#1. The Avoider

This personality type avoids confronting financial issues, particularly debt. Avoiders may feel overwhelmed by finances and neglect to open bills or check account balances. This person also tends to procrastinate making debt payments or even acknowledging the amount owed.

The avoider’s anxiety about money often stems from childhood experiences or a lack of financial education. On some level, they believe that ignoring debt will make the problem go away.

#2. The Compulsive Spender

Compulsive spenders are conspicuous consumers, often buying things they don’t need. They’ll frequently use credit cards or arrange loans without considering long-term consequences. This personality type justifies debt as a way to “live in the moment” or “treat oneself.”

The compulsive spender’s unrestrained purchasing may be a reaction to stress or low self-esteem, or simply cultural pressure to maintain a particular lifestyle.

#3. The Anxious Saver

Fearful of debt and financial insecurity, anxious savers tend to over-save and under-invest. They’re often unwilling to spend money, even on necessities or meaningful experiences, due to fear of debt accumulation.

Frequently, these individuals were raised in a financially unstable environment, or they experienced monetary hardship at some point. As a result, they developed a belief that spending money inevitably leads to financial disaster.

#4. The Rational Debtor

Rational debtors are every A/R professional’s dream. They approach debt with logic and a clear repayment plan, often incurring debt strategically for investment purposes or to advance their career goals. These consumers are disciplined about making their payments and managing interest rates. Financial education at some point in their lives has made them pragmatic about spending and borrowing.

#5. The Carefree Borrower

Debt is not a serious issue for carefree borrowers, who are usually unconcerned about paying it off quickly (if at all). They rely on minimum payments and/or frequent refinancing instead of creating a feasible repayment plan. “Mañana” is their mantra, as they assume the debt will be easy to repay at some future date.

These individuals may have a history of readily accessible credit or financial assistance, which can lead to an “optimism bias,” the belief that future income will resolve their current financial issues without any consequences.

Collection Challenges

Collecting from avoiders, compulsive spenders, and carefree borrowers is often challenging. Avoiders must be located through skip tracing, compulsive spenders often have numerous accounts in collections at the same time, and carefree borrowers need to understand the seriousness of defaulting on their obligations.

If your collections team is overwhelmed by the time and energy required to collect from these consumers, it’s time to call for reinforcements. The CBSI professionals have the required technology and training to ensure you’re paid what you’re due.

Sources:
Featured Image: Adobe, License Granted
FinTraits
True You Journal
Potentash
Social Science Research Network

The Health Benefits of Hugging

Sat, 07 Feb 2026 14:05:41 GMT

The Health Benefits of Hugging

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How Embracing Others
Helps Us Embrace Life

"The world is not comprehensible, but it is embraceable through the embracing of one of its beings."

- Martin Buber
Austrian-Israeli Philosopher

Whenever Valentine's Day rolls around, our hearts and minds tend to focus on the loving relationships in our lives.

But are you aware of the multiple health benefits associated with each warm embrace you give or receive? Decades of scientific research confirm that the simple act of hugging primes the human immune system and improves both physical and emotional health.

For example, consider a 2015 study in which scientists at Carnegie Mellon University exposed 400 healthy volunteers to the common cold virus over 14 days. Participants who received multiple hugs during that two-week period were 60% less likely to contract the infection than those who were rarely hugged. And the hugged participants who did get sick recovered more quickly and had stronger immune responses than their hug-deprived counterparts.

The Physiology Behind the Stats

There are at least two physiological reasons for these results:

Gentle pressure on the sternum activates the thymus gland, generating disease-fighting white blood cells.
Hugs increase circulation in the body's soft tissues, reducing inflammation by delivering healing nutrients to the inflamed area.

This conclusion was confirmed by a 2020 study that revealed a significant association between hugging and fewer proinflammatory molecules. Using saliva samples from 20 adults, researchers found that inflammation was inversely related to the number of hugs these subjects had received over two weeks. In other words, more hugs equal less inflammation.

The Heart of Marriage

A happy marriage can lead to a longer and healthier life, particularly for men.

Ongoing research from the Framingham Offspring Study evaluated 3,682 adults over 10 years and found that married men had a 46% lower death rate than unmarried men, regardless of major cardiovascular risk factors.

In a similar study, Japanese scientists reported that never-married men were three times more likely to die from cardiovascular disease than married men.

Then, in 2023, researchers from the American College of Cardiology found that lifelong bachelors are more than twice as likely to die from heart failure within five years of diagnosis than married men or women of any marital status.

Source: Harvard Health

"Cuddle Nerves" and "Feel-Good" Hormones

Upon closer examination, the physiological effects of embracing someone encompass both neurobiological and neurochemical impacts.

Neurobiologically, hugging stimulates C-tactile afferents , sensory receptors under the skin, known as "cuddle nerves." These nerves send signals directly to the brain's center for emotional processing (the insular cortex), releasing endorphins — the body's natural painkillers and mood enhancers.

From a neurochemical standpoint, hugging triggers the release of several feel-good brain chemicals, primarily oxytocin (the "love hormone"), dopamine (the "pleasure hormone"), and serotonin (the "happiness hormone"). When oxytocin binds to specific sites along the central nervous system, it can significantly reduce chronic pain.

Hugs All Around

Physical touch also improves cardiovascular health by increasing heart rate variability, a crucial measure of how well the body responds to stress. (See sidebar, "The Heart of Marriage.”)

A 2003 study revealed that hugging contributes to lower reactivity to a specific stressful life event: public speaking. In this study, couples who held hands for 10 minutes, followed by a 20-second hug before delivering a speech, exhibited blood pressure and heart rate measurements that were 50% lower than those without prestress partner contact.

Research published in the International Journal of Environmental Research and Public Health in 2023 revealed the carryover effects of hugging. This study found that first-year college students who received daily hugs from friends and family members demonstrated reduced stress levels the following morning.

In addition, the Journal of Sleep Research reported in 2024 that adults who receive consistent physical comfort sleep more soundly and wake more refreshed than those lacking such contact.

Hold It!

How long should a hug be for maximum physical benefit? As it turns out, there is a hug-duration sweet spot between the two extremes of the awkward, too-short hug that leaves you feeling shortchanged and the over-hugger who clings like a koala to a eucalyptus tree.

—Article Continues Below—

Researchers who tested different hug styles and durations have discovered precise requirements for optimal health benefits: five to ten seconds. (Of course, hugs should always be consensual, regardless of duration.)

For intimate relationships, a 20-second embrace produces the strongest measurable benefits.

Wrapping It Up

Hugging is a powerful tool for enhancing health and well-being that requires no expensive equipment, special training, or pharmaceutical intervention. People who are consistently hugged report better overall physical, emotional, and mental health, as well as improved medical outcomes, compared to those who are hug-deprived. Every embrace we give or receive helps us embrace life more fully.

Have you hugged someone today?

Sources:
Featured Image: Adobe, License Granted
National Center for Biotechnology Information
American Heart Association
ScienceAlert
The Epoch Times
MedicineNet
NeuroLaunch

How Much Do You Know About MLK?

Wed, 07 Jan 2026 13:45:00 GMT

How Much Do You Know About MLK?

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Celebrating a Civil Rights Icon

On January 19, Americans will celebrate the birthday of our most prominent civil rights leader -- Dr. Martin Luther King Jr.

A tireless activist, Baptist minister, and political philosopher, Dr. King continues to inspire a nation almost 60 years after his assassination. But how much do you actually know about MLK? Take our quiz and find out!

#1. Martin Luther King Jr. was jailed 29 times during his career, primarily for engaging in civil disobedience. What were the other charges?

In January 1956, he was arrested for driving five miles per hour over the speed limit; in May 1961, his offense was obstructing a sidewalk and parading without a permit; and in September 1958, he was arrested for loitering.

#2. How old was MLK when he entered college?

He graduated four years later and went on to earn a doctorate in theology from Boston University at age 25. By the time he was 19, Martin had already earned a Bachelor of Arts degree in sociology. A year later, he graduated from Crozer Theological Seminary in Chester, Pennsylvania. He went on to earn a doctorate in theology from Boston University at age 25.

#3. Ten years before his death, MLK survived another assassination attempt. Who was his attacker in the earlier attempt?

Thomas Hagen was the assassin of another civil rights leader—Malcolm X—who was shot in 1965 while addressing the Organization of Afro-American Unity in New York City. Sara Jane Moore , an unassuming San Francisco bookkeeper, raised a gun and fired at President Gerald Ford's head in 1975. James Earl Ray was convicted of assassinating Dr. King in 1968 (although the King family has consistently stated that they believe Ray was innocent).

James Earl Jones is a distinguished African-American actor of stage and screen. (But he has been confused with James Earl Ray. In 2002, a plaque intended for Jones at a Florida MLK celebration mistakenly displayed the inscription: "Thank you, James Earl Ray, for keeping the dream alive." Fortunately, the error was corrected before the presentation.)

#4. Dr. King was a prolific writer, authoring several inspirational books. Which of the following is NOT one of them?

#5. Which of the following awards did Dr. King receive?

In 1971, three years after his death, Dr. King won a Grammy for Best Spoken Word Recording, "Why I Oppose the War in Vietnam." The Presidential Medal of Freedom was bestowed on him in 1977, and the Congressional Gold Medal in 2004.

#6. Who prompted MLK to talk about his "dream" during his 1963 iconic speech at the Lincoln Memorial?

A. Mahalia Jackson

B. Jesse Jackson

C. Jackie Robinson

D. Rosa Parks

E. His wife, Coretta Scott King

(Need a hint? Click the video below.)

Answer: A. While all of the people mentioned attended this transformative speech, it was the legendary gospel singer Mahalia Jackson who prompted Dr. King, "Tell them about the dream, Martin." King then disregarded his prepared notes and improvised the remainder of his historic speech.

And with that, a civil rights icon was born.

Sources:
Featured Image: Adobe, License Granted
Black History
Morehouse College
King Institute
TopTenz
Grammy.com
History.com

Paws for Concern: Holiday Pet Safety

Wed, 03 Dec 2025 17:23:53 GMT

Paws for Concern: Holiday Pet Safety

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Keeping Our Furry Friends
Safe at Yuletide

Americans love to pamper their pets during the holiday season.

According to a recent TotalVet survey, a large number of Americans not only buy gifts for their companion animals but also prepare special meals for them and include them in holiday activities. But amidst all the holiday bustle, it's easy to overlook potential hazards lurking behind a delicious meal or seemingly harmless decoration.

Not surprisingly, an analysis of Google Trends data for the past five years revealed that internet searches for "ER vet" peak during the last two weeks of December. Here are a few suggestions to help keep your pet from becoming a holiday statistic.

Drop It! Foods That Are Toxic to Pets

Before handing Fido or Muffin that tasty tidbit, check this list of common holiday foods that are toxic to pets:

Chocolate. The theobromine and caffeine in chocolate can lead to gastrointestinal upset, agitation, tremors, and even seizures at high doses.

Macadamia Nuts. Even small amounts of these nuts can lead to serious health issues, including weakness, tremors, vomiting, and potentially seizures or paralysis.

Fatty Foods . Bacon, ham, and cheese can cause GI problems in pets and can lead to pancreatitis in dogs.

Grapes and Raisins . Grapes and raisins contain tartaric acid, which, even in small amounts, can lead to kidney damage or acute kidney failure, requiring prompt medical attention.

[Note: smart pets know where they can find leftovers, so be sure to remove trash and secure lids on garbage cans containing food.]

Virtual Vet

Veterinary telemedicine enables pet owners to consult with a veterinarian via text, phone, or video chat to receive real-time advice.

However, this service is not a replacement for regular in-office visits, and most vets who offer telemedicine services are not permitted to diagnose or prescribe medications for pets they haven't previously examined in person.

While some states prohibit veterinary telehealth, Iowa is not one of them.

Source : WIRED

Typical symptoms of food poisoning in pets include vomiting, diarrhea, and upset stomach. If you notice these signs, call the Pet Poison Helpline® at 855-764-7661 as soon as possible. They can help determine if the food or ingredient is toxic.

Continued vomiting, lethargy, trouble walking, and weakness are indications that emergency care is needed.

Deck the Halls – With Caution

Holiday decorations pose many potential hazards to your animal companions. For instance:

Ornaments. Dogs and cats view Christmas tree ornaments as colorful toys. If chewed or broken, they can cause injury to your pet's mouth or paws. Consider purchasing shatterproof ornaments instead.

Tinsel and Ribbons. One of the most common pet emergencies at this time of year is the surgical removal of ingested tinsel or ribbon obstructing a pet's intestine. So, skip the tinsel and ribbon, particularly if you have curious kitties.

Electrical Cords. Puppies are prone to chewing on the power cords used for holiday lights, which can cause electrical shock. Keep the cords wrapped and off the floor.

Holiday Plants. Mistletoe, holly, poinsettias, lilies, and yews (used in Hanukkah decorations) are all poisonous to pets. If you suspect your pet has ingested any of these plants, seek medical care immediately or call the Pet Poison Helpline. (Also, see sidebar, "Virtual Vet.”)

Tree Water. Ensure the Christmas tree water is covered and/or inaccessible to curious pets, as it can become a breeding ground for bacteria that may cause nausea, diarrhea, or an upset stomach.

Candles. Whether lighting a menorah or filling your home with holiday scents, never leave burning candles unattended. Curious paws and happily wagging tails can easily knock them over, possibly burning your pet or starting a fire.

Snow Globes. Snow globes contain ethylene glycol (the same chemical used in antifreeze), which is highly toxic to all pets. A broken snow globe emits a sweet fragrance that can attract pets to taste it, often with fatal results.

Making Sure "All Is Calm"

Changes in your pet's routine during the holidays can induce stress. Here are some strategies for reducing such anxiety:

Place your pet in a safe interior room, away from holiday guests and loud noises.

Keep pets occupied with interactive toys or by spreading pet-friendly treats on a lick mat.

Use pet pheromones (e.g., Feliway® for cats and Adaptil® for dogs ) or soothing music to help keep companion animals calm.

—Article Continues Below—

Keep Watch

Keep a close eye on your pet as much as possible to ensure they don't slip out the door while guests are coming and going. Affix signs to keep the door securely closed and install dog gates to prevent escape. If your pet is not microchipped, make sure they're wearing their collars and ID tags.

In Case of Emergency

Be prepared for emergencies by keeping the following phone numbers handy:

Animal clinic used by your veterinarian

24/7 emergency veterinary clinic (if different)

Pet Poison Helpline: 855-764-7661

ASPCA® Animal Poison Control Center : 888-426-4435

The holidays should be fun and joyous times for everyone involved. Following the above guidelines can help ensure your yuletide celebration doesn't beget a pet tragedy.

Sources:
Featured Image: Adobe, License Granted
Total Vet
dvm360
ASPCA
Chewy

Veterans and PTSD: The Ongoing Battle

Fri, 07 Nov 2025 12:57:07 GMT

Veterans and PTSD: The Ongoing Battle

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The Mental and Emotional
Aftermath of War

In February 2015, Iraq War veteran Richard Miles entered a VA hospital in Des Moines, Iowa, and told the staff: “I need help.”

This wasn’t his first visit to the Iowa VA. Between 2008 and 2009, Miles had been admitted four times after two unsuccessful suicide attempts.

This time, he was diagnosed with “worsened PTSD,” anxiety and insomnia. He assured the staff that he was not a harm to himself, but “I do need some medicine so I can just rest.” He was given the medication that had helped him in the past.

Five days later, Miles was found frozen to death in the woods, having consumed a toxic amount of the pills. He was 40 years old.

Every Veterans Day, we celebrate the brave individuals who have served our country through the armed forces. For many of them, however, the mental and emotional warfare continues long after they've left the physical battlefield behind.

Recent studies indicate that almost 16% of U.S. veterans will experience PTSD at some point in their lives, compared to a 9% PTSD rate for the general population. (See sidebar, "PTSD by Service Era.”) In addition, veteran suicide rates hover around 35% -- more than double the 15% rate for non-veterans.

Regional Differences

U.S. states vary widely in the PTSD rate among their military veterans, from 9.9% (Alaska) to 3.8% (Hawaii). Military and governmental authorities offer several reasons for this discrepancy:

PTSD by Service Era

The following table outlines PTSD rates for U.S. veterans engaged in military conflicts since WWII:

Source: VA National Center for PTSD

Veteran Demographics

States with more post-9/11 vets (such as Alaska, New Mexico, and Wyoming) see higher PTSD rates. According to Mission Roll Call , younger combat veterans, especially those who served multiple tours, are much more likely to carry psychological trauma than older, peacetime veterans.

Access to Mental Health Care

Mental health care is not always accessible in remote or rural areas. While telehealth is helping to bridge that gap, broadband access remains spotty in many rural areas.

Stigma and Culture

In tight-knit rural or traditional communities, veterans suffering from PTSD can be encouraged to "tough it out." Dissuaded from talking about mental health or seeking treatment, their PTSD goes untreated.

Screening and Reporting Practices

Some government sources indicate that VA-heavy states, such as Rhode Island and Massachusetts, may be detecting more PTSD cases early or offering better support. Other states may underreport PTSD because of cultural or logistical barriers.

Ways You Can Help

Here are four key ways to lend support to PTSD victims suffering from the aftermath of combat.

1. Listen

If the veteran wants to talk about what they experienced, encourage them to do so. Give them your full attention, maintain a non-judgmental attitude, and don't rush them.

Keep your questions unintrusive. Avoid offering advice or opinion unless asked.

2. Build Social Support

Social withdrawal is a common symptom among veterans struggling with PTSD. Encourage the veteran to maintain other relationships, participate in social activities, and confide in at least one other safe individual.

3. Create a Sense of Safety

Stability is essential for veterans with PTSD. Take care to provide a consistent, steady presence in the veteran's life.

The timing of recovery is a personal matter for each individual, so be sure to respect the veteran's privacy. Treat everything they tell you as completely confidential (unless you're genuinely afraid they're about to harm themself or another person).

4. Encourage Specialized Treatment

Finally, encourage the veteran to seek out and enroll in specialized treatment for military PTSD.

--Article Continues Below--

Treatment Options

Proper mental health care can not only minimize the symptoms but also reduce the long-term risk of developing additional health conditions. Many treatment options for PTSD in veterans are available:

Medication for anxiety and depression
Counseling and talk therapy, including:

Cognitive Behavioral Therapy

Schema Therapy

Dialectical Behavior Therapy

Eye Movement Desensitization and Reprocessing

Chemical dependency detox for individuals struggling with addiction or substance use

Holistic treatment, such as meditation, mindfulness, acupuncture, music, or pet therapy

In-person and online mental health services are available through the VA .

Ensuring Proper Diagnosis

Military veterans deserve our support. Unfortunately, PTSD is often underdiagnosed or misdiagnosed. The website Tethered to PTSD is designed exclusively for healthcare professionals, providing the resources they need to identify probable PTSD in a primary care setting.

Sources:

Featured Image: Adobe, License Granted
CNN
VA National Center for PTSD

National Alliance on Mental Illness
Help for Heroes

Doctor’s Prescription: “Go Outside!”

Fri, 10 Oct 2025 16:21:10 GMT

Doctor’s Prescription: “Go Outside!”

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Spending Time Outdoors Benefits
All Aspects of Human Health

Want to improve your mental, emotional and physical health? Take it outside.

In today’s relentless, techno-driven world, anxiety, stress, and burnout have become commonplace. However, one of the most accessible, effective, and low-cost therapies for overall wellness is right outside our doors.

Nature’s Remedy

“Nature’s therapy” (also known as ecotherapy or green therapy) is being promoted by an increasing number of healthcare providers, as scores of scientific studies confirm the health benefits of being outdoors. Evidence-based research suggests that even brief interactions with nature reduce stress, elevate mood, and enhance physical well-being.

A 2015 Stanford University study published in Proceedings of the National Academy of Sciences concluded that natural environments have directly affect brain function. Research participants who walked for 90 minutes in a natural setting showed decreased activity in the prefrontal cortex—the brain area associated with negative thoughts, anxiety and depression.

Further research from the University of Exeter Medical School found participants who spent at least two hours per week in nature were significantly healthier than those who did not.

Prescribing Nature

Other studies have confirmed the physiological benefits of spending time in both green spaces and “blue spaces” (aquatic environments such as lakes, rivers and oceans), specifically:

Digging in the Dirt

Direct exposure to diverse soil microbes has been proven to enhance both physical and mental wellbeing.

With more than a billion bacterial cells, fungi and viruses per gram, soil is a microbial heaven that significantly benefits our immune systems.

In addition, one particular soil bacterium – Mycobacterium vaccae – actually increases the circulation of serotonin (the feel-good hormone) in our brains. In other words, this microbe affects mental health much like an antidepressant, but without any negative side effects.

Source: Neuroscience

Lowering of cortisol levels and blood pressure

Regulation of melatonin and serotonin levels due to exposure to natural light

Improvement in heart rate variability, indicating a balance between the sympathetic and parasympathetic nervous systems

Reduction of activity in the brain area responsible for fear and stress response

Improvement in chronic conditions, such as hypertension, diabetes and obesity

Reduction in symptoms for cancer patients and mitigation of the negative consequences of treatment

Enhanced cognition and memory

Increased levels of blood oxygen and natural killer cell activity

Reduction in cardiovascular disease

Strengthened immune function

As a result, a growing number of physicians are now writing “nature prescriptions” as part of their treatment plans, often in collaboration with park and public land agencies.

ParkRx and Park Rx America (PRA) are two initiatives driven by medical professionals seeking to improve their patients’ health by connecting them to nature. Doctors affiliated with these programs work together with local parks to integrate nature-based interventions. (Click here for instructions on writing a nature prescription.)

Wilderness Therapy is another organization that matches licensed clinicians and their patients with structured outdoor activities. Designed for youth with psychological, emotional, behavioral, or substance abuse problems, wilderness therapy programs treat patients suffering from PTSD, ADHD and depression.

Getting Your Daily Dose

To receive optimal health benefits from nature, scientists recommend exposure to natural environments for at least two hours per week. To this end, every small, consistent interaction with the outdoors can make a significant difference in human health.

Here are some ideas to get you started this fall:

Take a daily walk in a park, woodland, or even along a tree-lined street to enjoy the fall foliage.

Now’s the time to plant spring bulbs. Tending to plants and digging in the soil nurtures mental health and boosts the immune system. (See sidebar, “Digging in the Dirt.”)

Practice mindfulness or yoga outdoors to enhance relaxation and deepen your connection to nature.

--Article Continues Below --

Disconnect from technology and immerse yourself in a natural setting on a camping overnight or weekend getaway.

Engage in outdoor fall activities, such as apple picking, hayrides, fall festivals, or playing touch football.

Visit a pumpkin patch or head to the farmers market for winter vegetables.

Go birdwatching for migratory species.

Before the cold weather sets in, enjoy picnics with family and friends in a natural setting.

Observe the beauty of a sunrise or sunset, or practice stargazing to enhance personal reflection and gratitude.

Get Out!

Now that you know what to do, it’s time to get out there! The following award-winning video offers a little additional incentive:

Sources:
Featured Image: Adobe, License Granted
Proceedings of the National Academy of Sciences
Scientific Reports
The Epoch Times
American Psychological Association

What Goes on Inside a Debtor's Brain?

Wed, 10 Sep 2025 04:00:00 GMT

What Goes on Inside a Debtor's Brain?

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Understanding the Neuroscience of Debt

Debt changes the way our brains work.

Understanding the chemical reactions that take place in the consumer's brain -- before and after debt is incurred -- can benefit professional debt collectors.

Neurological Reasons for Incurring Debt

How do people get into debt in the first place?

According to noted science journalist Jonah Lehrer, the human brain is vulnerable to certain innate flaws. "These are the situations that cause the horses in the human mind to run wild, so that people gamble on slot machines and pick the wrong stocks and run up excessive credit card bills," Lehrer told InsideARM .

Because the brain craves certain sensations and chemicals, it can compel certain behaviors (such as gambling or overspending) that produce these chemicals. In addition, consumers can subvert their brains' pain/reward response when they rely on credit instead of working hard to achieve a financial goal. Paying with plastic allows them to receive the reward first without the pain of hard work.

When credit is overused, the brain becomes confused, triggering a destructive loop of bad spending. Once this occurs, the ensuing financial stress hijacks neural pathways, rewiring consumers' minds in unexpected ways.

--Article Continues Below--

Impact of Financial Stress on the Brain

The brain perceives financial strain as a threat, stimulating a "fight or flight" response. The adrenal glands then pump out stress hormones adrenaline and cortisol, which induce physical reactions like increased heart rate, sweating, and anxiety.

If financial stress is prolonged, the area of the brain responsible for logical thinking (the prefrontal cortex) can be impaired. We become more reactive and less capable of managing situations. Strain also weakens the brain's primary memory hub (the hippocampus). The end result is difficulty concentrating and remembering important details that could help resolve our money troubles.

Take Back Your Brain

Consumers have the power to minimize the psychological and neurological impact of debt.

Here are a few strategies to help lower stress hormones and boost feel-good brain chemicals (like serotonin):

Practice self-care through exercise, sleeping well, and limiting alcohol and caffeine intake.

Challenge negative thoughts and reframe your situation more constructively.

Set small, manageable goals to give yourself a sense of progress.

Don't isolate yourself; seek others' input and support.

Overcoming debt and financial stress is difficult, but a more positive financial future is attainable with the right mindset and proper self-care.

Source: Neuro-Based Leadership Centre

The good news is that our brains are plastic and can rewire themselves. (See sidebar, "Taking Back Your Brain.”)

Attacking the Problem

Successful debt collection requires acknowledging that consumers often feel anxious, ashamed, and stuck. Empathy is essential from the get-go.

Validate the consumer's feelings. Then, help them understand how much better they'll feel once they have a repayment plan in place. With every payment made toward their goal, the consumer's brain will release dopamine, the reward chemical.

Because a consumer's willpower is exhaustible, encourage them to set up an automatic payment plan. If credit card debt is the problem, you could suggest they unsubscribe from store marketing emails and sales notification pop-ups to reduce temptation.

Finally, reframe the situation in the consumer's mind. Help them view their debt as a temporary condition that they have the power to remedy through a realistic repayment plan.

Survey Says...

In 2017, a curious Australian debt collector surveyed every consumer who paid in full within 24 hours of the account being sent to collections. He wanted to know what had changed for these people, since they clearly had had access to the funds all along.

Here are the results of the collector's unofficial survey:

62% said they didn't understand how serious the matter was until a collection agency contacted them.

22% said they forgot.

9% said they didn't want to part with the funds

7% said they had been waiting on money and always intended to pay after it arrived.

So, helping consumers understand the seriousness of their debt is key to getting paid.

At CBSI, our professionals are trained to recognize the influence of financial stress on a debtor's mind. We know that successful debt recovery requires a proper balance between patience and persistence.

If you're ready to let us carry the debt collection burden for you, we're ready, too.

Sources:
Featured Image: Adobe, License Granted
Trends in Cognitive Sciences
InsideARM
Brainz Magazine
Collect More Australia

How Much Do You Know About Summer's Last Hurrah?

Wed, 20 Aug 2025 14:15:00 GMT

How Much Do You Know About Summer's Last Hurrah?

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Test Your Knowledge With Our Labor Day Quiz

Many of us will spend the Labor Day weekend feasting on barbecue or lolling in the sun.

But "summer's last hurrah" was actually borne out of the toil and sweat of America's manual laborers. How much do you know about the history of Labor Day? Take our quiz and find out:

#1. When was Labor Day officially designated a national holiday?

In 1879, Congress designated George Washington's birthday as a federal holiday. Most Americans now deem it "Presidents' Day" to honor all U.S. presidents. However, the official name has never been changed.

#2. How long was the average work week for American industrial laborers in the late 1800s?

A. 80 hours
B. 100 hours
C. 60 hours
D. 120 hours
E. 40 hours

(Need a hint? Check out the video.)

Answer: B. U.S. industrial workers regularly toiled for 100 hours per week in deplorable conditions before the Labor Movement.

Nowadays, about 2-3% of American workers regularly work more than 80 hours per week. Most work in high-demand professions such as tech, finance, and healthcare. Most U.S. farmers average 60 hours of work per week—80 hours during harvest season and about 40 hours in winter. Few Americans attempt to work 120 hours per week.

#3. What instigated the fashion rule against wearing white after Labor Day?

Also, back in the days when industrial pollution was severely unchecked, soot and smut emissions made white clothing a high-maintenance color choice. The condition worsened in fall and winter, when colder air trapped more pollution, and mud and slush compounded the problem.

#4. If you were a male New Yorker in 1922, which fashion item did you not want to be seen wearing after Labor Day?

This practice reached a climax on September 13, 1922, when enthusiastic youths began removing and stomping on straw hats worn by dock and factory workers. The incident sparked a series of riots that lasted more than a week, with mobs roaming the city and destroying hats. Several people were injured and arrested.

Two-tone shoes, striped blazers, and linen suits were typical summertime fashions for men in 1922. Although they were not typically worn after Labor Day, doing so never caused a riot.

Newsboy caps were worn year-round by all classes but were especially popular with the young, the working poor, and the rich while playing sports.

#5. Which state has the lowest percentage of labor union members?

#6. Who is credited with originating Labor Day?

Many sources, including the U.S. Department of Labor, credit Peter McGuire for the holiday. However, the New Jersey Historical Society recently revealed that the true father of Labor Day may, in fact, be Matthew Maguire. Both Peter and Matthew were respected union leaders in their day. However, Matthew Maguire's politics were a shade too radical for American Federation of Labor (AFL) leader Samuel Gompers. So, he publicly credited Peter McGuire instead.

The Molly Maguires was the name of a secret (often violent) society best known for activism among Irish-American and Irish immigrant coal miners in Pennsylvania. (Tobey Maguire is Spider-Man.)

Sources:
Featured Image: Adobe, License Granted
Forbes
NPR
ProProfs
U.S. Bureau of Labor Statistics
The Science Survey
Vintage Dancer
U.S. Department of Labor

Court Vacates Medical Debt Reporting Rule

Thu, 31 Jul 2025 19:44:34 GMT

Court Vacates Medical Debt Reporting Rule

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CFPB Rule Will Not
Take Effect

The U.S. District Court for the Eastern District of Texas has vacated the CFPB’s medical debt reporting rule, which was originally scheduled to take effect last March.

On July 11, the district court decided in favor of Cornerstone Credit Union League and Consumer Data Industry Association, who filed a lawsuit in January challenging the government agency’s rule.

The CFPB rule would have removed medical debt information from consumer credit reports and prohibited lenders from using such information in credit decisions. The lawsuit argued that the rule exceeded the agency’s statutory authority and violated the Administrative Procedure Act and Fair Credit Reporting Act.

The court agreed and completely nullified the CFPB rule, which will not take effect, pending any potential appeal.

A Big Win

This news marks a big win for the credit and collections industry. Had the rule been enacted, healthcare providers would have lost $24 billion in the first year alone and potentially more than $972 billion over 10 years, according to the ACA.

In addition, medical collections referred to third-party debt collectors would have decreased by 8%, further reducing revenue for medical providers.

CBSI President Brian Grimes is currently serving as president of the Iowa Collectors Association and Vice President of the Iowa HFMA. He believes the court’s ruling is “a significant victory for fairness and financial accountability.”

“By preserving the ability to include medical debt on credit reports, the court ensures that consumers and lenders can continue to rely on accurate, comprehensive credit information,” Grimes said, adding that “it also protects vital revenue streams for healthcare providers, helping them maintain operations and continue caring for patients. This decision supports responsibility while safeguarding access to credit and healthcare."

Sources:
Featured Image: Adobe, License Granted
ACA International

Iowa State Fair Trivia You Never Knew

Tue, 22 Jul 2025 15:27:23 GMT

Iowa State Fair Trivia You Never Knew

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♫ “Don’t Miss It – Don’t Even Be Late” ♫

The only state fair to be immortalized in a novel, two feature films, and a Rodgers and Hammerstein stage production, the Iowa State Fair runs from August 7 through August 17 this year.

Where else can you find traditions like outhouse races, mutton busting, and – many an Iowan’s personal favorite – a cow chip throwing contest?

In 2024, state fair attendance was a record-breaking 1,182,682. Perhaps you already knew that. Here’s some state fair trivia you may not know:

Collision Course

In the late 1800s, the Iowa State Fair was in deep financial distress. Organizers needed an event that would draw crowds willing to pay the fair admission price.

Along came theatrical manager and carnival barker Joe Connolly -- later known as "Head-On Joe” -- and his idea to stage a head-on collision of two locomotives. The resulting fireball was sure to attract spectators. (This was long before the days of demolition derbies and monster truck rallies.)

State Fair Safety Tips

Consuming corn dogs and riding roller coasters is a lot of fun, but be sure to take precautions when visiting the state fair:

Stay hydrated – with water, not soft drinks.

Wear closed-toe shoes to protect your feet from injury and animal waste.

Wash hands frequently, especially after petting animals and before eating.

Avoid overindulgence in fair food.

Watch kids carefully and have a separation plan.

Follow the ride rules, including height restrictions, and review them with your children.

Source: Johnson Memorial Health

Fair organizers quickly jumped on board. Connolly purchased a couple of obsolete trains, laid down some tracks in front of the grandstand, and set the engines on their destructive course.

"I believed that somewhere in the makeup of every normal person, there lurks the suppressed desire to smash things up.”

– Joe Connolly

The scheme worked. The first explosion in 1896 was so successful that it was repeated in 1922 and 1932. Each time, the state fair drew between 40,000 and 70,000 paying visitors -- huge crowds for that era. Organizers netted more than $10,000 (about $250,000 in today’s currency) in direct gate receipts.

Connolly staged the 1932 crash as a presidential year showdown, pitting a Roosevelt train against one named for Iowan Herbert Hoover:

Soapbox Derby?

Several sitting presidents have visited the Iowa State Fair over the years. Dwight D. Eisenhower was the first in 1954, accompanied by former President Herbert Hoover. The others were: Gerald Ford in 1975, George W. Bush in 2002, and Barack Obama in 2012.

Since the fair precedes the Iowa caucuses (the first major contest in the presidential and congressional nomination process), it’s a political magnet for candidates.

For decades, the Des Moines Register has sponsored a "Political Soapbox,” providing candidates of all persuasions with 20 minutes to speak to the crowd and answer questions. Noteworthy presidential candidates who’ve taken advantage of this opportunity include Jimmy Carter, Donald Trump and Joe Biden.

Ronald Reagan also visited the fair – but not as a president or candidate. In the 1930s, young Reagan broadcasted from the fair as sports director for Des Moines-based WHO radio.

Our State Fair Is a Great State Fair

Between 1904 and 1954, Iowa's population increased by only 17%, while state fair attendance increased by a whopping 400%.

After being canceled during the war years of 1942-1945, the fair came back in full force in 1946. That year's attendance was partly boosted by the 1945 release of the Rodgers and Hammerstein musical film "State Fair." It was the team’s only musical written directly for the screen.

--Article Continues Below--

The movie was a remake of a 1933 film based on a novel of the same name, all set in Iowa. (A third feature film, remade in 1962, was set in Texas.)

The 1945 R&H version was a huge success, winning an Oscar for Best Song ( “It Might As Well Be Spring” ) and boosting attendance at state fairs nationwide. Iowa State Fair turnout continues to grow (see infographic above) , increasing by more than 25% from 1998 to 2024, even though state population declined slightly during that time.

And that’s more than you ever knew about the Iowa State Fair. Enjoy!

Sources:

Featured Image: Adobe, License Granted

Iowa State Fair Image: Wikimedia Commons , Phil Roeder
Des Moines Register
The Marcus News
Guinness World Record
Iowa State Fair.org
University of Iowa
Turner Classic Movies

Iowa's Challenge; Enticing Physicians “Into the Field”

Wed, 11 Jun 2025 15:15:00 GMT

Iowa's Challenge: Enticing Physicians “Into the Field”

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The Ups and Downs
of Rural Medicine

A rural doctor recently shared his story about a grandmother who was bitten by a snake.

The elderly woman drove two miles to her nearest neighbor, and together they hopped on an ATV to kill the snake before driving to the emergency room.

The doctor asked her if she was sure the snake was a copperhead. “Yep,” she replied, pulling the critter’s head out of her purse.

Medical practitioners who serve rural communities encounter a wide variety of unusual situations and colorful characters, which is one reason they find the job both challenging and rewarding. But in Iowa, the number of rural physicians falls far short of the demand.

State of Emergency

Iowa’s physician shortage is one of the worst in the country, ranking 45th in the nation for physician-resident ratio, according to the Iowa Medical Society . In addition, a 2024 report by the American Association of Medical Assistants (AAMA) revealed that the state retains only 22% of its medical school graduates and 36.5% of its residency graduates.

Travel Subsidies?

A recent University of Iowa study explores another possible approach to addressing the gap in rural medical care. Noting that health care specialists are particularly scarce in rural areas—and getting scarcer—the U of I researchers suggested that these physicians be subsidized for their travel expenses.

In Iowa, specialists typically visit consulting clinics to treat rural residents, but traveling can be costly and time-consuming for physicians in high demand. Paying them for their travel encourages specialists to continue these clinical visits.

Source: Iowa Capital Dispatch

Two-thirds of Iowa's 99 counties are federally designated as lacking in primary care physicians. More than a third (37%) are classified as completely rural, meaning they have no urban population at all.

Earlier this year, Iowa Gov. Kim Reynolds introduced legislation to increase medical access in rural areas. Her plan would expand the number of residencies by 115 and draw down $150 million in federal funding for the new positions, creating around 460 new physician positions across the state in six years. The bill also would double the state's loan repayment programs for any doctor who practices in rural Iowa for at least five years.

Becoming a Center of Attraction

What can Iowa health care executives do to attract medical talent to the state? Rural health management experts suggest a three-fold recruitment approach:

Appeal to physicians' greater purpose
Proactively address potential concerns
Emph asize non-monetary benefits

Appeal to Their Greater Purpose

Delivering much-needed care to rural populations can be extremely fulfilling, ideal for physicians who seek to have a measurable positive impact on their communities.

Highlight the intrinsic benefits of working rurally beyond the clichés of small-town life. (See sidebar below, “4 Reasons to Practice Rural Medicine.”) Collect materials from the local Chamber of Commerce or tourism office and share videos on YouTube and other local websites so candidates can develop a feel for the area.

Address Potential Concerns Head-On

Anticipated heavy workload, lack of continuing education and networking opportunities, and family considerations can present potential concerns. Address these concerns head-on by communicating:

Available telemedicine programs and technology

--Article Continues Below--

Any affiliation with regional institutions and practices that offer networking and educational opportunities

Educational and extracurricular options for school-age children

Local recreational and cultural offerings (even quirky festivals, farmers’ markets, or local breweries)

Promote Non-Monetary Benefits

Attracting talent doesn’t have to be a “show me the money” situation, especially if:

Working hours can be more flexible than in an urban-based organization

4 Reasons to Practice
Rural Medicine

Impact on Patients : Rural medicine allows practitioners to significantly impact the health and well-being of their communities, where health care access is often limited.

Work-Life Balance : Rural physicians report better work-life balance and lower stress levels than doctors who practice in urban settings, as well as a more affordable cost of living.

Diverse Clinical Experiences : Rural areas expose doctors to a wider variety of clinical experiences, which is often more fulfilling for health care providers.

Lifestyle Preferences : Rural practitioners enjoy a slower pace of life, less traffic, and a feeling of safety within their communities.

Sabbaticals are available for research or mission work

Local institutions offer low-interest home loans

Childcare and spousal employment opportunities are available

Well Worth the Effort

Whether Gov. Reynolds succeeds in her plan to attract more medical talent to Iowa’s rural areas remains to be seen. Most of the rural doctors currently practicing here already know that the blessings outweigh the challenges.

When Storm Lake physician Kyle Glienke isn’t serving his patients, participating in church activities, or coaching kids’ sports, he works the family farm with his father and brother. He believes farming helps him achieve work-life balance.

It’s also a way for Glienke to stay connected to his roots and relate with the experiences and hardships of his patients. Practicing broad-spectrum medicine in rural Iowa has been highly rewarding for him.

“I think I was meant to be a doctor in Storm Lake,” Glienke said. “I have a very strong feeling of purpose here.”

Sources:
Featured Image: Adobe, License Granted
Des Moines Register
Daily Iowan
Iowa Medical Society
Wolters Kluwer
University of Iowa

Memorial Day Pop Quiz

Wed, 14 May 2025 13:45:00 GMT

Memorial Day Pop Quiz

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How Much Do You Know About
America’s Most Solemn Holiday?

Memorial Day is commonly recognized as the unofficial start of summer – a three-day weekend devoted to backyard festivities and fun in the sun.

But it’s also America's most solemn holiday, a time to honor our fallen military heroes. How much do you know about Memorial Day? Take our pop quiz and find out:

#1. Memorial Day is often confused with another annual observance. Which one?

#2. Memorial Day was established to honor soldiers killed in which U.S. military conflict?

The military casualties of the other wars mentioned are:

World War I – 53,000
Revolutionary War – 6,800
World War II – 292,000
Vietnam War – 58,000

#3. By what name was Memorial Day previously known?

Remembrance Day is observed in British Commonwealth member states to honor the members of their armed forces who died during military service. Like Veterans Day in the U.S., it marked the end of hostilities during World War 1. Armistice Day is another name for Remembrance Day, although our Veterans Day was also called Armistice Day prior to 1954. (Are you confused yet?)

#4. Which of the following was a favorite picnic spot for Memorial Day celebrants in the late 1800s?

Families could visit the burial sites of their fallen loved ones and then enjoy a picnic lunch on the family plot. These meals were known as "dinner on the ground."

#5. Which town is credited with celebrating the first Memorial Day in 1866?

That finally happened two years later, in 1868.

But Waterloo, Iowa, is not without its own unique tribute to our fallen heroes. While serving together during WWII, five brothers from Waterloo's Sullivan family all perished when a Japanese destroyer torpedoed the USS Juneau. The Sullivan Brothers Iowa Veterans Museum memorializes their bravery. In addition, the U.S. Navy later named two destroyers The Sullivans , to honor the Iowa siblings.

Lest We Forget

We leave you with this poignant tribute to all those who never made it home:

Sources:
Featured Image: Adobe, License Granted
CITI I/O
Military.com
EarthShare
National Archives
Library of Congress

Atlas Obscura

The Fluoridation Debate: What's in the Water?

Thu, 01 May 2025 12:42:39 GMT

The Fluoridation Debate: What's in the Water?

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The Benefits and Risks
of Fluoride Exposure

In May 2024, a study published in the Journal of the American Medical Association concluded that prenatal fluoride exposure was associated with increased neurobehavioral problems in children and limiting fluoride exposure in pregnant women may be recommended.

In August 2024, the National Toxicology Program released a report stating that drinking water with a higher fluoride concentration than the recommended 0.7 mg was associated with lower IQ levels in children.

In September 2024, a federal judge ruled that the U.S. Environmental Protection Agency must address the impact of fluoride on public water systems. However, the ruling did not ban or otherwise limit the addition of fluoride to public water.

In November 2024, Florida Surgeon General Dr. Joseph Ladapo became the first state officer to publicly recommend that communities stop adding fluoride to their water systems.

Meanwhile, the American Dental Association remains “staunchly in support” of community water fluoridation at optimal levels to help prevent tooth decay.

These and other recent events have fueled an intense and controversial national debate around the benefits and risks of fluoride exposure. Let’s sort out the opposing views.

How It Began

Fluoride was first discovered to inhibit tooth decay in 1901. Over the next 40 years, research revealed that adding fluoride to drinking water prevented cavities and improved oral health.

In 1945, Grand Rapids, Mich., became the first city to add fluoride to its public water system. Today, nearly three-quarters of the U.S. population – about 209 million people – are served by fluoridated water, according to the Centers for Disease Control and Prevention (CDC).

Water fluoridation has been considered a cheap decay-prevention strategy and a significant public health achievement. However, new research has raised questions about both its safety and effectiveness.

Is Water Fluoridation Still Necessary?

Recent reports suggest the benefits of adding fluoride to public water systems may not be as significant as they once were.

--Article Continues Below--

While research prior to 1975 showed extensive benefits, an October 2024 report from the Cochrane Collaboration found that water fluoridation resulted in only slightly fewer cavities in children’s baby teeth. Specifically, children living in areas with fluoridated water averaged about one less cavity than those without water fluoridation.

The researchers concluded that current U.S. populations have broader access to alternative fluoride sources, particularly toothpaste, which has become widely available and more commonly used since the 1970s. As a result, they said, water fluoridation may have little to no general effect on tooth decay.

Still, proponents of fluoridation claim that it is the most cost-effective means for ensuring all communities receive the benefits of cavity prevention.

The Question of Health Equity

Steven Levy, a professor of preventive and community dentistry at the University of Iowa’s College of Dentistry, is very concerned about removing fluoride from public drinking water.

“As a society, we’ve partly forgotten how bad cavity problems were 50, 60, 70 years ago when most people, prior to that, had very few teeth. It’s unfortunate when people are quick to dismiss that,” he said.

According to Levy, there are still communities that suffer from cavity problems and who continue to benefit substantially from water fluoridation. People dealing with poverty or lack of access to dental care may not be able to prioritize oral hygiene. Toothbrushes, toothpaste, and dental floss can be too costly for them, and regular dental visits are out of the question. Water fluoridation, therefore, helps those who are “not fortunate enough to have access to individual-level fluoride exposures.”

About Dental Fluorosis

About 23% of the U.S. population is affected by dental fluorosis. This condition occurs when children consume too much fluoride while their teeth are growing, resulting in white spots or lines on the enamel.

Most cases of dental fluorosis in the U.S. are mild and primarily cosmetic. However, in countries with high levels of naturally occurring fluoride in drinking water (such as India), the condition can be severe, causing extensive damage to tooth enamel

To prevent fluorosis, the CDC recommends limiting a child’s exposure to fluoridated water and fluoride products prior to age 6.

Source: CDC

The CDC agrees. In a statement last May, the agency said: “Water fluoridation has been identified as the most cost-effective method of delivering fluoride to all members of the community regardless of age, educational attainment, or income level.”

The American Academy of Pediatrics also continues to support the use of fluoride, citing the chronic effects of cavities -- which are both common and preventable. To be sure, we’re talking about more than a toothache here. When left untreated, tooth decay can result in severe infection, heart disease, and death.

Mounting Evidence of Risk

But emerging research elevates concerns about the risks of fluoride exposure.

Much of that research was conducted in other countries. A study of pregnant women in Canada, for instance, linked fluoride exposure to l ower IQ among children ages 3 to 4 years old . Likewise, a Mexican study associated fluoride exposure with lower IQ, attention-deficit/hyperactivity disorder (ADHD), and reduced brain function among children 6-12 years old.

The risks also include dental fluorosis, a condition that can cause speckles on tooth enamel. (See sidebar, “About Dental Fluorosis.”)

Going Forward

Many questions remain. How much fluoride is safe for pregnant women and their babies? At what age do the adverse effects of fluoride manifest? How should policymakers weigh the benefits of decay prevention with the risks of compromised brain function?

As we continue to learn more about the impacts of fluoride, we must rely on the scientific data proffered on both sides of the issue and the wisdom of our elected officials to effectively address the problem.

Sources:
Featured Image: Adobe, License Granted
Journal of the American Medical Association
CourtListener
Becker's Dental Review
The Hill
Cochrane Library
CNN

Tax Season Is Debt Payoff Season

Fri, 11 Apr 2025 13:57:45 GMT

Tax Season Is Debt Payoff Season

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Using 2024 Tax Refunds Wisely

“Pay off your debt first. Freedom from debt is worth more than any amount you can earn.” - Mark Cuban

Do you know the average 2024 federal tax refund is expected to exceed $2,800? Your consumers can use that money to improve their financial health (and yours) by paying off debt.

That’s precisely what 44% of refund recipients plan to do, according to a CNBC survey of 4,300 U.S. adults. The survey also found that most Americans (53%) have no emergency fund to cover unforeseen expenses.

Choose Wisely, Grasshopper

While paying off debt may not sound as glamorous as booking a cruise or splurging on a new wardrobe, it’s a much wiser choice. Here’s how you can help your consumers choose wisely:

Remind them that using their refund to pay off their debts can prevent damaging their credit score or becoming charge-offs .

Inform consumers of the significant money they’ll save on interest and reduced monthly debt payments if they use their tax refund to pay down their credit cards. Financial radio host Dave Ramsey offers the following illustration:

April Is Financial
Literacy Month

More than half of all Americans (57%) score lower than 50% on a financial literacy test conducted annually by the Global Financial Literacy Excellence Center . And only 16% of American s scored between 75% and 100% on last year’s test.

According to the GFLEC study, consumers with very low levels of financial literacy were twice as likely to become debt constrained.

For more than 20 years, April has been recognized as National Financial Literacy Month. This annual observance originated through the National Endowment for Financial Education as part of its High School Financial Program.

Financial Literacy Month engages banks, credit unions, credit counselors, schools, and other organizations to provide educational resources to empower consumers’ financial futures.

To learn more about the need for financial literacy and ways to get involved, visit Jump Start .

It would take 14 years to pay off a $16,748 credit card at 15% interest by making minimum payments. Using a $2,800 tax refund and increasing the monthly payments to correlate with the average increase in income, the card can be paid off in less than two years, saving the consumer $5,600 in interest.

If your customer owes you more than the tax refund he received, apply the refund to the balance and then work out a payment plan with them for the remainder.

On the other hand, if the tax refund comes close to covering the debt, consider negotiating a settlement by accepting the refund as payment in full. (Note: Make sure your consumers know that the IRS may deem the unpaid portion of the debt as taxable income.)

If you’re a healthcare provider, inform your patients that legal complications resulting from medical debt can severely impact their financial well-being. In fact, more than 66% of consumer bankruptcies are caused directly by medical expenses.

If the tax refund is sizable, suggest that the consumer split the monies between paying off debt and padding their emergency fund, to help them avoid future problems.

Financial Emergency Kit

Here’s a wake-up call: Almost one-third of Americans (32%) would be unable to cover a $400 emergency.

While many experts suggest that the equivalent of three to six months’ salary is the ideal emergency fund, the truth is that as little as $500 or $1,000 set aside in a savings account can provide a significant buffer for your consumers whenever unexpected bills pop up.

In addition, healthcare providers can encourage patients to open a Health Savings Account, especially those who are enrolled in a high-deductible medical insurance plan. HSAs are a tax-free way to help patients save for future qualified medical care. Once they’re no longer incurring medical debt, subsequent tax refunds can be used to build up the consumers’ emergency fund.

Strike While the Iron Is Hot

Tax refund season is the best time to collect on your overdue accounts and help your consumers become debt-free.

Using their tax refunds to pay down their debt probably won’t elicit the same excitement as splurging on luxuries. But it will provide them with much-needed relief while positioning them to reap long-term financial benefits.

Consumers can check on the status of their 2024 federal tax refund using the IRS Where’s My Refund ? tool.

If your company struggles with overdue accounts, the CBSI professionals are ready to help you take advantage of this once-a-year opportunity.

Sources:

Featured Image: Adobe, License Granted
CNBC

News Medical
Ramsey Solutions

Investopedia

Lexington Law

Global Financial Literacy Excellence Center

Meet CBSI’s New Director of Sales and Marketing

Mon, 31 Mar 2025 15:21:07 GMT

Meet CBSI’s New Director of Sales and Marketing

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Introducing Josh Schilling

Josh Schilling, the new Director of Sales and Marketing at Credit Bureau Services of Iowa, is very proud of CBSI’s exceptional debt recovery rate. “The industry standard is 18%, and we currently have a recovery rate of 32% to 35%,” he said.

About Josh

Josh attended Upper Iowa University in Fayette, where he majored in Education. He is married and has two daughters, one who attends Iowa State University and the other who will attend Western Colorado University on a basketball scholarship.

Josh is excited to be part of the CBSI team. “Our collectors truly believe that they are helping their consumers get out of debt,” he added.

Featured Image: Adobe, License Granted

How Much Do You Know About the Ides of March?

Wed, 05 Mar 2025 16:00:00 GMT

How Much Do You Know About the Ides of March?

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Test Your Knowledge of This Ominous Day

On March 15, 44 B.C., Roman dictator Julius Caesar was stabbed to death by 60 conspirators.

The day subsequently became infamous as the "Ides of March," associated with misfortune and doom. But few people know much about it. Do you? Let's find out.

#1. Prior to the introduction of the Julian calendar in 45 B.C., the Ides of March was a day for celebration and rejoicing. Why?

#2. What is the origin of the expression "Beware the Ides of March"?

#3. Which of the following celebrities died on the Ides of March?

#4. The American jazz-rock band The Ides of March had a major hit song in 1970. What was the name of it?

A. "Keep on Truckin'"

B. "Drive My Car"

C. "Low Rider"

D. “Truckin’”

E. "Vehicle"

Answer: E. "Vehicle" was the name of The Ides of March 1970 hit song. It reached #2 on the charts and was the fastest-selling single in the history of Warner Bros. at that time. "Drive My Car" is a Beatles classic, released on their 1965 album Rubber Soul.

"Low Rider" is a song by American funk band War that appeared on their 1975 album Why Can't We Be Friends? The song reached number one on the Billboard R&B singles chart that year.

"Truckin'" was released in 1970 -- but by the Grateful Dead, not The Ides of March. In 1997, the song was recognized by the United States Library of Congress as a national treasure.

#5. Over the years, some terrible events have occurred on the Ides of March. Which of the following is NOT one of them?

#6. According to William Shakespeare, Julius Caesar's dying words were, "Et tu, Brute?" What does the phrase mean?

However, according to historians , Caesar never spoke these words. Neither was Brutus his closest friend or his uttermost betrayer. That distinction falls to Decimus Junius Brutus Albinus, a distant cousin of Marcus Brutus. History records that Caesar did not particularly trust Brutus, whereas Decimus was part of the dictator's inner circle. And it was Decimus who convinced Caesar to attend the senate meeting, luring him to his death.

Sources:
Featured Image: Adobe, License Granted
HISTORY

The Archaeologist

CNN

The Independent

National Institutes of Health

Investing.com

Interesting Literature

U.S. Presidents and Their Debts

Sat, 25 Jan 2025 13:49:43 GMT

U.S. Presidents and Their Debts

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Chief Executives Who

Fell on Hard Times

"I am miserable until I owe not a shilling."

- Thomas Jefferson

Did you know that multiple U.S. presidents struggled with personal debt?

Some presidents carried their burdensome debt with them when they entered the highest office in the land, and others were broke when they left. A few even declared bankruptcy. In honor of Presidents' Day, let's look at some of our most influential chief executives who grappled with their financial obligations:

The Sage of Monticello

A hardworking farmer, brilliant writer, visionary, and Founding Father of our country, Thomas Jefferson inherited massive debt from his father-in-law. He also lived beyond his means and was generous to a fault, frequently lending money for which he was never repaid.

The Buck Stops Here

Harry Truman was one of the poorest candidates to reach the White House, having lost his inheritance in 1915 in a zinc mine investment that ultimately went under. In 1922, his own business failed, and Truman's partner declared bankruptcy.

Truman never did, however. Like Lincoln, he insisted on honoring his financial obligations. As a result, he was saddled with debt for more than 20 years. Because his presidential salary wasn't enough for Truman to meet these obligations, Congress increased his pay to $100,000 in 1949.

Unfortunately, Truman's financial struggles continued after he left office and had to survive on an Army pension of $112.56 a month. Once again, Congress intervened, creating a pension for ex-presidents in 1958.

Source: The New York Times

At that time in our country's history, bankruptcy was not usually an option. However, a brief window of opportunity arose between 1800 and 1803, and Jefferson took advantage of it. Still, he was a poor financial manager, and money problems continued to plague him.

Land-rich and cash-poor, Jefferson devised a lottery to raise money. The winner would gain title to Jefferson's estate, including his beloved Monticello, appraised at $71,000 ($1.5 million today.) Ultimately, the lottery failed to generate the cash he desperately needed.

At the time of his death in 1826, our third president still carried $107,000 in debt – about two million dollars by today's standards.

The Great Emancipator

In 1832, a young Abraham Lincoln and his partner purchased a small general store, acquiring the inventory on credit.

Despite the booming economy, the two prairie entrepreneurs couldn't make a go of it and soon began sliding into debt. While Lincoln sold his share in the business, when his partner died, Lincoln voluntarily assumed $1,000 of his partner's debt to protect the grieving family. (That's roughly $27,000 in today's currency.)

Creditors hauled Lincoln into court, and the sheriff seized his only assets -- survey equipment and one horse. Honest Abe was still repaying that debt well into the 1840s. The burden seemed so onerous to Lincoln that he called it "my national debt."

He focused on paying off his obligations at great personal sacrifice. Lincoln worked several jobs, and he and his wife moved into a small, smoke-filled tavern where room and board cost a mere four dollars a week.

Thirteen years later, the future president and one of American history's most revered leaders finally resolved his debt.

A Hardscrabble Life

A failed farmer and rent collector prior to the Civil War, Ulysses S. Grant lived in a log cabin that he dubbed "Hardscrabble." In 1848, he met and married his wife Julia, and her father gifted them part of the family's Missouri plantation. But the operation struggled. To make ends meet, Grant sold firewood on the streets of St. Louis.

Following his brilliant military performance during the Civil War, Grant became a national hero and was elected president in 1868. He served for two terms, with Reconstruction his primary focus.

By the mid-1880s, Grant had invested most of his assets in a pyramid scheme operated by an unscrupulous business partner. The scam wiped out his life's savings.

--Article Continues Below--

Broke and dependent on friends and kind-hearted strangers to keep him financially afloat, Grant, by this time, had been diagnosed with cancer. He was now confronted with the terrifying prospect of leaving his wife an impoverished widow.

His buddy Mark Twain convinced Grant to pen his memoirs, which he did, finally completing his manuscript seven days before his death. The resulting two-volume boxed set quickly outsold Twain's Adventures of Huckleberry Finn. Julia Grant received $450,000 in royalties--equivalent to $12 million in today's currency.

It Happens

Unresolved debt can happen to anyone. The professional collectors at CBSI understand since many of them have been in the same situation. If you're looking for a collection agency with compassion for consumers, you'll find it right here .

Sources:

Featured Image: Adobe, License Granted
The Saturday Evening Post
U.S. National Park Service

Abraham Lincoln Presidential Library
White House Historical Association

History.com
Forbes

Surviving an Iowa Winter

Mon, 06 Jan 2025 14:00:09 GMT

Surviving an Iowa Winter

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How to Take the Bite Out of Jack Frost

Iowa resident Steve Lose recalls vividly the day his life changed forever.

In February 2020, an automobile accident left him trapped inside his car for 15 hours in subzero temperatures. He had broken multiple bones, and his kidneys were failing. But it was the frostbite in his extremities that caused the most severe pain.

Lose said it felt like animals were gnawing on his hands and feet.

By the time a snowplow driver finally rescued him, his body temperature had dropped to 77 degrees.

In the end, doctors had to amputate his hands and feet, but Lose was grateful to be alive.

Ninety-four percent of all temperature-related deaths in the U.S. are caused by extreme cold. According to the CDC, more than 1,500 Americans die from hypothermia each year, and the risk of death by excessive cold is significantly higher in rural areas, particularly among males.

Welcome to Winter in Iowa

Last January, a brutal arctic blast besieged the Hawkeye State, resulting in temperatures over 20 degrees below zero and wind chills of -45. Iowa hospitals and clinics saw a sharp uptick in frostbite cases, with dozens requiring inpatient care. Many of these patients were elderly or stranded motorists.

The Deadliest Time
of the Year

Researchers from the obituary website Legacy.com have revealed that more U.S. deaths occur in January than in any other month. CDC statistics confirm that more than 250,000 Americans die each January -- well above the norm for other months.

Several factors play into this figure, but not all are fully understood.

Extreme cold can exacerbate pre-existing medical conditions, particularly cardiovascular and respiratory diseases. One British researcher found that most January deaths are due to respiratory and circulatory diseases, such as pneumonia, coronary heart disease, and stroke.

In addition, people who are seriously ill may hang on during the holidays for a final opportunity to see loved ones and enjoy the emotional warmth of the season.

While cold weather is inherently deadly, it can also kill indirectly by suppressing our immune systems, making us more vulnerable to illness. (See sidebar, "The Deadliest Time of the Year.”)

Out in the Cold

When spending time outdoors this winter, an ounce of prevention is worth a pound of cure. The Mayo Clinic offers the following frostbite-prevention tips:

Limit your time outside whenever the weather is cold, wet, or windy.

Dress in multiple layers of loose, warm clothing. Choose undergarments that wick moisture away from your skin and outer garments that are both wind- and waterproof.

Wear a hat or headband that fully covers your ears, and wear mittens (not gloves).

Seek warm shelter immediately if you notice red or pale skin, prickling, or numbness.

Avoid alcohol; it will cause your body to lose heat faster.

Before venturing out in the cold, eat well-balanced meals and stay hydrated.

Keep moving to stimulate blood flow, but don't exercise to the point of exhaustion.

Once inside, immediately remove wet clothing, particularly gloves, hats, and socks.

On the Road

Before you head out on the road this winter, stock your vehicle with emergency supplies, including:

Snow shovel, ice scraper, and broom;
Sand, kitty litter, or any abrasive material to help with traction;
Jumper cables, flashlight, and flares or other emergency markers;
Blankets, a cell phone and charger, water, food, and necessary medicines.

--Article Continues Below--

In addition, the National Highway Traffic Safety Administration (NHTSA) recommends the following:

Keep your gas tank filled.
Postpone non-essential travel until roads are clear.
Even if you use a GPS, familiarize yourself with directions and maps and let others know your route and expected arrival time.

Lastly, if your winter driving skills are a bit rusty, bone up – but not like these guys:

Sources:

Featured Image: Adobe, License Granted

Collecting Debt at Holiday Time

Wed, 11 Dec 2024 22:15:00 GMT

Collecting Debt at Holiday Time

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How You Can Offer Hope to
Stressed-Out Consumers

It's the time of year for festive gatherings, family dinners — and big hits to your consumer's wallet.

While there's no perfect time of year to recover debt, the holidays can be particularly stressful for American consumers. So, what's the best way to collect your receivables during the holidays?

The Holidays and Debt

Consumers whose accounts are already in collections can easily incur even more debt over the holidays. According to a recent LendingTree survey, 34% of Americans ran up more than $1,000 of debt to pay for their 2023 holiday expenses.

Sixty-five percent of the survey respondents who incurred holiday debt in 2023 said they hadn't expected to do so, 57% said they were stressed about the debt, and 40% were plagued with buyer's remorse.

Taking Care of You

Collecting debt from stressed-out consumers can be emotionally draining during the holidays. You’ll be better equipped to offer them compassionate and effective support if you effectively manage your own stress first.

Here are some basic tips to minimize stress and maintain mental wellbeing:

Eat a balanced diet and stay hydrated.

Engage in regular exercise.

Get a minimum of eight hours of sleep each night.

Practice mindfulness, deep breathing, or other relaxation techniques.

Take frequent short (e.g., five-minute) breaks to stretch or walk around during the day. (Changing your environment, even briefly, helps your brain rest and switch gears.)

Similarly, a 2023 American Psychological Association (APA) poll found that almost 90% of U.S. adults feel overwhelmed by the holiday season. Financial issues were the primary holiday stressors, with 58% of the respondents stating that monetary concerns caused them the most anxiety.

Overall, 63% of American adults polled by the APA used negative words, such as "overwhelming" or "exhausting," to describe the holiday season.

Additional stressors can compound the problem. For some consumers, for instance, the holidays are a painful reminder of loss due to death or estrangement.

Others suffer from loneliness and depression (such as Seasonal Affective Disorder) at this time of year or dread anticipated family conflict. In addition, holiday pressure can weigh especially heavily on women, who feel they are expected to create magical (and costly) experiences for their families.

As a creditor or collector, you must be sensitive to these feelings when attempting to collect receivables at holiday time.

Keep a Cool Head

You can set the tone for your collections calls even before contacting the consumer by maintaining a composed and confident attitude. (See sidebar, "Taking Care of You.”) A calm demeanor can help soothe an anxious debtor.

Did you know that the very act of smiling improves your disposition? It also changes the tone of your voice. Smiling raises the soft palate at the back of your mouth, resulting in more fluid sound waves, making your voice sound warm, friendly, and receptive.

It’s a good idea to keep a mirror near your desk and periodically check your reflection during a collections call. Do you look tired or irritated? That will be conveyed in your voice!

If the consumer becomes emotional or angry during the course of the call, recognize that his financial fears may be exacerbated by holiday stress. Allow him to vent and listen without speaking so you can help steer the conversation in a positive direction.

Remain Flexible

Be sure to have flexible payment options available to present to your consumer. Offering multiple options, payment plans, or other arrangements will go a long way toward satisfying your company's or client's needs while alleviating consumer anxiety. Once the consumer realizes he can feasibly pay off a debt he's been avoiding, he'll begin to feel relief.

Although you may feel pressure to wrap up overdue accounts before the end of the year, remember to be patient and recognize that not everyone will be able to pay during the holidays. But be sure to follow up with those consumers after the New Year.

--Article Continues Below--

When You Need Help

Business owners, healthcare providers, and property managers deserve a happy holiday, too.

As the year draws to a close and you reassess your accounts receivable practices, you may find collecting on overdue accounts is more than you can handle on your own. If so, it's time to let the CBSI professionals carry the debt collection burden for you. We can recover what's owed to you while remaining sensitive to the various holiday stressors your consumers are struggling with.

And THAT can mean a happier holiday for everyone!

Sources:
Featured Image: Adobe, License Granted

LendingTree

American Psychological Association

Retail Dive
F orbes Advisor

How Much Do You Know About Thanksgiving?

Wed, 13 Nov 2024 21:45:00 GMT

How Much Do You Know About Thanksgiving?

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Test Your Knowledge With Our
Turkey Day Quiz

Need to break the ice over Thanksgiving Day dinner?

Bone up on your Turkey Day trivia while testing your knowledge of this uniquely American holiday with our Thanksgiving quiz. Let's get started!

#1. Where was the first Thanksgiving celebrated?

#2. What percentage of Americans celebrate Thanksgiving?

#3. How many tofu turkeys are sold each holiday season ?

#4. How fast did the Mayflower travel?

A. 20 mph

B. 10 mph

C. 2 mph

D. 100 mph

E. No one knows; speedometers had not yet been invented.

(Need a hint? Check out the video clip.)

Answer: C. The Mayflower averaged only two miles (3.2 kilometers) per hour during its historic voyage across the Atlantic Ocean. The voyage took 66 days, from the ship's departure on September 6, until Cape Cod was sighted on November 9, 1620.

#5. Why are turkey, stuffing, sweet potatoes, cranberry sauce, and pumpkin pie typically associated with Thanksgiving dinner?

#6. Which of the following continents produces almost 90% of the world's sweet potato crop?

#7. When was the first official Thanksgiving Day football game played?

#8. What is the most popular Thanksgiving side dish in Iowa?

BONUS QUESTION: True or false? The turkey was named after its country of origin.

A. True
B. False; there’s no connection between the country and the bird.
C. False, but there is a connection between the country and the bird.
D. False; in Turkey, the bird was called “Indian chicken.”
E. Both C and D.

Answer: E. The large bird doesn’t actually hail from the country Turkey, but there is a connection. During the Ottoman Empire, a bird called the guinea fowl was imported to Europe by Turkish traders. So, Europeans began to call these birds "turkeys," but in Turkey, they called the bird “Indiana chicken.” It’s also known by many other monikers worldwide. Check it out:

Now that you're a fount of Turkey Day trivia, you'll know just how to bridge those awkward moments around this year's holiday table.

Happy Thanksgiving from CBSI!

Sources:

Featured Image: Adobe, License Granted
Statista
Mashed
CNN
National Geographic
Mental Floss
Zippia
International Potato Center

Horrifying Tales from the FTC Vault

Wed, 16 Oct 2024 12:15:00 GMT

Horrifying Tales From the FTC Vault

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Most Egregious Violations in
FDCPA History

The Federal Debt Collections Practices Act (FDCPA) has safeguarded consumers from deplorable debt collection practices for more than 45 years.

The vast majority of collectors willingly comply with FDCPA regulations against abusive tactics. Among those who don’t comply, the most appalling violations read like a Stephen King novel.

In the spirit of Halloween, we share with you some genuinely horrifying tales from the Federal Trade Commission (FTC) archives.

"We're Coming to Get You – and Your Little Dog, Too!"

In 2013, the FTC shut down Texas-based collection agency Goldman Schwartz after its collectors threatened consumers with imprisonment and government custody of their minor children. The firm also was charged with contacting a woman's coworkers, claiming they would be required to pick her out of a lineup after she was arrested for failure to resolve her payday loan debt.

Our Compliance
Commitment

Here are the various ways CBSI is committed to regulatory compliance:

Our collectors are highly trained according to FDCPA, HIPAA, and CFPB guidelines to comply with all state and federal regulations.

Our compliance officer continually reviews all CBSI processes.

Our custom-made compliance management system responds proactively to the continually changing regulatory environment.

We extensively document our policies, procedures, and all consumer interactions.

We stay current on all regulations governing our business activities.

The district court permanently banned Goldman Schwartz from any future collection activity. (Here’s a list of all FTC-banned debt collectors. )

That same year, the FTC successfully sued California-based Rumson, Bolling & Associates for escalating consumer harassment to a whole new level.

One plaintiff in that case testified that the agency’s collectors threatened to arrest, shoot, and then eat her dog before dispatching police to take her into custody.

But wait – it gets worse.

Deepening Horrors

Rumson, Bolling & Associates collectors also allegedly terrorized consumers who owed family funeral bills in the most egregious way imaginable: By threatening to exhume the bodies of deceased relatives and hang them from a tree or drop them outside the debtor’s door.

According to the FTC case file , these collectors also shouted profanities and allegedly terrified consumers with their final ultimatum: “Are you going to pay this bill right now ... or am I going to have to kill you?"

[The defendant's attorney claimed that the company's owners did their best to ensure regulatory compliance and that any wrongdoing was against company policy.]

When all was said and done, the district court halted operations at Rumson, Bolling & Associates, froze the agency’s assets, ordered them to pay a $700,000 fine, and permanently banned the firm from the collections industry.

The Phantom (Debt) Strikes Again!

A 2018 FTC case involved a Charlotte, N.C., collection operation known as Lombardo, Daniels & Moss (LDM). LDM collectors routinely impersonated lawyers in an attempt to recover phantom debts from unsuspecting consumers.

The imposters threatened consumers with lawsuits and jail time unless they paid immediately by credit or debit card over the phone – for debts they did not owe. Once again, the district court ruled that the defendants be permanently banned from future debt collection activity.

In 2021, the FTC charged an Atlanta-based firm, Critical Resolution Mediation, with impersonating police officers, attorneys, mediators, and process servers, in an attempt to collect on phantom debt. The bogus collectors routinely threatened consumers with imprisonment if they failed to pay.

In addition to banning the defendants from the debt collection industry, the court also ordered that they be prohibited from making any misleading claims while selling any product or service.

--Article Continues Below--

Never on Our Watch!

At CBSI, we are every bit as horrified as you are by such appalling violations, and we applaud the FTC’s prosecution of these bad actors. As recent recipients of the Better Business Bureau Torch Award for Ethics , we work hard to ensure our reputation with consumers remains above reproach.

You never have to worry about consumer harassment when CBSI has got your back.

Sources:
Featured Image: Adobe, License Granted
Federal Trade Commission
CNN
The New York Times

Say Cheese! The Evolution of Oral Hygiene

Wed, 11 Sep 2024 16:00:00 GMT

Say Cheese! The Evolution of Oral Hygiene

How Our Ancestors Treated Their Teeth

Did You Know...

The humble toothpick is the oldest dental implement, dating back to prehistoric times.

Ancient civilizations believed that cavities were caused by tiny worms burrowing into teeth. The most common treatment for "tooth worms" was to smoke them out with a mixture of charcoal and beeswax.

In 1960, almost half (49%) of American adults could be expected to lose all their teeth. As of 2010, that figure has dropped to 13%.

For as long as humans have roamed the planet, keeping teeth healthy—indeed, keeping them at all—has presented a challenge. The practice of dentistry began around 7000 B.C., but professional dental care wasn't widely available until many centuries later.

As recently as 200 years ago, barbers typically doubled as dentists, yanking teeth as well as cutting hair. Today's familiar red-and-white-striped barber pole traces its origins to when barbers hung bloody towels outside their establishments following surgical procedures.

DIY Dental Care

For countless generations, dental care was essentially a do-it-yourself project.

Ancient peoples may not have understood that cavities were caused by bacteria (not tooth worms), but they did recognize the importance of keeping their teeth clean. For instance, in pre-toothbrush times, early ancestors would chew on thin twigs until one end frayed, creating a sort of brush. "Chew sticks" are still used in some cultures today.

Iowa Welcomed First Woman Dentist

The world's first fully accredited female dentist could credit her fellow Iowans for helping her achieve that esteemed designation.

After the Ohio College of Dentistry refused to admit Lucy Beaman Hobbs in 1861, the dean agreed to teach her privately. A year later, she relocated to Iowa (first Bellevue and then McGregor), where she spent three years practicing dentistry.

Hobbs gained professional recognition in 1865 when she was admitted to the Iowa State Dental Society and appointed as a delegate to the American Dental Association convention in Chicago.

By then, the Iowa State Dental Society had pressured the Ohio college to finally admit Hobbs as a student. Because she had already practiced successfully for several years, Hobbs was only required to attend one session before earning her DDS in 1866.

Source: Sindecuse Museum

While oral hygiene tools available to our ancestors have evolved, they bore a striking resemblance to modern implements.

Picking Through the Past

According to anthropologists, the toothpick dates back more than a million years. Over the centuries, this humble dental implement has transitioned from an everyday object to a status symbol and back to an everyday object. The earliest toothpicks were tiny slivers of wood, bone, or ivory, although crow and goose quills were also popular.

Toothpicks rose to the rank of status symbol during Victorian times when the elite would brandish picks made of silver or gold. (In 2009, an engraved ivory and gold toothpick that once belonged to Charles Dickens was sold at auction for more than $9,000.)

Toothpicking at meals was so prevalent in 19th-century social circles that etiquette books frequently addressed the topic.

But in the 1860s, the toothpick returned to its unassuming wooden roots when an American entrepreneur began mass-producing 500 million a year. Free toothpicks quickly became ubiquitous restaurant giveaways.

Today, toothpicks are no longer favored by oral healthcare practitioners due to the potential damage to gum tissue.

The First Dentifrices

Surprisingly, toothpaste predates the toothbrush. As early as 5000 BC, ancient Egyptians created a dental cream from powdered oxen hooves, myrrh, eggshells, and pumice. About 4,000 years later, the Persians added burnt snail and oyster shells, gypsum, herbs, and honey.

Homemade toothpastes and powders remained popular well after the introduction of commercially produced versions centuries later. Common mixtures included powdered orris root, charcoal, and Peruvian bark with prepared chalk and lavender oil.

The first squeezable tube of toothpaste became available in the 1880s. It was quickly mass-produced, marketed, and sold nationwide.

Fluoride entered the picture in 1954 when Proctor & Gamble launched "Fluoristan," a precursor to Crest. Today, all toothpaste brands bearing the American Dental Association's seal of acceptance must contain fluoride.

Brushing Up on Oral Hygiene

The toothbrush was invented in China during the Tang Dynasty, between 618 and 907 A.D. At that time, and up until the 15th century, bristles were made from boar's hair, while brush handles were fashioned from bamboo or bone. (Environmentally friendly boar-bristle toothbrushes are still available today.)

The prototype for the first mass-produced toothbrush was created in 1780, but the first patented toothbrush didn't arrive on the scene until 1857. Nylon bristles were finally introduced in 1938.

A year earlier, an American inventor had patented his design for an electric toothbrush, but it failed to catch on. That is until a Swiss scientist unveiled his particular model in 1954. The "Broxodent" was initially intended to assist people with limited mobility but was soon marketed to the general public.

--Article Continues Below--

Don’t Forget to Floss!

Dental floss was a relative latecomer to the oral hygiene world. First introduced by New Orleans dentist Levi Spear Parmly in 1819, the idea of running "waxed silken thread" between the teeth to help prevent disease gradually became more common throughout the 19th century.

By 1882, commercially available floss of waxed or unwaxed silk became available. Nylon floss replaced silk during World War II because of silk rationing and nylon's resistance to shredding. The modern-day floss that's become a staple in dental offices and American households is comprised of various synthetic fibers.

To all our dental industry friends
who keep us smiling…

THANK YOU!

Sources:
Featured Image: Adobe, License Granted
History.com
Oral B
Fourteenth Century Fiend
History of Dentistry and Medicine

Cyberattacks on the Rise: Be Prepared!

Wed, 07 Aug 2024 19:46:27 GMT

Cyberattacks on the Rise: Be Prepared!

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How Small Businesses Can Protect
Themselves from Bad Actors

On June 19, 2024, software giant CDK Global was the victim of a ransomware attack that took most of its services offline. As a result, business operations were crippled at more than 15,000 U.S. car dealerships, forcing employees to revert to paper-based processes.

On February 21, 2024, cybercriminals attacked Change Healthcare, preventing electronic payments and medical claims processing, forcing patients to pay out of pocket for medications, and causing healthcare providers to lose millions in revenue while threatening small practices with insolvency.

As cyberattacks continue to mount, small businesses across the country are scrambling to protect themselves. The statistics are sobering:

82% of ransomware attacks target companies with fewer than 1,000 employees, 37% of which employ fewer than 100.

In 2020 alone, U.S. small businesses experienced 700,000 cyberattacks, totaling $2.8 billion in damages.

51% of small businesses attacked by ransomware pay the money.

75% of small-business owners and managers stated they would have to cease operations if they were hit with ransomware.

Cyberattack Prevention

Cybersecurity measures are no longer optional for small businesses – they’re a necessity. Owners and managers must evaluate areas most at risk and determine how an IT outage could affect their finances and operations.

How Do They
Do It?

Here are five of the most common hacking methods cybercriminals use against small businesses:

Phishing —Phishing emails appear to originate from an authentic brand. They contain a sense of urgency, persuading the user to click on a malicious website or attachment. Phishing is commonly used to hack into accounts receivable.

Clickjacking —Clickjacking also tricks the user into clicking a malicious link; doing so allows the hacker to control the user’s device.

Keylogging —Keylogging allows hackers to record every keystroke on a user’s device, providing them to access sensitive information.

Viruses —Computer viruses, worms, and Trojan horses are software programs that can be installed in IT systems. These programs lock up files and spread quickly across entire networks. Ransomware is a virus that makes data inaccessible until a ransom is paid to the hackers.

Denial of Service (DoS)—A DoS is a hacking technique that takes down a website by overwhelming the server with fake data requests. The server cannot process all the requests and crashes.

Source: Intellicomp

Once you’ve established the high-risk areas of your organization, security experts suggest the following:

Implement mechanisms to establish redundancy, such as routinely backing up digital records and storing copies in separate locations. Also, maintain a secure off-site location for paper files.

Ensure digital files are properly encrypted, and firewall protection and antivirus software remain active at all times.

Restrict access to electronic records via user authentication and other controls to ensure only authorized personnel can access digital files.

Assess the cybersecurity protocols of vendors and other third parties. If you can’t persuade a vendor to improve its security, you may want to consider switching vendors or having a backup available.

Regularly audit your record-keeping systems for security and accessibility.

Educate your staff on appropriate documentation and record-keeping practices and make sure all employees understand their role in maintaining accurate and up-to-date records.

Designate a staff member, team, or third party to continually monitor and evaluate your cybersecurity systems.

Back to (Old) School

While prevention is the best way to prepare for a cyberbreach, small businesses must also plan for potential periods when their systems are offline. That means relying on paper and manual procedures as a backup.

IT systems can be down for days or weeks in the aftermath of a cyberattack. Prudent business owners will develop a “pen and paper plan” to enable continued operations while unplugged from technology. For instance:

Keep paper copies of your plans for emergency operations and business continuity.

Maintain a supply of Post-it notes, flip charts, and construction paper. These can be handy when navigating many workflow changes.

Maintain a binder with paper forms needed to continue operations in the event of an IT outage.

Keep a hard copy of your business policies regarding payment to ransomware attackers in case a decision needs to be made.

Keep paper instructions for billing, ordering supplies, and collecting payments.

--Article Continues Below--

Establish access controls for physical records, such as locking cabinets and maintaining access logs.

Create protocols for the secure destruction of paper files that are no longer needed.

Two-Fisted Approach

Every small-business owner is responsible for thwarting cybercrime, and vigilant preparation requires a two-fisted approach. Utilizing the best technology your company can afford – while also maintaining paper-based backup processes – ensures fiscal resilience in the event of a cyberattack.

Sources:

Featured Image: Adobe, License Granted
CyberCatch
StrongDM
Becker's Hospital Review
House Committee on Energy & Commerce
Carstens

Surviving an Iowa Summer

Mon, 15 Jul 2024 14:00:00 GMT

Surviving an Iowa Summer

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Keep Your Patients Safe
During Peak Injury Season

A Texas man was rushed to the Emergency Room after being stabbed in the abdomen at a family barbecue.

While the ER staff was examining the injury, the man coughed, and his entire dinner began gushing from the wound. The staff s pent 20 minutes suturing the hole in the man's stomach and picking barbecue and corn out of his intestine.

The particular health risks associated with summertime present some unique challenges to healthcare workers. ER visits surge around summer holiday weekends, many involving children. The higher injury risk is commonly associated with increased daylight hours and popular outdoor activities, such as fireworks, swimming, and cookouts.

Lazy, Hazy, Crazy (and Risky) Days

The most common summertime injuries and illnesses requiring emergency care include:

Bicycle injuries : Biking accidents can cause serious damage like head trauma, broken bones, bruises, and lacerations.

Paws to Consider

Leaving an animal in a hot car is prohibited in 31 states. Unfortunately, Iowa is not one of them.

The inside of a vehicle parked in the hot sun can reach 120 degrees in a matter of minutes, causing an animal to suffer heat stroke, brain damage, or even death.

If you encounter an animal trapped in a hot car, The Humane Society recommends the following:

Note the vehicle's make, model, and license plate number.

Immediately notify any nearby businesses so they can attempt to locate the car's owner.

If the owner can't be found, call the non-emergency number of the local animal control or police. Then, wait by the car for them to arrive.

Source: Humane Society

Drowning: Swimming is a particularly high-risk summertime activity for kids. According to the CDC , drowning is the primary cause of death for children ages 1 through 4 and the second-leading cause of injury-related fatalities in older children.

Burns: Summer activities such as grilling, bonfires and fireworks are notorious for causing severe burns in children and adults. In 2022, an estimated 10,200 fireworks-related injuries required emergency care.

Sun-related illnesses: There's more than one way to get burned. Excessive sun exposure causes severe heat-related illnesses like extreme sunburn, blistering, heat stroke, heat exhaustion, and heat cramps. (See "Is It Hot in Here?" below.)

Orthopedic injuries: Summer means outdoor sports and recreational activities. Soccer, basketball, baseball, and football involve sudden twisting or pivoting movements that can place excessive stress on the knee joint, resulting in anterior cruciate ligament (ACL) injuries. Other common orthopedic injuries include rotator cuff tears, muscle strains, and golfer's/tennis elbow.

ATV accidents: Crashes on all-terrain vehicles (ATVs) result in more than 800 deaths and an estimated 100,000 ER visits every year.

Spread the Word

You can help your patients minimize summertime injuries by identifying the common causes for these incidents and sharing a few summer safety tips.

Encourage cyclists and ATV enthusiasts to wear protective gear like helmets, knee pads, leather gloves, and goggles.

Remind parents of small children to closely supervise them around pools, lakes, fires, and outdoor grills.

Regarding fireworks, advise patients never to ignite fireworks while impaired by alcohol or drugs, light only one device at a time while maintaining a safe distance from people and buildings, use protective eyewear, and keep a bucket of water handy.

Encourage patients to use sunscreen, sunglasses, and a wide-brimmed hat to protect against the sun's harmful rays.

Summertime in Iowa means bugs, so advise patients to wear insect repellent, keep their lawns trimmed, and check themselves for ticks before coming inside. Note: A "bullseye rash" (a ring around the bite) is a classic sign of Lyme Disease and requires immediate medical attention.

Advise patients to always warm up before engaging in rigorous physical activity.

--Article Continues Below--

Is It Hot in Here?

Iowa summer is hot -- sometimes extremely hot.

Heat is the top weather-related killer in the United States. In 2022, more than 1,000 Iowans were treated for heat-related illnesses, 49 of whom required hospitalization. Overexertion on a hot day and too much sun exposure can push the body beyond its limits. The combination of extreme heat and humidity slows evaporation, straining the body to maintain a normal temperature.

Offering your patients the following reminders can help prevent heat-related illnesses:

Plan outdoor activities for the cooler morning or evening hours.

Drink plenty of fluids before feeling thirsty, and eat plenty of fruits.

Avoid alcohol and energy drinks, as these encourage dehydration.

Know the signs of heat-related illness: headache, thirst, nausea or vomiting, weakness, dizziness, confusion, or fainting. Anyone experiencing these symptoms should be moved to a cool place, clothes loosened, and a cool compress applied. If in doubt, call 911 immediately, as heat stroke is a medical emergency.

Never leave a child in a hot car, even with open windows. The temperature inside a parked vehicle can quickly rise to a dangerous level for both humans and pets. (See sidebar, "Paws to Consider.”)

Smooth Sailing

As a healthcare provider, your patients rely on you to help them avoid summertime health risks. Your timely advice can prevent ER visits and ensure your patients’ memories of Summer 2024 are nothing but pleasant.

Sources:

Featured Image: Adobe, License Granted
Rectangle Health
How Stuff Works
Ready Iowa
Regional Medical Center
American Red Cross
Rytel Sports Medicine

CBSI Receives BBB Torch Award for Ethics

Mon, 08 Jul 2024 14:00:00 GMT

CBSI Receives BBB Torch Award for Ethics

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Collectors Are "Passionate
About Helping People"

Credit Bureau Services of Iowa Inc. (CBSI) is a 2024 recipient of the Better Business Bureau (BBB) Torch Award for Ethics.

The BBB selects its annual award winners based on “the four C’s”: The Character of the organization’s leadership, the Culture fostered within the company, its transparent relationship with Customers, and Community impact.

Don't Call Him "Guido"

In accepting the award, CBSI President Brian Grimes recounted how, when he first began working in the collections industry, he had some concerns. “People sometimes ask if my real name is Guido,” he laughingly remarked.

About the BBB Torch Award

How Much Do You Know About Men’s Health?

Thu, 06 Jun 2024 18:51:17 GMT

How Much Do You Know About Men’s Health?

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Test Your Knowledge During
Men’s Health Month

June is National Men's Health Month, a time to remind men – and the women who love them -- of the specific health issues they face and the importance of maintaining their health.

But how much do you really know about it? Take our quiz and find out!

#1. The most common type of cancer for American males is:

#2. Men are almost twice as likely to suffer from heatstroke than women. Which of the following is NOT a sign of heatstroke?

#3. At what age does heart attack risk increase in men?

#4. Which of the following is NOT a common heart attack symptom for men?

#5. Which of the following is a symptom of prostate cancer?

However, these symptoms may also be caused by other prostate problems that are not cancer-related, such as an infection or an enlarged prostate.

#6. The fourth-leading cause of death for black American males (after heart disease, cancer, and unintentional injuries) is:

#7. Over the last several years, gonorrhea has become increasingly resistant to treatment. (See video below.) Untreated gonorrhea can result in which of the following health problem(s) in men?

A. Epididymitis (i.e., swelling of the tube leading from the male testicle to the urethra)

B. Higher risk of contracting or transmitting HIV

C. Testicular cancer

D. Both And B

E. All of the above

Answer: D. Untreated gonorrhea can cause severe and permanent health problems in both women and men. Men with gonorrhea can develop epididymitis, a painful condition of the testicles that may result in infertility.

If gonorrhea spreads to joints or the blood, it can be life-threatening. In addition, men infected with gonorrhea can more easily contract HIV, the virus that causes AIDS. And HIV-infected men with gonorrhea are more likely to transmit HIV to someone else.

#8. Which of the following is a symptom of depression commonly found in men but not in women?

How’d You Do?

If you answered at least six of the above questions correctly, you’re well aware of men’s health issues. Less than that, it may be time to bone up. Here are a few places to start:

Sources:
Featured Image: Adobe, License Granted
Men's Health Month

National Institutes of Health

Lessons from the "Blue Zones"

Wed, 08 May 2024 12:30:00 GMT

Lessons from the "Blue Zones"

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Nine Principles for a
Long, Healthy Life

A shepherd in Sardinia, Italy, walks more than five miles a day up and down steep mountain paths.

A cheerful loom weaver on the Greek island of Ikaria plies her trade daily with care and precision; time is meaningless to her.

An Okinawan householder takes daily barefoot walks on the beach and consumes a predominantly plant-based diet of rice and fresh vegetables.

In Costa Rica, a popular single mother of four celebrates regularly with her community and greets all strangers as friends with her infectious laugh.

A mild-mannered cardiothoracic surgeon in Loma Linda, California, with a spiritually based approach to life routinely socializes with members of his faith community.

What do these five individuals have in common? Two things: 1) they've all lived past 100 years of age, and 2) they each reside in a so-called Blue Zone. Indeed, these regions boast ten times as many centenarians per capita than the average population.

Welcome to the Blue Zones

In 2003, award-winning journalist and bestselling author Dan Buettner was commissioned by National Geographic to investigate areas of the world with exceptionally high longevity. These areas had been dubbed "Blue Zones" by scientific explorers a few years earlier.

Over the next several years, Buettner and his team identified five such regions across the globe:

Okinawa, Japan
Loma Linda, California (Seventh-Day Adventist community)
Sardinia, Italy
Nicoya, Costa Rica
Ikaria, a Greek island

Buettner synthesized his years of research into nine lifestyle habits that he believes other populations can adopt to "reverse engineer" longevity. Here are his "Power 9":

Healthcare in
the Zone

Physicians who practice Lifestyle Medicine (LM) will immediately recognize the similarity between LM's six pillars (plant-based nutrition, physical activity, stress management, avoidance of risky substances, restorative sleep, and social connections) and the nine Blue Zone principles.

But Blue Zone researchers encourage medical professionals to take these principles a step further by connecting their practices and patients with community-wide health-promoting activities and helping shape public policy. To this end, the Blue Zones Project facilitates physician involvement in creating more healthful environments.

More than 75 Blue Zone Project communities have already improved the health of millions of Americans by drastically lowering obesity rates and smoking prevalence in urban communities. They have also decreased healthcare expenditures for chronic illnesses and reduced absenteeism.

Click here to learn more.

#1. Move Naturally

The world's longest-lived people reside in environments that continually encourage movement in everyday activities. They move naturally throughout the day, walking wherever they need to go and managing their own homes and gardens, usually without mechanical conveniences.

#2. Maintain Purpose

Maintaining a sense of purpose can add as much as seven years to your life. Okinawans call it "Ikigai," and the residents of Nicoya, Costa Rica, call it "plan de vida," but for both groups, it means "why I wake up in the morning." In Loma Linda, volunteering is a key component of maintaining purpose in life.

#3. Downshift

All of us, even Blue Zone residents, experience some stress. When left untreated, stress results in chronic inflammation and can trigger every leading age-related disease. People in the Blue Zones maintain specific routines to shed that stress. Ikarians take an afternoon siesta, Okinawans quietly memorialize their ancestors each day, Adventists pray, and Sardinians enjoy a happy hour with friends.

#4. Apply the 80% Rule

Before each meal, the Okinawans recite an ancient Confucian mantra, "Hara hachi bu" ("eat until you are 80% full"). This 20% gap can make the difference between losing or gaining weight. Blue Zone residents eat their smallest meal in the late afternoon or early evening and then stop eating for the rest of the day.

#5. Eat Your Veggies

The cornerstone of most centenarian diets is beans – fava beans, black beans, soybeans, and lentils. Blue Zone residents also consume plenty of (usually homegrown) fresh vegetables and fruits. Pork is the predominant meat staple, but it is only eaten about five times per month in small (3-4 oz.) servings.

#6. Wine @ 5:00

Moderate alcohol consumption reduces personal risk of premature death. Except for the Seventh-Day Adventist community in Loma Linda, people in the Blue Zones drink alcohol moderately and regularly. Sardinians, for example, daily consume a regional red wine called Cannonau, which contains two to three times the level of artery-scrubbing flavonoids as other wines. And Ikarians consume at least two glasses of wine daily, primarily the locally produced 16-proof variety.

#7. Belong

Virtually all of the 263 centenarians whom Buettner's team interviewed belonged to a faith-based community. Denomination was irrelevant. Research indicates that attending faith-based services once a week prolongs life by as much as 14 years.

#8. Put Loved Ones First

Blue Zone centenarians put their families first. Aging parents and grandparents live near (or with) their families. Most have been committed to a life partner and invested in their extended families with their time and love.

#9. Connect to the Right Tribe

Maintaining social bonds is critical to longevity. The world's longest-lived people choose social circles that support healthy behaviors. For Blue Zone residents, this almost always means face-to-face (rather than Facebook) interaction. Friendships and social connections provide not only intellectual stimulation but also emotional support through hardships.

Transforming Iowa Communities

In 2013, seven Iowa communities were selected as demonstration sites for implementing Blue Zone principles via the Blue Zones Project. The following video illustrates how local grocery stores got on board:

Sources:
Featured Image: Adobe, License Granted
PBS
CNBC
New York Post
Greek City Times
Loma Linda University
News Medical

Frame of Mind - Iowa's Mental Healthcare in Dire Straits

Wed, 10 Apr 2024 12:30:00 GMT

Frame of Mind: Iowa's Mental Healthcare in Dire Straits

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State Ranks Worst in the Nation
for Psychiatric Facilities

In April 2017, Chase Nicholson, a young Iowa man experiencing a severe psychotic episode, shot and killed his parents and 24-year-old sister in their home.

Just days before the murders, Chase had suffered a severe suicide attempt and had been rushed to the ER, where he told doctors he was sick and needed to be hospitalized.

But there were no psychiatric beds available for him in the entire state. Chase was sent back home with his parents. Days later, he killed his entire family.

Last for a Long Time

At the time this tragedy occurred, Iowa ranked last in the nation for state-managed inpatient psychiatric beds. Seven years later, it's still ranked last – with only two adult beds per 100,000 residents, according to a new Treatment Advocacy Center (TAC) report published in January. (The optimal number of psychiatric beds is about 50 per 100,000.)

Between 2007 and 2016, Iowa's total number of state psychiatric beds dropped from 223 to just 64 -- which is where it stands today – even though an estimated 84,000 Iowans live with serious mental illness (SMI). SMI includes schizophrenia, severe major depression, and severe bipolar disorder.

While the TAC report tallies only state-managed psychiatric beds, private Iowa facilities haven't enough beds either.

Types of Psychiatric Facilities

Public psychiatric hospitals provide both short-term and long-term care to forensic (criminally charged) patients and those without the means to pay. These hospitals are often the only places that will accept patients with a history of violent behavior or who suffer from both SMI and complex medical issues.

Private psychiatric hospitals and the psychiatric units within general hospitals provide inpatient, 24-hour care. They generally do not accept forensic patients, and the length of stay often depends on the patient's ability to pay.

Residential care facilities provide long-term, 24-hour psychiatric care and addiction treatment in a residential setting. Prices range from $10,000-$60,000 per month for psychiatric treatment and $3,000-$10,000 per month for sober-living care.

The Iowa Department of Health and Human Services (HHS) reports 809 licensed psychiatric beds for both adults and youth at private facilities across the state. However, only 646 of those beds are staffed, further limiting access to inpatient care. (See sidebar, "Types of Psychiatric Facilities.")

Mental Illness and Suicide

According to public health experts, most suicides are related to psychiatric illness, with psychosis, depression, and substance use disorders being the most relevant risk factors.

In 2022, Forbes Advisor compared all 50 states to determine the percentage of adults who had mental illness within the past year. Iowa ranked number 10 for the prevalence of mental illness, with 24.7% of its residents reporting some mental illness and 6.3% reporting a serious mental illness.

CDC data reveals that 549 Iowans committed suicide in 2021, representing 17.5% of the state's population – three percentage points higher than the national average. In 2022, Iowa suicides rose to 582, according to the Iowa HHS.

The Governor's Plan

Improving Iowans' access to mental healthcare is now a top priority for Gov. Kim Reynolds.

Noting that more than 25% of adults with serious mental illness also grapple with substance use disorders, Reynolds lamented that there's currently "little to no coordination" between the state's 13 mental health regions and 19 substance use regions.

She has proposed consolidating these regions into seven unified districts to manage both behavioral health and substance use services. Iowa HHS would oversee the effort and establish contracts with local administrative organizations to manage each district.

Through Behavioral Health System Alignment, we will align Iowa's fractured local delivery models for substance use and mental health care into a simplified structure supporting improved statewide access to care for all Iowans.

-- Iowa Gov. Kim Reynolds

The governor has also recommended increasing Medicaid payments for behavioral and inpatient psychiatric care. In addition, the governor's plan entails refocusing state-run mental healthcare toward behaviorally complex youth and forensic (criminally charged) patients, as well as increasing access to outpatient services through Certified Community Behavioral Health Clinics.

The state legislature is currently reviewing Gov. Reynolds' proposal.

--Article Continues Below--

A Story of Hope

The proposal to revamp Iowa's fractured mental healthcare system comes at a time when mental illness and suicide rates are at an all-time high across the country. Suicide prevention advocates are working tirelessly to reduce those numbers.

Kevin Hines, a San Francisco native who suffers from bipolar disorder, travels the globe, sharing his incredible story of hope, healing, and recovery.

In September 2000, when he was 19, Hines heard voices in his head telling him to die. He took a bus to the Golden Gate Bridge and threw himself over the rail. As he was plummeting 220 feet at 75 mph, Hines instantly regretted the decision and desperately prayed to live.

Struggling to surface, he felt a creature nudging his body. Amazingly, an accommodating sea lion kept Hines afloat until the Coast Guard could rescue him.

Here's the rest of Kevin's story:

Sources:

Featured Images: Adobe, License Granted

Iowa Capital Dispatch

Des Moines Register

Treatment Advocacy Center

Iowa HHS

National Institutes of Health
Forbes Advisor

Kevin Hines Story

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6165520/

Is AI Responsible for Denied Claims?

Wed, 06 Mar 2024 12:42:49 GMT

Is AI Responsible for Denied Claims?

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Providers Note Costly Rise in
Medical Claim Denials

Dr. Nick van Terheyden knew something was fishy.

When his own physician ordered bloodwork to diagnose the cause of van Terheyden’s bone pain, both of them fully expected his insurance plan to cover the cost. But instead, Cigna denied the medical claim as “not medically necessary.”

Dr. van Terheyden realized that was not right. His suspected vitamin D deficiency could lead to osteoporosis if left untreated. The vague wording of the claim denial indicated to van Terheyden that Cigna’s medical director, Dr. Cheryl Dopke, had not actually reviewed the case.

As it turned out, van Terheyden’s file was only one of 60,000 that Dopke denied in a single month in 2022.

Other Cigna medical directors have done the same – one issued more than 80,000 instant denials during the same time frame. Over a two-month period in 2022, Cigna doctors denied more than 300,000 claims, spending an average of 1.2 seconds on each case.

Automated Bulk Denials

The health insurance giant is now embroiled in a massive class-action lawsuit that alleges Cigna uses a computer algorithm to automatically deny hundreds of thousands of medical claims without examining them individually as required by California law. (See sidebar, “About PxDx.”)

About PxDx

Cigna's claims review system PxDx (corporate shorthand for procedure-to-diagnosis) was developed more than a decade ago by former pediatrician Alan Muney, who now advises insurers on how to save costs.

PxDx involves a list of tests and procedures approved for specific illnesses. The program would automatically deny payment if a treatment did not match a listed condition. Denials were then sent to Cigna medical directors, who would reject these claims without reviewing the patient file.

Muney and his team previously worked for United Healthcare, where they devised a similar system that allows UHC doctors to bulk-deny claims quickly.

Source: Propublica

The plaintiffs seek "statutory and punitive damages," costs and attorneys' fees, and "appropriate declaratory and injunctive relief enjoining Cigna from continuing its improper and unlawful claim handling practices."

Former Cigna employees have stated that the vast majority (about 99.8%) of patients will pay the denied claims rather than deal with the hassle of an appeal.

UHC's Legal Woes

Cigna is not the only insurance provider using artificial intelligence to issue bulk denials. United Healthcare (UHC) is battling a class-action suit claiming the company knowingly used a faulty AI algorithm to deny elderly patients coverage for medically necessary extended care.

The families of two deceased patients argue that UHC deployed AI technology known to have a 90% error rate (called "nH Predict") to deny medically necessary care to seniors. The plaintiffs also stated the insurer expected only a fraction of policyholders to appeal the denied claims, knowing patients would either pay out-of-pocket costs or forgo the remainder of their prescribed care.

They are seeking monetary damages.

Denied Claims on the Rise

In 2021, insurance companies denied about three percent of all medical claims (and 17 percent of all in-network claims) filed. In 2022, that figure rose to 11 percent, representing 110,000 unpaid claims for each average-sized healthcare system.

These denial rates are not likely to decline any time soon. According to the latest Experian Health data, 30 percent of healthcare leaders say that claims denials are increasing by 10 to 15 percent.

Legal experts anticipate more insurers will encounter similar complaints as they increasingly incorporate AI in their claims management processes. Medical professionals also advise health insurers to rein in their expectations of AI's utility.

Last year, the American Medical Association (AMA) cautioned health insurance companies to require human examination of patient records before denying medical claims. "AI is not a silver bullet," said AMA Board Member Marilyn Heine, MD.

--Article Continues Below--

How to Fight Autogenerated Denials

What can medical practitioners do about bulk AI-generated claims denials? Dr. John Lin, an Arizona urologist, offers the following advice:

Understand payer policies and rules to secure prior authorization for procedures properly. Keep track of which payers will pay for which procedure using which diagnosis.

Always appeal the denial. If your billing is outsourced, check with the billing company to ensure they aren't automatically writing off denied claims. Open communication with the coding and billing staff is vital to an effective and timely appeal.

Finally, if a particular payer continues to play games with your medical practice, Dr. Lin suggests you hit them where it hurts:

The Rest of van Terheyden's Story

After a second Cigna doctor insisted that van Terheyden's blood test was unnecessary and again denied the claim, he took the matter to an independent reviewer, as allowed by his insurance plan.

Seven months after van T erheyden's procedure, the external physician determined that "This patient is at risk of bone fracture without proper supplementations. Testing was medically necessary and appropriate."

Sources:
Featured Image: Adobe, License Granted
Medical Economics
Propublica
U.S. PIRG Education Fund
Experian
RevCycle Intelligence
Modern Healthcare

Till Debt Do Us Part?

Wed, 14 Feb 2024 21:45:00 GMT

Till Debt Do Us Part?

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How Money Issues Can
Make or Break a Relationship

Brian and Lynn never talked about money. When unanticipated expenses -- such as a medical emergency or necessary home repair -- cropped up, they relied on credit cards to pay.

Eventually, they maxed out all their cards and were $109,000 in debt. Their marriage hit rock bottom, as communication became limited to disagreements about money. They knew they needed a plan to save their family.

Marriage and Debt in America

For a significant portion of Americans, debt is a source of strife that portends calamity for the health of their marriage. Consider the following statistics:

A study from Utah State University revealed that couples who fight frequently about money are 30% more likely to divorce than those who rarely argue.

In a recent OnePoll survey, 54% of respondents stated that a spouse's debt is a justifiable reason to consider divorce.

A 2019 Harris Poll found that 35% of respondents blame finances for the stress in their relationships.

A 2022 survey by Orion Advisor indicated that 42% of U.S. couples have arguments about money; for 27% of respondents, these disagreements occur weekly or monthly.

Did You Know?

Iowa statute dictates that both parents are responsible for their children’s medical debts, regardless of marital status.

A 2022 survey by Orion Advisor indicated that 42% of U.S. couples have arguments about money; for 27% of respondents, these disagreements occur weekly or monthly.

The Four Loves

Psychologists generally recognize four different types of love: familial ("storge"), brotherly ("philia"), romantic (eros), and selfless (agape).

Storge is the love one feels for family members, such as a parent for a child. It is unbidden affection and is considered the most natural of all the loves.

Philia is the accepting love between close friends. It positively impacts health and can make us more resilient during hard times.

Eros is sexual or passionate love. This type of love is more about the person feeling it and less about the person who is the focus of it. It can result in great joy and great sorrow.

Agape love is the unconditional love of humankind. It's based on acceptance and understanding and is expressed through acts of kindness, service, and compassion. Creditors who treat consumers with empathy and benevolence demonstrate agape love.

Source: University of Utah Health

But carrying a boatload of debt does not have to be a death sentence for a relationship. As with most interpersonal relations, communication is the key to resolving money issues in a marriage. Once both partners are on the same page, with clearly defined expectations regarding budget, responsibilities and goals, they can begin to overcome their financial hurdles.

Money Talks

Discussing finances with a spouse is not easy. Money is often an emotionally charged topic, underscoring cultural or family differences and past problems. Here are some tips to get started:

Share your story. ("When I was growing up, money was . . .")

How was money handled in the household where your spouse was raised? Their experience was likely very different than yours, so you're likely approaching the issue from differing perspectives. Discovering a spouse's money history can help each partner understand the other's foundational beliefs.

Share your fears. ("My biggest financial fear is . . .")

Fear is a bad financial advisor. While some fears can motivate us to take positive action (such as setting aside funds for unexpected medical care), living in fear of financial ruin makes us feel like there's never enough. Identifying each spouse's financial fears helps to reveal their motivations.

Share your goals and dreams. ("Someday I want us to . . .")

Sharing goals and dreams can be inspirational. While your short-term goal may be to resolve your debt, what about long-term goals? Tap into your dreams if you want to start making real financial progress.

Be kind. Money mistakes happen. But as long as each spouse treats the other with kindness, forgiving each other and themselves, they can learn from past errors while strengthening their marriage.

Create a Sustainable Budget

The next step is to create a budget together that's sustainable for the entire household. The following video offers a quick tutorial:

Bonding Over Debt

While debt may never be considered a blessing, it can serve as a tool for helping couples learn how to work as a team.

According to Joy Lere, a clinical psychologist and behavioral finance counselor, debt can be "a powerful catalyst for change and growth." In Lere's experience, couples who work together to identify their shared financial challenge -- and then strategize collaboratively to overcome it -- typically can deepen their bond and strengthen the relationship.

--Article Continues Below--

The Rest of the Story

Whatever happened to Brian and Lynn, the couple that was $109,000 in debt? Using a plan they formulated together, they worked out a monthly budget for the first time in their married lives. They changed their lifestyle, drastically reducing unnecessary expenses, and devised novel ways to save and stretch their dollars.

By paying $2,000 a month, they resolved the entire balance in slightly more than four years. Brian chronicled the family's journey on his personal finance blog, Debt Discipline . He and Lynn will soon celebrate their silver wedding anniversary.

Sources:
Featured Image: Adobe, License Granted

Business Insider
CNBC
Ramsey Solutions
Huffington Post

https://www.businessinsider.com/couple-paid-off-109000-credit-card-debt-save-their-family-2019-8#money-problems-destroy-marriages-3 https://www.businessinsider.com/couple-paid-off-109000-credit-card-debt-save-their-family-2019-8#money-problems-destroy-marriages-3

https://www.businessinsider.com/couple-paid-off-109000-credit-card-debt-save-their-family-2019-8#money-problems-destroy-marriages-3

Three Doable New Year’s Resolutions

Wed, 10 Jan 2024 21:45:00 GMT

Three Doable New Year’s Resolutions

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How to Attain Your Goals
Through Baby Steps

Did you know that most Americans abandon their New Year’s resolutions within the first month?

And less than ten percent see their resolutions through to completion.

If your resolve begins to wane as February approaches, perhaps it’s time to reassess your goals. Let’s look at ways to make three of the most common resolutions more doable.

Slim Chances

When setting weight-loss goals, many of us bite off more than we can chew (if you’ll excuse the pun). Losing 50 or 80 pounds over the course of a year is reasonable and highly doable; losing it within a couple of months is not—if you want to remain healthy.

If you dive into an aggressive weight-loss program without the proper motivation, you’re setting yourself up for early failure. Try to look at the long-term picture and focus on getting a little bit healthier every day.

Regional Resolutions

A recent YouGov survey of past New Year’s resolutions reveals some interesting regional differences.

For instance, Midwesterners are the most concerned about losing weight (46%) and the least concerned with quitting alcohol (1%). Here’s how the stats line up for the most popular resolutions:

Source: YouGov

For instance, eliminating all processed foods from your diet may not be doable, but restricting them certainly is. Here are some small changes that can make a big difference:

If soft drinks are your weakness, try switching up to flavored, unsweetened sparkling water and save the Pepsi for special occasions only. (Even so-called “diet” sodas have been shown to cause weight gain.)

Do you crave the crunch of potato chips or high-carb crackers? Reach for an apple or a handful of lightly salted nuts instead.

If chocolate is your thing, opt for a small amount of dark chocolate with at least 70% cocoa content. Milk chocolate contains the wrong kinds of fat, twice as much sugar, and less than a third of the fiber found in its darker cousin.

Choose whole-wheat pasta; it’s more filling than conventional pasta, and you’ll eat less.

Wherever possible, add more vegetables to your meals. Their natural fiber will make you feel full and help curb the tendency to snack. (Not a vegetable lover? Try cauliflower “mashed potatoes .”)

A realistic program for permanent weight loss involves baby steps. Aim for losing 1 to 2 pounds per week.

No Pain, No Gain

According to the most recent Forbes Health/OnePoll survey , getting in shape is the #1 New Year’s resolution for 2024. It doesn’t have to entail a gym membership — although it certainly can! Any activity that gets your body moving will be an improvement.

If you’ve been sedentary for years, get approval from your doctor before embarking on an exercise regimen. (See “ The Exercise Prescription .”) Then, invest in a good pair of walking shoes that provide the proper support. The benefits of walking are manifold: lower body fat and improved circulation, joint health, bone density, blood pressure, and mood.

Begin by walking just 10 minutes a day at a comfortably brisk pace. (A good gauge is you can talk but not sing.) Do this for one week, allowing one day for rest or mild strength training (such as squats). For Week 2, repeat the regimen, but increase your walking time to 15 minutes per day. Increase your walking time by 5 minutes each week. By Week 5, you’ll be walking 30 minutes daily, six days a week -- the recommended amount of daily aerobic exercise for optimal health.

Here are a few more suggestions to keep your exercise program on track:

If you happen to have at-home fitness equipment, it’s time to use it for something besides a clothes hanger. It will help you incorporate exercise into your daily routine (e.g., walking on a treadmill while watching your favorite program or reading while riding a stationary bike).

Some people feel more motivated to exercise with a friend . If you’re one of them, ask a buddy to meet you for a scenic walk or to join a water aerobics class.

Set a workout milestone, such as walking for two weeks in a row, and then reward yourself with a massage or a new article of clothing when you meet it.

Don’t punish yourself if you miss a workout. Instead, consider it a rest day, and remember there’s always tomorrow.

The Buck Stops Here

If one of your New Year’s resolutions is to get out of debt in 2024, there are several baby steps you can take to achieve your goal. The key is to stop creating new debts until the old ones have been satisfied. (Some debts, like medical bills, may be unavoidable, but you can at least have a plan to pay them off before incurring new credit card debt, for instance.)

Once you’ve stopped incurring new debt, make a list of all your debts, from smallest to largest. This means gathering all your bank statements, credit card statements, and any correspondence from creditors. Include interest rates in your calculations, as these can change your monthly figures.

Pay off the smallest balance first. This practice, called the snowball method , was first popularized by financial expert Dave Ramsey. It will give you the motivation and momentum to tackle the larger debts. (For details, see the infographic below.)

Work on cutting your expenses. For instance:

--Article Continues Below--

Review your auto insurance annually, comparing quotes online. Consider increasing your deductible or eliminating collision coverage for an older vehicle.

Check with your local library to see if they offer free access to online entertainment like Libby, Kanopy, or Hoopla Digital, so you can eliminate online streaming fees.

Prepare meals at home instead of eating out (Even fast food is more expensive than home cooking.) You can stretch your food budget by purchasing produce in season, store brands, and items with longer shelf life.

Reduce your energy bills by adjusting your thermostat, taking shorter showers, setting your refrigerator to 37 degrees and your freezer to 0 degrees, washing clothes in warm or cold water, and using smart power strips.

Paying off your debt may seem nearly impossible, but it’s highly doable if you take baby steps.

Sources:
Featured Image: Adobe, License Granted

Inside Out Mastery
Mayo Clinic
Everyday Health
Nerd Wallet

Coping With Holiday Blues

Tue, 12 Dec 2023 19:23:04 GMT

Coping With Holiday Blues

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When the Most Wonderful
Time of the Year Isn’t

The holidays are supposed to be the most wonderful time of the year, with "everyone telling you be of good cheer." But for many people, this season is difficult and emotionally exhausting.

For years, medical professionals have documented increased rates of depression during the holidays. According to the National Alliance on Mental Illness (NAMI), 64% of patients diagnosed with mental illness reported that their conditions worsened at this time of year.

Blue Christmas

Several factors contribute to the holiday blues. Festivities and social interactions can result in stress caused by the pressure of multiple responsibilities. Sometimes, complicated memories of Christmases past can cause anxiety about family gatherings.

Other common causes of holiday-time depression include:

Physical and mental fatigue

Financial stress

High expectations caused by the exaggerated portrayal of the holidays on TV and social media

Travel stress due to crowded airports, traffic jams, and the effects of jet lag.

Feeling SAD

Clinical depression with a seasonal pattern is known as seasonal affective disorder (SAD). SAD often appears in the late fall and can last until early spring.

The disorder is more common in northern climates, correlating with changes in photoperiod during the wintertime. With SAD, a person's limited exposure to natural light impacts body rhythms and neurochemical balance.

SAD affects about 6% of the U.S. population. Even people who do not usually struggle with depression can experience SAD temporarily during winter.

Treatments for SAD may include light therapy, psychotherapy, Vitamin D supplements, and medication.

First holiday after the passing of a loved one

Loneliness

Another contributing factor is the shorter photoperiod in the Northern Hemisphere at holiday time. (See sidebar, “Feeling SAD.”)

No Downtime for Healthcare Professionals

Healthcare is one of the few industries without downtime or a more relaxed pace during the holidays. (Of course, retail is another one.) While everyone else is occupied with caroling, opening gifts, and spending time with loved ones, medical staff are busy caring for patients. In fact, these months are often particularly hectic for them.

Most care providers naturally become even more empathetic to their patients' suffering during the holiday season, resulting in emotional and physical exhaustion. Consequently, caregivers themselves often struggle with the holiday blues.

Coping Strategies

Here are some ideas to help care providers and other holiday workers manage stress during this hectic season.

Plan Ahead Whenever Possible

One of the most challenging aspects of holiday work is missing out on time with friends and family. Whenever possible, plan ahead for holiday gatherings or even arrange alternative days for celebrations.

Are you scheduled to work Christmas Day? With a little planning and coordination, you can organize an alternative time to celebrate. A genuine holiday is whenever you and your favorite people can be together.

Keep It Real

You may feel pressured to be extra cheerful at this time of year, but maintaining a realistic approach to the holidays can help manage expectations.

For instance, remember that the holiday season lasts only weeks within your entire year. When you're feeling overwhelmed by it all, take a few deep breaths and know that "this too will pass."

Does seeing other people's holiday photos cause you to engage in unhealthy self-comparison? Take a break from social media. Seek out winter activities (solo or with others) that aren't associated with the holidays, such as ice skating or skiing.

Finally, it's okay to say "no" if you feel yourself being stretched too thin.

Decorate Your Workspace

Just because you'll be spending the holidays working doesn't mean you can't spruce up your environment with some holiday cheer, even if you're employed in a medical environment. So long as it doesn't interfere with patient care, holiday decorations can help brighten the moods of both staff and patients.

--Article Continues Below--

Limit Overtime

Enticed by the lure of holiday pay and extra shifts, overly ambitious caregivers can become exhausted and then end up scrambling to find a last-minute replacement. The result is more stress for themselves and their colleagues who must fill the shifts.

You may have the best of intentions when picking up overtime or holiday shifts, but remember the gift of your presence (as opposed to your presents) is what your family and friends cherish most.

Enjoy Holiday Perks

Take advantage of any holiday perks your organization provides, such as free meals on Christmas or New Year's. If your employer doesn't offer these perks, you can create your own festivities, such as a staff potluck dinner or a Secret Santa gift exchange.

Take Care of You

Caregivers in particular must take extra measures to remain healthy during the hectic holidays. The additional stress, combined with less sleep and the peak of cold and flu season, makes taking care of you essential. Listen to your body. In addition to staying active, hydrated, and well-rested, take a few moments to center yourself through meditation, prayer, or just a few deep breaths.

Some industries -- such as healthcare -- must operate 24/7, 365 days a year. Working on holidays is often expected. But you needn't miss out on your favorite holiday traditions if you plan ahead. And by keeping realistic expectations, limiting your overtime, and practicing self-care, you can still be a source of holiday cheer for your patients, colleagues, and loved ones.

Sources:

Featured Image: Adobe, License Granted

National Alliance on Mental Illness
GH Resources
Health Partners
Relias

How Rude! Incivility on the Rise

Wed, 08 Nov 2023 19:15:00 GMT

How Rude! Incivility on the Rise

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Is Rudeness the New Epidemic?

"Attention! Our employees have the right to be treated with dignity and respect at all times.
They should be able to do their jobs without being physically or verbally abused. Most people respect this.
Thank you for being one of them."

( Sign posted in Atlanta's Piedmont Hospital)

Healthcare is just one service industry that has witnessed an alarming increase in rude behavior by the people they serve. Consider the following all-too-common incidents:

A retail employee who greeted a customer with “good morning” was told, "I do not need you for anything. Leave me alone. If I need you, I will call you. You are here to serve, not to talk with me."

A restaurant patron berated a waitress to tears because she didn't bring the customer's salad precisely as she ordered it.

A passenger yelled at a car service driver, "What are you waiting for?! Get your act together!” He then shoved his luggage at the driver and stormed out.

In 2022, 68% of nurses reported verbal abuse during the pandemic. The consensus is that these numbers are increasing, even though the public health crisis has abated. Bad behavior toward frontline workers -- regardless of the role or industry -- has become the norm rather than the exception.

Offensive Driving

In 2022, Forbes Advisor surveyed 10,000 licensed drivers, comparing all 50 states for aggressive driving (such as being forced off the road, cut off on purpose, and yelled at, insulted, or threatened).

The top 10 states with the most aggressive drivers were:

1, Arizona

2. Rhode Island

3. West Virginia

4. Virginia

5. Oklahoma

6. Alabama

7. Connecticut

8. Illinois

9. Texas

10. Ohio

Iowa ranked among the top 10 states with the most polite drivers. (See " Is Iowa Nice Real? ")

The 2023 National Consumer Rage Survey revealed that customers are becoming increasingly aggressive in their attempts to solve problems with businesses. For example, 43% of the respondents admitted to raising their voice to show displeasure, compared to 35% in 2015. The survey also found that the percentage of customers seeking revenge against businesses has tripled over the last three years.

What's Behind the Rise in Rudeness?

The increase in incivility reaches across all areas of human interaction. It seems poor behavior is having a moment in our society right now. For instance, violent road rage increased 135% between 2018 and 2022. (See sidebar, "Offensive Driving.”)

Dr. Christine Porath has studied incivility for about two decades, surveying all types of workers worldwide. According to her reports, nearly half of workers polled in 2005 had been treated rudely on the job at least once a month. This figure rose to 55% in 2011 and 62% in 2016.

In 2022, Dr. Porath surveyed more than 2,000 frontline workers across more than 25 industries and found that 76% reported experiencing rudeness at least once a month.

Porath believes that the No. 1 reason for societal incivility is stress. The continually accelerating speed of change and information delivery breeds impatience, resulting in unrealistic expectations of those who serve us. In addition, the pandemic-related transition to remote work reduced face-to-face interaction, resulting in fewer opportunities to develop empathy with one another.

A 2022 University of California study revealed that anxiety, anger, and sadness are the three emotions most strongly associated with increased incivility. According to Dr. Keith Humphreys, a psychiatry professor at Stanford University, people are easily set off by innocuous requests when they are under these stressors.

The Rudeness Contagion

And then there's the contagion factor. In the following video clip, Dr. Porath explains how incivility spreads swiftly throughout communities like a virus.

Responding to Rudeness

But responding appropriately to unabashed rudeness can be challenging, as one medical professional can attest when a patient greeted him with "HEY, A**HOLE!!" as soon as he walked into the ER. "I hadn't even started my shift yet, and he wasn't even my patient," the hospital staffer said.

Rude behavior is sometimes understandable in healthcare settings, where patients are physically and emotionally weakened. On the other hand, it's important to set boundaries. Behaving rudely once can be viewed as a mistake. Doing so repeatedly is a choice.

One way healthcare providers are responding to bad behavior is by adopting policies to help set expectations from the get-go. Hospitals in Boston, Houston, Pittsburgh, and Washington, DC, recently implemented codes of conduct to protect their staff from verbal abuse or disrespect from patients and visitors. More facilities will likely follow suit.

A recommended technique for all service industries is coaching frontline workers on de-escalation tactics and providing scripts for employees to use when responding to incivility. Avoid the temptation to combat rudeness with rudeness. Doing so only perpetuates the cycle of incivility.

--Article Continues Below--

Here are some tips for defusing a tense situation:

Get Them Talking. Customers sometimes raise their voices or act rudely to get your attention. But if you engage them in light, empathetic conversation, they'll know you're listening.

Stay Calm and Don't Argue. Remaining composed during a stressful encounter can help calm the customer or patient. On the other hand, arguing with them can cause the situation to deteriorate to a point where they become aggressive or leave.

Use Positive or Neutral Language. Positive language can change the way the brain responds to stress. So use only positive or neutral words, regardless of the language they use with you.

Apologize Without Admitting Fault. "I'm sorry for the frustration this situation has caused you."

A calm, confident person delivering brief, clear information is the best way to bring these situations back in line. As one physician commented in the Journal of the American Medical Association , being kind but firm is essential when encountering rudeness.

She suggests: 'I care about you as a person, but I will not tolerate offensive behavior. Now let's focus on how I can help you today."

Sources:
Featured Image: Adobe, License Granted
Atlanta Journal-Constitution
Becker's Hospital Review
Relias

Harvard Business Review
American Medical Association
Medjobs

Mastering the Art of Negotiation

Wed, 11 Oct 2023 13:30:00 GMT

Mastering the Art of Negotiation

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Tips to Improve Your Debt-Resolution Skills

Negotiating with people who owe you money, whether patients or other consumers, is not an exact science – it's an art.

You won't find a mathematical formula that works for every scenario. Successful negotiators always create a strategy but don't rigidly adhere to a predetermined plan. Instead, they remain flexible. Here are a few guidelines to consider when negotiating debt repayment with a consumer.

Research, Then Identify

Familiarize yourself with the facts about the account. conduct some internal research to be prepared to discuss the situation completely.

Learn to Recognize Stallers

Can you recognize when a debtor is stalling and has no intention of paying an overdue account balance? Here are some signs to look for:

The consumer ignores phone calls, emails, and letters, or their voicemail greeting claims they're always on vacation. You're being ghosted.

The consumer alleges a minor cost discrepancy in an attempt to hamper the collection process and escape paying the bill.

The consumer deflects blame by claiming they never received the invoice or they already sent payment.

The best strategy for handling stallers is the three-strike rule: If they offer excuses on three or more occasions, send the account to collections.

After researching the account, you'll be in a better position to identify the overdue consumer as one of three types:

Intends to pay
Wants to pay but is not yet able
Does not intend to pay

Listen to Find Out Why

How did this collection situation get out of control in the first place? Sometimes, simply asking the consumer about what went wrong, you'll learn that it's only a temporary problem or that help is on the way.

If so, you could structure a moratorium to help the consumer get through the rough patch before resuming regular payments. By understanding what went wrong in the first place, you can help find the best solution.

Actively listen to the consumers who want to pay you and strive to understand their personal circumstances. Allow them to air any grievances they may have. Doing so will help build trust and optimize your chances for recovery.

Negotiate as Equals

Treating the consumer as an equal will make them far more amenable to working with you. To find some common ground for negotiation, you must establish a level of respect.

Begin by asking the debtor to suggest terms that would work for them. If the proposal is unacceptable, counter the offer by suggesting a substantial down payment followed by monthly payments for the remainder.

For example, suppose the consumer offers to pay $25 monthly to cover a $500 debt, but your company's guidelines would consider such an offer unsatisfactory. In that case, it's up to you to turn the proposal into an acceptable arrangement.

You could offer to accept $50 monthly over six months if the consumer makes a $200 good-faith payment now. The consumer may either accept your offer or counter with payments of $40 per month instead. Either way, the negotiation is now moving in the right direction. Always work toward higher payments over a shorter term, but remain flexible.

Confirm and Finalize

Once you reach an agreement with the consumer, committing the terms to a written contract signed by both parties improves your chances of successful debt resolution.

After the consumer has remitted the first payment, end the conversation on a positive note. Reassure them that the payment arrangement places their account back in good standing with your organization.

At the same time, you also want to clarify the ramifications of failing to abide by the agreement. Tell them their account will be referred to collections if they breach the terms. This is your trump card -- one you must adhere to, no matter what relationship you have developed with the debtor.

--Article Continues Below--

Send in the Pros

If you've reached a stalemate in your negotiations with a past-due customer or patient, it's time to call in the professionals.

At CBSI, our collection professionals are skilled negotiators. Working within your organization's approved parameters, we maximize debt recovery by employing preparation, empathy, and creative problem-solving techniques. Contact us .

Sources:
Featured Image: Adobe, License Granted
Forbes
PDC Flow

The Exercise Prescription

Wed, 06 Sep 2023 13:00:00 GMT

The Exercise Prescription

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Is Physical Activity the Best
Medical Treatment After All?

Lucas Carr is on a mission to improve the health of Iowans through exercise.

“There is no medicine in existence that has all the benefits of this one thing,” Carr said. The associate professor of Health and Human Physiology at the University of Iowa is chair of UI’s Exercise Is Medicine® (EIM) program.

Exercise as Medicine

First launched in 2007, EIM is a global health initiative designed to increase awareness about the health benefits of physical activity and integrate exercise into the healthcare system.

Primary care doctor Robert Sallis, MD, chairs the national Exercise Is Medicine initiative. He’s “underwhelmed” by the medical status quo, and he believes doctors can help many more of their patients by simply following this three-step protocol:

Ask about exercise at every appointment.

Treat physical activity as a vital sign and make a note of it.

Prescribe exercise as a fundamental part of every treatment plan.

How the States
Stack Up

Insurance analysts at Quote Wizard recently rated all 50 states for physical activity levels based on the CDC’s Behavioral Risk Factor Surveillance System (BRFSS) data. Here’s what they found:

Colorado, Utah, and Washington are the most physically active states.

Alabama, Mississippi, and Arkansas are the least physically active states .

Iowa was the 31st most physically active state.

Twenty-four states showed a decline in physical activity over the last three years.

Since 2020, physical activity increased the most in New Jersey and decreased the most in Maine.

Click here to view the complete rating list.

Specifics are important for Dr. Cate Collings, president of the American College of Lifestyle Medicine. She recommends that physicians provide patients with an exercise prescription that spells out precisely what to do, for how long, and how often. Practitioners must specifically tailor prescriptions to treat the patient's condition.

Locally, Professor Carr is working to ensure that Iowa healthcare providers are on board. He’s got his work cut out for him.

Why Doctors Don’t Prescribe Exercise

Recent studies revealed that American doctors recommend physical activity to only one-third of their patients with high blood pressure and 18% of those with diabetes.

Research published in the Medical Journal of Australia identified two key barriers to prescribing exercise:

Lack of medical school training and
The doctors’ own level of physical activity.

The first obstacle may finally be changing as medical schools and residency programs begin to include training on exercise and other healthy behaviors in their core curricula.

According to a recent Wall Street Journal article , the universities that now incorporate "lifestyle medicine" into their training programs include Brown, Harvard, Stanford, the University of Oklahoma, historically Black colleges and universities, and schools of osteopathic medicine.

Student interest groups are active at more than 100 U.S. campuses, and more than 200 residency programs include a lifestyle-medicine curriculum.

Walk With a Doc

But prescribing exercise does not guarantee the patient will follow through.

Cardiologist David Sabgir of Columbus, Ohio, was frustrated with his patients’ reluctance to take that first step. So in 2004, he started walking with them. A year later, he launched Walk With a Doc , a nonprofit organization that pairs patients with doctors for walks. Today WWAD has chapters in 34 countries and hosts 130,000 walks per year.

In addition to the exercise benefits, Sabgir credits the effort’s success to group bonding and spending time outdoors.

--Article Continues Below--

More Than Exercise Needed for Weight Loss

However, if the main reason for starting an exercise regimen is merely to lose weight, most patients will be disappointed.

Most studies indicate moderate aerobic exercise without a change in dietary habits typically produces little or no weight loss. In fact, to achieve any meaningful weight loss through exercise alone, study participants had to burn a minimum of 400 calories per session five or more days per week.

That correlates to 90 minutes per day of brisk walking -- or 30 minutes of running eight-minute miles -- for a 150-pound person. Exercisers who can achieve that level of physical activity are often dismayed to discover that their bodies compensate by boosting their appetite and dialing down their metabolism.

The Fountain
of Youth?

A new study published in the Journal of Physiology suggests that exercise may reverse the effects of aging by helping to reprogram cells. Researchers who analyzed genes within the muscle fibers of aged mice found evidence of cell rejuvenation following exercise.

“Exercise is the most powerful drug we have,” said Kevin Murach, assistant professor at the University of Arkansas and one of the study’s authors.

Of course, the benefits of physical activity extend well beyond weight loss. And while moderate exercise may not melt away the pounds, it can prevent weight gain and increase muscle mass.

How to Get Involved

If you’re a healthcare provider interested in helping your patients become more active, EIM provides resources to get you started:

The EIM Summary Sheet offers a quick overview of Exercise is Medicine® and recommended physical activity guidelines.

EIM's Health Care Providers' Action Guide is a step-by-step tool to help providers integrate physical activity into their medical practices.

A series of patient handouts, Rx for Health, is tailored toward sedentary patients of all ages and those with various medical conditions.

Professor Carr hopes to get all Iowa care providers on board.

“A lot of times, it’s a matter of convincing hospital administrators that this is an important thing that we should be doing for every patient at every visit,” Carr said.

Sources:
Featured Image: Adobe, License Granted
University of Iowa
The Gazette
Medical Journal of Australia
Time
Journal of Physiology

How Professional Collectors Resolve Medical Debt Disputes

Wed, 09 Aug 2023 22:30:00 GMT

How Professional Collectors Resolve Consumer Debt Disputes

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Dispute Resolution
Requires Skill and Empathy

What should you do when a consumer disputes a debt? Should you allow a collection agency to handle the dispute or attempt to resolve it internally?

Some situations are best left to the professionals. Here's why: Reputable collection firms not only budget the time required to handle disputes, but they also extensively train their staff in best practices for dispute resolution.

Let's look at how professional debt collectors handle disputed accounts.

Walk a Mile in Their Shoes

A reputable collection agency will err on the side of caution and take all potential disputes seriously. They'll place themselves in the consumer's shoes and treat them as they would want to be treated. And they'll treat all situations equally, even with little or no information.

Most agencies do not differentiate between written and verbal disputes. Therefore, to avoid the potential for legal issues, the best collectors will identify all types of consumer objections as "disputes." Doing so ensures that these situations are adequately addressed right from the start.

The infographic below illustrates the process consumers are advised to follow if they receive a call about a debt they do not recognize:

Resolution Process

Any disputed account, whether past due or not, requires the debt collector to obtain proper documentation from the client. This extra information is critical to helping the collection agent determine the dispute's legitimacy.

For instance, it's important to provide the collector with a copy of the bill when the account is placed. Doing so helps avoid confusion with the consumer and significantly speeds up the dispute process.

Whenever a collector and consumer can review the bill together over the phone, they can often clear up any confusion. Simply explaining the bill's details may be all that's required to resolve a debt.

If the disputed account is significantly past due and has already been placed in "collections," the agent should first confirm that the consumer received a Debt Validation Letter. (See sidebar, "About the Debt Validation Letter.”)

If the consumer's mailing address is incorrect, they may not have received this important notice within the specified validation period. If the consumer claims they never received the validation letter, a reputable collector will give the consumer the benefit of the doubt. This simple good-faith gesture can make the consumer more amenable to resolving the debt. The collector will then authorize the issue of a debt verification letter pursuant to Fair Debt Collection Practices Act (FDCPA) regulations.

When attempting to resolve the dispute, the collector must ask questions and listen attentively to find a solution. If communication with the consumer is clear and open, it's easier for the collector to pinpoint the issue that requires resolution.

From there, the collector can review alternatives based on common ground, and propose solutions. After the collector and the consumer agree upon a solution, both parties should commit to a resolution deadline.

About the
Debt Validation Letter

The Debt Validation Letter must be sent within five (5) days of initiating contact with a consumer about his debt. With the adoption of Regulation F in November 2021, the Debt Validation Letter must now include the following information:

The total amount owed.

The name of the original creditor.

A statement indicating that the collector assumes the debt to be valid unless the consumer disputes it before the expiration date specified in the letter (30 days after first contact).

A statement indicating that the collector will verify the debt by mail if the consumer writes to dispute the debt or request more information before the 30-day expiration date specified in the letter.

A statement indicating that the collector will provide the consumer with information about the original creditor if the consumer requests it prior to the 30-day expiration date specified in the letter.

A statement indicating that the debtor may find additional information about consumer protections on the CFPB's website, and the website address must be included.

Source: Consumer Financial Protection Bureau

Client Communication

Reputable collection agencies will work directly with the client to resolve the dispute. Apprising creditors of a collection dispute as it unfolds can help them avoid similar situations and make collecting on future accounts easier for everyone.

Sources:

Featured Image: Adobe, License Granted
PDC Flow

Credit Guru

Employers to Staff: “We Need You Back in the Office”

Mon, 17 Jul 2023 13:11:05 GMT

Employers to Staff: “We Need You Back in the Office”

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Gentle Approach,
Hybrid Models
Help Lure Workers Back

With the lifting of COVID restrictions, American employers are eager for employees to leave their Zoom meetings behind and return to the workplace. But is that a realistic expectation?

Many companies are taking the bull by the horns and mandating that workers return to the office at least part-time. (See sidebar, "Companies Mandating Return to Workplace.”) Last November, Elon Musk began requiring staff at Twitter and Tesla to return to the workplace for at least 40 hours per week, or consider their “resignations accepted.”

Other firms, such as RCM giant Access Healthcare, are taking a more gentle approach. (See "Making It Work" below.) A study by workplace design firm Unispace reveals that 72% of all surveyed companies have some sort of return-to-work mandate. Most employers believe that corporate culture, collaboration, and innovation suffer when staff members are not gathered together in an office environment.

Companies Mandating

Return to Workplace

Here are some of the major U.S. companies now requiring their staffers to return to the workplace at least part-time:

Amazon – Employees must spend at least three days per week in the office.

Disney – Employees must work from offices four days a week.

JP Morgan – Half of all employees, including all executives, must work from the office five days per week. The rest must work from the office several days per week.

Starbucks – Employees within commuting distance are required to return to the office at least three days a week.

Uber – Employees in 35 of the company's locations must work from the office at least half of the time.

Source: Business Insider

Making It Work

But bringing employees back into the workplace after two years of working remotely is a challenge. Much has changed in the interim.

So when Access Healthcare wanted 9,000 employees in their various India locations to return to the office, the company carefully designed a strategy to encourage them. Instead of forcing the workers back with threats of termination, they projected the return as a collaborative effort to improve productivity.

"The entire process of bringing people back to work was very gradual," said Jacob Jesuroon, Senior Vice President of Human Resources. "We didn't position the office as a place of work, but we positioned the office as a place where people can collaborate."

Once Access Healthcare employees began returning to the worksite to collaborate, the next step was engagement. The company spread the word on social media, where employees could see their friends returning to the office, helping them develop trust in returning, too.

Many of the company's staff members had moved back to their hometowns two years ago so they could work remotely when the pandemic began. So now they had financial concerns about moving back to the city.

The company opted to ease the transition by arranging accommodations for these employees. They also developed a mobile app for administrative support and provided back-to-work counseling which included COVID safety training to alleviate health anxiety.

On the Clinical Side

For America's clinical workers, the pandemic exacerbated pre-existing financial stress, burnout, and mental health challenges. The result was nearly 334,000 medical staffers quit in 2021 alone.

Providers are now working hard to lure them back. They're offering better pay and work flexibility. Hospitals are implementing new safety measures and mental health resources to help clinicians cope with the daily stresses of their jobs. Some medical facilities are also hiring more support staff to take some work off these employees' already-full plates.

New Workers Benefit Most

Employment experts at Scoop Technologies believe returning to the worksite particularly benefits new employees, especially Generation Zers and younger Millennials. These workers must learn the ropes and be able to communicate with more established employees if they are to assimilate and truly understand the company's culture.

According to a 2023 study by the Greater Des Moines Partnership , workers in central Iowa understand the importance of workplace collaboration, training, and development. The study was based on a survey of more than 2,000 employees from 20 Des Moines-area organizations representing various industries.

Jenae Sikkink, Senior Vice President for the Partnership, noted that "young workers [in their 20s] understand the importance of being together. They're focused on culture, relationship building, and learning from others."

--Article Continues Below--

Remaining Flexible

But is it reasonable to expect employees to return to the workplace full-time after experiencing two years of working remotely?

According to the Des Moines study, workers want flexibility above everything else. Employees surveyed want to work from home 60% of the time and 40% from the office. Conversely, employers want their employees in the office 60% of the time and working remotely 40% of the time.

Requiring staff to work onsite every day could backfire, causing employees to seek more flexible job opportunities. As a result, many firms are adopting a "structured hybrid" work model, which sets specific expectations on when employees will work from the office.

Those expectations can vary, such as requiring a minimum number of days onsite, requiring specific days, or requiring a minimum percentage of time employees must be in the office. Of those options, requiring employees to come into the office a minimum number of days each week is the most popular. About 66% of large companies (with 50,000 or more employees) are adopting structured hybrid work and dramatically shifting away from fully remote work situations.

A Truce?

Some workforce development experts regard hybrid work policies as a kind of "truce" between bosses and their workers. Clearly, jobholders still value the workplace, but it must evolve to meet their needs. Prudent employers will work to balance in-office demands with the work flexibility employees will not easily relinquish.

Sources:
Featured Image: Adobe, License Granted
Fortune

Economic Times

Business Record

NPR

Providing Multi-Generational Healthcare

Wed, 07 Jun 2023 13:45:00 GMT

Providing Multi-Generational Healthcare

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Generational Differences Matter When
Engaging Patients

Just as each generation of patients expresses unique preferences for music and fashion, different generations seek different experiences in healthcare. Practitioners must understand these generational variations if they are to provide the most effective care.

Let's explore the preferences for each demographic group, as well as the best ways to engage them.

Generation Z

Birth Years: 1997 to 2012

Gen Zers were born into the hyper-connected world of social media and texting. They practically live on their mobile devices, and most have regular access to at least five screens (smartphone, TV, laptop, desktop, and iPad).

This young age group is the most racially diverse generation to date. They’re concerned about stress and often rank their mental health as poor. But they are unlikely to visit the doctor because of the cost, inconvenience, and lack of time. Instead, they’ll seek alternatives, such as wearable devices or supplements.

Of all the generations, Zers are the most likely to take preventative care into their own hands.

How to Engage Them

Generation Zers are looking to technology for healthcare engagement. They want:

Iowa's Shifting Demographics

Iowa’s median age has increased from 30 years old in 1980 to 38.3 years old in 2020, and 17.7% of Iowa’s population is older than 65 – the eighth-highest percent in the U.S. This number is expected to continue to grow as more as more Baby Boomers reach this milestone.

At the same time, 40% of the state’s forecasted 2045 population will be younger than 30. Millennials currently account for the majority of Iowa’s population, followed by Baby Boomers.

The figure below indicates Iowa’s estimated population by age for 1985, 2015, and 2045:

Sources: Iowa Dept of Transportation , U.S. Census

Telemedicine
Online scheduling and payment options
Wearable devices
Easy access to health data

To effectively engage this cohort of patients, you need more than just a website; you need a solid online presence. Adopting best SEO practices and creating a Google Business profile will display your site more prominently on search results. Integrating online scheduling and payment options will also boost your online presence and improve the patient experience.

For Gen Zers, convenience is king. A dedicated patient app allows them to perform simple tasks, such as viewing lab results, requesting prescription refills, or paying bills without a phone call or office visit. If your practice does not offer telemedicine, you’re missing out on an excellent opportunity to attract young patients without increasing overhead.

Millennials

Birth Years: 1981 to 1996

Millennials are the largest adult generation, partly due to the increase in young immigrants. However, they’re also the lowest users of traditional healthcare.

Like Gen Zers, Millennials want digital options in healthcare. They’re entirely comfortable with mobile devices, but about a third prefer the computer for online transactions. They typically maintain multiple social media accounts.

In addition to easy access to medical records and online scheduling, Millennials want the option of online chats with medical professionals. They also tend to make healthcare decisions based on emotional experiences.

As a result, a single negative experience will likely cause them to switch providers. They have high regard for peer input and current patient testimonials. They’re looking for deep, genuine connections with their doctors.

How to Engage Them

As with Gen Zers, engaging Millennial patients requires that healthcare professionals immerse themselves in digital technologies. Telemedicine, online payment and scheduling options, social media chats, and various mobile apps must be employed when facilitating patient-provider interactions.

Social media is vital to engaging this cohort of patients. Most social media apps offer instant messaging services so you can engage your patients in real-time. They also allow you to tailor your content to this demographic, providing immediate answers to prospective patients’ questions.

In this way, social media helps create brand awareness and forge a bond between your practice and your patients or potential patients.

Generation X

Birth Years: 1965 to 1979/1980

Generation X patients make frequent trips to the doctor – for themselves, their children, and their aging parents. When it comes to selecting healthcare providers, 75% of Gen X'ers are the primary decision-makers. However, compared to Baby Boomers and the Silent Generation, Gen X'ers report the highest dissatisfaction rate.

X'ers are digitally savvy, but they’re looking for personalization and compassion with each encounter – not just convenience. Trust is of paramount importance to them. They generally trust their individual providers, but not medical establishments per se.

Generation X tends to highly trust a health system’s website or direct mail marketing and this group is comfortable with traditional media (TV, radio, newspapers) providing healthcare information. They are not as trustful of social media, however.

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--Article Continues Below--

How to Engage Them

When making healthcare decisions, Generation X patients rely on various sources of information and carefully analyze all their options. As the most highly educated demographic, they want intelligent content and meaningful communications. You can appeal to them through an engaging website, as well as direct marketing and other traditional media outlets.

Many Gen Xers work full-time, comprising 33% of the U.S. workforce. So they seek convenience and ease of scheduling appointments for in-office visits. Extra appointment time options, such as evening and weekend hours, would be an important step toward satisfying this patient group.

Baby Boomers

Birth Years: 1946 to 1964

This aging demographic relies on healthcare providers often for existing and developing conditions. Almost 40% of Baby Boomer patients visit their doctors three to six times yearly, and 22% see the doctor seven or more times per year.

Boomers are interested in high-quality, individualized care. They tend to ask many health-related questions and research health topics online. Perhaps surprisingly, they often utilize patient portals to communicate with their providers.

Baby Boomers are more loyal to their healthcare provider than younger age groups are. They’re inclined to maintain physician loyalty as long as they receive quality care and coverage. They value practices with strong positive reputations because word-of-mouth recommendations are important to them.

Unlike the younger generations, Boomers are likely to follow health advice and care instructions from a physician they trust.

How to Engage Them

When engaging Boomer patients, balancing traditional and digital media is essential. While many still embrace television and print media (34% read at least one magazine daily), most patients are also active online.

Many seniors still prefer paper communications for billing statements, event invitations, and information about new procedures. Concerning appointment reminders, some Boomers want a person-to-person phone call, while others prefer a text – as long as the message is personalized.

The Silent Generation

Birth Years: 1929 to 1945

Silent Generation patients are the most frequent users of the healthcare system. Like Baby Boomers, they rely on their doctors’ advice. They are the most likely of all to follow doctors’ orders to the letter. They respect medical authority and firmly believe in good service. They seek credible health professionals and won’t trust just any expert.

The Silent Generation holds static views that are not likely to change. They stick to traditional health advice. They’re inclined to be uncomfortable with the technological shift within the health industry.

How to Engage Them

Because these patients depend heavily on their physicians’ opinions, providers must keep all instructions clear and explicit. This may require teaching them how to access the patient portal or enlisting a family member to help.

Engaging this patient demographic also means ensuring they’re properly cared for between office visits. Work to understand their living situations and support systems. Then, help them become more comfortable with healthcare technology while still delivering the quality of personal service they associate with traditional care.

Sources:
Featured Image: Adobe, License Granted
Patient Engagement Hit
Nebraska Health Network
Etactics
Meditab
Mercury Healthcare

Health Anxiety in an Anxious World

Wed, 10 May 2023 19:45:00 GMT

Health Anxiety in an Anxious World

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Anxiety Disorder Worsened by
COVID, Computers

Doris spends every free moment googling various diseases and their symptoms. She devotes hours to online searches, even staying up all night, terrified about what she might discover.

Evan focuses intently on every bodily sensation, continually scanning for signs of illness. His anxiety keeps him from leaving the house.

Trudy has just received a clean bill of health from her doctor. While attempting to fall asleep that night, her mind drifted back to something he said: “Tumors can form at any time.” Ridden with anxiety, she climbs out of bed and begins researching brain cancer. Within an hour, she’s convinced she has it.

None of these patients have ever been diagnosed with a serious illness, yet their suffering is very real. Their common disorder is health anxiety, the preferred term for what used to be called “hypochondria.” They obsessively and irrationally worry about having a serious medical condition. In a sense, these patients are being held hostage by their own bodies.

"I Got That”

Health/illness anxiety is relatively common, affecting some 4% to 5% of the population. But experts suspect the disorder is underreported; the actual figure may be closer to 12% — or even twice that amount.

The condition can be debilitating, leaving its victims unable to function or enjoy life. They obsess over normal bodily functions such as breathing and heartbeat, skin blemishes and other physical irregularities, and any bodily discomfort. They misinterpret normal or benign symptoms as something far more severe.

Or they may display no symptoms at all – until they hear about a specific disease or affliction. These patients may repeatedly pursue medical exams and procedures for reassurance. But they're less likely to seek mental health treatment because they're convinced their symptoms are physically based.

What Is Cyberchondria?

The term “cyberchondria” was coined in the mid-1990s by the British press. It refers to a clinical phenomenon of compulsive online health searches that worsen anxiety or distress.

Cyberchondria is strongly correlated with symptoms of health anxiety, although whether this disorder poses a unique public burden remains unclear. According to researchers at Imperial College London, the condition is leading to a health anxiety epidemic in the United Kingdom.

Source: Comprehensive Psychiatry

A doctor's reassurance provides only temporary relief, then new thoughts and physical sensations emerge, and the cycle repeats itself. It's like having a car alarm go off whenever a pedestrian walks by.

Health anxiety occurs on a spectrum; general anxiety can quickly develop into a full-blown psychosomatic illness. When patients are preoccupied with bodily sensations, those sensations intensify and last longer.

As they imagine the worst, their bodies’ internal alarms create anxiety symptoms: racing heart, difficulty breathing, jitters, lightheadedness, nausea, sweating, headaches. These symptoms then fuel their imaginations, worsening the situation. The thoughts may be false, but the symptoms are real.

Along Comes COVID

For patients already susceptible to illness anxiety, the COVID pandemic threw gasoline on the fire.

Compared to past disease outbreaks, health researchers noted some unique features that made the pandemic particularly troubling for these anxiety sufferers:

The highly transmissible and fatal nature of the virus.

The protocols for self-monitoring, hand and surface sanitization, and social disruption.

The fact that some COVID symptoms, such as shortness of breath, mimic anxiety.

The isolation factor compounded the problem, as homebound sufferers were stripped of their usual coping strategies. In addition, the inescapable news coverage and limitless reports exacerbated pandemic anxiety, as individuals sought out more and more online information.

As the global emergency diminishes, many health officials have declared a shift from pandemic to endemic . But for health anxiety sufferers, it really doesn’t matter.

Physician Guidelines

George Washington University clinical psychologist Dr. Lynne S. Gots offers the following tips for primary care physicians when treating patients with health anxiety:

--Article Continues Below--

Use patient-centered interviewing techniques by asking open-ended questions. Allowing the patient an extra two to three minutes to express his concerns will help build trust with a demographic that is often very mistrustful of doctors.

Schedule longer visits with a health anxiety sufferer. This additional office time will result in fewer calls and emails between appointments.

Schedule follow-up appointments on an agreed-upon timetable. A patient with health anxiety might initially need to visit your office once every four or six weeks to address their concerns. Eventually, as the patient becomes better able to tolerate waiting, the frequency of office visits can decrease.

Order diagnostic procedures and specialist referrals only when clinically indicated. Health anxiety can consume medical resources unnecessarily, even leading to complications from invasive procedures. If the patient’s doubts about a condition persist, ask him to return for a follow-up in one month.

Clearly explain why you think a symptom does not warrant concern. When a patient suffering from health anxiety googles “headache,” he fixates on “brain tumor,” not “eyestrain” as a potential cause.

Speak with the patient in person when discussing test results or medication. It’s better not to rely on other staff or an online patient portal to communicate this information to someone with health anxiety.

Always take the patient’s concerns seriously. Serious illnesses do occur in patients with health anxiety.

Once you've ruled out physical illness, it's time to employ some Cognitive Behavioral Therapy (CBT). CBT has proven to be the most effective treatment for health-related anxiety.

The following video clip demonstrates simple CBT strategies for managing a patient with high health anxiety levels:

The Center for Integrated Healthcare offers additional tips for referring anxiety patients to mental and behavioral health professionals.

Sources:
Featured Image: Adobe, License Granted
Anxiety & Depression Association of America
WebMD Health News
ABC Radio National
Harvard Medical School
KevinMD.com

The New Opioid Crisis: Counterfeit Pills

Wed, 05 Apr 2023 13:30:00 GMT

The New Opioid Crisis: Counterfeit Pills

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“Fentapills” Fueling Surge in
Overdose Deaths

In July 2021, 17-year-old Sebastian Kidd was preparing for soccer season and his senior year at Carlisle High School In Des Moines.

Having sustained past injuries, including several concussions and a broken collar bone, Sebastian was self-medicating with oxycodone. He took half a pill on July 29th to help him sleep.

He never woke up.

Unbeknownst to Sebastian, the pill was a counterfeit, laced with a lethal dose of fentanyl.

Unfortunately, this tragic story -- every parent’s worst nightmare – is repeated daily across Iowa. Statewide drug overdose deaths climbed more than 25 percent between 2019 and 2021, according to the Iowa Department of Public Health (IDPH). Opioid use alone claimed the lives of 258 Iowans in 2021 and just slightly fewer (238) in 2022.

Fueled by Fentanyl

According to Gabbie Ruggiero, opioid response coordinator for the non-profit Employee and Family Resources, this tragedy is fueled by the proliferation of fentanyl. “In 2021, for the first time, fentanyl in opioids were [sic] causing more deaths than meth[amphetamine],” Ruggiero said. Like Sebastian Kidd, young Iowans are purchasing “fentapills” -- drugs disguised as Xanax or Percocet that are, in fact, illicitly manufactured fentanyl pressed into pill form.

--Article Continues Below--

IDPH estimates that the number of fentanyl-related deaths jumped from 31 percent of all drug overdoses in 2016 to 87 percent of these deaths in 2021. This statewide increase corresponded with a national crisis in fentanyl overdose.

“We’re dealing with a different disease now than we were in 2018. In 2018, it was diversion of legitimate prescriptions. Now, it’s fentanyl poisoning or fentanyl murder.” - Rep. Michael Burgess, M.D. (R-TX)

In September 2021, the Drug Enforcement Administration (DEA) warned Americans about a nationwide surge in fentanyl-laced counterfeit pills, mass-produced by criminal drug networks, killing unsuspecting victims. In May 2022, the CDC reported 71,238 fentanyl-related deaths in 2021.

Saved by Naloxone

The synthetic drug naloxone (often known by the brand name Narcan ^® ) blocks opiate receptors in the nervous system and temporarily reverses the effects of an opioid overdose.

Naloxone typically restores the victim’s normal breathing within two to three minutes. A Penn State University study has shown that naloxone administration saves the lives of more than 75 percent of opioid overdose victims.

Since 2016 Iowa pharmacists have been allowed to dispense naloxone without a prescription. This life-saving medication can be administered by anyone and is available as a nasal spray or injection. Access to free naloxone is available through Naloxone Iowa .

Governor’s Response to Fentanyl Crisis

Iowa Gov. Kim Reynolds has proposed the following changes to combat the state’s fentanyl crisis:

Increasing penalties for the manufacture or delivery of fentanyl, including more serious charges, longer sentences, and higher fines against individuals with smaller amounts of the drug.

Doubling or tripling sentences for fentanyl crimes involving minors or resulting in death or serious injury.

Expanding distribution of naloxone (to reverse opioid overdose) to include all law enforcement agencies, EMS programs, fire departments, school districts, licensed healthcare providers, county health departments and the IDPH.

Source: Office of the Governor of Iowa

What Healthcare Providers Can Do

As a healthcare provider, you may wonder what you can do to protect your patients from this newest opioid crisis. Here are a few suggestions:

Talk to your patients about the changing illicit drug supply and risks associated with fentanyl-laced counterfeit pills.

Prescribe naloxone to patients with opioid use disorder (OUD) and individuals who use illicit drugs.

Co-prescribe naloxone to patients receiving opioids and benzodiazepines.

Consider shifting to a value-based care payment model. This can improve access to care for patients suffering from OUD, reducing the risk that these patients will seek illegitimate sources of medication.

Share the following video with your families, staff and school districts:

Sources:
Featured Image: Adobe, License Granted

NBC News
CDC Health Advisory
Iowa Dept of Public Health
El Paso Times

Is “Iowa Nice” Real?

Wed, 15 Mar 2023 14:00:01 GMT

Is “Iowa Nice” Real?

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Why Iowans Are Some of
the Nicest People

From an early age, Iowans are taught to be nice and to mind their manners -- not to mention their moms, scoutmasters, and 4-H leaders.

People from other states have noticed how nice Iowans are. Sometimes, they’re baffled by it. Truckers have said that Iowa drivers are much more likely to slow down and make room for them.

We Think We’re Nice, Too

Not only do folks from other states think we’re remarkably nice, but we think so, too. According to a 2021 Des Moines Register poll , 58% of Iowans think the residents of our state are nicer than people from other states. Another sizable group (36%) sees no difference between Iowans and other folks, but only 4% think Iowans are rude.

Poll respondents who consider Iowans especially nice represent every demographic of age, race, income level, and political affiliation. Most urban, suburban, small-town, and rural communities stated that Iowa has more than its share of nice people.

But why?

Country Charm

One explanation for Iowan’s niceness could be the state’s high percentage of rural residents compared to other states, since country folks are generally regarded as the most neighborly.

A recent Pew Research Center poll found that rural residents are more likely to know all or most of their neighbo rs. What’s more, they’re also more likely to trust their neighbors (such as by providing neighbors with a set of keys to their home).

More than Affordable

Forbes recently included Iowa among its Cheapest States to Live in for 2023 . That could help account for Iowans’ niceness.

The study considered each state's cost-of-living index, average salaries, and housing availability.

The Forbes researchers found Iowa housing costs 24% below the national average. And unlike most other states that made the list, Iowa was singled out as relatively prosperous, with a strong economy and a poverty rate lower than the national average.

Low-Pressure Zone

Not only is Iowa listed among the top states for affordability, low crime and quality of life, but our urban areas are more relaxed than those in other states. In 2016, Iowa City was named the "Least-Stressed City in America." Both Des Moines and Cedar Rapids were also recently listed among the country’s most stress-free cities.

A 2022 WalletHub study rated Iowa among the top 20 Happiest States In America . Perhaps a low-stress environme nt contributes to Iowans’ overall happiness, which in turn makes them nicer? There’s data to back up this idea.

Who Is the
Average Iowan?

According to government statistics, the “average” Iowa resident is a 38-year-old Caucasian female.

She is married with one child, and her annual household income is $65,429. She graduated from high school and probably attended college but did not complete her degree.

She and her family reside in their own home, valued at $193,341. She works in education or healthcare, and her daily commute is about 20 minutes.

Source: U.S. Census

If You’re Happy and You Know It…

Researchers in Great Britain have identified a type of “positive feedback loop” between kindness and happiness. Study participants who engaged in a single kind deed were found to be happier than those who did not.

They were also more likely to perform another act of kindness. In other words, kindness makes us happy, and happiness makes us kind.

At CBSI, We’re Iowa Nice

As “The Collection Agency That Cares,” we at CBSI pride ourselves on being Iowa nice. It’s the embodiment of who we are.

Our fair, compassionate approach to debt collection works -- our recovery rate is double the industry average. We treat our clients and their consumers as we want to be treated: with kindness, respect and empathy.

When you retain CBSI as your collection partner, you’ll receive a higher rate of return on overdue debts, your good name will remain intact, and your customers will be happier for having resolved their financial obligations.

What could be nicer than that?

Sources:

Featured Image: Adobe, License Granted

Des Moines Register

Pew Research Center

Scholaroo

Journal of Social Psychology

WalletHub

The Fat of the Land: Iowa Obesity a Growing Concern

Wed, 08 Feb 2023 19:00:00 GMT

The Fat of the Land: Iowa Obesity a Growing Concern

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Primary Care Doctors Are Key to
Effective Treatment

More than one-third of Iowa’s adult population is obese – 36.4 percent, to be exact, according to the latest CDC * figures. We’re now the 11th most obese state in the country.

An additional 34.3 percent of Iowans are overweight but not obese. In other words, only 29.1 percent of our state’s adult residents are within a normal weight range.

Nationwide, obesity climbed sharply during the last decade, but the highest increases occurred in only a handful of states -- including Iowa, where the rate jumped more than eight percentage points.

* The CDC collects obesity data from two different sources. State obesity figures (reported here) are based on self-reported data from the Behavioral Risk Factor Surveillance System (BRFSS). National obesity figures use National Health and Nutrition Examination Survey (NHANES) data based on measurements taken during physical examinations. As a result, the national figures are higher and considered more accurate.

Why Here?

Obesity is a complex disease, encompassing biological, psychological and environmental factors. Even so, research indicates that too many calories and too little physical activity are most often the primary culprits. Americans as a whole consumed 20 percent more calories in 2020 than they did in 1983.

Here are some of the other factors that likely contribute to Iowa’s particularly high rating:

Rural Population

Our state’s population is still about 36 percent rural – more than double the national average. Rural areas experience higher obesity rates than the nation as a whole. These less populated communities often lack facilities and infrastructure to encourage physical activity, as well as access to affordable, healthful food. (See "Food Insecurity" below.)

And healthcare facilities located in rural areas are less likely to employ nutritionists and other weight management experts.

Food Insecurity

Almost half of the Iowans who experience food insecurity are obese. While that may appear contradictory on the surface, these residents are typically "overfed but undernourished," according to Dr. Nicole Gilg Gachiani, former chief physician at Broadlawns Medical Center in Des Moines.

Obesity Figures
at a Glance

Here's how the latest Iowa obesity statistics compare with extrapolated national data:

Many of them rely on food banks and pantries where much of the donated food is high in carbohydrates and fats but low in protein and other vital nutrients.

Prevalence of Fast Food

Iowa is among the top 10 states in the country with the most fast-food restaurants per capita (4.7 per 10,000 residents). Busy executives, college students, and hectic families often rely on fast food because of its convenience. Journalist and food researcher Michael Pollen estimates that 20 percent of American meals are eaten in cars.

But this convenience comes with a price tag. The World Health Organization has identified a definite correlation between increased fast-food sales and higher body mass index (BMI) within a community.

Social Contagion

Then there's the social contagion factor. Research confirms that counties with a high obesity rate tend to perpetuate obesity via “social contagion.”

A 2018 USC study illustrated this phenomenon. By examining military families (who relocate frequently).

The researchers found that families assigned to installations in counties with higher obesity rates were about 25 percent more likely to become obese or overweight than those assigned to areas with lower obesity. They concluded that unhealthful eating, sedentary lifestyles, and being overweight are more socially acceptable in communities where obesity is common.

All the above factors combine to create an ideal environment for obesity to flourish. According to Rhea Farberman, policy research director at Trust for America’s Health , Iowa's obesity rate is at "crisis level."

What's Being Done?

Iowa officials have developed several programs over the years in an effort to curb the state’s obesity issue. Here are two of the most current initiatives:

--Article Continues Below--

Iowa Stops Hunger

Public and private organizations joined forces last fall and created the Iowa Stops Hunger Coalition to address food insecurity across the state. Insurers and healthcare providers are coordinating with nutrition partners to provide healthful food, nutrition education, and support in eight counties that Iowa HHS has identified as lacking reliable access to affordable, nutritious food.

Iowa Medicaid administers the coalition’s pilot program, which specifically targets mothers with young children residing in food-insecure areas.

Physician, Heal Thyself

Doctors are not immune from the obesity epidemic. A Johns Hopkins survey found that 51 percent of primary care physicians are obese or overweight.

Additional studies have shown that obese patients are less likely to accept nutrition advice from an overweight physician, and overweight physicians are less likely to offer it.

The Association of American Family Physicians (AAFP) recommends the following for overweight primary care doctors:

Regularly visit your own physician and adopt a healthier lifestyle.

Share your personal weight goals and achievements with your obese patients.

Create an office environment that promotes healthy lifestyles (e.g., include healthful food options in vending machines and initiate lunchtime walking programs).

5-2-1-0 Healthy Choices Count !

Fifteen Iowa counties recently received $265,000 in government grants through the state’s 5-2-1-0 Healthy Choices Count! program, an obesity prevention initiative launched in 2017 aimed at encouraging healthful habits in school-age children. (The numbers in the program’s name refer to five servings of vegetables per day, a maximum two hours of recreational screen time, one hour of physical activity, and zero sugary drinks.)

Information about how individual communities are utilizing these grants can be found HERE .

How Doctors Can Help

The Harvard T.H. Chan School of Public Health recommends the following best practices for primary care physicians:

Routinely measure BMI in all adult patients.

Order appropriate lab tests for patients who are overweight or obese.

Prescribe a long-term treatment strategy, including:

Diet and lifestyle counseling
Weight loss medication, when appropriate
Bariatric surgery for severely obese individuals, when appropriate.

Healthcare providers in rural areas can also help develop obesity prevention programs within their communities.

The Rural Obesity Prevention Toolkit provides resources to help identify regional factors that promote obesity, convene partners to address those issues, and apply proven obesity prevention strategies.

Speaking With Patients About Obesity

Primary care physicians are not always comfortable addressing their patient's obesity. Weight is a very sensitive subject for many patients, but particularly the obese. However, it's an area that cannot be ignored when caring for an individual's overall health.

The following video clip offers practical advice on how to discuss obesity with patients:

Sources:

Featured Image: Adobe, License Granted

CDC

Trust for America’s Health

USCDornsife
National Institutes of Health

Rural Health Information Hub

This Year, Resolve to Improve Your Practice’s Financial Health

Wed, 18 Jan 2023 20:44:59 GMT

This Year, Resolve to Improve Your Practice’s Financial Health

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Think of All You Could Do
With Recovered Funds

What could your medical practice do with all the money recovered from overdue accounts? Hire more staff? Invest in new technology? Pay your suppliers? Expand your facility?

By retaining a medical collection agency to recover payment on the past-due accounts, you’re taking the first step toward boosting the health of your business. So you can continue to provide exceptional patient care without a hitch.

Healthy Finances

Here are just some of the ways a professional collection agency can enhance a medical center’s finances:

Primary Care Practices
Still Feeling the Pinch

A recent survey from the Larry A. Green Center, in partnership with the Primary Care Collaborative, revealed that the number of primary care practices reporting layoffs, skipped salaries, and temporary closures has remained constant since the onset of the COVID pandemic.

Earlier, a 2020 Medical Group Management (MGMA) survey had reported that medical practices averaged a 55% decrease in revenue and a 60% decrease in patient volume directly related to the pandemic.

Source: Fierce Healthcare

Debt collection is all collection agents do. It’s their livelihood. By using proven collection methods they maximize recovery on your overdue accounts. That’s revenue you can use to ensure continued smooth operation of your practice – or to invest in your future growth.

Freeing up your valuable time and resources allows you and your staff to focus on addressing your patients’ medical needs.

Sometimes partnering with a professional collector is all that’s necessary to prompt consumers for payment. Past-due accounts are quickly resolved, and the valuable patient relationship is preserved.

Medical debt collectors utilize advanced technology and tools your practice or facility most likely does not possess. They can remain in continual communication with delinquent accounts through various channels.

By recovering debt quickly, you’ll significantly reduce the number of bad debt write-offs at the end of the year.

The Risk of Going Solo

On the other hand, attempting to collect these accounts on your own is fraught with potential financial (and legal) pitfalls.

–Article Continues Below–

The Compl iance Minefi eld

The federal and state regulatory environments are ever-changing; compliance can be a minefield for the inexperienced.

A reputable consumer collection agency will know the ins and outs of compliance. They continually review their processes and work to ensure their collectors are highly trained in accordance with all state and federal regulations.

Medical Collections
Are Different

Medical practices face unique payment challenges compared to businesses in other service industries. For example:

Patients often fail to prioritize their medical bills, especially if the bills are unexpected and not in the budget.

The cash flow that healthcare practices depend on comes from both patients and insurance carriers, so providers must plan on multiple payment sources for a single invoice.

The sensitivity of the doctor-patient relationship necessitates that medical debt collectors possess exceptional soft skills, as well as a firm understanding of the medical billing process.

Getting Professional Support

In addition, without professional help, you’re far less likely to recover monies owed to you.

Skilled debt collectors are trained negotiators who can handle your patients with tact and treat them with respect. Reputable collection agents will educate your patients and work with them – not against them -- to resolve the outstanding debt.

What’ve You Got to Gain?

At CBSI , our collectors are experts in handling sensitive financial matters. Many of them have also had an account in collection at one time or another, so they understand it’s not a situation most people choose (particularly where medical bills are concerned).

At the same time, we recognize that you have the right to be paid. A medical practice without a secure cash flow will not remain in business for long.

We at CBSI have recovered almost a quarter of a billion dollars for our clients! It’s what we do all day long. You really have nothing to lose (and a whole lot to gain) by retaining us to collect on your past-due accounts.

Why not make 2023 the year you resolve to improve your practice's financial health?

Sources:
Featured Image: Adobe, License Granted
Forbes
Healthworks Collective
Nolo

Working Remotely Benefits Both Employers and Staff – Even in Healthcare

Wed, 07 Dec 2022 20:37:50 GMT

Working Remotely Benefits Both Employers and Staff – Even in Healthcare

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More Providers Offering Remote/Hybrid
Opportunities for Non-Clinicians

Over the past few years, the boom in telemedicine has proven that the healthcare industry can operate (even thrive) under non-conventional working arrangements.

The pandemic forced medical facilities to transition much of their administrative staff to work from home. According to a 2022 Medical Group Management Association (MGMA) poll, almost 60% of medical group practices shifted their teams to remote or hybrid work in 2021. With today’s continued demand for employment flexibility, healthcare providers are now looking for more ways to implement long-term remote work options, particularly for non-clinicians.

Advantages to Employers

Here are a few reasons more medical employers are relying on remote workers as a long-term staffing solution:

Repurposing Space

As medical providers rely more on remote workers, many will choose to transform their physical office space. Areas formerly dedicated to staff who now work remotely can be repurposed as specialty clinics, outpatient imaging, or examination rooms.

In New York, for example, the state’s largest healthcare provider, Northwell Health, has identified about 500,000 square feet of space that will be converted from support service offices into revenue-generating clinical space, helping them achieve their financial goals.

Improved Performance and Productivity

S tudies indicate that remote employees work the equivalent of one more day per week and are 47% more productive than their in-office counterparts.

Working from home empowers employees to function in a way that suits them on their own time. With fewer distractions from other staff members, productivity and performance improve. Remote work also enhances work/life balance, alleviates burnout, and improves overall morale.

Larger Recruiting Pool

By shifting to remote work, healthcare employers can recruit nationally. Qualified candidates need only have reliable internet connectivity, allowing providers to hire the best talent regardless of location.

In addition, staff retention improves because employees who work remotely are more likely to stay with the companies that let them do so. Owl Labs and Global Workplace Analytics recently surveyed more than 1,200 full-time U.S. workers. They found that remote workers are 13% more likely than onsite staff to stay in their current job for the next five years.

Likewise, a 2022 Zapier report revealed that 32% of knowledge workers have already quit a job because they were not allowed to work remotely, and 61% would leave their current position to accept a fully remote opportunity. (See infographic below.)

Reduced Overhead Expenses

Providers who rely on remote workers pay less in overhead expenses, such as utilities, cleaning services, taxes, and office space. (See sidebar, “Repurposing Space.”) According to Dave Rietsema, founder and CEO of HR software firm Matchr, “Companies can save up to $11,000 per employee in terms of overhead costs if they switch to remote work.”

--Article Continues Below--

Making It Work for You

Healthcare organizations that have successfully transitioned to a more remote or hybrid work model offer the following suggestions:

Identify Suitable Positions

Non-clinical positions abound in the healthcare industry and many of these jobs can be performed remotely with relative ease. These include:

Medical Employers Who’ve
Plunged into the

Remote Worker Pool

Here are just a few of the larger healthcare providers who have successfully transitioned to remote and/or hybrid work for all or most of their non-clinical staff:

Cleveland Clinic (many national and international locations) Transitioned almost 8,000 non-clinical staff to remote or hybrid work.

Northwell Health (78 locations in New York) Implemented a 100% hybrid work environment across all non-clinical departments.

ID Care (10 locations in New Jersey) Transitioned 60 non-clinical staff to remote or hybrid work.

Patient intake coordination
Utilization and claims management
Medical records management
Community relations
Marketing
Call center work
Medical billing and coding
Information technology
Accounting and finance
Human resources

For example, the Los Angeles-based AltaMed network successfully transitioned more than 1,000 call center, medical management, IT, and human resources staff to a remote-work model.

Maintain Security and Privacy

Because healthcare entails using confidential personal data, employers must maintain appropriate security.

Fortunately, security systems have evolved from strictly on-premises technology to cloud-based solutions. As a result, IT departments no longer need to fully control all devices. Healthcare organizations can use cloud-based security applications without assuming control of a user’s device. These tools can manage multiple systems regardless of where they originate.

Other security options include virtual private networks (VPNs) and encryption with multifactorial authentication. Providers should also reassess each process involving confidential information within the context of a remote-work paradigm.

Reinforce Employee Engagement

Developing and sustaining camaraderie with colleagues can be a challenge when working remotely. So healthcare providers seeking to embrace the remote-work model must be culturally driven, with an emphasis on communication and connectivity.

Some practices have integrated employee engagement exercises into their routines, such as monthly in-person team meetings, virtual happy hour, and informal get-togethers. The idea is to create a level of engagement that helps build trust between individuals.

Going Forward

American businesses—including care providers—will likely never return to an all-onsite workforce. It’s more probable that workers everywhere will expect increased remote-work flexibility. Prudent healthcare organizations must thoughtfully implement long-term work-from-home solutions if they are to remain competitive.

Sources:
Featured Image: Adobe, License Granted
Forbes
MGMA
HealthTech Magazine
Fortune
Northwell Health

4 Mistakes That Can Inflate Your Company’s A/R

Wed, 02 Nov 2022 16:37:18 GMT

4 Mistakes That Can Inflate Your Company’s A/R

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How to Avoid Errors and
Unnecessary Write-Offs

High accounts receivable mean one thing: Consumers, patients, or insurance companies are not paying in a timely manner.

Did you know that bills outstanding for more than 90 days are worth less than half their original value? High A/R is a key indicator that you need to improve your company’s overall revenue cycle.

Here are four of the most common red flags that suggest your A/R is too high:

Poor Communication

Effective communication channels are an essential part of getting paid on time. Haphazard communications result in erratic customer payments. Keeping a customer communications log can help maintain a healthy information flow.

Routinely review your records for accuracy, and ask for updated information with each customer contact. Bills mailed (or emailed) to the wrong address only contribute to late payments.

The Precertification Predicament

It’s estimated that up to 80% of denied medical claims are due to failure to obtain proper precertification.

Once the claim is denied, the provider must try to obtain authorization retroactively. This can result in a long process of more denials, appeals, and reviews.

Medical practices without the time and resources to devote to precertification should consider outsourcing this task to a company that specializes in healthcare revenue cycle management.

Source: PracticeSuite

Send statements and invoices immediately after services are rendered or goods are received by the consumer. Then follow up with regular reminders.

Use A/R automation software and electronic invoicing to establish a recurring billing schedule and stay on top of customer communications. According to the Federal Reserve , 92 percent of electronic invoices are paid on time, compared to 45 percent of paper invoices.

Billing Errors

S taff members who don’t understand revenue cycle management are likely to make billing errors. This is especially true for medical practices, where employees can forget to verify or preauthorize insurance. (See sidebar, “The Precertification Predicament.”)

A well-trained A/R staff is your strongest line of defense for preventing billing and coding errors. This requires a two-pronged approach: 1) hiring only the most qualified workers and then 2) providing them with ongoing training.

If your company or medical practice has neither the time nor the resources to hire and train qualified A/R staff, you’ll want to consider outsourcing your revenue cycle mana gement.

Unnecessary Write-Offs

Regularly review write-offs to identify any errors. For instance, you can enable staff to closely monitor contractual write-offs by providing easy access to the company fee schedule. (Medical office staff should also check the reimbursement schedule from each primary claim payer.)

Many non-contractual write-offs are avoidable (e.g., missing a deadline or administrative errors). A monthly review of both contractual and non-contractual write-offs can help significantly improve your company’s revenue cycle.

When bills are deemed uncollectible, they become bad debt write-offs. The IRS requires that all collection efforts be exhausted before the debt may be written off. This brings us to the fourth mistake that can inflate a company’s A/R…

Low Collection Rate

A low collection rate is usually the result of two factors: 1) inadequate collection procedures and 2) a general failure to prioritize collection efforts.

Internet Usage in Rural America

Rural America has made significant gains in adopting digital technology over the last decade.

A 2021 survey by Pew Research Center revealed that 72 percent of rural residents have a broadband internet connection at home. That’s a 9 percent increase since 2016.

Source: Pew Research Center

Here are a few ways to address a low collection rate :

Encourage payments at time of service.

Offer multiple payment options and keep consumer credit card information on file.

Update billing information during every contact.

Offer incentives, such as a 10% discount, for early payment (e.g., paying within ten days when usual payment terms run up to 30 days).

Thoroughly explain financial responsibility to patients or other consumers, and offer to negotiate a payment plan.
Analyze monthly financial reports to identify problems.

Train staff members on proper collection procedures.

Finally, if your company’s internal collection rate is consistently subpar, or you don’t have the trained staff required to effective collect on overdue accounts, it’s time to retain a collection agency for help.

CBSI is ready when you are.

Sources:
Featured Image: Adobe, License Granted
Pay stan d
RevCycle Intelligence
American Medical Associa tion

Getting Paid on Workers' Comp Claims

Tue, 18 Oct 2022 12:37:15 GMT

Getting Paid on Workers' Comp Claims

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Workers’ Compensation Can Be a
Big Headache for Healthcare Providers

Collecting on workers’ comp claims is an exasperating exercise for healthcare providers. While these claims represent only a small percentage of a practice’s total A/R, they can present some of the biggest headaches.

What with different terminology, numerous logistical hoops, and specialized collection forms, it’s easy for providers to become discouraged when attempting to collect on these claims.

Workers’ compensation is a government-regulated program designed to reimburse lost wages and medical costs for work-related injury or illness. Although it may resemble standard health and disability insurance programs, it's quite different when collecting on claims.

Iowa’s Work-Related
Injuries

According to the Bureau of Labor Statistics, more workplace injuries and illnesses are reported in Iowa each year than the national average. In 2020, Iowa-based private industry employers reported 34,000 nonfatal workplace injuries and illnesses, resulting in an incidence rate of 3.3 cases per 100 FTE workers.

Iowa was among 20 states that had an incidence rate significantly greater than the national rate of 2.7 cases per 100 FTEs. The state’s higher-than-average incidence rate has remained consistent over the past several years.

Iowa industries with the most work-related injuries and illnesses were manufacturing and health services.

www.bls.gov/regions/midwest/news-release/workplaceinjuriesandillnesses_iowa.htm

https://www.bls.gov/regions/midwest/news-release/workplaceinjuriesandillnesses_iowa.h

Source: Bureau of Labor Statistics

Rules Upon Rules

Standard commercial health insurance basically uses the same rules, processes, and procedures for each claim. Workers' comp, on the other hand, varies by state: fifty states, 50 different ways of handling claims.

The result is a myriad of fee schedules, rules, reports and treatment plans that providers must understand in order to follow the rules precisely. Failure to do so will likely result in a rejected claim.

Not Your Typical
Insurance Claim

Worker's compensation is highly specialized. Insurance companies that offer it do not sell standard plans, and traditional insurance carriers don't provide worker's comp. Healthcare providers who submit worker’s comp claims to the wrong payer or administrator risk violating state filing requirements.

These claims also require an understanding of the program’s special terminologies and unique collection forms. For example, in the world of standard health insurance, the patient is typically the policyholder. Not so in the workers’ comp world, where the patient’s employer is the policyholder.

In the workers’ comp world, the explanation of benefits (EOB) becomes an explanation of review (EOR). Claims are identified by claim or case file number instead of healthcare ID. There’s no deductible or copay linked to the worker’s comp claims.

More importantly, providers must accept compensation paid through workers’ comp as payment in full. Billing patients for any outstanding balance is illegal.

Before filing a claim under workers’ comp, the healthcare provider must obtain a First Report of Injury Form from the patient’s employer. The provider must complete the medical section of this form when the patient first seeks treatment for the work-related injury or illness. Failure to obtain this pre-authorization can adversely impact the reimbursement process.

--Article Continues Below—

Follow-Up Is Critical

Once all the necessary forms and authorizations have been properly prepared and submitted per state requirements, you’ll want to follow up regularly to ensure the timely processing of reimbursement.

After reimbursement, the provider must then check the accuracy of each payment, to ensure the payer is using the correct fee schedule. Any over-payment or under-payment means the provider must promptly file an appeal.

Standard Insurance
vs. Workers’ Comp

Should You Consider Outsourcing?

It’s easy to see how providers may indeed struggle to get paid for workers’ compensation claims. With so many rules and procedures that must be followed to the letter, practitioners could end up losing money in the long run.

But not every aggravating job must be handled internally. There are plenty of healthcare RCM companies that specialize in workers’ compensation claims. Outsourcing may be your best bet if you're devoting too many resources in attempting to collect on these claims. It could minimize problems for your staff while also freeing them up for more meaningful work.

The following healthcare RCM companies specialize in managing workers’ comp claims:

Sources:
Featured Image: Adobe, License Granted
Continuum
Becker's Hospital Review
Thomas, Coon, Newton & Frost

How’s Your Bedside Manner?

Wed, 07 Sep 2022 16:15:00 GMT

How's Your Bedside Manner?

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Tips for Improving the
Doctor-Patient Relationship

The relationship between doctors and their patients can profoundly impact medical outcomes positively or negatively.

Here are three key factors that can influence this relationship.

#1. Open Communication

Research studies prove that a physician’s ability to communicate information is every bit as important as the information itself. No wonder 65% of medical schools teach communications skills, and this training is regarded as a core competency in accreditation settings.

The Four Models

In 1992, two physicians, Ezekiel and Linda Emanuel, proposed four models for the doctor-patient relationship:

1. Paternalistic – The doctor acts as the patient’s guardian, promoting the patient’s wellbeing, independent of the patient’s current preferences.

2. Informative – The doctor acts as a competent technical expert, supplying relevant factual information, and implementing the patient’s chosen medical intervention.

3. Interpretive – The doctor acts as a counselor or advisor, interpreting and elucidating relevant patient values, advising the patient and implementing the patient’s selected intervention.

4. Deliberative – The doctor acts as a friend or teacher, helping the patient to determine and choose the best health-relative values that can be realized in the clinical situation.

Source: Journal of the American Medical Associatio n

Effective verbal and nonverbal communication can positively impact a patient’s symptoms, pain control, emotional health, and blood pressure levels. Likewise, miscommunication and a poor bedside manner can have severe negative implications.

Medical practitioners can facilitate open communication with their patients by remembering these guidelines:

Take the time to sit down and establish eye contact with your patient.

Listen without interrupting, so you can determine what your patient already knows.

During examinations, explain what you’re doing and reassure your patient.

Speak slowly and deliberately.

Keep your explanations clear and straightforward.

Empathize with your patient by acknowledging and validating his feelings.

Allow your patient time to formulate his thoughts.

Note your patient’s facial expressions and body language.

2. Shared Decision-Making

Doctors and their patients must collaborate on their medical decisions. The decision-making process should be shared with patients right from the onset. That way, all decisions will reflect the patient’s beliefs and values, not just the doctor’s medical expertise.

Even relatively small decisions should involve shared decision-making. For instance, "I can prescribe a medication to help with your symptoms, but I suspect they may go away on their own if you wait a while. Which would you prefer?"

Collaborative decision-making results in increased patient satisfaction and loyalty. Patients feel empowered in this process, enabling their doctors to provide more personalized care.

3. Doctor-Patient Trust

Trust is fundamental to any physician-patient relationship. To achieve the best medical outcome, patients must believe their doctors are working in their best interests.

A 2017 study found that a patient’s trust in his practitioner is even more critical than his satisfaction with a given medical treatment. Patients who trust their doctors feel better overall, have fewer medical complaints, and enjoy a higher quality of life.

You may be surprised that almost half of all patients fail to follow a doctor's recommended treatment. Why? Because they’re filtering these instructions through the competing demands on their time and energy, as well as their existing belief systems.

They then decide if the recommended treatment is desirable (or possible), given the demands of their everyday lives.

The patients who are more likely to follow the doctor’s recommendations and instructions are the ones who trust their physicians. These patients are also more satisfied with overall quality of care and more likely to continue with that particular care provider.

Doctor-patient trust hinges on several factors. Here are three of the most important:

The physician’s willingness to listen,

The patient's belief that the doctor appreciates his ability to make informed decisions, and

The patient’s comfort level when engaging in health-related dialogue.

--Article Continues Below--

Besides actively listening and maintaining eye contact, doctors can also build trust through light touch, when appropriate. (To avoid any misinterpretation, it's usually best to do this when someone else is in the room.) A hand on the shoulder demonstrates an understanding of the patient's stress or pain.

Impact on the Future of Healthcare

Healthcare continues to become more personalized and patient-centered. In the future, the doctor-patient relationship will increasingly shape medical outcomes. Doctors can break down potential barriers to this more customized approach by understanding the factors influencing the relationship with their patients.

A physician’s bedside manner can make or break a treatment plan. How’s yours?

Sources:
Featured Image: Adobe, License Granted
Duke Personalized Health
Journal of the American Osteopathic Association
University of Washington Medicine
American Association for Physician Leadershi p

Inflation: Bad for Patients & Not So Good for Providers, Either

Wed, 10 Aug 2022 12:38:00 GMT

Inflation: Bad for Patients, and Not So Good for Providers, Either

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The Effect of High Inflation on
Your Ability to Collect

With the U.S. inflation rate now higher than it’s been in 40 years, healthcare providers are wondering what the impact will be on their revenue cycle if patients are unable to pay their medical bills.

A combination of the global supply chain crisis, unexpected demands for certain goods (think, toilet paper), and the increased amount of currency in circulation have created a “perfect storm” for rampant inflation.

But regardless of its causes, what effect can you expect inflation to have on the cash flow of your medical practice?

Problem for Providers

Here are a few reasons high inflation is troublesome for medical practitioners:

Is All Inflation Bad?

Many people believe that all inflation harms everyone financially, but this is a misconception.

In fact, a small and predictable rate of inflation is generally considered not only acceptable but good. That’s because it offers a hedge against something far worse: deflation.

If the inflation rate hovers too close to zero, the risk of deflation (negative inflation) is increased. And that’s when a deflationary spiral can turn hard times into an economic recession or depression.

Inflation will increase operating costs, especially labor. The current staffing shortages have already resulted in higher staff salaries, overtime pay and temporary worker costs. High inflation will exacerbate these challenges.

More patients will delay elective care or default on their medical debts, as they struggle with the higher cost of basic necessities.

The money received from patients who have arranged payment plans -- particularly, longer-term plans -- has decreasing value over time. (In other words, cash now is worth more than cash later).

Impact to Patients

While high inflation rates can have some positive effects on some consumers, most of the repercussions to your patients will be negative.

For instance, as inflation increases, so does the interest rate. This means that consumers who are paying car loans and mortgages at a fixed rate of interest will benefit, since the money they’re paying back is worth less than the money they borrowed. But this benefit will probably be nominal unless they also receive an inflationary wage increase.

In addition, patients who owe on variable-interest loans -- such as those with significant credit card debt -- will end up paying out more because of the higher interest rate.

Also, your patients must spend more on their basic necessities, leaving less money to apply toward their medical bills. Purchasing power decreases whenever prices increase but wages don’t. With less money available to pay their financial obligations, patients are more likely to default on loans of all types, including their medical debt.

How Should You Respond?

If you’re concerned about the impact of inflation on your health center’s bottom line, here are a few suggestions:

Payroll Expenses

You can keep a lid on labor expenses and address staff shortages by automating more processes. Online self-scheduling and registration allows patients to handle these administrative tasks themselves, reducing the need for valuable staff time. The latest tools pre-fill patient information, limiting the risk for errors.

Countries with Highest
Inflation Rates

Venezuela — 284.4%
Sudan — 260.2%
Lebanon — 208.1%
Syria — 139.0%
Zimbabwe — 96.4%
Suriname — 61.5%
Turkey — 61.1%
Argentina — 55.1%
Iran — 34.7%
Ethiopia — 34.7%

Source: Trading Economics

Billing

Help your patients to better understand their medical bills and payment options. ( See “ Improve Collectability with Patient-Friendly Billing® . ”) And keep your invoicing timely to help minimize revenue cycle issues.

Payment Options

Provide upfront estimates, with links to appropriate payment plans and methods.

This would not only keep recovery cash flowing, it could also motivate patients to proceed with elective care they might otherwise have deferred.

Make sure your payment plans are flexible and accommodating. Offer multiple payment tools, such as an online portal, to simplify ease of payment. You may also consider:

A prompt-payment discount for paying within a certain time frame;

Extending the payment term;

Allowing patients to pre-pay in installments prior to a large, planned medical expense (such as childbirth); and

Offering some basic services at a flat rate for self-pay patients.

Rely on Us

Surging inflation increases the risk your patients will default on their medical bills. In times like these, it’s important to partner with a collection service that knows the ins and outs of medical collection like no other. That's CBSI.

And our compassionate approach to collection results in a recovery rate that far outpaces the industry. When it comes to debt collection, we’re here to do the heavy lifting – so you can focus on more important matters.

Sources:
Featured Image: Adobe, License Granted

Experian

Healthcare Financial Management Association
Khan Academy
Christian Science Monitor

Patient Friendly Billing ® is a proprietary trademark of the Healthcare Financial Management Association (HFMA).

Medical Claim Denials Continue to Climb

Wed, 06 Jul 2022 18:00:00 GMT

Medical Claim Denials Continue to Clim b

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How to Prevent Denied Claim s

Medical claim denials increased by 17% in 2021.

According to the most recent Medical Group Management Association (MGMA) poll, nearly 70% of healthcare leaders cite the rise in denials, indicating that the pandemic has caused more rejections. In 2020 a Healthcare Revenue Cycle Denials Index revealed that claim denials had climbed by 23% over the previous four years. That analysis examined more than 102 million claims submitted by 1,500 U.S. hospitals.

The highest denial rates were concentrated in two regions that were hardest hit by the pandemic – the Northeast and the Pacific coast.

Pre-Pandemic Problem

Although the pandemic has aggravated the problem, the increase in medical claim denials began before the COVID outbreak, according to 2019 data. An American Hospital Association (AHA) 2020 report confirmed that 89% of hospital administrators had witnessed an increase in denied claims over the last three years. About half of those respondents described the increase as “significant.”

According to the AHA, claim denials not only impact revenue performance for care providers, they also affect the quality and accessibility of patient care. ( See box below, "Claims Denials Fueling Burnout.")

Preventable Issues

Eighty-five percent of the denied medical claims are potentially avoidable, the research suggests. Even worse, according to studies by Change Healthcare, 48% of revenue lost from these denials are not recoverable.

Claims Denials
Fuel Burnout

More clinicians are experiencing burnout because private health insurance carriers abuse practices such as prior authorization and medical claim denials, according to a pre-pandemic American Hospital Association (AHA) survey.

The survey asked more than 200 hospitals and healthcare systems, including several hundred executives, about the ways in which claims denial practices and pre-certifications impact their operations.

In addition, since 2020, COVID-related staffing shortages have made these issues "increasingly urgent," an AHA spokesperson said.

Source: Becker's Hospital Review

The largest portion of those claims are denied because of inaccurate or incomplete data, insufficient explanation of benefits, and incorrect or incomplete prior authorizations.

In other words, this revenue loss was preventable.

Why Are Claims Denied?

Insurance carriers usually deny claims for the following reasons:

No Prior Authorization

Failure to obtain prior authorization for treatment is one of the top reasons for claim denial, according to the AHA. Staff members who are responsible for submitting insurance claims must know which insurance carriers require prior authorization for which treatments.

Pre-certification requirements impose a significant burden on medical offices. According to the American Medical Association (AMA), 86% of physicians’ offices rate the burden of prior authorization as “high” or “extremely high.” Offices typically must devote two business days per week just to addressing these requirements.

Inadequate Information

Another common mistake that leads to denied claims is providing inadequate information to the insurance carrier. Omitting the smallest detail (such as demographic information, treatment date, or date of onset) can result in claim denial.

Coding Errors

Referring to an obsolete codebook, or otherwise using incorrect codes occurs often.

The result is a denied claim and lost revenue. Failure to provide proper documentation when coding and submitting claims can cause insurance companies to assume the services were not performed.

Duplicate Billing

Whenever a staff member fails to remove a claim from a patient’s account after it has been resubmitted, duplicate billing is often the result. Duplicates are usually detected and flagged by claims processing systems; if the original claim is identified as a duplicate, the claim could be denied.

So simply preventing duplicates is not enough. Original claims need to be properly coded with the required modifiers and documentation so that the bill is identified as an original.

--Article Continues Below--

Bad Timing

Even when the claim is legitimate and properly coded, it can still be denied if it’s not submitted in a timely manner. (For example, did you know the Affordable Care Act reduced the deadline window for submitting Medicare claims from 15-27 months to 12 months after the date of service?)

Furthermore, different insurance carriers have different deadlines. If you fail to meet these defined deadlines you’ll lose some serious revenue.

No Cover age Verification

Health insurance is continually changing all the time. Which means coverage eligibility must be verified every time medical services are provided. Tedious? You bet. But doing so could save your practice a significant amount of money down the line.

Tackle It from the Front

You can help prevent denied medical claims by addressing front-end issues. Don’t assume that inaccurate or incomplete information will be fixed on the back end. It’s best to nip these potential denials in the bud. Here’s how:

Train office staff to take the time at registration and pre-registration to ensure patient information is accurate and complete.

Keep your charge description master current, to ensure that correct charges are always being used.

Verify that your billing software and claim edits are up to date.

Regularly communicate claim denials received on rejection reports. This will guarantee that corrections are implemented in a timely manner and will help avoid additional claim delays.

Sources:
Featured Image: Adobe, License Granted
RevCycle Intelligence
American Hospital Association
Becker's Hospital Review
Right Patient

MGMA

Why Isn’t My Patient Paying This Bill?

Wed, 08 Jun 2022 19:35:12 GMT

Why Isn’t My Patient Paying This Bill?

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The Many and Varied Reasons for
Non-Payment of Debt

There are multiple reasons why your patients may not be willing or able to pay their medical bills. These reasons typically fall into four categories: Circumstantial, Emotional, Intellectual and Criminal.

Let’s explore each.

Circumstantial

The vast majority of patients with overdue accounts belong in this category. These patients may want to pay their medical bills, but they’ve fallen on hard times. Consumers in all walks of life have been adversely impacted by the COVID-19 pandemic and its economic aftermath.

Empathy goes a long way when trying to connect with these patients. Effective medical collectors will first listen to the their stories and gather as much information as possible. Then – together with the patient – they can devise a payment plan.

Patients Delaying
Healthcare

A 2018 CarePayment survey revealed the various ways consumers are neglecting their healthcare needs due to financial stress. Specifically:

61% of Americans have no money saved to cover their healthcare expenses.

64% have avoided or delayed medical care in the last year due to expected costs.

44% would not receive needed medical care, even if it put their health at risk, if their out-of-pocket expenses would exceed $500.

69% of those surveyed reported that their deductible was at least “somewhat difficult” to afford, with 22% reporting “very difficult” or “impossible.”

It also helps to remind these patients that their current financial situation is temporary.

Emotional

Patients are sometimes ruled by their emotions, blaming their debt on other people. When patients fail to take ownership of their situation, they may either deny the debt or become angry about it.

Debt Denial

Indications of debt denial include:

Underestimating the amount owed.
Refusing to answer collection calls.
Refusing to open bills or stuffing them in a drawer.

Unfortunately, this kind of behavior only leads to more debt with the accruing of interest charges and late fees. Emotional patients rationalize their mistakes as a way to protect their egos. But reality always sets in, sooner or later.

Debt-Anger Syndrome

Rather than panic or deny, these patients get mad.

They’re angry with the healthcare providers who continually send them bills. They’re angry with the postal carrier who delivers those bills. They’re angry with their employers for not paying them more. They’re angry with their spouses, their kids and themselves. They’re basically just mad at life.

Angry patients need to know that, once they have a plan to dig out of their financial hole, they can start feeling better right away.

Intellectual

Intellectual patients are often disorganized. They may possess a higher degree of education, but have little understanding of finances. In the grand scheme of things, their debts may seem trivial to them. Showing them why they owe the debt in the first place is often helpful.

It’s often fairly easy to encourage intellectual patients to the account right away.

--Article Continues Below--

Criminal

There’s no proven method for identifying patients who have no intention of paying their bills. However, the number of accounts and types of debts the patient incurs might provide a hint about his intentions.

For instance, substantial medical debt usually isn’t a red flag. But if the patient also has excessive credit card debt, that could indicate a pattern.

Are You Offering Multiple Payment Options?

The more payment options you offer your patients, the greater your chances of being paid. Here are a few you may wish to consider:

Co-branded, personalized financing services for healthcare providers (such as AccessOne or CarePayment).

Prompt-payment discount (e.g. 10 to 20 percent) for paying within a certain time frame.

Increased payment periods for patients suffering through hard economic times.

Prepayment arrangement for large, planned medical expenses such as childbirth.

Basic services offered at a flat rate to uninsured or other self-pay patients.

An online payment portal that’s easily accessible via mobile device.

Overcoming Objections

There are steps you can take to overcome patient objections to paying their bills. Reputable collectors often can move quickly to resolving an overdue account by putting the consumer at ease.

Professional collectors will:

Validate the patient’s feelings. If the patient is feeling anxious, hopeless, or angry, a reputable collector will listen and express empathy.

Help the patient feel better about the situation. Patients’ financial hardships are almost always temporary. Remind them of that. Help them to recognize that the creditor and collector are not their enemies, but rather their allies – working together to resolve the debt.

Let the patient know what can be done to help. Offering a flexible, zero-percent interest payment plan should be central to possible solutions. In fact, Journal of Health Care Finance has indicated that such payment arrangements not only allow patients to pay their medical bills, but also result in public health benefits and contribute to the financial well-being of care providers.

For example, compared to patients without access to affordable payment plans, patients with zero-interest plans are:

Less likely to avoid medical care because of the cost, and

Better able to pay for necessities like food or heat.

Need Help?

Would you like to offer alternative payment plans to your patients, but don’t know where to start? The medical collection professionals at CBSI can help. Contact us today!

Sources:

Featured Image: Adobe, License Granted

PDC Flow

Journal of Health Care Finance

Debt.org

State of Decay: Dental Care in Rural Iowa

Wed, 11 May 2022 21:27:35 GMT

State of Decay: Dental Care in Rural Iowa

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Access to Dental Care Seriously
Limited for Rural Iowans

Vadim, a 26-year-old California truck driver, was headed to New York when he started feeling pain on the left side of his mouth. He pulled over in Oklahoma to see a dentist, who diagnosed a tooth infection and prescribed antibiotics.

The pain temporarily subsided -- but then increased. After he delivered the load in New York, Vadim felt too weak to drive back alone, so his brother joined him. By the time they reached Utah, he had to be taken to a hospital and placed on oxygen.

The infection spread to his blood and lungs. Doctors administered stronger antibiotics and placed him on dialysis.

Four days later, he was dead.

While deaths from tooth infection are relatively rare these days, many chronic diseases are nevertheless directly attributed to poor dental health – particularly in rural communities. In fact, rural Americans are twice as likely to lose their adult teeth as their urban counterparts. For these residents, tooth decay and periodontal disease are commonplace, despite being largely preventable.

Obstacles to Dental Care

What makes rural America so vulnerable to dental disease? A number of factors come into play, creating a tangled web of disparity. Here are the most prominent reasons:

Acute Provider Shortages

Because dentists often graduate with heavy debt, they tend to establish practices in populated areas where they can attract more paying patients. Rural areas offer too few paying customers for a practice to be profitable.

Furthermore, in high-poverty areas (such as many rural districts), most potential patients are covered only by Medicaid, resulting in low profit-margin payouts for dentists. (See "Fewer Dentists Accepting Medicaid," below.)

With such a severe shortage of dental providers, rural residents must travel farther to obtain oral care. This results in a significant burden on those without adequate transportation.

Fewer Dentists Accepting Medicaid

Iowa’s dental Medicaid rates have not changed in 20 years, reimbursing only 30-40 cents for every dollar of care provided. As a result, fewer Iowa dentists are now accepting Medicaid.

Dental HPSAs in Iowa

A dental HPSA (Health Professional Shortage Area) is an area or population federally designated as having an acute shortage of dental practitioners.

Eighty-six of Iowa’s 99 counties are designated dental care shortage areas. For 77 of them, the dental HPSA includes the entire county.
Twenty-one of these 86 counties are considered high priority (e.g., they have one or less than one full-time dentist, or their dentists are all aged 60 or older).
Only 12 of Iowa’s HPSAs are in “metro” areas (i.e., they have an urban core of 50,000 or more people). The remainder are rural.
Twelve percent of Iowa’s population resides within a dental HPSA.
Four Iowa counties have no dentists, and three counties have no full-time dentists.

Sources:
Rural Health Information Hub
Kaiser Family Foundation
Iowa FIND Project

And while every adult Medicaid member is enrolled in the state’s Dental Wellness Plan, the annual benefit maximum is limited to $1,000 per year (excluding preventative, diagnostic or emergency services).

Higher Poverty Rate

The rate of poverty is higher in non-metro areas. Rural residents living in poverty can afford neither dental care nor dental insurance. Even for those residents who are employed, research indicates that employers in rural areas are less likely to offer dental insurance than those in more populated areas. (See "Fewer Dentists Accepting Medicaid," above.)

Older Population

Rural America comprises a higher percentage of people age 65 and over. Most of these residents are not employed and are less likely to carry dental insurance. Because they are older and sicker than urban dwellers, rural Iowans rely more heavily on Medicaid and Medicare. Traditional Medicare does not include dental benefits and, of course, fewer dentists are now accepting Medicaid.

Strategies for Bridging the Care Gap

The disparity in dental care between metro and rural populations is not new, although it has become more pronounced as the U.S. population ages. Over the years, numerous strategies for addressing the dental care gap have been proposed.

Active Recruitment

Actively recruiting new dentists to fill gaps in underserved communities is crucial in light of the current shortage and imminent retirement of many practicing dentists.

Efforts such as The FIND (Fulfilling Iowa's Need for Dentists) Project do just that. Working with the University of Iowa College of Dentistry and the Iowa Department of Public Health, as well as professional and civic organizations, The FIND Project has helped to repay loans and establish private practices for 56 Iowa dentists over the past 20 years.

The Iowa Area Development Group (IADG) is also actively involved in helping to procure local funding and low-interest loans for the establishment of dental care offices in rural communities.

--Article Continues Below--

Dental Therapists

A dental therapist is a midlevel provider who assists a dentist in much the same way that a nurse practitioner assists a doctor: by performing the common, lower-level procedures, enabling the dentist to focus on more complex cases.

Dental therapists are an emerging healthcare trend that can both increase access for underserved populations and drive down dental costs. They are trained in routine preventive and basic restorative services, and are authorized to practice under the dentist’s “general supervision.”

This means they may travel and treat underserved populations across the state, even if the dentist is not present.

The I-Smile™
Program

The I-Smile™ Program , sponsored by the Iowa Department of Public Health (IDPH) is a statewide initiative to connect Iowans in all 99 counties with dental, medical, and community resources.

The program’s 23 designated coordinators collaborate with local dentists to establish dental homes for underserved Iowa populations and also partner with community leaders in recruiting new dentists.

A 2018 federal study recommended that individual states should “evaluate emerging healthcare occupations, such as dental therapy, and consider ways in which their licensure and scope of practice can increase access and drive down consumer costs while still ensuring safe, effective care.”

As of October 2021, 13 states have authorized the use of dental therapists; Iowa is not one of them. (For a more in-depth examination of how dental therapy can benefit Iowa, see the white paper “ Iowa Needs Dental Therapists .” )

Medicaid Reimbursement Rate Increase

Fewer Iowa dentists are accepting Medicaid because the plan’s reimbursement rates are so abysmal they don’t even cover the costs of basic procedures. Neighboring states of Minnesota and Wisconsin had the same problem, which is why they recently increased their dental reimbursement rates by 98% , so underserved populations can get the care they need.

Most Iowa dental practices are small businesses operating on fairly tight budgets. They’re happy to give back to the community, and often do so through multiple charity programs. But they are forced to limit or exclude new Medicaid patients because they cannot afford to do otherwise.

Increasing the state's reimbursement rate would enable more dentists to provide preventative care to rural Iowans, reducing both the number of dental emergencies, as well as the distance patients must travel to receive care.

Mobile Oral Health Programs

Mobile oral health programs have been successfully developed and widely used in other predominately rural states.

Portable dental clinics, such as mobile dental vans, travel to various rural population centers to provide preventive care, x-rays, and other dental procedures.

The following video clip highlights the mobile program operated by Delta Dental to expand dental care access for children throughout the rural areas of South Dakota:

Sources:
Featured Image: Adobe, License Granted
Health Journalism
We Are Iowa
Rural Health Information Hub
Tax Education Foundation of Iowa
Des Moines Register

Let’s Talk: Communicating With Consumers in Default

Wed, 13 Apr 2022 13:55:25 GMT

Let’s Talk: Communicating With Consumers in Default

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How to Make Collection Calls
Less Daunting

A young woman had fallen upon hard times and missed a payment on an overdue debt. So she called the collection agency in order to work out an adjustment to her repayment plan.

But rather than receive compassion or empathy, the debt collector berated her. “You need to figure out how to pay it right now," she was told.

Because the young woman had nothing to offer besides grocery money, she asked if the payment could be deferred until she received her next paycheck. She was told that was “unacceptable.”

The conversation went downhill from there. It finally ended with the collection agent screaming, “What the heck is wrong with you?! [Only she didn’t say “heck.”] You need to pay this debt! If you can’t work with us, we’ll take you to court!” Then she hung up.

This nightmare true story is a shocking example of how NOT to handle a collection call. Let’s explore some more reasonable and effective techniques.

Have a Plan

Collection calls are not easy. The collector must work to maintain (or rebuild) trust while seeking a resolution that meets the needs of both parties. This process cannot be approached haphazardly; it requires a plan.

Regulation F
Restrictions

Regulation F , a revision to the Federal Debt Collection Practices Act (FDCPA) which became effective last November, places the following restrictions on the number of times debt collectors may attempt to call consumers:

Collectors may not attempt to call more than seven times within seven consecutive days. Any call that is placed and connected is considered an attempt to call, including voicemails, ringless voicemails, and limited-content messages.

Collectors are limited to one debt-related conversation with a consumer within a seven-day period.

First of all, an effective collection process uses multiple channels (phone, text, email) over a period of several weeks. The key is to persist without becoming overly intrusive.

Attempting multiple contacts every day, or utilizing aggressive automated dialing campaigns, will not only backfire, it could be illegal. (See sidebar, "Regulation F Restrictions.")

While it’s true these tactics can result in an occasional payment, the risk of damage to the consumer relationship – as well as the risk of noncompliance – is simply too great.

Different people will respond differently to your attempts to contact them. Some will readily work with you to resolve the unpaid account. Others may be evasive, irate, or scared (maybe even abusive).

It’s important to keep in mind that the vast majority of patients and consumers want to pay their bills. It’s your job to help them do just that.

Defusing an Argument

What should you do if you encounter an angry or hostile consumer?

First of all, resist the temptation to retaliate! Try to defuse the situation instead. The following strategies have proven helpful:

Let ′Em Vent

Allowing consumers to vent their frustrations does not mean you’re losing control of the conversation. Rather, it’s an intentional means of defusing their anger in order to move toward your goal of payment. Sometimes people just want someone to listen.

Don’t argue with patients or try to prove them wrong. Tell them you understand how exasperating things can be.

Four Tips for

Empathetic

Listening

Be nonjudgmental.
Give the consumer your undivided attention.
Listen to both facts and feelings.
Restate and paraphrase.

Source: Crisis Prevention Institute

Admit Mistakes

If a consumer is angry because of a situation due to an error on your end, own up to the mistake. Then apologize. A simple apology may catch them off guard and neutralize their hostility. Then you can proceed to correct the error (or at least, begin the correction process).

Acknowledge Their Value

Long-term patients or other customers need to know how much you appreciate them. If the patient has a history of paying on time, tell them how much you value that. Help them feel important. Most people are not inclined to argue with someone who’s validating their worth.

Perfect the Process

Once you have a process in place, it’s important to continually review and revise it, based on any data you can gather.

Then, don’t hesitate to make adjustments as needed.

For example, you might need to alter the content of your communications, the communications channel you’re using, or the types of repayment terms you offer. Flexibility is key. Be aware that successfully identifying the strategies and techniques that work best for you and your patients may take some time.

Send in the Cavalry

Are your internal A/R staff members at their wits’ end attempting to collect on overdue accounts? Do you think they may be doing more harm than good? If so, it’s time to bring in the pros.

--Article Continues Below--

CBSI’s respectful, solution-focused services produce far better results than harsh demands. Our in-house compliance officer is continually reviewing our processes. And our custom-made compliance management system ensures we’re always current with the ever-changing regulatory environment.

Knowing the best way to communicate with your consumers in default is what we do.

Problem solved.

Sources:
Featured Image: Adobe, License Granted
Entrepreneur
InsideARM
PDC Flow

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Test Your Knowledge With Our Humor Quiz

#1. “Laughter therapy” incorporates humor into clinical settings. Who is credited with pioneering this approach?

#2. Humor and laughter are medically documented to induce multiple physical health benefits. Which of the following is NOT one of them?

#3. Which of the following humor styles typifies the late comedian Rodney Dangerfield?

#4. Patch Adams, a medical doctor portrayed by Robin Williams in the eponymous 1998 film, believes that laughter is an integral part of the healing process. What’s the name of his non-profit healthcare organization?

#5. What is laughter yoga?

#6. The American Medical Association offers several suggestions for incorporating humor within a clinical setting. Which of the following is NOT one of them?

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#1. Martin Luther King Jr. was jailed 29 times during his career, primarily for engaging in civil disobedience. What were the other charges?

#2. How old was MLK when he entered college?

#3. Ten years before his death, MLK survived another assassination attempt. Who was his attacker in the earlier attempt?

#4. Dr. King was a prolific writer, authoring several inspirational books. Which of the following is NOT one of them?

#5. Which of the following awards did Dr. King receive?

#6. Who prompted MLK to talk about his "dream" during his 1963 iconic speech at the Lincoln Memorial?

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#2. How long was the average work week for American industrial laborers in the late 1800s?

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