Why charge an “administrative fee” on insurance visits?

The lengthy rant:

Insurance reimbursement is stuck in the past.  Washington-based private health insurers reimburse clinics such as ours at the same rate as they did 20 years ago.

This is why most clinics are forced to either chase auto injury cases, drop insurance, or shorten visits to under 5 minutes long for “rack and crack” treatments.

We wish to do none of these things.  We wish to continue our goal of providing individualized care that empowers the patient with skills and understanding of their biomechanics.  We wish to continue to be the sort of clinic that we would seek when we are injured.  We wish to be the sort of place that we would refer our mother to.  

“What “administrative” expenses are we offsetting?”

• We have a billing person who takes a percentage of every insurance visit payment to submit the claim to your insurance.
• We hire two full-time staff (Jen and Relaigi) who check the benefits of every one of our new patients as well as update that info every year and every time your insurance changes.  There is a reason why most places don’t do this.  It is difficult and time-consuming.  When the insurance company gives us inaccurate information, we often eat the costs and write off the lost revenue.  
  • It is important to us that we continue with this practice though.  It is how we wish to be treated when we are in your shoes.  We find it reprehensible when a hospital refuses to provide out-of-pocket estimates for costly medical procedures.  Thousands of American families go into deep medical debt every month because of this calloused protocol.  We will not participate in that.  We will continue to begin our doctor/patient relationship with honest communication and information on the costs and benefits of care to the best of our ability.  

To continue with this standard, and continue to accept insurance, the fee is necessary for all who can afford it.  

We are all in this economy together.  If you require financial assistance, and this fee will cause a barrier between you and the care you would otherwise receive, please inform the staff and your fee will be waived.  No questions asked.  At this time we sincerely offer this waiver to anyone who feels they need it, regardless of income level.    We recognize how current economic realities can put the pinch on anyone in any economic strata.

For those of us who prefer to be awake, but want the health and performance benefits of deep rest, comitting a month to sleep optimiztion interventions is time well spent.

Sleep optimization is the endevour of getting more quality recovery from the same number of hours spent in bed.  That’s right.  You can potentially have it all.  If you are like me that means you are unwilling to trade your early morning workout time OR your post-dinner family time for more hours of sleep.  Or maybe you’re a shift worker.  Or maybe you have an incredible nightlife.  Or maybe you’ve noticed that you live in a crazy time where stress and fear are pumped into you through your phone 24 hours per day?  Whatever the reason, if you are in a position where you value improving sleep quality but still prefer your life out of the bed, then this article is for you.

The following are the results of my 6 week all-in, full committment execution of  Andrew Huberman’s sleep toolkit protocol.  I added a couple elements of my own as well.  I began with a base of his entire Toolkit then I added intermittent fasting, some meditation breathing techniques, probiotic foods and the “daytime supplements” listed in the next section.

Take the time to check out Andrew Huberman’s podcast.  Each episode is full of actionable intel on the available science of health, happiness and performance optimization.  If for instance you don’t care about sleep optimization right now but you want to know how to use meditation to enhance creativity.  There’s an episode on that.  Increase flexibility?  Yep.  Hormone optimization?  Check.  The ideal use of caffeine for performance?  Roger that.

It is my experience that individual physiology varies significantly and tailoring your protocol is a process of beginning with the basics then customizing by prioritizing what you respond best to.  The data provided by researchers like Huberman provides a framework from which to experiment, observe and refine.  The following is my experiene with that exact process with Humerman’s Sleep Toolkit.  This has been a powerful process for me.  I hope you jump in and experience it for yourself and when you do, feel free to reach out with your outcomes, comments, insightes and questions.  You can message me in the text field under “What is your chief complaint” 

My Sleep Optimization Protocol breaks down into two segments:

1)  Lifestyle interventions

and

2)  Sleep Stack supplementation.

Part one is critical.  A foundation of lifestyle interventions is necessary to achieve maximum (and perhaps any) benefit from supplementation.

When lifestyle is in the way, using supplementation is like hitting the gas with one foot still firmly on the brake.

My results:  I ran the following interventions to a T for a 6 week stretch from 12/27/22 through 2/10/23.  My subjective results were super high energy that lasted throughout the day.  No more post lunch fatigue, no coffee needed during our long dark Northwest days.  I honestly felt pretty incredible.  Objectively, I lost 5 pounds and leaned out quite a bit.  I tracked my sleep quality with a Whoop watch and dramatically improved my sleep quality from my December baseline compared to the January and February performance.  (See Photos)

BASELINE NUMBERS: The 5 day baseline from 12/19-12/27 was 5 consecutive “poor” sleep quality days. 0 “sufficient” and 0 “optimal.

 

INTERVENTION: Now an 8-1 “Optimal vs Poor” ratio. 10x “Sufficient”. Febuary numbers a little rough with some late night bjj training and an anneversay weekend away from the kids on the 11th.

Lifestyle

MORNING INTERVENTIONS

• Early morning direct sunlight exposure or bright light exposure from sounces such as a Ring Light.
  • 5-8 minutes of this as soon as you can upon waking.
  • You want the light exposure directy on your eyeballs for the effect we’re after but it should not be uncomfortable.
  • Some people work light exercise into this i.e. skipping rope while looking near the morning sun.
• Early morning cold plunge
  • Ironically short duration cold exposure induces your body to raise your internal thermostat settings and core temp.  That is an important tool for ending the sleep sate and transitioning to the wakefull sate.
  • 3-4 minutes chin deep
    • I don’t usually time these anymore as I noticed that 11 very slow breath cycles have me in for about 3 and a half minutes.
  • I use a 4′ steel horse trough that stays in the low 40’s  in the early mornings in the PNW this time of year.
  • Try not to hold completely still.  Moving a bit will keep the water from forming a warm little barrier around you.
  • When the time is up, get out and dunk the face and head.  Just for a breath.  3x.
  • Try not to go to a hot shower after.  If you can, just pull on some warm clothes and let your body warm itself back up
• Early morning exercise
  • For me that is 6am jiu jitsu.  Anything to get the heart rate up will work.
• Delayed Caffeine intake
  • Waiting 90-120 minutes before having coffee optimizes the impact of the stimulant
    • The body takes some time to wake all the way up.  This is why we love to speed up the wakeful state with a stimulant.
    • Taking a stimulant while your body is still waking up is like using a nitris oxide booster while your e-brake is still engaged and you’re driving up hill.  That’s no way to Tokyo drift.
    • In my case I kept my ritual of immediatly making an espresso upon waking up but I put it in a thermos to have at 7:30am after jiu jitsu.  This part had a huge impact on my daily energy levels.  With this new timing I no longer felt the need for any more caffeine throughout the day.  I even managed a couple days with zero coffee and still somehow experience super high energy days.  That’s a tremendous change for me.  In the dark Winter months here I typically run on caffeine:
      • 2 espresso shots and sometimes even a super-potent preworkout supplement before bjj.  I wake up at 4:50am to train and this is my 20 year long “burn the boats” ritual.  Yes it is dark, it is cold, and nobody would notice if I took the day off and went back to bed, but after espresso and preworkout there is no turning back.  This makes for a fun, high energy training session, but by the time I leave class at 7:30am, I’m completely gassed and often stopping for a potent double italiano on the way into the clinic.  Some days, a second crash would hit me in that post lunch hour and I’d have a third double espresso in the early afternoon so as to not rudely and repeatedly yawn in the face of a patient.  Upwards of 6 shots of espresso and the occassional high caffeine preworkout as well.  That is a lot of stimulants just to feel good and get by.  Rolling into the evening with this much caffeine in the system also put some urgency behind a glass of wine or a beer with dinner to help wind back down. . . you can see how that nasty little cycle can build on itself over time.

AFTERNOON INTERVENTIONS

• Intermittent Fasting
  • First food intake 11am or later
    • Break the fasting state with probioitic foods at 11am
      • A bowl of low sugar probiotic yogurt with some stuff mixed in or a cup of Kiefer and a glass of kombucha.  Probiotic foods have potential to be more impactful on an empty stomach so I give them some time and space to work by waiting an hour or two before I eat my first big meal of the day.
• Daytime Supplements  (These are my personal supplements and are not part of Huberman’s Toolkit)
  • Lion’s Mane, Creatine, Milk thistle, vit D/K, B12
  • Usually taken at 11am breakfast (see probiotic foods above)
• No caffeine, THC or Alcohol in the afternoon
  • Specifically the research states none within 8 hours of going to bed.
  • I’m not much of a morning drinker anyway so I went with none.
• Final fluid intake of the day by 4pm
  • Important if you are annoyed by getting up in the night to go to the bathroom

EVENING INTERVENTIONS

• Hot bath before bed
  • Within an hour of bed time
  • No longer than 20 minutes duration
  • Ironically this results in cooling the body’s core temperature.  An important sleep inducing mechanism.
• Avoid bright artificial lighting before bed
  • Pretty obvious, but doomscrolling on the phone before bed isn’t an ideal way to wind down.

Sleep Stack supplementation 30-60 minutes before bed:

• Magnesium Threonate 145mg
• Inositol 2g every 3 days per week
• Theanine 100-400mg (decrease dosage if vivid dreams wake at night)

Enjoy the jarring adventure of this challenge and again feel free to reach out with your outcomes, comments, insightes and questions.

Yours in Resilience,

Dr. Pond

Click play on the file below to hear Skylar recently featured on Jon Vroman’s The Front Row Dad Podcast.

We cover some of my favorite topics on this including:

• How to challenge kids with progressive weight training
• Skylar’s wife Alicia!
• Malcolm Gladwell
• Fist Fights in Italy!

Who is the best West Seattle Chiropractor?  It can be hard to objectively say as there is not an annual head to head winner take all chiropractic competition.  A good place to start though would be eliminating everyone who claims to be “The Best” or “Elite.”  It is just not a great sign that they are grounded and secure.  Excellence in medicine does not from exclusivity or being “elite”.  Quality in medicine is the result of the ongoing endeavor to be better today than you were the day before.

Your search for “The Best West Seattle Chiropractor” will begin with personal recommendations from trusted friends with first hand experience.  In the absence of that, online reviews can be helpful.  The next tier down is the online search where you may find out who has “The Best SEO” but you will likely not find “The Best Chiropractor”  You may find some great blog posts with SEO pandering titles such as “How to pick the best West Seattle Chiropractor.”. . . Here you are.

Unfortunately, there is not a Best Chiropractor in West Seattle.  I know these people.  They are talented and caring people.  You have many high quality options to chose from.  You don’t need to find The Best Chiropractor in West Seattle.  What you need is the Best Chiropractor and clinic model for you.

Here at Sports Medicine Northwest we take an integrated approach to get the results our patients need.  The sessions can be a bit longer.  They involve corrective exercises, manual therapy, massage, sometimes acupuncture, nutritional counseling as well as regenerative medicine.  We have a team of skilled practitioners to tailor a plan with.  This gives us options to design a specific protocol for specific presentations.  People who gravitate to our kind of model are usually engaged and pretty educated about their body.  It is a fun group to work with.  We involve them in the solution.  We give them an understanding of where they are, how they got here and what they can do to make long-term changes in the future.  We strive to instill confidence and independence in the patient.  This is what we call active care.

We do have some patients who are seeking passive care as well.  They are busy with life and just want to pop in once a month for a quick adjustment and a massage.

We are very good at delivering results.  We’ve worked on this model for over 10 years and are always in a state of improvement and growth.  Your key for success in you finding The Best West Seattle Chiropractor for you is to find the team of practitioners that you have clear lines of communication with, and who resonate with your goals.

To Request an appointment or to set up a consultation with Dr. Pond to see if SMNW is “The Best” for you, Click Here.

Skylar Pond is a Certified Chiropractic Sports Physician and with his wife Alicia, is Co-Owner at Sports Medicine Northwest

Sports Medicine Northwest is a medically integrated clinic in West Seattle.  This is the story of one of our patients and how we used regenerative medicine tissue allograft injection therapy in Seattle to get him back on the field.

To schedule a free consult to determine if you are a candidate for regenerative medicine at Sports Medicine Northwest  CLICK HERE.

To schedule a free consult to determine if you are a candidate for regenerative medicine at Sports Medicine Northwest  CLICK HERE.