Issue 114.4 - Dr. Kianor Shah by topdoctormagazine

Introducing the Global Summits Institute

SPECIAL EDITION October 2020

DR. KIANOR SHAH 2020 DENTIST OF THE YEAR

Pg 02

Introduction to the Regents Pg 05

Corporate Social Responsibility In The Post COVID-19 World Pg 20

How Stress is Destroying Your Teeth Pg 23

Corporate Social Responsibility In The Post COVID-19 World

Introduction to the Regents

How Stress is Destroying Your Teeth

Dr. Arash Hakhamian

Dr. Randall Whitaker Maxey

Dr. Kayvon Javid

Dr. Ioannis Georgakopoulos

You Should Be Aware Of These Cross-Industry Trends Escalated By COVID-19

A Champion of Dentistry

These Diseases Are Killing More People Than COVID-19

Getting Ahead of Flu Season

Dr. Sandeep Singh

Telehealth - The Doctor’s House Call for the 21st Century

Dr. Raquel Zita Gomes

How Boredom Fueled Innovation Amid A Pandemic

Dr. Carlos Fernando Mourão

Dr. Joseph Mina Atalla

Dr. Behnam Shakibaie

Dr. Harvey Risch of Yale on Hydroxychloroquine

Coronavirus VS. Hay Fever - How 48 Can You Tell? Black Panther No More: The Death of a Hero

Telehealth: The Next Revolution

Google Invests $100 Million in Telehealth Provider Amwell at IPO

The Next Pandemic: What You Need to Know about Rising Mental Health Concerns

The Physicians Game Plan

Is Ivermectin a 'Wonder Drug' for COVID-19?

The 5 Best Kept Secrets Physicians Are Using to Attract and Retain More Patients, TODAY!

Are You Leaving Money on the exam Table?

You Could Be Earning Another 4-6% on Your Investments with This One Simple Tax Haven

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A Champion of Dentistry “A dentist is a lifetime professional commitment. Part artist, part architect, part entrepreneur, part physicist, part surgeon, part businessman, part therapist, and part community friend.”

Dr. Kianor Shah is a practicing dentist, entrepreneur, and innovator behind the International Extraction Academy first established in 2013 and the founder of the Global Summits Institute. Believing that a “great smile gives confidence”, Dr. Shah has been working his entire career to helping the 1 in every 3 Americans suffering from dental hardships. He says that he loves the look on a patient’s face when he or she looks in the mirror post smile design as well as being able to witness the emergence of newfound confidence. “The value in that cannot be measured in numbers,” Shah says.

Born in Iran in 1980, Dr. Shah migrated with his family to Germany in 1989 where he was raised and attended high school. In an interview with Top Doctor Magazine, Shah remarked on how, even from an early age, traveling had a huge impact on his life and his practice today. Having traveled to 60 countries, Shah advises fellow doctors to be cognizant of cultural

Images by Owen Duckett

differences that may positively or negatively reflect in the chair to

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patient relationship.

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TOPDOCTORMAGAZINE.COM

While every human being often desires the same thing - to be treated with kindness and respect - if a doctor is not able to adapt to various cultural differences in their patients their practice and reviews can suffer needlessly. Graduating from high school as the German equivalent of a valedictorian, Dr. Shah showed remarkable drive in his educational journey. He later moved to the United States and attended Western Illinois University to pursue a Bachelor of Science. While majoring in Biology, he also minored in both Chemistry and German Literature.

Upon completion of his Doctorate in Dental Medicine from Southern Illinois University, Dr. Shah chose to further his education, and broaden his horizons, with an MBA in International Business from Brandman University. He became interested in pursuing an education in the financial sector after being intrigued as to how it could work to advantage his career. This degree ultimately led him to be able to expand his financial knowledge, giving him the tools needed to better run his own private practice. While completing his MBA, Shah worked part-time assisting general practitioners in performing more extensive oral surgeries within their practices. It was here that he first implemented his doctor-to-doctor system concept. The goal of which is to maximize collaboration between dentists. Within the doctor-to-doctor system, a strategy forms where doctors can learn from one another and assist each other to ensure more efficient patient care inside of their practices. He was inspired by the blockchain system which works to cut out third party influence and control. As a life-long learner and businessman, Dr. Shah understood the need to network with colleagues, creating new and exciting opportunities for both parties. “Through this it is possible”, says Shah, “to maintain autonomy and freedom over your profession.” Something that is slowly being eroded away as the competition shifts the marketplace. Following his trend of leveraging opportunities and offering peer-topeer networking, Dr. Shah created the International Extraction Academy in 2013. A continuing education program, IEA trains general dental practitioners to perform office-based oral surgeries by providing them with stepping stones into implantology. Through IEA’s training, dentists are gaining the skills to provide the best possible care to their patients while also growing their practices internally.

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In 2018, Dr. Shah began the Global Implantology Summit and it took place with over 500 participants and 63 sponsors. From this Summit’s success, Dr. Shah began implementing a series of doctor-to-doctor events, a few of which were a roundtable executive summit in 2019, the World’s Top 100 Doctors early this year, and the Global Interdisciplinary Summit. The Global Interdisciplinary Summit, a TED Talk formatted discussion and multi-course surrounding motivation and innovation, features speakers from over 70 countries who are volunteering their expertise and knowledge.

Due to the rise of COVID-19, the Summit had to be transferred to an online platform instead of in-person and was consequently switched to open source. This was received with staggering support. Over 45 consecutive days, over 2.2 million viewers tuned in. The Global Interdisciplinary Summit was so successful that since its consecutive end it has continued on weekends consistently. With many years and much expertise behind him, Dr. Shah says that he has observed a change in the dental industry. As the newer generations of dentists come into the market with student loans significantly higher than previous generations, his words of encouragement and guidance are worth heeding. If one is to walk away with a single piece of inspiration from Dr. Shah’s extremely successful career, let it be this: Do not become a slave for corporations. Do not be afraid of living your dreams of having a personal practice due to fears of future financial hardships. As Dr. Shah’s own experience can attest, the tools and networking capabilities are available. All one needs is to leverage the opportunities.

"Give me a lever long enough and a fulcrum on which to place it, and I shall move the world." Archimedes of Syracuse (c. 287 BC – c. 212 BC) Taken from https://www.extacademy.com

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Speaking as someone who was running six

It is because of his tireless effort and

offices at one time, Dr. Shah commented that

contributions for the dental industry and

after dropping that number down to one he is

community that Top Doctor Magazine is

able to do more and give better care to his

honored to elect Dr. Kianor Shah as Dentist of

patients in that one office than in six because

the year. His experiences and goals should

of personalized attention. The trend today for

inspire the next generations of dentists for

private practice dentistry is to keep

years to come, ever urging them forward to

multiplying and building in order to make

autonomy and freedom as they provide the

more and do more. This is simply not how it

best care to their patients.

works. Dr. Shah says that what you can do in one office is significant and oftentimes more

Dr. Shah will be interviewing Top Doctor

than enough. It is this type of capitalization

Magazine on October 4th for the Global

and attentive focus that will propel a dentist

Summits.

into a champion of dentistry.

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Introduction to the Regents The Global Summits Institute, beginning in 2018 with the Global Implantology Summit and continuing to the most recent Global Interdisciplinary Summit in early 2020, is a Doctor-To-Doctor movement revitalizing the way Dentistry is done. Dr. Kianor Shah founded the Institute to act as a platform in which Dentists and professionals within the industry could come together under the motto: learn one, do one, teach one. Through this, the goal is to bring true autonomy to the dental industry, cutting out third-party organizations who wish to control practices and techniques. The Institute has connected the best and brightest, bringing a community of dentists and dental specialists together to share, educate, and collaborate. In the following pages, the Regents of the Global Summits Institute are highlighted. Each Regent is an ambassador to the dental industry, creating and promoting global synergy and autonomy in their own successful practices.

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Dr. Arash Hakhamian Born in the city of Tehran, Iran, Dr. Arash comes from a family of Dentists and Doctors. Spending much of his childhood in his father’s dental practice, his passion for dentistry has been lifelong. Likewise, Dr. Arash’s passion for public service was inspired by his mother who, as a nurse and midwife, was deeply involved in multiple charities and service programs. In the 1980s, Dr. Arash’s family immigrated first to Germany, then to Austria, and finally to the United States where he has resided for the last 30 years and currently practices. After graduating from Beverly Hills High School, where he played varsity football, basketball, and volleyball, Dr. Arash attended UCLA and graduated with honors with a degree in Anthropology and Psychobiology. He was then accepted into USC’s School of Dentistry and graduated again with honors. As a dentist, Dr. Arash specializes in Implant and Cosmetic Dentistry. And in the last 5 years, he has developed into a leading expert in Teledentistry. When asked where he sees the dental industry going in the next few years, Dr. Arash said, “The dental industry will experience massive growth and consolidation over the next 5 years with corporate interests investing billions of dollars into the profession. Dentists will have to catch up with technological advancements such as Teledentistry, robotics, and mobile dentistry if they want to stay competitive with the medical field. These technologies will not only serve to increase access to dental care for millions of patients around the world, but they will also create new and innovative ways for new graduates and retiring dentists to generate revenue and practice dentistry.” With his expertise and knowledge, Dr. Arash predicts that Teledentistry will undoubtedly be one of the major players in advancing Dentistry around the world. And, when combined with robotics, will serve as the future of Dentistry with virtual dentists providing remote patient monitoring and even treatment of patients. His company, Dentulu, was recently recognized by the American Dental Association as the best Teledentistry company in the world.

“Technology has the power to connect us all and my vision is to maximize and leverage technology to help Dentists reduce their costs and increase the efficiency of how they practice Dentistry.” With the goal of being an ambassador of Dentistry to the general public and also the medical profession, Dr. Arash aims to create communication, collaboration, and connectivity between dentists, their medical counterparts, and of course, their patients. It was because of this that being chosen as a Regent for the Global Summits Institute, founded by Dr. Kianor Shah, was a perfect fit for Dr. Arash - and, as he says, “One of the highlights of my career.”

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In his interview with Top Doctor Magazine, Dr. Arash explained that he was honored to share the stage with some of the greatest Dentists in the world where everyone could share their experiences and techniques to strengthen the common goal of advancing their noble profession. The Doctor-To-Doctor movement that was established with the Global Summits Institute was recognized by Dr. Arash as a movement that not only empowers the professionals in a marketplace where third-party companies are disrupting the autonomy of healthcare, but that also protects the interests of doctors and patients. He believes that dentists and all doctors have to collaborate much more directly with one another, share information, recommendations, and experiences to protect themselves and their patients from too much corporate interest.

“The Doctor-To-Doctor movement is the fundamental backbone of everything I am doing now since its defining principles are to help fellow practitioners through education, support, and freedom of information.”

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When he is not practicing dentistry, Dr. Arash travels internationally to developing countries where he volunteers his time and expertise establishing dental protocols for various medical missions. Additionally, as a self-proclaimed technology convention junkie, he spends a significant amount of time researching emerging technologies - often the only dentist to be found immersing himself within a sea of other techie nerds, software developers, and entrepreneurs. When asked what’s next for him, Dr. Arash told Top Doctor Magazine that for the next 10 or so years of his life, outside of seeing patients and volunteering, he will be focused on advancing his Teledentistry company Dentulu. His goal is to grow it into a dental technology company made by Dentists for Dental professionals - a unicorn of a company that will be going public within the next few years.

“I hope to change dentistry for the better and leave a mark on this profession in the most positive way possible.” You can learn more about Dr. Arash and his practice here.

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Dr. Kayvon Javid Born in Iran, Dr. Javid moved to the United States when he was 14 years old. His life story is living proof that America is the land of opportunity.

“Starting from zero to where I am right now, I feel very blessed to have the privilege of being an American.” Receiving a Bachelor of Science degree in 1995 from the University of Southern California, Dr. Javid went on to spend two years researching Neurobiology through the Hedco Neurobiology Department. Then, in 2001, he returned to USC to achieve his DDS (Doctor of Dental Surgery) and graduate amongst the top ten students. Because of his success, he was offered a teaching position in the Advanced Education in General Dentistry program. From there, he had the ability - and experience - to open his own family-operated practice, Doctor Smile Dental Group in California. He is now a general practitioner with an emphasis on dental implants. In addition, he is a Diplomat and Board Certified Implantologist. When asked where he sees the dental industry going in the next 5 years, Dr. Javid said, “There will be a lot of changes in the healthcare profession and we need to focus on infection control and cross-contamination between patients.” He advised that this be accomplished through the use of extra oral suction devices to reduce aerosols, more human-friendly UVC light, and other infectious control protocols.

“In the next 5 years, there will be a surge in virtual events and video appointments as the use of a virtual experience for patients. I believe that the epidemic will bring positive changes for dentistry, and because of the “Zoom” effect, people will be more concerned about their facial aesthetics. A lot more people will be focusing on their teeth and smiles and that is going to affect dentistry in a positive way.” Dr. Javid serves as a Regent for the Global Summits Institute alongside other talented and dedicated dentists. As he remarked to Top Doctor Magazine, “when we started the Global Summits Institute, we were two doctors and no audience. Now we are hundreds of dental surgeons from all over the world and our audiences have surpassed millions.” Through the Institute, Dr. Javid hopes to provide the best education for general dentists at minimal cost so they can have the ability to better help their patients.

“I do not want to leave any doctors out. I want to help those doctors in underprivileged areas where they do not have access to better education and techniques to help their patients.”

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Speaking specifically to the Doctor-To-Doctor movement conceived by Dr. Kianor Shah and implemented through the Global Summits Institute, Dr. Javid explained that its synergy will enable doctors to stay in business against service organizations vying for control. He says that DSO (dental service organizations) purchase in bulk so that they can compete and offer things that a normal General Practitioner will never be able to. Because of this, private practitioners should join forces through the Doctor-To-Doctor movement so that they can have a presence and a voice for the benefit of themselves. In his personal practice, Dr. Javid plans on focusing not only on growing the practice but also succeeding in quality control. His goal, as it always has been, is to provide optimal health for all of his patients. This is achieved by being proactive instead of reactive. “It is best to intercept the problems before they become larger issues,” says Dr. Javid. Extractions, for example. It is best to extract a young tooth instead of waiting and letting them grow uncontrollably to an older age. The same can be said for cavities. By identifying the problems in the early stages, gum disease and bad oral habits can be avoided.

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“Treat them early and do preventative measures to ensure a long-term healthy smile.” In addition to practicing dentistry, Javid is passionate about documentation and photography. He enjoys documenting every detail such as photos for his cases, experiments, and research. Saying that photography has always been a part of his life when he is not practicing dentistry you can find Dr. Javid taking photos. Always working to better himself, Dr. Javid is currently in the process of achieving a Ph.D. in Oral Surgery. You can learn more about him and his practice here.

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Dr. Ioannis Georgakopoulos Dr. Georgakopoulos is an oral surgeon and implantologist who serves as the president of WAGRO International (Word Academy of Growth Factors and Stem Cells in dentistry) and a Regent to the Global Summits Institute. Born close to the sea in the beautiful city of Athens, Greece. He has lived outside of Greece and in Africa and Asia throughout his life and attributes much of his personality to the influence of such vast cultures. From a very young age, Dr. Georgakopoulos had an attraction to danger leading him to participate in various sports. At the age of 17, he parachuted for the first time and years later was involved in acrobatic skydiving groups. This, Dr. Georgakopoulos says, ultimately contributed to him choosing dentistry as his profession of 34 years. After graduating from high school, Dr. Georgakopoulos completed military school in Greece. He served as an officer in the Special Forces for several years. It was during this time that a botched parachute operation ended with Dr. Georgakopoulos hitting the ground hard on his lower jaw. “My contact with the great doctor who operated on me without leaving any marks on my face affected me, and that was the reason why I decided to become a dentist,” says Georgakopoulos. “You see, life often plays strange games with our decisions.” Graduating from the Dental School at the University of Athens, Dr. Georgakopoulos later studied at the Medical School of Patras University in Rio, Greece where he also received his Ph.D. He would go on to complete postgraduate programs at various other universities in Austria, Italy, Greece, and the USA. One such postgraduate program was an executive MBA from the Athens University of Economics and Business. Dr. Georgakopoulos has specialized over the years in growth factors and stem cells. He received his Master’s degree in oral surgery and implantology at the University of Bari “Aldo Moro” in Italy after studying Oral Biology. As both an oral surgeon and implantologist, he is constantly working in his field and enriching his knowledge of the applications and methods of molecular biology in Oral Surgery and Dental Implantology. When asked where he sees the dental industry going in the next 5 years, Dr. Georgakopoulos responded with, “The technological developments in science and consequently in our lives in recent years are rapid and of course they could not fail to influence dentistry. As a result, every year we see developments in new technologies. At the same time, the demands of patients have changed, they are much higher. For example, nobody wants dentures anymore - they prefer stable teeth, which are only achieved through implants.” He further projects that what we consider classical dentistry will no longer exist in developing countries in a few years. With digital technology, non-traumatic surgery, and molecular biology now being used by many dentists in their daily practices, even the most skeptical dentists are slowly changing and trying to harmonize.

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“If dentists want to be competitive, they must follow the trends of the times and the developments in science. To do so, they not only have to keep their eyes open but also be open-minded and think outside the box.” In 2019, Dr. Georgakopoulos attended the G20 Summit at Lake Forest, California. It was here he met with Dr. Kianor Shah, founder of the Global Summits Institute, and forged a relationship that would lead to a regency position with the Summit. Speaking to Dr. Shah’s doctor-to-doctor movement, Georgakopoulos says, “The doctor-todoctor movement is a brilliant idea, which in my opinion will positively influence all dentists involved. It offers new possibilities in the relationship between dentists, dental education, and dental companies. Although it is still in its infancy, I believe it will be a great success.”

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In his closing statement to Top Doctor Magazine, Dr. Georgakopoulos explained that his goals for the future are to continue growing in his knowledge, and when he can no longer do that, teach others. His wish is that WAGRO will become more widespread and travel to more countries, offering university degrees combined with live clinical education. Recently offered a position as Dean of a newly founded European Dental School, Dr. Georgakopoulos encourages readers of this article to “always dare to achieve goals that we dream of, no matter how far they seem to be. Have trust and love for oneself, but also for everything around us.”

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Dr. Sandeep Singh Dr. Singh grew up in a collection of ancient and historically important Indians cities. Born in Prayagraj, one of the principal pilgrim cities for Hindus around the world, he spent most of his childhood in Varanasi also known as Temple City. Varanasi is one of the biggest centers for International Tourism in India and Dr. Singh describes having many great childhood memories of it as he did his basic schooling there. After completing his basic schooling in Varanasi, Dr. Singh received his Bachelor of Science Honors degree in geology from Banaras Hindu University before joining VYWS Dental College and Hospital Amravati in the State of Maharashtra, India in 1990. Upon finishing his Dental schooling, he worked for a year at Banaras Hindu University in 1996. From there he went on to do a residency at India’s most premier Institution, All India Institute of Medical Sciences (AIIMS) in New Delhi in 1997. He has been in private practice since 1998 at Sahaj Dental Care & Academy. While a general dental surgeon, Dr. Singh’s first love in Endodontics, the branch of dentistry that specializes in the pulp and tissue of the tooth and root canal procedures. He is certified in Endodontics from Mallifer Institute, Dentsply-Sirona, Switzerland. To further his ability and the level of care he can give to patients, Dr. Singh earned his Master of Science in Implant Dentistry from UCLA. Additionally, he trained in Piezoelectric Bone Surgery and Growth Factors, Perio Plastic Surgeries, and is certified to train others in Advanced Hard and Soft Tissue Regeneration Techniques. When asked where he sees the dental industry going in the next 5 years, Dr. Singh predicted a major sophistication in digital advancement. To prepare for this he advises dental surgeons to adapt to the latest technologies and advancements.

“Keep yourselves updated, balancing growth and sustainability and remembering the COVID-19 scenario.” In his personal practice, Dr. Singh’s goals are to provide premier care to his patients and to educate the younger generation of Dental Surgeons. By offering the latest treatment modalities in Dentistry, he has been able to accomplish the first goal and is always striving to make life easier for those he cares for. To pursue his second goal, Dr. Singh created the Sahaj Dental Academy, an internationally acclaimed institution that he is in the process of creating into the most advanced academic institution in the dental industry. As educating the younger generations of Dental Surgeons is Dr. Singh’s self-proclaimed passion, it comes as no surprise that he is one of the founding Board Members of the Global Summits Institute.

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This Doctor-To-Doctor continuing education platform, spearheaded by Dr. Kianor Shah, has provided the perfect opportunity to instruct and guide fellow dentists to be successful in their careers. Dr. Singh told Top Doctor Magazine that his memorable moment with the Institute was getting to meet Dr. Kianor Shah along with Dr. Kayvon Javid and Dr. Arash Hakhamian in Los Angeles, California in 2018. Speaking directly to the Doctor-To-Doctor movement, Dr. Singh remarks that it has changed his career positively - bringing about an amazing community of millions of Dentists on one single platform. The Global Summits Institute's motto, imparting education, is integral to Singh’s own journey.

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“I am really proud of our organization as we have created a sort of World Record in giving Free Online Education to Dental Surgeons around the world and we are moving ahead in our unique endeavor.” On the horizon for Dr. Singh is online virtual dental education, possible through platforms such as the Global Summits Institute. To learn more about the Institute here and Dr. Singh here.

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Dr. Raquel Zita Gomes Dr. Gomes was born in the beautiful country of Portugal, growing up in the city of Porto. She studied at a Catholic school before going to the Faculty of Dental Medicine at the University of Porto (FMDUP) to pursue her dental medical degree. She graduated in 2002. From there, she went on to study Implantology in Sweden at Branemark Institute and Maxillofacial hospital in Vasteras. In the course of years between 2003 and 2007, Dr. Gomes completed a specialization course and her Master’s degree in Implantology before receiving her Ph.D. of Dental Medicine in 2018 from FMDUP. She has been a certified Oral Surgeon with a specialization in oral surgery by the Portuguese Dental Medical Association since 2017. When asked where she sees the dental industry going in the next 5 years, Dr. Gomes said, “The dental industry is growing amazingly fast, becoming more specialized, more digitized, and more female.” She recommends that for dentists to be better prepared for the future, they should be focusing on specialized education, learning to work as a team, and transitioning to a more digital-savvy practice. In her own practice, Dr. Gomes’ is striving to do this by bringing about next-level care through top-notch equipment, a very specialized team, and investments into advanced techniques. Her objective in this is to not only captivate national patients but international ones as well. In 2020, Dr. Gomes was nominated as one of the Top 100 Doctors in the world by Global Summits. Following that, she became a part of the Board of Regents for the Global Summits Institute, which reached more than 2.2 million peers worldwide, educating them in Dentistry and business during the first months of the COVID-19 pandemic. This Doctor-To-Doctor movement, says Dr. Gomes, gave her a big projection as a person and as a professional.

“[Doctor-To-Doctor] is a way to connect with doctors from all around the world, opening opportunities for global collaboration in many education programs and to make friends from different corners of the world.” In her continued pursuit of being better than the day before, Dr. Gomes wants to learn more and dominate in the advanced oral/maxillo-facial surgery technique industry. She wants to invest in her dream clinic and education center in addition to reaching a total of 50 countries in which she has spoken. For now, she has already had the pleasure of speaking in 30 countries. When she is not practicing dentistry, Dr. Gomes loves spending time with her family, playing with her daughter, teaching, and motivating her students and colleagues. She enjoys staying involved in the arts as she dances, does yoga, and goes to the cinema. You can learn more about her here. 14

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Dr. Carlos Fernando Mourão Born in Rio de Janeiro, Brazil, Dr. Mourão lived in the Recreio dos Bandeirantes neighborhood most of his life only recently moving to California. He received his degree in Dentistry from Universidade Estácio de Sá in Rio de Janeiro. In 2012, he finished his Master’s Degree in Surgical Sciences at the Federal University of Rio de Janeiro and then his Doctorate in Dentistry at the Federal Fluminense University (UFF) in 2017. Soon after, in 2018 and 2019 respectively, Dr. Mourão went on to achieve a post-doctorate in Biotechnology and a post-doctorate in Dentistry from UFF. Specializing first in Oral Medicine, Dr. Mourão went on to complete a specialization in Implantology and another one in Oral and Maxillofacial Surgery. When asked where he sees the dental industry going in the next 5 years, Dr. Mourão said; “I see that the possibilities are increasing every day. With the development of new technologies that can be included in Dentistry, I can imagine simple ideas, which were not taken forward, or often fell into disuse, as they were ahead of their time. With that, the development of the industry, aided by investment in new research, will be significant for our area.” He hopes that this will inspire dentists to continue to improve and never stop studying because we are in a vital area of health that involves oral, body, social, and psychological areas of the patients who come to doctors now. With this in mind, Dr. Mourão is currently dedicating himself to teaching and researching. He intends to stay in these areas, bringing knowledge to the largest number of dentists possible. This personal goal seems to be a driving force in Dr. Mourão’s work as a Regent for the Global Summits Institute. The Doctor-ToDoctor platform, started by Dr. Kianor Shah in 2018, has been an excellent open-sourced way for the greatest in the profession to share their knowledge. In the first few months of 2020, the Global Summits Institute reached more than 2 million viewers on Facebook. A moment that Dr. Mourão recalls as making him the happiest.

“[The Doctor-To-Doctor movement] is a great move. In addition to the visibility of the group, I believe that the most important thing was to create a friendship with different people in my area and around the world.” When he is not practicing Dentistry, Dr. Mourão loves spending time with his wife and children. His vision for the future is to get to a place where he can have a laboratory and trained team to be able to carry out more research and develop techniques and products to continue improving the dental industry.

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Dr. Joseph Mina Atalla Originally from Egypt, Dr. Atalla spent his early childhood growing up in Cairo, Alexandria, and London. Then, when he was older, between Cairo, Alexandria, and Los Angeles. Similar to his childhood, Dr. Atalla pursued his education from a varied array of countries. He achieved his pre-dental IGCSE (International General Certificate of Secondary Education) from Cambridge University, a Bachelor’s Degree of Science from Misr University for Science and Technology in Cairo, and DDS (Doctor of Dental Surgery) from the Universidad de la Salle in Leon, Mexico. By the age of 30, he had completed his dental education 3 times in 3 different countries. When asked about this kind of educational drive, Dr. Atalla said, “I like having different schools of thought for education to be able to see things from different angles.” While a general practicing dentist, Dr. Atalla focuses primarily on implant dentistry as he holds a special interest in the biomechanics, architecture, and surgery aspects of this field.

“My passion is in art and working with my hands, yet I love physics and design, and no career blends these things better than dentistry.” In his personal practice, he strives to not only treat his patients like friends and family but also to be the best equipped so as to support his implantology. One of the many ways in which he works to build a better working lifestyle is to think of the surgeries he completes as art. He told Top Doctor Magazine that he likes to listen to classical French music while working. This allows him, and consequently, his staff and patients, to better enjoy what they do and the experience of it. He has been voted one of America’s best dentists on multiple occasions and led his private practice to become one of the few worldwide offices to be ranked as a World Member of leading Implant Centers. When asked where he sees dentistry going in the next 5 years, Dr. Atalla predicted, “I think dentistry is going to take two approaches. The first is the computer design - printing or milling implication for easier and faster treatments. And the second approach - the very expensive high-end handmade artistic dentistry that will have a bigger market in some of the richer European cities where a single crown can be as expensive as 10-20K euros and no dentist can tell it’s a crown.” Serving as one of the eight Regents for the Global Summits Institute, founded by Dr. Kianor Shah, Dr. Atalla told Top Doctor Magazine that the most memorable times from the Summits have been because of the genuine friendship it has brought to him and other dentists.

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“It has a very joyful, strong family feel to it. No institution could have ever achieved that much in this little time unless everyone’s heart was into it. Dr. Kianor Shah was wise enough to make the board members and team feel ownership of what we are doing.” As someone who enjoys teaching and learning and connecting with people, Dr. Atalla is extremely proud and grateful to Dr. Kianor Shah for making him a part of the Global Summits Institute. He remarks that it’s not part of what they do individually, but who they are now as a strong team that cares and is excited about what can be accomplished together.

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“We will invent, teach, create, and build together for the coming generation, bringing better things for our children.” You can learn more about Dr. Joseph Mina Atalla and his practice here.

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Dr. Behnam Shakibaie Dr. Shakibaie was born in Ahwaz in the south of Iran in 1972. Moving to Germany in 1986, he continued his education completing high school in Berlin in 1991 and the study of dentistry at Berlin Charite University in 1998. Deeply interested in reducing surgical trauma and increasing treatment safety for patients, Dr. Shakibaie has been involved in the development and publishing of new microsurgical techniques and instruments for Oral Implantology and jaw bone reconstructions since 2005. He is considered one of the main pioneers of the new discipline of “Microscopic Implant and Jaw Bone Reconstructive Surgeries”. Currently, the head of “Implant Division”, the world’s greatest Microdentistry Community with almost 30,000 dentists as members from 135 countries, as well as Head of the “Implant Department” of Carl Zeiss International Academy of Microdentistry, Dr. Shakibaie continues to conduct his research and teaching activities internationally. When asked where he sees the dental industry going in the next 5 years, Dr. Shakibaie shared, “I can best predict the dental industry development from the viewpoint of my specialty, which is minimally invasive and microscopic implantology and dentistry. As medicine is very rapidly moving into minimally traumatic procedures in almost all specializations, dentistry has been following this trend for more than a decade. Nowadays patients are more aware in which way and how much dentists are going to harm natural structures of their mouth while providing a particular treatment procedure. Well-paying patients will not be looking for highly esthetic solutions only, rather more for a combination of excellent esthetic and minimally invasive treatments, that last for life and are repeatedly extendable while having less pain, bleeding, swelling etc. Intelligently planning dental schools like the University of Pennsylvania and others have already started educating students in lower years with optical magnification using microscopes and loupes. I think dentists worldwide should prepare and educate themselves and their teams for minimally invasive treatment concepts step by step and in all fields of dentistry. That means investing time in training, equipment, and rethinking ongoing workflows in clinics, taking more time for “Slow Dentistry.” Speaking to Top Doctor Magazine, Dr. Shakibaie explained that while he has already achieved more than he ever imagined possible in his 15 years of dentistry, he wants to continue integrating the most advanced technologies into his daily work.

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“A few years ago, I recognized that I could not move on as just a specialist practice, even though it is world unique and known, to provide my highdemanding patients with excellent multidisciplinary care. So, we will continue integrating other disciplines of microscopic dentistry into our implantperio loaded concept, like microscopic restorative dentistry, prosthetics, and smile designs.” As a result of this realization, Dr. Shakibaie’s new specialized clinic in Tehran, Iran, is considered to be one of the world’s leading centers in the field of “implant microsurgery and minimally invasive implant prosthetic oral reconstructions." He is planning his own international academy to concentrate his educational activities in one place.

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Working in the trend of educating other Dentists, Dr. Shakibaie is a Regent for the Global Summits Institute. He believes that this movement will help the dental world grow and improve authentically as dentists involve dentists in education or cooperation by exchanging scientifically and clinically based achievements and contents. In addition to the Institute, Dr. Shakibaie is one of the “World’s Top 100 Doctors in Dentistry” having been presented the award in early 2020. He recalls that this has been his favorite part of being involved with the Institute. He commented that “the idea [for Top 100 Doctors] is great, and I will never forget the countless hours of work and efforts that Dr. Shah and his team put into it for preparations to make it true.” You can find out more about Dr. Behnam Shakibaie on his official website or his Instagram account.

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CORP ORAT E S OC IA L RES PO NSIBILI TY IN TH E POS T COVI D19 W OR LD How has Covid-19 affected corporate social responsibility in health care? We live in a time like no other. The “post Covid19” world has introduced a new range of issues that reach into every home, impacting every culture around the world, including a particularly intricate set of new challenges to global corporate systems. As it pertains to health care, this calls for immediacy to reassess priorities in corporate social responsibility. While the importance of social responsibility in the health care industry has been increasing for years, the pandemic has only gone to accelerate perceptions of how well corporations perform when embracing social concerns, influencing everything from patient loyalty to investor interests.

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W HAT IS CORPO RATE SOC IA L RESPO NSIBILI TY? According to Investopedia, corporate social responsibility, or CSR, is a “self-regulating business model that helps a company be socially accountable— to itself, its stakeholders, and the public…” where by practice, companies engage to be more “conscious of the kind of impact they are having on all aspects of society, including economic, social, and environmental.”

M EDICAL COR PO RATE SOC IA L RESPO NSI BILI TY TEA M S ARE SHIF TING FO CUS TO W A RDS TH E U NDERSE RVED. Prior to the 2020 pandemic, CSR outreach has focused on raising funds and hands-on support in natural disasters, helping to organize events and coordinate teams on-site. In a time of fear and uncertainty, efforts cannot conflict with the mandates and a general need to promote distancing and minimal human contact. This presents challenges in traditional relief efforts. While Covid-19 affects everyone, some of the underserved members of society are more greatly impacted than others. Those who suffer extreme poverty, inequality, and a compromised mental health, for instance, are especially susceptible to the worst elements of the pandemic. There is an overall shift in thinking taking place, that companies need to place more focus on social outreach, interests in how best practices affect the public, caring for staff safety and emotional wellness, and a general interest in public-facing generosity above profits. Businesses are encouraged to include staff in these new initiatives, including generating a culture of volunteerism among staff and leadership. Since Covid-19 is now synonymous with remote work for many, companies turn to online connectivity for CSR outreach solutions, reassuring the public and launching social media campaigns centered around care and well-being.

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Hospitals are at the forefront of public scrutiny, especially in times of crisis. With the Covid-19 pandemic, it is impossible to ignore how standards are placed on display for all to see. It has been a time for the effectiveness of social responsibility programs to be illuminated at every level, from the efficiency of operations to the use of resources. Every step in the chain has a direct impact on communities, and CSR is a primary mechanism for hospitals to attempt to repair, refine, and improve broken services and their impact on the society they serve. With efficiency comes responsibility, which can be the difference between having enough hospital beds to handle an outbreak, to building capacity for testing the public, and even messaging about the importance of caution in spreading the virus. The first half of 2020 alone has served as a prime example of how the ability to scale and adjust is scrutinized and rated by potential investors in new initiatives and building projects. It isn’t just the efforts of health care businesses on their own, but also their ability, interest, and willingness to partner hand-in-hand with government programs and incentives to adopt better business practices that serve the community, health programs, fundraising and organized events focused on safety and mutual caring.

A SH I FT FR O M COMPLIANCE TO B RA NDI N G In an article by Jillian Einck, we are shown examples of CSR from several health care companies. The thinking, especially after the impact from Covid-19, has moved beyond doing the minimum necessary to comply with public CSR expectations, and centering more on embracing the need for outreach perception, branding every effort as part of the vision for the company. For example, Northwell Health’s “Outpacing the Impossible...” raises hundreds of millions of dollars that go to numerous programs, including clinical program improvements, advances in research, and funding endowment for education”. Dignity Health has launched a program called “Project Humankindness…” which is “centered around the concept of personal and community wellness being inextricably linked to the health of our planet” extending to communities in order to help manage outbreaks like the Covid-19 pandemic with testing, on-site clinics and numerous partnered efforts. In a time of crisis that is truly once-in-a-generation, the Covid-19 pandemic has shined a light on where companies stand in their best practices. Corporate Social Responsibility plays a specific role in how the health care industry interacts with its customers, the citizens of all walks of life. Every local community seeks leadership in a time of need, and we have all seen the best and worst cases of CSR at work, whether we knew that was the name for it or not. The pandemic has only gone to further emphasize the vital importance for companies to reach out to their communities, especially those who are in the greatest need, playing a role of connectedness. In place of focusing on how society can serve company wealth and growth, companies are looking to bridge the gap toward future preparedness. We’ve all learned that building trust goes a long way to healing the worries of a global event. So, tell us your stories! How has CSR changed with your business after Covid-19? What kind of outreach programs have you used to adjust to the “new normal”?

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Coronavirus & Stress: Disastrous Bedfellows

HOW STRESS IS DESTROYING YOUR TEETH

While the COVID-19 pandemic remains the headlining topic of distress for America and many other countries around the world, an underlying issue continues to be exposed as doctors on the frontlines are observing what they predict could be on the next horizon. The issue? Stress. From rising mental health concerns, potential vision loss, and now a growing epidemic of dental issues, the common denominator doctors are reporting is stress as impacted by the COVID-19 pandemic and its influence over normal life and activities. In the dental industry, increasing complaints related to jaw pain, headaches, and cracked teeth is being observed as clinics are reopening across the country. Additionally, dental emergencies are occurring in growing numbers. These issues are all being linked back to the stress (the root cause of each complaint) of the last several months by many practitioners. The combination of not taking proper care, not having access to regular maintenance, and assuming bad eating habits all contributing.

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A survey, conducted by the insurance company Guardian Life, reports that one in five adults have visited a dentist amid the pandemic but two in five adults have reported having dental issues since March. One of the common complaints recognized by dentists is Bruxism. Often referred to as teeth grinding, this habit can cause a host of issues including cracked teeth, tenderness in the gum, enamel deterioration, tooth decay, lockjaw, and headaches. Bruxism can be an issue in both a person’s daytime hours as well as at night when he or she is sleeping. The action of pushing the teeth together and grinding them is one of the many ways the human body reduces the energy made from stress. In mild cases, it can cause pain or sensitivity in the tooth, tired or tight jaw muscles, soreness in the jaw or face, headaches, and sleep disruption among other symptoms. In extreme cases, Bruxism can cause teeth to fracture or chip, wear down the tooth enamel, and lockjaw. Dentists across the country are noticing a higher than normal rate of chipped and fracturing teeth in patients. The alarming observation is that the breaking of the teeth is a manifestation of the overreaching mental health issues starting to become an epidemic of its own. While dentists may not be able to make stress or other mental health concerns go away, they can protect your teeth.

For treatment of Bruxism, dentists recommend wearing a mouth guard that patients can wear at night (or during the day if teeth grinding occurs during these hours) to protect the integrity of your tooth’s structure and enamel as well as alleviate pain or other symptoms. By seeing your dental practitioner, they can easily identify Bruxism signs and symptoms and prescribe a mouth guard that fits for you. However, Bruxism is not the only dental concern. Many people were forced to, or opted to, postpone regular cleanings. This, coupled with a months-long comfort food diet has exposed the teeth and gums to excess amounts of sugar with no expert care checking in.

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As the adage goes, sugar is bad for your teeth. But that’s not necessarily the entire truth. Sugar on its own is not the culprit, says an article done by Healthline. Rather, the process that occurs after sugar is consumed. Sugar, once consumed, interacts with the bacteria that is found within the plaque of the tooth, producing acid. It is this acid that is the actual cause of tooth decay because it dissolves the enamel, creating cavities. If left untreated, the hole (cavity) can move deeper into the tooth causing pain and even potential tooth loss. While cavities are almost completely preventable with proper maintenance such as routine flossing and brushing, the only true way to ward off these painful areas of decay is to visit your dental practitioner on a regular basis.

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Additionally, another common issue dentists are seeing in an emerging post-pandemic world, is the shifting of teeth out of proper alignment. While it is natural for your teeth to shift throughout your life, minor shifting can quickly become more extensive and require professional attention. The best way to prevent teeth shifting is to be proactive. Since treatment for teeth shifting is truly dependent upon the spectrum of severity, the only way to be sure of correct intervention is to consult with a professional. Whether you might need braces or a retainer, a dentist will be able to accurately prescribe you the proper course of treatment for a confident smile. The fact is that oral health is a pivotal building block for overall health making dentistry essential health care. Chad P. Gehani, President of the American Dental Association, made a statement following the CDC’s interim guidelines saying: “Dentistry is essential health care because of its role in evaluating, diagnosing, preventing or treating oral diseases, which can affect systemic health.” While people are free to delay regular dental screenings, it may come as a detriment to their oral - if not overall - health. Fortunately, the vast majority of dental clinics across the country are strictly adhering to the safety guidelines to protect both their patients and themselves from the coronavirus. They recognize, perhaps best of all, that without the adequate safety measures you are suffering because of inability to have access to proper dental care. As the coronavirus pandemic continues to cause stress and changes in daily life, it is important to remain actively involved in self-care and stress reduction routines. Stick to your good habits. Continue flossing and brushing your teeth. Remain proactively aware of teeth grinding or shifting - and go see your dentist if you notice either issue or experience pain.

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Citations https://boston.cbslocal.com/2020/09/14/dentists-surge-tooth-problems-coronavirus-pandemic/ https://www.cleveland.com/news/2020/09/dentist-see-surge-in-teeth-grinding-due-to-pandemic-inducedstress.html https://www.wral.com/coronavirus/more-dentists-suspect-impact-of-covid-19-is-root-cause-of-many-dentalcomplaints/19287809/ https://www.ada.org/en/publications/ada-news/2020-archive/august/ada-respectfully-yet-strongly-disagreeswith-who-guidance-recommending-delay-of-dental-care https://www.colgate.com/en-us/oral-health/cosmetic-dentistry/adult-orthodontics/why-does-teeth-shiftinghappen-https://www.healthline.com/nutrition/how-sugar-destroys-teeth https://www.mayoclinic.org/diseases-conditions/bruxism/symptoms-causes/syc-20356095 https://www.guardianlife.com/news/dental-covid-report-2020

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DR. RANDALL WHITAKER MAXEY: A Voice of Reason and Hope on Both COVID-19 Misinformation and Racial Disparity in Medicine Dr. Randall Whitaker Maxey is a native of Cincinnati, Ohio with over 48 years of experience as a top Nephrologist. In this time, Dr. Maxey has also been a dedicated civil rights activist and lawyer. Dr. Maxey goes on to explain where his dedication to further his education stems from his current views on today’s health issues among minorities, as well as his thoughts on the current Covid pandemic. Dr. Maxey was raised in a Mid-west family setting with his mother, father, and his three siblings. His mother was a schoolteacher, his father a local mortician. Dr. Maxey’s childhood was filled with fond memories consisting of weekends spent fishing with his father. Following in his father’s footsteps, Dr. Maxey became a licensed mortician and embalmer, with a degree from the Cincinnati College of Mortuary Science. He continued his education with a pharmacy degree from the University of Cincinnati. Torn between a career in medicine or law, he applied for graduate school in both fields of study. After trying his hand in both programs, he ultimately chose law school.

Dr. Randall WHITAKER MAXEY Images by Owen Duckett

Dr. Maxey was the first black assistant Dean of Men at the University of Cincinnati, an honor which helped him pay his tuition. By the age of 30, Dr. Maxey had already acquired a Bachelor of Science, an M.D and a PH. Dr. Maxey’s interest in practicing law diminished over time, and with that realization, he went on to attend the Howard University College of Medicine in Washington, DC. He was the first student to enter and complete their dual M.D/PhD in cardiovascular pharmacology. Dr. Maxey describes his time at Howard University as being “a special experience”. It was the first time in his already accomplished, young career that black professors and instructors surrounded him. He moved to New York to complete his internship and fellowship at Harlem Hospital Medical Center in conjunction with Columbia University and Kings County Hospital of Brooklyn.

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Dr. Maxey moved to Inglewood, California in 1978, pursuing his work as an attending physician in numerous hospitals, including Sinai Medical Center, Robert F. Kennedy Medical Center, and Daniel Freeman Marina Hospital. During the 1980s he would serve 8 years at Los Angeles’ Charles R Drew University as their Clinical Assistant Professor in Medicine, as well as the Director of Nephrology at Daniel Freeman Memorial Hospital and Robert F. Kennedy Medical Center. The early 90s-pointed Dr. Maxey’s interests towards the field of Renal failure where he followed his desire to become a licensed attending Physician in Guam. During this time, he published several notable medical papers on renal failure. Dr. Maxey’s dedication over the years was not limited to the struggle between medicine and law. After joining the NMA in 1972, it was only a few years before he was elected to their Board of Trustees. His goals with the NMA have been aimed at “eliminating health disparities between underserved Americans and the general population”. He has remained driven and determined to push for quality, accessible healthcare for the underserved Black and Latino minority communities. Dr. Maxey’s years of awareness in this critical area inspired him to found the Church Health Network in 1990. The Church Health Network’s goal was to help connect the health needs of the disadvantaged to local community churches to provide the most necessary medical resources.

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It is Dr. Maxey’s firm belief that African

TheBlackhealthtrust.org is an educational tool

American and Latino populations suffer the

to give communities information from

greatest from inadequate access to healthcare.

physicians of color, who present academic

He explains that due to allostatic experiences,

topics about protecting oneself from COVID-19,

medically known as the allostatic load, that

providing accurate statistics, up-to-date facts

poor communities suffer an excessive medical

on the pandemic, and lifestyle tips to protect

burden from traumatizing experiences, often

one’s mind and body.

beginning at childhood. The underserved become more susceptible to diseases like

The legacy of Dr. Randall Whitaker Maxey has

diabetes and hypertension, and thus,

spanned decades, touching the lives of

vulnerability to illness and high-stress levels

communities across so many sectors, not only

compromise their immune system. In today’s

as a doctor, but as a lawyer, activist, and a

climate, his message is incredibly helpful in

concerned citizen who seeks out solutions

building constructive solutions to systemic

everywhere he turns. He’s proven the example

problems.

of a life that is never limited, pursuing every degree and honorable position in excellence,

With 2020 bringing the rise of the COVID-19

while using his remarkable gifts to help others

pandemic, Dr. Maxey has founded a nonprofit

overcome their challenges.

organization called TheBlackhealthtrust.org, focused on stopping the spread of misinformation on COVID-19 and other health crises.

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YOU SHOULD BE AWARE OF THESE CROSS-INDUSTRY TRENDS ESCALATED BY COVID-19

A recent article from Trendwatching raised the topic of trends that have been growing in popularity as a result of the coronavirus. While there are some activities that may have already been taking hold prior to COVID-19, we can learn a lot about ourselves by observing how the pandemic has affected our way of life, a new reliance on virtual experiences from home, and the expectations we have from the world around us. We’re starting to care a lot more about our online experiences.

Ten post-COVID-19 trends described

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1- The Virtual Experience Economy With everything from e-sports to social media, virtual experiences that let the user take an interactive role, have increased in relevance for more people in this time, beyond the more passive activities like binge-watching your favorite TV show.

2- Shopstreaming Growing rapidly in Asia, and now the rest of the world, this is the combination of e-commerce and livestreaming, which involves sharing real-time shopping with interviews from owners and social media interaction with followers.

3- Virtual Companions As people use digital assistants and chatbots more and more, especially during the lockdown, they will continue seeking out a wide range of A.I. ‘bots’, or chatbots, artificial assistants and virtual online characters that can be helpful, but also entertaining.

4- Ambient Wellness Ambient wellness is about making use of sights, sounds, and smells to improve our general well-being, where our “surrounding environment can have a huge effect on us physically, mentally and emotionally”. This can include everything from controlling our temperature to listening to soothing sounds. Since our immediate surroundings can have a profound effect on our own well-being we should determine “if they are hugging us or bugging us”.

5- M2P (Mentor to Protégé) Most people will suffer the temptation to fill countless hours with online activities designed to pass the time, but there’s a growing move towards embracing platforms that can connect us to others we can learn from. Mentor to Protégé is about making better use of expendable hours, where people will increasingly seek out “experts, mentors, and teachers in their quest for self-improvement”. These virtual learning experiences can be anything from learning to play an instrument to virtual culinary experiences.

With everything from e-sports to social media, virtual experiences that let the user take an interactive role, have increased in relevance for more people in this time, beyond the more passive activities like binge-watching your favorite TV show.

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6- ACommerce A-Commerce stands for automated commerce. Understandably, COVID-19 has stepped up the desire to avoid human contact, shifting a wide range of local shopping and restaurant visits to the already-long list of items people prefer to buy online. As we all utilize new resources, we discover many of these platforms will simplify our daily lives even after social distancing has subsided.

7- The Burnout This refers to people’s general mental wellness. We can all understand 2020 as the year of a massive transition in people’s lives, with health concerns, a dramatic shift in social interaction, and job loss. The desire for online sources that promote mental well being is a must, and it is a field that is likely only to continue growing.

8- Open-Source Solutions Open source technology, especially as it pertains to sharing online source computer code, is a mindset and not just a shared interest. The days of the coronavirus point towards people’s desire to collaborate online, taking an interest in activities they can learn from, contribute to, while avoiding taking on an expensive side interest.

9- Assisted Development For everyone over 40, this is one of those complex topics that make the most sense to the ‘younger’ trendy generation, but imagine assisted development, at its core, as a combination of paid mentorship and hired parenting, with the aim at learning (sometimes useful) life lessons or new skills that go hand-in-hand with today’s gig culture and branded ‘life-oriented’ products. This is a trend that is often placed in the category of #adulting, where customers can learn “to become more independent, better versions of themselves”. The brands that successfully embrace these trends are likely to maintain long-term customers when, or if, we ever return to normal. Assisted development is a chance for businesses to win over long term customers by teaching them life skills that go along with branded products. For the individual, it is the opportunity to take on important processes in which they weren’t active or interested, like cooking or qualitative hobbies. 32 | TOPDOCTORMAGAZINE

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10- Virtual Status Symbols Imagine the impact the virus has had on people’s interest in online, interactive experiences. Everything from games to social media have become an entertainment and creative life-line. Software developers and online content creators have tapped into the world of e-valued items, where collectibles that only live on the internet and in the hearts and imagination of users, have taken on an increased monetary value. Now more than ever, people will seek to attain items that are collected, bought, sold and traded online, in many cases more than they have traditionally done so with physical treasures. This includes assets in games that improve a character’s abilities, and online collectibles that people can share with their friends on social media.

It’s not just about tech, it’s about trust Among the new lessons we’re learning from lockdown and social distancing, is that millions of people are having to discover how to rely on their technology in ways they never have before. This cultural shift is a profound one, but it is also something none of us have been through before. Previous pandemics and economic disasters have given us parallels to draw upon, but we are just now entering a reality of technology so unified, with fast internet and robust software not only planting us face to face with the world, but helping to integrate smart learning and intelligent assistance It is a bold step for many, to entertain spending valuable time with virtual personalities, or to place actual monetary value in items they cannot hold in their hands or place on the shelves. With all of these new changes comes the trust in the platforms that serve us, and a sobering reminder to always trust, but verify. Things like viruses and surveillance are a real part of our new realities, in virtual reality. As we step towards horizons that are opening up to us, let’s not forget how to protect our online identities, and place a high value on the relationships we share in person.

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Where are we headed from here? All of these trends speak to a value-shift towards emerging markets where “consumer thinking and behavior are becoming apparent as the pandemic moves through distinct phases in individual markets”. Many of us seek out ways to connect with friends, family, and co-workers during this time when it’s not possible to see others in person. This has led to a boom in the use of video conferencing software, which has allowed people to continue holding meetings at work, but also to engage in virtual meeting experiences, like attending happy hours with friends or going on dates, all with the aid of virtual conference platforms.

Can virtual experiences replace reality? For many years, it has been a closely-held adage, that online experiences cannot be a replacement for the real world. The sights, smells, challenges and accomplishments we receive from experiencing the world in person, and sharing in that time with close human contact are things in which we must re-engage. But, with an entire year devoted to learning new ways of experiencing life, many of these online trends are going to stay with us, only to increase.

For some, it may sound dismissive to offer an open warning not to let the new trends phase out the values of the “real” world, but there is an important truth to be found there. These trends in virtual life experiences are just that: virtual. There will be no shortage of trends increasing in that direction. Technology, the sharing of knowledge, the ability to tap into new aspects of merging human experience with the electronic will be mind-blowing, earth-shaking, and will also be experiences that human-kind has never taken part in; never in history before now. Virtual reality, for instance, with the increased capabilities of modern computing, is reaching a point of potential realism that can completely immerse, even transport a person from their surroundings. This can be healing and useful, for instance in helping recovery for people suffering PTSD, but it can also take us further ‘out there’ into an abyss with which we’re all unfamiliar. With that comes a warning to be cautious; to make sure a large portion of our humanity remains in the known, tangible, physical world that has thus far served us well.

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These Diseases Are Killing More People Than COVID-19 A Voice of Reason and Hope on Both COVID-19 Misinformation and Racial Disparity in Medicine

We’re all growing accustomed to new terms we never used to use. Sayings like “contact tracing”, “social distancing” and “shelter in place” have become common vocabulary since COVID-19 entered our lives. In fact, with so much focus on COVID-19, there is a growing concern that we should be paying much closer attention to infectious disease outbreaks that have been around a long time. With global resources going towards COVID-19, tuberculosis, malaria and H.I.V. have become neglected, and their numbers are now on the rise. TB, H.I.V. and malaria are unique in how they spread, but what they share in common is the ability to reach pandemic levels when treatments are neglected. The spread could lead to new death tolls that eclipse those of the past.

Staggering numbers: it all adds up There are more than 6 million reported cases of COVID-19 in the USA and more than 183,000 deaths. As a result, the world has reorganized to rigid protocols designed to contain the outbreak. Tuberculosis was discovered in 1882. It took over 60 years to find a cure in 1945, and over that period of time, one person out of seven died from TB in the U.S. alone. Today, tuberculosis is still “...the biggest infectious-disease killer worldwide, claiming 1.5 million lives each year.” Annually, there are more than 10 million cases of TB, with tuberculosis deaths per year exceeding 1.6 million. These numbers are almost entirely due to living conditions stemming from poverty in countries like India, Indonesia, China, Nigeria, Pakistan and South Africa.

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It’s all connected People suffering a combination of COVID-19 and TB show similar symptoms like a cough, fever and difficulty breathing. Both diseases attack primarily the lungs, with biological agents transmitting mainly from close contact. Without testing for TB alongside COVID-19, and interrupted treatments for those who are already infected, the death toll is rising quickly. COVID-19 has “... already disrupted 85% of HIV programs, 78% of tuberculosis projects and 73% of malaria programs…”. While H.I.V. is not a pandemic on its own, the highest cases exist in the same populations that are being treated for outbreaks in TB and malaria, and these same socioeconomic conditions cause a crossover of symptoms. Modern H.I.V. treatments that dramatically reduce health risks have been inaccessible, threatening to increase the death toll from other diseases due to patients’ compromised immune systems.

Most of the world’s cases of malaria are in Africa, due to a shortage of bed nets and pesticides. The World Health Organization estimates that lost access to treatments could result in over 500,000 H.I.V. related deaths and 770,000 deaths from malaria over just one year. Dr. Pedro L. Alonso, the director of the World Health Organization’s global malaria program stated that “Covid-19 risks derailing all our efforts and taking us back to where we were 20 years ago”.

Darned if you do, darned if you don’t The increase in testing for COVID-19 is causing a reduction in regimented testing for TB. This, combined with a disruption of TB services is estimated to cause a “13% increase in TB deaths, bringing us back to the levels of TB mortality that we had 5 years ago” according to the W.H.O.. The lockdowns have made it difficult to gain access to drugs or testing for TB, H.I.V. and malaria in countries like Africa, Asia and Latin America, as COVID-19 continues to overwhelm the health care system.

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How can we do better? In the same way that leaders of countries and

already recovering from TB, and those who have a life-

institutions across the globe have coordinated to fight

long regimen for their H.I.V. If this continues to be

COVID-19, there’s an urgent need to take the same care

neglected, experts all agree that decades of success

to continue treatments for those who are suffering TB

will be quickly undone to a level that is hard to

and H.I.V..

recover from, economically and in the cost of lives.

Since TB and COVID-19 can share extremely similar

Keeping medical records in a digital database,

respiratory symptoms, considerations need to include

especially while much of the world’s population is on

the regional likelihood for both, dependent on where

lockdown, can mean the difference between

the spread has historically been the worst. TB patients

recognizing those with the highest risks and a huge,

should “...take precautions as advised by health

compromised portion of the world’s population

authorities to be protected from COVID-19 and

slipping through the cracks. This means that online

continue their TB treatment as prescribed.”

doctor visits can assist in making sure everyone is assessed quickly, and the right questions are being

Programs are striving to adapt, with some allowing HIV

asked in diagnosis.

patients “... to pick up prescriptions at a community pharmacy locker…” while pharmacy groups “... allow one

Despite their differences, TB, malaria and COVID-19

person pick up prescriptions for several others…” and

solutions could work hand in hand. Contact tracing,

programs for malaria “... are buying motorcycles and

diagnosis and remaining in contact with those tested

protective gear so workers can deliver bed nets house

and treated can make the difference in years, not to

to house.” Estimates from the Global Fund place the

mention billions of dollars.While not everyone agrees

cost of such programs at nearly $30 billion.

on how to carry out solutions, there is universal certainty that the poorest populations tend to suffer

Agencies need to make it a priority to find new and

from a combination of diseases, and we all share an

creative ways to get ongoing treatments to those

obligation to do a better job reaching them.

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JUSTIN MILLER

GETTING AHEAD OF FLU SEASON The flu season is almost among us, and now is the right time to get ahead of it. Seasonal flu is a pathogenic viral infection that occurs annually in the U.S. from late fall to early spring. The flu is common within all age groups, with children infected more often. Most individuals recover without serious complications, however, some cases can result in severe illness or death. Not only is Influenza physically a burden, it takes a toll economically due to medical costs and job productivity loss. (Putri et al., 2018). It is recommended in the U.S. that persons aged older than six months receive an influenza vaccination, but less than half the population is vaccinated each year. Common knowledge dictates that populations most at risk are children, pregnant women, adults over 50, and patients with pre-existing conditions. “Molinari et al. estimated that, in the U.S., seasonal influenza is associated with approximately 10 million individuals seeking outpatient care, 300,000 hospitalizations, and 41,000 deaths annually based on the 2003 demographic profile” (Putri et al., 2018). Putri et al. (2018) also noted that direct medical costs in the US were estimated around 10.4 billion, and productivity loss caused by illness and death at a cumulative cost of 16.3 billion. With statistics and information such as these, why are people so hesitant to get a flu vaccine? An overabundance of misinformation and conspiracy fueled ideology are to blame. Web sites such as “Vaccine Resistance Movement” and “Anti-Vaxxer” promote hate fueled ideologies, entertaining the idea that the influenza vaccine will harm kids and adult users. These groups also declare that global elite’s plan vaccinations, attempting to dumb the population and introduce new pathogens into society. However, this belief is strongly inaccurate. Another factor into anti vaccination comes from parent social media accounts and websites. Parents meet in online groups, share stories or bad statistics, and confuse each other regarding vaccination efficacy. Groupthink blurs truth from fiction, causing parents to choose not to vaccinate their children because their online friend told them to do so. When situations like this happen, hundreds of thousands of children and elderly are put at risk of serious implications and even death. So, preparing for flu season early on is vital, not just for your health, but for the health of others, because much like Covid-19, protecting yourself means protecting others. Vaccination efficacy is a group effort that starts with one easy decision, getting vaccinated. “ ...in 2018-2019, the vaccine efficacy was 29% and only 49% of people in the US opted to receive the vaccine, but the Centers for Disease Control and Prevention (CDC) estimates that it still prevented 4.4 million flu illnesses, 58 000 hospitalizations, and 3500 deaths. The more people vaccinated in a population, the larger effect the vaccine has, even when vaccine effectiveness is low” (Solomon, para. 2). It takes about two weeks for the flu shot to take effect, therefore early preparation is key to immediately defend yourself from flu season. (Solomon, para. 7)

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However, if you are fully against vaccinations, there are a few things you can do to protect yourself and others. Consuming Vitamin D is a great way to stimulate the immune system and boost overall health. Vitamin D is a polypeptide, meaning it has antiviral and antibacterial properties. There’s also Vitamin C that also acts as an immune system booster alongside vitamin D. Another great way to prevent influenza is to regularly wash your hands and commonly touched surfaces. Much of what is being done to prevent Covid-19 can be done to prevent influenza. The overall best way to prepare for flu season is to get your flu shot, stock up on Vitamin C and D, as well as purchase antibacterial soaps and cleaning supplies. If you’re eating well, practicing good hygiene, and responsibly preparing for flu season, you shouldn't have much to worry about. TopDoctor Magazine has discovered an outstanding resource, Germkiller.solutions, to complement your influenza and Covid-19 prevention efforts. Germkiller.solutions has a great product, Proguardeum, that will defend you and your home from pesky germs and viruses. Visit germkiller.solutions to learn more and purchase your Proguardeum today!

References Lily Ph. Nizolenko, Bachinsky, A. G., & Bazhan, S. I. (2016). Evaluation of influenza vaccination efficacy: A universal epidemic model. BioMed Research International, 2016 doi:http://dx.doi.org.ezproxy.liberty.edu/10.1155/2016/595 2890 Putri, W. C. W. S., Muscatello, D. J., Stockwell, M. S., & Newall, A. T. (2018). Economic burden of seasonal influenza in the united states. Vaccine, 36 (27), 39603966. doi:http://dx.doi.org.ezproxy.liberty.edu/10.1016/j.vaccine .2018.05.057 Schilling, R. (2020). Fight the cold or flu with mega vitamin D3 doses. Retrieved September 15, 2020, from https://www.askdrray.com/fight-the-cold-or-flu-withmega-vitamin-d3-doses/ Solomon, D. A. (2020). Patient Information: Seasonal Influenza Vaccination. Retrieved September 15, 2020, from https://jamanetwork.com/journals/jama/articleabstract/2769679

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Telehealth - The Doctor’s House Call for the 21st Century The doctor may see you now… literally

When we think about the future, a lot of things come to mind. For some, it might be the jet pack, hover boards and moving sidewalks. For others, perhaps a Jetsonslike-world of semi-automated ‘everything’ with the zip, boom, pow of 50’s-inspired space cars and glass-domed houses spread across the clouds. In any scenario, everyone could fancy a world that simplifies the way medical care is handled. To that end, there is a resounding; “the future is now!” And, that future is called remote health.

What is remote patient monitoring? To be more specific, the future of medicine is remote patient monitoring, or (RPM), defined as the use of ”digital technologies to collect medical and other forms of health data from individuals in one location and electronically transmit that information securely to health care providers in a different location for assessment and recommendations. This type of service allows a provider to continue to track healthcare data for a patient once released to home or a care facility, reducing readmission rates.” This means that remote patient monitoring programs collect everything from vital signs to patient weight, blood pressure, blood sugar, oxygen, heart rate, and they can even perform electrocardiograms. This data can be collected from primary care, hospitals, intensive care, nursing facilities, and wherever the skilled medical professionals are available to assess the results.

The aim is for RPM to help “keep people healthy, allow older and disabled individuals to live at home longer and avoid having to move into skilled nursing facilities. RPM can also serve to reduce the number of hospitalizations, readmissions, and lengths of stay in hospitals—all of which help improve quality of life and contain costs.” RPM is a part of an even larger world of complex medical connectivity called telehealth, where every aspect of healthcare is gathered together, outsourced, driven by software, and designed with the intent to simplify an entire system.

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How is telehealth different from telemedicine? Telehealth deals with a wide range of medical services beyond the scope of clinical sessions alone. Where telemedicine “refers specifically to remote clinical services, telehealth can refer to remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services.” Telehealth includes assessing and diagnosing patients, intervention, doctor consults, and shared access to results. Often, things sound easier in theory compared to the reality. For instance, in this video produced by the Mayo Clinic, we see an example of an elderly patient whose participation in a remote monitoring program prevented the need for a clinical visit. By monitoring the patient’s weight at home, they were able to adjust their diuretic medication by phone. Getting patient information to their healthcare professionals is partly carried out by a process called Store and forward, which involves the transfer of data using a “camera or similar device that records (stores) an image that is sent (forwarded) via telecommunication to another site for consultation. Asynchronous or "store and forward" applications would not be considered telemedicine but may be utilized to deliver services.” If everyone can benefit from fewer doctor visits, and those tests we’re used to experiencing in person can be handled remotely, then what’s the hold up? Technology isn’t the only challenge in the booming telehealth industry. Medicaid and insurance providers have to work with state and federal rules regarding what is permitted, how different services are categorized and thus billed, and the logical organization of how these things are handled isn’t always the most obvious choice. A one-size-fits-all blanket of rules and codes simply cannot address the immense variance of service and classification across every state border. If other aspects of medical insurance are an indicator of the pace at which these challenges will be resolved, one can assume the red tape in proper billing and coverage for telehealth will be an ongoing, perhaps indefinite process. Regardless of the immense organization of systems that is taking place, the answer to solving these problems is found in remote patient monitoring. Everything from reimbursement policy to state and national laws, cost-cutting and billing are all a part of RPM. In fact, the possibilities are so expansive, 3rd party technology companies provide turnkey Remote Patient Monitoring solutions to assist with regulation and billing, training and everything in between.

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RPM in the time of COVID-19 As one can imagine, the COVID-19 pandemic has

One challenge that comes to mind, is that technology

provided the perfect real-world test for the usefulness of

is a built-in comfort to those who have grown up with

telehealth. It is an issue that the CDC (Center for Disease

an internet their whole lives. But, the elderly still tend

Control) focuses on, not just for getting through this

to struggle with today’s ‘gadgets’. There is a chance

challenge, but viewing this as a transitional opportunity

that those who wish to remain independent while

for change, calling for healthcare systems to “adjust the

taking advantage of the benefits of RPM may need

way they triage, evaluate, and care for patients using

increasingly simple solutions to help them translate

methods that do not rely on in-person services.”

their data to their caretakers. The technology and equipment used are straight forward, but we have to

The CDC looks at the need to improve systems for more

remain thoughtful to those who may still find the

rapid response in a crisis, in order to screen patients

everyday TV remote a mysterious futuristic device.

quickly, gain quicker access to their records, sharing data in order to limit the spread of the virus to others,

At the end of the day, we have entered a new era

etc. This means coordinating with billing, triage, and

towards the future in healthcare, and the potential

making the best use of patient data that will be an

benefits to patients, healthcare providers, and those

ongoing part of the telehealth field.

middle-men who provide the software and staff to make this all possible are a huge leap forward.

As an example, we know that COVID-19 tends to cause the greatest risk to the elderly and those with

As it is with all things, we have to also keep our eyes

compromised health, lung issues etc. If telehealth

open to the changes and make sure the benefits

becomes a standard for routine monitoring of patient

always outweigh the downside. A little bit of

vitals, when an outbreak scenario does come along, that

convenience can always run the risk of a loss of

data can help medical teams automatically shift primary

privacy, from the ways that technology can peak into

response towards people who are already in a shared

our private lives, to the open sharing of a database of

database, which could indicate who might be at the

all of these test results. With ease of shared data

highest risk. Getting to those patients early could mean

always comes the potential exposure of privacy. We

getting ahead of the curve, which we’ve all learned is a

can all remain hopeful that the end result will be

crucial element in reducing fatalities.

shedding many headaches and inconvenient pauses in our lives in waiting rooms.

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H OW BO REDOM FUELED INNOVATION AM ID A PA ND EM IC Boredom always precedes a period of great creativity-Robert M. Pirsig

In March, normal life stopped. Businesses and restaurants closed. Jobs and schools shut down or transitioned to be remotely accessible. Extra curricular activities and social events were banned. As a result, many of us woke up with lots of time on our hands and the startling realization that we didn’t have enough hobbies to fill that time. For weeks the trending topic of conversation was what to do to keep from going stir crazy while in quarantine. Suggestions ranged from completing a puzzle, texting your exes, reading a book, learning a different language, or taking up knitting or crocheting.

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Regardless of the hobby, one thing remained true: People had more time on their hands than what they knew to do with. At home workouts increased by 400%, Netflix viewership by 122%, home yoga by 222%, and more. Unsurprisingly, Apocalypse movie viewership skyrocketed past 600%, because who doesn't like watching the world end while the world “ends” around them. However, when not streaming movies and watching Tick Tocks, what else were people doing? Well, statistics say people began baking, gardening, meditating, and learning languages. Quarantine sparked a new age of self care and critical thinking. With responsibilities limited, and more downtime at home, personal flaws and bad habits surfaced forcing people to come to grips with the harsh reality that they truly didn’t have it all together.

So, why is it that when people remove their educational, career, and family obligations from the spotlight, they begin to look less like themselves and more like a stranger? Perhaps it’s because humans as a race tend to find their identity in their accomplishments and careers, rather than personal inflection and meditation. This shouldn’t be, because people need to learn how to not place their identity in temporary things, lest they lose themselves when the wind blows against them. However, quarantine created the perfect environment for people to stop, slow down, and breathe. Regardless of the stress from worrying about the virus, the situation created some much needed R&R. Although, a mind at rest, tends not to stay at rest for long, especially a previously hard working mind. The brain becomes creative when bored and highly task oriented. Humans just can’t sit still for long, unless it’s in front of a screen, yet even that has its limits. People need to do something, create something, invent something. Through quarantine, innovation found its place back in people’s minds once more.

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By definition innovation can be pretty much

When not being forced to go to class or the

anything, as long as it is being newly invented

office, people went out of their way to seek

or worked. In Les Mis terms people often call

and consume information to better

boredom-induced innovation the “redneck

themselves, for the primary reason of

method”, and during quarantine there was a

becoming more employable after quarantine

lot of rednecking. Water parks became

ended. People were just hungry to learn, as

waterslides down muddy hills, playgrounds

proven by Duolingo’s 200% increase in daily

became tire swings in the backyard, and the

use. Google as well saw a mass increase in

office became a bedroom with a lapdesk with

education based web searches. If quarantine

a lukewarm cup of joe. Yet, all of this was okay,

proved one thing, it's that people truly do care

because for once in their lives people were

about their health and wellness, and if they

finally gaining time, rather than losing it.

didn’t before they sure do now. But the search for medical knowledge doesn’t have to end

Yet, the most incredible thing about

there. TopDoctor Magazine is a vital resource

quarantine is just how much knowledge was

during this time. Not only does it cover the

consumed.

virus, it exists to help you stay relevant in the field. If you value the latest trends in medical science and more, TopDoctor is your premier resource to accomplish that.

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DR. HARVEY RISCH OF YALE ON HYDROXYCHLOROQUINE 2020 has seen more uses of the phrase “in these unprecedented times” more than any of us thought possible, and ever want to see again. One of the interesting sagas going on in these unprecedented times, amidst the Covid-19 pandemic, Black Lives Matter movement, and presidential election is the spotlight on an ordinary little drug called hydroxychloroquine. This drug, which has been used for over 60 years to treat and prevent malaria, as well as autoimmune conditions, has been studied and used safely without question, until a tweet by the President of the United States, Donald Trump, suggested it may have a role in the fight against the Coronavirus. All at once, whether or not one supported the use, or even the possibility of using this drug was all people needed to know about where you stood politically. Shortly after President Trump’s tweet went out in late March the FDA approved the use of hydroxychloroquine; patients began requesting the drug and doctors began prescribing the drug for their Covid patients.

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In April, the FDA quantified their authorization, reminding doctors that there are associated risks of heart arrhythmias, and to be cautious in prescribing hydroxychloroquine to every Covid patient. The effectiveness and safety of Hydroxychloroquine quickly became a hot-topic, polarizing issue. Dr Harvey Risch, of Yale University, has been speaking out in favor of using this drug as a cure for Covid-19. In an interview on Fox news, Dr. Risch stated, “The evidence [in favor of hydroxychloroquine] is stronger than anything I’ve studied.” In response to the side effect of an irregular heart rhythm, Dr Risch reminded the world that no doctor should be prescribing drugs to a patient that he or she does not know the health history of. For previously healthy patients, with no prior history of heart disease, there is no evidence that hydroxychloroquine has life-threatening impact on the heart. Again, this is a drug that has been studied, declared safe, and used for over 60 years up until this point.

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So with the safety of hydroxychloroquine for 90% of patients out of the question, is it truly effective and worth looking into as a potential cure for Covid? And if it is, why are we not using it? There are over 50 studies that have been conducted that show the effectiveness of using hydroxychloroquine in the early stages of the coronavirus. Of the 14 studies that claim either negative or inconclusive results, ten were done on patients who were in very late stages of Covid-19, and the other four are from sources without repute.

In countries around the world, patients who are diagnosed with Covid are taking the drug early on, and are seeing amazing results. Spain released a study in late July that revealed a 66% survival rate of Covid patients who began taking hydroxychloroquine. There have been no epidemics of irregular heartbeats or other sideeffects in the patients who have taken the drug. In Switzerland, they were using hydroxychloroquine within the first week of Covid symptoms appearing with great efficacy; however they began ceasing widespread use as questions of safety arose. Shortly after, the Covid death toll began increasing. They have since resumed use of hydroxychloroquine, but the damages caused by the controversy surrounding the drug are irreparable. An article by Steve Hatfill breaks this information down in several other countries with graphs to emphasize the data backing the usage of hydroxychloroquine. America has been taking a different tack to fight the coronavirus pandemic than many other countries, but sadly we are not seeing better results; in fact, the results of America’s response are some of the worst. One of the leading voices in coming up with America’s protocol is Dr. Anthony Fauci, who also speaks against the use of hydroxychloroquine. The method he has recommended, and is in place for treating Covid patients recommends using a new anti-virus drug called Remdesivir, an experimental drug given through an IV. Since then, studies have shown this costly drug to have little to no effect on coronavirus. Why has a drug that has hitherto gone unquestioned all of a sudden become the most demonized and controversial drug of 2020? 47 | TOPDOCTORMAGAZINE

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Coronavirus VS. Hay Fever - How Can You Tell? YOUR ALLERGIES MAY BE TRYING TO TELL YOU SOMETHING

Anyone who suffers from a hay fever allergy may run a higher risk of catching the coronavirus. It isn’t hard to find out if your symptoms are just coming from hay fever, but it’s not enough to eliminate the concern of one’s exposure to the coronavirus. Experts are concerned that the greatest risk to those who suffer from seasonal allergies is the temptation to rub their eyes and nose strictly due to the irritation they experience. In fact, this is one of the easiest ways for a person to become infected with COVID-19.

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Those with pre-existing conditions may be harder to assess You may think that double-checking with a doctor to be sure your symptoms are just coming from seasonal allergies means that you’re in the clear from COVID-19, but the truth is, that people with chronic issues that affect specific organs are likely to see an increase in common symptoms. This can be particularly tricky, since it will appear as if it is the medical condition for which they’ve already been diagnosed, when in reality, these same allergies could be aggravated by catching COVID-19.

Confusing hay fever for COVID-19

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Hay fever is the result of “...an allergic response to pollen and mold and you can get it at any age.” Hay fever symptoms include “...sneezing, runny eyes and itchy throat that signals the air is thick with pollen”. Dr. Kate Tulenko, physician and CEO of Corvus Health explains that hay fever “... is an allergic response triggered by very specific types of mould and pollen…” causing an immune system that “...releases histamine which makes all the blood vessels leaky... which is what gives people puffy eyes and makes them sneeze.” With a normal flu, only your respiratory and musculoskeletal systems are affected, but COVID-19 “...can cause many symptoms affecting different organs and systems, so the challenge is it can look like anything.”

Not just the window to the soul Since COVID-19 can include eye-related issues, it’s clear why it could be mistaken for ‘hay fever eyes’. In China, a small study of 38 patients showed that COVID-19 increases the symptoms of pre-existing eye conditions. Conditions include epiphora, or “...excessive tear production” and “...chemosis, which is inflammation and swelling of your conjunctiva… the transparent lining that covers the front of your eyeball and the inside of your eyelids. Three had conjunctival hyperemia, which blood flow to your conjunctiva causing them to appear red. And seven of the patients had eye secretions”. The hope is that studies like this can “...assist ophthalmologists and others to understand the ocular manifestations of COVID-19, thus enhancing the diagnosis and prevention of the transmission of the disease.” COVID-19 can cause a person to experience fluid overload if it damages their kidneys. This leads to reduced urine output and can make “...all your mucosa leaky, including your nose mucosa and your eye mucosa.”

What should hay fever sufferers do? First things first; if you’re suffering from seasonal allergy symptoms, have a doctor check to make sure these are actually coming from hay fever. Doctors are able to detect hay fever allergies easily with a nasal swab that presents particular cells that are only present from specific allergens.

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For those with eye and nose irritation, the best thing for them to do is take their normal medication and see if symptoms go away. If they persist, or are accompanied by a fever and aches, most likely there is something more going on. In addition to medicine, those who suffer hay fever allergies should use a saline solution to clear out the actual allergens. Changing clothing and bedding can help reduce the source as well. Wearing protective goggles or glasses and a mask can help in the conscious effort to avoid rubbing one’s face. There are so many symptoms that can appear to be a wide range of other illnesses and allergies, the only solution is for everyone to be tested for COVID-19 who has any similar symptoms. One thing is for sure; as concerns over future outbreaks linger, all of us are looking for ways to be safe, watching for potential warning signs that we may have the virus. A mystery continues to loom over this disease that can cause permanent organ damage or death to some, while going almost completely undetected for others. The medical field is hard at work to address signs we can assess with our pre-existing allergies. Some will remain skeptical about whether everyone should be tested for COVID19 or whether concerned parties are best to shelter in place, but either way, the more information we can all learn, the more we can be responsible in trying to avoid spreading the virus.

What do you think? Do you believe that everyone who displays potential symptoms for COVID-19 should be tested for the virus? Or, do you think people who are not feeling well should simply stay home and take care of themselves, sheltering in place?We’d love to hear your input.

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Black Panther No More: The Death of a Hero Chadwick Boseman, The Black Panther, beloved actor, director, and writer died August 28th from colon cancer. Born in South Carolina in 1976, Boseman rose to attend Howard University in Washington D.C., where he graduated with a degree in Fine Arts in directing. From there he went on to attend the British American Drama Academy in Oxford, England. Despite his tremendous work as the Black Panther, he was well known for his portrayal of major African American icons such as baseball player Jackie Robinson in 42, and James Brown in Get on Up. Boseman was first diagnosed with stage III colon cancer in 2016 and managed to keep his struggle silent for 4 years as it progressed to stage IV. The death of Chadwick Boseman is a colossal loss, not only for the industry, but for all those that he blessed with his presence, and philanthropy. An example of Boseman's character can be seen in his college years when a teammate on his basketball team was murdered. Rather than react in anger, Boseman reacted through creativity. It was at this time he wrote his screenplay Crossroads. 51 | TOPDOCTORMAGAZINE

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TOPDOCTORMAGAZINE.COM

“Whatever you choose for a career path, remember the struggles along the way are only meant to shape you for your purpose”

He was also passionate regarding his ancestry, attending Howard University, also known as “The Mecca” so that he would be surrounded and educated by other african americans. For him this meant growing up and investing in his culture as well as his peers, so that he could better understand and serve them. So, when he got the roll of Black Panther, this was his chance to do his people right; and he did. His portrayal of T’challa was so moving that he was given the name of Mxolisi which is Xhosa for ‘peacemaker’.

Boseman’s peacemaking didn't end there. He was frequently found donating to organizations and hospitals, where he once donated 4.2 million dollars to hospitals who service black communities. Even in death Boseman is promoting life. His death sparked a massive surge of donations and awareness to cancer research facilities. These funds will be used to stimulate research and development into cancer treatment, as well as aid family members of sick loved ones. For Boseman, he fought a hard battle and gave it his all. He was fortunate enough to be surrounded by his family and loved ones at his passing. Sadly, that is not always the case, especially today during the Covid-19 pandemic. However, don’t let the pandemic hinder seeking and receiving professional medical care. Cancer is ugly, and understanding the warning signs is crucial. You don’t have to be a medical professional to be educated and concerned about your own health, as well as your loved ones. TopDoctor Magazine is just one tool among many that you can use to better understand your health and wellness. Here at TopDoctor Magazine our goal is to improve the lives of the patient and patient outcomes for the doctors. The power for a more fulfilling life is at your fingertips, and TopDoctor Magazine is always one click or tap away. But it doesn’t have to stop there. In these uncertain times it is imperative to be equipped to combat Covid-19 to protect yourself and those you hold dear. That is why TopDoctor has discovered a great resource: germkiller.solutions to help you defend your home. It’s not by luck, nor by chance that you are prepared for Covid-19, it's by you taking action today.

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IMS Medical Equipment THIS CUTTING EDGE EQUIPMENT IS PROPELLING MANY DOCTORS TO SUCCESS WHILE OTHERS ARE STRUGGLING IN 2020 WITHOUT IT

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Telehealth: The Next Revolution BY LEAH CHRISTIANS

Medical technology takes a leap during the pandemic… and shows no signs of stopping! In the blink of an eye, everything stopped. Life as we knew it ceased to exist and in its place, uncertainty and fear emerged. It is no exaggeration to say that the COVID-19 pandemic changed the world, affecting countries, governments, businesses, and individuals in massive ways. And, as a result, we had to find innovative means in which to cope and adapt to the “new normal”. Consequently, technology took unforeseen leaps and bounds - helping millions respond to the crisis at hand. With work-from-home, social distancing, and quarantine orders, it became paramount that we be able to continue living, dependent upon already existing and start-up technology alike. Such technologies took numerous forms: video conferencing, contactless robotic deliveries, and 3D printing for example. But perhaps most notable was the increase in and advancement of telehealth capabilities across the globe.

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In a recent survey conducted by Updox, a virtual care and healthcare communication company, it was revealed that Americans are using telehealth services more and more since the start of the pandemic and liking them. The survey, after reaching out to 2,000 U.S. adults, published that 42% of those adults used telehealth services since March 2020. Among the many reasons stated by the survey participants for making the switch from inperson visits to virtual ones were “convenience for the patient” and “not having to worry about being potentially exposed to coronavirus or other illnesses”. Updox further published that a significant percentage (51%) of participants said that they would continue utilizing telehealth services post-pandemic.

The truth is, it actually

With the understanding that a wide swath of

offers a higher level of

demographics will continue pursuing telehealth services even after the COVID-19 pandemic ceases to be an active concern, it is essential to

care.

consider the impact such a transition will have. Can telemedicine offer the same level of care that an in-person visit with a physician can?

Benefits of Telehealth For example, the ability to speak with a patient and use medical devices to monitor his or her health from afar introduces not only convenience but also the concept of consulting with any specialist regardless of distance. This has huge implications for rural communities and the elderly population. In both cases, access to proper specialists or adequate care can sometimes be difficult if not impossible to achieve. With telehealth, there is virtual access to practically any specialist in the world all within the comfort of one’s home. Those living in rural areas would no longer have to drive for hours just to be seen by a physician - or, in severe cases, die from lack of care consultation. And the elderly can be treated by the best possible doctors without having to expose themselves to dangerous illnesses. 55 | TOPDOCTORMAGAZINE

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Telehealth also offers the highest caliber of quality. Through remote patient monitoring (RPM) doctors are able to diagnose faster and with more assurance. Preventive care is always better than reactionary care. RPM devices are wireless and track a range of metrics such as blood pressure, oxygen levels, and glucose. Unlike monitoring done in a hospital or with hospital equipment, RPM devices typically connect to a patients’ tablet, smartphone, or even an Apple Watch via Bluetooth. These devices receive and then transmit the readings back as a continuous stream of uninterrupted data for a physician to review. This type of data gathering is not only more reliable, but also easier to process and understand leading to quicker diagnosis and better care. Additionally, RPM devices are monitoring the patient in real time. Through this technology it is possible to see when a patient is taking their medications, if the proper dosage is achieved, and watch the results. It is also possible with RPM to alert proper medical personnel should a patient need immediate care in the face of a stroke, fall, complication, or misdosage. For example, if an elderly chronic care patient who lives alone falls, with a RPM device an alert can be sent immediately to a local medical team as well as a family member notified. This is a recent development in RPM programs that companies such as TopDocRX, headquartered in Las Vegas, are perfecting in order to stand out in the industry.

LOOKING AHEAD The rise of telehealth brings about a unique perspective for the medical industry in coming months and years. With the projection of a seven-fold increase by the year 2025, telehealth is set for a “tsunami of growth” according to Frost & Sullivan. What was once considered futuristic has now arrived at our doorstep in near full force. And companies are rushing to embrace, support, and capitalize on it. For example, in August, Google invested $100 million dollars into Amwell (formerly American Well), one of the largest telehealth providers in the U.S. This investment was preceded by an $18.5 billion dollar merge that took place between Amwell’s largest competitors, Teladoc and Livongo. With this kind of movement and projection, it is easy to envision the very near future of telehealth. In a matter of mere months, it went from mostly conjecture to a necessity. As companies such as Amwell, Livongo/Teladoc, TopDocRX, and others vie for prominent space in such a fast-pace market, it will become an amazingly fertile ground for the patient to choose the best option for their health care. This truly opens up the endless possibilities and benefits of telehealth for doctors, patients, and vendors. As Michael Morgan, Updox’s CEO, stated; telehealth will no longer be just a “plus” or something “nice to have” for medical practices… it will become a requirement to stay in business.

Our mission is to cure people and save lives. Click here to learn more

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STAY HOME STAY SAFE OUTSOURCE YOUR TELEHEALTH SERVICES FOR EASY, PASSIVE INCOME WHILE INCREASING YOUR MIP SCORE AND PATIENT CARE OPTIONS

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GOOGLE INVESTS $100 MILLION IN TELEHEALTH PROVIDER AMWELL AT IPO Not surprisingly, this year’s COVID-19 pandemic has spurred on a large increase in the usage of Telehealth procedures with over 2.9 million electronic visits completed within the first six months of 2020. As a result, Google has recently stated that they have filed to go public with their current investment made in the previously known Telehealth provider American Well (now known as Amwell) in the amount of 100 million dollars. This investment would be provided by Google’s Cloud Division with Amwell primarily choosing Google Cloud as its “preferred global cloud partner”. Thus, Google will no longer be using Amazon Web service.

Next Gen HEALTH CARE

With expectations of Telehealth growing even larger in the future due to continued avoidance of physical spaces, Google and Amwell plan on developing new telehealth technologies. A savvy integration of opportunity plus societal need as the use of Telehealth in the health care system gives patients flexibility with appointments and access to the best care while adding efficiency for health care providers to receive payments. Since the end of 2019, Amwell has seen almost three times the amount of revenue and use of service. It faces competition from both Livongo and Teladoc, two companies that merged in a 18.5 billion dollar deal. Another Telehealth provider, TopDocRX, headquartered in Las Vegas, is rumored to be in talks for acquisition. They could not be reached for comment.

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THE NEXT PANDEMIC: WHAT YOU NEED TO KNOW ABOUT RISING MENTAL HEALTH CONCERNS The last few months have been difficult on the American people. The coronavirus (COVID-19) pandemic has taken the already existing mental health crisis in America and put it on steroids. No one had time to prepare for the pandemic’s effects, especially the current and unforeseen impact on mental health in our country. Before COVID-19, we were seeing high rates of anxiety, depression, and suicide, but with the virus’ effect on the economy, mitigation activities, and losses on all fronts, the rise in statistics are staggering.

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Fear and panic have caused widespread feelings of stress, anxiety, and loneliness as people continue to self-isolate and practice social distancing. For some this has taken a devastating toll. Without question, health professionals need to, now more than ever, be attuned to mental health issues and needs. It is also time for the individual to double down on self-care and evaluate how to best help those most impacted.

Rising Concerns Anxiety disorders are the most common mental illness in the United States affecting 40 million adults, ages 18 and older, according to the Anxiety and Depression Association of America. This number calculates to 18.1% of the population. And while highly treatable, only 36.9% of those suffering actually receive treatment. In addition, it is not unlikely for anxiety disorders to cause or be associated with other mental health issues. Depression, for example. According to the National Institute of Mental Health, in 2014 around 15.7 million adults, ages 18 or older, in the United States had experienced at least one major depressive episode in 2013. In 2017, an estimated 17.3 million adults in the United States had at least one major depressive episode.

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These numbers, and the trend of increase, are a sobering consideration in light of the COVID19 pandemic and the toll it already has had— and will continue to have—on the U.S. population. In March, The Washington Post reported a substantial uptick in mental health hotline calls since the beginning of the outbreak. One hotline that provides crisis counseling to people experiencing emotional distress related to any natural or human-caused disaster told Paige Winfield Cunningham for the Post that in April alone 20,000 people texted the hotline. These numbers skyrocketed from the reported number of 1,790 texts in April of 2019. Many of the people calling or texting in have described not only emotional distress but also the feeling of being overwhelmed. This feeling, coupled with preexisting anxiety or depressive disorders is a formidable trigger that many are fighting to overcome. As reported by the CDC, 40% of U.S. adults struggled with mental health or substance abuse in June. The cause of these struggles are traced back in large part to the toll mitigation activities, such as physical distancing and stay-at-home orders, have had on the populace. Additionally, more than half (55%) of adults have experienced high levels of distress in relation to financial situations. Symptoms of anxiety and depressive disorders are at a considerably higher level than the same periods in 2019 as a consequence.

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However, it is not just mental health that is at risk as a survey conducted by the Pew Research Center discovered. They reported in March 2020 that nearly one-in-five U.S. adults (18%) say they have had a physical reaction at least some or a little of the time when thinking about the outbreak. The study emphasizes that these reactions are particularly true of those affected financially. In the light of the above concerns, health experts are encouraging people to be aware and start preventing further increases in mental health issues caused by or related to COVID-19 or mitigation activities.

Suicide The coronavirus pandemic has brought on a swift wave of intense stressors while removing much of the traditional ways in which people cope with stress and mental health. Consequently, the result could be a “perfect storm” when it comes to risk of suicide says Mark Reger, PhD, chief of psychology services at the VA Puget Sound Health Care System in Seattle and an associate professor of psychiatry and behavioral science at the University of Washington School of Medicine. While the true impact of the coronavirus pandemic on suicice is still unknown, there is clear evidence that it has caused emotional distress and feelings of hopelessness.

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Suicide is preventable, says Reger, and thus we can use what we know can work to help mitigate the risk in this time being proactive instead of reactive. Be aware of the warning signs of suicide. Even in this pandemic, there are ways to safely reach out for help. Do not be afraid to let others know that you are feeling overwhelmed and need support. At least start the conversation or process of getting help.

Additionally, be conscious of those around you. Pay attention to signs or behaviors that may indicate someone close to you is contemplating suicide or at risk. Suicide is preventable, do not downplay or ignore a situation. If you're concerned about a friend or loved one, consider these actions, depending on the situation: Offer the person the opportunity to talk

If you think you may hurt yourself or attempt

about his or her feelings, but keep in mind

suicide, get help right away by taking one of

that it's not your job to substitute for a

these actions:

mental health professional.

Contact your doctor or a mental health

Encourage the person to call a mental

professional to help you cope with suicidal

health crisis center or suicide hotline.

thoughts.

Encourage the person to seek professional

Call a mental health crisis number or a

treatment.

suicide hotline. In the U.S., call the National

Urge him or her to find help from a trusted

Suicide Prevention Lifeline at 1-800-273-

person, support group or faith community.

8255 any time of day — press "1" to reach

Offer to help the person find the necessary

the Veterans Crisis Line or use Lifeline Chat.

assistance and support, including staying

Call 911 or your local emergency number.

with the individual until a safe environment

Reach out to a close friend or loved one.

can be arranged.

Contact a minister, spiritual leader or someone else in your faith community.

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SUBSTANCE ABUSE As mentioned above, 40% of adults in the U.S. struggled with mental health or substance abuse in the month of June. The COVID-19 pandemic creates a unique challenge for those facing substance abuse. Not only are many recovery support systems disrupted because of stay-at-home orders, but people who have been exposed to certain substances are at a higher vulnerability to getting infected with the coronavirus. Like its impact on suicide, there is no firm consensus on how COVID-19 and its related topics will affect the on-going pandemic of substance abuse. However, it is important to be aware and knowledgeable on the subject. Even after this pandemic and the coronavirus is either cured or ended, the pandemic of substance abuse will still continue. In June, approximately one in 10 people reported that they started or increased substance use because of COVID-19. With this in mind, society as a whole should be preparing for an influx of substance abuse with both alcohol and drugs during the pandemic and particularly afterward. The foundations for a counter strategy against substance abuse because of COVID-19 need to be laid now.

LOOKING FORWARD Now is the time to attune ourselves to the rising tide of mental health concerns, their long-term effects, and how to shepher others to recovery. Below are some special takeaways to help navigate the current crisis:

What The Individual Can Do While it is easy to rattle off what has been taken during this pandemic, it does not help personal mental health or others’ mental health. By doing a reframing of one’s mental processes, it is possible to recast the current situation into something positive.

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While it is easy to rattle off what has been taken during this pandemic, it does not help personal mental health or others’ mental health. By doing a reframing of one’s mental processes, it is possible to recast the current situation into something positive. The pandemic has offered a reset around issues such as time spent with family members or loved ones, getting outside, and more. Helping yourself and others to stay positive is essential to combating mental health issues now and in the future. This pandemic is a marathon, not a spring. Take care of yourself and others, preventing long-lasting issues as society goes through this event together. And if you are experiencing emotional distress, suicidal thoughts, or substance abuse, reach out to trusted medical experts or helplines.

What The Physician Can Do Now, more than ever, healthcare providers are leading others through unprecedented times. Like the rest of society, their lives have been upended. Clinics and practices have made mass transitions to telehealth platforms to help ease the accessibility and continuity of care. Workloads and responsibilities have increased at a time when resources are either scarce or difficult to acquire. The true impact of coronavirus on mental health issues is yet to be known, but the indicators show a potential for long-term problems. As society maneuvers through this pandemic, it is important for everyone to stay up-to-date and educated on what is happening around you and to others. Become knowledgeable on future potential or impending difficulties now. The postpandemic world will need sound plans and structure for recovering. As we join together to fight the unseen enemy of COVID-19 and its effects on the mental health crisis in America, we must be digilent and proactive in our efforts to bring healing to others. It starts by taking care of yourselves and others, staying aware, and stepping up to address the mental health issues around us. Lives, now and in the future, are depending on it.

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TH E PH YSICI ANS GAM E PLAN Your practice is suffering. Imagine the benefits your practice would reap if you were as good at the business side as you are at medicine. You would have greater income streams, more productive staff members, a better valuation of the practice, and efficiency overall. Now, imagine what would be possible if you could also cater to niche markets and bring in new services, all while not having to hire more staff, disrupt your patient flow, or add more real estate. Learning as you go is not an effective strategy for good business. In fact, it will eventually lead to poor management and, ultimately, burnout. Author and Podcaster, Brian Hazelgren has trained over 85,000 business owners, 3,500 plus MBA students, started the Entrepreneurship Center at University of Utah, and has had seventeen years in the healthcare industry coaching medical professionals. His latest training, The Physicians Game Plan: MBA for Doctors is the sixteenth book in his long line of successful works.

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In The Physicians Game Plan, Hazelgren discusses the ugly truth that doctors usually have a difficult time maneuvering through the complex maze of business. An extremely prevalent topic for today especially since many practices have been completely shut down or severely limited for 10 plus weeks due to the COVID-19 pandemic. While most doctors are brilliant when it comes to science and medicine, they struggle with the nuances of marketing, administrative duties, billing, HR, building a positive culture, and finding news ways to drive extra income into their business. This is where Hazelgren’s Game Plan steps up. Having been involved in the medical industry since 2003, Hazelgren is well versed in traversing the intricacies of working with physicians and generating new streams of income. He states that “Physician entrepreneurs are vital to the advancement of medicine. Physicians with a business background, coupled with their incredible

“Great things are not done by impulse, but by a series of small things brought together.”- Van Gogh

medical skills, are literally an unstoppable force.” As Hazelgren says, “There is plenty of data showing the presence of a physician owner is associated with higher quality care, including better structure, efficiencies, processes, and outcomes. I have been in the medical field for a long time and have designed systems to help create new income streams for physicians and hospitals that reached over $1.3 billion. The systems work when they are followed.” When asked who would benefit the most from his training, Hazelgren responded with independent physicians, physicians in need of CME credits, and administrators or office managers. “The MBA for Doctors training system has thirty-four sessions including highly successful and proven marketing strategies; products and services that drive a six figure income in additional revenue; exciting ways to liven things up in the practice; what the practice of the future must include; and how to create and maintain a positive culture… just to name a few,” added Hazelgren. “This system will help any medical or dental professional run a much more successful practice.” 64 | TOPDOCTORMAGAZINE

Click Here for Your '17 Key Strategies to Accelerate Your Practice' and for $12,000 in Free Advertising

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IS IVERMECTIN A 'WONDER DRUG' FOR COVID-19? BY CATHERINE BONANDIN Doctors in the United States and Australia report rapid recovery from CoronaVirus-19 infections through the use of the so-called wonder drug, Ivermectin. According to doctors experimenting with its use, most cases take 6-8 days to see patient recovery from the disease. In April of this year a peer reviewed study conducted by Monash University indicated that a single dose of Ivermectin could kill COVID-19 within 48 hours, with significant reduction in 24 hours. This study was conducted in-vitro and more research is needed to see if these results can be replicated in other human trials. According to Dr. Kylie Wagstaff, one of the researchers on the project, the drug is likely to result in a more efficient antiviral response. This is because the drug “binds to, and destabilizes, the receptor responsible for transmitting viral proteins into the host cell nucleus”. The lack of research is not stopping doctors who want to find a fast and effective cure for their patients suffering from the disease that was initially thought to be incurable.

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Dr. Thomas Borody, an Australia doctor and researcher, claims that Ivermectin, when used in conjunction with the anti-viral drug doxycycline and the mineral zinc, has a 100% success rate for treating COVID-19. He says it works by allowing healthy cells to quickly remove the virus, preventing it from taking hold.

WHAT IS IVERMECTIN USED FOR? While Ivermectin has not been widely used to treat COVID-19, it has been widely used across the globe for decades to treat parasitic infections in both humans and animals. This drug was discovered through a soil sample taken from a golf course in Japan in the 1970’s. After research conducted at the Kitasato Institute in Tokyo, Japan it was released as an antiparasitic drug for animals in 1981. Ivermectin was considered the world’s first “endectocide”, meaning it could treat both internal and external parasites.

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Currently Ivermectin is used in popular pet medications, such as Heartguard, as a monthly heartworm prevention for household dogs and cats. It also has use for livestock, including cattle and swine, to prevent a long list of parasites such as roundworms, lungworms, grubs, sucking lice, chorioptic mange mites and sarcoptic mange mites. Ivermectin has been FDA Approved for internal use in humans for specific intestinal parasitic infections, and topically for external infections such as lice and rosacea. According to the US National Library of Medicine, Ivermectin works as a successful treatment for threadworm (a roundworm scientifically known as strongyloidiasis) by killing the living worms inside the intestines of humans and animals. It is a partial treatment for “river blindness” (caused by a roundworm scientifically known as onchocerciasis) by killing the larva of the worm inside the intestines. It does not kill the adult worms, which can lay eggs for up to 15 years, and Ivermectin must be taken once a year for 15 years to fully treat the infection.

IS IVERMECTIN SAFE? Since its discovery in the 1970s, the drug has become FDA approved in the United States for select human applications, and it appears on the World Health Organization’s list of “Essential Medicines”. As recently as 2011 a scientific journal in Japan called Ivermectin a “wonder drug” because of its broad spectrum use for humans and animals - stating its as universally loved as penicillin and aspirin. While Ivermectin is known to have very few side effects and is considered one of the safest drugs in the world, the FDA recently issued this strong warning, “FDA is concerned about the health of consumers who may selfmedicate by taking ivermectin products intended for animals, thinking they can be a substitute for ivermectin intended for humans. People should never take animal drugs, as the FDA has only evaluated their safety and effectiveness in the particular animal species for which they are labeled. These animal drugs can cause serious harm in people. People should not take any form of ivermectin unless it has been prescribed to them by a licensed health care provider and is obtained through a legitimate source.”

A WONDERFUL POTENTIAL Right now, the verdict is still out on Ivermectin as a treatment for COVID-19, but the science is promising. Dr. Borody mentioned that Ivermectin could be a more beneficial treatment for COVID-19 than a vaccine. Why? Because it not only helps prevent the disease, as a vaccine would, but it also treats the disease, which a vaccine will not. Borody claims that he and other doctors who are treating COVID-19 patients on the front line of this pandemic are taking a preventative dose of Ivermectin every two weeks. Their first hand experience is anecdotal, and cannot replace a scientific study, but their experience makes a good case for investment in future clinical trials.

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THE 5 BEST KEPT SECRETS PHYSICIANS ARE USING TO ATTRACT AND RETAIN MORE PATIENTS, TODAY! BY CINDY ASHTON AND CHRISTINA DAVES

The way healthcare providers run their business has changed dramatically since the beginning of 2020. When the year started, there were networking events, tradeshows, and community activities to be able to meet potential patients. Now, because of COVID-19, everything has shifted online and if your office hasn’t adapted to this new normal, not only will you lose potential clients but you might lose existing patients to those professionals who have.Here are 5 things you must be doing today, to attract and retain more patients. 1. Have a brand message that stands out. It’s no longer okay to just be a doctor. You need to build a brand around what you do. When a potential patient checks you out online, do you check out? What do they find when they enter your name into Google? People used to choose doctors based solely on recommendations from their friends or family. In today’s world, they take that recommendation and then they head to Google to make their own determination. Things to consider: Do you have a strong presence online? Do you have a brand that identifies you, your practice, and your beliefs? Is your website inviting? 67 | TOPDOCTORMAGAZINE

What are you putting out on social media that will connect you with both your existing and potential patients? Can they relate to you? Do you appeal to this demographic? These are all questions you need to ask yourself about your particular business. Take the free assessment below to see how you’re doing on all of this. 2. Position yourself as a healthcare expert and land in the media. Is that something you’ve even considered? By being in the media you are automatically positioned as an authority in your field and that makes you much more credible to existing and potential patients. By “celebritizing” yourself, you will attract more patients. Imagine when someone Googles you and a segment from your local news comes up showing you discussing a healthcare issue or a new medical procedure. You’ve just established yourself as an expert and people will want to visit the healthcare professional who the media is using as their expert. This allows you to ride the media’s coattails. If the media uses you as their medical expert, then the patient will want to use you as well.

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3. Use social media to expand your reach. Imagine you land in the media and you then use that segment, article, or interview and push it out on social media and expose your practice to thousands, even hundreds of thousands of potential patients. Social media must be an integral part of your marketing. Depending on who your ideal patient is, you’ll want to decide which social media platform is best to help you get found by that demographic. Educating and informing people about your topic of expertise online also positions you as an expert in your field and with the appropriate use of hashtags, will help you get found online. Don’t forget to check out the free assessment below and see how you are doing.

5. Know how to optimize your Telehealth/virtual visits so patients come back to you. When COVID hit, many of the insurance companies sent email blasts to their members about their in-house Telehealth programs. This took business away from the individual practices. Your patients should be coming back to you. You know them. You have their medical history. You have worked with them before. Many people were scared and found alternatives by using Telehealth/virtual services outside of their personal healthcare professionals. If you offer virtual visits, did you let your patients know? Do you have a system in place to keep your patients informed of these types of changes? And, most importantly, are you optimizing these visits so your patients feel comfortable and informed of the process?

4. Do you have an engagement program set up so that you stay in front of your existing patients? With things like urgent care and local drugstores having a medical professional located right there in your neighborhood, people sometimes forget to go to their regular doctor. Reminding them you are there and staying front of mind will have them wanting to come to you versus a quick alternative. Some medical practices have lost as much as 80% of their patients, don’t let that be you. Something as simple as an electronic newsletter will allow you to provide value to your patients. Things like best practices for your industry, a tip, an exercise, a healthy recipe, and your recent media exposure will allow you to stay in front of your patients on a regular basis.

If you need help with any of these, there is a simple system available to help you incorporate these into your practice. Before you learn more about it, take this free assessment and see where you are on your 2020 and Beyond Marketing Plan and what specifically could benefit your practice today. Get started here.

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Click Here to Take the no cost Healthcare Marketing Assessment

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ARE YOU LEAVING MONEY ON

THE EXAM TABLE? As a physician; we’re all looking for ways to increase the profit in our practices. But when presented with an opportunity, the big question we always ask is, “Will it disrupt my flow?” Good news! There is actually a program that can drive new income to your practice and keep your flow intact, all while providing patients with a much-needed value service.This sounds-almost-too-good-to-be-true opportunity is called CCM, an abbreviation for Chronic Care Management. It’s a program for elderly Medicare patients, and it’s not new. But have you heard of it?The CCM program has actually been around for over five years. When it launched in January 2015, many doctors looked at it and said, “This is a great program, but I can’t make it work in my practice. I’m just too busy.” Consequently, it was off to a slow start for the first couple of years. But that has since changed as more doctors have realized the across-the-board benefits. Nowadays, the CCM program is a mainstay for physicians—a perfect solution to a growing demographic that has yet to be reached.

CCM IS HERE TO STAY Brian Hazelgren couldn’t help but be intrigued when a couple of doctors called him in 2014. “Medicare’s going to be releasing a new program called chronic care management,” they announced. “Since you’re in medicine and health care, can you help us hire people to call our Medicare patients? This program will reimburse us an average of $42 per patient per month if we spend twenty minutes on the phone with them every month. That’s 20 minutes per month, not per call.” After accepting this offer, Hazelgren’s company RX2Live started working on this program during the last quarter of that year in preparation. In January 2015, the CCM program launched, and so did RX2Live’s participation as they became one of the pioneering companies. They hired medically qualified military veterans to make patient calls. In 2016, they were told that about 14% of the 48-million Medicare population possessed six or more chronic illnesses or conditions. Then a 2016 survey reported that Medi-care was spending about 49% of its annual costs on these chronic conditions. Still, many doctors bowed out of using the program, believing the $42 per patient per month reimbursement wasn’t enough anymore. But RX2Live saw the opportunity to not only serve Medicare patients but the doctors by making those phone calls for them. They decided to keep moving forward with the program—even created software that records patient conversations and prepares their annual care plans—and they’re glad they did. Fast forward to today… close to 20% of the now-56-million Medicare population have six chronic conditions. Spending on these chronic conditions has increased to over 51%. Obviously, it continues to grow and is not slowing down… and so does the need.

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CCM REQUIREMENTS In order to qualify for the CCM program, the patient has to meet only three requirements: 1. was seen by their physician in the last twelve months 2. consents to calls from CCM during the month to ask questions and see if they’re okay 3. has at least two chronic conditions, which consists of about 72.5% of today’s 56-million Medicare beneficiary population Based on the above statistics, that means 40.6 million recipients have at least two chronic conditions, yet only 2.8 million are enrolled in this program. There’s still many more—almost 30 million—who could benefit from CCM. Additionally, Medicare requires us to address three concerns during every phone call and ask: 1. Are you taking your medications as prescribed? 2. Are you following the care plan that the doctor and you have agreed upon? 3. Is there anything else you’d like the doctor to know about, or would you like to come in and see the doctor?

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CCM PROGRAM’S IMPORTANCE TO DOCTORS Most physicians don’t call their Medicare patients often enough. The lack of contact or during those times when the doctor is too busy to see them for three days, sometimes several weeks, that patient goes to the ER, knowing they’ll be seen that day. The patient may not be paying much money for that ER visit, but the system is. What could have been an office visit costing a couple of hundred dollars or less, now costs about $3,000. Contacting these patients can keep them from being admitted into the hospital as well. When taking a proactive approach, the system saves $75 per patient per month. Multiply that by 2.8 million patients, and that’s over $2 billion dollars in savings to the system every year. Outsourcing these phone calls to RX2Live helps you, the physician, whether you want to maintain or grow your Medicare base. We assign a case manager—LPN, RN, or medical assistant— to each patient and call them on a consistent basis, presenting ourselves as an extension of your medical practice; we will never disclose our company’s name.

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We can also contact your Medicare patients to ask them to come in for an appointment, including annual wellness visits that sometimes get ignored. In fact, we can schedule the appointment and call the medical transport to pick them up if they can’t get there on their own. Not only do you have the assurance your patients are being taken care of, but these appointments and the extra time involved to arrange the logistics for them now become another stream of income that you currently don’t have. And you don’t have to pay us until you get reimbursed, which alleviates your upfront expenses.

TRYING CCM ON YOUR OWN We’ve known of doctors who’ve tried to capture all of the $42 per patient per month. However, with just about every case we’ve seen over the past five years, the already-overwhelmed staff at the practice doesn’t have a few minutes a day or even several minutes during the month to make phone calls and do it consistently. They’re still taking care of the patients coming through the door, and trying to juggle both can burn them out. We can also contact your Medicare patients to ask them to come in for an appointment, including annual wellness visits that sometimes get ignored. In fact, we can schedule the appointment and call the medical transport to pick them up if they can’t get there on their own. Not only do you have the assurance your patients are being taken care of, but these appointments and the extra time involved to arrange the logistics for them now become another stream of income that you currently don’t have. And you don’t have to pay us until you get reimbursed, which alleviates your upfront expenses.

For more information contact us at

1-855-904-1047.

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You Could Be Earning Another 4-6% on Your Investments with This One Simple Tax Haven The Fortune Law Firm and the Death of Conventional Financial “Wisdom” Conventional wisdom teaches doctors that to protect your personal assets, you need to do business as a corporation or LLC, carry malpractice insurance, and have a trust. Conventional wisdom also dictates that for doctors to save in taxes, you will want to participate in some sort of “tax-savings retirement plan” like a deferred compensation plan to reduce your taxable income now, then save up all the receipts from your business and give it to your CPA at the end of the year, who will then find maximum deductions for you and reduce your tax liability.The problem with these tidbits of conventional “wisdom” is that they are absolute, 100% false. FORTUNE LAW FIRM is a law firm of entrepreneurs. Real business owners who know and understand the law and have realworld experience.

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The Fortune Law Firm is a Vegas-based law firm that travels the country speaking to medical professionals educating them on the myths of conventional financial wisdom and showing the doctors how to truly protect their practice, their licenses, and their assets while dramatically increasing tax savings. The Fortune Law Firm teaches the same strategies the ultra-wealthy have been using since before the U.S. started collecting income tax just over 100 years ago. Although The Fortune Law Firm has a team of traveling presenters, its two most prominent figures, Nick Fortune, a structures expert who got his masters in tax at Stanford, and Zach Parry, the Firm’s founding attorney, still love to present and turn a crowd. At first, the claims the Fortune Law Firm makes seem revolutionary, but all they’re really doing is pulling back the curtain on this so-called conventional wisdom. So what about those tidbits of “wisdom” introduced in the article? If they’re not true, then what is?Here’s the truth of it, as learned from the Fortune Law Firm:

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Corporations and LLCs do not protect doctors from their patients.

Corporations and LLCs do not protect doctors from their patients. There are a reason business own-ers set up business entities when they're running a business. Doing business as a sole proprietor means you are the business, and any liabilities of you personally or the company are the same. When you set up an entity, you are creating a separate "person" with its responsibility and liabilities distinct from your own actions, and LLCs Do Not Protect Doctors from Their Patients.

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There is a reason business owners set up business entities when they're running a business. Doing business as a sole proprietor means you are the business, and any liabilities of you personally or the business are the same. When you set up an entity, you are creating a separate "person" with its own responsibility and liabilities separate from your own. So, for example, when Sam Walton created what would become the world's largest retail chain, he established a corporation. And now, when people enter Walmart and get hurt, they seek to hold Walmart responsible, they're going to go after WalMart, Inc., and Sam Walton's personal assets are safe. But what few doctors understand is that the protections of an LLC work much differently in their field. A doctor may run her practice through an LLC, and that's certainly going to protect her if her LLC breaches the lease agreement. But that's not the potential liabilities that are keeping doctors up at night. The best way to protect your personal assets has nothing to do with whether your business should be a ccorp or an LLC. The best way to keep your stuff from being taken away from you is to make sure you don't own any stuff. The logic there seems sound, but it doesn't seem like a tenable solution. We all like our stuff, after all. But that's just a conventional mindset we need to get over. Poor people want to own stuff. They want to own a nice house in the hills and the fast sports car. The ultra-wealthy know, better, though. They don't want to own a nice house in the hills. They just want to live in it. They don't want to own a fast sports car. They just want to drive it every day. Because they know that if they own it, it can be taken away. It's not ownership that matters, then. It's controlling.

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If you structure your business and your assets in a way that you still control your stuff, but you don't own it, then you can enjoy it without risking it getting taken away. That's one of the strategies The For-tune Law Firm is good at.

MEDICAL MALPRACTICE DOES NOT PROTECT DOCTORS FROM THEIR PATIENTS The second false sense of security doctors uses their medical malpractice insurance coverage. Unlike the business entity, malpractice insurance does provide some modicum of protection, but it isn't what doctors think it is. Malpractice insurance is governed by the contract between the doctor and the insurance carrier. At its core, the terms of that contract are simple: the doctor pays the premiums, and the insurance company defends and indemnifies the doctor if there is an insurable event, like a malpractice claim. That’s two duties the insurance carrier has: the duty to defend and the duty to indemnify. The duty to defend means that the insurance carrier will hire a medical malpractice defense attorney if a claim is made against the doctor. The duty to indemnify is the insurer’s duty to pay any losses stipulated to or proven in the course of the malpractice claim. There are limits, outlined in the policy, to what the insurance company is willing to pay on the doctor's behalf. And that's the extent of the protection. And while it's good to know that the first $1 Million in liability is going to be covered by your insurance carrier, doctors who really understand the consequences of being sued are less concerned about the ultimate payout and more concerned about the potential permanent stain on their reputation that could result from having any amount of money paid on their behalf. That's because the savvy doctors are familiar with that dark presence in their lives, known as the National Practitioner's Data Bank (NPDB). Implemented by the U.S. Department of Health and Human Services in 1986, the NPDB is essentially a blacklist of doctors: a database that keeps an everlasting account of all doctors who have had adverse actions taken against them, medical malpractice payments made on their behalf, and health-care related civil judgments or criminal convictions. It is, in effect, the sex-offender registry of doctors. It's no less damaging nor less permanent.

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For example, although most standard patient contracts include an arbitration clause, far fewer contain an even more essential clause: the mediation clause. Mediation is the process through which the aggrieved party (the patient) has a chance to sit down with the accused (the doctor) and try to reach an agreement that will dispose of all issues. But even doctors who have mediation clauses usually have clauses that are written not for license protection, but to save money in legal fees, which protects insurance companies more than it protects doctors. If drafted right, the mediation clause will require the patient to request mediation as a mandatory prerequisite to filing a lawsuit. If the patient follows the contract, it gives the doctor a chance to reach a settlement prelitigation. And if done right, that prelitigation settlement does not get reported to the NPDB, so both the doctor's assets and her reputation remain intact. But what is more likely is that the patient, who hasn't read the agreement, sues the doctor without having first requested mediation. When that happens, the doctor's first call is going to be to the Fortune Law Firm. The Firm is then going to coordinate with the malpractice carrier and coach the defense attorney (who knows nothing about the NPDB and cares even less) to file a motion to dismiss against the plaintiff for failure to meet the contractual prerequisites to filing a lawsuit.

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When that motion is granted (and given judges' love for mediation and the fact that the contract is written so clearly, it will be), either the case goes back to a mediator, where the doctor has a chance to settle, or if the statute of limitations has expired—and because most cases are filed on the eve of the statute expiring, there is a good chance it will be—then the case is over, the doctor has won, and there is neither payment nor reporting. And then, the patient can pursue a malpractice case against her attorney, who filed a lawsuit without looking at or abiding by, the patient contract. If the patient does request mediation but fails, and the lawsuit moves forward, the doctor is not out of the woods yet, but there is hope on the horizon. If the doctor is a Fortune Law Firm client, she is a member of a clinical practice group that protects her in the event of post- demand settlement. Again, this requires some finesse, and so once again the Fortune Law Firm is going to coach that defense attorney to make sure he knows exactly how to structure any future settlements using the clinical practice group, which will obviate the need for any reporting to the NPDB and keep the doctor's name, license, and reputation unscathed.

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