October in Family Medicine in Ohio brings another set of problems to the office. The new Medicare year starts October 1. Typically, on the business side of the practice, Medicare makes changes that result in delayed payments for a couple months. Cash flow gets stuck.
The ragweed season downshifts to the damp and moldy season outdoors and dust and mold indoors. Somehow allergies beget acid reflux and respiratory infections, aided by the start of the school year which traps coughing children in tight quarters. Upper respiratory infections sometimes make too much mucous to be tolerable and inability to breathe through the nose which causes insomnia. The URI finds the lungs and adds lower respiratory tract infection to the code list. Then the cough lasts 12-15 days, which can be really annoying (and good for business).
Added problems this October include the FDA labeling hydrocodone a Schedule II drug which makes it similar to Oxycodone in how we have to handle it. One month at a time. Patients no longer get any refills on the hydrocodone pain meds and they have to see us once monthly to get evaluated and prescribed again.
Flu shots are on more patient's minds since the threat of the Ebola virus is looming. Airport workers may become more concerned about the Ebola uncertainty as they process passengers from Africa.
Welcome to October.