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The Chargemaster and it's role in the healthcare system

Author: Dr. William Rappaport
Date: April 2017

medical costs with stethoscope

In the past couple of weeks we have seen much debate regarding the health care system. President Trump tried to reform Obama Care in what he termed  “Repeal and Replace”.  The bill ultimately did not pass because the president had no support in the house and senate.
This begs the question of where is the real problem? What can be done about the costs of rising healthcare in our country?
All the politicians have it wrong, Republicans and Democrats. It's not about who pays for healthcare; it's all about the pricing from supplies to procedures. This pricing is determined arbitrarily by the same facilities that are supposed to be loyal to saving a life. THE HOSPITALS!
Why should a pacemaker cost $56,000 in one hospital and $23,000 in another? Why should a box of gauze be charged at $77 when you can buy a box for a dollar? Until we rein in the hospitals, which represent 33% of a trillion dollar medical budget, we will never control costs and will never have an open and fair market.

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ADHD Symptoms & Myths

Author: Dr. William Rappaport
Date: March 2017

ADHD KidsAttention-deficit/hyperactivity disorder (ADHD) is a brain disorder.  It is marked by inattention, hyperactivity and impulsivity. A person can have one or all three characteristics simultaneously for a long period of time.  It is absolutely normal for children to show these behaviors from time to time. However, those with ADHD present in a more severe consistent way. It can interfere with how they function at school, in the playground, at home, and through their schoolwork. It presents through inattention, hyperactivity/impulsivity or a combination of all three.
Kids with symptoms of inattention only, often make careless mistakes and have problems sustaining attention in conversation, reading and during play. They do not listen when spoken to directly and have problems organizing tasks, schoolwork and personal belongings. These children often are seen as forgetful or disorganized when in reality they actually cannot help the behavior.

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Hidden Dangers of Marijuana

Author: Dr. William Rappaport
Date: January 2017

The dangers of marijuana Marijuana legalization, decriminalization, or medicalization is on the rise. Eight states have made it legal to carry and use pot. More states are right behind those with more and more legislation in favor of its broader use. This new movement to make pot smoking legal brings hidden dangers the legislators are not telling us about. Cannabis is stronger and more potent than ever before with higher levels of THC, the main active chemical. By legalizing it our youth are getting the wrong message.

A person’s brain is not fully developed until the age of 25. When marijuana is smoked, THC goes into the lungs, then the bloodstream, and into the brain and other organs. THC works by connecting onto nerve receptors in the brain. When THC reaches different parts of the brain sensory perception, thinking, memory, and coordination all get impaired. This in turn can lead to difficulty learning, thinking and solving problems. Distorted behavior becomes the norm and is a result since decision-making centers are greatly impaired. These are all the short-term effects when a person is “high”. It can lead to risky behavior like driving while under the influence, sexually acting out, or even arrest for doing something risky.

The long - term effects on a growing brain can lead to irreversible damage. Studies have proven long term use of marijuana leads to chronic respiratory problems, low fertility rates, and impaired cognitive abilities. It can also lead to psychological problems like anxiety and depression. If someone is diagnosed with bipolar disorder, schizophrenia, or has psychosis it can actually make it worse. Long-term effects can touch every area of a kids life from schoolwork to career choices to achieving goals.

Marijuana is addictive and withdrawal can be difficult. It can alter a growing brain to the point of no return just like other recreational drugs used by our youth today. If you need help talking to your child there are many sites and books to inform the best and most affective way to do this.




Thank you for continuing to read these blogs. Feel free to suggest any topics you would like to hear about in the upcoming year. 


 Dr. Rappaport




Have you noticed your child having frequent coughing at night, during the day, with colds or playing sports? It could be an asthma attack.

Asthma is a chronic inflammatory condition of the lungs leading to airflow obstruction and airway hyper responsiveness. This condition is characterized by symptoms of coughing, chest tightness, shortness of breath and wheezing.  As mentioned above triggering factors are often infections, cold air, allergies and exercise.

Asthma is the leading cause of chronic illness in children affecting 7 million in United States alone. It can begin at any age but most symptoms are seen early as young as 2 to 5 years of age and two thirds of asthmatics are diagnosed before the age of 18. Who are these children? Asthmatic children usually come from families that have a history of allergies Including food or environmental and live in an urban setting.They have other family members with asthma particularly on the mothers side. Common presentation is a young child between the ages of two and five with unexplained coughing and difficulty breathing with a common cold.

It can be difficult to determine whether your child is having asthma related symptoms particularly under the age of five. That's why it's important to track when, where and how symptoms present, keeping a diary for your doctor. A good history along with a physical examination and breathing tests for children over the age of six often secures the diagnosis. As well, children with asthma have a 90% chance of being allergic to environmental allergens such as pollen, dust mites or animal dander. Skin testing for allergies can also add more evidence towards the diagnosis and help with treatment.

Once your child is diagnosed with asthma he or she can live a normal, extremely active life which can include any aerobic sport. Newer medications which are extremely safe with few side effects have aided in complete control of symptoms. Your doctor and you can develop an individual emergency action plan to avoid symptoms and keep asthma silent.



Tic Disorders and Twitches

Has Your Child Ever Had Uncontrollable Facial Movements or Vocal Outbursts?

If the answer is YES they may have a common TIC DISORDER.Tic disorders and twitches

Parents who watch and hear their children repeat movements or vocalize noises worry something must be terribly wrong. In most cases the opposite is true! Tics are involuntary, cannot be controlled and are often a source of social embarrassment for both parent and child.

They present as involuntary:

  • blinking
  • twitches
  • movements
  • humming
  • shoulder shrugging
  • throat clearing
  • or a combination of all at various times

They often appear when a person is under high stress situations such as school pressures, family emergencies, peer pressures and even normal everyday stress associated with a growing body and mind. They are seen most often in boys. In severe cases genetics plays a role such as in Tourette’s syndrome. Tics may be simple or complex. A simple tic may be something like eye blinking, a grunt, muscle twitches, facial grimacing, or nasal flaring. These are purposeless movements. A complex tic consists of throwing, scratching or chewing. These are muscle movements with a purpose. A vocal complex tic produces a word not just a sound.

Tics fall into different categories such as:

  • Chronic Vocal or Motor Tic Disorder: Motor and vocal tic involvement that appear many times a day for a period of at least a year.
  • Provisional Tic Disorder: Tics of either vocal or motor in nature that lasts for less than a year and is eliminated when a stressful situation resolves.
  • Tourette’s Disorder: The presence of tics for at least a year, which are both vocal and motor in nature. They must be frequent and never stopping for a period of longer than 2 months. It is also usually associated with ADHD and obsessive-compulsive difficulties or certain diseases such as Huntington Disease or post viral encephalitis.

Tic and Twitching Disorder Treatment:

The first line of defense should be wait and watch. Most tic disorders are over as the individual matures.  It tends to resolve gradually even if medication is used to treat. Talk to your doctor, keep a log of your child’s tics from month to month, and most importantly try to ignore it. The more attention it is given the worse it can be! 

Talk to your doctor and have him/her evaluate the child before any further action is taken. 


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