Monthly Archives: December 2009

Blue Bloods 5: Misguided Angels by Melissa De La Cruz

I remember the day I discovered the Blue Bloods series. It was 2007 and I was walking through Barnes and Noble, probably looking for some unnecessary self help book when I stumbled upon a side display of Blue Bloods. The cover showed nothing but a neck of a young girl with two small bite marks on the side of her neck. Being a fan of vampire fiction, I never pass up a vampire novel.

I have been a reader of the series ever since. I would not call myself a fan but I read the series because I cannot stand not knowing how a story ends and also because there has been (before Twilight was the latest tween phenomenon) a lack of decent vampire fiction during previous years. Given the fact that Melissa De La Cruz, the author of the novels, is now making spin off series, I doubt this is a story that will end anytime soon.

The problem I have with this series is that it is not about vampires at all. The 5th Blue Bloods book is titled Misguided Angels and that accurately describes the content of what you are reading. The vampires in De La Cruz’s story are not vampires at all but angels, cast out of heaven after the downfall of Lucifer, trying to earn their way back into Heaven. Throughout the books we are occasionally reminded that they are vampires with about a teaspoon helping of biting/feeding here and there but other than that, they don’t exactly have any “vampire characteristics,” well, none that an angel wouldn’t already have. They aren’t immortal, which I always thought was the whole point to being a vampire, but semi-immortal and age just like normal humans until they die at the age of 100 only to be reincarnated over and over again.

Ultimately, you are reading a novel about the ongoing battle between Heaven and Hell, Lucifer and God, angels and demons. In addition to remembering who is who and what is what we are also introduced into every characters past lives as well as their angel names and memories which also ties into actual events in history. It can get rather exhausting.

Albeit, the story is well written and De La Cruz has done a good job at keeping the readers interest as well as developing each character thoroughly. She mixes just the right amount of action, suspense, drama and romance into just 400 pages. I rather enjoy the way chapters alternate narrators between our main heroin, her best friend and her worst enemy. By the end of the fourth novel I was no longer jeering the enemy, I was cheering for her because I could finally see where she was coming from and how it all looked through her eyes; she was in love and just trying to keep what was hers and had always been hers, ever since creation. I appreciate that about De La Cruz’s writing.

In the end, the story is highly enjoyable by all ages even though it is labeled as young adult; I am still reading it in my early twenties. The novels are quite popular amongst the Twilight-ers of the world and will gain even more popularity when the new spinoff is released which is about werewolves. Yes, werewolves. Although, in De La Cruz’s style, werewolves are not werewolves at all but hell hounds.

According to De La Cruzs twitter, the 5th book of the Blue Bloods series titled Misguided Angels will be likely be released sometime in the Fall of 2010. The sister book in which we learn more about Allegra Van Allen titled Keys to the Repository will be released in May of 2010. And the spinoff werewolf series titled Wolf Pack starring our good friend Bliss Llewellyn will be released sometime in 2011.

The coolest guy in Phoenix

I spent a few years in phoenix, and for the most part, I did not like it.  But I did make a few good friends.  Chad, Phil, Morgan, and quite possibly the coolest guy in Phoenix, Chris.  Chris is one of those guys you instantly like because he’s not afraid to be himself.  He took me an awesome jazz club, and we shared some great conversations.  So for those reasons, I nominate my friend Chris as the coolest guy in Phoenix.

Concierge Medicine in New York

Why are patients in New York choosing to switch to concierge medicine? Concierge doctors charge an annual fee or retainer for their services. For the small fee of around $1000 to $2500 you and your family can obtain concierge like care from your primary physician. The practice of this boutique medicine business model was started in the 90’s but has since risen dramatically in popularity. Why are more patients growing increasingly unhappy with their primary care physicians and making the switch to concierge doctors?

Patients who have made the switch to concierge medicine often express dissatisfaction with their primary care physicians. This dissatisfaction more often than not is the result of impersonalized care including long waits for appointments, shorter doctor visits and shuffling of midlevel caregivers like nurses and physical assistants.

Some patients require a slightly different and sometimes higher demand from their doctors. Many primary care physicians are unable to handle the amount of patients they have. Concierge doctors limit the amount of patients they take so they can spend more time caring for each patient individually.

Common and basic preventative services in traditional primary care are often missed or delayed because of time constraints that limit compliance with currently acknowledged clinical guidelines. Concierge medicine would result in comprehensive outpatient visits and enhanced physician compliance with these suggested guidelines.

There haven’t yet been any evidence-based studies done yet that would determine the effectiveness of concierge medicine over more traditional managed health care. However, one could assume that with proper preventive care, that concierge medicine is supposed to provide, the average patient would generally be healthier.

The overall response to concierge medicine has been varied. Some healthcare providers, medical centers and economists would say that concierge medicine is creating a two-tier health system that further separates the rich and the poor. The practice of concierge medicine has been described as both an effort by physicians to sustain a high-income ratio and an effort to offer patient higher quality healthcare services.

Concierge medicine is expected to grow over the coming years with the development of the healthcare reform bill.

Concierge Medicine in Miami

One of the most common arguments against universal health care is the long wait times to see a doctor. I read a story once about a woman who called her doctor complaining about rectal bleeding. Unfortunately, her doctor was too busy to see her. The medical assistant to her doctor insisted that rectal bleeding is caused by hemorrhoids and to wait it out a few weeks to see if it cures itself. The rectal bleeding subsided, briefly, but did return after a few months. When she finally got to see the doctor he informed her that she had a tumor in her colon and that it was now inoperable. This woman may have had a different result or a better chance if she had an earlier diagnosis.

Almost everyone has their share of doctor horror stories that may or may not involve long waiting times or not being able to find a general practitioner with an open schedule.

Are primary care physicians an endangered species? Statistics would say yes. In the U.S., around 1/3 of all general practitioners and family practitioners are over the age of 55 and are very likely to retire within the next 5 to 10 years. At the same time a shockingly low percentage of medical school students are choosing to become general practitioners.

It is no surprise that many physicians are choosing not to become general practitioners with the current health care nightmare. As one doctor once so eloquently put it, “Too many hours, too many patients, feels like fast-food medicine.”

What are physicians doing to keep themselves in the black while not being over-worked with the excess of patients? Many are trying concierge or boutique medicine. This involves patients paying an additional annual fee, ranging from $60 to $15,000, for a doctor who provides 24/7 accessibility. The doctor takes on just enough patients ranging anywhere from 100 to 1,000, a fraction of the 3,000 to 4,000 that the average physicians sees per year. This allows the physician to make a generous income while hand-picking their patients.

There are those that would say that concierge medicine is creating a two-tiered health care system that favors the wealthy. In addition, concierge medicine is limiting the already dwindling number of primary care physicians that can care those who cannot afford it and causes middle and lower class citizens to pay higher insurance premiums.

Concierge medicine seems to be making a grasp on the field of medicine and very likely will grow in popularity over the coming years as the number of patients grows and the number of general practitioners reduces.

Concierge Medicine in Scottsdale

Is concierge medicine affordable now? Concierge medicine isn’t going anywhere son, for years doctors have been offering concierge medicine to paying patients. Since the practice continues to increase in popularity are the prices seeing any difference?

Concierge doctors charge an additional annual fee to patients and offer concierge like service. They take on only a fraction of the amount of patients that the average doctor sees per year. The retainer allows doctors to offer more personalized service and 24/7 availability by phone, email and sometimes same-day appointments. They may also coordinate or sit in on specialty care and give bedside attention during hospital visits.  Fewer patients mean less wait time for you when seeing your doctor and higher profits for your doctor.

Most doctors that start their own concierge medicine practices are primary care doctors who feel they are underpaid and/or overworked. The average primary care physician sees between 3,000 and 4,000 patients per year and is unhappy with the impersonal care.

The practice of concierge medicine has been heatedly debated by economists, insurance companies and health-care professionals. One such argument is that the practice of concierge medicine is broadening the gap between the rich and the poor. In additional, doctors are allowed to hand-pick their patients meaning that the seriously sick patients are less likely to find a concierge doctor.

Supporters of concierge medicine argue that the practice of concierge medicine re-introduces patients and practitioners. They are able to take control of their health care again. Physicians are able to take better care of their patients. She can also advise the best type of treatment without worrying about whether insurance will cover it.

It is no secret that the U.S. may soon be facing a doctor shortage. Supports of concierge medicine argue that the practice will encourage more medical students to become primary care physicians.

The average annual retainer for obtaining a concierge doctor in Scottsdale is around $1500. Given the rising cost of health insurance, premiums and lack of available primary care physicians, $1500 doesn’t seem so steep to me. I wouldn’t mind paying the extra fee to know that I would be able to see my doctor immediately in case of emergency.