Thursday, December 20, 2012


By John Norris, Managing Director, and the Head of Wealth Management at Oakworth Capital Bank in Birmingham

Our elected politicians are currently sparring over tax rates and spending cuts to avoid something popularly called “the fiscal cliff,” as we head into 2013. If the two sides can’t reach a conclusion, all the so-called Bush tax cuts expire, as does the Administration’s payroll tax break. Further, the Congress will have to start cutting spending, or at least cut the growth of deficit spending moving forward.
When combined, the US economy is presumably facing a sudden loss in liquidity, or government largesse if you will. While experts can’t reach a unanimous conclusion as to the outcome, they are in agreement it won’t be positive for the economy. Frankly, that probably isn’t very likely.
The reason is pretty simple: either party’s proposal is preferable to letting everything expire, no matter what the media leads you to believe. Further, Washington’s concept of spending cuts is much different than yours or mine. When we cut spending, we reduce the absolute number of dollars going out the door. When the Federal government does it, it simply reduces the projected amount of deficit spending over the next 10 years.
As a result, the biggest problem with the fiscal cliff is psychological, in so many ways. Yes, your tax bill is likely going to go up no matter what happens, but the end result is probably not going to be as bad as you currently think. Once you accept this, the only thing left is for Washington to quit the fooling around, and set the rules moving forward. After all, knowing what the rules are is arguably more important than the rules themselves.
What is more concerning is the public’s basic illiteracy regarding what has become known as Obamacare.
I admit I haven’t taken the time to read the entire 2000 page healthcare bill. So, I don’t know all the nuances and the like. Does anyone, really?
Obviously, the problem with predicting the future is things can change. I have seen the numbers Washington is throwing around in regards to associated costs, and think you can throw them out the window. They are estimates about something that has never happened from people who have never had to make them. Were the original 10-year estimates for Social Security, Medicaid, and Medicare accurate? You know, who cares? What good is a 5-10 year guesstimate when you are talking about a perpetual entitlement/program?
Now, throw political ideology out the window, and look at the issue in terms of basic economics. What ultimately determines the price of a good or service in a competitive market? Perhaps it has something to do with the level of consumer demand relative to the supply, you think? If demand is greater than the available supply, prices go up. If it is less, they go down. This makes sense.
For all the hand-wringing in Washington, I still can’t figure out where the increase in supply is going to come from in order to drive down the price of healthcare. Oh, I understand forcing people to buy insurance policies and the like, and there might even be a public option. Who knows? But that isn’t the same thing as increasing the supply of healthcare, is it? Wouldn’t that actually be increasing the number of people demanding it? Hmm.
Think of it this way. From what I have read, the new Birmingham Barons stadium, Regions Field, is estimated to have a seating capacity of around 8,500. Now, what if the Yankees come to town to play an exhibition against the Barons, and I stand outside the stadium selling $5 general admission tickets to everyone who walks up? If I sell 20,000, how many people will be able to get inside to watch the game? What? 8,500? Maybe 10,000 if you use a shoehorn? What about the other 10,000?
Hey, you might not get to see the Yankees play, but you would have an affordable ticket to watch them, wouldn’t you? As such, you should be happy and thank me.
The only real way to have a meaningful decrease in healthcare costs is to increase the number of trained medical professionals and decrease our demand for them. It is kind of like losing weight. You won’t keep the weight off for good unless you fundamentally change your eating habits and get some exercise. Everyone thing else is just pushing string, wasting time, and spending someone else’s money. 
So which is it? Forcing people to buy insurance will increase demand, but what about supply? Well, cutting Medicare payments 21%, tacking an additional $2 billion tax on medical device companies, and forcing states to pick up more of Medicaid at first blush don’t look like good attempts to increase the supply of healthcare. In fact, you could even argue these things might actually decrease the supply. Hey, you seniors on Medicare, the doctor won’t be taking on anymore Medicare patients this year! If they do, they make less money, and making less money isn’t what most people go into medicine to do. 
In the end, from what I have seen thus far, healthcare reform, at this stage, proves to be a costly endeavor, for someone, which won’t be able to deliver as promised. Still, there are people who honestly believe Obamacare is going to provide “free healthcare” and the same measure of care to everyone. That is very frustrating, because it simply isn’t going to happen.
Where the rubber meets the road, between the fiscal cliff and Obamacare, the American public gets bombarded with a lot of talk and not a lot of useful information. If Washington’s end aim is to frustrate and confuse the medical industry and the rest of us, it seems to be doing a good job. If it is to rapidly expand the economy and increase the supply of healthcare in the country, I am afraid its current actions and game plan are, well, ironic.

John Norris is a Managing Director, and the Head of Wealth Management at Oakworth Capital Bank in Birmingham. He can be reached at
The opinions expressed within this report are those of John Norris as of the initial publication of this blog. They are subject to change without notice, and do not necessarily reflect the views of Oakworth Capital Bank, its directors, shareholders, and employees.       

Tuesday, December 18, 2012

Retrieving Data When and How You Need It

Written by Emily Jones, Senior Manager of Jackson Thornton Technologies

We all know how much we depend upon our business’ data to be able to make accurate decisions.  However, most businesses struggle with retrieving and utilizing their information.  It can prove to be a daunting task to gather information from various electronic applications only to end up manually combining all that information to finally have the data you need.

You may have heard the buzz word - Business Intelligence (BI) – and wondered what it is.  BI is somewhat self-explanatory in that it is a way to make your business more intelligent.  Business Intelligence streamlines the day-to-day processes and procedures of data management.  It is a method of looking at data to make better business decisions both for today and into the future. 

One of the most common uses of BI addresses the issue of retrieving information in an automatic, accurate, and easy to understand format.  This allows you as a business manager to easily spend your time running your business rather than combining your business information.  BI can consolidate, normalize, and analyze the data from various sources that your organization has been collecting.  Business Intelligence is an integral piece that joins business activities and the information technology necessary for those activities. 

Many have thought that BI was only needed by mega corporations and that they were the only ones that could afford to use it.  With today’s technology, this is false.  Over the last several years, BI has moved into mainstream usage for mid-size and small businesses alike.  Companies such as IBM have products like Insight and Cognos Express that fit well in this arena by providing mid and small sized companies with excellent BI tools that are both easy to use and affordable.  Business Intelligence solutions give your company the ability to track, analyze, and manage its internal information more efficiently.  And, we all know that an increase in efficiency has a direct correlation on overall profits.

We’ve all been saving our data in various methods, and for what reason?  If you cannot quickly and easily access the data to make knowledgeable business decisions, you need to check into what a good BI system can do for you.  Implementing a Business Intelligence strategy is a great way to keep your company as efficient as possible to consistently stay competitive in today’s business environment.

Monday, December 10, 2012

Bad to the Bone

By Ryan Cordry, DO, MBA with Medical West

Did you know that bone is a living tissue? It's true. During our lives, bone is being continually replaced by new bone. But what happens when you don't produce enough new bone to replace the old? Then you have osteoporosis.

In its most basic terms, osteoporosis is when you are losing density in your bones. This loss of density makes your bones more susceptible to breaking. It is the most common bone disease, and prevalent among women. Around 50 percent of all women over 50 years old will fracture a wrist, hip, or a vertebra.

If you've ever broken a bone, you know what a pain it is and how difficult it can make life. It causes you to adjust the way you do things - from not being able to hold a cup of coffee to wearing a boot or having to use a wheelchair.

Osteoporosis can have a major effect on how you live your life. It's important to know how you get it, and how you manage it so you can live comfortably. While there are occasions when bone loss occurs with no explanation, there are a several factors that can put a person more at risk.  
Risk Factors
 For women - a significant drop in estrogen (often triggered at menopause) and a long period of time without menstrual periods
 For men - a drop in testosterone
 A low body weight increases risk
 Smokers have a higher risk of osteoporosis
 Consuming heavy amounts of alcohol
 Osteoporosis presence in family history
 Some medications can reduce bone density

When it comes to risk, the older you are - the more likely. And older white women are at the top of the osteoporosis totem pole.

Diagnosing can be tough, as there are many times when people don't realize they have osteoporosis until they actually break a bone and it is discovered.

Often times a Dexa Scan (a bone mineral density test) will be conducted to gauge the density of your bones and how much bone loss is present. It can also help determine just how likely you are to break more bones.

Treatment of Osteoporosis

Lifestyle changes are often recommended. Diet and exercise can help maintain bone strength. Stopping smoking and drinking less alcohol may also be recommended.

Calcium and vitamin D. Milk does a body good? The right amount does. Calcium is an important mineral in bone formation. You could just be deficient here. Ask your doctor what the right amount of calcium is for you.

There are medications for osteoporosis that are often used when a deficiency in bone density is revealed. Depending on your sex and situation, your doctor will know best.

Hormonal replacement is also an option - estrogen or testosterone enhancements can get the body jolted back to a healthier bone production level.

Quick Tips to Prevent Falling, If You Have Osteoporosis
 Stay on stable ground - avoid icy sidewalks, slick surfaces
 Use the handles on stairs, to get out of bathtubs
 Leave a few lights on at night - if you can't see where you are going or what you are stepping on, you're asking for a problem
 Don't exercise or go on a walk alone - if you do fall, you need someone there to help

As stated above, osteoporosis is extremely prevalent. Do your best to live a lifestyle that puts your body at less risk. It's about living healthy to live happily.

Monday, December 3, 2012

Hyperbaric Oxygen use in Delayed Radiation Injuries

By Jeff Rickert, M.D.
Board Certified, Internal Medicine
Director, Hyperbaric Oxygen Department, Princeton Baptist Medical Center

Many patients receiving treatment for various types of cancer undergo radiation therapy either alone or in combination with surgery and/or chemotherapy. Although the benefits of radiation therapy are widely known, one potential side effect is Delayed Radiation Injury to hard or soft tissues of the body. This unfortunate side effect can have a significant impact on the quality of life for the brave patients battling cancer. 

Symptoms of injury to irradiated tissues can occur at any point after exposure -- sometimes years after radiation therapy is finished. Delayed Radiation Injury is usually seen at least six months after therapy is complete and can involve both soft tissues, such as the lining of the bladder or intestines, or hard tissues like bone.

The causes of Delayed Radiation Injury result from the release of inflammatory substances after exposure to radiation. These inflammatory markers, called cytokines, are involved in the formation of fibrosis, scar tissue, and damage to small blood vessels that supply oxygen to tissues. This results in compromised delivery of oxygen, or hypoxia, to these vital tissues which can lead to chronic inflammation, bleeding, ulcer formation, delayed healing and even severe infection.

A disruption in the normal framework of these blood vessels and local cell structure can cause severe tissue inflammation seen in proctitis (with colorectal cancers), cystitis (with bladder cancer), and bone necrosis (especially in those patients with oral cancer and radiation to the neck or jaw). With radiation injury to the jaw, patients often experience loss of teeth or require tooth extraction due to extensive bone damage.

For patients suffering from Delayed Radiation Injury, Hyperbaric Oxygen therapy has been shown to provide significant benefit in tissue healing. Hyperbaric Oxygen therapy involves breathing 100% oxygen under pressure which dramatically increases the amount of oxygen circulating in our blood, thus improving oxygen delivery to damaged bone or soft tissues.

Hyperbaric Oxygen therapy has been used in Delayed Radiation Injury since the 1980s.  This treatment has been shown to (a) enhance new blood vessel growth into the irradiated areas (b) improve the local tissue framework that was previously damaged to promote healing and (c) reduce fibrosis and scarring.

As one of only two Hyperbaric Oxygen departments in Alabama with accreditation by the Undersea & Hyperbaric Medical Society (UHMS), the Princeton Baptist Hyperbaric Oxygen Department has broad experience in treating these types of Delayed Radiation Injuries. This accreditation demonstrates a commitment to patient care and facility safety by meeting benchmarks of excellence & adherence to the standards of care set forth by the UHMS.

For more information, please contact the Princeton Baptist Hyperbaric Oxygen & Wound Care Center at (205) 783-3727.