Have you thought about the possibilities of cosmetic surgery but made the mistake of believing it was only for the Hollywood elite? This is misconception couldn’t be further from the truth. As a matter of fact, everyone and anyone can be a candidate for cosmetic surgery. It is a surprisingly affordable lifestyle choice. Getting your body beautiful again has never been such an easy option as it is now.

When it comes down to it, cosmetic surgery is a medical procedure done to improve your appearance. The reason why it is so popular is because it can be applied to any part of your body. Wherever you feel like you would desire a change, cosmetic surgery can make it happen. The most common areas of the body to get work done are face, breasts and waist.

Cosmetic surgery comes in many forms. As with any type of elective surgery, there may be many options available to the individual. These range from the type of procedure, technique used, and the physician who will be performing the surgery. Each procedure carries its own individual benefits and risks. As such, you should carefully review each with a qualified cosmetic surgeon.

Breast augmentation – This medical procedure involves the use of a prosthetic device to increase, decrease, or reshape the size of an individual’s breasts. Through the use of a silicone shell filled with a solution, the Colorado breast augmentation can molded to the patient’s specifications. Either saline or a silicone gel is the typical solutions used to fill the shell.

Liposuction – This increasingly popular cosmetic procedure involves the removal of deposits of fat from the body. You’ll also hear to it referred to as Lipoplasty, which is its more technical term but you’ll also see it referred to as body contouring sometimes. Denver liposuction should not be thought of as an alternative to weight loss. Instead, it should only be done once dieting and exercise have shown no results to reduce these fatty deposits.

The main techniques used are basic Denver liposuction with a fluid injection, tumescent liposuction, use of stitches, super wet liposuction, ultrasound assisted liposuction, power assisted liposuction and external ultrasound assisted liposuction. A local or general anesthetic is often used depending upon the particular procedure and technique being used.

There are many considerations prior to undergoing any cosmetic procedure. Issues include the elasticity of the skin around the area to be treated, and the general health of the individual. Consult with your doctor beforehand to any surgery.

By: Anne Harvester

In his recent book The Checklist Manifesto, Dr. Atul Gawande describes in great detail the creation of the World Health Organization’s Safe Surgery Checklist. Checklists for healthcare were first discussed by Gawande in an article in the December 2007 issue of The New Yorker titled (what else?) The Checklist. The central point of this article is how the use of a 5-point checklist helped in dramatically reducing infection rates associated with the insertion of central lines. There you have it, one shining example of the power of the humble checklist. Why then are healthcare professionals so slow are at adopting standardization practices in their daily work?

Standard Work is not your enemy! There is a misconception among clinicians that by standardizing some of the repetitive tasks they do every day, they will lose the autonomy that characterizes their professions. Nothing could be farther from the truth. By making repetitive work predictable, you save your energies for the unpredictable. For example, by making sure that there is a clear and repeatable procedure to assemble case carts and deliver all the required supplies to the OR prior to the surgery, you can dedicate all your energies to the patient, and not to hunting for supplies or wondering if everything you need is there. Do not be afraid of standard work, just trust your judgment as to what processes should and should not be standardized in your clinical work.

Checklists are a tool to aid with standardized work. They aim at ensuring repeatability of certain critical elements of work. Wash hands with soap, check. Clean procedure area with chlorhexadine, check. We are all humans and we are bound to forget something, no matter how small, when we are immersed in the non-stop world of the OR. Observations of work in ICUs show a rate of error for around 1%, or an average of two mistakes per patient!

What checklists should we adapt? The WHO Safe Surgery Checklist is one of them, check. How about a checklist for the Pre-Surgery department to ensure that every patient receives all the necessary care and talks to every required clinician before being wheeled to the OR? What about a checklist to ensure that every patient has all the necessary documentation before the day of Surgery? How about a checklist for the OR Suite changeover? The opportunities are vast, once you put your mind to it.

Clinicians and OR Nurses are not opposed to checklists or other tools for standardizing work. They do, however, have a problem with being told what to do. Here is a recommendation: be pro-active. By being against something you are on the losing side of the issue. The next time something does not go as planned, you might be slapped with another checklist developed by some external expert that may have no knowledge of your processes and culture. Cross the road to the sunny side and embrace the Culture of Continuous Improvement that Lean brings to the OR.

Next time you see a process that has some weaknesses and potential failure points, organize an OR team for a Kaizen project. Outsiders and consultants are welcome, but this is your project, not somebody else’s. Plan for a maximum of three days to complete the project and deliver a functional checklist. Evaluate the process and figure out the critical works elements that may lead to failure. Test the checklist with staff. Do a quick pilot run, make tweaks, implement it, observe the new process, gather performance data, and prepare a quick presentation to tell your success story. Here are a few pointers that may help you develop an effective checklist:

• Decide on the type of checklist. A Do-Confirm checklist assumes that team members work independently from memory until they stop to go over the checklist to confirm that the right steps were completed. With a Read-Do checklist one team member carries out the tasks while another one reads each task and checks them off as they are completed.

• Make it short. It is a checklist, not a training manual. The checklist is not there to tell you how to do the job. Think index card, rather than legal size paper.

• Keep wording precise and simple while avoiding unnecessary clutter and coloring.

• Turn the brain on. The checklist must help you turn your brain on when you are using it. A checklist is not a replacement for a brain.

• Test the checklist. There is a very good chance that your first draft will need revision. Do not be discouraged, but correct it and try again.

Healthcare around the world is at a crossroads, evolving from a craftsman-style delivery of care to the creation of an integrated healthcare delivery system. This change is necessary, both to improve patient outcomes and to reduce costs that are growing at an unsustainable rate. The use of checklists will be a powerful tool in this transformation. Being left behind is entirely up to you.

By: Gerard Leone

How much insurance claims adjusters can make per annum is the subject of considerable interest and speculation to those interested in a career in claims. As unstable weather continues into the fall, and the Atlantic hurricane season reaches its stride, its important to correctly understand the financial landscape of the adjuster industry.

Some folks have heard from their girlfriend’s brother or an estranged uncle that claims adjusting is a money tree. The money tree sits there blooming Benjamins, apparently just waiting happily to be plucked by any newcomer with the inside scoop. And as an added bonus, you really don’t have to do work. The opposite extreme is my own previous misconception of the monetary compensation for claims adjusters which is that they made next to nothing and it was essentially a dead end job. This is as far from the truth as the money tree concept but, I would hazard to guess, a much more prevalent misunderstanding.

So how much money does an insurance adjuster really make?

According to the U.S. Department of Labor, claims adjusters earned an average of $44,220 in 2004. The top ten percent earned more than $72,620. The bottom ten percent earned less than $27,220. This seems like a fairly significant disparity. What type of adjuster is at the bottom and what type at the top?

The answer to this question depends largely upon the type of claims adjuster you are referring to. In general, there are two types of adjusters: staff adjusters who are salaried employees of an insurance carrier, and independent adjusters who are independent contractors working for adjusting firms. This initial difference will make as much of a difference in pay structure as the type of claims actually handled – from worker’s compensation to multi-million dollar commercial properties.

Staff adjusters are typically going to be earning less than independent adjusters and in some cases dramatically less. $25,000-$60,000 is a reasonable salary range for a career staff claim adjuster.

An independent adjuster in a good year, however, especially if he or she works catastrophe claims, can make well in excess of $100,000.

Staff adjusters can make a good stable living. For independent adjusters, the opportunity can be a little more interesting and, I think, exciting. Independent adjusters working catastrophe claims make essentially a percentage of the amount of each claim they settle. This system of payment is known as a fee schedule and is formulated differently for each insurance carrier represented and storm situation confronted. For example, an independent adjuster handling hurricane claims may receive a fee schedule that pays $500 for claims between $3,000 to $5,000, $650 for claims between $5,000 and $7,500, and $750 for claims between $7,500 and $10,000. An adjuster will receive between 60-70% with the other 30-40% going to the adjusting firm they work for. Hurricane adjusters can easily average $10,000 settlement per claim and thus average between $400 and $500 dollars in their pocket per claim. A good adjuster should be closing 2 to 4 claims per day with superb adjuster closing 4 to 7.

Making over $1,000 a day as an independent adjuster working catastrophe claims is common and very attainable. In this way, a good independent adjuster can surpass six figures income in less than six months.

So, is this the money tree after all? Well, not so fast. Remember that catastrophes, especially catastrophes sufficient to employ significant numbers of adjusters, are relatively few and far between. During “dry” spells for independent adjusters, work can be scarce and competition fierce for the claims that do come along. That said, there is a tremendous and exciting opportunity for very real, very lucrative money when disaster does strike.

Whether its operating on staff or as independent contractor, claims adjusting offers potential for solid and, in some cases, spectacular income.

By: Dan Kerr