Caring for the Caregiver

When constantly putting others first, it’s easy to forget or simply lack the energy to care for ourselves. As November and National Family Caregivers Month wrap up, we wanted to recognize that caregiving is selfless work that can be exhausting, both mentally and physically. Ironically enough, the effects of caregiving on health and well being is associated with health problems and even premature death. That’s why it is so critical for those in a caregiving roll to allocate adequate time to take care of themselves as well.

  1. Make YOU a Priority

It’s the cardinal rule of helping and caregiving: only when we first help ourselves, can we effectively help others. However, this is often much easier said than done. So begin by simply figuring out what areas of your personal life are lacking (i.e. time with family/friends, relaxation, hobbies, exercise). “If I had more time for __________ I would feel happier/less stressed.”

  1. Identify barriers

After identifying what you wish you had more time for or what would make you happier, start to think about what prevents you from these activities. What is getting in the way and keeping you from caring for yourself? Do you think you are being selfish if you put your needs first? Do you have trouble asking for help? Not enough time? Once you’ve started to identify what prevents you from self-care, you can slowly begin to break down these barriers and change your behavior.

  1. Lean how to ask for help

Many caregivers struggle with asking for help because they believe “I can do it myself,” “no one else can do it as well as I can.” Other times it’s that they don’t want to “burden” others or admit that they can’t handle everything on their own. This can-do attitude, albeit admirable, can be crippling for caregivers, leaving them with no time for themselves and lots of stress. Imagine how you would feel if you enlisted a friend or family member to watch the person you care for while you take a 15-minute walk. Or if your neighbor could grab a few items at the grocery store for you this week. Just like you, most people want to help. All you need to do is ask and maybe show them how. Remember that reaching out when you need support is a sign of strength.

  1. Talk with your doctor

Time is precious, especially as a caregiver. You may dread taking the person you care for, or yourself to the doctor because it takes two weeks to get an appointment and then you sit in the waiting room for an hour before seeing a doctor with whom you have no relationship.  Direct Primary Care will save you time, money and allow you to develop a relationship with your personal doctor who will listen and help you work through your stress and the burdens of caregiving in a healthful way.

Dr. Steve Horvitz is R-Health’s Medical Director and one of the physician’s part of the NJ SHBP / SEHBP program

How You Can Foster Gratitude This Holiday Season

As we enter into the hustle and bustle of the holiday season, it’s easy to get caught up in materialism and lose sight of what this time of year is really about. Research shows that people who regularly practice gratitude experience more positive emotions, tend to be more successful, sleep better and have stronger immune systems. Sounds great, right? But starting any new practice can be difficult, especially during the holidays, so here are a few tips that may help start and maintain a gratitude practice as we enter into the season of gratitude and giving.

  1. Write it down

Putting pen to paper and actually writing out what you are grateful for is one of the best ways to reap the benefits of gratitude. When we acknowledge small fortunes each day we slowly change the way we perceive situations. For example, you may have had a great accomplishment like, “today my boss told me I was doing a good job,” something small such as “a stranger held the door for me when my hands were full,” or something like, “I am grateful to have found a doctor that takes the time to listen to me, to get to know me, and to help me become a healthier person.”  Sometimes it can be challenging to dive into the blessings beyond those that are right in front of you such as family, friends and basic needs, but once you open your eyes to the “small mercies” in your daily life you will notice a shift in your practice and general attitude.

  1. Commit to it

Making a conscious effort to write down your daily blessings and affirmations will enable you to grow and obtain the physical and mental health benefits of gratitude fostering. Writing small notes each day makes us happier, thankful and more optimistic. These positive feelings are encouraging and help us to maintain our practice, especially on those tougher days. I highly recommend using a journal of some kind to keep log of your practice. A regular ruled journal is great or you may choose a journal specific to gratitude fostering. As your practice grows you will be able to flip through pages of full of daily affirmations and positive events. It is also helpful to choose a set time of day to journal. Will you write in the morning to set intentions for the day ahead, in the evening to reflect on the day, or both?

  1. Verbalize and embody it

One of the many rewards of channeling appreciation for life’s small gifts is that you are more likely to be oriented towards being compassionate, sharing and helping. Fostering gratitude and love for your life is very important but radiating that positivity outward is equally rewarding and crucial to your practice coming full circle. Write a letter to someone who you are grateful for, share your gratitude at the dinner table every night, show someone your appreciation through a thoughtful gesture, volunteer or donate.

Manifesting your practice into your daily life will not only make you feel good for extending extra compassion into the world, but it will make others feel a little more appreciated as well. And that, is the beautiful cycle of gratitude, which can lead to a beautiful cycle of health.

Dr. Steve Horvitz is R-Health’s Medical Director and one of the physician’s part of the NJ SHBP / SEHBP program

Preventing Unnecessary Trips to the ER and Urgent Care

When you have a real relationship with your doctor in a Direct Primary Care practice, this can help minimize unnecessary trips to the emergency room or urgent care center.


Instead of heading straight to the ER when facing a health issue, you can instead pick up the phone and call your personal doctor. (Please note that you should head straight to the ER or call 911 for life threatening medical emergencies). Your doctor can then help guide you on the best approach to your care.

Maybe that means your doctor meets you at the office to see you for a quick appointment. Or that you just need a prescription, which your doctor can call in for you over the phone – eliminating the need for an appointment altogether. Or maybe you really do need the emergency room and your doctor can give you this advice based on the symptoms you are experiencing and his or her knowledge of your medical history.

By empowering this relationship – it eliminates many of the barriers to care that are unfortunately so prevalent in healthcare today.

And not only does this lead to better health outcomes – it also saves you money but not having to deal with the high co-pays, deductibles, and co-insurance that so often accompany a trip to the ER or urgent care center.

This is all part of the relationship we aim to empower between our members and our doctors in a Direct Primary Care setting. If you are a member of the New Jersey State Health Benefits Program(SHBP) or School Employees’ Health Benefits Program (SEHBP) you can sign up for this experience as an add-on benefit.

What you Get with Your Very Own Personal Doctor

When you join a Direct Primary Care practice, you get your own personal doctor. Not an office that has 12 doctors and it’s a flip of the coin who you will see when you make an appointment. One. Personal. Doctor. This empowers you to build a trusted and enduring relationship with your doctor?

Why does this matter?

When your doctor gets to know you and vice versa all kinds of wonderful things can happen. The sky’s the limit.

  • Your doctor really gets to know you and your health.
  • Your doctor knows your history – not just your medical history, but your family, your relationships, your job, and any issues you may be facing.
  • Your doctor is aware of any chronic conditions and how this impacts you.
  • Your doctor can coordinate your care. This doesn’t mean just writing a referral, but truly serving as the quarterback for your care.
  • You trust your doctor and will become more and more comfortable sharing information with him / her.
  • You can become an active participant in your own care – this is what happens when you develop a relationship with your doctor.
  • Your doctor can help you on the go. When you have an actual relationship and can call your doctor, he or she may be able to help you without having to come in for an appointment every time.

Does this kind of care sound great to you? If so, Direct Primary Care may be a good fit for you. If you are a member of the New Jersey State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP) you may be eligible to sign up for an R-Health practice at no extra cost to you.


5 Tips to Quit Smoking

November 17th is the Great American Smokeout – a great time to commit to finding ways to quit smoking. Use these five tips to help you on your way.

Tobacco use, particularly cigarette smoking, is a primary risk factor for the leading causes of death in the developed world.  Smoking may harm nearly every organ of the body and diminishes overall health. It can lead to heart disease, stroke, lung diseases like chronic bronchitis and emphysema, osteoporosis, and cataracts. From your health and finances to your self-esteem and productivity, the rewards of quitting smoking are profound and begin immediately. Many people will experience the benefits of not using tobacco within 20 minutes of quitting, and as your tobacco-free days accumulate, the benefits will accumulate, too.

  1. Find Your Reason:

Why are you thinking about quitting? Is it to lower your chance of developing cancer, heart disease or other chronic conditions? To look and feel younger and prevent premature aging? To protect your family and friends from second hand smoke? To save money? Whatever it is that motivates you, acknowledge it, say it out loud and reaffirm to yourself that you are capable of quitting.

  1. Develop a Quit Plan:

Nicotine is very addictive and you will likely experience withdrawal upon quitting. That is why it is very important to establish a quit plan ahead of time. Will you go “cold turkey,” use nicotine replacement therapy, pharmaceuticals or mindfulness//hypnosis techniques.  This is a great time to talk with your doctor about your options and decide what method you believe will be best for you.

  1. Enlist Support:

Let your friends and family know you are going to quit. Having a support system will help keep you on track when you may be struggling. Have a main point of contact when you feel unsteady. Enlist a health coach to keep you on track. You may like to join a support group to share your experience and learn from others. Don’t be afraid to reach out to others – a single phone call can help you reconnect with your intention and ward off cravings.

  1. Avoid Triggers and Create New Habits:

Recognize your triggers. Do you tend to reach for a cigarette after drinking alcohol or coffee? Are you more likely to light up when you are stressed or when you are in the car? Once you acknowledge these times and triggers, find a new habit to work towards instead of smoking. Avoid drinking and over eating. After coffee or a meal, brush your teeth or go for a walk. When you are in the car, dial a supportive friend or family member. When you feel stressed try exercising, take a long bath or use breath-work/meditation. Smell can be a trigger too so after your last cigarette get rid of ashtrays and lighters. Wash your clothes, clean your carpets, draperies, upholstery and car.

  1. Don’t Give Up:

Many people try several times before giving up cigarettes for good. If you slip, try not to get too discouraged. Instead, determine why you relapsed. Use this experience as a learning opportunity. Revaluate your quit plan and make adjustments as needed. Remember that within only one day of quitting your blood’s carbon monoxide level returns to normal. In just 2-3 weeks, you will start to lower your odds of having a heart attack. Quitting smoking greatly reduces the risk of heart disease within the first 1 to 2 years, reduces respiratory issues and cancer risk. It’s never too late to quit!

Quitting smoking is not easy. If it was easy, you probably would not still be smoking. So I recommend that you prepare a battle plan using any or all of the techniques listed above. But be prepared for the battle and fight to win.

If you only try you may not succeed. But if try to win, your chances of quitting smoking and improving your overall health are much greater.

Dr. Steve Horvitz is R-Health’s Medical Director and one of the physician’s part of the NJ SHBP / SEHBP program

5 Tips for Healthy Sleep Habits

Most of us know how important sleep is to our health and well-being, but we still have a hard time sticking to healthy sleep habits. In fact, half of Americans (48%) say they don’t get enough sleep, but less than half of us take any action to help get a better night’s sleep. These 5 simple tips will help you on the path to better sleep – and better health.

  1. Establish a bedtime. One of the most important sleep habits we can adopt is going to bed and waking around the same time every day. A consistent sleep schedule reinforces our body’s internal clock which helps optimize the quality of our sleep and reminds our brain when it’s time to release sleep and wake hormones. Establishing a relaxing bedtime routine also helps signal to the brain that is time to unwind and prepare for sleep.
  1. Turn off electronics and limit light exposure. Our sleep cycles are strongly influenced by light and dark. While any light has the ability to disrupt our circadian rhythms and suppress the secretion of melatonin, blue light from electronics is particularly disruptive and damaging. Try turning off phones, computers, TV, etc. at least 1-2 hours before bedtime. Dimming the lights in your home hours before bed can also be very effective.
  1. Exercise daily. Engaging in regular exercise each day will help you sleep better at night and stay alert during the day. The more vigorously you exercise the more powerful the sleep benefits, but even just 10 minutes of brisk walking can help. Be mindful that working out close to bedtime can interfere with sleep, however, gentle yoga and stretching in the evening can help promote better sleep.
  1. Eat and drink well. Eating a diet abundant in colorful fruits and vegetables and avoiding large, heavy meals before bed will help achieve you better sleep quality. Limiting caffeine in general or avoiding it after 3 pm will allow your body to effectively let you know when it’s ready to rest. Ideally a healthy, well-rested and active body doesn’t need stimulants to feel well and energized. If you feel dependent on caffeine to get you through your day it may be time to think about making some lifestyle changes.
  1. De-stress and de-clutter. Many people have difficulty falling asleep and staying asleep as a result of stress and worry. Exercise, yoga and deep breathing techniques are all very effective in relieving stress and anxiety. Creating new bedtime rituals can also help you feel organized and relaxed. One strategy is to check all emails and social media early in the evening and then put it away for the night – new messages can wait until tomorrow. Sometimes light cleaning and simple preparations for the next day can help ease the mind as well. And finally, carve some time out of the evening for you – read a book, listen to music, take a warm bath, do some gentle stretching anything that you enjoy and helps you relax.

Still have questions? Reach out to one of the R-Health doctors to talk about your own habits and healthy sleep.

Dr. Steve Horvitz is R-Health’s Medical Director and one of the physician’s part of the NJ SHBP / SEHBP program

3 Reasons to Join a Direct Primary Care Practice

There are many, many reasons to join a Direct Primary Care practice, but let me boil down the top three that I believe are the most impactful.

  1. It’s amazingly convenient. From my perspective as a busy working mother, I love that there are same-day and next-day appointments, evening and weekend hours, and truly little to no time in the waiting room. In fact, we have non-waiting rooms! I also love that there is the ability to text, e-mail, and call the doctor, so you don’t always to see the doctor via an in person appointment.
  1. It’s personal. Every single members gets their very own personal physician. You get their personal phone number. You get their e-mail. You get to see the same doctor every time. You get a doctor who actually gets to know you. You get to build a relationship with your doctor. These things matter.
  1. It’s full service. Primary care doctors can actually take care of about 80 to 90% of your healthcare needs. Most just aren’t set up to do that right now. You’ll get your personal doctor, access to health coaching, care coordination, and much more.

Interested in this approach? If you have a NJ SHBP or SEHBP health plan, you may qualify for R-Health at no co-pays or extra costs.

R-Health Announces New Direct Primary Care Pilot Program in New Jersey

New Jersey State Health Benefits Program Plan Design Committee Establishes DPC Pilot Program as Model for Future of Healthcare Delivery

R-Health, a leader in innovative healthcare solutions, today announced the company has been awarded a contract to provide Direct Primary Care (DPC) services to members of the New Jersey State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP) and their families. Read more on the program here.

The R-Health DPC program is a free enhanced benefit option for public sector employees and their family members who are enrolled in the SHBP and SEHBP health programs. R-Health DPC is launching with three initial practices in Haddonfield, NJ; Moorestown, NJ; and Washington Crossing, PA. The company has plans to add new practices across the state, with a new location opening in the Trenton area in early 2017.

R-Health DPC is focused on bringing the doctor-patient relationship back to the forefront, offering R-Health members the personal care they deserve. This membership-based approach to primary care turns the typical volume-based or current fee-for-service model on its head, offering members real relationships and accessibility to their own personal physician.

“In the state of New Jersey, we are facing out of control healthcare cost increases and we knew we had to take a hard look at the various ways we could fix this,” said Patrick Nowlan, Executive Director of Rutgers AAUP-AFT and Chair of the SHBP Plan Design Committee. “After much research, we realized a core component of cost savings – and better patient experience – was more proactive and relationship-based primary care.”

“NJEA is proud to have introduced this opportunity to the SEHBP Plan Design Committee because we recognize the overall benefits that a Direct Primary Care Medical Home Model can bring to thousands of public school employees,” said Wendell Steinhauer, New Jersey Education Association President and Design Committee Member. “Increasing quality care to members and their families as well as providing them with more information to make better quality healthcare decisions – while simultaneously reducing overall healthcare costs – is a win-win for all.”

“CWA is very excited to be at the start of this cutting edge healthcare pilot,” said Hetty Rosenstein, Area Director of CWA New Jersey. “We believe that primary care is the future of wellness and preventative medicine. This is a union-designed program that has healthcare outcomes as its goal.”

“With this pilot program established by the Plan Design Committee, we are providing access to DPC with no co-pay for any members, and their families, of the SHBP or SEHBP,” said Robert Little, Assistant to the Director at AFSCME Council I. “This means there will be no co-pays, deductibles, or other out of pocket costs to see a participating DPC physician.”

The DPC model is designed to give members unparalleled access to outstanding, relationship-based primary care. This includes same-day or next-day appointments, evening and weekend hours, little or no wait time in the waiting room, unhurried consultations with the doctor, and access to a personal physician via phone and digital messaging.

“We have all been frustrated by how hard it is to reach our doctor and how long we have to spend in the waiting room before we are seen,” said Mason Reiner, CEO of R-Health. “R-Health Direct Primary Care is designed to provide the convenient access to care that our members deserve.”