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As millions of Americans avoid routine doctor’s appointments right now for fear of catching COVID-19, a decades-old practice is suddenly gaining new attention: the house call.“The notion of a house call means the care provider can get a more comprehensive view of you as a person,” explained Stacey Chang, who serves as the executive director for the Design Institute for Health.Chang says a reinvention of the house call could be a viable solution to America’s evolving post-coronavirus healthcare system. New portable technology means doctors can do more than just check your temperature.Health officials across the country are also worried that Americans in isolation are avoiding routine check-ups, which could lead to more long-term issues once the pandemic ends.“The care that didn’t happen, the routine care for managing chronic diseases, we may end up having greater mortality from those missed interventions than what COVID itself caused,” Chang added.Aside from keeping people away from hospitals where COVID-19 might be lurking, the house call gives physicians a chance to get to know their patients. Spending more than 10 minutes with someone in an office would give doctors a better chance to treat chronic diseases.“It’s really a relationship between the person that’s caring for you and the person you’re caring for,” Chang said. 1352

Back-to-school shopping is an expensive chore in a normal year; this year is anything but normal. But with August upon us, stores are putting out back-to-school displays in anticipation of children needing to learn, whether in the classroom or at home.Two-fifths (40%) of parents with children in K-12 or college anticipate their children will be attending classes in a hybrid environment (both in-person and remote) in the fall of 2020, according to a new NerdWallet survey conducted online July 16-20 by The Harris Poll among over 600 parents. Planning for multiple scenarios could result in the need for increased back-to-school spending, but many may not have the extra money this year.Nearly half (47%) of parents expect they’ll spend less on back-to-school shopping than they otherwise would, due to the coronavirus pandemic, according to the survey. Of them, 40% say it’s because their household income has been affected by the pandemic and related economic effects.On the other hand, one-fifth (20%) of parents expect to spend more this year on back-to-school purchases than they otherwise would, due to the pandemic. Of them, 54% think they’ll be spending more to outfit a home learning environment, and 50% will be spending more to account for supplies for both in-person and at-home learning.“Saving on back-to-school shopping takes some strategizing in a normal school year, but this year poses unique challenges: Not only is it harder to know what students might need, but many families are eyeing big purchases to make remote learning easier, including electronics and desks,” says Kimberly Palmer, personal finance expert at NerdWallet. “At the same time, many families have less room in their budget to make new purchases because of the pandemic.”1. Shop for the short termWhether you’re spending less this year out of necessity or you’re anticipating having to spend more: Buy only what you need. If 2020 has taught us anything, it’s that well-laid plans can change. So purchase what you need to get the school year started and plan to supplement those purchases as the semester unfolds. You may find that some items get less expensive as the seasons change.“Unless you have your eye on a specific type of computer or another item that could sell out, it’s OK to wait to make your purchases until after the school year begins — in fact, that’s when you see many of the best deals,” Palmer says.2. Take advantage of credit card rewardsMore than half (53%) of parents who will back-to-school shop this year plan to use a credit card on those purchases, according to the survey. Putting your expenses on a cash-back credit card could put your money to work for you. You may even reap enough to cover next year’s back-to-school expenses entirely. Just make sure you’re able to pay off the balance each cycle, as interest can quickly negate any benefits.3. Check prices before and after shoppingPrice matching involves comparing identical items at other stores and asking a retailer to match a lower price. The trick may not make sense for a package of pencils, but for clothing, electronics and other higher-dollar items, a successful price match could save you tens of dollars, if not more.Check a retailer’s website for its price matching policy details. Many will also refund the price difference if you spot a cheaper price within a certain time frame after the purchase.4. Team up to buy in bulkRegardless of where your child is learning this fall, they’ll need supplies that other students are also after. By teaming up with other parents, you can purchase things like hand sanitizer and supplies for homework and note-taking in bulk. If your child’s teacher is reluctant to give out parents’ contact information, ask if they would send out yours in a group email so other parents can reach you if they’re interested in group savings.“With many parents focused on at-home learning, you can also find savings by teaming up with other families in your neighborhood on purchases,” Palmer says. “Some communities are forming ‘pandemic pods’ to share the burden of teaching at home and keep kids socialized — pooling school supplies across the pod can spread the expenses and make them more manageable.”5. Shop on tax-free holidaysSixteen states are having sales tax holidays in August 2020. Most of them last through a full weekend, and some even longer. Retailers that offer online ordering for in-store pickup may require you to order and pick up on those particular days to reap the tax-free benefits. The specifics of each state’s holiday vary, but generally, they allow you to purchase certain back-to-school items without paying sales tax.6. Practice and teach thriftinessIf money is very tight, your child might be able to reuse some of last year’s supplies such as their backpack or leftover pencils and notebooks. You can also shop secondhand on sites like Poshmark or thredUP for clothing throughout the school year. And don’t be afraid to ask for help — many schools are putting programs in place that help outfit homes with the technology needed for remote learning.If your child isn’t accustomed to having to make sacrifices like this, use them as a teachable moment. Older kids can learn the complexities of managing a budget, a tool they’ll need in adulthood, and younger ones can learn what saving money means and help you search for the lowest prices.“Some communities are also organizing online volunteer opportunities for high schoolers to help match up with elementary school children who need extra help, which can be a great way to provide learning opportunities to both age groups in a safe, free way,” Palmer adds. “This school year will be unlike any other, which means parents and children will have to get more creative with stretching their back-to-school budgets.”More From NerdWalletWhat to Know Before Laying Down Money for a MattressWhat to Buy (and Skip) in FebruaryHere’s When Everything Will Go on Sale in 2020Elizabeth Renter is a writer at NerdWallet. Email: elizabeth@nerdwallet.com. Twitter: @elizabethrenter. 6071

As pressure mounts for congressional action on gun control, it's unclear just how much can be done given the thick political fog that shrouds any major legislative effort on Capitol Hill -- especially in an election year.President Donald Trump tweeted Thursday that Congress "is in a mood to finally do something on this issue," but lawmakers are at home on a weeklong recess and it's too soon to tell if there's enough appetite to tackle gun legislation when they return next week. Republican leadership in the House and Senate have been silent on the question.A number of proposals to curb gun violence are floating around in Congress, some of which were started last year after a spate of other mass shootings.  727

As states begin to reopen, a new stage in the pandemic means elective surgeries are back on schedule.For 51-year-old mother of two Honaire Murillo, the pandemic delayed a much needed spinal surgery.“The shooting pains all the time and you know I had kids I have to run around. And so, it took about a year and I was so disappointed,” says Murillo.Twenty-four years ago, the aspiring pro-bodybuilder’s dreams were cut short when she was hit by a motorboat while visiting Puerto Rico on business.More than 20 surgeries later, Murillo needed another one.“The pain started coming back and so I knew I was going to have more surgery,” she says.Last week, doctors at Rush University Medical Center’s Midwest Orthopaedics in Chicago were able to get Murillo into surgery for a first-of-its-kind procedure.It was a minimally invasive spine surgery that utilized augmented reality.“The efficiency this provides because of the accuracy and the visualization of the spine is remarkable,” says Dr. Frank Phillips, the director and minimally invasive spinal surgeon at Rush who performed the procedure.A headset guidance system allowed Dr. Phillips to see Murillo’s spinal anatomy – essentially giving him X-ray vision.“That's exactly what it is,” says Dr. Phillips. “It really is X-ray vision. Except it's not just X-ray vision, you're actually seeing the real spine through the skin.”The CT scanned images are directly projected onto the surgeon’s retina and then superimposed right on top of the patient’s surgical area.“I was just blown away,” says Dr. Phillips. “The minute I put my headset on and looked down at the spine it was like that wow moment. I was like ‘this is crazy.’”Researchers say the FDA-cleared x-vision system could revolutionize the way surgeons perform complex procedures.“It's so accurate so precise the visualization so good you can do the surgery more efficiently which obviously translates into less anesthetic time and advantages to the patient,” says Phillips.For Murillo, who eventually went pro 15 years after her accident, this latest groundbreaking surgery has her thinking about another return to competition.“I'm still looking to see if I could comeback one more time. I'm not sure. But, yeah to me it's a dream.”Augmedics, the maker of the technology says it plans to explore the x-ray vision technology beyond just spinal surgery. 2365

As the coronavirus pandemic surges across the nation and infections and hospitalizations rise, medical administrators are scrambling to find enough nursing help — especially in rural areas and at small hospitals.Nurses are being trained to provide care in fields where they have limited experience. Hospitals are scaling back services to ensure enough staff to handle critically ill patients. And health systems are turning to short-term travel nurses to help fill the gaps.Adding to the strain, experienced nurses are “burned out with this whole (pandemic)” and some are quitting, said Kevin Fitzpatrick, an emergency room nurse at Hurley Medical Center in Flint, Michigan, where several left just in the past month to work in hospice or home care or at outpatient clinics.“And replacing them is not easy,” Fitzpatrick said.As a result, he said, the ER is operating at about five nurses short of its optimal level at any given time, and each one typically cares for four patients as COVID-19 hospitalizations surge anew. Hospital officials did not respond to requests for comment.But the departures are not surprising, according to experts, considering not only the mental toll but the fact that many nurses trained in acute care are over 50 and at increased risk of complications if they contract COVID-19, while younger nurses often have children or other family to worry about.“Who can actually work and who feels safe working are limited by family obligations to protect their own health,” said Karen Donelan, professor of U.S. health policy at Brandeis University’s Heller School for Social Policy and Management. “All of those things have been factors.”Donelan said there is little data so far on how the pandemic, which has killed more than 231,000 people in the country, is affecting nursing overall. But some hospitals had a shortage even before the virus took hold, despite a national rise in the number of nurses over the past decade.With total confirmed coronavirus cases surpassing 9 million in the U.S. and new daily infections rising in 47 states, the need is only increasing.Wausau, Wisconsin-based Aspirus Health Care is offering ,000 signing bonuses for nurses with at least a year of experience and hiring contract nurses through private staffing companies to handle a surge in hospitalizations that prompted the system to almost quadruple the number of beds dedicated to COVID-19 patients.Aspirus, which operates five hospitals in Wisconsin and four in small communities in Michigan’s Upper Peninsula, also is moving nurses around between departments and facilities as hot spots emerge, said Ruth Risley-Gray, senior vice president and chief nursing officer at Aspirus.Outside help still is needed, in part because some nurses have gotten sick from or were exposed to the cornavirus during the current wave, which “came with a vengeance” starting in August, Risley-Gray said. At one point in mid-October, 215 staffers were in isolation after showing symptoms or being exposed to someone who tested positive, and some are just starting to return to work.Aspirus recently was able to hire 18 nurses from outside agencies, and may need more if the surge continues.Because the pandemic is surging just about everywhere in the country, hospitals nationwide are competing for the same pool of nurses, offering pay ranging from ,500 a week to more than ,000, said April Hansen, executive vice president at San Diego-based Aya Healthcare, which recruits and deploys travel nurses.She said demand for their services has more than doubled since early in the pandemic when the greatest need was in hot spots like New York and New Jersey and then moved to southern states. In recent weeks the virus has been spiking across the country, with the new hot spots in places like the rural upper Midwest and southern-border communities such as El Paso, Texas.Now placing nurses where they’re needed is “like a giant game of whack-a-mole,” said Hansen, whose company has about 20,000 openings for contract nurses.In North Dakota, where infection rates are exploding, hospitals may cut back on elective surgeries and seek government aid to hire more nurses if things get worse, North Dakota Hospital Association president Tim Blasl said.In Texas, Gov. Greg Abbott recently announced he was sending 75 nurses and respiratory therapists to El Paso to help handle the city’s surge. Wisconsin Gov. Tony Evers, meanwhile, issued emergency orders making it easier for nurses from elsewhere to practice in his state and for retired nurses to come back.“This has been a challenge, and we’ve been pleading with the community members to protect themselves and others,” by wearing masks and social distancing, said Aspirus’ Risley-Gray, who said the positivity rate among community members tested by Aspirus rose from under 10% in September to 24% last week.To combat the emotional toll and fatigue that comes with caring for COVID-19 patients, including just donning and removing protective equipment all day, Aspirus has been giving nurses microbreaks and quiet places to get away and collect themselves when they feel overwhelmed.Travel nurses say the need at small hospitals tends to be greater than at larger facilities.Robert Gardner, who’s currently assigned to a hospital in a small town about 20 miles west of Atlanta, said he did search and rescue in the Coast Guard during Hurricane Katrina and the pandemic is “a lot worse.”He worked at a large New Jersey hospital when that state was swamped by the virus in the spring, and now worries that flu season could bring further chaos to hospitals. But he’s determined to stick it out, no matter what.“It’s not even a question,” Gardner said. “Nursing is a calling.” 5727