Archive for the ‘Wellness’ category

Meditation and Neuroplasticity

August 27th, 2023

           Back in the 1960s or as the Brits nicknamed it, The Swinging Sixties, lots went on that some of us would prefer to remember as interesting, youthful experiences that created lifetime memories.  Besides the British music invasion, drugs became popular and commonplace among the hippie generation, but I missed out on all of that because my education took place at a conservative school.

          Being a traditional student heading toward a teaching career also meant that my career would be significantly jeopardized had I not stayed within the parameters of expected behavior. Unfortunately, the movie, Animal House, was not a realistic depiction of my college experience.

          One phrase that did catch on during that liberal era of the late 60s and early 70s was “Don’t bother him, he’s contemplating his navel.” It’s thought that it became popular in Western culture during a time when the Beatles and other luminaries were practicing transcendental meditation.            This navel-gazing phrase related to introspective thinking and mindfulness through meditation. It  implied the person in question was engaged and completely focused on their own thoughts or mental silence. If done correctly, one’s emotions often feel disconnected from the outside world.

            Since that time, numerous well-known people have found meditation to be an important part of their lives. Meditation practicing entertainers include Hugh Jackman, Ellen DeGeneres, Jerry Seinfeld, Katy Perry, and the late basketball great Kobe Bryant who practiced meditation to enhance focus and mental resilience as part of a daily training routine. Of course, there are also thought leaders like the Dalai Lama, Drs. Deepak Chopra and Dean Ornish, publisher Arianna Huffington, the entrepreneur Russell Simmons, and former NFL player Ricky Williams who are famously recognized for using these mindful practices.

            Individuals who practice meditation regularly credit the practice with positive outcomes ranging from better sleep, stress reduction, relief from both anxiety and depression, much-improved focus and concentration, enhanced self-awareness, better relationships, lower blood pressure, pain management, enhanced creativity, spiritual growth, and one of my favorites, neuroplasticity.

            Several studies have shown that practicing and playing musical instruments can significantly contribute to neuroplasticity. Music can enhance fine motor skills, auditory processing, memory and pattern recognition, multi-sensory integration, cognitive flexibility, brain connectivity, and brain reserve.

            Neuroplasticity is the underlying property of the brain that includes learning, adaptation, and recovery from injuries. It truly represents the brain’s ability to rewire itself. With that in mind, neuroplasticity contributes significantly to education, therapy, and overall cognitive health.

            If I recommended that you meditate for 10 or 20 minutes in the morning and again at night, you might snicker and suggest that not only do you not have time, but more bluntly that you also think it’s a waste of time. If I told you that by doing so you could significantly impact the creation of new neural connections that would modify your brain’s function in ways that would permit you to improve and optimize your performance while adjusting to new circumstances, you also might suggest that I move on.

            Let’s, however, look at the list of positives related to further development of neuroplasticity beginning with the fact that it will allow you to acquire new skills, knowledge, and behaviors. It also enables you to adjust, and more importantly, to adapt to changes in your environment.  It contributes significantly to more efficient memory storage, the capacity to adapt and remain functional as we age, and the ability to shift perspectives and respond to new challenges. And the list goes on and on.

            If you’re a type A, hyper-active person, meditation may provide you with a welcome relief from yourself. Find a peaceful, quiet space, force yourself to focus on the present, breathe deeply and use that breath to anchor. Acknowledge external interferences but don’t dwell on them and remember that contemplating your navel by deep breathing alone will create a natural relaxation response that is good for your health. Try it. You might like it.

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Tops in Care in PA

August 14th, 2023

If you were to see a list that included UPMC Shadyside, UPMC Passavant, St Clair Hospital, Geisinger and Chan Soon Shiong Medical Center, but no other local hospitals in this immediate geographic region, your initial question might be something like, “What’s this list represent?”

Here’s the succinct answer to that question for people living in the Greater Johnstown Area. This is part of a list of the top rated hospitals in Pennsylvania.  

 Let’s be perfectly clear about this, too. When you consider every aspect involved in evaluating a hospital for elite status, it’s very relevant that this is not some type of purchased PR accolade meant to create a smoke-screen for publication. It is, in fact, the result of serious patient analytics by the Centers for Medicare and Medicaid. More importantly, it is a sincere recommendation meant to assist patients in their healthcare selections.

 No, Chan Soon-Shiong Medical Center is not in the same league clinically as the hospitals listed above in range of services, but the services offered there do contribute significantly to one very important aspect of evaluation. When patients are asked if they would recommend CSSMC, their sincere answer to many detailed questions is “Absolutely, yes.” In other words, the range and scope of services offered at CSSMC are top-notch.  

 If you’re wondering how an achievement like this is possible, there is only one answer, teamwork, teamwork under the umbrella of incredible clinical leadership that is endorsed at the very top by the CEO, Tom Kurtz. Dr. David Csikos, MD, Chief Medical Officer, and Sherri Spinos, Vice President of Nursing are two of the hundreds of members of the CSSMC staff who should be standing in the winner’s circle accepting this Gold Seal of approval.

 Not only did Tom Kurtz, CEO turn around a small rural hospital that, like all of its peers in the State at that time, was heading toward either merger or closure, he did it with a spirit of good humor, compassion, kindness and positive energy. His positive energy was passed on to CSSMC’s physicians and staff in ways that create patient satisfaction at the highest levels.

 Congratulations to Chan Soon-Shiong, to Tom Kurtz and the Windber clinical leadership, staff, and physicians involved in this significant accomplishment. They have achieved “Best of Show” as Blue Ribbon winners in this national recognition. As the former Windber Medical Center continues to achieve these incredible quality standards as a small, rural hospital, we need to recognize and thank them for their efforts to provide quality healthcare to our region.

 They’ve done it again. Keep up the magic.     

 

Becker’s Hospital Review

The top recommended hospitals in every state

Mackenzie Bean (Twitter) – Friday, August 4th, 2023

Becker’s has compiled a list of the hospitals patients are most likely to recommend in every state using Hospital Consumer Assessment of Healthcare Providers and Systems data from CMS.

CMS shares 10 HCAHPS star ratings based on publicly reported HCAHPS measures. The recommended hospital star rating is based on patients’ responses to the question, “Would you recommend this hospital to your friends and family?” Hospitals must have at least 100 completed HCAHPS surveys in a fourth-quarter period to be eligible for a star rating. Learn more about the methodology here.

The star rating is based on survey data collected from hospital patients from October 2021 through September 2022. The figures are from CMS’ Provider Data Catalog and were released July 26. Asterisks denote that CMS included a footnote about the organization’s data, which are summarized below.

The hospitals that received five stars for patient recommendations in every state:

Pennsylvania
Advanced Surgical Hospital (Washington)
AHN Hempfield Neighborhood Hospital (Greensburg)
Bryn Mawr Hospital
Chan Soon-Shiong Medical Center at Windber
Chester County Hospital (West Chester)
Doylestown Hospital
Edgewood Surgical Hospital (Transfer)
Evangelical Community Hospital (Lewisburg)
Geisinger Jersey Shore Hospital
Geisinger St. Luke’s Hospital (Orwigsburg)
Hospital of the University of Pennsylvania (Philadelphia)
James E. Van Zandt VA Medical Center (Altoona)
Lebanon VA Medical Center
OSS Orthopaedic Hospital (York)
Paoli Hospital
Physicians Care Surgical Hospital (Royersford)
Rothman Orthopaedic Specialty Hospital (Bensalem)
St. Clair Hospital (Pittsburgh)
St. Luke’s Hospital-Anderson Campus (Easton)
Surgical Institute of Reading (Wyomissing)
Troy Community Hospital
UPMC Passavant (Pittsburgh)
UPMC Presbyterian Shadyside (Pittsburgh)

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Guest Post Dr Dan Handley

July 6th, 2022

I attended a video conference tumor board today as a guest observer.

If you don’t know what a tumor board is, it is an interdisciplinary team of professionals that can include oncologists, geneticists, and others such as pharmacists, nurses, genetic counselors, bioinformaticists, and anyone else who can help by providing their professional expertise.

Tumor boards systematically examine cancer patient histories, current clinical test results, and any other relevant information. As a team, they come together to propose the optimal treatment and support for patients based on the latest scientific information.

These are consummate professionals who are dedicated to understanding each patient’s unique situation and work together to provide the best care possible with the best outcomes combining their respective areas of expertise. It’s amazing to see such communication and cooperation. That’s not hyperbole, it’s the truth.

I understood all the underlying science since that is what I’ve been involved with for so many years in laboratory research, and it’s now what I teach, Not being an oncologist myself there were some learning opportunities for me on some of the clinical details. I am an information sponge, though, so I’m delving deeper into the clinical literature to make sure I understand anything that wasn’t completely clear to me.

Despite some people’s uninformed cynicism, we have thousands of dedicated professionals working together both on the scientific front and the clinical front in synergy to cure each person’s cancer if possible, prolong quality life, and at least minimize suffering. And along the way, gathering all of our understanding towards finding a way to cure as many cancers as possible.

It’s an honor to be involved in this continuing endeavor with so much promise and progress, and even more, to have students who want to participate in this amazing transformation of medicine into the 21st century.

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The Integrative Journey

March 28th, 2022

 

After having returned from the Ornish Coronary Artery Disease Reversal program in Sausalito, California, my life, my mental health, and my view of healthcare had been changed forever. Having previously been selected as the CEO of a traditional hospital that, like all hospitals, was all about sickness, I now realized I had new tools in my toolbox, new arrows in my quiver, and new eggs in my basket. . . you get the idea.

That workshop had taught me that there is no one right way to go through life, to achieve a better quality of life, to deal with health issues, and to survive this journey. I came home armed and informed that sickness could be stopped or reversed, and this concept did not just apply to heart disease. There was significant evidence that Type 2 diabetes, some autoimmune diseases, erectile dysfunction, some prostate cancers and other diseases could be positively impacted by diet, exercise, stress management and group support.

As Americans in one of only two developed countries that permits advertising of pharmaceutical products on our air waves, we had been carefully trained, pruned, mentally shaped and, if you will, brainwashed to believe in the “heal to the pill” method of care. We get sick, go to the doctor or hospital, are prescribed pills, and move on. Or we get a shot, or get the offending body part cut out, and life goes on, or not. Those were the options previously permitted on the proverbial healthcare menu.

It was only a few years later when the chief scientific officer of a major drug company explained his world to me like this, “You don’t understand the pharmaceutical industry. We’re like the movie business. We only want the blockbusters. We want to give you a pill that you’ll have to take from the time you’re five until you die at 75 or 80 that will never make you better. It will just help control the symptoms.”

In 1987, I was working toward another Masters Degree at Carnegie Mellon University, and our epidemiology professor challenged us to find something that would significantly alter the health, lives, or future of at risk people in our hospital’s catchment area. I decided to have our physicians give pneumococcal (pneumonia) vaccines to our at-risk senior population.

When I told my CEO of that plan, he suggested I present it to the primary care physicians at their monthly meeting. I boldly stood in front of a room full of internal medicine and family practice physicians and made my pitch. You would have thought I asked them to bring in their first born child to be assassinated. I was very nearly strung up. I heard cries like, “How are we supposed to pay or bills? How can we pay off our loans? What am I supposed to do, pull my kids out of college? Treating those patients is how we make our livings.”

Ironically, in 2017, I found myself in front of the leadership of a major health system with 125 cardiologists, and I informed them we were going to enter into the coronary artery disease reversal program. The spokesperson for the group put up his hand and said, “Let’s talk about the elephant in the room, do we really want these people to get better?”

Bottom line, we have created a medical industrial complex that is dependent upon sickness, and what I had learned in California was, “Yes, we’re all going to eventually die, but why not give your body a chance and live as healthy as you can for as long as you can?”

Interestingly, the Ornish program was not yet being offered in many places in the country, and when I asked if we could bring it to Western Pennsylvania, there was a long pause on the other end of the line, and Dr. Ornish asked,”What do you want?” He explained that he was working on a licensing project with our local Blue Cross, and I was not going to be able to bring it into my hospital, but that didn’t stop me.

We worked out a deal with some local churches to bring elements of the program that were available to the public just to test the water. Within weeks, we had heart disease participants in their 60’s, 70’s, and 80’s doing stretching exercises, meditation in whatever form they selected, nonjudgmental group support, and vegetarian covered dishes to church halls and basements.

The amazing thing about this program was that people who were suffering from angina pectoris (chest discomfort) found relief in sometimes less than a few weeks. They were no longer living in fear of dropping dead, and more importantly, they were taking control of their life without having to be afraid of the outcome. It was giving their bodies a chance to do what those bodies are so great a doing, healing.

Of course no good deed goes unpunished, and those non-believers, or those individuals who were potentially most negatively impacted by a health and wellness program began to identify me as a zealot, a fanatic, a vegetarian warrior. I was openly mocked at board and physician meetings when I ate my specially prepared vegetarian meals, and when I started holding meetings on the indoor track we had created with our new wellness center, those who would not benefit from my new found center for wellbeing went on a mission to discredit these ideas.

At one point the powerful head of a local Baptist Church began to take steps to have various conservative sects actually picket our hospital for teaching yoga and trying to take away the souls of our participants. (Their interpretation of yoga.) One of our powerful physicians sent emails on a regular basis to our staff with the intention of discrediting me and my programs for wellness and prevention. It was not unlike Salem, Massachusetts for a few years. Then something incredibly powerful occurred.

I was, for only the second time in my 30+ year career in hospital administration, invited to have dinner at a physician’s home. At that dinner, I was seated beside our local congressman, John P. (Jack) Murtha. The host’s wife did not know what to prepare for my meal so she gave me a large white plate with two egg whites on it. When the Congressman saw it, he asked, “What the heck is wrong with you?” I carefully explained my experiences in California with heart disease reversal, meeting patients who had successfully stopped and or reversed their disease, and how well they were living. He leaned back and said, “We’re spending a billion dollars a year on heart disease in the military. Maybe if you got to Bethesda or Walter Reed and find someone who would work with you, I might be able to help>”

We knew that his 25 plus years in Congress had given him some seniority, but what I didn’t realize was that he was in charge of the subcommittee on appropriations for the department of defense. His committee was responsible for well over $300B dollars of government spending. Well, my board chair was a former Navy airman and he flew me to Bethesda where we met with and were politely turned down by the Navy. A few months later when I was in D.C. for a meeting, I got in a cab and, without any knowledge of military life, command, or structure, I showed up at the front door of Walter Reed Army Military Hospital which became Walter Reed National Military Medical Center Bethesda several years later.

When I walked inside, I saw hundreds of soldiers, family members, and medical personnel, but I didn’t have an appointment. Consequently, I walked up to the first white coat I saw, explained who I was, where I was from, and who had suggested I come there. Serendipitously, he was the only physician who had ever received a federal earmark and it was about $75M from Senator Ted Stevens of Alaska to create a center for the study of prostate cancer. He looked at me, smiled, and said, “Follow me.”

After meeting with a Walter Reed cardiologist, I went home, wrote a white paper, and several months later we established two Ornish Centers, one at Walter Reed and one at Windber with a grant that was made possible through Congressman Murtha. The reason you need to understand this back story is that without these grants, there would have been no way a hospital our size could have supported a program featuring integrative medicine.

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Meditation

August 16th, 2020
Western Pennsylvania Guide to Good Health
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Acupuncture why not

February 19th, 2020

 

Accupuncture, why not?

NICK JACOBS

Published Tue Feb 18, 2020 8:15 PM EST

In a recent article in Time Magazine, Jeffrey Kluger wrote “The Mystery of Acupuncture.”

In the article he said the “World Health Organization has declared acupuncture a useful adjunct for more than 50 medical conditions, including chronic stress.” He went on to write that the NIH (National Institute of Health) also agrees and has endorsed acupuncture as a potential treatment for migraines, menstrual cramps, abdominal pain, tennis elbow, and nausea resulting from chemotherapy and more. “The fact the Mayo and Cleveland Clinics have embraced acupuncture and groups like the AMA have gotten states to designate acupuncture as an essential health benefit is more than significant.”

Kluger went on to say that more than 3.5 million adults and 80,000 children use acupuncture in the U.S annually. The military is using it for PTSD, pain disruption, and an assortment of ailments not the least of which is lower back pain. With all this information and these overwhelming statistics, why aren’t more of us using acupuncture?

If it’s fear of needles, you’re uninformed. These needles couldn’t be any smaller and less noticeable. As stated in the article, “The analgesic impact of a tiny needle is more than worth it.” The real beauty of this ancient Chinese practice is even if the practitioner doesn’t do it perfectly, it can’t hurt you.

Probably the most powerful potential use for acupuncture is in the treatment of addiction. Considering that more than 50 million Americans suffer from chronic pain, acupuncture as a treatment for chronic pain is one possible alternative to OxyContin and other addictive pain drugs. Of course, spinal manipulation by a physician trained in osteopathic medicine, a DO, or a chiropractor, plus yoga, and potentially non-addictive cannabinoids are also being used.

There have been more than 19,000 papers written about the efficacy of acupuncture, and recently I saw statistics on back surgery that were less than encouraging. According to recent studies, back surgeries are sometimes as low as 30% effective. Moreover, having been personally a regular sufferer from back pain, osteopathic manipulation, exercise, weight loss, and acupuncture have all been medical gifts that have worked beautifully for me over the years.

The question then becomes, why not? Why aren’t you trying acupuncture? Is it because you don’t understand how it works? Is it because some medical professional has indicated it is “woo-woo medicine?” Or is it because you’re afraid of the tiny little needles?

Maybe it is because you’re concerned it might be harmful in some manner? If you could be assured all these are really non-issues, what else would prevent you from trying this?

I’ve often quoted the book “Change or Die” which examines the thesis that many of us would rather die than change. I’m sure this idea sounds incomprehensible to many of you, but think about it. We are inundated every day with advertising, political narratives, and scientific treatises sponsored by organizations, businesses and associations that want us to remain loyal to their financial interests.

I’ll never forget the conversation I had with a scientist who once told me that hydrogenated fats were the biggest medical experiment perpetuated on mankind without our knowledge. It prolonged the life of food on the shelves while killing half a million Americans each year from inflammatory disease.

Industrial farms, Big Pharma, the soft drink and snack food industry all have their stakes firmly planted in the ground, or more specifically in our brains, with millions or billions of dollars of advertising to indoctrinate us over the years.

One of Jerry Seinfeld’s routines talked about food from his era, including boxes of chocolate chip-filled mini cookies that were sold as cereal.

We Boomers all remember hydrogenated margarine that sat on the table all day without refrigeration, those wonderful Twinkies, and, of course, physicians who were featured in ads endorsing the health benefits of cigarettes.

Try acupuncture. It really can’t hurt you.

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Temporary Immortality

November 8th, 2011

ABIHM Header 1 - Integrative holistic medicine

I’m speaking at the American Board of Integrative Holistic Medicine’s Educational Conference today at 2:00 PM, but have been listening intently to the various presenters — my fellow board members, throughout the event. All of these folks are MD’s who embrace holistic (body, mind and spirit) and integrative (the world’s greatest) treatment modalities for appropriate care in medicine.

I’ve learned about Abraham Flexner who wrote a white paper in 1910 that became the de facto guideline for what would be taught in medical schools; essentially, a reductionist approach to practicing medicine which has led to the modern formula of medical practice, where the physician asks, “What’s your chief complaint.” Then he or she treats that — many times as if it were a stand-alone, unconnected condition, unrelated to any other causal factors.

This type of practice has virtually eliminated the holistic approach and pushed medicine into ICD9/10 codes, (currently going from about 14,000 codes to nearly 68,000…in fact, there’s even one, specific code for “injury caused by riding on the back of pig.)  It all becomes a matter of diagnosis of disorders leading to the prescription of drugs. The U.S. is spending $308 billion a year on pharmaceuticals, which is one half of the expenditures of the rest of the entire world in drug purchases. We’re spending about $14.6 billion on anti-psychotic drugs and $10 billion on antidepressants, alone.

The $2.5 trillion that we are spending on healthcare in the United States is NOT allowing us to live longer than other countries, and the really sad news is that most of these expenditures are for preventable diseases. About 90 percent of our expenditures are because of stress related issues, and when we take such amazing statistics into consideration as the fact that the United States consumes two times more fat than Asia, three times less fiber, and 90 percent more animal protein, it has to make us think a little bit about this course that we are currently pursuing.

If you study the statistics, you’ll see that China consumes less red wine than us…but their population lives longer. Japan consumes less fat than we do, and their population lives longer. Italians consume much more red wine than we do, and they live longer. Germans do everything wrong, i.e., eat high fat, drink lots of beer, eat sausages and fats and even they live longer than Americans. What must our conclusion be? Maybe living in the United States is the problem? (Just kidding . . . but maybe it is the fact that we are so intensely committed to a more-is-better philosophy.)

As a population we eat about 50 tons of food in our lifetime. In fact, it’s probably been closer to 51 tons for some of us, and, for the most part, we’re eating lots of chemicals, insecticides and antibiotics in our unnatural and subsidized corn fed animals, and farm raised fish.

Where am I going with all of this? Have you ever been around a really cocky kid who acts like he or she is invincible? That’s why our highest death rates in the teenage years are primarily related to automobile accidents with Caucasian teens and guns with many of the ethnic teens. They truly believe that they are invincible.

It’s always been interesting to me that those people who have been fortunate enough to have lived charmed lives with no sickness and no close relatives or friends who have died have a certain air of immortality that surrounds them. They are lulled into the belief that they will beat the odds and live forever. We are, in fact, on a finite journey that requires us to provide some self-nurturing, lots of personal lifestyle education and a willingness to try to do what is best for our long term quality of life issues the majority of the time.

The bottom line? as my blogger friend, Paul Levy says in his most recent blog post, we are dealing with “temporary immortality.” So, live every day as if it is your last and take better care of yourself.

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It’s Not Just About the Passion

February 20th, 2011

Get up at 3:00 AM, get to the airport at four, fly out at five, arrive in Austin, Texas at 10:20 AM, wait until 1:30 PM to meet three other board members, rent a car and drive to the retreat center. Check–in, have a quick dinner and go to the first evening board meeting; in bed by 11:30 PM, up at 6:30AM and meetings on Saturday until 11:00 PM. Next day: Up at 6:30 AM, meet until 10:30 AM, drive to the airport and fly home through multiple cities; arrive at around 8:00 PM. That was my weekend. Why? Because I am the only non-physician member of the American Board of Integrative Holistic Medicine. More specifically, I am the not-so-token former hospital administrator, and that’s how much ABIHM cares about spreading the word.

This is my third year as a board member, and during that time, it has been my genuine pleasure to watch this amazing group of caring, integrative/holistic physicians build what is fast becoming the most important element in the U.S. healthcare reform movement. Most of them may not be seeing this the same way that I am (i.e., as not only life but also economic saviors), but it is absolutely a fact that their way of providing care is the only hope that we have in this country to contain health care costs and improve the quality of life in America.

As physicians, this group of humble yet brilliant men and women are true giants in their respective fields of endeavor, be it Family Practice, Internal Medicine, OB/GYN, or Psychiatry. They are “top docs” in combining traditional practice with integrative and holistic medicine. They come from prominent medical schools, and some eve teach residents at these schools. Some are in private practice and still others are working for large, prestigious health systems. They have literally written many of the books on integrative and holistic medicine, but the most important thing that I can tell you is that they are all unbelievably positive people; kind, caring, nurturing, thoughtful human beings who are “in it for all the right reasons.” No kidding. All of them.

Why am I so enthusiastic about these folks? They truly practice what they preach. Spending even 50 hours with them revives the soul and confirms my beliefs that every one of these holistic modalities can contribute to our well-being. I’ve heard their stories about the power of meditation, of vigor restored by appropriate diet and things like simple yoga stretching and walking. They casually discuss case after case of people who have been cured or healed of what would otherwise be considered debilitating maladies simply by altering a diet; cutting out the processed foods and sugars, walking a little every day and finding anywhere from 20 to 40 minutes a day to just step back and focus on themselves, their hopes, dreams and positive outcomes through internal journeys of self-exploration and meditation.

So, where do we go from here?

If you’re a doctor, look them up on the web at integrativeholisticdoctors.org, attend their seminars and workshops, meet them, learn about their peer mentoring program, embrace them and their 1200 Diplomates, and, most importantly, get on board. Each and every one of these gifted, inspired physicians has one thing in common: they love their work; they love to go to work, and their patients and staff love to work with them. If for no other reason, look them up for yourself.

If you’re a patient, don’t settle for less. Search their website at and find physicians near you who are certified in Integrative Holistic medicine. Get off those medicine cabinets full of pills, start taking care of yourself, and begin to live the life that you and your loved ones deserve. It’s the only way. The promise of technology has not cured us. The skill of steel from our gifted surgeons has not prevented the malady from impacting us in the first place, and, finally, the pain and suffering keeps going on and on in our lives.

The solution? Find an ABIHM doctor and start the change today.

The American Board of Integrative Holistic Medicine (ABIHM) is pleased to announce an additional opportunity to take the 11th Annual Board Certification Examination, on-site at the conclusion of the iMOSAIC Conference in Minneapolis, MN.  Please take a moment to review the iMOSAIC conference schedule at www.imosaicconference.com, where you will see an impressive program of faculty and topics!

Date: Sunday, April 10th, 2011 at 1:30 PM. Sign in between 1:00-1:30 (preregistration required).

Location: Minneapolis Convention Center, Room 208 AB

Duration: 5 hours allotted; at least 50% of candidates finish by 2.5-3 hours

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Carrots or Sticks?

January 30th, 2010

When you do the math, you can rather quickly determine that, as the aging process continues with the Boomer generation, federal funding for health care and Social Security will become more and more scarce. At the same time, we have all read the sobering national statistics regarding unnecessary deaths from hospital missteps. The CMS (Center for Medicare and Medicaid Services) previously introduced a form of pay for performance, or –more accurately– no pay for performance, which has already caused a great deal of change in the American Healthcare System.

As is widely known by now, CMS has decided to literally stop paying for the treatment costs of preventable medical complications.  This actually may seem like an intelligent idea. This approach is referred to by some as visibility for good care, and there is no doubt that it will represent the beginning of a stampede from the third-party insurance payers to follow the CMS “Big Dog.”  In fact, several companies have already announced that they will not be reimbursing hospitals for similar errors, as well.  The truth of the matter, however, is that this step does not even begin to address the problem.

The problem is not about penalizing hospitals, it’s about creating an incentive system that is not disease and sickness based.  Until the pyramid is flipped, we will not see the necessary changes to halt this financial slide to economic oblivion.

Sanjay Saint, MD, MPH

About 9% of U.S. hospitals presently use daily reminders to help physicians remember which patients have urinary catheters in place.  According to the University of Michigan’s Sanjay Saint, a professor of internal medicine, about 74% of hospitals don’t keep tabs on how long the catheters are in place.  But the real issue is that about 98% of hospitals and physicians don’t completely address issues of wellness and prevention that can allow us to remain well until we die because there is little or no incentive to do so.

Logic would dictate that because financial reimbursements will be connected to these hospital-created mistakes, infections or injuries, someone will surely pay more attention to the current misses.  But what if the entire system was based on keeping people healthy?  What if all of our focus was on exercise, appropriate food consumption, and stress management?

Unfortunately – or fortunately, depending upon your perspective – the United States has become the most proficient country in the world when it comes to capitalism, and much of capitalism is based on manipulating people to get them to consume what will bring the financial success and rewards to the corporations.  If you doubt this, just go to Eastern Europe to see what is happening in an environment with unregulated tobacco advertising.  The circle has started all over again.

In the old carrot-and-stick arrangement, there will be plenty of hits.  Wouldn’t it have been interesting, though, to reward hospitals where mistakes are almost nonexistent so that the less successful medical centers might line up to learn from them, or to reward docs and hospitals for helping to keep people healthy all the time. Carrots work, too, and with much less grief.

Carrots and (Celery) Sticks

What’s the old line?  “We’re going to beat the troops until morale improves.”

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Don’t Drink the Water?

July 8th, 2009

Ever wonder about this whole water, nutrition, thrown-away-or-passed-through-pill thing?  I was talking to a friend who was explaining her box filled with powered, bio accessible supplements to me.   You know, the kind you drink in a milk shake in the morning.  She explained that her house had a septic system and that the annual visit by the septic maintenance truck was usually an occasion to discuss topics that the rest of us don’t get into on any given day.  Interestingly, she asked the septic  guy if things have changed “down there” over the years. (I know, I know. Too much information.)

His answer was terse.  He said, “Yep, all we see now when we start our work is pills, undigested pills.”  I’ve written blog posts about the lack of filtration capability built (or not built) into our water purification systems, and suggested that you move to Chicago if you have high cholesterol because there are so many lipids in the water.

Nicholas D. Kristof, Pulitzer Prize winning columnist for the New York Times has always been one of my literary heroes.  His coverage of Darfur, his reports on the Iraq war, Afghanistan, China, and gender rights issues have all captured my attention and admiration.  His column last Sunday in The New York Times, It’s Time to Learn from Frogs, was deeply disturbing and raised issues that should capture not only our imaginations but also should tickle our most profound concerns.

three legged frog
Photo credit: Discovery Channel/TreeHugger.com

For those of you who did not read it, the basic thesis was one of caution as we see our amphibian friends sprouting extra legs and some developing stunted genitals, while some of their fish companions are devolving into intersex fish that display female characteristics and produce eggs.  The reason for these changes is being attributed to a class of chemicals that scientists refer to as endocrine disruptors.  Some are passed into the environment through the urine of human females on estrogen treatments.  Although these theories for the disruptive changes in nature are still only theories, we have also begun to see a serious percentage of male babies  (7%) being born with undescended testicles and 1 percent being born with the urethra exiting the penis improperly.  Obesity may also be impacted by chemicals that contributors.

As the founder and former CEO of a research institute, our scientists constantly reminded me that 75% of our cancers were produced from the environment.  As we saw completely substantiated reasons in our economy to add man-made chemicals to retard spoilage, discourage bug infestations, and produce larger chicken breasts, or more attractive fruits and vegetables, the cascade of potential consequences caused by these decisions were never really known to us.

Mr. Kristof ends his op-ed by stating that “Those deformed frogs and intersex fish – not to mention the growing number of deformities in newborn boys-should jolt us once again.”

Could someone pass the “Fresh Mountain Spring Water?”  Oh, yeah, the one that’s full of heavy metals from the acid rains.  You know, that Grey Goose is looking better every day.

For further reading:

What Are Endocrine Disruptors?

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