Archive for 2. Current events
Debra Mazda – A Fit Shapely Girl
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Debra Mazda is the brains and the brawn behind the business called ShapelyGirl Fitness. If you click on the link you will visit the “about” page and see pictures of Debra at age 21 and 300 pounds.
Debra did 3 things, first she made a decision to change and stuck with her decision. Second, she started to move more and third she slowly and steadily improved her eating.
Debra wants you to hear her story and so do I, so I have invited Debra to be my guest on Ask an Expert Anything. She will talk with me and answer your questions on August 12 at 830PM EST. The pre-event page is ready for you to begin typing in your questions.
Visit Debra’s site ShapelyGirl Fitness, read about what she did and what she does now. Ask some questions by typing them in on the pre-event page and then be sure to listen in on Wednesday night, August 12 at 830PM EST to hear Debra tell her story and give her tips to women wanting to become more fit and shapely.
Popularity: unranked [?]
Get the Skinney Mobile
Posted by: | CommentsEveryone has a mobile device. Many of these are web enabled. I would like you to be able to receive what I write
in the most convenient way so I am publishing my content via SMS and via mobile web browser right to your phone.
Here is how you can sign up for my mobile web page if I did not send you an invitation. At the bottom of the post I will embed a link. It will be a box with overlapping hearts in it. They are a blue-green color. Click on that link and it will take you to my sign-up page. I am using an original WWII picture of a P51 Mustang above the clouds – as my wallpaper. It will be easy to recognize. Click on the hearts, sign up and stay on as long as you like. If you want out, just unsubscribe.
The second way is to get a daily SMS. Actually about 3-4 times a day I will send a text message to Twitter. If you send the message – Follow DurhamDad1 – to 40404 you will receive the wellness tips I send to Twitter via text messaging to your phone. I will be holding contests as soon as I get 25 people following on sms or subscribed to the mobile version. Get the word out so you not only receive my outstanding content, but you get to have some fun too. You don’t need a Twitter account for just SMS.
To follow me on Twitter, set up an account there. Go to Twitter.com, create an account, enable your mobile device in settings and then text – follow DurhamDad1 – to 40404 to get my messages plus see what I write there. Now I will have lots more messages but you will only get the messages I text in to Twitter 3-4 times a day.
OK, you are becoming the leading edge of early adopters in Web 2.0. Congratulations! Let me know when you are online or SMS ASAP. Ready, set, Go – sign up now! Got questions? Remember the only dumb question is the one you do not ask. Below is the comments section, ask there. If it isn’t clear I will email you and be sure I have it straight before I publish it. Don’t hesitate now, sign up or ask up. What are you waiting on?
Popularity: unranked [?]
How to insure Everyone?
Posted by: | CommentsPresident Obama has perceived correctly that we in America want change. We want things to have a low cost, we want protection from mistakes we make and we want someone to solve our health problems no matter what we have done. If we smoke, over eat, under-exercise, don’t brush our teeth or see the dentist regularly we want a bail out.
We perceive health insurance as a way to cover first costs and catastrophic costs. If we have great coverage, we don’t want to change it. If we are receiving outrageous renumeration for our services as many insurance company executives are, we don’t want it to change. Because of the tremendous financial clout of the insurance companies, they have many friends in Congress to represent their interests.
We have been fighting a war on two fronts in the name of national interests. Thousands of our own citizens have been killed or wounded and hundreds of thousands of the idigenous people have suffered the same or at best terrible lifestyle if you can call living in a war zone without protection of law, adequate food and little or no medical care a lifestyle. What is the national interest in our citizens health?
We have a national interest in helping our citizens to have good health and in providing them with the most accurate unbiased information on which to base their decisions. How should we do this? What should be covered by insurance and what should we have to pay? We are more and more aware of our finite financial position. We have borrowed against future earnings in order to pay for war and priviledge now.
Some are in favor of a single payer system like Medicare where the government is in control and there is no where to go to resolve problems. Others don’t want anything to change – they are doing fine with the system as it is. Some want insurance companies to be regulated like utilities. Some think insurance should only be for big unforseen circumstances and we should pay out of pocket for the rest.
I think we need a system that helps us out of a jam – if we get cancer we need some help but if we smoke or drink too much or eat too much and have disease related to over consumption of food we need to be responsible for that behavior. When I was trained years ago, renal dialysis was not paid for by medicare or medicaid. To receive it you appeared before a review committee and that committee composed of medical and social science professionals and people from the community decided yes or no. Literally life or death. If you were elderly, a felon, or had more than one complicating factor, you did not get it. I had problems with that system just like I do with this one.
It costs you to live. What should it cost you to have access to medical care? We consider cable TV, video games and eating out to be necessities – our rights! What are your rights? I think we have the right to knowledge and a level playing field. We have a right to live well and to have preventative care – but that care does not have to be provided by physicians. Prevention can be delivered by mid-levels (PAs and NPs) at a much lower cost.
Physicals and some things like colonoscopy, certain cardiac stress tests, etc… can be done by these mid-level practitioners. We need to pay physicians for thinking, not procedures. Is it worth more to do a hip replacement or to treat severe rheumatoid arthritis? There is a huge discrepancy in payment yet the person treating rheumatologic disease spends hours and hours in preparation for the visit. The surgeon spends hours learning the skill but once acquired the surgery is routine. The surgeon does not clear his patient for surgery, yet the person who does the thinking to say it is OK to have the surgery gets paid much less for the thinking than the surgeon does for the surgery. If there are post-operative complications, the surgeon keeps the fee he was paid even if the person requires many more days of care by “thinkers”. This is not to disparage surgeons who often are called upon to operate in emergency conditions on people who have neglected themselves for years.
There are no easy answers. There are lots of opinions! What is yours? How would you like to see this play out? I would really like to hear what you have to say in the comment section. Please, tell me what you think.
Popularity: 1% [?]
Does YOUR Doctor have a Conflict of Interest
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Patients go to doctors to improve their health. They want the best care and advice possible. Patients today, in my experience, are often better informed but without experience to use the information effectively. Does this mean that they should not have the information?
It depends on what the information is and what I have to do about it. If it requires me to give a lengthy explanation when I am really pressed, I wish the patient did not have information they don’t fully understand in context. I love to explain things, it is a passion, but I like to pick the time and venue.
One thing patients might not fully understand but to which they are entitled is potential conflicts of interest their provider may have. Most people are aware that representatives of the pharmaceutical companies visit physician offices and clinics. The Drug Rep lunch is a staple of many offices, often more than once a week. These Reps have a budget that allows them to buy lunch for the whole office. During lunch, the Rep gives their spin for their companies drug, device or service.
The motive for this is to establish a relationship. With this relationship the Rep hopes to influence prescribing habits. Sometimes the best they can do is just remind the Provider of the availability of their drug. Along with lunches are occasional dinner invitations, odds and ends gifts of clocks, pens, pads etc that bear the name and logo of the product and the company that makes it. The provider must sign for samples received but not lunch, dinner or minor freebies.
I have made it a tougher and tougher personal policy to not accept anything except samples from drug companies. I have accepted a new stethoscope which I use daily. I removed the logo and can’t remember who gave it to me, but I think it was for a drug that has since been removed from the market due to safety concerns. I have also accepted a textbook and a headlamp in the past 5 years. The reps who gave those to me no longer call on me so they lost their influence. I have to admit that I was more sympathetic to them because of those gifts.
What about a physician who is paid to speak for the company? At about $1000 a speech, does this influence them? How about some one who is paid to sit on an advisory board? Aren’t they influenced a bit? They say they are impartial and unbiased and I am sure they try to be. I believe if you have a relationship, then you are biased in some way you would not be if that relationship did not exist.
BusinessWeek ran an article on this subject entitled Doctors Under the Influence.
The article deals with this issue and uses a case study of physicians who prescribe the drug Chantix. About disclosure one of the physicians said, Telling patients more about industry ties “would just puzzle them,”
I think you are entitled to know the extent of your physicians involvement with a drug company. I am not suggesting that he or she is unduly influenced. If they see reps, accept lunch and/or dinners plus occasional gifts they are influenced. This practice is so ubiquitous that there is no thought of impropriety.
In the state of North Carolina where I am licensed, the medical board is going to publish major negative uninterpreted data about providers. Any malpractice claims paid for them, any disciplinary action taken against them for any reason etc…
I feel like I am under a microscope sometimes. I am definitely held to a very high standard. I like it. I want to be part of a group that can say, “I have extremely high ethical standards.” I do not think that I need to see a Pharmaceutical Representative to get drug related information. I receive plenty of information from unbiased sources. I am happy to accept samples of medication and the price reduced programs that come with them. I just wish the companies charged prices in line with those of other countries. The reason prices are lower there is that they are capped legislatively.
That is socialism. It is a good form of it. I don’t know what if any concessions are given to the drug companies because of this. I do think you should know if a part of the reason you are receiving a drug has to do with the relationship your physician has with the company manufacturing that drug.
WHAT DO YOU THINK? Leave me a comment on this please.
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I could use your feedback
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I am interested in knowing more about what you like and want to read.
Would you answer some of the following questions in the comments section below.
1. What article here has been most helpful to you in your wellness goals? How or Why?
2. What have you found most interesting?
3. If you were to rate the blog overall, 1-10 with 10 the best, what would you rate it?
What was best and what needs work?
4. What other subjects would you like to read about?
Popularity: 2% [?]
Which Drug War should WE be Concerned about
Posted by: | Comments 
This is a Home Work Assignment to all my readers.
Are we a society that seeks a pill for the solution for all our troubles. Which pill is better? One that cures you in 90 days and costs $10,000 or one that controls your condition but requires a daily dose all your life and costs $3.50 per day or over $27,000 during the remaining 25 years of the persons life? We are at war with Big Pharma. They get breaks from the Federal Govt. like no negotiating the price of Medicare part D drugs, the FDA having to collect fees for drug approval from the company that wants the approval and other sordid situations. It is in the interest of the company bottom line to control and not cure problems.
Should we use pills to control a child’s behavior or should we use other modalities and pills occasionally. At what age is a child’s brain ready for the medication without harm?
Should members of panels making recommendations for the care of patients and the use of medications have had any financial dealings with a drug company in the preceeding 5 years or the 5 years after serving on the panel? Should a physician have to decide early in a medical career that they will or won’t have income from the suppliers to the medical community like pharmaceutical companies and medical device companies? They do it for their speciality, why not for business relationships. You opt for a number that indicates to everyone throughout your career that you will work on industry and ethics then removes you from making recommendations on general patient care like the panel that recommends standards of care for prevention and treatment of heart disease and cholesterol.
I have written a blog post on my site on Stumble Upon. (But to save you the time http://drop.io/oneanswer. The password is myanswer. the phone number is -
646 495 9203 ext 30697. Look forward to hearing from you there.) It is in response to an article I read and book marked there. I also set up a drop at drop.io(www.drop.io/oneanswer Password myanswer) for comments. Please, click on the link, go to the post on stumble upon, if you agree with the article and what I have written there, go to the Drop.io site or use the number (646 495 9203 ext 30697) and call in your comments and suggestions.
I want to do something and I want to use what the editors on lifehacker.com call the “Hive Mind”. The collective suggestions and opinion of everyone. We know there is a problem, lets begin to solve it. Lets discuss it and lets bring it to the attention of all our friends and neighbors. Lets think about things like getting all physicians to quit letting drug companies to buy them lunch. To get all physicians to quit seeing drug sales representatives. Lets have an online place so that physicians could get samples sent to their neediest patients but none in the office. I work in medicine and I won’t eat with the drug reps and won’t accept dinner invitations or anything I can’t use to help patients. Mostly I will sign for samples only but I would rather have a voucher and just give it to those who need it most. I want to use your comments to influence the FDA. I need 300-400 people to call the number and leave a comment about this problem.
I want your opinions. Please, read the article on Stumble Upon (Mercola here) and then call the Drop.io number or go to the site and use the password in my blog article on Stumble Upon (or as listed in the paragraphs above) and write a response. I appreciate your time and effort. Let’s DO something besides complain or restate the problem over and over.
I will be checking the Drop.io site daily an reporting results periodically.
Popularity: 1% [?]
Universal Health Care – the moral argument against it
Posted by: | CommentsThere is an argument that if everyone is covered, there will be a free-for-all of spending on health-care. That doesn’t make sense to me and to many people better informed than I am, but I will get to them in a minute.
Let me ask you, Are you insured? Do you go to the doctor just because you are? If you have dental insurance the answer is probably yes. Same with eye coverage, you are more likely to go to the doctor to get an eye exam if you are covered. So I would have to say that yes there is a little more cost to offering preventative services.
What is the cost of not offering coverage. The uninsured don’t go to the doctor, the eye doctor or the dentist unless they have a bad problem. Lack of prevention over a life time leads to more serious problems later and a habit of putting off care leads to poor compliance, more complications, overall increased cost.
Here are the opinions of several others. Malcom Gladwell has an article in the New Yorker on the case against the moral argument. Joseph Padula has the seventh of 7 articles on this issue on his blog Managed Care Matters. He makes an eloquent argument for universal coverage.
I am for universal preventative services. Some of these could be delivered at school, like tooth care, dietary information, exercise benefits to health and brain etc… Some have to be delivered by Doctors. No one wants to get their pap test at the nurses clinic at work and they shouldn’t. Cholesterol screening, risk factor evaluation, prostate and colon cancer screening need to be done with a physician involved.
The most important interventions require more than just physicians to be involved. Who benefits from healthy citizens?
We all do but especially insurance companies, employers and the largest payer for health services, the government. Lets get our citizens eating right, exercising, with good teeth and gums. Then we will see our costs go down. We have an aging population that are going to cost more health care dollars. Old people get sicker under our current system. It costs far less to help someone stay healthy than it does to restore them to health.
What is your opinion? How will you vote now and in the future? Everyone votes for what benefits their bank account. You have to protect your own income but look down the road. What can you do now to protect your earning capacity well into your 70’s. You are going to need it. What do you think the plan should be?
Popularity: 2% [?]
Great Britain’s Health Care System Problems – 3 examples
Posted by: | CommentsDr. John Crippen is a generalist or what we would call a family practitioner in the National Health Service in England. He is also the author of NHS Blog Doctor.
There is no doubt that our health care system is poor but the fix is often alleged to be the British and Canadian models. They have their fair share of problems and Dr. Crippen who has experienced these for a number of years has some humorous articles on his blog about these issues.
I would like to direct you to three of these articles.
1. Out of Hours Work deals with the issue of accessibility to your Doctor on weekends and after hours.
2. State Sponsored Shag talks about how the political machine dealt with the problem of ED.
3. Pissing Money Away is a report about how hard it was to get something necessary for an elderly patient.
If we use these systems example to repair our own, we need to be careful to find what is right and use it but to use their experience to avoid the pitfalls that have caused so many troubles.
Popularity: 2% [?]
3 Questions answered, Billions saved
Posted by: | CommentsHealth information illiteracy costs our nation 58 billion dollars per year. This type of illiteracy is common not only in the immigrant and HS dropout but in college graduates also. Health information is written above the 12th grade reading level. Most people in our country read at 9th grade or below.
If each person would ask 3 questions each time they saw a health care provider, and each provider answered the questions before the patient left, we could save billions.
Ask Me 3 is an organization devoted to getting three questions answered for each patient every time they are treated, tested, or fill a prescription. It is a non-profit organization funded by a grant from Pfizer, a pharmaceutical manufacturer.
What are these 3 questions?
1. What is my main problem?
2. What do I need to do?
3. Why is it important for me to do this?
These should be asked of your doctor, nurse and pharmacist. They should be asked when you receive care, purchase medicine, or are preparing for a medical test or procedure. Often when you are sick, you get new and sometimes complicated instructions. Don’t be afraid to ask “Would you explain that to me one more time?” Bring someone with you to hear instructions and take notes. Recording instructions is a good idea also. Visit Ask Me 3 to learn more.
Thanks to Jane Sarasohn-Kahn and her blog Health Populi for bringing this issue to my attention.
Popularity: 2% [?]
Prescription Drugs – coupons aren’t just for groceries
Posted by: | CommentsJD on the blog Get Rich Slowly quotes a fellow named Tyler from Houston who was searching for the best generic drug deal. In his search he found two things. 1. The best deals were to be found at discount stores like Costco and Sam’s Club. I believe you can use their pharmacies even if you are not a member. 2. Every brand name prescription he received in a 2 year period had an online coupon available making it even cheaper than generic drugs.
I tested this hypothesis. I looked at the top 10 drugs prescribed in sheer numbers and by highest cost. When I searched online, I found each brand-name drug had a coupon associated.
One example is Lipitor. A top seller in the category “statins”. Statins are used to lower cholesterol and control or even reverse the effects of cholesterol in the arteries. On the official Lipitor site I found a free 30 day trial offer and a coupon worth $10-15 each time you filled Lipitor for 12 months.
On another site, Reduce Prescription Cost I found a list of links to coupons for popular drugs like Actos, Crestor, Cymbalta, Flomax, Nasonex, Premarin, Protonix, Valtrex and many others.
It is worth a search before you buy. To find Lipitor coupons I simply entered – Lipitor + coupon – into a Google search box. The number one choice was Lipitor Offers which contained the information in the link I highlighted above.
Other sites of interest are Internet Drug Coupons that has 216 coupons to download, and Synthroid.com. Many of the brand name drugs you may be taking have websites that will give you a coupon.
I hope you search these sites for coupons. Let me know if you have before or did after reading this. How did it go? Are coupons accepted by your pharmacy if you present the coupon with your prescription ? Leave me a comment about your experience please.
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