Are you drinking enough milk?
To remain active and healthy, your body needs calcium. Without it you would lose bone mass and weaken, increasing your chances of injury while making it harder for you to maintain the strength needed to exercise. Drinking milk is a great way to get the calcium you need on a daily basis. Drinking milk helps to protect teeth, protect against heart disease, and allow muscle contractions.
Many people have dairy for breakfast, if they eat breakfast. The bad news is that many Americans skip breakfast on a weekly basis at least once, and out of the ones that faithfully get up and eat a healthy meal in the morning, a certain percentage of them either eat the wrong types of foods, or forget to get the other 2/3 of their recommended daily intake of calcium for good bone and muscle health by carrying on the habit during other meals. Dietary guidelines recommend at least 3 servings of calcium rich products each and every day, with dairy products and green leafy vegetables the best sources of natural calcium.
What is at stake?
Osteoporosis affects 1 out of every pair of people on the planet after the age of 50. Lack of calcium in the diet and lack of physical activity can increase your chances of osteoporosis later on in life, but that does not mean that you have time to waste. Bone development in young adults is usually completed by the age of 25, and up to this point, calcium is important to the development of bone tissue and the strengthening of it. after this point calcium is needed to replenish calcium leaving the body and to decrease the amount of bone mass lost as we get older. The first half of life is important to build out defenses, and the second half to preserve them.
Falls become more of a concern for older adults. This is quite reasonable when you consider that a large percentage of older adults who have a fall that results in a broken hip do not live longer than a year after the fact. Getting enough calcium now and in the future can help hedge your chances of not becoming a statistic, and enjoying the ability to remain active and in tip top shape for many years to come.
If a person is lactose intolerant, other foods other than dairy products that are rich in calcium as well. If needed, there are lactose free calcium supplements that can be taken to make up in deficiency.
As millions people consume caffeinated beverages in ever increasing amounts, the effects of caffeine on the system needs to be better understood. Recent studies have shown that the stimulant in our coffee, teas, and ever more popular by the day, energy drinks is a complex chemical that has a myriad of effects both in the immediate and long term.
Caffeine is a stimulant, and as such, has serious influence over the central nervous system. Mental alertness is found to be sharpened in the short term, with a lowered ability to concentrate and focus present as the effect of the drug wears off, or when caffeine addiction pushed the body into withdrawal in its absence. The duration and power of the stimulant effect is in direct relation to the amount of caffeine ingested. Though considered a mild stimulant, overuse can lead to insomnia, irritability, and even moderate signs of physical addiction. The recent popularity of energy drinks including guarana as a caffeine source has been of particular notice, as the amount in caffeine contained in this South American Fruit is up to 4 times as potent as the coffee bean and 3 times as strong as stout tea. These drinks also contain high levels of simple sugars, especially fructose, which are horrible for health, and should be considered when evaluating them for use.
While the adverse side effects of caffeine addiction can usually be reversed with discontinued use, the mildness of its effects make addiction hard to take seriously by most people, and the will to discontinue its use low. Longer term side effects do not seem to have an overall negative impact on health in general, but the existence of certain health conditions or the taking of particular medications might make the taking of caffeine a more risky endeavor. While usually considered safe in moderation it is always advisable to talk over dietary and medication conflict over with your health care professional. For now, caffeine is seen to increase temporary mental alertness with minimal negative results. Abuse of any drug increases these results, and caffeine is not different in this matter, and should be respected as the stimulant it is. If you have a history of drug abuse, especially stimulants, then drinking coffee can actually help to trigger this addiction, so precaution is to be taken. Minors, pregnant women, and those with sleep sensitivity issues are recommended to choose caffeine free alternatives because of its stimulant properties.
Many of us have to battle acne on a constant basis. The only thing that seems to be more consistent than the pimples is the barrage of medical remedies that are being pushed on us on a daily basis as a solution to our problem. While some of these products definitely have the benefit of helping to clear up acne, often you can get the same results by doing self treatment. Here are 5 simple solutions that offer healthy benefits to the skin and general health that often have a positive effect on acne removal, reduction, or prevention.
* Eating plenty of fresh fruits and vegetables. Often the source of our acne troubles is a high sugar and fat, low nutrient diet. Skip the Ho Hos, and instead eat a salad, enjoy a mango, or consume green leafy vegetables instead. Healthy skin usually begins with a steady supply of nutrients and vitamins that fruits and vegetables are chock full of. Instead of a soda, have a fruit juice. Your body will thank you for it.
* Drink water. The average person is supposed to consume an average of 10 full glasses of water each and every day. However the average person does not. Clear, healthy skin is well hydrated. Dead skin cells are reluctant to make way for new if your skin is dehydrated, and without fresh skin cells, you are more prone to develop acne.
* Avoid the use of harsh chemicals, especially in the treatment of acne. Natural products are always better than their man made counterparts. With the use of chemical products, there is a higher risk of unwanted side effects from the treatment, often with no understanding of the cause. Not only are natural products better for you, but with lower production and regulation costs, they are also usually more cost effective. Why pay more for less benefit and higher risk?
* Relax a little- Many people have a tendency to break out more when under stress. On often overlooked method of creating an acne breakout is to constantly touch the face, as people under stress tend to do more than those not under such stress. Stress also releases hormones into the system that exacerbate acne, increase it, while reducing the ability for other treatment options to remain effective. Exercise, meditation, or even relaxing with friends can have a positive effect on the reduction of stress levels that make getting you acne under control much harder.
* Get some fresh air and a little sun- While not advising to get a tan, getting out of a stale air, indoor environment for 20-30 minutes a day can keep your skin flush with vitamin E, essential to good skin health. Not only that, indoor environments have a dampening effect on the mood, which can also lead to higher stress levels and worsen your acne problems. Take a break from your indoor activities and go outside for a bit. It can do wonders for your complexion as well as your psyche.
Some of the best skin wrinkle reduction products can be found it the grocery store and offer other health care benefits. Several foods not only help to make your skin look younger and smoother, but also help to preemptively protect our skin from damage.
If you want to protect your skin from the elements, promote anti-aging, and make you look as good as you ever have, then there are several natural ingredients that you can add to your skin care regime.
One of the best ways to reduce wrinkles is to eat foods high in anti-oxidants. Anti-oxidants help to protect your skin from the number one cause of signs of aging, free radicals. Free radicals are extremely harsh on skin and other cells in your body, and have even been linked to some cancers. Eating foods high in anti-oxidants help to protect your skin from the damage that free radicals can cause. Green leafy vegetables are an excellent source of anti-oxidants, especially spinach and broccoli. Other greens such as collards and kale also offer free radical protection, helping to reduce the effects of aging and reducing the chances for unsightly wrinkling.
* Fish high in Omega-3 fatty acids, such as salmon are vitally important to the health of skin and your general health. The nutrients provided by salmon, tuna, and other Omega-3 fatty acid rich foods provide an excellent source of protection in the battle for better skin, especially the effects of aging.
* Other “healthy” fat enriched foods, such as certain nuts, especially cashews are not only great for the skin, but also provide the body with much needed fats without having to resort to “unhealthy” fats such as are found in processed foods and trans-fat fast foods. Getting enough fat in your diet is essential to health, but unfortunately most people get too much of the unhealthy fats, and not enough of the fats that provide energy without damage to a person’s overall health.
* While not often seen as food, the skin creams that offer the best chance of benefits to the skin without unneeded side effects are mainly natural food items, or have these included in the ingredients. Your skin is the largest organ of the human body, but few people care for it as such. Using natural ingredients in the care of your skin is probably the best thing a person can do to protect it, improve its appearance, while at the same time avoiding the harsh and often chemical solutions that many might apply to their skin without a natural alternative.
As we age, our skin has a tendency to become thinner and more brittle, allowing us to bruise more or even tear easily. This is usually due to the reduction of elasticity and collagen in the system. In addition to the foods above, One such food additive is within common Japanese sea kelp, which can be eaten regularly to promote skin health. Phytessesnse Wakame, the main ingredient, is also extracted and used in several effective skin care products. It is proven to help in the reduction of wrinkles as well as promoting the natural and healthy glow that many people are looking for without resorting to the use of harsh drugs or chemicals that might eventually be more damaging to the skin than beneficial.
Photo aging, skin damaged caused by prolonged time in the sun, resulting in high levels of UV radiation, is usually recognized by the appearance of spots, wrinkles, sagging skin, jaundice like features, is not only unsightly, but also has been known to carry a heightened risk of certain skin cancers. Skin cancer, while often overlooked as a major health concern, actually affects over one million people annually, and poses serious risks to the afflicted person’s life.
Ultraviolet radiation from the sun enter the Earth’s atmosphere even when the sky is not sunny, and have proven to be human carcinogen, speeds up the aging of skin, can produce severe burns, and is a major cause of wrinkles in almost all people who do not protect themselves from its rays.
Ultraviolet radiation comes in two forms from its natural source, the sun. UVA radiation is the most common, with over 90 percent of all UV rays being of this type. It is this type of radiation that advances skin aging prematurely, contributes to wrinkles, and is also a source of cancer.
UVB, though being less than 10 percent of the UV rays that come in contact with the skin due to atmospheric filtering, is known to be extremely harmful to skin, a known carcinogen, and even in smaller amounts, is much more damaging than UVA. UVB rays are the central reactionary triggering sunburn and other immediate skin damage, and also harms the eyes, being the main source for cataract destruction.
While this news is not likely to make you jump with joy at the knowledge, there is something you can do to help reduce the chances of permanent skin damage and cancers, prevention. Wearing a sunscreen at all times that you expose yourself to the sun’s rays, even when cloudy, is the most prominent and most effective method of protecting skin from UVA and UVB. While it does not offer 100% protection from the sun, the SPF, or protection rating of your sunscreen will tell you the rate at which UVA and UVB will enter the skin with its protection as opposed to without. An SPF rating of 35 states that UV rays will take 35 times longer to reach and damage your skin than untreated skin.
While many people wear sunglasses, most do not realize that if their glasses have no UV protection, then they are actually helping to promote eye damage, as they allow for pupil dilation due to shading, allowing more damaging rays to enter the eyes. When choosing sunglasses, make sure that they clearly state that they are UV protective lenses, or you will be doing more harm than good. UV protection lenses also help to protect the area around the eyes that are prone to wrinkling, where application of sunscreen is not recommended.
Your skin is the first line of defense your body has against outside invaders, seen and unseen. If you do not take proactive solutions to your skin’s defense, then painful surgery, excessive wear and aging, fragility of the dermis, or even cancer might be in your future. Your skin is too important to ignore. To combat photo aging, prevention is truly the best medicine.
I do not think that there has ever been a time throughout history where women have not resorted to some type of potion or other remedy in the search for perfect skin. Everything from a change in diet, to the use of drugs, and even surgery have been used in order to combat wrinkles and to try to get back the smooth skin that we were born with. The only thing that is different in this day and age is the availability of products and procedures that a person has to choose from, as well as the wealth of information available on each and every one of them.
One thing is for certain. Several of the wrinkle reducers and skin care procedures on the market today come with their own specific set of side effects and drawbacks. Many of the best techniques and products shown to work at reducing the signs of aging are very expensive or only available in a limited region. Others, though widely available and affordable, simply do not produce the results that they claim, and some procedures, such as plastic surgery, while seen as widely effective, in rare cases, can leave a person scarred, and far worse off than they were before the treatment. Drugs, though seen as less invasive than surgery, can also come with a whole host of side effects that have to be weighed before use.
Does this mean that in the search for the dermic fountain of youth one has to undergo the knife, risking possible horrific scarring, take drugs that might lead to further complication, or use foreign creams or even resort to injections to see desired results? Does getting older necessarily mean that your days of smooth skin are gone forever? Is there even a safe way to reduce the signs of aging of the skin, or are risks inherent to improving your skins appearance? One technique that proves to both effective at combating facial wrinkles and aging, and with little risk, is the use of facial exercises.
Facial exercises are definitely safer than surgery, can be done from the comfort of your own home, and cost nothing to perform. Not only are facial exercises good for the reduction of wrinkles in older women, but can also be used as a preventative measure by the young. Like any other boby part, the face can benefit from exercise by improving facial health, tighten muscles, and improve the look and feel of the skin over them. Not mny people think of putting the face through a “workout”, but it is the least intrusive method of improving facial health without surgical or drug intrusion.
The greatest thing about facial exercises, is that a person that practices them regularly can often see results within 4-6 weeks, which is better than several of the more expensive wrinkle medications and creams on the market today. While many of the medications try to improve collagen and elastic levels to no avail, facial exercises improve the blood flow to the face, increasing collagen and elastic naturally and conclusively. This gives way to a more natural looking, smoother looking skin, reducing wrinkles and the effects of dark spots. Even oversize pores are improved upon with the use of facial exercises, leaving smaller pores and a smoother look after only a few weeks of “working out”.
Everybody knows that a healthy diet and an active exercise program are the best ways to lose weight and to the tendency to put on extra pounds under control. What do you do during those times where you have tried everything that you can? You eat a balanced diet, and you work out on a regular basis, but the weight just does not seem to be coming off as fast as it seems like it should. Sometimes the best solution doesn’t lie in getting involved in the latest crash diet or chugging down nasty food replacement shakes. Sometimes the extra push you body needs is a vitamin supplement.
Some studies have shown that certain vitamins help the body in the carbohydrate to sugar and starch processing functions by making sure that the body is able to process the most fuel for your body as possible, eliminating the need for the body to retain the food instead as fat stored in all of the wrong places.
Another benefit of the use of vitamin supplements is that for people on the go, the limited availability of certain food choices allows them to use supplements to replace used nutrients in the body that are missing in the person’s diet.
While the use of vitamin supplements has shown great promise, the idea that taking a multi vitamin in hopes of better body intake processing can simply be dismissed off hand. The ability to make vitamin supplements work for you is to research the body processes that you wish to be affected and which vitamins have shown to progress this process. By targeting specific functions and the vitamins that affect them is not only more effective but more efficient, as you might be getting too much or too little of a specific vitamin with the use of general multi vitamin combinations on your local store shelves.
Know what you nutritional goals are and take the correct vitamin combination to promote it. You can have adverse side effects from taking too much of one kind of vitamin, so be sure to also keep track of the nutritional intake of the foods that you eat on a daily basis, so tat you can accurately manage the amounts of specific vitamins that you put into your system.
Remember, that vitamin supplements are just that, supplements. Do not use them as a food substitute or expect positive results without proper diet and exercise.
Losing weight has become a favorite pastime in the West, and more and more of a preoccupation in the East also. The effects of the western diet and lifestyle have been devastating for the weight management and healthy living of almost all people touched by it. The ever increasing availability of instant, often over processed and nutrient deficient food, to the daily commutes we make from one location of idleness to another, all while sitting down in the comfort of a car have had huge impact on obesity and general lowered the amount of physical activity that a person is faced with.
Losing weight and being thin, in contrast to these norms, is still seen as the only way to be, and the pressure society places on this ideal is immense. Everywhere you look, in the media, and even in interpersonal expectation, thin is in. In a society that places heavy emphasis on weight control while at the same time places every obstacle possible in your way at the same time can be very frustrating, and is probably one of the main reasons diets fail.
There are many options out there for the person trying to lose weight. There are the usual options of a good diet and exercise, and then there are the extra provided options of binge diets, herbal supplements, drugs, and even surgery. The sad fact is that while many people opt for the instant options such as binging, drugs, or surgery, the duration of weight loss is usually short lived, though dramatic. The risks to health are much higher than if pursuing to lose weight with a healthy diet and exercise and the end effect is a diminished health, relapse into weight gain, loss of energy and resources put into the attempt, and a further shattered self esteem, making coming back from setback even harder than before on many different levels.
The best way to lose weight is to start a healthy and active lifestyle, not just go on a diet. If you make consistent, health improving changes to your life and stick with them, no matter how small, the accumulated effect will be healthy weight loss that sticks, instead of yo yo diet failure or added health risks with few positive results. Knowing what you put into your body is the first step to controlling your diet, and the first step in exercise is to find simple activities to replace inactivity, such as walking to the market instead of driving. Simple changes in lifestyle are more effective in weight loss than inconsistent workouts and dieting attempts of any level.
Western society has a never-ending obsession with weight, while at the same time producing the most obese populations on the face of the planet with no side of subsiding the trend.
This strange irony has led to the multitude of products and services that are promoted to the public in order to help them with their weight loss dilemma. Everything from hypnotism, pharmaceuticals, to surgery has been offered as the sure fire solution to your overweight woes.
One often overlooked method of encouraging weight loss is the use of herbal supplements.
Our emphasis on getting what we want when we want it has created a society of “have it now”. While the positive effects of both natural and synthetic treatment are the same, many opt for the fast results of drugs or surgery at the risk of increased complication, and even death. One alternative to these risks is to opt for a sane progress schedule and the elimination of several of the risks involved with other options through the use of herbal weight loss products.
The use of natural foods and herbal products to control weight should be approached as any other medical decision. When used with physically altering goals, certain herb, though generally safe, may still produce side effects in certain individuals. as many herbal weight loss supplements and products are a combination of more than one ingredient, it is wise to read the label and decide if its contents are going to promote your personal weight loss goals or conflict with any medications you might take or conditions that you might have.
Many of the dietary supplements on the market contain one or more of the following ingredients:
Senna, a natural laxative is often one of the main components in herbal dietary supplements. They promote quick weight loss by stimulating the colon. Be aware that if using Senna, you should monitor to make sure you have a proper water intake, or dehydration may become an issue.
Some dietary supplements contain Chromium Picolinate. This is not a natural but a chemical additive, and has been known to cause genetic problems in high doses. It is best to be avoided if possible, but safe to use at recommended doses in most cases. The risk of dehydration is also a factor in its use, so you should drink plenty of water.
St John’s Wart is also very popular in dietary herbal supplements. This herb is not only used in weight loss solutions, t has shown promise in helping to promote cognitive ability. If abused however, the eyes and skin might become irritated, stomach ache may result, or fatigue may set in after ingestion.
Although Dietary supplements can be found in a variety of forms, two sources of natural weight fighting in their rawest forms are green tea, and organic food. Green tea has long been used to promote enhanced digestion and weight control, and the chemical application or use of chemicals in processing of non organic food can sometimes affect the ability for the body to process food correctly and efficiently.
One of the most common mistake that people make that leads to weight loss failure is to chase fast weight loss solutions.
Whether it is in the supermarket in the magazine rack, or on late night television, everyone is talking about the best ways to loose weight at an extremely fast rate. They tell you tahat they personally lost 5-10 pounds a week for a total of over a hundred pounds with the use of the advertised product or technique solution. While they disclose the fact that the results that they discuss are not typical, the want of such a product to work for you can often get you to ignore this fact and palce your hopes on getting a miracle in return for your hard earned cash. What you are often overlooking is the fact that diet results are reliant on several variables, and the variables that contributed to the weight loss on the screen may not have even had anything to do with the drug or weight loss program that they are promoting. These testimonials are very good at getting desparate people to part with their money, but do very little to tell the average person what effect the use of the product shown will have on their weight loss success.
Healthy, permanent weight loss depends on a consistant and positive change to ap erson’s lifestyle over a prolonged period of time to be effective.
A large percentage of dieters will fail due to giving in to the slick sales messages of commercial powers that pry on laziness. By targeting consumers that they know have trouble with the two ingredients for dieting success, pesistance and patience, they can market differnet products to those wishing to lose weight while keeping them inoerpetual need of another solution, one that they will readily and eagerly provide.
Both history and medical science have shown that the only consistantly proven way to lose weight and keep it off is to eat the proper foods in the proper amounts, and to increase physical activity to burn calories and keep the body from storing excess enery as fat. Though some people might find extra support or metabolic advantage from taking herbal suppliments or following a specific dietary regimine, without these two factors, and the will power to control them on an ongoing basis, any fast weight loss solution will ultimately end up in temporary, minmal weight loss with the highest health risks.
As I often do, I’m reviewing expenses with my wife, and we’re considering cancelling our gym membership.
We got it because we not only wanted a good gym to exercise at, but we also wanted affordable child care. (Since we both exercise at the same time, we put our two children in the “Kid’s Club.”)
But there’s a problem. While my wife and I are exercising, our daughter is vegging out in front of a TV for 90 minutes!
The Kid’s Club has videos playing constantly. My son is immune at this point. He just plays on the slide. But my daughter can’t resist watching cartoons. So she gets a whopping 90 minutes of viewing time two or three times a week.
That’s a lot of TV.
This right now is a big factor in our decision. Because while the gym is healthy for us, it’s not healthy for my daughter. Something to think about…
Today I thought I’d share something I’ve been making my 5 yr olds to get them interested in eating lots of leafy greens. Greens are the food highest in mineral (per calorie), and I want to make sure my kids are getting plenty of minerals, but some kids have a hard time with greens. My kids don’t mind eating them but I was trying to get them to eat bigger portions of tender leafy greens.
So here’s what I did.
They’re really into pirates right now and one day I decided to make a “Treasure Salad.” I took a big pie plate for each kid and covered the entire bottom area with some fun salad fixin’s that they like. Fresh orange slices, almonds, cherry tomatoes, mushrooms, baby carrots, mango pieces, pineapple. Then, I shredded a bunch of lettuce and piled it all on top of the plate to make a mountain, covering all the fixin’s I had on the bottom. I squeezed fresh orange juice over the lettuce mountain.
When the kids first saw it, they were like, “What??? We’re having just plain lettuce?” and I said, “It’s a treasure salad! Eat all your lettuce to get to the bottom and you may find some treasure!”
Lets just say, it worked like a charm. I’ve never seen them eat lettuce more enthusiastically. They ate and ate and ate, and were so excited when they got to the bottom and there was all this “treasure”! :) They savored each bite of the juicy fruit, veggies and nuts I had “hid” on the bottom.
Now, they ask me for a Treasure Salad several times a week. I hope this will be a family tradition/meal that they will take with them when they grow up!
I’d love to hear any creative ideas you all have had to help your children make healthy choices. I will be sharing a couple more ideas this week that has worked with my kids.
For a few years, my kids had almost the same breakfast every morning - cheerios in soy milk, occasionally with a piece of fruit on the side. We didn’t do dairy and I didn’t want them to have sugar, so this seemed the best option to me at the time. They loved this breakfast.
Awhile back, I was looking for a healthier option to this breakfast. I was reading some things about soy that concerned me, especially since my kids were having it every single day - and I was also looking for ways to increase their fruit and veggie intake.
So here are 2 ideas I eventually came up with and now they’re staples that my kids beg for in the morning! They haven’t asked for either cheerios or soy milk in quite awhile.
Idea 1:
Fruit smoothie - blend a few ripe bananas with water, add another fruit - strawberry, mango, date… the possibility is endless. A plain banana based smoothie is actually more delicious than one would think. You don’t *have* to add yogurt or soy or dairy or protein powders in there! It’s good all by itself. (I would argue, that it’s BETTER all by itself). :)
Idea 2:
Banana milk and fruit cereal bowl. Blend 2-3 bananas with enough water to make a milk-like consistency, pour into a bowl of diced fruit pieces and little berries. You can add a few nuts too if you want, but fruit alone digests better in your stomach. It looks VERY attractive because the banana milk is light yellow and the fruit pieces are very colorful! My kids’ favorite fruits to go in their cereal are the berries - blueberries, raspberries, blackberries.
On Monday February 26, the Center for Science in the Public Interest (CSPI) held a press conference that put the spotlight upon several chain restaurants which offer single-course menu items each loaded with 2,000 calories or more. In their March issue of the Nutrition Action Healthletter, the article titled “X-treme Eating: Increasingly Indulgent Menus Entice Diners to Pig Out†detailed the caloric and fat content of these dishes. Many contained over a day’s requirement of calories and more than two days’ worth of fat. CSPI Executive Director Michael Jacobson is pushing for city, state, and federal laws requiring nutrition information on chain restaurant menus.
Councilwoman BrownIn response to this report, Philadelphia City Councilwoman Blondell Reynolds Brown (pictured at left) proposed a measure requiring chain restaurants that operate within the city to provide nutrition information for their menu items. Required information includes caloric content, fat, carbohydrate and sodium. The proposition has been praised by CSPI as well as by Sara Solomon of Temple University’s Center for Obesity Research and Education. “Knowledge, if not power, is at least progress,†stated Solomon, in regards to fighting the obesity epidemic.
Says Councilwoman Brown, “Consumers want to know.†And by all indications, she’s absolutely right. Customers who were interviewed on the street by Philly’s ABC news affiliate WPVI seemed to whole-heartedly support her new proposal. As they exited chain restaurants, they were asked if knowing the caloric content of the dishes would affect how they order. One young woman from Ridley Park said, ” If I knew what was in [the food items], and the calorie intake, would I change my mind? Absolutely.”
A WPVI reporter placed calls to members of the Philadelphia’s restaurant industry. He received no response. (I imagine that the restauranteurs are all busy getting in contact with the NRA — no, not the gun people… The National Restaurant Association — to learn what their collective answer should be. I also imagine that their answer will have much more to do with the well-being of their restaurants’ profits than with the health and well-being of their customers.)
What do you think? Would you support a menu labelling proposal if your city representative suggested it?
Have you noticed how when people who are overweight lose a bunch of weight in a short time period, they seem to have flaps of loose skin leftover that seems to sag and stay on forever?
I’m not really overweight but I did have twins in 2001. I’m very petite (4′11″, started out probably around 100 lbs at the beginning of the pregnancy) so I got extreeeeeeemely stretched out by the end. Afterwards, even though I lost the 70 lbs I gained, I still had this huge fold of skin on my tummy that has never gone away in 6 years.
At least, I really thought it was mostly skin. Everybody said so.
Now that I’m cleaning up my diet and working out more, I’ve been wondering if this flap of “skin” would always be there. Almost everybody I talked to about it said yes, unless I had surgery (which is not an option for me).
How depressing.
And then, a few days ago I came across this article:
The Myth of Loose Skin
It made so much sense to me, and it gave me hope. The guy really sounds like he knows what he’s talking about. Basically, the gist of the article is that skin is thinner than paper. So all that “loose skin” is really not just skin but a layer of fat. And fat CAN be gotten rid of with proper diet and exercise! And the skin will adjust. So, read it and tell me what you guys think. It sure gave me hope for my “twin skin” problem!
Oh, and if anyone out there (Ryan? Anybody?) has tips on what specific exercises to do to work on the tummy fat, please give me suggestions. I’ve been doing lots of crunches and cardio and need more ideas.
Politicians like to couple the adjectives “accessible” and “affordable” with the word “healthcare” when describing the goals of healthcare reform. They say that with reform, all Americans will have health “insurance” and that it will be “affordable”. I’d like to suggest that we eliminate the term “insurance” when talking about healthcare.
Insurance protects us from experiencing an unexpected loss that is greater than our ability or willingness to pay. I spend thousands of dollars a year on home owners insurance to protect me from financial catastrophe if my house is destroyed by fire or an earthquake. I spend thousands more to insure my automobiles against theft and collision. In both cases, I am
pooling my money with tens or perhaps hundreds of thousands of other people to protect me from a loss that statistically only happens to a very few those who are insured.
But healthcare is a different kind of animal. Insuring people for healthcare expenses, especially with low deductible plans that cover almost everything, simply doesn’t pencil out and especially doesn’t if we try to affix the word “affordable” to the premiums needed to support such “insurance”. How much would my home owners insurance cost if every covered home would one day 
burn to the ground? How much would car insurance cost if everyone in the country drove a red Ferrari, and every red Ferrari got totaled? To my perhaps simplistic way of thinking, that is the conundrum of health “insurance”. We are asking for “affordable” premiums that will protect us from the financial burden associated with services that each and every one of us will need; services that will cost hundreds of thousands of dollars over the course of a lifetime. In fact, I’ve read recent statistics suggesting that the average American will need $240,000 just to cover out of pocket healthcare costs not paid by Medicare between eligibility and death. Affordable? I don't think so.
When it comes to discussing healthcare, I think politicians need 
to start using a word other than insurance, and they certainly need to get rid of “affordable” in the same sentence. Yes, there’s plenty of room to make healthcare “less expensive”. Technology, preventive services, disease management, and process design re-engineering can make healthcare less expensive and more accessible. But no country can deliver affordable healthcare, insured or not, that provides everything than can be done for everyone who wants or needs it. Healthcare reform should not be debated without a healthy dose of “tough love” on basic economics and a whole lot more detail about what we’ll really be getting. And for goodness sake, let’s stop talking about “affordable” insurance. Am I missing something here? I don’t claim to be an economist. I’m just a doctor who gets really confused when people throw around terms that don’t “add up”.
Know The Basics Before You Buy.
You are here because you want to know all you can about health insurance, right? Health insurance is a process that requires your involvement. If you put in the time and effort to understand health insurance, it will reward you with the best coverage possible. The more you know about health insurance, the more you will be able to help yourself. Health insurance is important for your family's well being also. Nobody within your family should be left out in the dark when it comes to learning more about health insurance. Use these blogs to gain some valuable health insurance knowledge. You and your family will depend on it.
The best place to begin is with the basics. The basics of health insurance will set this process in motion. If you become an expert at the basics you will get a head start on the health insurance process. We realize that the basics can be boring, or you might think that you know all about them already. It never hurts to have a refresher on some of the insurance information. The basics will give you an insight into how the rest of the health insurance process will go, and what you can do to make sure it works perfectly in your life. These blogs want to take you back to some of the basics of health insurance. Put in as much time and energy as you wish.
The Federal Government introduced the Private Health Insurance Rebate to make private health insurance more affordable for Australians who chose to take out private health cover.Who is eligible for the Rebate? The Rebate is available to anyone who is eligible for Medicare benefits and who holds any level of private health insurance cover, no matter the level or type of cover. The Rebate eligibility is not subject to a means test.What rebate am I entitled to receive?From 1 April 2005:if you and all persons covered by your policy are under the age of 65 years, you are entitled to receive a 30% rebate on your premiums.if either you or a person covered by your policy are aged 65 to 69 years, you are entitled to receive a 35% rebate on your premiums.if either you or a person covered by your policy are aged 70 years and over, you are entitled to receive a 40% rebate on your premiums. How can I claim the Rebate? You can claim your rebate in one of three ways:as a reduction in your contributions; or
| The benefits of private health insurance Peace of Mind Protecting and ensuring the health of yourself and family is important. Through having private health insurance you can make sure that if you or your family require treatment you have greater control over who treats you, where and when. Having insurance provides financial peace of mind in knowing that you are guarded against large and unexpected hospital bills. Hospital TreatmentPrivate health insurance enables you to choose who will treat you, where they will treat you and when the treatment will take place. Medicare cover alone does not provide this control. Non Medicare benefitsMedicare does not cover services such as dental, optical and physiotherapy. HCI offers extras cover options to assist in meeting these and other costs. |
In the modern age, successful business concerns have made globalization and worldwide operations their forte. Companies make huge foreign investments and a major portion of the generated revenue comes from overseas operations. To maintain fruitful liaisons with their foreign bases and forge new alliances, companies often send forth their employees on foreign trips. Keeping this increasing trend in mind, numerous affordable yet lucrative insurance policies have been drafted that would provide unmatched security for employers and companies.
The medical insurance for employees who are actively deployed in foreign projects constitutes a primary concern for the employer. International medical insurance agencies are now offering policies that could be particularly drafted to meet the company’s budgetary plans. These small group health insurance policies are designed to include employees who are deployed on both short and long term projects.
International medical insurance policies offer comprehensive medical coverage to defray charges for physician?s consultations and necessary hospitalization. The policies also defray incurred service charges for floor nursing, food and cleaning. An exhaustive insurance coverage list also includes ancillary services like ambulance, advanced diagnostic scans and intensive care units (if prescribed).
The employee?s international medical insurance also offers a host of extremely beneficial supplementary benefits as per specific policy requirements. Periodic detailed medical evaluations, arrangement of emergency medication, emergency administration of oxygen and pharmaceuticals are few of the facilities offered. The insurance policy entails flexible subscription and payment options (as per subscriber?s convenience) and options regarding deductibles and coverage benefits.
Employee wellness benefits, designed according to the companies? budgetary requirements, are offered by the employee’s group international insurance policies. The employers could also avail of flexible payment options for policies as well as options pertaining to deductibles and coverage value.
The international medical insurance for employees is fortified by the coverage offered by established underwriters like AIG, Lloyds and Sirius International. This bevy of extremely vital services is efficiently supported by a worldwide dedicated customer support network that remains active throughout the day.
A majority of insurance policies are affiliated to a definitive PPO network to facilitate prioritized cashless billing. As a conglomeration of employees, subscription to the health insurance small group is extremely easy. Only the essential medical documents, medical history and documents pertaining to the company’s budgetary requirements are asked for. A well-equipped and knowledgeable medical insurance agent could then design and customize the insurance policy to best accommodate the company budget.
International health insurance for employees offer a bevy of advantages like flexible, customer-oriented plans and dedicated 24X7 customer support. With these lucrative benefits, its little wonder that employee?s insurance coverage typically form an integral part of every company?s benefit package.
In April 2006, the Government announced reforms to private health insurance, including a requirement that health insurers provide Standard Information Statements (SIS) on all private health insurance products they offer. These reforms were introduced on 1 April 2007. Health insurers are required by law to provide these Statements so you can review your existing policy or compare private health insurance products.
A Standard Information Statement only gives a summary of the key product features. However, it does allow you to see if your broad needs are covered and where products differ in both price and features. You will need to contact Health Care Insurance to get all the details about the product.
You should not rely on the $ amounts for premiums or benefits on the Statement as they are there for comparison only. The actual premium may vary depending on your circumstances, for example, your age and your age when you first got health insurance. Benefits will vary depending on the details of your policy, the treatments you are having, the hospital you visit and who treats you.
Note that some words used in the Statement may not be exactly the same as those that Health Care Insurance uses, but we will be able to explain any differences.
As with all types of insurance, conditions will apply, so don't just rely on the Statement - once you have full details from Health Care Insurance, make sure you read them carefully before signing up and paying your premium.
There are three types of Standard Information Statements:- describes the features and limitations of hospital cover, including the type of accommodation, which medical services are covered in full, part or not covered, waiting periods and additional payments (excesses, co-payments and gaps),
Sharona Hoffman, Professor of Law and Bioethics and Co-Director of the Law-Medicine Center, Case Western Reserve University School of Law, and Andy Podgurski, Professor of Electrical Engineering and Computer Science at Case Western, had written an important article on HIT that I highlighted in my March 2009 post "Let's Deregulate Pharmaceutical Information Technology."
In that article, entitled "Finding a Cure: The Case for Regulation And Oversight of Electronic Health Records Systems", Harvard Journal of Law & Technology 2008 vol. 22, No. 1, they called for premarketing and postmarketing surveillance of healthcare IT, adverse events reporting, and tight regulation as in the medical device and pharmaceutical industries. summarized and amplified their views in the short piece , Bioethics Forum, March 20, 2009.In a remarkable new followup article entitled E-Health Hazards: Provider Liability and Electronic Health Record Systems, they expand their case in a highly organized and extremely well documented piece. The abstract is as follows:In the foreseeable future, electronic health record (EHR) systems are likely to become a fixture in medical settings. The potential benefits of computerization could be substantial, but EHR systems also give rise to new liability risks for health care providers that have received little attention in the legal literature. This Article features a first of its kind, comprehensive analysis of the liability risks associated with use of this complex and important technology. In addition, it develops recommendations to address these liability concerns. Appropriate measures include federal regulations designed to ensure the quality and safety of EHR systems along with agency guidance and well crafted clinical practice guidelines for EHR system users. In formulating its recommendations, the Article proposes a novel, uniform process for developing authoritative clinical practice guidelines and explores how EHR technology itself can enable experts to gather evidence of best practices. The authors argue that without thoughtful interventions and sound guidance from government and medical organizations, this promising technology may encumber rather than support clinicians and may hinder rather than promote health outcome improvements. EHR systems can facilitate access to patients’ medical records, improve the quality of care and the accuracy of treatment decisions, achieve cost savings, and promote clinical research. Without discounting any of these potential benefits, this article focuses on the risks of EHR systems and on liability concerns associated with their use ...The liability risks of EHR systems have received little attention in the legal literature. This new technology may bring with it novel responsibilities, burdens, and complexities for medical practices at the same time that it can potentially enhance health outcomes.The liability risks are not just to hospitals, but to EHR users of all stripes. They find current efforts at HIT "certification" severely lacking in usefulness, and strongly support federal regulation of health IT due to the risks and dangers involved. The authors are opposed to vendor "hold harmless" and "defects nondisclosure" clauses, and have included in their article many well thought out solutions to the double-edged sword that HIT represents.
In summary, though, they believe that:It is only with appropriate interventions that they will become a much-hoped for blessing rather than a curse for health care professionals and patients. I am in strong agreement with their positions. The unregulated free-for-all that has been the health IT marketplace, with dangerous and even outrageous practices I noted starting a decade ago, must come to an end as the market matures and as diffusion of this technology massively increases per the government mandates now in effect.
The rationalizations for problems, the excuses for defects and the starry eyed utopian exuberance about this technology (not to mention the conflict-of-interest and/or HIT lobby-driven irrational exuberance) must come to an end.
This informaticist can't escape clinical IT issues even on personal business, I observed that I encountered HIT informational issues even in my own family matters, when least expecting them. I've had a few incidents since then, generally each time I've taken relatives to the hospital as a medical advocate.
It seems every time I step into a hospital as a medical advocate such issues arise, whether they be complaints from staff about IT, my mother being prescribed an IV antibiotic in the ED that an hour before told the intake nurse she was severely allergic to, that fact being dutifully entered into the EHR - or as in the case below, outright errors regarding surgical procedures.
Either medical information errors follow me around, or they are more common than I realize, because I just spent a few days as a medical advocate for a very long and dear friend.
She had a suspicious thyroid nodule found at the time of exam for excision of a small breast carcinoma. She was set to have a thyroidectomy at a major NYC hospital with relatively advanced HIT capabilities and large endowments from very wealthy contributors, whose paintings hang in the lobbies (and where some high level informatics professionals are involved in clinical IT projects).
When I arrived the evening prior to surgery, my friend showed me her pre-op instructions. They were printed out in a neat and organized fashion, and she'd shown me the calcium supplements she'd purchased as the instructions advised.
"Calcium supplements?", I asked...
The computer form, properly labeled with her name and ID and the name of the nurse practitioner she'd seen for preop evaluation, was quite improperly entitled "Preoperative instructions to patients undergoing
First thing I did in the morning was insist on seeing the surgeon in person. I wanted zero chance for error. Fortunately, the surgeon was familiar with her case and knew this was an error. Suppose, however, the surgeon was not so knowledgeable about the patient, or unavailable, or called away for some emergency and someone else filling in?
I do not know if the error was simple human error by the NP or someone prior who'd performed data entry, a wrong selection due to a mission hostile user interface in the setting of overwork, a computer error due to some cross-link between (to non biomedical personnel) two similar-sounding terms - parathyroid vs. thyroid - or some other cause.
Needless to say, if this error had resulted in an unnecessary and injurious parathyroidectomy and necessity for followup thyroidectomy on a postoperative area, and had been as a result of IT problems either totally or partially , it is likely the vendor would have been "held harmless" and the defect nondisclosed to other organizations.
(Anecdotally, on going to the bathroom, I also noted a group of residents on rounds energetically discussing what "template" was the correct one in which to enter patient data of some type. When I rounded years ago, I remember discussing medical issues...)
While I agree the likelihood of major IT contribution to this error was low, this was a reminder of just how problematic healthcare quality can be, even with advanced IT.
I think the solution is not to see IT as a panacea, and maintain adequate human involvement (with humans not overburdened feeding the bureaucratic machine) in safety issues.
-- SS
Addendum:
One physician replied to this message as posted in a private medical informatics listserv with the following statement that I do not identify with:
Regarding the calcium supplement, since unplanned loss of parathyroid tissue is a recognized and fairly common event with thyroid surgery (relative tolerance depends on unilateral or bilateral dissection), you might have been better served by the "error" than its omission.
Medical errors and indolence in correcting the problems can be as much a human attitudinal problem as IT-related.
There has recently been debate on these pages regarding optimal expertise for biomedical leadership, precipitated by Roy Poses' posts NY Times Proclaims Anyone Can Run a Health Care Organization with a Little Studying Up.
I am resurfacing a post I wrote in Jan. 2009 entitled that I believe succinctly states the problems with 'management by amateur.'
Read the entire post, but here are the highlights:
...
They cannot see because they lack the training, experience, and what is described as 'meta-competence' essential to seeing that which is obvious. Obvious, that is, to those who lack these characteristics. In addition, I've also observed that some lack the fundamental analytical abilities essential to understanding and managing the complexities of biomedical R&D.
Why those without domain expertise are in charge of organizations whose long term viability depends entirely on the most advanced and creative pursuit of biomedical 'miracles' is another matter. I won't address this here, other than saying it reflects the adverse consequences of a bias that has evolved in management "science."
That bias is the belief that all the world consists of faceless labor resources performing easily definable processes upon interchangeable widgets, and that management can therefore be done by generic managers. Some of the world is like that , but some isn't, such as biomedical R&D. There is nothing here to spin, there is nothing to debate. There is nothing to discuss. This is a Failure to accept this reality results in Those who believe otherwise are engaging in magical thinking.
Further, those without biomedical domain knowledge who disagree should be prepared to discuss how their lack of domain knowledge might affect their insights and opinions on such complex matters, compared to those with both domain knowledge and leadership experience. A question is this: based on the same Western traditions of inquiry and critical thinking that led to modern biomedical science and its accomplishments, whose opinion is likely to be more valid?
I have written on these pages about a cross-occupational invasion of medicine by IT personnel, wherein the IT personnel seem to forget that they are facilitators of healthcare, not enablers, with a primary purpose of serving the needs of clinicians. site recently posted an attorney's views on the "hold harmless" and "defects nondisclosure" controversy first reported on by Koppel and Kreda in JAMA, and amplified in my letter to the editor in the same publication. The attorney's views at HISTalk (link below) are quite reasonable regarding such practices.However, the user comments thread reveals some attitudes exemplifying the "invasion" of which I've written. Both the attorney's post and the responses by a poster under the nom-de-blog "Programmer" to others' concerns can be read Read it all. The attitudes of "Programmer" (assuming they are genuine, which is likely) are remarkable.
Read More..Our recent about health care organizations recruiting executives with no experience in or knowledge about giving health care or biomedical science has attracted some attention. Some people suggested that letting some people from the "outside" into health care leadership might lead to fresh thinking and new ideas. My concern was not about that. However, I do believe that to be succesful, the leadership of health care organizations ought to collectively be knowledgeable about health care, and understand its context, culture, science base, and values. My concern was not about a few "fresh thinkers," but that the preponderance of health care leaders today know little about what it's like to actually take care of patients, have little understanding of biomedical science and health care research, and do not understand, much less share the values of clinicians.
To illustrate with some admittedly anecdotal data, I looked up the official biographies of the CEOs of some health care organizations that have recently been mentioned in Health Care Renewal. I selected the most recently mentioned examples of the following types of health care organizations: hospitals and health care systems, managed care organizations/ health care insurers, pharmaceutical companies, device companies, biotechnology companies, and health care information technology companies.
Here are the results.
Hospitals/ Health Care Systems
Example: Sutter Health
CEO: Patrick Fry
Mr. Fry joined the Sutter organization in 1982 as an administrative resident at Sutter General Hospital in Sacramento. Over the ensuing years he held increasingly responsible administrative positions both at the local affiliate level and region level, with responsibilities covering the breadth of Sutter Health's services.
After serving as regional president for Sutter Health’s affiliates in the greater Sacramento region, Mr. Fry became president of the organization’s eastern operations. He later assumed leadership of Sutter Health’s Western Division and in 2000 became Sutter Health’s second-in-command, serving as chief operating officer and executive vice president. In 2005 Mr. Fry became President and CEO.
Mr. Fry earned a bachelor’s degree in public health administration from the University of California, Davis in 1979 and earned a master’s degree in health services administration from George Washington University in Washington, D.C.
Managed Care Organizations/ Health Care Insurers
Example: WellCare
CEO: Heath Schiesser
Heath Schiesser assumed the role of president and chief executive officer in January 2008. He originally joined WellCare in 2002 as senior vice president of Marketing and Sales and focused most of his effort on the growth of the Company’s Medicaid and Medicare businesses. As president of WellCare Prescription Insurance, he led the Company's successful national entry into Medicare prescription drug plans. Between mid-2006 and the assumption of his current position in January, he served in a part-time role as a senior advisor, focusing on WellCare’s rapidly growing Medicare products.
Mr. Schiesser brings extensive experience in improving operations, developing strategies and growing businesses in several sectors. Prior to joining the Company, he worked at the management consulting firm of McKinsey & Company, co-founded an online pharmacy for pharmacy benefit manager Express Scripts and worked in the development of new ventures.
A cum laude graduate of Trinity University, Mr. Schiesser received his Master of Business Administration from Harvard University.
CEO: William C. Weldon
William C. Weldon is Chairman of the Board and Chief Executive Officer of Johnson & Johnson, the world's most comprehensive and broadly based health care products company.
Mr. Weldon assumed his current responsibilities in April, 2002. Previously Mr. Weldon served as Worldwide Chairman, Pharmaceuticals Group, and a Vice Chairman of the Board of Directors. He was elected to the Board in February, 2001.
Mr. Weldon joined Johnson & Johnson in 1971 in the sales and marketing department of its McNeil Pharmaceutical subsidiary. In 1982 he was named manager, ICOM Regional Development Center in Southeast Asia. Mr. Weldon was appointed executive vice president and managing director of Korea McNeil, Ltd., in 1984 and managing director of Ortho-Cilag Pharmaceutical, Ltd., in the U.K. in 1986. In 1989, he was named vice president of sales and marketing at Janssen Pharmaceutica in the U.S., and in 1992 he was appointed president of Ethicon Endo-Surgery.
In 1995 Mr. Weldon was named a company group chairman of Johnson & Johnson and Worldwide Franchise Chairman of Ethicon Endo-Surgery, the Johnson & Johnson affiliate that develops new procedures for minimally-invasive surgery and designs related products. In 1998 Mr. Weldon was promoted to the Executive Committee and named Worldwide Chairman, Pharmaceuticals Group.
Among his outside activities, Mr. Weldon is a member of the Board of Directors of JPMorgan Chase & Co. He is also Chairman of the CEO Roundtable on Cancer, Vice Chair of The Business Council and a member of The Sullivan Commission on Diversity in the Health Professions Workforce. Mr. Weldon also serves on the Liberty Science Center Chairman's Advisory Council and as a member of the Board of Trustees for Quinnipiac University. He previously served as Chairman of the Pharmaceutical Research and Manufacturers of America (PhRMA).
Mr. Weldon was born in Brooklyn, NY, and is a graduate of Quinnipiac University in Hamden, Connecticut. He and his wife have two children and one grandson.Senior Vice President and President of Medtronic's Vascular business in January 2002.
Bill joined Medtronic from Novoste Corp., where he had been President and Chief Executive Officer since 1998. Previous positions included Corporate Vice President and President of the Sherwood Davis and Geck organization of American Home Products; President of the Ethicon Endo-Surgery organization of Johnson & Johnson; President, Devices for Vascular Intervention and U.S. Operations, for Guidant Corp.; and several increasingly responsible executive positions culminating in the presidency of the Ivac organization for Eli Lilly & Co. He began his medical technology career with Carolina Medical Electronics in 1977.
He received his bachelor’s of science degree in electrical and biomedical engineering from Duke University in 1976 where he also conducted medical research in pathology. Bill also earned a master’s degree in business administration from the Darden School of Business, University of Virginia, in 1982.
Bill is a member of the Board of Visitors of the Engineering School of Duke University and the Guthrie Theatre Board.CEO: Mitchell H Gold, MD
Gold joined Dendreon in 2001 as the vice president of business development. He subsequently was appointed a director in 2002 and was named the chief executive officer of the Company in 2003. Dr. Gold has led the Company’s corporate development, acquisition and financing efforts in recent years, completing transactions valued at approximately $225 million, including the acquisition of Corvas International, and raising approximately $350 million in capital. Prior to joining Dendreon, he served as the vice president of business development for Data Critical Corporation, a company engaged in wireless transmission of critical healthcare data, now a division of GE Medical. He also served as the co-founder, president and chief executive officer of Elixis Corporation, a medical information systems company. Dr. Gold is a former urologist at the University of Washington and currently serves on the boards of the University of Washington/Fred Hutchinson Cancer Research Center Prostate Cancer Institute and the Washington Biotechnology and Biomedical Association. Dr. Gold received his B.S. from the University of Wisconsin-Madison and his M.D. from Rush Medical College in Chicago.Glen E. Tullman joined Allscripts as Chief Executive Officer in August 1997 to lead the Company's transition into the Healthcare Information Sector. He led the Company's Initial Public Offering and Secondary Offerings of the Company, which is now traded on NASDAQ (MDRX) and has driven the Company to becoming the leading provider of clinical software, connectivity and information services to physicians.
Prior to joining Allscripts, Mr. Tullman was Chief Executive Officer of Enterprise Systems, Inc., a leading healthcare information services company providing resource management solutions to large integrated healthcare networks, from October 1994 to July 1997. Mr. Tullman led the company's Initial Public Offering and secondary offerings. HBO and Company of Atlanta acquired Enterprise in 1997 in a stock transaction valued in excess of $250 million. From 1983 to 1994, Mr. Tullman served in a number of management roles including President and Chief Operating Officer of CCC Information Services, Inc., a provider of information systems to the country's largest property and casualty insurers. Under his leadership, the company grew from $17 million to more than $100 million and is publicly traded.
Mr. Tullman graduated from Bucknell University Magna Cum Laude, with a double major in Economics and Psychology. Upon graduation, he joined the Executive Office of the President of the United States in Washington, D.C. and later accepted a fellowship to study social anthropology at St. Antony's College, Oxford University, England. Mr. Tullman serves on the International Board of the Juvenile Diabetes Research Foundation and on the Board of Trustees of the Certification Commission for Healthcare Information Technology (CCHIT). He also is Co-Chair of the National ePrescribing Patient Safety Initiative (NEPSI), a $100 million campaign, led by Allscripts and Dell Computers, to deliver free electronic prescribing to every physician in America. In 2006, he was named CEO of the Year by the Illinois Information Technology Association.So there we have the leaders of seven important health care oganizations. Only one is health care professional (although he is described as a "former urologist.") Only one of them claims any biomedical science experience, and that was in college. One has bachelors and masters level degrees in health administration, and another has a bachelors degree in electrical and biomedical engineering. That seems to be the sum total of the group's experience, expertise, and formal training in health care and biomedical science. Only one claims any experience directly taking care of patients. Only one has training in any health care profession. Only one is a (?"former"?)doctor, nurse, therapist, or biomedical scientist.
Of course, there are at least thousands of health care organizations in the US alone, each with its own often large (and some might say top-heavy) management teams. But I would wager that if there was a systematic survey of these leaders, the majority would turn out not to be health care professionals, not to be biomedical scientists, and not to have much direct health care experience. I would further wager the larger the organization, the less health care experience, knowledge and training would be found among the leadership.
I repeat, to really reform health care, we need health care leaders who actually understand health care, and support its values. But the bubble may have to burst before many people learn that lesson. For now, there is too much money to be made.
A somewhat remarkable new book will be released in Nov. 2009 by the American Health Information Management Association , of which I am an associate editor. It is aimed at the non-medical- informatics IT and healthcare management professional. I express thanks to AHIMA for their forward thinking in accepting and publishing this material.
Books such as this were difficult to get into print just a few years ago, likely due to resistance to their publication by the powerful trade organizations of the health IT vendors:
H.I.T. or Miss: Lessons Learned from Health Information Technology Implementations
In H.I.T. or Miss: Lessons Learned from Health Information Technology Implementations, the editors—all of whom have led successful electronic health record (EHR) and Health Information Technology (HIT) projects—have collected case studies of HIT implementations that didn't go as planned, offering expert insight into key obstacles that must be overcome to leverage IT and modernize and transform healthcare.
... the adoption of effective HIT—now a national priority with the passing of President Obama's American Recovery and Reinvestment Act of 2009 (ARRA)—remains at a fairly primitive stage compared with IT adoption in every other major industry. In fact, healthcare is the only trillion dollar industry that remains primarily in the paper stage, even though most healthcare data are available electronically.
By studying HIT implementations that failed, the editors are able to document, catalogue, and share key lessons that all project managers of HIT, health system leaders in informatics and technology, hospital executives, policy makers, and service and technology providers must learn in order to succeed with HIT.
H.I.T. or Miss presents a model to discuss HIT failures in a safe and protected manner, providing an opportunity to focus on the lessons offered by a failed initiative as opposed to worrying about potential retribution for exposing a project as having failed.
Authors
The editor and associate editors all served on the 2007 leadership board of the Clinical Information Systems Working Group of the American Medical informatics Association (AMIA).
Editor: Jonathan Leviss, MD
Associate Editors:
Brian Gugerty, DNS, MS, RN
Bonnie Kaplan, PhD
Gail Keenan, PhD, RN
Jonathan Leviss, MD
Larry Ozeran, MD
Eric Rose, MD
Scot Silverstein, MD
This book follows the anonymized case study approach I used in my website on HIT difficulties, started in 1999, itself based loosely on the style of the introduction of the 1994 book (ed. 1) by sociotechnical issues pioneers informaticists Nancy Lorenzi and Robert Riley.
One can talk about "healthcare transformation" via HIT all one wants, but until the current inadequate approaches to HIT are themselves transformed, doing so is largely wide-eyed utopianism.
I am quite pleased to see this new book appear. (Note: I will not receive any royalties for sales). Read More..
We just posted about the onrush of people into health care management, including many with little knowledge of or experience in health care. one prominent politician defended at least pharmaceutical company managers who "don't make a lot of money." [Warning, irony and sarcasm ahead.
Billionaire Mayor Michael Bloomberg defended multibillion-dollar pharmaceutical companies and their chief executives on Friday, declaring that they 'don't make a lot of money' and shouldn't be scapegoats in the health care debate.
The mayor — and wealthiest person in New York City with a fortune estimated at $16.5 billion — made the comments on his radio show Friday during a discussion about health care.
"You know, last time I checked, pharmaceutical companies don't make a lot of money, their executives don't make a lot of money — not that they couldn't be better," Bloomberg said.
The mayor, a Republican-turned-independent who already has spent more than $36 million on his re-election campaign this year, often battles criticism that he is out of touch with regular people. He built his fortune after founding the financial information company that bears his name.
Earlier this year he declared "we love the rich people" while arguing against raising taxes on the wealthy, and said recently that President Barack Obama, who earns $400,000 a year and has made millions from book sales, "doesn't get paid that much" and is "on a budget" like millions of Americans.
In its article on the Mayor's health care wisdom, the NY Daily News noted,
The highest-paid drug executive last year, Johnson & Johnson CEO Bill Weldon, took home a reported $29.4 million after his company raked in $63.7 billion.
The Associated Press article also commented,
Pharmaceutical CEOs are known to make millions, with generous salaries, stock options and other perks.
Abbott Laboratories Inc. Chairman and Chief Executive Miles White's compensation was $25.3 million in 2008. The North Chicago, Ill.-based company saw profit rising 35 percent to $4.88 billion.
Merck & Co.'s chief executive, Richard T. Clark, received a $17.3 million compensation package for 2008. The company's profit more than doubled to $7.8 billion.
Later,
It was clear that Bloomberg or one of his aides realized his gaffe while he was still on the air Friday.
The mayor, who has sought to cast himself as a financial and business expert, came back from a break and said he had looked up the pay of some pharmaceutical executives.
'Some of them are making a decent amount, more than a decent amount of money,' he said.
Either way, Bloomberg said, it doesn't solve anything to beat up on pharmaceutical companies while trying to come up with health care solutions.
We have previously posted about the notion that the US and the rest of the world is increasingly run by members of the whose disconnection from the realities of daily life, including the US dysfunctional health care is likely to translate into little real support by the powers that be for meaningful health care reform. Mayor Bloomberg's wealth and political power would qualify him for superclass membership. His notion that multi-million dollar a year pharmaceutical imperial CEOs ought to be pitied for their paltry incomes suggests not only that the very rich are unlike you and me, but that meaningful health care reform is unlikely as long as we allow ourselves to be lead by people so insulated from the vicissitudes of daily life.
From a report in the St Petersburg (Florida) Times:
WellCare Health Plans on Wednesday admitted to making 129 'questionable' contributions to Florida politicians over four years ending in 2007. In a consent order with the Florida Elections Commission, the Tampa-based managed-care company agreed to pay a $120,000 fine and did not contest the commission's finding of probable cause that the contributions violated state law.
The Associated Press reported in February that WellCare, its subsidiaries and executives spent $2.4 million in political contributions in the 2004 and 2006 elections. More than 95 percent went to Republicans, who pushed a plan to send more state and federal Medicaid spending through private companies like WellCare.
In May, 2009 we posted about WellCare's submission to a deferred prosecution agreemeent based on charges that it defrauded state programs by inflating its expenses. In 2007, we posted about how the state of Connecticut stopped WellCare from running a plan for poor children after the company refused to reveal what it was paying physicians, and why it was failing to pay for particular services. So WellCare has paid three penalties for three different kinds of unethical behavior in the last two years.
WellCare is one of numerous health care organizations which seem to be serial violators of reasonable ethical norms. Usually, however, the penalties paid for these behaviors are trivial, given the financial capacities of the offending organizations. Furthermore, rarely are the individuals who made the decisions that caused the behaviors identified, much less subjected to negative consequences.
Given our continued permissiveness towards all sorts of deception, dishonesty, cheating, and even outright fraud, bribery, and corruption, is it any wonder that the unethical behavior continues? Such behavior doubtless directly drives up costs. Furthermore, leaders focused on their personal power and enrichment may not lead well, and demoralize employees and professionals who want to do the right thing, leading to further cost increases, access decrements, and threats to health care quality. I submit that to truly reform health care, and have a chance at improving cost, quality, and access, we cannot continue to shrug off these sorts of ethical violations.
A postscript - as we have noted before, one member of the WellCare board of directors is Regina Herzlinger, a well known and prolific health policy expert, and holds the Nancy R. McPherson Professor of Business Administration Chair of the Harvard Business School. As far as I know, Prof Herzlinger is one of the many health policy experts who avoids discussing the sorts of problems with the accountability, integrity, and transparency of health care leadership which is grist for the mill here at Health Care Renewal. Perhaps, Prof Herzlinger, like many other main stream health policy experts, should learn to acknowledge that health care leadership may be unaccountable, opaque, dishonest, and sometimes flagrantly corrupt. Furthermore, Prof Herzlinger, like many other well-paid board members of health care organization, should pay a bit more attention to the mischief being committed by those who answer to her. Read More..
Everywhere you look there is a new medication to help you get you depression under control. While medication is definitely an option that helps many, it should not automatically be the first choice that comes to mind when it comes to overcoming a mood disorder. Not all mood disorders are caused by chemical imbalances, and some of those that are can even be treated with changing other variables in the equation of body, mind, and environment that affect depression symptoms.
The first thing, and the most readily available to management and self control is diet. Vitamin D has been shown to affect mood levels and is very important for alertness and mental health. If you are overweight, underweight, or struggling with eating unhealthy foods, this can have a drastic impact on your ability to control mood. This is the first factor that you need to make sure is optimized for good physical an mental health.
Inactivity can also be a major source of unhappiness, both on a physiological as well as an emotional level. Get out and take a walk, ride bike, or swim. Just getting in 20 minutes of energetic activity a day can help to elevate mood and ward of boredom.
If you low mood is not affected by lifestyle change alone, it is time to seek out professional help. The help of a mental help professional can help you to decide if your depression is mainly an emotional disorder that might be able to be managed through counseling sessions, or if a referral to a physician to see if medication might be needed. There is nothing to be ashamed of, mental health is not different than any other health need, other than the fact that stigma increases the likelihood of lack of treatment due to refusal to acknowledge there is a problem at all.
If medication is needed, then working closely with your doctor and open communication is essential to making sure that the best medication at the appropriate levels helps you to control mood swings as well as allowing you a happy and normal life. There are many people taking depression medication without noticeable difference in behavior or physical ability. Depending on the medication program that is chosen to help you with you depression, regular visits to monitor your progress or regression into depression related symptoms will follow, allowing both you and your doctor to optimize the results of your medication and other treatment.
Though ADHD is predominantly thought of as a childhood disease, there are many adults that also suffer from the condition. If you are an adult, and you experience any of the symptoms of adult ADHD, then it would be best for you to get into contact with your local health care professional and seek diagnosis and treatment if needed.
ADHD is an attention disorder that can usually be controlled by improving the connections between synaptic receptors in the brain that process information. In adult ADHD, the chemical balances that regulate such transmissions is disrupted, and thus the connections, causing loss of the ability to focus, remain committed to activities, or to generally stay motivated. Small doses of prescription medication has shown to improve the connection in the synaptic chain, allowing better processing of information and hormone responses that control these brain-behavioral functions.
ADHD is often diagnosed in adults as they are no longer in the educational system, and the inability to remain on task or keep thoughts in focus is not paid attention to in the same manner. While the child in school might get a referral to the school medical clinic for testing, the adult is usually offered no more than the threat of lost employment or discriminatory behavior as they are seen as lazy or unintelligent.
This same stigma is also a contributing factor in adults not seeking medical treatment for adult ADHD, especially amongst men. The need to seek medical treatment for ADHD is urgent as well as extremely beneficial for the adult who exhibits ADHD symptoms. The difference that proper diagnosis and treatment of ADHD can make in an adults life can be dramatic. Even small imbalances in hormone levels and chemical reactions can have profound effects on the mind and body. Sometimes the mental clarity and ability to focus can be greatly benefitted by better diet and medication without the need for any further medical intervention, though some sort of psychological counseling is usually recommended to deal with the emotional changes that can sometimes come with coping with ADHD or as side effects of medication.
Far from being something to be ashamed of, getting treatment for your adult ADHD can be the best thing that you can do to for your own health and the health of your family. Like other mental and physical health issues, the patient is usually one in a host of people affected, and ADHD is no different.
ADHD is probably one of the most misunderstood, misdiagnosed, and mistreated medical concerns of the 21st century. There are 3 misconceptions about this rather common attention disorder that need serious clarification before an honest and helpful approach to diagnosing and treating ADHD can be undertaken.
Misconception number one. My child has been tested for ADHD.
There are several factors that must be taken into consideration before a person can be said to have problems with ADHD. There is not urine test or other simple sample evaluation process that signifies the existence of ADHD. ADHD is not a known chemical imbalance or a specific disease as in the presence of a specific physical defect in the body, but rather a whole host of symptoms and symptomatic reactions that when taken together, give a consistent picture of what we refer to as ADHD. Behavioral patterns are not enough. Reaction to physical stimulus or chemical makeup alone are not enough. Even when diagnosed with ADHD, it is best to seek out a second opinion as even the definition of ADHD and the severity and extent to which the disease is thought to be able to be controlled by medicine alone can vary from one medical professional to another.
Schools diagnose ADHD.
Teachers and educational professionals play a large part of our children’s lives and our children have a huge impact on theirs. But even with daily close contact and the best intentions at heart, a person who is not a medical expert for one, and a specialist in ADHD in children for two, has no authority to administer a diagnosis of ADHD on a child. Often there are other issues at hand. The most common reason for teacher diagnosis is in fact misbehavior. A child who acts up in class more than the others or has problems focusing does not necessarily have ADHD, but might just be bored. It is my personal opinion that it is sometimes the teacher, unable to maintain the attention of young children, is a problem, and not the child at all. That is not to say that the observations of the educational community are to be ignored, but should be backed up with medical expertise before taking unneeded action.
Misconception number three, ADHD children are intellectually impaired.
ADHD can definitely have a negative impact on academic performance and may even disrupt social skills, but intelligence is not the issue here. There are several incredibly smart people who are affected by ADHD. The inability to concentrate on material at hand or simply being able to stay motivated for any length of time for any single task has nothing to do with how smart a person is. ADHD is a medical condition with accompanying psychological and sometimes behavioral repercussions, but these symptoms usually only act as a barrier to education if they are left unchecked, uncontrolled, and unchanged. Getting over the fear of stigma or guilt, and making sure that ADHD is managed at the first sign of trouble is the best way to ensure that your child continues to learn at a normal pace and does not fall behind the others.
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