health, medicine

The Retainer Model or Single payer-What willsave primary care?


The Retainer Model or Single Payer — What Will Save Primary Care?

Robert M. Centor, MD; Charles P. Vega, MD

Point: The Retainer Model May Stimulate a Rebirth of Outpatient Internal Medicine

Robert Centor, MD

Outpatient internal medicine has joined the endangered species list, or at least so many commentators have opined.

Fewer internal medicine residents are opting for outpatient jobs. Many outpatient internists are leaving practice, either for fellowships or for hospitalist jobs.

As I consider the medical student’s choice of internal medicine for his or her career, I note that the fascination with internal medicine usually results from the complexity of the field. Internists champion the care of complex patients. We love diagnostic and management puzzles. In the 1970s and 1980s, many internists embraced a definition of primary care that the Institute of Medicine (IOM) codified:

"A set of attributes, as in the 1978 IOM definition — care that is accessible, comprehensive, coordinated, continuous, and accountable — or as defined by Starfield (1992) — care that is characterized by first contact, accessibility, longitudinality and comprehensiveness."[1]

Training programs produced internists who could care for complex disease and also handle a wide variety of clinical issues, including episodic care and preventive medicine. Over the following 30 years, our society apparently has redefined primary care to a definition that degrades the original concept. The American Heritage Dictionary in 2006 provides this definition for primary care: "The medical care a patient receives upon first contact with the healthcare system, before referral elsewhere within the system."

I believe that most insurers and other physicians no longer consider comprehensiveness when they think of primary care.

I would argue that internists do not want and are not trained to do this limited conceptualization of primary care as defined by the American Heritage Dictionary; rather, we are trained to add primary care services to our comprehensive care. Such distinctions underlie the angst of many practicing internists. We have trained a generation of internists to provide comprehensive care, including episodic and preventive care, and yet insurers and especially health maintenance organizations complain that internists are not good at providing quick, efficient primary care. Family physicians are in a similar situation. We have a problem of semantics and thus our discussions about primary care remain confused.

Our reimbursement system also does not pay internists sufficiently to provide high-quality comprehensive care, although our patients are too complex and require more time than what insurers believe constitutes a standard office visit.

Specifically, patients need various levels of intensity. A 30-year-old mother with a sore throat has different physician needs than a 55-year-old man with chronic obstructive pulmonary disease, heart failure, and type II diabetes mellitus.

Clearly, the latter patient will need longer and more frequent visits. Moreover, our current system does not reimburse out-of-office continuity. We have no reimbursement for telephone calls or emails, although patients often have questions

for their physicians. They would like to call their physician for advice, or to …


Acai – Food or Drug?

So here’s the dilemma: If it’s produce, then the US Food and Drug Administration (FDA) wants to call it a food. If you use it to heal you in some way, then the FDA wants to call it a drug… There is a very fine line in most peoples’ minds, but any line left between the two the Acai berry has just totally erased.

If one plant serves two different needs, such as a root sold as produce that can be used as a healing agent, (Ginseng and Green tea leaves also comes to mind) then we have to be really careful. Naturally we’d want it to be regulated so we don’t accidentally overdose on it… Although I have no idea if a ginseng or green tea overdose would be harmful or not.

However, the FDA, who has already approved Mona Vie’s bottling plants in Utah, is making it incredibly difficult for their distributors to sell Mona Vie & other Acai berry juices for their healing properties.

I have seen at least two such reports on the FDA website where they have pretty much persecuted distributors of Acai juice blends just because those distributors claimed that their product was healthy.

According to the FDA’s rules, if you sell something as a food, you cannot claim it has the power to heal anything. You are not even allowed to infer that consuming it can bring you better overall health. It’s either a just food in their eyes, or a drug, which must be monitored and well-tested.

The Acai berry fits right in the no-man’s land for the FDA, and it is even more difficult for them that Acai doesn’t grow in the USA. The fruit itself has to enter the country as produce of another country, which undergoes testing for USDA and FDA guidelines before it leaves its’ country of origin.

At bottling plants like Mona Vie, the FDA approval process is nothing more that a way of ensuring that everyone is wearing their gloves while handling food… It has nothing to do with drug protection or assurance at all.

So if they won’t let Acai juice distributors claim that their product has any healing abilities but that’s clearly the reason that everyone is buying it for, then I for one say that something is wrong with the system.

I’m not radical enough to suggest that we do away with the FDA or anything so risky, but perhaps a third category should be introduced. While the FDA makes it hard for distributors to sell great products like Acai, in the meantime it is saving lives by ensuring people don’t overdose on seemingly-harmless drugs, and ensuring the quality of those drugs at the same time.

So how about a new category for the FDA, of ‘Healing Foods.’-Specifically, healing foods that you cannot overdose on.

Dr. Schuass has proven that you cannot overdose on Acai. The human body can only use about 6,000 TE of Antioxidant per gram at a time, and if …


The importance of checking health early on

You always hope you’ll be fortunate, that you’ll stay in good health and you won’t need anything more than your regular checkup at the doctor’s office. If you get to a point in your life where illness, injury, or something unexplained strikes, you may need advanced imaging Toms River NJ. When your physician recommends a more in-depth look, the best thing you can do is take a medical expert’s advice. A physical evaluation may not be able to provide your doctor with enough information. Blood testing is often only one more piece of the puzzle. Your medical team needs to do more than look at the outside of your body or what is happening in your blood. They need a closer look.

Various Types of Imaging Could Suit Your Needs

Depending on what the concern is, your doctor will advise you about the next step in medical imaging. It could include an open MRI or a CT scan. You may need an ultrasound. Mammography could be recommended if there is any type of concern with your breasts. Bone density testing is also common where there is a concern about multiple fractures and brittle bones. Your doctor may recommend one type of imaging or you may need a comprehensive battery of testing for a complete evaluation. Each step will take you closer to finding out what is happening inside of you.

Imaging May be a Part of Preventative Care

In addition to identifying the source of concerns, your physician may recommend advanced imaging in order to help you to be proactive about your health. Mammography testing is beneficial for both men and women to ensure that there are no underlying concerns. If something is caught early on, it can mean the difference between a speedy recovery and a condition that is going to be in greater need of attention. The most important thing you need to remember is that ignoring a health concern is not going to make it go away. You should always follow up on your doctor’s recommendations. You can always ask for a second opinion as well if you are not happy with the answers you receive.…


CrossFit gym equipment

There are a lot of videos online mocking people who don’t know how to use gym equipment, but everyone has to start from scratch. So, before you start pulling strings and lifting weights, it is smart to get some advice for each machine you use in the gym. Also, working out without knowledge is very bad for your body because you can get injured easily.

When it comes to CrossFit there is more to it than regular gym equipment. Working with gym likes these require a great understanding of each exercise if you don’t want to get injured. They are famous for their rigs where people usually train in groups where they swap exercises after some period of time. CrossFit is a great way to make your focus better and of course, boost your physical strength.

Training equipment

The first and the essential thing you will need are the right shoes for training. Nike Metcon and Reebok Nano are made specifically for CrossFit. So, if you chose any of these you won’t make a mistake. They have a flat sole and reinforced heel. When it comes to indoor training where you won’t have that much running, they are the perfect match. For outdoors, if you have to run more than 2 or 3 miles you need to have joggers.

Read more about it here:

Next piece of essential equipment is going to be a pair of shorts. Typically there are a lot of guys wearing football shorts, but for this type of training you need your shorts to be flexible and there are also Reebok shorts made for CrossFit you can find online. They have a higher price than regular shorts, but they are definitely worth it. You want to be able to squat in perfect motion without your clothes making it harder. This also goes for the t-shirt.

Because you are going to do weight lifting and also a lot of exercises where you use bars, you are going to need good hand protection. There are a lot of styles you can choose from. Most commonly used in CrossFit are also used for gymnastics. Their main job is to protect you from blisters and also for better grip.

There are also many non-essential items you can use if you are starting out, and want to protect yourself from injuries. There is something called goat tape which you put on your thumbs where you stop the bar rubbing on to them. One of the non-essential equipment that is used much is the knee guard. It gives some extra cushion when you are doing squats and it makes you feel more supported. As your training becomes more advanced you are probably going to get more equipment that professionals are using like lifting boots.

Most common setup

There are a lot of companies that build gym machines, but for this kind of training, there are more similar to calisthenics where you have more bars than weights. CrossFit is the combination of …

health, medicine

Universal Healthcare And Death Panels – Sarah Palin Was Right

Sarah Palin was roundly criticized, laughed at, and excoriated by supporters of Obama when she said that the universal health care plan would lead to death panels. The characterization of the term ‘death panels’ was quickly associated with people wearing tin foil hats. It is ironic that a group of people who believe the twin towers were brought down by inside conspiracies and that a plane never crashed into the Pentagon, could call other people ‘tin foil hat wearers’.

When liberals are afraid of a person or of a particular point, they attack it with a vengeance. It’s much like the story ‘The Emperor’s New Clothes’ by Hans Christian Andersen. The Emperor is told that his clothes will be invisible only to the incompetent and the stupid. He doesn’t want to seem incompetent so, of course he says that he sees the clothes, as does everyone else until a child says “He hasn’t got any clothes on!”

The moment the term ‘Death Panels’ is labeled as a lunatic term; everyone is supposed to be afraid to explore the logic behind the term. It is a strategy often used by liberals. We see the proof that there are, in fact, ‘Death Panels’ but we are supposed to be afraid to say it for fear of being labeled incompetent or stupid – but if you see the emperor wearing a pair of stripped boxer shorts, it’s stupid to pretend that he’s wearing a three piece suit.

When this health care debate started, the first instinct was to look at other countries which have tried universal health care. What we saw was frightening – long waits for MRIs, horrific survival rates for cancer, waits for hip surgeries and on and on. It is so bad in England that there is a waiting list just to get on the waiting list! There are 40,000 people in the UK who have been waiting over a year for surgeries. There are shortages of critical supplies, drugs and medical equipment. According to the Burton Report, it is so bad in some countries that there is a black market in health care. In Japan life saving devices such as defibrillators are rarely available.

Socialized medicine has ruined the medical profession in any country where it has been tried. It’s basic economics. Increase the demand for a product and decrease the incentive to supply that demand and you create a shortage. Not only is there a shortage in medical care, there is little to zero medical innovation and advancement. There is no money to invest in research and no incentive to even try. There is a reason why most new medical innovations come out of the United States – it is called the free market.

People who support the Obama-Pelosi-Reid Health care plan say that their plan is different. They say their plan will give people a choice; that people will be able to keep their current plan and won’t be forced into anything they don’t want. Their own …


Herbal easy slim tea weight loss solution and health benefits

Herbal tea is found in different kinds and types that provide a relaxing power to the consumer. Easy slim tea is believed to be very effective in maintaining great wellness program. Herbal slim tea is produced way of herbal results in fresh/dried and roots/seeds. Herbal tea is also referred as tisane or infusions. hot water is added on the natural herbs for some time to get the blend of the 100 % natural ingredients existing in the results in for flavor.

Things to know about herbal easy slim: –

Always make sure you select the right of herbal tea for delightful flavor and for wellness advantages.

Herbal tea is more popular in Indian, China and Japan. Following the customs and ancient methods,

Original easy slim teas are prepared with right mix of natural herbs, vegetation, origins, plant seeds and blossoms of natural herbs.

Herbal tea has vital elements like vitamins, anti-oxidants, and nutrients that help in exciting one’s body program and program.

There are different kinds of herbal tea that decreases you from different wellness issues and problems.

Cardamom Tea is safe on wellness and decreases digestive function related issues like gas trouble, stomach pains and unwanted gas. It allows in activation and decreases the pain caused due to gas established in the digestive system.

Advantages of choosing weight loss herbal easy slim tea: –

  1. Green Tea gives the relaxing point for removing your stress and functions as a skin cleaner.
  2. It allows settling down and calming your mind. It is an exclusive type of herbal tea that gives many wellness advantages.
  3. Herbal slim Tea is loaded with germ killing properties and allows in great way to reduce complications. That tea has even more better flavor if a one or two spoons of sweetie is mixed with it.
  4. It is beneficial in eliminating harmful toxins existing in one’s body program that are harmful in characteristics.
  5. Organic slim  tea is pure herbal that is very diluents and cleans the blood veins. This tea also allows in decreasing the symptoms of respiratory disease.

Herbal easy slim Tea price has excessive mix of anti-oxidants and nutrients when compared to white tea and green teas. They avoid cell damage that occurs due the exposure of sunshine. It can also help to avoid from senility. It is specifically used for decreasing and gets over the menstruation pains. This tea increases the levels of glycogen that decreases pains in the muscle and also calms one’s body program. Blueberry Foliage is beneficial in cleaning the blood veins and as a pick-me-up. It also allows in inflammation of the renal system. Intake of one to two glasses daily is very excellent for fine wellness adjusting.

Herbal easy slim Tea is the best helpful action for until. It allows destroying the bacteria and stops the malfunction of the gems crystals that build up in the kidney. The cleansing characteristics of this herbal tea decreases harmful toxins, extra liquids and fat gathered in one’s body program.…


The Effective of Turmeric within the Human Body

Turmeric is one of the most popular spices that are entirely derived from the rhizomes of the herbaceous perennial plant of the ginger family. The powder of turmeric is mainly extracted from the horizontal underground stems or roots of the plant. After attaining those roots, they are boiled for several hours and then dried in ovens to get that yellowish-orange coloured spice. It is commonly used by the name curries. It is mainly harvested in the regions of South and Southeast Asia and so is the prime ingredient of the Asian dishes. Moreover, the yellowish colour of the spice mainly comes from fat-soluble and polyphenolic pigments known as curcuminoids. The most active constituent of turmeric is curcumin along with varied others such as demethoxycurcumin and bisdemethoxycurcumin. Not only this, it is also used as one of the important medicine as well, including significant impact over anti-inflammatory and anticancer disorders.

 Turmeric or Curcuma Longa plays a major role in Ayurvedic medicine. Curcumin can also be used for boron quantification that can be named curcumin method. It mainly reacts with the boric acid forming a red coloured product named rosocyanine. It is also used for its antioxidant, anti-inflammatory, antiviral and antifungal actions. It is not a toxic but extremely friendly with the digestive organs of the human body. Along with this, it also helps in reducing atherosclerosis by preventing the formation of clots of blood. Not only this, this medicinal herb is also used as an inhibitor of cyclooxygenase, 5-lipoxygenase and glutathione S-transferase. Moreover, this herb created a strong hold in the west as well, due to its medicinal effectiveness. So, it is also used as a potential antioxidant.

 Apart from this, as it is a powerful antioxidant, so is used as a medicine to reduce the effects of cancer. It can also be used for the protection of liver functions and premature aging. It also helps in easing several other disorders such as back pain, arthritis, bursitis and many others. It also lowers the production of inflammation by introduction of histamine. It also improves the level of circulation by generation of toxins from small joints of the body. Along with this, it also helps in the levels of digestions of the body. Due to such reason, it is widely preferred by the individuals all-round the world. Other than this, the Curcuma Longa also helps to body to fight against varied disorders namely cancers. It also helps in the immunity power of the body, resulting in improvement in the quantity of anti-bodies. It is also quite useful for the females at the time of pregnancy and lactation as well. Furthermore, as cortisone is present within curcumin, so it is also extremely effective in resolving the effects of inflammatory disorders. According to the medical research of turmeric, it can be found that, arthritis, diabetes can also be prevented with the help of this herb. Due to its various medicinal features, it is also used as a tropical analgesic in china. Thus, it can …


The Rainbow Diet & Solarized Water

The Rainbow Diet is based on the proponents of colour therapy; it is an easy to use system that ensures a healthy diet by the colours of food on your plate. Meals rich with different coloured fruits, vegetables, meat, chicken, fish and whole grains mean you are getting the healthy variety of nutrients that your body needs. The rainbow diet is simply a balance of attractive colours in the foods we eat, but they play an instinctual part as to what the body needs in the moment. The colour energy of fruits, vegetables, vitamins and minerals all come into play when furnishing our bodies with the proper nourishment.

The Colour Energy Of Foods.
Medical research continues to find elements in fruits and vegetables that strengthen our immune systems, impede the development of degenerative diseases like cancer and heart disease, and contribute to good health in many other ways. Maintaining a healthy diet translates into eating more nutrient-dense foods. This means consuming a diet rich in fresh fruits, vegetables, grains, legumes, nuts and seeds. In fact, the majority of the diet should consist of plant-based food. By eating a variety of natural, full spectrum foods, you obtain the healthiest combination your body can utilize. The colour energy of foods are not mutually exclusive, some foods share different “colour values”, properties and common healing affects.

To Aid Digestion Take Acidophilus.
It is the friendly bacterial flora found in yogurt or taken as a capsule and is essential to the digestive system. The normal, healthy colon contains “friendly” bacteria (85% lactobacillus and 15% coliform bacteria). When these bacteria are not in balance, then the person may experience bloating, flatulence, constipation, and mal-absorption of nutrients. Acidophilus taken as a dietary supplement may help to detoxify and to rebuild a balanced intestinal flora. It is used for the prevention of Candida as well as for treatment. Acidophilus aids the digestion and helps to replace the “friendly” intestinal flora.

Red Whole Foods.
Red foods are great sources of protein, vitamins and minerals such as Vitamin C, beta-carotene and lycopene.Vitamin C, beta-carotene and lycopene are potent antioxidants. Iron is vital to the body’s formation of red blood cells, which help carry and store oxygen throughout the body. Red foods are especially important to men’s health, as they have been linked to reductions in the risk of prostate cancer. Black beans are high in fibre and calcium whereas red beans are a good source of iron. Calcium strengthens bones and teeth. Include these red and black foods into your diet: Strawberries, raspberries, cherries, tomatoes, watermelon, guava juice, red cabbage, beetroot, radishes, red onions, chillies, red pepper, pink grapefruit, black beans, kidney beans, red meat, chicken, and fish.

Orange Whole Foods.
Orange foods assist in detoxifying and releasing toxins from the body. As in theChakra System, orange foods and orange energy help with the reproductive system, muscle and joint flexibility stagnation in many forms. Beta-carotene, Vitamin C, Calcium, copper, selenium and zinc are all plentiful in orange foods. These …


The Best Outdoor Play Gym – Little Tikes Hide and Slide Climber

Thinking of providing your kids some interesting outdoor activities? I would highly recommend you to get them Little Tikes Hide and Slide Climber. The particular combination is the most suitable outdoor play gym for toddlers and preschoolers to burn their boundless energy. At the same time, the kids are given the chance to enhance their imagination and creativity.

Let’s take a look at its structure. Basically, this playset includes high walls, a wavy slide and a secret area below the main platform. How can kids be attracted to this playset so much?

• First thing first, let’s see the climber. The kids find it easy to climb because the climber comes with large and easy-to-reach steps. They can climb up easily to the slide. The climbing process helps to increase the lung capacity and cardiovascular fitness.

• The wavy and gentle slide provides smooth rides and soft landings to the kids. The first time players will not feel afraid and the most important is this slide is safe. Kids will not get hurt. Both slide and working steering wheel help the toddlers to have better physical development. Without going to the park, your young children can enjoy playing in the yard at anytime they like.

• Here comes the most exciting part, i.e. the secret play area underneath the platform. It is used by the kids to play hide and seek games. The cool hideout and crawl tunnel are specially designed to enable the kids to enjoy adventurous experience. At the same time, the kids are able to gain more self-confidence through the games.

For parents, you are free to choose different models of slides for your kids. There is a wide variety of selection which you can choose from such as regular slides, water slides, bounce house slides, slides with climbing walls, etc. If you require customized slide to suit your children’s special needs, you can place your order directly from the manufacturers. If you just need normal one, you can get it easily from any toy store or online retailer.

I would say it is not hard to assemble different parts of this playset. You can install the hide and climber easily by referring to the step-by-step manual which comes with the set. The best thing about this set is it can be located in your backyard easily without taking up much space. Furthermore, it can also be taken apart easily when you need to clean the yard. You can even keep it in store when you are not in use. This set is durable and it can be used for long-term. Furthermore, the cost of getting it is very reasonable.

In the young children’s point of view, it is indeed exciting to climb and slide with their playmates. Moreover, they can play hide and seek to find out who the winner is. In order to give a memorable and enjoyable childhood to your beloved kids, you are recommended to get a colorful set of Little Tikes Hide …

health, medicine

Why Doctors Can’t Practice Good Medicine

Bette Dowdell

Arizona, where I live, is a standard-of-care state–as are many others, although that’s kind of a secret that you have to discover on your own.

Let me describe in a nutshell what this means: Patients get one-size-fits-all treatment, whether it works or not.

Big Pharma muscles its way onto State Medical Boards. Once there, they use that significant power to shut down real medicine. If healing happens, it’s an accident.

The Board sets standards for each medical condition, which sounds hopeful. However, the standards are intended to minimize costs and guarantee legal protection to doctors no matter what happens to patients.

For instance, the standard of care for thyroid is the TSH test, ignoring the fact this test is perhaps the premier example of unreliability, and treatment with Synthroid or a generic equivalent. Synthroid doesn’t work for the vast majority of us. That’s bad enough, but it causes an allergic reaction in lots of folks. So the TSH test is bogus, the only medicine allowed doesn’t help and may harm, your hair continues to fall out, your brain continues to be consumed in a pea-soup fog and life loses all its joy. But the standard of care has been met.

And standard-of-care State Medical Boards don’t approve of the adrenal saliva test, although it’s accurate while their preferred bloods tests are pointless. So adrenal problems remain unaddressed and untreated, wreaking all sorts of health havoc. If your adrenals are suffering, so are you–in spades.

And it’s not just about thyroid (et al) problems. State Boards decree normal cholesterol levels are too high and insist doctors prescribe statin drugs to lower them–although cholesterol has nothing to do with heart disease and statins are a disaster, with serious side effect upon serious side effect. And for nothing. Research says statins save less than one life per twenty years of patient suffering and expense.

And on and on. Standard-of-care means inferior care.

And your doctor can’t do anything outside the very limited bounds of standard-of-care without risking his/her medical license. A doctor I admire said she fears the State Medical Board above everything.

Want more? If you refuse to do as you’re told, the doctor’s supposed to dismiss you as a patient.

Arizona has a doctor shortage, at least in part because doctors are leaving. They want to practice medicine in a state that still allows them to use their knowledge and skills to treat patients. Those states are few and far between.

Because of the Arizona State Medical Board, I’ve lost some doctors, and I’ve made others crazy by my unwillingness to ride with the tide. I recognize the doctor’s dilemma, but, golly gee whiz, I”m not about to live half a life.

Fortunately, my years of study give me a huge edge in self-care. So I try to break doctors in with the idea of being a coach. I’ll study, I’ll experiment on myself and I’ll tell them all about it–if, and I have to be really diplomatic about …