Recently, Blue Shield of California announced its plans to raise rates by as much as 59%, and as the bellwether Golden State goes, so does the nation.
Most Americans fail to realize the huge economic impact of the medical industrial complex until they feel the crunch from unpaid medical bills that caused 62% of all personal bankruptcies filed in the US in 2007, according to study by Harvard researchers. To the surprise of even the researchers, 78% of those filers had medical insurance at the start of their illness, including 60.3% who had private insurance coverage, not Medicare or Medicaid.
Dr. David Hemmelstein, the lead author of the study and an associate professor of medicine at Harvard, commented: “unless you’re Bill Gates you are just one serious illness away from bankruptcy”.
Not only are costs and bankruptcy skyrocketing, so is accountability. During the health-care reform debate it was notable that the medical industrial complex — the American Medical Association, the HMOs, big Pharma and the American Hospital Association — was not called before Congress to explain why there is a healthcare crisis wrought with high costs and poor outcomes.
Unlike the Detroit auto executives and Wall Street bankers, whose feet were held to the fire at congressional hearings, the medical cartel avoided such public humiliation and offered no explanations.
In 2006, doctors performed at least 60 million surgical procedures of all types, one for every five Americans. No other country does nearly as many operations on its citizens.
Although America is touted as the best of the best in healthcare, undoubtedly those many countries whose health statistics are superior to America’s might disagree.
Not only are surgeries rampant, but many are also ineffective and dangerous. Barbara Stansfield, M.D., MPH of the Johns Hopkins School of Hygiene and Public Health, reported that medical care is now the third leading cause of death in the United States, causing 225,000 preventable deaths every year as tools to make them safer go unused. Deaths from prescription drugs now ranks fourth only to cancer, heart disease and diabetes.
According to the World Health Organization (WHO), in 2000 the US ranked number one in cost, number 72 in population health, 37th in healthcare delivery, with 48 million Americans lacking sick care coverage.
According to Forbes.com, back pain ranks in the top 10 of diseases in America, with over $40 billion spent annually for direct treatment costs and other estimates of indirect costs, including disability & work loss, totaling $100 to $200 billion per year.
Data Provided By J.C. Smith MA, DC
Back pain is possibly in the top ten of most mismanaged diseases as well, which leads to higher cost and poor outcomes. This doesn’t have to be, newer data supports more effective and thus less costly assessment and treatment approaches to treating back, neck and extremity pain.We practice outcome orient care! If you need care, give us a call and lets us put things in better perspective in short order. Experience good results at less cost!
Dr. James E. Greathouse
Back & Neck Pain Treatment
Best Guess vs. Pattern Recognition
When it comes to back and neck pain there’s no shortage of opinion as to what’s causing it and how to treat it. It never ceases to amaze me as to what patients think is causing their pain or what someone else told them it likely is. Just by virtue of the fact that there is such disparity in these opinions (professional and layman), one has to realize that they all can’t be correct, no matter how logical they may seem. This is corroborated by past and current outcome studies, of which, to put it simply, stink! Bear in mind this includes all specialties and most forms of care, from surgeons to voodoo doctors; not to mention chiropractors, which, by the way, are still considered not far from voodoo doctors in some circles.
Most health care providers stick with their own unique training for clinical reasoning, most of which is based on “hypothetico-deductive reasoning (Jones 1992: Terry & Higgs 1993) or what is also called “best guess management” and is much like trying to pick the best candy from a box of chocolates, you never really know if it will work. Best Guess is a relatively scientific approach but back problems have proven to be difficult to successfully treat, and as indicated above, the outcomes with best guess management are poor.
More valid and reliable models have been developed but not fully embraced by the health care delivery system, and are based on “pattern recognition”.
We utilize pattern recognition assessment and care and subsequently have experienced greatly improved outcomes over orthodox chiropractic and physical therapy protocols alone.
Probably the most dramatic or demonstrable example is with the severe sciatic pain patient. A high percentage of the time we can successfully assess, properly treat and achieve significant pain relief and increased function on the first visit.
If you are experiencing headache, neck, back, sciatic or other extremity joint problems, give us a try. We are outcome oriented and we don’t mess around with unending visits. Your problem is assessed and screened for likely success or not in short order. For those who fit the pattern, outcome success is high. For those who do not, a timely and appropriate referral is given.
Don’t mess around with “best guess” care!
Save time & money with a more valid & reliable assessment and treatment approach.
Forward to someone in need.
Be Kind To Your Spine!
Potatoes sometimes get a bad health rap. But new research shows that certain varieties may help quiet inflammatory processes that set the stage for disease.
Specifically, researchers recently sang the praises of potatoes with yellow flesh — like Yukon Gold. In a small study of men, eating a cup of yellow potatoes every day for 6 weeks helped lower blood levels of interleukin-6 (IL-6), a compound that promotes inflammation.
Inflammatory cycles go something like this: First, free radicals in your body — generated by stress, illness, pollutants, and normal everyday body processes — start to damage cells and tissues. In response, your body releases IL-6 to help corral and neutralize some of those free radicals. But chronically high levels of IL-6 can up your risk of inflammation-related diseases. Enter, potatoes. Research suggests that antioxidants in yellow potatoes — like phenols and carotenoids — may help fight the out-of-control inflammation that makes you susceptible to a wide range of illnesses, from heart disease to cancer.(Are you getting enough of this inflammation-fighting vitamin?) Don’t confuse french fries with heathy potatoes. Most fries are cooked in grease that promotes inflammation!
Purple potatoes seemed to be beneficial, too. In the study, adult men up to age 40 ate a cup of boiled potatoes every day for 6 weeks. The men who ate yellow potatoes had lower levels of IL-6 and exhibited less DNA damage compared with the men who ate white potatoes. Purple-potato eaters had lower levels of a different inflammatory marker, C-reactive protein, compared with white-potato eaters. Researchers suspect the rich pigments in colored potatoes help protect cells, tissue, and DNA from the free radical injuries that initiate inflammation. Here are three more ways to fight inflammation:
We’re declaring war on crap food habits! We grazed all day on organic bananas, oranges, sliced cucumbers, and fresh pealed and chopped beets (yes, beets). We also had kiwi for a special snack. Enough of the fatty foods, salty, sugary, refined, processed foods, and simple carbs (that turn to fat). Not to mention, we eliminated the pesticide residues from the fruit & veggies. By the way, the beets taste great, similar to raw carrots, but sweeter & softer, and are supposed to be effective at reducing high blood pressure.
Our organic fruit & veggie supplier is Danielle, in Melbourne Beach. A big perk is that the cost is comparable to nonorganic prices and sometimes cheaper than store bought! For those of you who buy organic, you realize that’s a big plus!
Below please find a notice from Danielle with contact information.
Hello. I just wanted to remind you that we will be receiving a fresh delivery of Organic fruits and vegetables on Tuesdays. The food will be available from 1PM-6PM (possibly earlier if the truck arrives sooner than expected-feel free to call us to check- 321-373-4599) this Tuesday (5100 Palm DR). Please note that if you are not able to make it during this time, we completely understand. Feel free to call us for other times and arrangements at 321-373-4599. Please note this is a co-op with the intention of delivering fresh, healthy, and cost effective produce to our neighbors and friends. If you think you may be interested this week, please reply to firstname.lastname@example.org . This will allow us to order appropriately for the amount of people interested.
Please note, all items are a la carte–you choose what works for you.
Special Order Items–Please let us know if you are interested in any of the following so we can pre-order the correct amount:
Organic Eggs (dozen)
Young Thai Coconuts
Organic Isreali Medjoul Dates (#)
Biodynamic Raisins (#)
Biodynamic Almonds (#)
Please feel free to forward this to any of your friends or neighbors who may be interested…
Health Care Myth Busters: Is There a High Degree of Scientific Certainty in Modern Medicine?
Two doctors take on the health care system in a new book that aims to arm people with information
By Sanjaya Kumar and David B. Nash | March 25, 2011 | 27
Myth: There is a high degree of scientific certainty in modern medicine
“In America, there is no guarantee that any individual will receive high-quality care for any particular health problem. The healthcare industry is plagued with overutilization of services, underutilization of services and errors in healthcare practice.” – Elizabeth A. McGlynn, PhD, Rand Corporation researcher, and colleagues. (Elizabeth A. McGlynn, PhD; Steven M. Asch, MD, MPH; et al. “The Quality of Healthcare Delivered to Adults in the United States,” New England Journal of Medicine 2003;348:2635-2645.)
Most of us are confident that the quality of our healthcare is the finest, the most technologically sophisticated and the most scientifically advanced in the world. And for good reason—thousands of clinical research studies are published every year that indicate such findings. Hospitals advertise the latest, most dazzling techniques to peer into the human body and perform amazing lifesaving surgeries with the aid of high-tech devices. There is no question that modern medical practices are remarkable, often effective and occasionally miraculous.
But there is a wrinkle in our confidence. We believe that the vast majority of what physicians do is backed by solid science. Their diagnostic and treatment decisions must reflect the latest and best research. Their clinical judgment must certainly be well beyond any reasonable doubt. To seriously question these assumptions would seem jaundiced and cynical.
But we must question them because these beliefs are based more on faith than on facts for at least three reasons, each of which we will explore in detail in this section. Only a fraction of what physicians do is based on solid evidence from Grade-A randomized, controlled trials; the rest is based instead on weak or no evidence and on subjective judgment. When scientific consensus exists on which clinical practices work effectively, physicians only sporadically follow that evidence correctly.
Medical decision-making itself is fraught with inherent subjectivity, some of it necessary and beneficial to patients, and some of it flawed and potentially dangerous. For these reasons, millions of Americans receive medications and treatments that have no proven clinical benefit, and millions fail to get care that is proven to be effective. Quality and safety suffer, and waste flourishes.
We know, for example, that when a patient goes to his primary-care physician with a very common problem like lower back pain, the physician will deliver the right treatment with real clinical benefit about half of the time. Patients with the same health problem who go to different physicians will get wildly different treatments. Those physicians can’t all be right.
Having limited clinical evidence for their decision-making is not the only gap in physicians’ scientific certainty. Physician judgment—the “art” of medicine—inevitably comes into play, for better or for worse. Even physicians with the most advanced technical skills sometimes fail to achieve the highest quality outcomes for their patients. That’s when resourcefulness—trying different and potentially better interventions—can bend the quality curve even further.
And, even the most experienced physicians make errors in diagnosing patients because of cognitive biases inherent to human thinking processes. These subjective, “nonscientific” features of physician judgment work in parallel with the relative scarcity of strong scientific backing when physicians make decisions about how to care for their patients.
We could accurately say, “Half of what physicians do is wrong,” or “Less than 20 percent of what physicians do has solid research to support it.” Although these claims sound absurd, they are solidly supported by research that is largely agreed upon by experts. Yet these claims are rarely discussed publicly. It would be political suicide for our public leaders to admit these truths and risk being branded as reactionary or radical. Most Americans wouldn’t believe them anyway. Dozens of stakeholders are continuously jockeying to promote their vested interests, making it difficult for anyone to summarize a complex and nuanced body of research in a way that cuts through the partisan fog and satisfies everyone’s agendas. That, too, is part of the problem.
Questioning the unquestionable
The problem is that physicians don’t know what they’re doing. That is how David Eddy, MD, PhD, a healthcare economist and senior advisor for health policy and management for Kaiser Permanente, put the problem in a Business Week cover story about how much of healthcare delivery is not based on science. Plenty of proof backs up Eddy’s glib-sounding remark.
The plain fact is that many clinical decisions made by physicians appear to be arbitrary, uncertain and variable. Reams of research point to the same finding: physicians looking at the same thing will disagree with each other, or even with themselves, from 10 percent to 50 percent of the time during virtually every aspect of the medical-care process—from taking a medical history to doing a physical examination, reading a laboratory test, performing a pathological diagnosis and recommending a treatment. Physician judgment is highly variable.
Here is what Eddy has found in his research. Give a group of cardiologists high-quality coronary angiograms (a type of radiograph or x-ray) of typical patients and they will disagree about the diagnosis for about half of the patients. They will disagree with themselves on two successive readings of the same angiograms up to one-third of the time. Ask a group of experts to estimate the effect of colon-cancerscreening on colon-cancer mortality and answers will range from five percent to 95 percent.
Ask fifty cardiovascular surgeons to estimate the probabilities of various risks associated with xenografts (animal-tissue transplant) versus mechanical heart valves and you’ll get answers to the same question ranging from zero percent to about 50 percent. (Ask about the 10-year probability of valve failure with xenografts and you’ll get a range of three percent to 95 percent.)
Give surgeons a written description of a surgical problem, and half of the group will recommend surgery, while the other half will not. Survey them again two years later and as many as 40 percent of the same surgeons will disagree with their previous opinions and change their recommendations. Research studies back up all of these findings, according to Eddy.
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For what it’s worth, chiropractors and physical therapists are included in this issue as well.