Organic Meats and Milk Frequently Has More Omega -3's !
By Carina Storrs, Special to CNN
RePost By Dr. Kandilakis
Thursday, February 18, 2016
Organic Meats and Milk Frequently Has More Omega -3's !
Organic Meats and Milk Frequently Has More Omega -3's !
By Carina Storrs, Special to CNN
RePost By Dr. Kandilakis
Thursday, March 13, 2008
Posted for Patient Education
F.D.A. Finds Increase in Suicide Symptoms for Patients Using Seizure Medications
By GARDINER HARRIS and BENEDICT CAREY
Published: February 1, 2008
Drugs for epilepsy, bipolar illness and mood problems double the risks of suicidal thoughts and behavior, and patients taking them should be watched for sudden behavioral changes, drug regulators have said.
The increased risks, while double in relative terms, are small. The Food and Drug Administration undertook a combined analysis of 199 clinical trials with 43,892 patients and found 4 suicides and 105 reports of suicidal symptoms among the 27,863 patients who were given the drugs compared to no suicides and 35 reports of suicidal symptoms among the 16,029 patients treated with placebos.
Taken together, the risk of suicidal thoughts and behavior was 0.43 percent for those on drug therapy and 0.22 percent for those given placebos. These medications are primarily used to help epileptics control seizures and to calm the surges in energy and mood that, along with bouts of depression, characterize bipolar disorder. The drugs, which include Depakote, Lamictal, Topamax, Keppra, Lyrica and Neurontin, are sometimes prescribed for chronic pain and headaches, as well. Doctors said Thursday that the increased risk did not outweigh the benefits of the drugs. “What’s really important to say is that bipolar disorder is very difficult to treat, the burden is enormous, and these medications help keep people free of mood and anxiety symptoms and allow them to function,” said Andrew A. Nierenberg, medical director of the bipolar clinic and research program at Massachusetts General Hospital.
The increased risks began as early as the first week of therapy and never seemed to leave, the drug agency said. The risks were higher among epileptics than among those given the drugs for psychiatric or other problems. The agency will convene a panel of experts to discuss the findings and add risk information to the drug labels.
A spokeswoman for the agency, Sandy Walsh, said she could not comment on the label changes. “Those discussions will take place between the F.D.A. and the drug manufacturers,” Ms. Walsh said. She said all anticonvulsant drugs had increased risk of suicidal symptoms, meaning each would have similar warnings.
A spokesman for Pfizer, Jack Cox, said its review of Neurontin and Lyrica found “no evidence of an increased risk of suicide-related events in either product.”
A spokeswoman for GlaxoSmithKline, Mary Anne Rhyne, said its analysis of clinical trials of Lamictal found “general trends that were similar to those seen in the F.D.A. analysis.”
Laureen M. Cassidy, a spokeswoman for Abbott, which makes Depakote, said, “This is important information for care-givers to monitor patients, but this shouldn’t change how epilepsy is treated.”
The new finding, a result of a two-year study, is a coda to the finding three years ago that antidepressants also doubled the risks of suicidal symptoms. With antidepressants, the risks of suicidal symptoms, rose to 4 percent for children and teenagers compared to 2 percent among those given placebos, risks 10 times higher than those found in the trials of anticonvulsants.
The agency, in a major change for experimental medicines, requires drug makers to study closely whether patients become suicidal in clinical trials of different medicines.
The finding on antidepressants led to a label warning that many psychiatrists say has caused more harm than good by dissuading some patients from finding needed care.
Ann Marie Thomson, of Lindenhurst, N.Y., said her husband, Peter, was prescribed Keppra in 2002 for a seizure disorder. Within days, Mr. Thomson became moody and violent, Ms. Thomson said, and when he stopped taking the drug, his behavior and mood immediately improved.
Dr. Cynthia Harden, a professor of neurology at Weill Cornell Medical College, said she would monitor her epilepsy patients taking the drugs more closely but would not end their treatment.
“The consequences of seizures are dire,” Dr. Harden said. “There’s a risk of injury, even brain injury from a prolonged seizure, a loss of awareness and tremendous anxiety as these episodes can come without warning. It’s a very difficult illness to live with, and these drugs are well worth trying.”
F.D.A. Finds Increase in Suicide Symptoms for Patients Using Seizure Medications
By GARDINER HARRIS and BENEDICT CAREY
Published: February 1, 2008
Drugs for epilepsy, bipolar illness and mood problems double the risks of suicidal thoughts and behavior, and patients taking them should be watched for sudden behavioral changes, drug regulators have said.
The increased risks, while double in relative terms, are small. The Food and Drug Administration undertook a combined analysis of 199 clinical trials with 43,892 patients and found 4 suicides and 105 reports of suicidal symptoms among the 27,863 patients who were given the drugs compared to no suicides and 35 reports of suicidal symptoms among the 16,029 patients treated with placebos.
Taken together, the risk of suicidal thoughts and behavior was 0.43 percent for those on drug therapy and 0.22 percent for those given placebos. These medications are primarily used to help epileptics control seizures and to calm the surges in energy and mood that, along with bouts of depression, characterize bipolar disorder. The drugs, which include Depakote, Lamictal, Topamax, Keppra, Lyrica and Neurontin, are sometimes prescribed for chronic pain and headaches, as well. Doctors said Thursday that the increased risk did not outweigh the benefits of the drugs. “What’s really important to say is that bipolar disorder is very difficult to treat, the burden is enormous, and these medications help keep people free of mood and anxiety symptoms and allow them to function,” said Andrew A. Nierenberg, medical director of the bipolar clinic and research program at Massachusetts General Hospital.
The increased risks began as early as the first week of therapy and never seemed to leave, the drug agency said. The risks were higher among epileptics than among those given the drugs for psychiatric or other problems. The agency will convene a panel of experts to discuss the findings and add risk information to the drug labels.
A spokeswoman for the agency, Sandy Walsh, said she could not comment on the label changes. “Those discussions will take place between the F.D.A. and the drug manufacturers,” Ms. Walsh said. She said all anticonvulsant drugs had increased risk of suicidal symptoms, meaning each would have similar warnings.
A spokesman for Pfizer, Jack Cox, said its review of Neurontin and Lyrica found “no evidence of an increased risk of suicide-related events in either product.”
A spokeswoman for GlaxoSmithKline, Mary Anne Rhyne, said its analysis of clinical trials of Lamictal found “general trends that were similar to those seen in the F.D.A. analysis.”
Laureen M. Cassidy, a spokeswoman for Abbott, which makes Depakote, said, “This is important information for care-givers to monitor patients, but this shouldn’t change how epilepsy is treated.”
The new finding, a result of a two-year study, is a coda to the finding three years ago that antidepressants also doubled the risks of suicidal symptoms. With antidepressants, the risks of suicidal symptoms, rose to 4 percent for children and teenagers compared to 2 percent among those given placebos, risks 10 times higher than those found in the trials of anticonvulsants.
The agency, in a major change for experimental medicines, requires drug makers to study closely whether patients become suicidal in clinical trials of different medicines.
The finding on antidepressants led to a label warning that many psychiatrists say has caused more harm than good by dissuading some patients from finding needed care.
Ann Marie Thomson, of Lindenhurst, N.Y., said her husband, Peter, was prescribed Keppra in 2002 for a seizure disorder. Within days, Mr. Thomson became moody and violent, Ms. Thomson said, and when he stopped taking the drug, his behavior and mood immediately improved.
Dr. Cynthia Harden, a professor of neurology at Weill Cornell Medical College, said she would monitor her epilepsy patients taking the drugs more closely but would not end their treatment.
“The consequences of seizures are dire,” Dr. Harden said. “There’s a risk of injury, even brain injury from a prolonged seizure, a loss of awareness and tremendous anxiety as these episodes can come without warning. It’s a very difficult illness to live with, and these drugs are well worth trying.”
“Spillover” in HealthCare
By Drew S. Kandilakis, DC
Several examples of “spillover” in everyday life may include: A flood control dam recently built benefits everyone in the area regardless of who built it; if research and development scientists discover a new way to treat a common disease or create a new drug everyone suffering from the disease will benefit; if you contribute to public television, everyone who watches it will benefit, or lastly if your local telephone company invests in technology and improves its infrastructure, every other phone company that leases their lines will benefit by the improvement in technology.
The concept of spillover has further definitions that are important to a comprehensive understanding, and the marketplace forces that they set into play are critical to understanding “spillover” in healthcare settings. Economists and other social scientists have demonstrated that the research and development activities (and the programs and services they generate) of private corporations generate widespread benefits enjoyed by employers, consumers and society at large. As a result, the overall economic value to society often exceeds the economic benefits enjoyed by innovating corporations as a result of their innovative programs and services. This excess of the social rate of return over the private rate of return experienced by those corporations creating the innovation is described by economists as “spillover”.
These spillovers take on a number of distinct forms. Firstly, spillovers occur usually due to requested innovations or services by an employer or special interest group in the marketplace. These innovated services or products create benefits for consumers and non-innovating corporations ("market spillovers"). Additional spillovers occur due to the research and understanding of a specific process or product and its effect in the first introduced market and the knowledge created by the innovating corporation is typically not contained within that corporation, and thereby creates value for other corporations and other corporations' customers ("knowledge spillovers"). Finally, because the profitability of a set of interrelated and interdependent services, processes or technologies may depend on achieving a critical mass of success, each corporation or entity pursuing one or more of these related services, processes or technologies creates economic benefits for other corporations and their customers ("network spillovers"). In healthcare the general concept of spillover is the “something else” that happens when a large employer or a business coalition and a health plan jointly develop and implement a quality improvement initiative. It is in essence the “spilling over” of effects into the community.
This spillover effect can be represented in a positive way by a health plan, responding to an individual employer’s challenge to make improvements in services and quality of care, improves care for everyone who belongs to the plan, not just the company’s employees who requested the improvement/change. Another example can be illustrated when an individual employer’s successful challenge to one health plan to make improvements “raises the bar on quality” for all health plans in the community by causing them to improve care for their enrollees in order to remain competitive. Still another example may be illustrated when large employers in coalitions with both large and smaller companies set improvement goals for the whole community such as depression or diabetes screening programs for the entire community, not just their own plan members.
Examples of spillover can be divided into three categories: improving community acute care, improving community chronic care, and improving community health.
There are also negative “spillover” effects. The creation of environmentally toxic chemicals or byproducts from the fabrication of products in industry has two negative “spillover” effects. One is the chemicals are toxic and therefore dangerous to anyone who may inadvertently come in contact with them and the second is the cost it takes to isolate, modify or detoxify the byproducts is passed on to the consumer or user of the final product. For this discussion we will only focus on positive “spillover” effects.
General Health-Related “Spillover” Effects
One study has an interesting outcome related to hospital ownership: It affects the costs associated with caring for heart attack patients. A recent study by NBER research associates Daniel Kessler and Mark McClellan finds that the presence of a few for-profit hospitals as competitors in a non-rural setting. They found that the presence of a for-profit hospital actually decreased the costs of the nearby not-for-profit hospitals in the area 2.4 percent per patient for patient expenditures, without affecting patient care outcomes (NBER Working Paper, No. 8537). This “spillover” effect in not-for-profit hospitals was noticed when hospital admissions in for-profit hospitals went from zero to a few per month. There was obvious sharing of procedural, efficiency and protocol -oriented information among healthcare institutions.
Another positive “spillover” effect is the economic growth of a region after a major employer locates in the area, such as IBM, UPS, Kmart, Target, or a community or teaching hospital. Once a large employer creates an economic base for a community, smaller service industries and merchants also locate their businesses close to the action. This “spillover” effect then continues to create more opportunity for employment and even training and education in increasingly diverse employment environments. . This would be an example of a “network spillover”.
“Spillover” Effects in the Community Acute Care Environment
There is much evidence that a spillover effect from employer-sponsored quality improvement programs can lead to better acute care for every person in the community, even save lives.
Seventeen area hospitals in Orlando, Florida, thanks to the Central Florida Health Care Coalition, have implemented clinical “best practices” in such critical areas as heart bypass surgery. The coalition has documented over $300 million in savings as a result of the quality improvements not by reducing overall cost, but as a result of quality improvements that “benefit everyone utilizing those 17 hospitals”. After the Cleveland Health Quality Choice coalition distributed comparative information on local hospitals in Cleveland, hospital mortality rates for a number of common procedures, including heart attacks, pneumonia and stroke, declined. Similarly in Portland, Oregon, The Portland Medical Outcomes Consortium, pioneered an innovative community program in breast cancer detection and treatment that increased the survival rate of women with the disease to higher than the U.S. norm.
Non-healthcare corporations such as Pilkington Libbey-Owens-Ford, contributed better information systems to manage patient outcomes (they were so good at it that now they are locally used by Medicaid and Medicare) , Pennsylvania-based Hershey Foods (drove to reduce mortality and complication rates that impacted local hospitals) , and Minneapolis-based Dayton Hudson’s cancer and leukemia specialists were so good they were even hired by the Mayo clinic to help develop and improve on cancer treatment protocols. These corporations have been tremendously instrumental in creating positive “spillover” in the communities in which they are located.
“Spillover” Effects in the Community Chronic Care Environment
Improvement in chronic illness throughout the community can be the spillover effect from business-sponsored programs that result in better care for persons within health plans. This has occurred in Detroit and the surrounding Southeast Michigan area where health plans have stepped up programs to manage diabetes, asthma and behavioral health problems due to the efforts of the Greater Detroit Area Health Council’s Value-Based Purchasing Initiative.
New York-based Pfizer, Inc. and California based Pacific Business Group on Health have influenced their local chronic health outcomes by identify areas for quality improvement and to implement effective programs. As a result, six of the seven largest participating plans initiated aggressive steps to educate and support primary care physicians in the management of behavioral health care, helping all patients in those plans. One of their strategies was to reward high-quality providers by publicly ranking physician groups on everything from ease of referrals and patient satisfaction to the groups’ success in maintaining patients’ health status over a two-year period. This information made the entire region’s healthcare providers more competitive in all areas cited.
Improving Community Health
Very apparent measures of community health can be improved as a result of the spillover effect from corporate efforts. The Dallas-Fort Worth Business Group on Health, has worked with the local hospital and medical societies to snapshot and improve the care provided by obstetrician-gynecologists in the entire metropolitan area. General Motors in partnership with the United Auto Workers has improved the actual health status of entire communities, such as Flint, Michigan. Chicago-based Baxter International has created community based soup kitchens and free health screenings for the uninsured as well as instituted “socially responsible” purchasing criteria.
In Minneapolis-St. Paul, The Buyers Health Care Action Group ranks providers using 28 different performance measures. The group also requires participating medical groups to implement best-practice protocols. It has been noted that they have seen improved office hours and greater access to urgent care for the entire community. The Health Improvement Collaborative of Greater Cincinnati has initiated many community reforms to track changes in community health status and to target areas for intervention and improvement.
One innovative and “mom friendly” corporation in North Carolina, Burlington Industries’ has created a “healthy babies” program which was so successful at providing prenatal care to at-risk moms that the number of low-birth weight babies at just one plant dropped from ten to zero. In response, competitors in the textile industry have attempted to duplicate the program—and Burlington’s insurance carrier made the program part of its standard package of benefits.
Digital Equipment Corporation’s has a comprehensive performance standard benchmarks for health plans which has prompted measurable improvements in quality and outcomes in cardiovascular, obstetrical and chronic disease management. All of which has become a national model with impact far beyond the suburban Boston area where Digital is headquartered. Achieving quality improvements and pressuring its health care plans to make system-wide improvements in the areas of access, customer service and care are Connecticut-based General Electric’s “Six Sigma” program goals.
Taking into account all of the positive effects of healthcare marketplace spillover, from shared benefits of drug research and development to a new hospital opening up with higher healthcare standard benchmarks than it existing community hospital competition, the effect felt of “spillover” has many positive impacts to the individual, employer and community and should be fostered and positively exploited whenever possible.
References:
McKethan, A., NC Med J, May/June 2007, Vol. 68, N3, pp 208-209
Hennessy, Shaun; Strom, Brian, Leonard Davis Institute of Health Economics, Volume 9, Number 1, Sept, 2003
Kessler, D & McClellan, M, NBER Working Paper No. 8537, “ The Effects of Hospital Ownership on Medical Productivity”
American Society for Quality, Handbook for Managing Change in Health
Care (Chip Caldwell ed.) (1997).
Government Accounting Office, Health Insurance Management Strategies
Used by Large Employers to Control Costs (May 1997).
Linda Kohn et al., Center for Studying Health System Change, Health
System Changes in Twelve Communities (1997).
UCLA Center for Health Policy Research, Policy Report: State of Health
Insurance in California 1996 (1997).
Buyers Health Care Action Group, The Choice Plus Performance Results/
Consumer Satisfaction Survey Results 1997 (1997).
Portland Medical Outcomes Consortium, Information on Quality and
Results: Breast Cancer Treatment 2 - 3 (May 1997).
Digital Equipment Corp., HMO Performance Standards 13-14 (1995).
Robert L. Lowes, “GM wants to tune up your practice,” Medical
Economics, Sept. 8, 1997.
By Drew S. Kandilakis, DC
Several examples of “spillover” in everyday life may include: A flood control dam recently built benefits everyone in the area regardless of who built it; if research and development scientists discover a new way to treat a common disease or create a new drug everyone suffering from the disease will benefit; if you contribute to public television, everyone who watches it will benefit, or lastly if your local telephone company invests in technology and improves its infrastructure, every other phone company that leases their lines will benefit by the improvement in technology.
The concept of spillover has further definitions that are important to a comprehensive understanding, and the marketplace forces that they set into play are critical to understanding “spillover” in healthcare settings. Economists and other social scientists have demonstrated that the research and development activities (and the programs and services they generate) of private corporations generate widespread benefits enjoyed by employers, consumers and society at large. As a result, the overall economic value to society often exceeds the economic benefits enjoyed by innovating corporations as a result of their innovative programs and services. This excess of the social rate of return over the private rate of return experienced by those corporations creating the innovation is described by economists as “spillover”.
These spillovers take on a number of distinct forms. Firstly, spillovers occur usually due to requested innovations or services by an employer or special interest group in the marketplace. These innovated services or products create benefits for consumers and non-innovating corporations ("market spillovers"). Additional spillovers occur due to the research and understanding of a specific process or product and its effect in the first introduced market and the knowledge created by the innovating corporation is typically not contained within that corporation, and thereby creates value for other corporations and other corporations' customers ("knowledge spillovers"). Finally, because the profitability of a set of interrelated and interdependent services, processes or technologies may depend on achieving a critical mass of success, each corporation or entity pursuing one or more of these related services, processes or technologies creates economic benefits for other corporations and their customers ("network spillovers"). In healthcare the general concept of spillover is the “something else” that happens when a large employer or a business coalition and a health plan jointly develop and implement a quality improvement initiative. It is in essence the “spilling over” of effects into the community.
This spillover effect can be represented in a positive way by a health plan, responding to an individual employer’s challenge to make improvements in services and quality of care, improves care for everyone who belongs to the plan, not just the company’s employees who requested the improvement/change. Another example can be illustrated when an individual employer’s successful challenge to one health plan to make improvements “raises the bar on quality” for all health plans in the community by causing them to improve care for their enrollees in order to remain competitive. Still another example may be illustrated when large employers in coalitions with both large and smaller companies set improvement goals for the whole community such as depression or diabetes screening programs for the entire community, not just their own plan members.
Examples of spillover can be divided into three categories: improving community acute care, improving community chronic care, and improving community health.
There are also negative “spillover” effects. The creation of environmentally toxic chemicals or byproducts from the fabrication of products in industry has two negative “spillover” effects. One is the chemicals are toxic and therefore dangerous to anyone who may inadvertently come in contact with them and the second is the cost it takes to isolate, modify or detoxify the byproducts is passed on to the consumer or user of the final product. For this discussion we will only focus on positive “spillover” effects.
General Health-Related “Spillover” Effects
One study has an interesting outcome related to hospital ownership: It affects the costs associated with caring for heart attack patients. A recent study by NBER research associates Daniel Kessler and Mark McClellan finds that the presence of a few for-profit hospitals as competitors in a non-rural setting. They found that the presence of a for-profit hospital actually decreased the costs of the nearby not-for-profit hospitals in the area 2.4 percent per patient for patient expenditures, without affecting patient care outcomes (NBER Working Paper, No. 8537). This “spillover” effect in not-for-profit hospitals was noticed when hospital admissions in for-profit hospitals went from zero to a few per month. There was obvious sharing of procedural, efficiency and protocol -oriented information among healthcare institutions.
Another positive “spillover” effect is the economic growth of a region after a major employer locates in the area, such as IBM, UPS, Kmart, Target, or a community or teaching hospital. Once a large employer creates an economic base for a community, smaller service industries and merchants also locate their businesses close to the action. This “spillover” effect then continues to create more opportunity for employment and even training and education in increasingly diverse employment environments. . This would be an example of a “network spillover”.
“Spillover” Effects in the Community Acute Care Environment
There is much evidence that a spillover effect from employer-sponsored quality improvement programs can lead to better acute care for every person in the community, even save lives.
Seventeen area hospitals in Orlando, Florida, thanks to the Central Florida Health Care Coalition, have implemented clinical “best practices” in such critical areas as heart bypass surgery. The coalition has documented over $300 million in savings as a result of the quality improvements not by reducing overall cost, but as a result of quality improvements that “benefit everyone utilizing those 17 hospitals”. After the Cleveland Health Quality Choice coalition distributed comparative information on local hospitals in Cleveland, hospital mortality rates for a number of common procedures, including heart attacks, pneumonia and stroke, declined. Similarly in Portland, Oregon, The Portland Medical Outcomes Consortium, pioneered an innovative community program in breast cancer detection and treatment that increased the survival rate of women with the disease to higher than the U.S. norm.
Non-healthcare corporations such as Pilkington Libbey-Owens-Ford, contributed better information systems to manage patient outcomes (they were so good at it that now they are locally used by Medicaid and Medicare) , Pennsylvania-based Hershey Foods (drove to reduce mortality and complication rates that impacted local hospitals) , and Minneapolis-based Dayton Hudson’s cancer and leukemia specialists were so good they were even hired by the Mayo clinic to help develop and improve on cancer treatment protocols. These corporations have been tremendously instrumental in creating positive “spillover” in the communities in which they are located.
“Spillover” Effects in the Community Chronic Care Environment
Improvement in chronic illness throughout the community can be the spillover effect from business-sponsored programs that result in better care for persons within health plans. This has occurred in Detroit and the surrounding Southeast Michigan area where health plans have stepped up programs to manage diabetes, asthma and behavioral health problems due to the efforts of the Greater Detroit Area Health Council’s Value-Based Purchasing Initiative.
New York-based Pfizer, Inc. and California based Pacific Business Group on Health have influenced their local chronic health outcomes by identify areas for quality improvement and to implement effective programs. As a result, six of the seven largest participating plans initiated aggressive steps to educate and support primary care physicians in the management of behavioral health care, helping all patients in those plans. One of their strategies was to reward high-quality providers by publicly ranking physician groups on everything from ease of referrals and patient satisfaction to the groups’ success in maintaining patients’ health status over a two-year period. This information made the entire region’s healthcare providers more competitive in all areas cited.
Improving Community Health
Very apparent measures of community health can be improved as a result of the spillover effect from corporate efforts. The Dallas-Fort Worth Business Group on Health, has worked with the local hospital and medical societies to snapshot and improve the care provided by obstetrician-gynecologists in the entire metropolitan area. General Motors in partnership with the United Auto Workers has improved the actual health status of entire communities, such as Flint, Michigan. Chicago-based Baxter International has created community based soup kitchens and free health screenings for the uninsured as well as instituted “socially responsible” purchasing criteria.
In Minneapolis-St. Paul, The Buyers Health Care Action Group ranks providers using 28 different performance measures. The group also requires participating medical groups to implement best-practice protocols. It has been noted that they have seen improved office hours and greater access to urgent care for the entire community. The Health Improvement Collaborative of Greater Cincinnati has initiated many community reforms to track changes in community health status and to target areas for intervention and improvement.
One innovative and “mom friendly” corporation in North Carolina, Burlington Industries’ has created a “healthy babies” program which was so successful at providing prenatal care to at-risk moms that the number of low-birth weight babies at just one plant dropped from ten to zero. In response, competitors in the textile industry have attempted to duplicate the program—and Burlington’s insurance carrier made the program part of its standard package of benefits.
Digital Equipment Corporation’s has a comprehensive performance standard benchmarks for health plans which has prompted measurable improvements in quality and outcomes in cardiovascular, obstetrical and chronic disease management. All of which has become a national model with impact far beyond the suburban Boston area where Digital is headquartered. Achieving quality improvements and pressuring its health care plans to make system-wide improvements in the areas of access, customer service and care are Connecticut-based General Electric’s “Six Sigma” program goals.
Taking into account all of the positive effects of healthcare marketplace spillover, from shared benefits of drug research and development to a new hospital opening up with higher healthcare standard benchmarks than it existing community hospital competition, the effect felt of “spillover” has many positive impacts to the individual, employer and community and should be fostered and positively exploited whenever possible.
References:
McKethan, A., NC Med J, May/June 2007, Vol. 68, N3, pp 208-209
Hennessy, Shaun; Strom, Brian, Leonard Davis Institute of Health Economics, Volume 9, Number 1, Sept, 2003
Kessler, D & McClellan, M, NBER Working Paper No. 8537, “ The Effects of Hospital Ownership on Medical Productivity”
American Society for Quality, Handbook for Managing Change in Health
Care (Chip Caldwell ed.) (1997).
Government Accounting Office, Health Insurance Management Strategies
Used by Large Employers to Control Costs (May 1997).
Linda Kohn et al., Center for Studying Health System Change, Health
System Changes in Twelve Communities (1997).
UCLA Center for Health Policy Research, Policy Report: State of Health
Insurance in California 1996 (1997).
Buyers Health Care Action Group, The Choice Plus Performance Results/
Consumer Satisfaction Survey Results 1997 (1997).
Portland Medical Outcomes Consortium, Information on Quality and
Results: Breast Cancer Treatment 2 - 3 (May 1997).
Digital Equipment Corp., HMO Performance Standards 13-14 (1995).
Robert L. Lowes, “GM wants to tune up your practice,” Medical
Economics, Sept. 8, 1997.
“Focused Factories”: Specialty Hospitals and Ambulatory Surgical Centers - Better Service, Repetition Makes Excellence --- or --- Just Further Splitting the Pie & Adding Cost?
By D. S. Kandilakis, DC
The US healthcare system in the past has already established a trend for several specialty hospital care services, usually integrated in the hospitals network or hospital itself. Traditionally, these specialty services were children’s services, ear, eye and rehabilitative, physical therapy services, specialty stroke clinics or “mini” hospitals, usually wings of hospitals, or ground level outpatient centers dedicated to specific conditions. The huge wave of “baby boomers” coming into the healthcare system, over-burdened state Medicaid and federal Medicare healthcare system coupled with the continued need to develop more efficient ways for healthcare service organizations to render quality, yet cost-effective, even profitable care has led entrepreneurs in healthcare to develop and expand on another healthcare model, “Focused Factories”.
The idea of a “Focused Factory” in healthcare.
The term “Focused Factories” can be defined as both Specialty Medical Facilities (SMF) and Ambulatory Surgical Centers (ASC). ASC’s are much less complex to establish, less costly, and are not generally subject to stringent certificate of need (CON) guidelines. They primarily compete now with hospital outpatient surgery centers. Their numbers have doubled the past decade to 3,371 Medicare-certified ASC’s, closely totaling the 3,859 hospital outpatient surgery centers. The “focus” is to treat a specific, limited number of conditions in a high-volume, extremely repetitious and cost-effective, profitable manner while maintaining high patient satisfaction and very, very good, above average patient medical outcomes and reimbursement for medical services. It is interesting to note that franchised food service organizations and franchises and the auto industry are the true current refined derivatives of the model of “factory production”. Develop an extremely efficient process, be dedicated to continually improve on the process, be able to duplicate the process in many locations, closely monitor the interactive aspects of the organization, contain cost, make a profit. So in essence these facilities are focused “disease management” centers, specializing in surgical procedure related interventions.
Among many, three main influences to the impetus to build specialty hospitals are “the relatively high profit margins of these select procedures, specialists’ desire to increase control over the care environment and increase their (physicians’) income.”, as per the Center for Studying Health System Change. There are many in healthcare that think they will out-compete traditional hospitals. I am in agreement, and so is Regina E. Herzlinger, Ph.D, Harvard’s Professor Business Administration Chair. She sees the trend to be baby boomer needs driven. Her idea takes focused factories a step further, she relates that a ”true” focused factory will deliver services wherever consumers need it, in their home, in a mall, neighborhood pharmacy, community center, shopping mall, hospital or specialist hospital. This example may be more appropriate for managing hypertension or diabetes than surgical interventions for laproscopic surgical procedures that make up most of the SMF and ASC repertoire of surgical services for cardiovascular and orthopedic diseases. In fact The Center for Studying Health System Change (HSC) had site visit findings in 1996-1997 with hospital executives across the nation who reported that surgical admissions were much more lucrative than medical admissions and among the procedures, orthopedic and cardiovascular the most profitable.
Integration versus going your own way
Traditional hospital are costly. Not just a little. They turn a profit by profiting well from specialty procedures and programs that are well reimbursed by payors and these allow the hospital to carry the cost of services that are either break-even or just plain put them in the red, such as ER’s, burn units, trauma centers and generous community education programs and renal dialysis centers.
Of late, between 1990 and 2003, there has been over 90 specialty facilities, built or under construction nationally, with seventy percent partially physician owned with the median ownership if 2% per individual physician. There appears to be less SMH’s appearing where there is a dominant hospital network present, mostly because of more stringent certificate of need regulation, not true for ASC’s, which are more prevalent.
The current trend is in the rendering of specialty services in the cardiovascular and orthopedic disease markets. The sheer increasing number of individuals presenting with both arthritic and cardiovascular conditions justify these specialties as chosen “focused factories”. The synergy of advances in technology, market forces (cost of goods), changes in the physicians practices themselves, increased regulation, paperwork and quality assurance oversight and public policy changes have allowed physicians to consider joint ventures and partnership with large facilities like hospitals and large disease management corporations.
Traditional hospital networks have tried to compete by increasing their own vertical and horizontal integration of healthcare facilities and services. Good “vertical” integration, for example, would involve a specific delineated protocol for transferring patients from large hospital centers to smaller community hospitals, skilled nursing facilities, outpatient specialty clinics, as the medical need changed, therefore keeping their costs under control while maintaining patients within their own network, as they would own all of these affiliated facilities. Efficient “horizontal” integration would involve numerous hospital centers networked together to share resources and possibly specialize in specific diseases, as for example a “diabetes” disease center at one facility but focus on cardiac surgeries in another, thus reducing duplication or equipment and specialized labor costs. Horizontal integration has been in the industry for years in the form of group purchasing of goods by hospital networks, but the creation of specialty centers within hospital networks is more recent. The problem with this setup is that it involves taking patients usually far away from their neighborhoods, so there are access issues, especially for those patients with ambulatory difficulty, and they often happen to be diabetic, cardiovascular or orthopedic surgical patients.
Efficient disease management by its very nature involves close monitoring. Just as the individual must be in touch with his healthcare status on a daily basis, so must a medical oversight team. So for a “focused factory” to be in the most efficient setting it would have to be relatively small (indeed they are, ASC’s have usually 2 to 4 operating rooms) and be located in many communities. Would it not be easier if all of the healthcare teams’ focus was on your specific diseases and your could access these services right in your community? Of course………….enter the justification and need for ASC’s and SMF’s.
These facilities are designed and managed in a way to render surgical services so frequently, with constant repetition that improves accuracy, reduces medical error (reducing possibility of complication and re-hospitalization), improves patient comfort by being in their close community, decreasing overall cost in general by not requiring all the high end capital equipment of full-service traditional hospitals, this is what the proponents say. Critics of these “focused factories” argue that with the entrepreneurs in healthcare that led to the development of this model, and physician ownership, it would lead to “cherry picking” healthier patients for operative procedures, those that are less sick and therefore more profitable. This would in turn lead to the sicker individuals being admitted for surgical procedures at traditional community hospital centers. Hence the profit would stay in the SMF or ASC and the traditional community hospital would be left with the brunt of the lesser profitable patient cases.
Ethics and Policy
This scenario has raised a few eyebrows, and one study by Mark Chassin, in JAMA seems to support that as physicians become owners of healthcare facilities the probability of over-utilization goes up. Is it ethical? There are already federal laws in place to structure, limit and restrict certain types of self-referral for profit (Stark I & II). Do regulators have to step in to force the acceptance of Medicare, Medicaid and some percentage of gratuitous cases to allow an ASC or SMF to be permitted and built? Some regulators believe this is the only way to level the playing field for traditional medical centers, and to provide services where needed. I don’t believe it makes sense myself. Most SMF and ASC currently are now built in regions where there is no certificate of need (CON) legislation required for approval in place. So now there are questions of access to SMF and ASC facilities, so indeed access to care. Indeed, all patients are not welcome. Ethical or not when physicians and healthcare management companies team up, the result is a focus on profitability.
Some hospitals have responded by trying to deny the admitting privileges of physicians that have ownership in other facilities that compete with the hospital for services. Some courts have agreed with the hospital petitioners while the “jury is out” still yet on others. There is a lot a stake, as of 2003, cardiology services accounted for 25 percent of all hospital stays and 35 percent of all community hospitals’ revenue. If community hospitals cannot compete with their “Focused Factory” competition, then they will be forced to cut back on services or negotiate higher prices from payors.
Due to the rise of ASC’s and Specialty Hospitals, state and federal policy makers are considering a variety of legislative changes that will address issues raised about cost, quality and access. What is a known loophole in Stark self referral legislation is that it allows self-referral to “whole” hospitals without restrictions in which physicians have an ownership interest in, but places restrictions on other facilities (SHF’s and ASC’s). In an attempt to curtail the “cherry picking” of healthy patients the American Hospital Association and other organizations have proposed extending the law to specialty hospitals as well. Other legislative proposals include the requiring of the acceptance of Medicare, Medicaid and gratuitous patients; imposing the same patient safety standards and quality standards as traditional hospitals; requiring full service ER’s or have cooperative transfer protocols in place, revising Medicare reimbursement of selected procedures to reduce reimbursement; and revamping certificate of need laws to prevent specialty hospitals from gaining access to markets traditionally dominated by community “full-service” hospitals.
In either scenario, the bottom line is that research shows that higher volume is associated with better quality and leads to lower cost. Applying this to the “Focused Factory” model, it would sure seem that they are positioned to out-compete traditional hospital structures, due to their smaller less complex structure and inherent cost-saving, low capitalization approach and the fact that they have clear cut physician ownership, this leads to less administrative layering and oversight ….a highly motivating factor in both the quality of care and the desire for extreme efficiency.
My vote is for the continued development of the “Focused Factory” model.
References:
1. Casalino; Devers; Brewster (2003) “Focused Factories” Physician Owned Specialty Facitlities”, Health Affairs, 22, no. 6, pp. 56-67.
2. Aspen, Bruce, "Specialty Hospitals Are a Pain for Rivals," Chicago Tribune (Dec. 1, 2002).
3. Chassin,Mark R., et al., "The Urgent Need to Improve Health Care Quality," Journal of the American Medical Association,Vol. 280, No.11 (Sept. 16, 1998); Gray, Bradford, The Profit Motive and Patient Care: The Changing Accountability of Doctors and Hospitals, Cambridge,Mass.: Harvard University Press (1991).
4. Managed Care, May 1998, Herzlinger, Regina E., “Focused Factories will Provide Care”, “A Conversation with Regina E. Herzlinger.
5. Birkmeyer, John D., Andrea E. Siewers, Emily V. Finlayson et al., "Hospital Volume and Surgical Mortality in the United States," New England Journal of Medicine,Vol. 346, No. 15 (April 11, 2002).
6. Lynk,William J., and Carina S. Longley, "The Effect of Physician-Owned Surgicenters on Hospital Outpatient Surgery," Health Affairs, Vol. 21, No. 4 (July/August 2002).
7. Dobson, Al, "A Comparative Study of Patient Severity, Quality of Care and Community Impact at MedCath Heart Hospitals," The Lewin Group (September 2002) (Executive Summary posted on MedCath's Web site at: http://www.medcath.com/index.asp?INTR_%20ElementI%20D=corp_Study).
8. Winslow, Ron, "Fed-Up Cardiologists Invest in Own Hospital: They'll Regain Autonomy but Critics See a Grab for More Profitable Care," Wall Street Journal (June 22, 1999) cites a study by Health Care Report Cards Inc. of Lakewood, Colo., that suggests patients at a MedCath hospital in McAllen, Texas, are less severely ill.
By D. S. Kandilakis, DC
The US healthcare system in the past has already established a trend for several specialty hospital care services, usually integrated in the hospitals network or hospital itself. Traditionally, these specialty services were children’s services, ear, eye and rehabilitative, physical therapy services, specialty stroke clinics or “mini” hospitals, usually wings of hospitals, or ground level outpatient centers dedicated to specific conditions. The huge wave of “baby boomers” coming into the healthcare system, over-burdened state Medicaid and federal Medicare healthcare system coupled with the continued need to develop more efficient ways for healthcare service organizations to render quality, yet cost-effective, even profitable care has led entrepreneurs in healthcare to develop and expand on another healthcare model, “Focused Factories”.
The idea of a “Focused Factory” in healthcare.
The term “Focused Factories” can be defined as both Specialty Medical Facilities (SMF) and Ambulatory Surgical Centers (ASC). ASC’s are much less complex to establish, less costly, and are not generally subject to stringent certificate of need (CON) guidelines. They primarily compete now with hospital outpatient surgery centers. Their numbers have doubled the past decade to 3,371 Medicare-certified ASC’s, closely totaling the 3,859 hospital outpatient surgery centers. The “focus” is to treat a specific, limited number of conditions in a high-volume, extremely repetitious and cost-effective, profitable manner while maintaining high patient satisfaction and very, very good, above average patient medical outcomes and reimbursement for medical services. It is interesting to note that franchised food service organizations and franchises and the auto industry are the true current refined derivatives of the model of “factory production”. Develop an extremely efficient process, be dedicated to continually improve on the process, be able to duplicate the process in many locations, closely monitor the interactive aspects of the organization, contain cost, make a profit. So in essence these facilities are focused “disease management” centers, specializing in surgical procedure related interventions.
Among many, three main influences to the impetus to build specialty hospitals are “the relatively high profit margins of these select procedures, specialists’ desire to increase control over the care environment and increase their (physicians’) income.”, as per the Center for Studying Health System Change. There are many in healthcare that think they will out-compete traditional hospitals. I am in agreement, and so is Regina E. Herzlinger, Ph.D, Harvard’s Professor Business Administration Chair. She sees the trend to be baby boomer needs driven. Her idea takes focused factories a step further, she relates that a ”true” focused factory will deliver services wherever consumers need it, in their home, in a mall, neighborhood pharmacy, community center, shopping mall, hospital or specialist hospital. This example may be more appropriate for managing hypertension or diabetes than surgical interventions for laproscopic surgical procedures that make up most of the SMF and ASC repertoire of surgical services for cardiovascular and orthopedic diseases. In fact The Center for Studying Health System Change (HSC) had site visit findings in 1996-1997 with hospital executives across the nation who reported that surgical admissions were much more lucrative than medical admissions and among the procedures, orthopedic and cardiovascular the most profitable.
Integration versus going your own way
Traditional hospital are costly. Not just a little. They turn a profit by profiting well from specialty procedures and programs that are well reimbursed by payors and these allow the hospital to carry the cost of services that are either break-even or just plain put them in the red, such as ER’s, burn units, trauma centers and generous community education programs and renal dialysis centers.
Of late, between 1990 and 2003, there has been over 90 specialty facilities, built or under construction nationally, with seventy percent partially physician owned with the median ownership if 2% per individual physician. There appears to be less SMH’s appearing where there is a dominant hospital network present, mostly because of more stringent certificate of need regulation, not true for ASC’s, which are more prevalent.
The current trend is in the rendering of specialty services in the cardiovascular and orthopedic disease markets. The sheer increasing number of individuals presenting with both arthritic and cardiovascular conditions justify these specialties as chosen “focused factories”. The synergy of advances in technology, market forces (cost of goods), changes in the physicians practices themselves, increased regulation, paperwork and quality assurance oversight and public policy changes have allowed physicians to consider joint ventures and partnership with large facilities like hospitals and large disease management corporations.
Traditional hospital networks have tried to compete by increasing their own vertical and horizontal integration of healthcare facilities and services. Good “vertical” integration, for example, would involve a specific delineated protocol for transferring patients from large hospital centers to smaller community hospitals, skilled nursing facilities, outpatient specialty clinics, as the medical need changed, therefore keeping their costs under control while maintaining patients within their own network, as they would own all of these affiliated facilities. Efficient “horizontal” integration would involve numerous hospital centers networked together to share resources and possibly specialize in specific diseases, as for example a “diabetes” disease center at one facility but focus on cardiac surgeries in another, thus reducing duplication or equipment and specialized labor costs. Horizontal integration has been in the industry for years in the form of group purchasing of goods by hospital networks, but the creation of specialty centers within hospital networks is more recent. The problem with this setup is that it involves taking patients usually far away from their neighborhoods, so there are access issues, especially for those patients with ambulatory difficulty, and they often happen to be diabetic, cardiovascular or orthopedic surgical patients.
Efficient disease management by its very nature involves close monitoring. Just as the individual must be in touch with his healthcare status on a daily basis, so must a medical oversight team. So for a “focused factory” to be in the most efficient setting it would have to be relatively small (indeed they are, ASC’s have usually 2 to 4 operating rooms) and be located in many communities. Would it not be easier if all of the healthcare teams’ focus was on your specific diseases and your could access these services right in your community? Of course………….enter the justification and need for ASC’s and SMF’s.
These facilities are designed and managed in a way to render surgical services so frequently, with constant repetition that improves accuracy, reduces medical error (reducing possibility of complication and re-hospitalization), improves patient comfort by being in their close community, decreasing overall cost in general by not requiring all the high end capital equipment of full-service traditional hospitals, this is what the proponents say. Critics of these “focused factories” argue that with the entrepreneurs in healthcare that led to the development of this model, and physician ownership, it would lead to “cherry picking” healthier patients for operative procedures, those that are less sick and therefore more profitable. This would in turn lead to the sicker individuals being admitted for surgical procedures at traditional community hospital centers. Hence the profit would stay in the SMF or ASC and the traditional community hospital would be left with the brunt of the lesser profitable patient cases.
Ethics and Policy
This scenario has raised a few eyebrows, and one study by Mark Chassin, in JAMA seems to support that as physicians become owners of healthcare facilities the probability of over-utilization goes up. Is it ethical? There are already federal laws in place to structure, limit and restrict certain types of self-referral for profit (Stark I & II). Do regulators have to step in to force the acceptance of Medicare, Medicaid and some percentage of gratuitous cases to allow an ASC or SMF to be permitted and built? Some regulators believe this is the only way to level the playing field for traditional medical centers, and to provide services where needed. I don’t believe it makes sense myself. Most SMF and ASC currently are now built in regions where there is no certificate of need (CON) legislation required for approval in place. So now there are questions of access to SMF and ASC facilities, so indeed access to care. Indeed, all patients are not welcome. Ethical or not when physicians and healthcare management companies team up, the result is a focus on profitability.
Some hospitals have responded by trying to deny the admitting privileges of physicians that have ownership in other facilities that compete with the hospital for services. Some courts have agreed with the hospital petitioners while the “jury is out” still yet on others. There is a lot a stake, as of 2003, cardiology services accounted for 25 percent of all hospital stays and 35 percent of all community hospitals’ revenue. If community hospitals cannot compete with their “Focused Factory” competition, then they will be forced to cut back on services or negotiate higher prices from payors.
Due to the rise of ASC’s and Specialty Hospitals, state and federal policy makers are considering a variety of legislative changes that will address issues raised about cost, quality and access. What is a known loophole in Stark self referral legislation is that it allows self-referral to “whole” hospitals without restrictions in which physicians have an ownership interest in, but places restrictions on other facilities (SHF’s and ASC’s). In an attempt to curtail the “cherry picking” of healthy patients the American Hospital Association and other organizations have proposed extending the law to specialty hospitals as well. Other legislative proposals include the requiring of the acceptance of Medicare, Medicaid and gratuitous patients; imposing the same patient safety standards and quality standards as traditional hospitals; requiring full service ER’s or have cooperative transfer protocols in place, revising Medicare reimbursement of selected procedures to reduce reimbursement; and revamping certificate of need laws to prevent specialty hospitals from gaining access to markets traditionally dominated by community “full-service” hospitals.
In either scenario, the bottom line is that research shows that higher volume is associated with better quality and leads to lower cost. Applying this to the “Focused Factory” model, it would sure seem that they are positioned to out-compete traditional hospital structures, due to their smaller less complex structure and inherent cost-saving, low capitalization approach and the fact that they have clear cut physician ownership, this leads to less administrative layering and oversight ….a highly motivating factor in both the quality of care and the desire for extreme efficiency.
My vote is for the continued development of the “Focused Factory” model.
References:
1. Casalino; Devers; Brewster (2003) “Focused Factories” Physician Owned Specialty Facitlities”, Health Affairs, 22, no. 6, pp. 56-67.
2. Aspen, Bruce, "Specialty Hospitals Are a Pain for Rivals," Chicago Tribune (Dec. 1, 2002).
3. Chassin,Mark R., et al., "The Urgent Need to Improve Health Care Quality," Journal of the American Medical Association,Vol. 280, No.11 (Sept. 16, 1998); Gray, Bradford, The Profit Motive and Patient Care: The Changing Accountability of Doctors and Hospitals, Cambridge,Mass.: Harvard University Press (1991).
4. Managed Care, May 1998, Herzlinger, Regina E., “Focused Factories will Provide Care”, “A Conversation with Regina E. Herzlinger.
5. Birkmeyer, John D., Andrea E. Siewers, Emily V. Finlayson et al., "Hospital Volume and Surgical Mortality in the United States," New England Journal of Medicine,Vol. 346, No. 15 (April 11, 2002).
6. Lynk,William J., and Carina S. Longley, "The Effect of Physician-Owned Surgicenters on Hospital Outpatient Surgery," Health Affairs, Vol. 21, No. 4 (July/August 2002).
7. Dobson, Al, "A Comparative Study of Patient Severity, Quality of Care and Community Impact at MedCath Heart Hospitals," The Lewin Group (September 2002) (Executive Summary posted on MedCath's Web site at: http://www.medcath.com/index.asp?INTR_%20ElementI%20D=corp_Study).
8. Winslow, Ron, "Fed-Up Cardiologists Invest in Own Hospital: They'll Regain Autonomy but Critics See a Grab for More Profitable Care," Wall Street Journal (June 22, 1999) cites a study by Health Care Report Cards Inc. of Lakewood, Colo., that suggests patients at a MedCath hospital in McAllen, Texas, are less severely ill.
Wednesday, February 27, 2008
Tuesday, February 26, 2008
Our Food - Just Empty Calories?
Unfortunately, America's food source is not what it seems, nor does the food contain the vitamins, minerals, enzymes and available amino acids and proteins required for good nutrition. In order to mass produce, distribute and protect from spoilage, our food manufacturer's and distributors, must irradiate our food with ionizing gamma radiation to kill microorganisms and parasites and protect from the development of toxic microoganisms during storage and transport. Sulphites and Nitrites are also often added to food, which places extra stress on our kidneys when clearing out these chemicals. There are many other techniques, but these i find to be the most troubling as they chemically or structurally modify the actual molecules the food is made of, altering their use as fuel in our bodies. For example, Gamma radiation has the potential of permanently modifiying the actual protein and DNA structure that the food is made of rendering it unusable by the body or what's possibly more troubling, making the proteins mutated in a way that they may cause dysfunctional or even mutated structures in our bodies once incorporated into our cells and tissues. Microwaving foods, especially protein, at prolonged higher temperatures may have a similar effect, and none of these effects and the possible creation of mutated proteins that we ingest have been studied long-term. Much of our food sources are stored in bright Ultraviolet lighting which also has long-term effects of destroying vitamins in food, particularly vitamins, B, C and A and D. So Buyer beware that the stated vitamins and minerals listed on food packaging are not what you are ingesting and absorbing when you eat your chosen foods. It would be in the consumers best interest to choose minimally processed, fresh food and supplement their diet with high levels of B Vitamins, Vitamin C and fresh enzymes, Macro and trace minerals.
For Vitamins, Minerals and Enzymes to improve your health go to www.AcropolisRx.com
--- Dr. Sparta
For Vitamins, Minerals and Enzymes to improve your health go to www.AcropolisRx.com
--- Dr. Sparta
Sunday, February 24, 2008
Trauma and Arthritis
It isn’t thought about much, but slips, falls and car accident trauma such as whiplash or low back strain earlier in life often lead to premature arthritic conditions in middle age. Many of my patients who have had previous trauma find that they have onset of pain, stiffness and swelling after only minor to moderate activity. This is most likely due to deposition of scar tissue, which is not quite identical to the original injured tissue that is created in joints and other connective tissue regions of the body. With time, these “healed injuries” made up of scar tissue regions, contract and age, and often due to poor blood supply and circulation, are not maintained well by the body. Even minor to moderate stress on these tissues, by lifting, repetitious activity, poor body posture or mechanics or exercise for example, may cause reinjury and accelerated changes to the connective tissue made up of cartilage, collagen and elastin fibers. Thus, it is the incomplete repair or healing of previous trauma to connective tissue that will eventually set the stage for premature arthritic changes to joints. It is reported that approximately 47 million adults in the USA have been diagnosed with arthritic conditions by healthcare professionals, with a little over a quarter of these patients saying that it impairs their life significantly enough to seek treatment. A projection by the CDC for 2030 indicates an increase to over 67 million affected Americans. With such a magnitude of people facing premature arthritis, it is truly important to make lifestyle and dietary changes to enable the best chances for connective tissue health, including proper weight management. As the country truly becomes more obese by definition, so will we see a proportionate increase in the incidence of "premature arthritis".
For Arthritis Treatment options go to http://www.acropolisrx.com/
--Dr. Sparta
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