10 Signs You Have a Top Doctor and Dentist

Even if you don't see a doctor all that regularly, having one you can call when you need one is important. After all, who wants to be scrambling to find a doctor when you are not feeling well or have a medical emergency on your hands? But, finding a great doctor and dentist (I mean really top notch!) is even more paramount. Your medical team plays an enormous role in your life helping you create your optimal health as well as diagnosing issues and addressing larger health concerns, too - maybe even some that could mean life or death to you or a family member!

Nope - you can't just accept anyone to be part of that vital medical team for you and your family. But, how do you really know your health practitioners are really that great?  There are a lot of considerations, and it is important to ponder!  So, let's take a moment and do just that!

I have put a short list of a few signs I think indicate you have a good medical team member on your hands. Come take a look and let me know what you think! I would love it if you would add to the list and let me know how you know you have a great doc or dentist, too, or what you think is important to look out for to find a doctor as well.

5 Signs You Have A Great Doc

Shopping for a new doc? Look for these qualities that may indicate you have a winner:

1.  Look for lots and lots of experience.

Quality medical care is not only about internet doctor ratings or where and how many degrees hang on the doctor's wall, but more about how many times the doctor has done the procedure or dealt with the medical issue you are experiencing.  If there is a complicated procedure your child may require or you are managing a chronic illness like asthma, a doc who specializes in your condition is usually a safer bet.  

A doctor that stays up to date with continuing education is key, too.  You want a doctor that is knowledgeable of the latest research and newer procedures. Perhaps he or she teaches at the local teaching hospital, which is a good sign he or she is passionate about his or her work and thinks it is important to give back and stay up on the latest findings.

Don't miss this: Here are 9 top health books you can learn so much from to enhance your healthy living game and help build that relationship with your medical team.

2.  Lean in and listen.

Some people have the real scoop! Especially nurses -- they always know what is really going on! Where would we be without nurses?! Pay attention to what they and the rest of the staff say in the office and hospital about your doctor.  Poke around and ask you friends, your neighbors, extended family that work in the medical world what kind of reputation your doctor has in the medical community, too.  Investigate! 

Don't miss this: Home remedies can play a part to keep you well! I have gathered several home remedies for you and your family to try right here.

3.  Trust and honesty go both ways.

Just like with all your other relationships, honesty and transparency play a role in building trust; naturally, you want that with your medical team, too.  You need to hear the truth about your health, what can be done to improve it as well as how much experience your doctor has in handling it or how successful he or she is at helping to repair it.

In turn, you must be honest and forthright with your symptoms, lifestyle, good habits and bad.  The doctor can't make a correct diagnosis if you are keeping something from him or her.  A good doctor will ask lots of questions to dig deep about your health to get a true picture. But, please, answer them honestly and don't be embarrassed about the answers!

Don't miss this: Here are great questions to ask the growers at your farmers' market to see if the foods are grown using health-promoting practices.

4.  Nice is not necessarily necessary!

That is a bit of a tongue twister! In some situations and if you are dealing with a special condition, the doctor's personality is not the top concern. If the doctor that you have researched to have the best medical outcomes doesn't have the best personality to match and is anything but charming, I wouldn't let that stop you from proceeding.  Being nice is not the most important quality, but being the most technically correct surgeon probably is! I have been lucky enough to get both on occasion and consider it an act of grace! Let me clarify, though, that having a general practitioner that you see more regularly for check-ups and one that you can build a rapport and relationship with is a very, very good idea, though!

5.  Egos are nowhere to be found.

A good doctor will encourage you to seek out more information and other medical opinions and options and even help you to do so! The doctor will also listen to your ideas or research that you have produced.  The doctor should also get to know you and your lifestyle to gain a better picture of who you are and your daily habits and stress levels that could affect your health. Don't trust a doc who tells you they are the only ones with the answers and you shouldn't question him or her.

Don't miss this: A health coach may be a great asset to you! Here is an interview with an awarding-winning health coach that has loads of tips on living healthy and how to find the perfect coach for you.


And, now, on to your very important dental team . . .

5 Signs You Have a Great Dentist

Like a great doctor, a great dentist and hygienist should be part of your medical team.  Your dental health has a big impact on the health of other parts of your body, too! Besides a thorough cleaning and check-up, make sure your dental team checks off these:

1.  All issues start small. 

Early detection is important as many head and neck cancers begin in the oral cavity.  Thus, make sure your dentist does an oral cancer screening that includes checking for lumps in the neck and mouth as well as your lips and the inside of your mouth and throat.

In addition, there are mouth rinses with a dye that help detect lesions. Abnormal cells in your mouth may take up the dye in the rinse and appear blue. Your dentist may also use a special light to examine the inside of your mouth to make abnormal tissues show up easier as well.

Don't miss this: See what other important things dentists can spot!

2.  Don't forget next time.   

Before you leave your appointment for dental cleaning and check-ups, make sure to schedule the next one six months later.  Regular dental check-ups and cleanings keep toothaches at bay and prevent much bigger and painful issues. Good dentists provide reminders through email or phone calls to ensure you don't forget to keep your appointment.

3.  Dental issues, as well as health issues, play a role.  

A great dentist asks about your overall health - not just your mouth! Several health issues affect your dental outcomes. For example, a diagnosis of diabetes may require you to come more often for cleanings. Diabetes is directly related to periodontal disease so extra brushing or flossing may be needed, too. Headaches could be caused by teeth grinding and the dentist can help you there as well. The hormone levels in pregnancies could pose some dental issues as well. Even new medications since your last visit could affect your dental health and should be noted.

Don't miss this: Here is a dental routine that takes 5 minutes a day for your brightest and whitest smile.

4.  Find what is new and maybe even better.  

Bring in any articles or questions to ask of new research on dental care or techniques.  Even a new type of toothpaste or toothbrush should be something the hygienist and dentist should be up-to-date on and discuss with you.  They should always review any new dental care techniques as well.

If you have silver fillings (that probably contain mercury), you may want to consider finding a holistic dentist to replace them with a less harmful substance. 

Don't miss this: You may want to check out how to clean all the brushes you use on your body (including that toothbrush) to avoid infection and breakouts with this super quick cleaning routine.

5.  Machinery and safe practices are critical.  

Ask if the X-ray machines are regularly calibrated and ensure they provide lead aprons and thyroid guards when performing x-rays. And, are the x-rays really even needed? All radiation exposure adds up! Ask!

For Even More On The Topic . . . 

• Thinking of starting a family soon? Wonderful! But check out these critical ways to ensure your body is in top form to grow a baby in perfect health! 

• Your healthy daily habits will make those doctor appointments a rare entry on your calendar. Find loads of small actions you can do to create a healthy daily routine.

Now is your turn!  What do you think makes a doctor or dentist top notch and how did you find your amazing doctor or dentist?

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Two huge new studies further undermine the "obesity paradox"

The "obesity paradox" is the observation that people with higher fat mass sometimes have better health outcomes than lean people, including a lower overall risk of death.  Evidence has been steadily mounting that this finding may be a misleading artifact of the methods used to observe it.  Two massive new studies add to this evidence.

Read more »

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Still No Questions Asked - Journalists Fail to Challenge Talking Points Used to Justify Million Dollar Plus Executive Compensation at New York Non-Profit Hospitals

It's deja vu all over again. I even get to reuse the introduction of a post from one month ago.  As I wrote in May, 2016,...

 The problem of ever rising, amazingly generous pay for top health care managers is a frequent topic for Health Care Renewal.  We have suggested that the ability of top managers to command ever increasing pay uncorrelated with their organizations' contributions to patients' or the public's health, and often despite major organizational shortcomings indicates fundamental structural problems with US health, and provides perverse incentives for these managers to defend the current system, no matter how bad its dysfunction.

In particular, we have written a series of posts about the lack of logical justification for huge executive  compensation by non-profit hospitals and hospital systems.  When journalists inquire why the pay of a particular leader is so high, the leader, his or her public relations spokespeople, or hospital trustees can be relied on to cite the same now hackneyed talking points.

As I wrote last year,  and last month,

It seems nearly every attempt made to defend the outsize compensation given hospital and health system executives involves the same arguments, thus suggesting they are talking points, possibly crafted as a public relations ploy. We first listed the talking points here, and then provided additional examples of their use. here, here here, here, here, and here, here and here. 

They are:
- We have to pay competitive rates
- We have to pay enough to retain at least competent executives, given how hard it is to be an executive
- Our executives are not merely competitive, but brilliant (and have to be to do such a difficult job).

Yet as we discussed recently, these talking points are easily debunked.  Additionally, rarely do those who mouth the talking points in support of a particular leader provide any evidence to support their applicability to that leader.

Bit at least most journalists who inquire into hospital executive compensation used to make an attempt to be "fair and balanced" by also quoting experts who question the talking points.

But not so much lately,...

Million Dollar Plus Hospital CEOs in New York

The Journal News, based in the northern New York City suburbs, ran a series of articles about executive pay and perks at NY hospitals and hospital systems.  The main aricle in the series is here.  A listing of the five highest paid hospital officials is here.  A listing of executive perks, and conflicts of interests affecting the hospitals' and hospital systems' board members is here.  The main article began,

New York's nonprofit hospitals paid millions in bonuses to executives and doctors despite a high-stakes battle to reduce health care spending.

As patients struggled to afford rising medical bills, incentive packages for top hospital executives reached seven figures and approached payouts at Wall Street banks, The Journal News/lohud has found.

Perks at the nonprofit hospitals included first-class plane tickets, chauffeurs and country club memberships. Severance and retirement payments mirrored golden parachutes awarded to for-profit corporate executives.

The article noted that 112 people who worked for non-profit hospitals in the Lower Hudson valley earned more than $1 million.  The biggest pay went to the top executives of the biggest systems:

Bonuses and payments spiked the highest among executives at the helm of major hospital consolidations, data show.

North Shore University Hospital’s President/Chief Executive Officer Michael Dowling topped the list in 2014. He was paid $10.1 million in salary, bonuses and other pay. That is compared to $3 million in 2010.

Dowling’s payments came as the Long Island hospital and its affiliated organization, then North Shore-LIJ, began its ongoing expansion.

The health system, now Northwell Health, has pushed into the Lower Hudson Valley, partnering with Northern Westchester Hospital in Mount Kisco and other regional providers.

Also,

Dr. Steven Safyer, president and CEO of Montefiore Medical Center in the Bronx, was paid nearly $4.9 million in 2014, including a bonus of $1.3 million.

That's an $800,000 increase from the $4.1 million he was paid in 2010. It came as Montefiore bought bankrupt hospitals in Mount Vernon and New Rochelle, and pushed its expansion northward into Westchester County, which now includes a partnership with White Plains Hospital.

Note that Dr Sayfer also was given a hospital-paid car and driver.  

An accompanying article noted the three other highly paid CEOs in New York state, Warren Hern, CEO of Unity Health Systems in Rochester, $7,490,213;  Mark Clement, CEO of Rochester General Hospital, $5,323,856; and Dr Steven Crowin, CEO, New York Presbyterian Hospital, $4,591,728 [who also benefited from a policy allowing first-class or business airfare for flights over 6 hours, and some form of housing allowance.)

Other million dollar plus CEOs in the Lower Hudson valley included John Federspeil, president, Hudson Valley Hospital Center, $2,055,377; Joel Seligman, CEO, Northern Westchester Hospital, $2,043,289; Dr Cary Hirsch, CEO, Bon Secours Charity Health System (Good Samaritan Hospital in Suffern), $1,170,575; Keith Safian,  CEO, Phelps Memorial Hospital Center, Sleepy Hollow, $1,494,760; Lawrence Levine, CEO, Blythedale Children's Hospital, $1,701,471, Edward Dinan, CEO, Lawrence Hospital Center, $1,707,780; Dr Craig Thompson, CEO, Memorial Sloan-Kettering Cancer Center, $2,944,926 (who also got first-class or coach airfare for flights over 6 hours, and some form of housing allowance); and Jon Schandler, CEO, White Plains Hospital, $1.799,952.

The Usual Talking Points to Justify Executive Compensation

The Journal News article also included justifications for this munificent pay by hospital officials that used the usual talking points. 

We have to pay competitive rates

We have to pay enough to retain at least competitive executives


The spokesman for Northwell Health asserted,

The fact that we're located in the New York market ... only increases the competitive pressures on compensation.

Then,

Julius Green, a partner at Baker Tilly, a New Jersey-based accounting firm advising 100 hospitals in the Northwest, attributed expansions and higher pay to growing competition nationwide.

Also, from Blythedale Children's Hospital,

As the [Affordable Care Act] mandates take effect, and the number of insured individuals rise, the need for skilled healthcare workers will surely increase as will the competition for that talent.

Our executives are brilliant

Said Michael West, senior attorney for the New York Council of Nonprofits,

If you're running an organization that has a $500 million budget, you have to have someone with the wherewithal to run it and you have to pay for that.

Said Rachael McCallen, a Montefiore spokeswoman,

Our executives navigate a complex healthcare environment making appropriate investments to ensure a forward-thinking, innovative and responsive care model that provides higher value, lower cost integrated care services.

Furthermore, the next week the Journal News publised an op-ed by William Mooney, CEO of the Westchester County Association, which was devoted to defending the pay of his fellow CEOs.  It started with indignation against anyone who would question the pay of our fearless leaders,

While it is fashionable to cast aspersions on high-income earners, the arguments set forth about the compensation levels of area health-care CEOs are misguided and erroneous.

Then Mr Mooney again hit the talking points.

We have to pay competitive rates

We have to pay enough to retain at least competitive executives

Given that a hospital is a community organization, the compensation of their executives is decided by boards made up of community members who base their decisions on research, competitive market analyses and responsible financial projections.

Our executives are brilliant

Running a hospital is a business unlike any other. First and foremost, hospitals are complex organizations that are about protecting and promoting health, and saving lives.

Also,

A hospital CEO is responsible for overseeing and guiding his or her staff through a maze of financial and regulatory challenges while making sure safety and performance standards are at the highest possible levels.

Third, the technology and infrastructure enhancements that today’s hospital CEO must manage are vast and rapidly changing. The staffing required to support all of these disparate functions encompasses a wide range of skill sets and education. A hospital CEO must understand and manage all of those roles, and must keep an eye on the demands and responsibilities of maintaining new technology.

In addition, the op-ed concluded with the argument:

your readers would be better served by reporting on the qualitative and quantitative benefits our community derives from having the best health-care leaders in the nation at the helm of our local hospitals.

And these leaders to more than manage finances. The op-ed implied that hospital CEOs are personally responsible for savings lives. This can be seen in the quote above under the brilliance argument, and later:

Non-profit status is conferred upon an organization that does something for the public good. Saving lives clearly is in the public’s best interests!

This despite the fact that the majority of CEOs in the article above, and indeed the majority of top managers of hospitals and hospital systems are not health care professionals, and cannot take any direct responsibility for patient care.  This also despite the assertion by Mr West, the senior attorney for the New York Council of Nonprofits, that "hospitals are run like a business,..."suggesting that the people running them might put money, not "doing something for the public good," first.

Also, note that while Mr Mooney extolled the community based boards whose members made such discerning decisions about executive pay, he did not address these members' numerous conflicts of interests.  For example, re some of hospitals and hospital systems with the most highly paid CEOs,

Stephen Friedman was a board member of Memorial Sloan-Kettering in 2014 when the cancer center paid $10.5 million for architectural services from Perkins/Eastman. Friedman’s brother-in-law, identified as Mr. Perkins, is affiliated with the firm, tax filing show. Bradford Perkins is listed as the co-founder and chairman of Perkins/Eastman, according to its website.

Jamie Nicholls was a Memorial Sloan-Kettering board member in 2014. Her spouse was a co-founder of King Street Capital Management, which the hospital paid nearly $700,000 for management fees, tax filings show.

And,

White Plains Hospital disclosed one business transaction involving an interested person. The filing has few details. It reported the name of the interested person as 'Donor #24' and the relationship with the hospital as a 'substantial contributor.' The amount of the transaction was $15,350,345, and the description is 'BUS TRANS.'

And,

New York-Presbyterian paid $440,225 for investment management fees to Coatue Management, which listed its founder and chief executive officer as Philippe Laffont, a hospital trustee, tax filings show.

And,

Kaleida Health in Buffalo paid $121,660 to the Greater New York Hospital Association for participation dues in 2014. James Kaskie, former president and chief executive officer at Kaleida, was also a board member at the association, tax filings show.

Finally, note that neither the main article nor Mr Mooney's op-ed cited any evidence, even anecdotal, that these particular leaders are so brilliant, or that their hospitals are better than average, even in terms of finance, much less actual care of patients.   

No Challenges to the Talking Points

The main article did not include any dissenters who questioned expansive executive pay.  An accompanying editorial in the Journal News could only muster some anemic concern.  It called multi-million dollar compensation for local non-profit hospital system executives "unsettling."  It did contrast ever rising executive pay with the difficulty patients have paying their bills.  But it could only muster conclusions that mirror the talking points:

Hospitals are quick to defend their executives' rising compensation, and their arguments are good ones. Chief among them is that hospitals must compete for the best top officials, including with for-profit hospitals across the U.S. They say they need to attract and keep leaders who can competently oversee growing health-care systems, meet ever-changing government regulations and improve patient care and satisfaction.

So, all they called for was disclosure of compensation:

Hospital executives deserve fair pay for hard work; taxpayers deserve to know that resources are being used to attain quality care for all.

Although Mr Mooney seemed to see "aspersions" in the article,  and thought "the article implies that hospital CEO compensation is somehow responsible for the continued rise in healthcare costs," and argued that "hospitals do not deserve to have nonprofit status," I could find no such challenges in the Journal News series to the notion that top non-profit hospital managers deserved every penny they got.

Conclusion

Sadly, the ever rising compensation of top health care managers seems to inspiring less, rather than more skepticism in the media.  No more is it true that  nearly all articles that try to delve into executive compensation at all at least quote some experts who are skeptical of current practices.

The Journal News series included no such attempts at balance.  In my humble opinion, while it reported on useful facts, the opinions it contained leaned towards propaganda for managers' current privileged position in health care. 

Despite all the blather about how top hospital executives deserve millions of dallars, there are real reasons to be skeptical.  As we discussed here, there is a strong argument that huge executive compensation is more a function of executives' political influence within the organization than their brilliance or the likelihood they are likely to be fickle and jump ship for even bigger pay.  This influence is partially generated by their control over their institutions' marketers, public relations flacks, and lawyers.  It is partially generated by their control over the make up of the boards of trustees who are supposed to exert governance, especially when these boards are subject to conflicts of interest and  are stacked with hired managers of other organizations. 

While Mr Mooney was indignant that high executive pay may be considered a reason that hospital charges and health care costs are rising, he did not even discuss the argument that the current method of determining such pay may provide perverse incentives to grow hospital systems to achieve market domination, raise charges, and increase administrative bloat.  As an op-ed in US News and World Report put it about executive pay in general,

But the executive pay decisions made inside corporate boardrooms have an enormous impact in the outside world. Outrageous pay gives top executives an incentive to behave outrageously. To hit the pay jackpot, they'll do most anything. They'll outsource and downsize and make all sorts of reckless decisions that pump up the short-term corporate bottom line at the expense of long-term prosperity and stability.

So I get to recycle my conclusions from my last post in this series....

We will not make any progress reducing current health care dysfunction if we cannot have an honest conversation about what causes it and who profits from it.  In a democracy, we depend on journalists and the news media to provide the information needed to inform such a discussion.  When the news media becomes an outlet for  propaganda in support of the status quo, the anechoic effect is magnified, honest discussion is inhibited, and out democracy is further damaged.

True health care reform requires ending the anechoic effect, exposing the web of conflicts of interest that entangle health care, publicizing who benefits most from the current dysfunction, and how and why.  But it is painfully obvious that the people who have gotten so rich from the current status quo will use every tool at their disposal, paying for them with the money they have extracted from patients and taxpayers, to defend their position.  It will take grit, persistence, and courage to persevere in the cause of better health for patients and the public. 

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New AMA President Andy Gurman, MD on EHRs: " I don't have one, and no one can make me use one."

The love-fest with EHRs continues, to the great chagrin of the believers in fairies, unicorns and cybernetic utopia.

Andy Gurman, MD, Takes Reins as AMA President
Jun 17, 2016
Gale Scott, HCPLive
http://www.hcplive.com/medical-news/andy-gurman-md-takes-reins-as-ama-president

The American Medical Association’s new president, Andrew W. Gurman, MD, known for his affability and quick wit, is not one to seek out controversy.

In an interview before being sworn in this week as the AMA’s annual meeting in Chicago, IL, Gurman said he has no agenda for his tenure at the top of the organization.

Considering the mass hatred of EHRs by physicians (and nurses), the issue of EHR-related harms, compromised patient data security, physician scorecards, and other noxious issues, maybe he should have an agenda.  E.g., see my Jan. 28, 2015 post "Meaningful use not so meaningful: Multiple medical specialty societies now go on record about hazards of EHR misdirection, mismanagement and sloppy hospital computing" at http://hcrenewal.blogspot.com/2015/01/meaningful-use-not-so-meaningul.html.

... Though physicians’ anger over the frustration of using existing electronic health records was a major topic of conversation at the [annual AMA] meeting, Gurman said he had little to add other than no one could make him use one.

 “I don’t have an EHR,” he said. Due to the fact that he runs his own practice he found it easier and cheaper just to forgo the enhanced payments he would get under the federal “meaningful use” regulations for converting to electronic records. “I just take the penalties,” he said.

Not every physician can afford the time sink most EHRs represent, and the increasing penalties for non-users, unfortunately.

Perhaps on the AMA agenda should be a return to sense regarding physician and nurse documentation, with significant reduction in their clerical burden for starters.

-- SS

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Healthy Eating Tricks Every Mom Should Know

Getting your family to make healthy food choices or stick to even a tiny semblance of a healthy eating plan - well, that that can be down right exacerbating to many Moms and Dads!  Could it be that you have heard someone at your house utter one of these recently . . . or maybe even said this to yourself?

• "Those vegetables are mushy and taste bad!'
• "My friends don't have to eat this!"
• "Preparing healthy foods to eat takes so much thought."
• "It is just easier to go through the drive-thru."
• "It is so expensive to eat healthier!"

Okay, so there are few small elements of truth in some of those claims.  But, allow me to assist with a few healthy tricks to help you create some magical healthy eating at your house without too much civil unrest! So. keep reading to steer around some of those obstacles and make eating right and family meal planning a whole lot easier as well as a whole lot more successful at your house, too!

2 Big Points To Remember When Creating Healthy Eating Habits 

Here are two points to keep in mind when you are trying to create healthy eating habits at your house:

• You absolutely have the power to create the new healthy norm! Yes, in the beginning, it is work to change unhealthier ways and begin anything new, and convincing others at your house to follow along and eat right can add to the burden. But, that is temporary.  Once you form a diet plan that works for you, the choices and family meal planning become a lot easier. New habits form to replace the old! Remember, it can be gradual! Change the biggest offenders first, and go from there.  

• Anything worthwhile takes effort.  I bet you can see the value in feeling better, looking better, having more energy and giving you and your family more time and more money in your pocket. After all, in the long run, it is less expensive to eat right, practice disease prevention and pursue the best health because you won't be making time-consuming and expensive visits to the doctor or missing work, but instead, enjoying life a whole lot more!

It makes logical sense to me and if it does to you, too, but creating a healthy eating plan still feels rather overwhelming, come see a few ways you can trick yourself (and the others in your family) to make the whole process of eating right second nature and a part of your daily life. And, if you have young children at your house, pay special attention to the last section of tips to let those precious ones start life off right!

15 Ways To Trick Yourself (And Your Family) Into Eating More Healthy  

Read this list below and see if any of these maneuvers could work for you and your family to implement and stick to a healthier eating plan. I have included a few links to other articles I think could help explain things more deeply as well as a few affiliate links to books and tools I think you may find helpful and inspiring as well:

1.  Begin at the beginning.

I want to make two points about those critical beginnings:

A.  Your start to the day can really set the intention for the rest of it. Chances are that starting off right can usually mean ending it right.  Starting off badly with an unhealthy food choice like pastries and doughnuts first thing in the morning sets the mindset to say, "We will start eating healthy tomorrow." Those first choices of the day can carry a big impact. Set out your healthy breakfast the night before so you don't even think about other options.

Don't miss this:  If you or your children don't have a big appetite in the morning, drinking to your health may be a good option. Try some healthy and delicious smoothie ideas here and if you ever begin your day with eggs, find the right ones you should be buying here. There is a difference in nutritional make-up, studies show.


B.  Beginning each meal with the healthiest of your choices. Dig into that salad first, those vegetables first or at least a lot of them. That way, you fill up on the health-promoting stuff first. Try serving the salad before anything else at your house and let everyone begin with that before you bring on the next dish.

Don't miss this:  Speaking of salads, try some of these tasty ones I pinned here that your family will love.


2.  Brown bag it.

Packing you own healthy lunch is a great way to save money as well as pack in some nutrients. And, I can guarantee, a healthy lunch will sustain you and your kids for the rest of your day to get more done and have a smile on your face doing it!  I have always sent my kids to school with healthy packed lunches and the others kids have always begged them for a bite!

Don't miss this:  Packed lunches don't have to be boring or complicated.  Look what amazing healthy things others put in their lunch sacks. 



3.  Make it nutrient dense.  

Some foods carry extremely high levels of nutrition even over other nutritious foods. Learn what they are (I have a whole Pinterest board dedicated to superfoods here.) and incorporate those foods in your meals as much as possible.  Some of these superfoods can be used in very small amounts sprinkled in your smoothies, sauces, soups, and spreads to provide opportunities to make your meals even healthier.

Don't miss this:  These healthy drink recipes provide amazing energy and are delicious and nutritionist-approved!

4.  Put pencil to paper.

Create notes on your cell phone or whatever way is easiest for you to record what you are eating. Sometimes doing this just for a few days to a week or two helps you see what you are doing right and where you fall to temptation and need to improve. It also may show you how you feel or your children feel when you eat certain foods, too.

5.  Cook every other day.

Don't like to cook a lot? That's okay. When I have a busy week ahead, I cook some healthy dishes with enough for two days and just cook every other day.  Round out the second day with a simple salad or other raw vegetables.

Don't miss this: Here in one healthy sauce my family loves that can make 5 different dinners all week super fast!




6.  Make plans.

If you take the time one day a week and plan out at least your main meals and make a grocery list accordingly, you will save an enormous amount of time and money. No over buying when you have your meals planned. No wandering about your pantry or pondering about what to make for dinner. You got it all planned.  Dinner comes together so much faster and so much healthier.  Plan some easy stuff and maybe one new dish to try a week. Ask your family for their healthy favorites to get buy-in for dinner time. Let them help prepare it, too!

Don't miss this: I showed you how to create a healthy kitchen and set it up right and it was there that I talked about having a chalkboard with the dinner plans posted for the week with buy-in from the family. Take turns featuring family members' favorites.



7.  Make it pretty.

If your food looks appetizing, it makes the whole dining experience an occasion!  Even a sprinkling of fresh herbs or spices at the end of preparation can do wonders and they contain so many healthy properties too!

Don't miss this: If you are so inclined and handy with a knife, here are some amazing shapes to create to get your kids to eat all those veggies up!

8.  Don't go near a grocery store with hunger pangs.

Always food-shop on a full stomach with a written list. I don't know about you, but stopping by the store when I am hungry (or anyone else I am with), everything starts to look good, even . . . the not so good.

Do take your children shopping with you.  Our family enjoys the farmers' markets especially with our Giant Schnauzer with us, too.  The food samples, the other pets there, and the music and fun atmosphere certainly don't hurt the association it can create with healthy foods.

Don't miss this: Learn best questions to ask growers and other tips with my Farmers' Market Mini-Guide.


9.  Don't be a saint all the time. 

If you and your family know you won't be giving up your favorite vices all the time, it makes it easier to abide by your guidelines if you allow yourself a cheat day or meal where you get to indulge in a few bites of your favorite rich desert or Mama's special sauce. Yes, eat what you want for that cheat, but stop when you feel full and don't overdo.  And, don't blow it so much that you just undid everything you strived for all week! But, enjoy those yummy bites and no guilt! And, let your children do that, too!

Avoid scolding your kids over poor food choices. However, it does not harm to point out possible connections with those choices, though, such as headaches, tummy ache, fatigue. Or even for older kids, there could be a connection to a bad skin breakout, mood swings, low energy, etc. Of course, point out how good food choices may make them feel energized, happy, and be headache and tummy ache free, too!



10.  Get inspired.

Allow others to spark your creative eating pursuits. Ask your friends how they eat well. Follow some great healthy eating blogs and pin boards. A few minutes poking around to see what others are doing can be so much fun and keep you motivated to join the movement!

Don't miss this:  Peek on over at these food blogs that make eating healthy extremely easy!

5 Healthy Eating Tips For Parents of Young Children

Here are 5 more tips to get your children to be healthy eaters:

11.  Put away your food-police badge.

Forcing kids to eat foods they hate most likely will not achieve what you want.  Besides, it really is not respectful and teaches them very little except for resentment and frustration. Instead, keep a healthy kitchen stocked with great healthy choices.

For self-serve snacks, create a healthy snack drawer and shelf in the fridge with healthy nutritious foods they can reach themselves. Let them start young to make their own decisions about what to eat (from an assortment of healthy options), to begin taking responsibility for their nutrition and care for their bodies.

Continue to serve some familiar favorites but introduce a few new healthy dishes each week - at various meals.  Begin trying to replace the biggest offenders first and go from there.  Remember, it could be really easy like a flour switch for their pancakes they may not even notice or choosing pasture-raised eggs rather than the commercial choices.  Keep trying! Kids often need several introductions to a new food before they may like it.  Be calm and respect their feelings and don't get upset if they refuse it for a while.


12.  Spend time at healthy places.

Check out these fun outings with a message:

• Visit a farm that produces foods in the right way for us and our environment.
• Go to restaurants with healthy menu choices and teach your children how to order.
• Take a healthy cooking class together for parents and children.
• Grow your own food. Let your children pick a favorite fruit or vegetable to nurture.
• Read books together that talk about healthy foods, gardening, etc.

Don't miss this: Young children LOVE this book and it helps them learn the connection between food and health and this children's cookbook gets great reviews, too.

13.  Sneaking is okay -  up to a point.

No deceit, but I think it if fine to throw in some spinach with their fruit smoothie or substitute healthier grains at dinner time and of course, toss in a new vegetable in your stir-fry.



14.  Be playful.

Teach them why you serve the foods you do and what it can do for them.  For example, you can point out that blueberries feed their brain to learn, red peppers keep them from catching a cold, etc.  Then, when serving it to them or shopping with them, see what they remember.  Make it a game and teach them the connection between the foods they choose and how it makes them feel and support their health.

Little children can't resist a fun plate with colorful foods presented in cute ways and shapes. Surprise them in their lunch box! This tool (under $6) can make creating fun food a snap!

15.  Just ask!

Ask your children to describe the foods they like. what they don't like. such as textures, tastes, smells, etc.  Then you can learn what turns them off and try to alter it.


So, what did I leave off? I am sure you have plenty of tips to add to what works for you and your family. I would love to hear them!


This post previously appeared on THM but has been updated.

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Reckless indifference to nurse's concerns about bad health IT results in showing her the door?

At numerous past posts I referred to hospital executives' reckless indifference to the concern of seasoned clinicians about bad health IT, such as at  http://hcrenewal.blogspot.com/2013/07/rns-say-sutters-new-electronic-system.html and  http://hcrenewal.blogspot.com/2013/11/another-survey-on-ehrs-affinity-medical.html and other posts.

I now see a stunning story of the results of EHR iconoclasty and patient advocacy:

CNO claims hospital forced her out after she raised concerns about EMR
Becker's Hospital Review
Written by Akanksha Jayanthi  
June 14, 2016 
http://www.beckershospitalreview.com/legal-regulatory-issues/cno-claims-hospital-forced-her-out-after-she-raised-concerns-about-emr.html

 A former nursing executive at Sonoma West Medical Center in Sebastopol, Calif., has filed a lawsuit against the hospital, alleging she was fired after raising concerns the EMR was a threat to patient safety, reports The Press Democrat.

Autumn AndRa, RN, was serving as CNO of the hospital when she approached CEO Ray Hino and said the EMR, called Harmoni, was unsafe, according to the report.

Ms. AndRa was reportedly terminated from her CNO position April 14 and was offered a position in the intensive care unit, which her attorney Daniel Bartley told The Press Democrat would have been a demotion. Ms. AndRa left the hospital due to alleged harassment, according to Mr. Bartley.

If these allegations are true, a clinician, the Chief Nursing Officer, was shown the door in an act of recklessness for her complaining about bad health IT.

Some definitions: 

Bad health IT:

Bad Health IT is ill-suited to purpose, hard to use, unreliable, loses data or provides incorrect data, is difficult and/or prohibitively expensive to customize to the needs of different medical specialists and subspecialists, causes cognitive overload, slows rather than facilitates users, lacks appropriate alerts, creates the need for hypervigilance (i.e., towards avoiding IT-related mishaps) that increases stress, is lacking in security, lacks evidentiary soundness, compromises patient privacy or otherwise demonstrates suboptimal design and/or implementation.   

Reckless indifference:

Deliberate indifference is the conscious or reckless disregard of the consequences of one's acts or omissions. It entails something more than negligence, but is satisfied by something less than acts or omissions for the very purpose of causing harm or with knowledge that harm will result.

A wrongful termination lawsuit was apparently filed:

... The lawsuit alleges the EMR system mixes patients' records, so information in one patient's chart moves to another patient's chart. It also alleges the EMR has issues tracking and updating patient medications and does not display patient code status information, which informs providers of patients' desired medical interventions, according to the report.

These types of gross defects, if true, represent an on its face menace to patient safety.

Further, these issues (and the harm that may result) are well known.  In fact ONC's contractor RIT just released a comprehensive review article on health IT problems (see "Report of the Evidence on Health IT Safety and Interventions", May 2016, at https://www.healthit.gov/sites/default/files/task_8_1_final_508.pdf).

CEO Ray Hino had the usual refrain seen in so many postings here (under the blog query "Patient care has not been compromised" - http://hcrenewal.blogspot.com/search/label/Patient%20care%20has%20not%20been%20compromised):

Mr. Hino told The Press Democrat the EMR did not pose any danger to patients, and no patients have been harmed because of software defects.

Like most others uttering that line, as I've documented, Mr. Hino apparently lacks expertise (e.g., in clinical, IT or Medical Informatics domains) to render such a judgment about patient danger if the EHR did or does exhibit such problems.  His bio is at https://www.linkedin.com/in/raymondhino.

As to whether patients were harmed, that is irrelevant if the EHR has such defects.  Sooner or later, they will be.  The issue is risk, not body counts (yet).

There's also this.  The EHR in question is not the product of the major EHR vendors but the work of apparent insider.  See http://about.harmonimd.com/usa/ referencing just two implementations, one at Somona West Medical Center, California, the subject of this post, and one at the Kilimanjaro Christian Medical Centre, Tanzania, Africa:

... The lawsuit also names Dan Smith, the developer of the EMR software in question, as a defendant. According to the lawsuit, Mr. Smith "has engaged in retaliation against [Ms. AndRa] and other employees who have voiced concerns that Mr. Smith's electronic medical records system, his self-dealing, and his management of medical and financial decisions are not in the best interests of SWMC and pose life-threatening risks to patient care," reports The Press Democrat.

Not only did Mr. Smith develop the software in question, but he is a significant financial backer and influencer at SWMC. According to a 2015 report from The Press Democrat, Mr. Smith and his wife have contributed nearly $9 million to the hospital in donations and forgivable loans, and he plays a role in "ever major decision" regarding the hospital. Mr. Smith is on SWMC's board of directors. 

I really don't think injured or dead patients (or juries) will find those relationships an excuse for bad health IT, what seems like a clinical trial of new IT by a private company and owner without informed consent (including divulging to patients and users a possible COI), and the discharge of someone complaining about it.

Mr. Smith and hospital officials declined to comment on the lawsuit, citing pending litigation, according to the report.

My expertise is available should the parties so desire.

-- SS

6/21/2016 Addendum:

https://en.wikipedia.org/wiki/Human_subject_research 

Human subjects

The United States Department of Health and Human Services (HHS) defines a human research subject as a living individual about whom a research investigator (whether a professional or a student) obtains data through 1) intervention or interaction with the individual, or 2) identifiable private information (32 C.F.R. 219.102(f)). (Lim, 1990)^[2]

As defined by HHS regulations:

"Intervention"- physical procedures by which data is gathered and the manipulation of the subject and/or their environment for research purposes [45 C.F.R. 46.102(f)]^[2]

"Interaction"- communication or interpersonal contact between investigator and subject [45 C.F.R. 46.102(f)])^[2]

"Private Information"- information about behavior that occurs in a context in which an individual can reasonably expect that no observation or recording is taking place, and information which has been provided for specific purposes by an individual and which the individual can reasonably expect will not be made public [45 C.F.R. 46.102(f)] )]^[2]

"Identifiable information"- specific information that can be used to identify an individual^[2]

Human subject rights

In 2010, the National Institute of Justice in the United States published recommended rights of human subjects:

• Voluntary, informed consent
• Respect for persons: treated as autonomous agents
• The right to end participation in research at any time^[3]
• Right to safeguard integrity^[3]
• Benefits should outweigh cost
• Protection from physical, mental and emotional harm
• Access to information regarding research^[3]
• Protection of privacy and well-being^[4]

-- SS

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CORRUPTION OF CLINICAL TRIALS REPORTS: A PROPOSAL

CORRUPTION OF CLINICAL TRIALS REPORTS:

A PROPOSAL

There is a disconnection between the FDA’s drug approval process and the reports we see in medical journals. Pharmaceutical corporations exploit this gap through adulterated, self-serving analyses, and the FDA sits on its hands. I suggest we need a new mechanism to fix the problem – by independent analyses of clinical trials data.

When they analyze and publish their clinical trials in medical journals, pharmaceutical corporations have free rein to shape the analyses. The FDA conducts independent analyses of the data submitted by the corporations, and it may deny or delay approval. But the FDA does not challenge the reports that flood our medical journals, both before and after FDA approval. It is no secret that these publications are routinely biased for marketing effect, but the FDA averts its gaze. That failure of the FDA – a posture known as enforcement discretion – has been well documented. The question is why? At the same time, exposing the biases has been difficult for outsiders because the data are considered proprietary secrets.

A Case Study

Now, a detailed example of deliberate corporate bias has finally been documented, through materials released in litigation. This exposé was reported by Drs. Jon Jureidini, Jay Amsterdam, and Leemon McHenry. Their findings were recently published, and their article is freely available on-line. This example concerned a clinical trial of an antidepressant drug in children and adolescents. The drug, citalopram, was already approved for use in adults, and its off-label use in children would spread if there was published supportive evidence. An Investigational New Drug (IND) protocol and plan of analysis were filed by Forest Laboratories with the FDA in 1999. The trial was completed in 2002, and the results were publishedin American Journal of Psychiatry in 2004 – but the FDA did not accept the results as sufficient to approve this drug for use in children or adolescent patients. By that time the patent on citalopram had expired and Forest Laboratories introduced a virtual twin drug, escitalopram (single active enantiomer). That more expensive version of citalopram was heavily promoted, and it was approved in 2009 for use in children, but even then the FDA specifically noted that safety and efficacy were not established in children under age 12. Since then, new analyses suggest that most antidepressant drugs have little evidence of efficacy even in older children.

Tricks of the Trade

In service of a positive report, the statistical analyses performed by Forest Laboratories deviated from the IND plan of analysis, and negative results were edited out. The biases now documented by Dr. Jureidini and his colleagues for that 2004 sponsored reportin American Journal of Psychiatry included:

·       Inflating the main measure of the drug's effect by reporting an incorrect and clearly exaggerated effect size. On being challenged, the authors later explained their misinformed computation without actually acknowledging the error.

·    Failure to report secondary measures of response because they were negative. Those measures had been stipulated in the IND protocol to serve as cross-checks on the main result. These negative findings were airbrushed out of the publication by corporate marketing.

·    Unplanned, new secondary measures of response were inserted ex post facto because they were positive (that is a real no-no).

·    Violations of the IND protocol were not reported and were then fudged (patients who had properly been excluded per protocol were put back in for analysis, which made a nonsignificant primary outcome analysis turn positive).

·    Adverse events were analyzed and summarized in a misleading way.

·    The finding that the drug had no effect on depression in children under age 12 was not reported, even though an age-effect interaction analysis had been specifically projected in the IND protocol. This strategic omission left the impression that off label use of citalopram in younger children could be clinically reasonable.

·    The corporation knew that another, unpublished, trial in children, conducted by their European partner Lundbeck was negative, and that it raised concerns about suicide risk, but that information was withheld. The authors later were challengedin the journal about this concealment. Their responsewas utterly disingenuous.

·    The published article failed to acknowledge that it was authored by a non-medical ghostwriter, who took direction from marketing executives – the 2004 publication was a marketing product purporting to be an objective scientific report.

·    Academic authors were recruited only after the manuscript was written, reviewed, and approved in-house – these nominal academic authors were signed on to front for the corporate narrative.

·    The perfunctory role of the academic (ahem) authors is clear from the fact that they failed to recognize the wildly inflated effect size claimed for the drug – something that was instantly obvious to several groups of competent readers.

The Payoff

These changes created the appearance of a positive result, and the publication drew wide attention. According to Thomson Reuters Web of Science, it has been cited over 160 times, placing it in the top 5% of cited articles in clinical medicine from 2004. This early publication gave plausible justification for off-label use of citalopram/escitalopram in children, even with FDA approval having been denied, and even though the trial was actually negative. The FDA has reported that between 2005 and 2010 well over 750,000 patients up to age 17 received escitalopram, including almost 160,000 under age 12. Thus, the sleight of hand about failure to show even fudged efficacy in younger children is especially deplorable. Internal memoranda reproduced in the exposé by Dr. Jureidini and his colleagues give a clear picture of the corporate manipulation of the scientific publication process. Now we know – in black and white – just how bad the bias can be. This kind of data manipulation, with ad hoc cherry picking and moving of goalposts, is unacceptable, but it is entrenched. Indeed, it is business as usual – and the FDA looks away.

A Specific Proposal

Our primary defense against such perversions of scientific reporting is fidelity to the registered IND protocol and plan of statistical analysis. The solution is not hard to see: We need independent analyses of clinical trials because we cannot trust the corporate analyses. In effect, we need something like the Underwriters Laboratory to verify the statistical analyses of clinical trials. Nobody takes the manufacturing corporation’s word for it concerning the safety and performance of X-ray machines or cardiac defibrillators. Why treat the statistical analysis of drug trials any differently? It’s highly technical work.

Who should assume that responsibility? Why not the FDA? After all, they alone see all the data. My specific proposal is for Congress to mandate that the FDA analyze all clinical trials data strictly according to the registered protocols and analysis plans. That requirement should apply to new drugs or to approved drugs being tested for new indications. It should apply also to publications reporting new trials of approved drugs. Corporations and investigators should be prohibited from publishing their own in-house statistical analyses unless verified by FDA oversight.

Why Bother?

There are three good reasons for prohibiting in-house corporate analyses of clinical trials data. First, as the present example illustrates, the inherent conflict of interest is simply too great to be ignored. Second, when corporate statisticians who answer to marketing executives get “creative” in the ways exposed here, then the conditions for valid statistical analyses no longer apply – the statisticians are then on a fishing expedition and they are no longer testing the defined study question with fidelity to the methods specified in the IND protocol. In that case, any nominally significant statistical findings are just exploratory, not actionable – not good enough to justify off-label use of the drug, especially when properly evaluated alternatives are available.

Third, there can be no justification for treating the production of influential publications in medical journals any differently than we treat the production of potent drugs. Our FDA continuously inspects production facilities for evidence of physical adulteration, even as far away as China. They now need to monitor the adulteration of clinical trials reports in medical journals. The harms of adulterated analyses can be just as serious as the harms of adulterated products.

Push Back from Pharma?

We can expect the pharmaceutical industry to mount a First Amendment challenge to this proposal. It will fail, because the public health is too important. Just as there is no First Amendment right to shout fire in a crowded theater, so also corporations have no First Amendment right to say a drug is safe and effective when they know it isn’t. That is a betrayal of patients.

The corporations will also claim piously that their publications undergo peer review. Sadly, that is no barrier to this pervasive corporate bias because the peer reviewers for medical journals don’t see all the real data – they see only the data the corporation wants them to see. Only the FDA sees all the data. We can no longer cling to the myth of informed and unbiased peer review of clinical trials reports. The corporations rely on that myth as a fig leaf to support their First Amendment claims and to defend their practice of in-house statistical analyses. Moreover, medical journals also are subject to bias and conflict of interest. We could note that the Associate Editor of American Journal of Psychiatry in 2004 was also a major U.S. key opinion leader for Forest Laboratories. According to one of the released depositions, he was instrumental in securing acceptance of the report by the journal.

Business as Usual?

The present example is not an isolated case. Dr. Jureidini and his co-authors described several similar, recent examples. One of those was the reanalysis by Jureidini and others of an infamous trial of paroxetine for pediatric depression. And still, fresh exposés keep appearing. The latest is from Lisa Cosgrove at the University of Massachusetts in Boston and her colleagues, involving “ghost management of the information delivery process” for another new antidepressant drug, vortioxetine – available on-line here. (What is it with the antidepressants, anyway?) On this Health Care Renewal blog, Roy Poses has called attention to these issues. As recently as June 8, 2016 he discussedthe Transparency International report on corruption in the pharmaceutical sector.

Eric Topol, who helped to expose the Vioxx scandal, made similar points recently in a BMJ commentary: “The bad science in clinical trials has been well documented and includes selective publication of positive results, data dredging, P hacking, HARKing, and changing the outcomes that were prespecified at the beginning of the study…. Furthermore, the disparity between what appears in peer reviewed journals and what has been filed with regulatory agencies is long standing and unacceptable.”

It’s No Time for Old Solutions 

As the eye-popping numbers of children treated with escitalopram show, even off-label use of an undistinguished drug in a niche population can be highly profitable. That is why I am proposing that the statistical analysis of clinical trials data can no longer be entrusted to pharmaceutical corporations, on account of their massive inherent conflict of interest. Open access to patient level data, as well as pre-registration of protocols and of data analysis plans, have been actively promoted for some years now to clean up the corporate bias in clinical trials. These are positive developments, but they will not close the disconnection highlighted just above by Dr. Topol. The once idealistic world of clinical trials has changed irreversibly in the past 30 years. As one observer has noted, “… in the course of time the coordinated actions of industry, government, and the biomedical research community have degraded the basic rules of empirical science…” We would do well to acknowledge this fact, and to recognize with Abramson and Starfield that “The first step is to give up the illusion that the primary purpose of modern medical research is to improve Americans’ health most effectively and efficiently. In our opinion, the primary purpose of commercially funded clinical research is to maximize financial return on investment, not health.”

When corporations are involved, there is no point in prolonging the myth of noble and dispassionate clinical scientists searching for truth in clinical trials. It’s over. We would do better to stop pretending that corporate articles in medical journals are anything but marketing messages disguised with the fig leafs of coöpted academic authors and of so-called peer review. The case study reported out by Drs. John Jureidini, Jay Amsterdam, and Leemon McHenry shows us the real face of business as usual in commercial clinical trials. That being the case, it makes no sense to expect corporations and academic key opinion leaders suddenly to reform their biased and conflicted behavior. Only a structural change from the outside like I propose here has any chance of succeeding. The statistical analysis of clinical trials is too important to be entrusted to the sponsoring corporations.

It is time for Congress to grasp this nettle. The time for enforcement discretion is past, and we need Congress either to direct the FDA to act or to create a new mechanism of oversight. To do nothing would be unthinkable.

Bernard J. Carroll

Professor and Chairman Emeritus,

Department of Psychiatry, 

Duke University Medical Center.

E-mail: bcarroll40@comcast.net

The writer is a former chairman of the Psychopharmacologic Drugs Advisory Committee, Food and Drug Administration, U.S Public Health Service.

Acknowledgment: Several colleagues commented and made suggestions on drafts of this post – in particular John M. Nardo, MD, Donald F. Klein, M.D., and Patrick Skerrett from STAT News.

Update 06-23-2016:  This post was cross-posted on Naked Capitalism, where some interesting comments can be found.

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A Plea from a Traveling Blogger

A thousand apologies - since the Society for Medical Decision Making meeting in London, we have been traveling in the UK, and I have been unable to find the time to post on the blog.  But in exchange we have caught up with good old friends, met lovely people, and seen fabulous sights and beautiful country.  I plan to return very soon, and then after much catching up, will then resume normal activity.

But a reminder - a comment on our latest post suggested that Health Care Renewal does good work, but requires more effort. 

Yet, all our blog posts are written by volunteers who have day jobs or are retired.  At the moment, we have no real budget, no paid staff, no investigators, no researchers, no paid legal counsel, much less communications and public relations specialists.  If more effort is required, it may have to come from YOU, dear readers.  If you think that casting light on the issues we discuss is important, and taking action to improve health care dysfunction is more important, YOU also need to do something.

Of course, we would greatly appreciate contributions to FIRM -  the Foundation for Integrity and Responsibility in Medicine, the tiny non-profit organization which we formed to provide support to the blog and similar dissemination, education and advocacy efforts to address health care dysfunction.  FIRM is a US 501(c)3 non-profit and so contributions are deductible in the US to the extent provided by law.  You can send contributions to FIRM at 16 Cutler St, Suite 104, Warren, RI, 02885, USA.  Or email me (info at firmfound dot org) with questions.

If FIRM had real money, maybe we could develop a staff and do a lot more to shine light on the dark side.  However, what is really required is effort by more than one organization and a few volunteer bloggers.   Consider doing something yourself.  Write a guest blog post for us, start your own blog, write a letter to the editor, an op-ed, or a journal article.  Write your legislator.  Meet with your legislator's staff.  Organize a group of like minded people and do something organized.  If you are a health professional, try to do your work in a way that will address health care dysfunction.

Howwever, do not expect it to be easy.  There are many people personally enriching themselves through the current system.  They will do all they can to preserve the status quo.  They may command vast marketing, public relations, lobbying, and legal resources (all ultimately paid using other peoples' - often your - money) to maintain the status quo.

Saying something to combat the anechoic effect is hard.  Doing something is harder.  But if we don't do something, it will all get worse.

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9 Health Books To Help You Heal Naturally, Eat Well And Boost Your Energy

I love to slip away, find a quiet spot and bury my nose (and my brain!) into a good book.  And, some of the books, being of the health-minded that I am, are, naturally . . . health related.  I thought I would share some of my favorite health books (as well as some others on my list I want to read) that you may want to crack open and pour over to learn a lot, too.  The writers are the real deal - doctors, chefs, naturopaths, researchers and more, and a few of these wellness books might even be considered healthy living classics. Come take a look and see which health book you may want to read first!

Top Health Books For Fitness, Nutrition and Natural Healing

See if any of these books on wellness catch your interest to deepen your quest for healthy living. Tap on the title to take you to a link for more information or if you would like to purchase it on-line.  I only link to items I think are of excellent value:

1.  Prescription for Nutritional Healing: A Practical A-to-Z Reference to Drug-Free Remedies by Phyllis Balch

This book belongs front and center on your reference shelf to begin your quest for a more holistic answer to any of your health woes, digestive issues or any nutritional questions you may have.  It is always a great place to start and is a no-brainer for under $8!



2.  Clean Eats by Dr. Alejandro Junger

I reviewed Clean Eats here fully. I still turn to it for inspiration for my weekly meal planning for whole food cooking that is not too complicated and for meals I look forward to eating!



3.  Healing With Whole Foods: Asian Traditions and Modern Nutrition by Paul Pitchford

I am fascinated by Traditional Chinee Medicine (TCM) and this popular book offers a focus on the Eastern fundamentals of acupuncture, diet, herbs and nutrition.  It offers easy recipes to manage your imbalances as seen by Eastern Medicine, too.

4.  Simple Chinese Medicine: A Beginner's Guide to Natural Healing and Well-Being by Dr. Aihan Kuhn

My daughter gave me this a while back when I was beginning my interest in TCM. Easily learn here why TCM can help you reduce prescription meds, pain pills, sleep issues and more.  It shows a plan to ward off many of the modern ailments of high blood pressure, headaches, arthritis and other diseases to feel your best, too.



5.  The Blue Zones Solution: Eating and Living Like the Worlds Healthiest People by Dan Buethner

This is such a fast and fun read and I love how Dan takes you through his journey of visiting the "blue zones" of the world where people seem to live the longest and are the healthiest.  Meet some inspiring people and leaders and learn all their secrets here – and it’s not only about what you eat!

Don’t miss this: See a whole day of eating like one of the healthiest people actually looks like here.



6.  Five to Thrive: Your Cutting-Edge Cancer Plan by Lise N. Alschuler, ND FABNO and Karolyn A Gazella

I read this some time ago but it really got me thinking about medical testing, cancer prevention and how that plays in our everyday choices.  It is a real wellness plan providing lots of details without being too hard-edge.



7.  Superfoods Rx: 14 Foods That Will Change Your Life by Steven G., M.D. Pratt (Author), Kathy Matthews

This is an inexpensive read (under $8) but value packed with information to introduce you to the research on the many delicious foods that can lower our inflammation, expose our body to more antioxidants and nutrients for much better health.

Don’t miss this: Tap here for loads of superfood information and recipes.



8. Gut and Psychology Syndrome: Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia by Natasha Campbell-McBride

See how research is repeatedly showing the link between our gut health and our mental health. In this best seller, this doctor walks us through how healing our digestive system can be a treatment for depression, anxiety, autism and more. I have not read this yet but know how many suffer from mental ailments and not sure many doctors have caught on to the gut-brain connection.

Don’t miss this:  Tips to keep your brain healthy and your mind balanced here and foods to calm your mind.



9. The Nalini Method: 7 Workouts for 7 Moods by Rupa Mehta

I have not read this one either but hear friends talk about it.  It is an interesting concept to match your workout to what mood you are in - other than that mood to not exercise! The author provides a fitness plan to coincide with your emotional state of happiness, anger, doubt and others. Could it work for you?

Don't miss this: I have organized lots of quick to extensive fitness routines here if you need more ideas.

Are you a reader like me? I would love it if you would include your favorite health reads in the comments, or, if you have read any of my suggestions, what are your true thoughts on them?

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