http://community.myhealthvillage.com/service/getFeed.kickAction?quantity=25 New blogs from tracy_korman on myhealthvillage Tue, 21 Apr 2009 19:44:26 GMT Tue, 21 Apr 2009 19:44:26 GMT info@longitudehealth.com (webmasterMHV) info@longitudehealth.com (webmasterMHV) KickApps Feed Builder 2009-04-21T19:44:26Z 6 http://community.myhealthvillage.com/service/searchEverything.kickAction?as=43145&sortType=recent 0 http://community.myhealthvillage.com/_Health-Friendship-and-Friendship-Health/BLOG/251786/43145.html Health = Friendship and Friendship = Health Don’t you just hate that trite expression – “It isn’t what you know… it’s who you know?”  Well it turns out that it is true in a way that you might not have expected.  Just knowing how to make good health choices isn’t enough.  You need to be connected to people in your life that care that you make those healthy choices.  A strong network of friends is an essential ingredient to achieving your health objectives and that is now being supported by real academic research. Here is a quote from today’s “Well” article from the New York Times: “Researchers are only now starting to pay attention to the importance of friendship and social networks in overall health.  A 10-year Australian study found that older people with a large circle of friends were 22 percent less likely to die during the study period than those with fewer friends.  A large 2007 study showed an increase of nearly 60 percent in the risk for obesity among people whose friends gained weight.  And last year, Harvard researchers reported that strong social ties could promote brain health as we age.” It makes so much sense that eating, exercising, drinking, smoking and managing stress have very strong social dimensions – we do these things as part of our lives with our friends and relations.  Just think how many people you know smoke, drink and overeat when at parties or in other social situations.  The social norm seems to approve of and support these decisions.  But it doesn’t have to be that way.  Why has Weight Watchers and other support-based health improvement approaches had so much success?  For one, they are establishing a friendship network that supports eating healthier and exercising more.  Because with a strong friendship network that is connected to our shared health, we can all truly live better longer – sound familier?   Health = Friendship and Friendship = Health Don’t you just hate that trite expression – “It isn’t what you know… it’s who you know?”  Well it turns out that it is true in a way that you might not have expected.  Just knowing how to make good health choices isn’t enough.  You need to be connected to people in your life that care that you make those healthy choices.  A strong network of friends is an essential ingredient to achieving your health objectives and that is now being supported by real academic research. Here is a quote from today’s “Well” article from the New York Times: “Researchers are only now starting to pay attention to the importance of friendship and social networks in overall health.  A 10-year Australian study found that older people with a large circle of friends were 22 percent less likely to die during the study period than those with fewer friends.  A large 2007 study showed an increase of nearly 60 percent in the risk for obesity among people whose friends gained weight.  And last year, Harvard researchers reported that strong social ties could promote brain health as we age.” It makes so much sense that eating, exercising, drinking, smoking and managing stress have very strong social dimensions – we do these things as part of our lives with our friends and relations.  Just think how many people you know smoke, drink and overeat when at parties or in other social situations.  The social norm seems to approve of and support these decisions.  But it doesn’t have to be that way.  Why has Weight Watchers and other support-based health improvement approaches had so much success?  For one, they are establishing a friendship network that supports eating healthier and exercising more.  Because with a strong friendship network that is connected to our shared health, we can all truly live better longer – sound familier?   Tue, 21 Apr 2009 19:44:26 GMT http://community.myhealthvillage.com/_Health-Friendship-and-Friendship-Health/BLOG/251786/43145.html tracy_korman 2009-04-21T19:44:26Z Unproctored Groups myhealthvillage Health = Friendship and Friendship = Health Don’t you just hate that trite expression – “It isn’t what you know… it’s who you know?”  Well it turns out that it is true in a way that you might not have expected.  Just knowing how to make good health choices isn’t enough.  You need to be connected to people in your life that care that you make those healthy choices.  A strong network of friends is an essential ingredient to achieving your health objectives and that is now being supported by real academic research. Here is a quote from today’s “Well” article from the New York Times: “Researchers are only now starting to pay attention to the importance of friendship and social networks in overall health.  A 10-year Australian study found that older people with a large circle of friends were 22 percent less likely to die during the study period than those with fewer friends.  A large 2007 study showed an increase of nearly 60 percent in the risk for obesity among people whose friends gained weight.  And last year, Harvard researchers reported that strong social ties could promote brain health as we age.” It makes so much sense that eating, exercising, drinking, smoking and managing stress have very strong social dimensions – we do these things as part of our lives with our friends and relations.  Just think how many people you know smoke, drink and overeat when at parties or in other social situations.  The social norm seems to approve of and support these decisions.  But it doesn’t have to be that way.  Why has Weight Watchers and other support-based health improvement approaches had so much success?  For one, they are establishing a friendship network that supports eating healthier and exercising more.  Because with a strong friendship network that is connected to our shared health, we can all truly live better longer – sound familier?   drinking, eating, exercising, network, smoking, stress, unproctored groups nonadult false Health = Friendship and Friendship = Health text blog drinking,eating,exercising,network,smoking,stress,unproctored groups 410 20 5.0 http://community.myhealthvillage.com/service/displayKickPlace.kickAction?u=3619544&as=43145 http://media.kickstatic.com/kickapps/images/43145/photos/PHOTO_1725816_43145_3619544_ap_160X120.jpg false United States NJ Princeton 08540 2 Unproctored Groups 0 251786 3619544 Member 0 http://community.myhealthvillage.com/_Genetic-Science-NOT-the-Holy-Grail-in-Disease-Prevention/BLOG/246623/43145.html Genetic Science Not the Holy Grail in Disease Prevention  I was recently at a health conference in Boston where some cutting edge health and life science technologies were being shared with the business and investment community.  Incredible presentations were made in social health networking by people like patientslikeme.com as well as some promising medical devises and molecular breakthroughs.  There was a lot of hype and sizzle around several genetic ventures that promised an individual road map for avoiding, preventing and erasing chronic disease.  That sounded pretty cool, but when I saw the reports, it became clear that these services cost a lot and offered very little beyond common sense and conventional wisdom.  Today’s article in The New York Times talks about a series of commentaries in the New England Journal of Medicine that largely reach the same conclusion.One of the presenters touted the ability to “pinpoint risk” but the risk they cited could be easily identified without spending hundreds of dollars.  For example, they showed a genetic pathway and marker linked to heart disease.  Well, we can easily identify risk for heart disease and other conditions in the metabolic cluster by asking about family history, measuring blood pressure, measuring body mass index and/or waist circumference and doing a simple blood test.    All this for a fraction of the cost of the gene test.And then you have to ask does the genetic test offer a different “so what?”  Whether I have the marker or not, the only realistic options I have to reduce my risk for heart disease are to exercise more, eat more sensibly, stop smoking if I haven’t already and stay on my blood pressure or cholesterol medicine if it has been prescribed by my doctor.  It isn’t like there will be a genetic fix to my risk – indeed there are so many pathways and markers to disease that we will all show up on the risk for many, many diseases.  To quote David B. Goldstein, a Duke University geneticist whose commentary on the subject appears in the current New England Journal of Medicine;“In pointing at everything, genetics would point at nothing.”And what if the test showed no risk for heart disease? Does that mean my being 30 pounds overweight, sedentary and a heavy smoker are now OK?  Or will by good genes be trumped by my bad lifestyle?  You know the answer there!I came away from the conference concluding that the genetic approach is useful for simply demonstrating that an individual is a human being and that human beings  carry many risk factors for disease.  An incontrovertible proof, but one hardly worth the price of the test.  Don’t get me wrong, if you suspect that you carry a genetic marker for aggressive breast cancer or other rare but deadly conditions, a gene test might be best to help you make difficult and critical decisions.  But for most chronic conditions, most of us can assume that we have risk, we can even measure and rank that risk and most importantly, we can do something about that risk.  While our gene story is interesting, it is not that clinically relevant.   To quote Dr. Goldstein again;“With only a few exceptions, what the genomics companies are doing right now is recreational genomics, the information has little or in many cases no clinical relevance.”   Genetic Science Not the Holy Grail in Disease Prevention  I was recently at a health conference in Boston where some cutting edge health and life science technologies were being shared with the business and investment community.  Incredible presentations were made in social health networking by people like patientslikeme.com as well as some promising medical devises and molecular breakthroughs.  There was a lot of hype and sizzle around several genetic ventures that promised an individual road map for avoiding, preventing and erasing chronic disease.  That sounded pretty cool, but when I saw the reports, it became clear that these services cost a lot and offered very little beyond common sense and conventional wisdom.  Today’s article in The New York Times talks about a series of commentaries in the New England Journal of Medicine that largely reach the same conclusion.One of the presenters touted the ability to “pinpoint risk” but the risk they cited could be easily identified without spending hundreds of dollars.  For example, they showed a genetic pathway and marker linked to heart disease.  Well, we can easily identify risk for heart disease and other conditions in the metabolic cluster by asking about family history, measuring blood pressure, measuring body mass index and/or waist circumference and doing a simple blood test.    All this for a fraction of the cost of the gene test.And then you have to ask does the genetic test offer a different “so what?”  Whether I have the marker or not, the only realistic options I have to reduce my risk for heart disease are to exercise more, eat more sensibly, stop smoking if I haven’t already and stay on my blood pressure or cholesterol medicine if it has been prescribed by my doctor.  It isn’t like there will be a genetic fix to my risk – indeed there are so many pathways and markers to disease that we will all show up on the risk for many, many diseases.  To quote David B. Goldstein, a Duke University geneticist whose commentary on the subject appears in the current New England Journal of Medicine;“In pointing at everything, genetics would point at nothing.”And what if the test showed no risk for heart disease? Does that mean my being 30 pounds overweight, sedentary and a heavy smoker are now OK?  Or will by good genes be trumped by my bad lifestyle?  You know the answer there!I came away from the conference concluding that the genetic approach is useful for simply demonstrating that an individual is a human being and that human beings  carry many risk factors for disease.  An incontrovertible proof, but one hardly worth the price of the test.  Don’t get me wrong, if you suspect that you carry a genetic marker for aggressive breast cancer or other rare but deadly conditions, a gene test might be best to help you make difficult and critical decisions.  But for most chronic conditions, most of us can assume that we have risk, we can even measure and rank that risk and most importantly, we can do something about that risk.  While our gene story is interesting, it is not that clinically relevant.   To quote Dr. Goldstein again;“With only a few exceptions, what the genomics companies are doing right now is recreational genomics, the information has little or in many cases no clinical relevance.”   Fri, 17 Apr 2009 19:41:02 GMT http://community.myhealthvillage.com/_Genetic-Science-NOT-the-Holy-Grail-in-Disease-Prevention/BLOG/246623/43145.html tracy_korman 2009-04-17T19:41:02Z Unproctored Groups myhealthvillage Genetic Science Not the Holy Grail in Disease Prevention  I was recently at a health conference in Boston where some cutting edge health and life science technologies were being shared with the business and investment community.  Incredible presentations were made in social health networking by people like patientslikeme.com as well as some promising medical devises and molecular breakthroughs.  There was a lot of hype and sizzle around several genetic ventures that promised an individual road map for avoiding, preventing and erasing chronic disease.  That sounded pretty cool, but when I saw the reports, it became clear that these services cost a lot and offered very little beyond common sense and conventional wisdom.  Today’s article in The New York Times talks about a series of commentaries in the New England Journal of Medicine that largely reach the same conclusion.One of the presenters touted the ability to “pinpoint risk” but the risk they cited could be easily identified without spending hundreds of dollars.  For example, they showed a genetic pathway and marker linked to heart disease.  Well, we can easily identify risk for heart disease and other conditions in the metabolic cluster by asking about family history, measuring blood pressure, measuring body mass index and/or waist circumference and doing a simple blood test.    All this for a fraction of the cost of the gene test.And then you have to ask does the genetic test offer a different “so what?”  Whether I have the marker or not, the only realistic options I have to reduce my risk for heart disease are to exercise more, eat more sensibly, stop smoking if I haven’t already and stay on my blood pressure or cholesterol medicine if it has been prescribed by my doctor.  It isn’t like there will be a genetic fix to my risk – indeed there are so many pathways and markers to disease that we will all show up on the risk for many, many diseases.  To quote David B. Goldstein, a Duke University geneticist whose commentary on the subject appears in the current New England Journal of Medicine;“In pointing at everything, genetics would point at nothing.”And what if the test showed no risk for heart disease? Does that mean my being 30 pounds overweight, sedentary and a heavy smoker are now OK?  Or will by good genes be trumped by my bad lifestyle?  You know the answer there!I came away from the conference concluding that the genetic approach is useful for simply demonstrating that an individual is a human being and that human beings  carry many risk factors for disease.  An incontrovertible proof, but one hardly worth the price of the test.  Don’t get me wrong, if you suspect that you carry a genetic marker for aggressive breast cancer or other rare but deadly conditions, a gene test might be best to help you make difficult and critical decisions.  But for most chronic conditions, most of us can assume that we have risk, we can even measure and rank that risk and most importantly, we can do something about that risk.  While our gene story is interesting, it is not that clinically relevant.   To quote Dr. Goldstein again;“With only a few exceptions, what the genomics companies are doing right now is recreational genomics, the information has little or in many cases no clinical relevance.”   chronic disease, genetic science, unproctored groups nonadult false Genetic Science NOT the Holy Grail in Disease Prevention text blog chronic disease,genetic science,unproctored groups 227 1 5.0 http://community.myhealthvillage.com/service/displayKickPlace.kickAction?u=3619544&as=43145 http://media.kickstatic.com/kickapps/images/43145/photos/PHOTO_1725816_43145_3619544_ap_160X120.jpg false United States NJ Princeton 08540 0 Unproctored Groups 0 246623 3619544 Member 0 http://community.myhealthvillage.com/_Making-Trade-Offs-Priorities-When-Managing-Chronic-Conditions/BLOG/242546/43145.html Making Trade-Offs: Priorities When Managing Chronic ConditionsReading this terrific essay by Lori Berlin who is living with and writing about her experiences with ulcerative colitis got me thinking about the trade-offs we all make in managing our chronic conditions and life-style related health challenges.  Lori writes about how managing her chronic condition required a medicine that led to weight gain.  Accomplishing one life-essential goal meant giving up on another life important goal – one that is so tied to self esteem and health.While Lori’s experience is a stark and extreme trade-off situation, we all make trade-offs around catering to, coping with or overcoming our chronic conditions.  Giving up on a near-term pleasure for a long-term goal is a more common trade-off for all of us trying to exercise, eat right and keep ourselves “heart healthy.”   Many MyHealthVillage.com members regularly adhere to drug therapies that come at the cost of unpleasant side effects – some are much challenging than just unpleasant.  To actively address our health and manage our chronic conditions, we each must figure out our priorities – which goal comes first.  Do I pick a health goal because it is most important according to my doctor?  Maybe.  But I might pick it a particular objective because I have the confidence that I can actually achieve my goal.  With success, I might then have the confidence to try the next goal which might be of even greater significance for my health.   I might feel that quitting smoking is beyond my current reach, but improving my diet and exercise is more “doable” at the moment.  Which is better:  continuing to fail at quitting smoking or making some real progress on my weight?  Later, when I have proven to myself that I can control what and when and how I eat and that I can find the time for nearly daily exercise, I can probably muster the courage to take on cigarettes too.  And having reduced my weight, I might be less frightened by the weight gain that might accompany my quitting.Trade-offs are a part of all of our lives all of the time.  But a little self-discovery and prioritization can make a big difference in your health management progress.   Lori describes putting treatment of her ulcerative colitis first – and rightly so because it was life-threatening.  When remission was achieved, she could get back to her next goal – keeping her weight in check.   I hope that the support and resources available at MyHealthVillage can help you prioritize your objectives, set appropriate health goals and manage your own trade-offs.  You can start by sharing some of your own trade-offs - in a comment here or in a blog post of your own.  With the help of your Village, it is easier to live better longer.    Making Trade-Offs: Priorities When Managing Chronic ConditionsReading this terrific essay by Lori Berlin who is living with and writing about her experiences with ulcerative colitis got me thinking about the trade-offs we all make in managing our chronic conditions and life-style related health challenges.  Lori writes about how managing her chronic condition required a medicine that led to weight gain.  Accomplishing one life-essential goal meant giving up on another life important goal – one that is so tied to self esteem and health.While Lori’s experience is a stark and extreme trade-off situation, we all make trade-offs around catering to, coping with or overcoming our chronic conditions.  Giving up on a near-term pleasure for a long-term goal is a more common trade-off for all of us trying to exercise, eat right and keep ourselves “heart healthy.”   Many MyHealthVillage.com members regularly adhere to drug therapies that come at the cost of unpleasant side effects – some are much challenging than just unpleasant.  To actively address our health and manage our chronic conditions, we each must figure out our priorities – which goal comes first.  Do I pick a health goal because it is most important according to my doctor?  Maybe.  But I might pick it a particular objective because I have the confidence that I can actually achieve my goal.  With success, I might then have the confidence to try the next goal which might be of even greater significance for my health.   I might feel that quitting smoking is beyond my current reach, but improving my diet and exercise is more “doable” at the moment.  Which is better:  continuing to fail at quitting smoking or making some real progress on my weight?  Later, when I have proven to myself that I can control what and when and how I eat and that I can find the time for nearly daily exercise, I can probably muster the courage to take on cigarettes too.  And having reduced my weight, I might be less frightened by the weight gain that might accompany my quitting.Trade-offs are a part of all of our lives all of the time.  But a little self-discovery and prioritization can make a big difference in your health management progress.   Lori describes putting treatment of her ulcerative colitis first – and rightly so because it was life-threatening.  When remission was achieved, she could get back to her next goal – keeping her weight in check.   I hope that the support and resources available at MyHealthVillage can help you prioritize your objectives, set appropriate health goals and manage your own trade-offs.  You can start by sharing some of your own trade-offs - in a comment here or in a blog post of your own.  With the help of your Village, it is easier to live better longer.    Tue, 14 Apr 2009 17:01:40 GMT http://community.myhealthvillage.com/_Making-Trade-Offs-Priorities-When-Managing-Chronic-Conditions/BLOG/242546/43145.html tracy_korman 2009-04-14T17:01:40Z myhealthvillage Making Trade-Offs: Priorities When Managing Chronic ConditionsReading this terrific essay by Lori Berlin who is living with and writing about her experiences with ulcerative colitis got me thinking about the trade-offs we all make in managing our chronic conditions and life-style related health challenges.  Lori writes about how managing her chronic condition required a medicine that led to weight gain.  Accomplishing one life-essential goal meant giving up on another life important goal – one that is so tied to self esteem and health.While Lori’s experience is a stark and extreme trade-off situation, we all make trade-offs around catering to, coping with or overcoming our chronic conditions.  Giving up on a near-term pleasure for a long-term goal is a more common trade-off for all of us trying to exercise, eat right and keep ourselves “heart healthy.”   Many MyHealthVillage.com members regularly adhere to drug therapies that come at the cost of unpleasant side effects – some are much challenging than just unpleasant.  To actively address our health and manage our chronic conditions, we each must figure out our priorities – which goal comes first.  Do I pick a health goal because it is most important according to my doctor?  Maybe.  But I might pick it a particular objective because I have the confidence that I can actually achieve my goal.  With success, I might then have the confidence to try the next goal which might be of even greater significance for my health.   I might feel that quitting smoking is beyond my current reach, but improving my diet and exercise is more “doable” at the moment.  Which is better:  continuing to fail at quitting smoking or making some real progress on my weight?  Later, when I have proven to myself that I can control what and when and how I eat and that I can find the time for nearly daily exercise, I can probably muster the courage to take on cigarettes too.  And having reduced my weight, I might be less frightened by the weight gain that might accompany my quitting.Trade-offs are a part of all of our lives all of the time.  But a little self-discovery and prioritization can make a big difference in your health management progress.   Lori describes putting treatment of her ulcerative colitis first – and rightly so because it was life-threatening.  When remission was achieved, she could get back to her next goal – keeping her weight in check.   I hope that the support and resources available at MyHealthVillage can help you prioritize your objectives, set appropriate health goals and manage your own trade-offs.  You can start by sharing some of your own trade-offs - in a comment here or in a blog post of your own.  With the help of your Village, it is easier to live better longer.    chronic conditions, colitis, goals, weight nonadult false Making Trade-Offs: Priorities When Managing Chronic Conditions text blog chronic conditions,colitis,goals,weight 265 0 0.0 http://community.myhealthvillage.com/service/displayKickPlace.kickAction?u=3619544&as=43145 http://media.kickstatic.com/kickapps/images/43145/photos/PHOTO_1725816_43145_3619544_ap_160X120.jpg false United States NJ Princeton 08540 0 0 242546 3619544 Member 0 http://community.myhealthvillage.com/_Prevention-versus-Vigilence/BLOG/115072/43145.html Prevention versus Vigilance It’s amazing to me how a subtle shift in language can have a big impact on policy, health risk and even quality of life.  Here’s a case in point: somewhere along the lines when people said “prevention” it started to mean early detection or vigilance against the onset of disease.  But true prevention which is avoiding disease by reducing the health risks that come with our lifestyle choices could not be more different from early detection and increased vigilance.    A number of leading practitioners of so-called preventative medicine are really providers of full body scans and whole batteries of expensive tests in the hope of finding disease at the earliest of stages.  And what’s wrong with that?  Well overly zealous early detection is expensive and often unreliable leading to false positives and unnecessary (and potentially dangerous) interventions.  Dr. H. Gilbert Welch in a well reasoned and well written essay in the New York Times shows that extra and unwarranted testing in the name of prevention actually increases health care costs and lowers quality of care and quality of life.  (There is a link to this essay at the bottom of this blog.)  It seems that this flavor of prevention is really applying the sins of specialty medicine to primary care.  Specialty medicine has often (but not always) been where lots of technology and lots of procedures drove lots one-time interventions and with them lots of expenses and fees.  Primary care, on the other hand, has been about holistic lifestyle management to reduce risk and improve health as on ongoing process.   Unfortunately for the thousands of Internists, Family Practitioners and other primary care physicians, this approach generate small office visit fees and not the big ticket items like full-body scans and the like. Don’t get me wrong.  Many people (even me) need to step up vigilance at certain times in our lives.  The cancer survivor needs more vigilance as do both men and women of certain ages facing higher risks of breast cancer, cervical cancer or colon cancer.  Family history, environmental factors and other issues can shift the equation to where true prevention and vigilance can and should work hand-in-hand.  But your primary care physician is best positioned to recommend this approach and not some “prevention” clinic that takes all comers and scans for any abnormality no matter how benign.  The expression is “an ounce of prevention is worth a pound of cure” but only when it is lifestyle based prevention and not the pseudo prevention of extreme early detection. Click here to read Dr. Welch’s essay. Tracy   Prevention versus Vigilance It’s amazing to me how a subtle shift in language can have a big impact on policy, health risk and even quality of life.  Here’s a case in point: somewhere along the lines when people said “prevention” it started to mean early detection or vigilance against the onset of disease.  But true prevention which is avoiding disease by reducing the health risks that come with our lifestyle choices could not be more different from early detection and increased vigilance.    A number of leading practitioners of so-called preventative medicine are really providers of full body scans and whole batteries of expensive tests in the hope of finding disease at the earliest of stages.  And what’s wrong with that?  Well overly zealous early detection is expensive and often unreliable leading to false positives and unnecessary (and potentially dangerous) interventions.  Dr. H. Gilbert Welch in a well reasoned and well written essay in the New York Times shows that extra and unwarranted testing in the name of prevention actually increases health care costs and lowers quality of care and quality of life.  (There is a link to this essay at the bottom of this blog.)  It seems that this flavor of prevention is really applying the sins of specialty medicine to primary care.  Specialty medicine has often (but not always) been where lots of technology and lots of procedures drove lots one-time interventions and with them lots of expenses and fees.  Primary care, on the other hand, has been about holistic lifestyle management to reduce risk and improve health as on ongoing process.   Unfortunately for the thousands of Internists, Family Practitioners and other primary care physicians, this approach generate small office visit fees and not the big ticket items like full-body scans and the like. Don’t get me wrong.  Many people (even me) need to step up vigilance at certain times in our lives.  The cancer survivor needs more vigilance as do both men and women of certain ages facing higher risks of breast cancer, cervical cancer or colon cancer.  Family history, environmental factors and other issues can shift the equation to where true prevention and vigilance can and should work hand-in-hand.  But your primary care physician is best positioned to recommend this approach and not some “prevention” clinic that takes all comers and scans for any abnormality no matter how benign.  The expression is “an ounce of prevention is worth a pound of cure” but only when it is lifestyle based prevention and not the pseudo prevention of extreme early detection. Click here to read Dr. Welch’s essay. Tracy   Tue, 07 Oct 2008 18:08:26 GMT http://community.myhealthvillage.com/_Prevention-versus-Vigilence/BLOG/115072/43145.html tracy_korman 2008-10-07T18:08:26Z Unproctored Groups myhealthvillage Prevention versus Vigilance It’s amazing to me how a subtle shift in language can have a big impact on policy, health risk and even quality of life.  Here’s a case in point: somewhere along the lines when people said “prevention” it started to mean early detection or vigilance against the onset of disease.  But true prevention which is avoiding disease by reducing the health risks that come with our lifestyle choices could not be more different from early detection and increased vigilance.    A number of leading practitioners of so-called preventative medicine are really providers of full body scans and whole batteries of expensive tests in the hope of finding disease at the earliest of stages.  And what’s wrong with that?  Well overly zealous early detection is expensive and often unreliable leading to false positives and unnecessary (and potentially dangerous) interventions.  Dr. H. Gilbert Welch in a well reasoned and well written essay in the New York Times shows that extra and unwarranted testing in the name of prevention actually increases health care costs and lowers quality of care and quality of life.  (There is a link to this essay at the bottom of this blog.)  It seems that this flavor of prevention is really applying the sins of specialty medicine to primary care.  Specialty medicine has often (but not always) been where lots of technology and lots of procedures drove lots one-time interventions and with them lots of expenses and fees.  Primary care, on the other hand, has been about holistic lifestyle management to reduce risk and improve health as on ongoing process.   Unfortunately for the thousands of Internists, Family Practitioners and other primary care physicians, this approach generate small office visit fees and not the big ticket items like full-body scans and the like. Don’t get me wrong.  Many people (even me) need to step up vigilance at certain times in our lives.  The cancer survivor needs more vigilance as do both men and women of certain ages facing higher risks of breast cancer, cervical cancer or colon cancer.  Family history, environmental factors and other issues can shift the equation to where true prevention and vigilance can and should work hand-in-hand.  But your primary care physician is best positioned to recommend this approach and not some “prevention” clinic that takes all comers and scans for any abnormality no matter how benign.  The expression is “an ounce of prevention is worth a pound of cure” but only when it is lifestyle based prevention and not the pseudo prevention of extreme early detection. Click here to read Dr. Welch’s essay. Tracy   cancer, health risk, prevention, primary care, scan, unproctored groups nonadult false Prevention versus Vigilence text blog cancer,health risk,prevention,primary care,scan,unproctored groups 797 10 5.0 http://community.myhealthvillage.com/service/displayKickPlace.kickAction?u=3619544&as=43145 http://media.kickstatic.com/kickapps/images/43145/photos/PHOTO_1725816_43145_3619544_ap_160X120.jpg false United States NJ Princeton 08540 3 Unproctored Groups 0 115072 3619544 Member 0 http://community.myhealthvillage.com/_Playing-the-odds-A-Smoking-Gun/BLOG/99838/43145.html Nicholas Bakalar had a great piece in the New York Times comparing the odds of dieing from different disesases at different ages. The post was based on a paper published in the Journal of the National Cancer Institute. What made this different from many of the Internet calculators was the accompanying chart that took into considersation age, gender and smoking status an compared the risk of dieing from different causes. [image] The chart is very cool. You can see at a glance that smoking changes everything and that until late in life, it is the chronic conditions that we should be preventing and or managing. The entire post is really worth a read. Tracy Nicholas Bakalar had a great piece in the New York Times comparing the odds of dieing from different disesases at different ages. The post was based on a paper published in the Journal of the National Cancer Institute. What made this different from many of the Internet calculators was the accompanying chart that took into considersation age, gender and smoking status an compared the risk of dieing from different causes. [image] The chart is very cool. You can see at a glance that smoking changes everything and that until late in life, it is the chronic conditions that we should be preventing and or managing. The entire post is really worth a read. Tracy Thu, 11 Sep 2008 01:32:07 GMT http://community.myhealthvillage.com/_Playing-the-odds-A-Smoking-Gun/BLOG/99838/43145.html tracy_korman 2008-09-11T01:32:07Z myhealthvillage Nicholas Bakalar had a great piece in the New York Times comparing the odds of dieing from different disesases at different ages. The post was based on a paper published in the Journal of the National Cancer Institute. What made this different from many of the Internet calculators was the accompanying chart that took into considersation age, gender and smoking status an compared the risk of dieing from different causes. [image] The chart is very cool. You can see at a glance that smoking changes everything and that until late in life, it is the chronic conditions that we should be preventing and or managing. The entire post is really worth a read. Tracy chronic conditions, risk factors, smoking nonadult false Playing the odds - A Smoking Gun! text blog chronic conditions,risk factors,smoking 504 10 5.0 http://community.myhealthvillage.com/service/displayKickPlace.kickAction?u=3619544&as=43145 http://media.kickstatic.com/kickapps/images/43145/photos/PHOTO_1725816_43145_3619544_ap_160X120.jpg false United States NJ Princeton 08540 2 0 99838 3619544 Member 0 http://community.myhealthvillage.com/_Live-Better-Longer/BLOG/99836/43145.html Live Better Longer Healthcare sites, blogs and resources have never been more available and well trafficked on the web. While still well below levels that we would all like, healthcare literacy is actually improving as we all have easier access to quality information, health information technology, peer support and expert guidance from a growing number of quality sites and resources. A leading driver of internet activity is the large volume of consumers searching health related subjects on general and specifics sites. While it is great to see our culture getting more interested in health, fitness and wellbeing, there is much evidence that that interest is not translating into better outcomes. We spend more on healthcare than any nation on earth, and yet on many measures, we are far behind countries that spend far less. Clearly, there are a number of culprits including wasted treatment, under-treatment and over treatment. Part of the blame can be placed on our toxic lifestyles that make it too easy to eat poorly, exercise infrequently, smoke cigarettes, drink excessively and manage stress unproductively. Part of the blame can be placed on a healthcare industry that favors specialty medicine and under-rewards primary care and preventative medicine. Together, our culture and our healthcare system condition us to worry about health only when it fails us and to shop specialists and procedures looking for episodic care. It appears that much of what passes as preventative medicine today is no better. Fully body scans and batteries of tests that do not adhere to evidence based guidelines are expensive and even dangerous as their extreme sensitivity can lead to false positive results and risky follow up procedures. Early detection is a great concept, but not if it continues to drive a care regimen based on specialists and procedures. Equally unproductive is the focus on longevity at all costs. Episodic, after-the-fact medicine leaves us to cope with more chronic conditions for more of our lifespan. The standard of care then becomes even more procedure intensive, more expensive and more detrimental to our quality of life. But isn't it best for all of us to avoid chronic conditions and their array of co-morbidities that so tax our health and well being? C ompressed morbidity is the fashionable term, but the concept is really simply living better longer. Living better longer includes means true disease avoidance as opposed to expensive vigilance and early detection. Living better longer means working with a primary care physician and achieving a truly collaborative and coordinated level of care that avoids waste, duplication and under-treatment. Living better longer means understanding how chronic conditions and their co-morbidities are closely tied to our modifiable lifestyle choices. Living better longer means being empowered to make the right decisions that reduce our health risks and improve our quality of life and well being. The MyHealthVillage.com community is here to help us all achieve the goal of living better longer. Like any village, it is only as strong as the commitment of its inhabitants. Our professional HealthGuides are here to help but we hope that you will make the village your village. Share your opportunities and your challenges. Reach out to help with your expertise, passion and experience. Seek out other villagers who can share their expertise, passion and experience with you. Together we can all live better longer. - Tracy Live Better Longer Healthcare sites, blogs and resources have never been more available and well trafficked on the web. While still well below levels that we would all like, healthcare literacy is actually improving as we all have easier access to quality information, health information technology, peer support and expert guidance from a growing number of quality sites and resources. A leading driver of internet activity is the large volume of consumers searching health related subjects on general and specifics sites. While it is great to see our culture getting more interested in health, fitness and wellbeing, there is much evidence that that interest is not translating into better outcomes. We spend more on healthcare than any nation on earth, and yet on many measures, we are far behind countries that spend far less. Clearly, there are a number of culprits including wasted treatment, under-treatment and over treatment. Part of the blame can be placed on our toxic lifestyles that make it too easy to eat poorly, exercise infrequently, smoke cigarettes, drink excessively and manage stress unproductively. Part of the blame can be placed on a healthcare industry that favors specialty medicine and under-rewards primary care and preventative medicine. Together, our culture and our healthcare system condition us to worry about health only when it fails us and to shop specialists and procedures looking for episodic care. It appears that much of what passes as preventative medicine today is no better. Fully body scans and batteries of tests that do not adhere to evidence based guidelines are expensive and even dangerous as their extreme sensitivity can lead to false positive results and risky follow up procedures. Early detection is a great concept, but not if it continues to drive a care regimen based on specialists and procedures. Equally unproductive is the focus on longevity at all costs. Episodic, after-the-fact medicine leaves us to cope with more chronic conditions for more of our lifespan. The standard of care then becomes even more procedure intensive, more expensive and more detrimental to our quality of life. But isn't it best for all of us to avoid chronic conditions and their array of co-morbidities that so tax our health and well being? C ompressed morbidity is the fashionable term, but the concept is really simply living better longer. Living better longer includes means true disease avoidance as opposed to expensive vigilance and early detection. Living better longer means working with a primary care physician and achieving a truly collaborative and coordinated level of care that avoids waste, duplication and under-treatment. Living better longer means understanding how chronic conditions and their co-morbidities are closely tied to our modifiable lifestyle choices. Living better longer means being empowered to make the right decisions that reduce our health risks and improve our quality of life and well being. The MyHealthVillage.com community is here to help us all achieve the goal of living better longer. Like any village, it is only as strong as the commitment of its inhabitants. Our professional HealthGuides are here to help but we hope that you will make the village your village. Share your opportunities and your challenges. Reach out to help with your expertise, passion and experience. Seek out other villagers who can share their expertise, passion and experience with you. Together we can all live better longer. - Tracy Thu, 11 Sep 2008 01:25:47 GMT http://community.myhealthvillage.com/_Live-Better-Longer/BLOG/99836/43145.html tracy_korman 2008-09-11T01:25:47Z myhealthvillage Live Better Longer Healthcare sites, blogs and resources have never been more available and well trafficked on the web. While still well below levels that we would all like, healthcare literacy is actually improving as we all have easier access to quality information, health information technology, peer support and expert guidance from a growing number of quality sites and resources. A leading driver of internet activity is the large volume of consumers searching health related subjects on general and specifics sites. While it is great to see our culture getting more interested in health, fitness and wellbeing, there is much evidence that that interest is not translating into better outcomes. We spend more on healthcare than any nation on earth, and yet on many measures, we are far behind countries that spend far less. Clearly, there are a number of culprits including wasted treatment, under-treatment and over treatment. Part of the blame can be placed on our toxic lifestyles that make it too easy to eat poorly, exercise infrequently, smoke cigarettes, drink excessively and manage stress unproductively. Part of the blame can be placed on a healthcare industry that favors specialty medicine and under-rewards primary care and preventative medicine. Together, our culture and our healthcare system condition us to worry about health only when it fails us and to shop specialists and procedures looking for episodic care. It appears that much of what passes as preventative medicine today is no better. Fully body scans and batteries of tests that do not adhere to evidence based guidelines are expensive and even dangerous as their extreme sensitivity can lead to false positive results and risky follow up procedures. Early detection is a great concept, but not if it continues to drive a care regimen based on specialists and procedures. Equally unproductive is the focus on longevity at all costs. Episodic, after-the-fact medicine leaves us to cope with more chronic conditions for more of our lifespan. The standard of care then becomes even more procedure intensive, more expensive and more detrimental to our quality of life. But isn't it best for all of us to avoid chronic conditions and their array of co-morbidities that so tax our health and well being? C ompressed morbidity is the fashionable term, but the concept is really simply living better longer. Living better longer includes means true disease avoidance as opposed to expensive vigilance and early detection. Living better longer means working with a primary care physician and achieving a truly collaborative and coordinated level of care that avoids waste, duplication and under-treatment. Living better longer means understanding how chronic conditions and their co-morbidities are closely tied to our modifiable lifestyle choices. Living better longer means being empowered to make the right decisions that reduce our health risks and improve our quality of life and well being. The MyHealthVillage.com community is here to help us all achieve the goal of living better longer. Like any village, it is only as strong as the commitment of its inhabitants. Our professional HealthGuides are here to help but we hope that you will make the village your village. Share your opportunities and your challenges. Reach out to help with your expertise, passion and experience. Seek out other villagers who can share their expertise, passion and experience with you. Together we can all live better longer. - Tracy chronic conditions, compressed morbidity, health, proctored groups, wellness nonadult false Live Better Longer text blog chronic conditions,compressed morbidity,health,proctored groups,wellness 484 10 5.0 http://community.myhealthvillage.com/service/displayKickPlace.kickAction?u=3619544&as=43145 http://media.kickstatic.com/kickapps/images/43145/photos/PHOTO_1725816_43145_3619544_ap_160X120.jpg false United States NJ Princeton 08540 0 0 99836 3619544 Member 0