Tuesday, June 30, 2009

Green Smoothies Don't Have To Be Green Anymore!

Smoothies are nothing new. For years, many people have been using their home blender to combine fruit, fruit juices, protein powders, and a wide assortment of spices to create nutrition that can be consumed from a glass.

Green smoothies in particular are delicious, and they are an easy, tasty way to add more fresh greens and vegetables to the diet. For a thicker smoothie, use green cabbage as the base; for a lighter tasting smoothie, try spinach or lettuce as the primary ingredient; for a really sharp, bitter tasting smoothie, begin with turnip or mustard greens. After the greens, one can add just about anything that suits the taste buds such as fruit, vegetables, juice, milk, spices, sweeteners, flax seed, or protein powder.

So why don’t more people enjoy green smoothies? Well, it probably has to do with the color. Green smoothies are seldom a pretty, healthy, vibrant shade of green. Oh, no. Somehow, they usually emerge as a sick, putrid shade of green, and they often look like something you certainly would not want to put in your mouth.

But, green smoothies don’t have to be green anymore. If one has difficulty eating a wonderful tasting green smoothie because of the resulting hue, try adding various other colors to the mix. For instance, use red cabbage instead of green cabbage, and the resulting color is a deep purple. Adding about a cup of blueberries will also result in a hue of deep blue to purple. For a pink or reddish tint, add strawberries or raspberries. Of course, if one is trying to eliminate or limit the amount of fruit in the green smoothie and has no qualms regarding artificial ingredients, artificial food coloring will help to change the color of the final product.

Personally, my favorite green smoothie changes with the weather. Today, the primary ingredient in the smoothie was green cabbage (about ¼ of a head of cabbage). Then, about one cup of blueberries was added along with some water, flax seed, and just a bit (less than a teaspoon) of raw honey. Yesterday, the primary ingredient was lettuce (about ¼ of a head of lettuce), and added to that was some unsweetened apple juice and flax seed.

Green smoothies are tasty, nutritious, and the ingredient combinations are endless. But, thankfully, for weaker stomachs, the color of the smoothie is as variable as the assortment of ingredients that can go into one. Just try a little creativity, and then enjoy a tasty treat.

Monday, June 29, 2009

An Unncessary Medical Test?

Throughout the past week, nearly every local news show and every twenty-four hour news channel has reported that various government leaders feel that health care reform could include legislation to save on medical expenses by preventing unnecessary medical testing that is alleging currently occurring in the health care field. But, what medical test is unnecessary? And, who shall decide? Will it be the patient? The doctor? The insurance company? Or, will it be a group of strangers who know neither the patient nor the situation?

One can assume that medical testing is much like testing in other fields. The tests are used to either eliminate potential findings or to confirm suspected theories. Physicians are faced with a myriad of possible diagnoses for any given set of symptoms reported by a patient, and tests are conducted to support or deny a doctor’s suspicions. Doctors are only human and fallible; with this in mind, is there really any such thing as an unnecessary medical test?

Patients, too, are human, and usually non-medical professionals. Symptoms not recognized as being symptoms, as being important, may go unreported to the physician, an error that could result in a misdiagnosis. As a patient, if you were given the choice of purchasing a test that could substantiate your physician’s diagnosis, would you buy it? Or, would you prefer to consider it an unnecessary expense and take a leap of faith, hoping that out of the many possible diagnoses it may be the doctor guessed well?

In an attempt to cut medical expenses, reducing medical testing may sound like a possibility. Yet, increasing medical testing may actually improve patient care and, ultimately, reduce overall health care costs.

Have you ever had this experience: After dealing with a few symptoms, attempting to self-diagnose and self-medicate with over-the-counter products, you finally give in and make an appointment with the doctor. If your symptoms are serious, you may be seen as a walk-in; if you feel you can wait, it may be a week or two before your appointment date arrives.

After sitting in the cold waiting room for a while, sometimes an hour or more, you are ushered back to an examination room where your temperature, pulse, and blood pressure are checked by a nurse; then you are left alone to continue to wait. Finally, you hear a rustle of papers just outside the door and the doctor enters the room.

The doctor is polite and kind, but he (or she) is busy, and there are other patients waiting to see him. You greet the physician and inform him of the list of symptoms that you’ve noticed and feel are important enough to be reported to him. If you’ve had symptoms that you don’t realize are related to the problem, they go unreported. The doctor asks you a few questions, writes something quickly on a script, tears the paper from its book, and hands it to you. “Take this,” the doctor says. “And, if it doesn’t work, come back.” Then, you look at your watch and realize that the entire visit took approximately five minutes, and no medical tests are conducted.

If you’re lucky, you have health insurance, and you stop at the front desk to pay the co-pay before leaving. Then, you head to the pharmacy, and pay another co-pay for the prescription. But, remember, the insurance company is also paying a hefty expense for both the visit and the medication.

Within a few weeks, your symptoms have continued or worsened, and you call to make another appointment with the doctor. Again, the same procedure of waiting and receiving a prescription without medical testing is conducted, co-pays are paid by the patient at the doctor’s office and the pharmacy, and the health insurance company pays for yet another visit and another pharmaceutical. After another couple of weeks without improvement, yet a third round of this dance is performed. And, so it continues.

Every day, scenarios similar to this are played out, an expensive circle that involves patients not receiving thorough care, and patients and insurance companies paying out money. Although medical testing will not guarantee that this scenario will never occur, it could prevent many episodes.

If more medical tests are performed, patients and doctors can be reassured that a suspected diagnosis and the treatment plan decided upon are correct. This, in turn, will not only increase the quality of medical care provided to the patient, but it can also decrease doctor liability and decrease the amount of money spent by patients and insurance companies on unnecessary repeat visits and inappropriate prescriptions. With these changes, patient-doctor trust should increase and malpractice charges should decrease, which could ultimately result in across-the-board medical savings.

The patients of America have a voice, and a right to speak up in regards to their own medical care. And, as Americans, we have the right to telephone, mail, or e-mail our representatives and let them know our opinion on any issue we feel is of importance. Few issues are as important to each individual as their personal health. So, the question is put forth to each of us. When it comes to saving on health care expenses, do we wish to save on health care by eliminating what some believe are unnecessary medical tests?

Saturday, June 27, 2009

The Cost of Prescription Medications

Flip through a magazine or sit down to watch the evening news and you’ll view at least one advertisement for a prescription medication designed to remedy anything from allergies to high blood pressure or cholesterol to sexual dysfunction. Each ad highlights the curative aspects of the product while quickly and quietly listing a long string of possible side effects. But as we skim the pages or lean back in our easy chairs, do many stop to realize that each advertisement is an expense that each American pays for at the pharmacy?

National advertising is expensive, and this expense is passed on to the consumer at the check-out register. But, is the additional expense actually beneficial? Is it even safe? The commercials are created in such a way as to make any living human believe that they have that particular medical problem. When springtime arrives, do you have sinus drainage? Do you or have you ever had acne? Do you need to lower your cholesterol? Are you sad sometimes? Are you feeling tired and run down? Are you older now and just not feeling as young as you used to? Is there anyone living who doesn’t fit into most of these categories?

In many ways, the pharmaceutical companies have begun to sell their products in the same manner by which the beauty industry lures customers to buy over-the-counter products—by doing nothing more than convincing the public that they need a particular product. But, anyone who has ever purchased beauty products knows that one product is not necessarily appropriate for everyone, even if they are experiencing the same problem. Prescription medications are the same way; one size does not fit all.

Too often, people self-diagnose and then visit a physician demanding the advertised drug; some refuse to appropriately take any alternative medication prescribed due to disagreeing with the physician’s findings. We will believe the commercials, but we’ll fail to read the insert that comes with the medication bottle or to further education ourselves on the drug beyond the commercial. During the process of attempting to empower ourselves by educating ourselves on prescription drugs, we put our own health at risk by refusing to listen to more knowledgeable health care professionals, by not following up with additional research on the product, and by ignoring the risks and the potential dangers.

Knowledge—information--is power, and patients deserve the right and the ability to empower ourselves, to educate ourselves, to know what options are available, and to be able to discuss potential diagnoses or treatment plans with the physician. Yet, the knowledge that most gain from advertising is quite expensive, especially considering how limited, vague, and distorted the information can sometimes be.

Returning to the time when drug companies did not advertise their prescription products on television and in magazines would lessen the cost of medications, but it would also decrease the amount of medical information available to the public. However, there is certainly no lack of information on the internet. So, perhaps the issue is not that pharmaceutical companies advertise but, rather, how and where they advertise. More economical advertising could be employed via the web, allowing the public to maintain a steady stream of information and yet finding somewhat lower prices at the pharmacy.

Ultimately, to cut the real cost of information the public receives on new pharmaceutical developments, perhaps the most beneficial changes that could be made is for pharmaceutical companies to be more responsible in their advertising and for citizens to be more proactive with our health by learning, reading, researching, by not falling prey to marketing gimmicks, and by remembering to listen to those more knowledgeable than ourselves.

Friday, June 26, 2009

Goodbye Farrah and Michael

I remember precisely where I was the moment the news came over the radio that Elvis had died. I recall what I was having for breakfast when I turned on the television and heard the news reports of the passing of Princess Diana. And, I suspect that years from now I’ll remember exactly where I was and what I was doing when the news was reported yesterday of the deaths of two culture icons, Farrah Fawcett and Michael Jackson.

Like so many other young females of that time, I secretly wanted to be one of Charlie’s Angels and I tried my best, yet unsuccessfully, to accomplish that Farrah-feathered hair. Along with the rest of the world, I sang along with Michael Jackson’s hits as they played through stereo speakers and tried, again unsuccessfully, to try to moon walk. In this generation, few have established the level of fame, recognition, and talent as Farrah Fawcett and Michael Jackson. Yesterday, the world lost two culture icons who not only provided the public with entertainment but also with memories of the progression of our own lives.

For all of the incredible acting skill and memorable projects that Farrah Fawcett shared with the public, it may very well be the recent documentary of her battle with cancer that may be the most respected. Her determination and her attitude in the no-holds-barred feature was an example to all who suffer from cancer, and it contained a personal honesty that sets it apart from all of her other film and television roles.

I doubt that there is a human being on the planet who isn’t familiar with the music of Michael Jackson. In the eighties, Jackson’s music was heard often on the radio and he was a regular presence at award shows and in television commercials. His videos were ground breaking, his dance moves were unlike any we’d ever seen, and his clothing began fashion trends that swept the world.

As we age, our lives are punctuated with memories of family, friends, and the changes we experience throughout the years. But memories are also made that are related to entertainment—who we were dating when we saw a popular movie, what hit song was playing at the prom, what was on television when we received a phone call containing exciting or devastating news, or the way we look in old pictures when we were younger and a popular hairstyle or jacket was all the rage. Very few entertainers can achieve the status of culture icon, someone who influences culture in one way or another, but Farrah Fawcett and Michael Jackson did exactly that.

For the entertainment you provided and for the memories of our own lives you helped to create, thank you. You will not be forgotten.

May you rest in peace.

Thursday, June 25, 2009

Electronic Medical Files: Economical Or Not?

One of the suggestions being openly debated by government leaders regarding health care legislation that will hopefully result in reducing medical expenses and increasing patient care is converting paper patient files to electronic patient files.

Electronic files sound like a positive change. With the push of a computer button, electronic files could assist doctors in more easily and more quickly transferring a patient’s medical record to specialists, to consulting physicians, or to hospital emergency rooms during situations when moments can mean the difference between life and death. It could help a doctor treating a new patient or a pharmacist filling a prescription for a new customer to immediately check for any possible drug interactions, drug allergies, or to know what prescriptions have been previously tried. Electronic files may actually be able to save duplicated tests, procedures, or treatments, or they could save a life.

For the physicians who completely convert to electronic records, it would save valuable office space, space that could be then used as additional exam rooms or as an area for additional medical equipment such as an in-office x-ray machine or a small in-office lab. Another use for the newly available office space might include a comfortable consultation room where doctors and patients could further discuss diagnoses, treatment plans, or possible outcomes.

Yet, for all of the positive potential of electronic records, there are some negative issues, too.

Anyone who works in an office knows that, typically, there is a paper file maintained to support the electronic file. The workload required of keeping a client file is not reduced by creating an electronic file; rather, it is doubled. Paper files are maintained, particularly in regards to important patient or client records, because electricity can fail temporarily, computers can fail or crash, computers can catch viruses or malfunction. And, the greatest issue regarding electronic files is data entry errors that can occur when typists incorrectly read a hand-written note, when typists are busily attempting to enter data into multiple patient files with multiple tabs on the screen simultaneously, or when the simple act of a typo occurs when entering the dosage or strength of a prescription.

Electronic files are much more expensive than paper files as well, a cost that will, no doubt, be passed on to the patient. Currently, doctors have paper files to search through, refer to, and hold in their hands as they speak to a patient. With electronic files, a computer connected to a mainframe would need to be present in each exam room so that the doctor could have access to the information. Computer programmers and computer maintenance technicians would have to be hired. New electrical wiring and maintenance to the wiring would be necessary throughout medical facilities to support the new computers. Finally, with all of this new workload of keeping two files on each client, new office personnel will need to be hired for data entry.

Yet, other questions exist regarding electronic files. If the electronic filing system is to be consistent so that doctors in different states can have immediate access to medical information, then there will need to be only one universal computer system available to any medical practitioner. Who decides what type of system it will be and how it will function? This could create a problem since some physicians in some locations may be unable to afford expensive computer systems or computers large enough to support such a program, possibly resulting in smaller, rural areas losing their physicians to clinics in larger cities.

Another issue related to the computer system is data entry. In addition to the potential for data entry errors, there is also the issue regarding time frames for entering the medical information. A patient may be treated in the morning at a local physician’s office, receive a prescription, and require an emergency visit in the middle of the night. But, what if the physician’s office staff was busied that day and did not or could not enter the updated information prior to the hospital visit? Electronic files have their advantages, but nothing will ever truly be better than an old-fashioned phone call and a consultation.

Finally, of prime importance, is the issue of privacy. If there will exist a national computer system so that medical practitioners can have instant access to a medical file—even if the patient is vacationing from out-of-state, there will be a need for security for the site, such as usernames or passwords. Who will have access to the files, which will probably not only contain medical histories but also addresses, phone numbers, emergency contacts, and, for patient identification purposes, a social security number? Will it be the doctors, the general practitioners, the dentists, the surgeons, the optometrists, and the other doctors who treat patients in any form? Doctors are often quite busy, particularly in emergency rooms. And, since doctors are sometimes on-call and en route as opposed to on-site when the information is needed, the administrators of medical facilities may need clearance. But, then, administrators aren’t always available either and, as we know, nurses do quite a bit of medical work. The nurses may need clearance. Then again, nurses are also quite busy and the nursing techs, who often deal with the patients one-on-one, may need some limited clearance to the medical records of their patients. Pharmacists will need clearance to know what prescription to fill (paper scripts will be gone) and to be able to double-check for potential interactions. What about the ambulance drivers and emergency medical technicians? Since they are usually the first on the scene, they would require clearance. What if a patient decides to go to a holistic practitioner or to someone practicing alternative therapies? It would be beneficial to have this information in the medical record to prevent possible interactions between herbal remedies and prescriptions, but then the practitioners of alternative treatments would also need clearance. Of course, anyone entering the medical data into the electronic files would require clearance. The insurance companies employees reviewing customer policies to determine whether or not a test is warranted or whether a bill will be paid will need clearance. And, anyone who has ever had a computer system knows that all too often usernames and passwords are written on paper and posted somewhere where they could be found and used unlawfully by those without clearance; other times, the codes are given by someone with clearance to someone without clearance when instant access to information is needed and time is an issue; and, yet at other times, computer systems are hacked into by unscrupulous individuals.

In an age where people are treated by multiple doctors, be they general physicians, specialists, dentists, optometrists, etc., electronic files can help to maintain medical histories over the course of decades in one tiny little computer space without worry of fading or becoming lost in storage, and they can quickly transfer information. But, electronic records come with their hazards and with their limitations, and they will inevitably be an additional expense to the patient and a significant risk that private information will find its way into the hands of people who have no use for it. So, the question remains: Are the benefits of electronic files worth the expense and the risks? Or, could a phone call and an old-fashioned paper file that has been diligently maintained post similar benefits with minimal risk and expense?

Perhaps, what is needed is not a national medical file database; rather, perhaps a more localized electronic database is called for, a database that could house the information provided for any patient being treated by multiple doctors, but a file that would have a very limited number of people with clearance to the information. A localized file, combined with a phone call and an electronic transfer of the medical file when a patient is treated out-of-area, may be a less expensive and less risky yet beneficial path to follow.

Wednesday, June 24, 2009

Insurance Companies and Health Care Reform

Since before winning the election, President Obama has stated that part of the reason for health care reform is to better control the medical expenses incurred by American citizens and the nation as a whole. For years, too many citizens have been forced into bankruptcy due to medical expenses; many others must regularly choose between their medical needs and what they can afford.

Health care reform will be neither inexpensive nor simple. Finding the balance between the needs of the patients, the needs of the physicians, the desires of the insurance companies, and the financial issues woven through them all will be no easy feat. And, it is certainly not a change that should be rushed through or approached recklessly.

Yet, for all of the speeches and debates about potential changes to the health care system that have graced the media and the floors of Washington, and for all those still to come, some questions linger on.

Is it really the health care system that is in need of an overhaul or is it the insurance companies alone that need to be changed? Each month, millions of people dutifully pay their insurance premiums. Yet, every month, people with chronic illnesses must hire attorneys to attempt to convince the insurance companies to pay what they are contractually obligated to pay. Additionally, millions who pay hundreds or thousands of dollars each year in insurance premiums may visit a doctor only once or twice, spending far more in insurance premiums (and co-pays) for the year than they would have had they paid for the visits completely out-of-pocket. Then, there are the millions without any health insurance who find it difficult to be seen by a doctor when it is necessary, resulting in expensive hospital emergency room visits.

Patients have gone bankrupt, doctors report frustration with the system and an inability to do their job, hospitals often report having difficulty balancing expenses with income and patient care, but have there been any insurance companies going bankrupt?

It seems that the common denominator amongst all of the issues regarding health care is the insurance companies. What an insurance policy covers often dictates the length of a hospital stay, what medical tests or procedures are performed, what referrals to specialists are made, and what medications are prescribed. Hospitals and doctors are charged exuberant fees for malpractice and other insurance policies by the insurance companies, a cost that is passed on to the patient. Patients seem to fall into two categories: People who cannot afford insurance premiums or people who can afford insurance premiums but are forced into bankruptcy due to the insurance companies not covering medical bills when premiums are paid, canceling coverage about the same time a diagnosis is made, or refusing coverage due to a pre-existing condition. The end result seems to be that the insurance companies are making profits while the patients and the medical providers are suffering.

Perhaps the real medical reform needed in America is legislation to regulate how insurance companies work, how much they can charge, how they fulfill their contracts, and how much control they have over the decision of physicians and patient care. Perhaps then doctors and patients can get back down to the business at hand: Healing.

Tuesday, June 23, 2009

One Factor About Health Care Reform That No One Is Talking About

Walk into any deli, stand in line at any bank, or simply walk down any street and one will inevitably overhear conversations regarding possible health care reforms being considered by the government in addition to hearing the opinions of everyday people regarding what changes they would like to see occur to the health care system. These conversations continue across the nation in medical facilities and at kitchen tables as families everywhere attempt to balance health and finances in a fierce battle between their medical needs and what they can afford.

Nightly, televisions and radios broadcast the voices of local and national leaders as they discuss their thoughts on health care reform, share their ideas on how to reform health care, and quietly mention the cost of implementing any new system. Yet, for all of the conversations, the speeches, and the interviews, there seems to be no focus on one particular aspect of health care.

Health care is about more than doctors and insurance companies; it is about tending to one’s health, one’s well-being, physically and emotionally. As school children we are taught about the food pyramid and about making healthy lifestyle and dietary choices, an education that continues as adults as we read magazines, newspapers, and watch television talk shows. Yet, how many Americans are forced into making unhealthy dietary choices because of finances?

People on budgets and those on fixed incomes know the truth: Processed foods, foods with little nutritional content that are high in fats, sugars, salts, and carbohydrates, are less expensive than healthier food choices. Americans who are already experiencing health problems are unable to afford fresh fruits and vegetables, the food choices that may actually improve their health, a problem that costs the nation valuable minds, valuable employees, valuable citizens, and puts a financial strain on the tax base. And, many who have met a new need to budget their grocery purchases have had to begin a meal plan that may destroy the health previously enjoyed.

Canned food products are much cheaper than fresh fruits and vegetables, although the canned products often have added salt, sugar, and preservatives, all of which have a negative long-term effect on health. A can of asparagus is usually less than one dollar, but the product seldom appears much like its fresh counterpart and lists very few nutrients on the label. A fresh asparagus bunch, however, will supply the same amount of servings but the cost is more than tripled. The same can be said for spinach, green beans, tomatoes, and potatoes. Canned fruit is often in the form of pie filling, with the pre-cooked fruit heavily laden with sugar or chemical substitutes.

Grain fed animal products always carry a larger price tag than their competitors. Unroasted nuts usually cost more per pound than nuts that have been baked in various oils, salts, and preservatives, a process that adds calories and fat grams without adding nutritional content. As one walks through the grocery store, comparing prices and making decisions, the list of price differences seems endless but the shopper is always aware that the budget is finite.

Organic fruits and vegetables are even more expensive than the “regular” fresh produce. During a recent shopping trip to a local market, one head of cabbage, unpackaged and possibly sprayed with pesticides or preservatives, cost less than fifty cents. However, in the same store, an organic head of cabbage cost over two dollars and fifty cents. Organic eggs typically cost a dollar more per dozen. An argument can be made that because of the additional chemicals that have been sprayed onto and absorbed into the food, even non-organic fresh fruits and vegetables may be damaging our long-term health, a problem that could eventually result in greater health care expenses.

As our politicians discuss potential changes in how insurance companies operate, how doctors perform their daily tasks, if socialized medicine would be a positive or negative outcome for America, and how much reform of the health care system is needed, hopefully they will begin to also consider and debate the need for healthy dietary choices to be available to and affordable for everyone. With affordable, more nutritious options at the supermarket, perhaps the overall health of Americans will improve and the future costs of medical care will decrease.