Dr. Saleeby contributes to Wikipedia - Rhodiola rosea

Rhodiola rosea

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Rhodiola rosea (Roseroot, Golden Root, Arctic Root, Orpin Rose, Rhodiole Rougeâtre)
Scientific classification
Kingdom:	Plantae
(unranked):	Angiosperms
(unranked):	Eudicots
(unranked):	Core eudicots
Order:	Saxifragales
Family:	Crassulaceae
Genus:	Rhodiola
Species:	R. rosea
Binomial name
Rhodiola rosea L.[1]
Synonyms
Sedum rosea (L.) Scop. Sedum rhodiola DC. Rhodiola arctica Boriss. Rhodiola iremelica Boriss. Rhodiola scopolii Simonk. Sedum scopolii Simonk. Золотой Корень, Solotoy Koren

Wikimedia Commons has media related to: Rhodiola rosea

Rhodiola rosea (Golden Root, Roseroot, Aaron's Rod) is a plant in the Crassulaceae family that grows in cold regions of the world. These include much of the Arctic, the mountains of Central Asia, the Rocky Mountains, and mountainous parts of Europe, such as the Alps, Pyrenees, Carpathian Mountains, Scandinavia, Iceland, Great Britain and Ireland. The perennial plant grows in areas up to 2280 meters elevation. Several shoots grow from the same thick root. Shoots reaches 5 to 35 cm in height. Rhodiola rosea is dioecious – having separate female and male plants.

Contents [hide] 1 Uses 2 Phytochemicals and potential health effects 3 Dosage 4 See also 5 References 6 External links 7 Further reading

Uses

Plant

Rhodiola rosea may be effective for improving mood and alleviating depression. Pilot studies on human subjects^[2][3][4] showed that it improves physical and mental performance, and may reduce fatigue.
Rhodiola rosea's effects are potentially mediated by changes in serotonin and dopamine levels due to monoamine oxidase inhibition and its influence on opioid peptides such as beta-endorphins,^[5] although these specific neurochemical mechanisms have not been clearly documented with scientific studies. However there have been extensive case studies undertaken by Richard P. Brown, MD, associate clinical professor of psychiatry at Columbia University College of Physicians & Surgeons and Patricia L. Gerbarg, MD assistant clinical professor of psychiatry at New York Medical College can be found in their book "The Rhodiola Revolution, printed in 2004 by Rodale, 2468109753. Rhodiola rosea has also been listed as a Complementary and Alternative Treatment in the American Journal of Psychiatry, chapter 104, pages 2147-2183 under Psychiatry Second Edition CAM TREATMENT by authors Allan Tasman, Jerald Kay & Jeffrey A. Lieberman
Rhodiola is included among a class of plant derivatives called adaptogens which differ from chemical stimulants, such as nicotine, and do not have the same physiological effects.
In Russia and Scandinavia, Rhodiola rosea has been used for centuries to cope with the cold Siberian climate and stressful life.^{[citation needed]} Such effects were provided with evidence in laboratory models of stress using the nematode C. elegans,^[6] and in rats in which Rhodiola effectively prevented stress-induced changes in appetite, physical activity, weight gain and the estrus cycle.^[7]
Rhodiola has been used in traditional Chinese medicine, where it is called hóng jǐng tiān (红景天).

Phytochemicals and potential health effects

The dried rhizomes contained essential oil with the main chemical classes: monoterpene hydrocarbons, monoterpene alcohols and straight chain aliphatic alcohols were the most abundant volatiles detected in the essential oil, and a total of 86 compounds were identified (Rohloff, 2002). Geraniol was identified as the most important rose-like odor compound besides geranyl formate, geranyl acetate, benzyl alcohol and phenylethyl alcohol. Its oxygenated metabolite Rosiridol is an aglycon of Rosiridin (Kurkin et al., 1985a; Kurkin and Zapesochnaya, 1986b) - one of the most active constituents of Rhodiola in bioassay guided fractionation of Rhodiolathe extract.^[8] Rosiridin was found to inhibit monoamine oxidases A and B in vitro implying its potential beneficial effect in depression and senile dementia.^[8] More than 50 polar compounds were isolated from the water alcoholic extracts, they are: monoterpene alcohols and their glycosides, cyanogenic glycosides, phenylethanoids and phenylpropanoids, flavonoids, aryl glycosides, proanthocyanidins and other gallic acid derivatives. (Zapeschnaya, and Kurkin, 1983, 1983; Kurkin et al., 1985a; Kurkin, and Zapesochnaya, 1986a,b; Ganzera et al., 2001; Tolonen et al.,2003; Saratikov and Krasnov, 2004; Akgul et al., 2004; Ma et al.2006, Yousef et al., 2006, Ali et al.,2008; Avula et al., 2008).

Withering flower

Rhodiola rosea contains a variety of compounds that may contribute to its effects,^[9] including the class of rosavins which include rosavin, rosarin, and rosin. Several studies have suggested that the most active components are likely to be rhodioloside and tyrosol,^[10] with other components being inactive when administered alone, but showing synergistic effects when a fixed combination of rhodioloside, rosavin, rosarin and rosin was used.^[11]
Although rosavin, rosarin, rosin and salidroside (and sometimes p-tyrosol, rhodioniside, rhodiolin and rosiridin) are among suspected active ingredients of Rhodiola rosea, these compounds are mostly polyphenols for which no physiological effect in humans is proved to prevent or reduce risk of disease.^[12]
Although these phytochemicals are typically mentioned as specific to Rhodiola extracts, there are many other constituent phenolic antioxidants, including proanthocyanidins, quercetin, gallic acid, chlorogenic acid and kaempferol.^[13][14]
While animal tests have suggested a variety of beneficial effects for Rhodiola rosea extracts^[15] there is scientific evidence only for depression as a benefit in humans. A clinical trial showed significant effect for a Rhodiola extract in doses of 340–680 mg per day in male and female patients from 18 to 70 years old with mild to moderate depression.^[16]
The effect of Rodiola Rosea promoting the release of NO from RPCSMC and RAEC was correlated with the effect of Rodiola Rosea to resist senility.^[17]
Rhodiola rosea extract SHR-5 exerts an anti-fatigue effect that increases mental performance, particularly the ability to concentrate in healthy subjects (Darbinyan et al., 2000; Spasov et al.,2000b; Shevtsov et al., 2003) and burnout patients with fatigue syndrome (Olsson et al., 2009). Rhodiola significantly reduced symptoms of fatigue and improved attention after four weeks of repeated administration (Olsson et al., 2009).
Olsson, E.M.G., von Schéele, B., Panossian, A.G., 2009. A randomized double-blind placebo controlled parallel group study of SHR-5 extract of Rhodiola rosea roots as treatment for patients with stress related fatigue. Planta medica 75,105-112.
Studies on whether Rhodiola improves physical performance have been inconclusive, with some studies showing some benefit,^[18] while others show no significant difference.^[19]
Inhibitory activities against HIV-1 protease^[20]

Dosage

Dried Rhodiola rosea root

Rhodiola rosea extract is mainly used in the form of capsules or a tablet, though tinctures are also available. The capsules and tablets often contain 100 mg of a standardized amount of 3 percent rosavins and 0.8–1 percent salidroside because the naturally occurring ratio of these compounds in Rhodiola rosea root is approximately 3:1. Authentication as well as potency of golden root crude drug materials and standardized extracts thereof are carried out with validated RP-HPLC analyses to verify the content of the marker constituents salidroside, rosarin, rosavin, rosin and rosiridin.^[21] However, as with many plant-based remedies, an approved dosage range in relation to the active constituents has officially not been established. In these cases, dosage recommendations of the individual manufacturers should be followed.
A typical dosage is one or two capsules or tablets daily; one in the morning and when taking two, one in the early afternoon. Rhodiola rosea should be taken early in the day because for some it can interfere with sleep. Others can take it in the evening with no effect on sleep patterns. If a user becomes overly activated, jittery or agitated then a smaller dose with very gradual increases may be needed. It is contraindicated in excited states.^{[citation needed]}
The dose may be increased to 200 mg three times a day if needed. A high dose is considered to be daily intakes of 1,000 mg and above.^{[citation needed]}
Rhodiola rosea may be beneficial to increase energy and mental performance for people suffering from Hashimoto's disease.^{[citation needed]}
In a 2007 clinical trial from Armenia, total effective doses were in the range of 340–680 mg per day for people aged 18 to 70. No side effects were demonstrated at these doses in the treatment of mild to moderate depression.^[22]

See also

• Rhodiola alsia

References

1. ^ "Rhodiola rosea - Plants For A Future database report". www.pfaf.org. http://www.pfaf.org/user/Plant.aspx?LatinName=Rhodiola%20rosea. Retrieved 2008-02-23. 
2. ^ Shevtsov VA, Zholus BI, Shervarly VI, et al. (Mar 2003). "A randomized trial of two different doses of Rhodiola rosea extract versus placebo and control of capacity for mental work". Phytomedicine 10 (2-3): 95–105. doi:10.1078/094471103321659780. PMID 12725561. 
3. ^ Darbinyan V, Kteyan A, Panossian A, Gabrielian E, Wikman G, Wagner H (Oct 2000). "Rhodiola rosea in stress induced fatigue—a double blind cross-over study of a standardized extract with a repeated low-dose regimen on the mental performance of healthy physicians during night duty". Phytomedicine 7 (5): 365–71. PMID 11081987. 
4. ^ Ha Z, Zhu Y, Zhang X, et al. (Sep 2002). "[The effect of rhodiola and acetazolamide on the sleep architecture and blood oxygen saturation in men living at high altitude]" (in Chinese). Zhonghua Jie He He Hu Xi Za Zhi 25 (9): 527–30. PMID 12423559. 
5. ^ Gregory S. Kelly, ND, (2001). "Rhodiola rosea: a possible plant adaptogen.". Alternative Medicine Review 6 (3): 293–302. PMID 11410073. 
6. ^ Wiegant FA, Surinova S, Ytsma E, Langelaar-Makkinje M, Wikman G, Post JA (Jun 2008). "Plant adaptogens increase lifespan and stress resistance in C. elegans". Biogerontology 10 (1): 27–42. doi:10.1007/s10522-008-9151-9. PMID 18536978. 
7. ^ Mattioli L, Funari C, Perfumi M (May 2008). "Effects of Rhodiola rosea L. extract on behavioural and physiological alterations induced by chronic mild stress in female rats". Journal of Psychopharmacology (Oxford) 23 (2): 130–42. doi:10.1177/0269881108089872. PMID 18515456. 
8. ^ ^{a b} van Diermen, 2009 Monoamine oxidase inhibition by Rhodiola rosea L. roots.
9. ^ Kucinskaite A, Briedis V, Savickas A (2004). "[Experimental analysis of therapeutic properties of Rhodiola rosea L. and its possible application in medicine"] (in Lithuanian). Medicina (Kaunas) 40 (7): 614–9. PMID 15252224. http://medicina.kmu.lt/0407/0407-02l.pdf. 
10. ^ Mao Y, Li Y, Yao N (Nov 2007). "Simultaneous determination of salidroside and tyrosol in extracts of Rhodiola L. by microwave assisted extraction and high-performance liquid chromatography". J Pharm Biomed Anal 45 (3): 510–5. doi:10.1016/j.jpba.2007.05.031. PMID 17628386. 
11. ^ Panossian A, Nikoyan N, Ohanyan N, et al. (Jan 2008). "Comparative study of Rhodiola preparations on behavioral despair of rats". Phytomedicine 15 (1-2): 84–91. doi:10.1016/j.phymed.2007.10.003. PMID 18054474. 
12. ^ Boudet AM (2007). "Evolution and current status of research in phenolic compounds". Phytochemistry 68 (22-24): 2722–35. doi:10.1016/j.phytochem.2007.06.012. PMID 17643453. 
13. ^ Yousef GG, Grace MH, Cheng DM, Belolipov IV, Raskin I, Lila MA (Nov 2006). "Comparative phytochemical characterization of three Rhodiola species". Phytochemistry 67 (21): 2380–91. doi:10.1016/j.phytochem.2006.07.026. PMID 16956631. 
14. ^ Liu Q, Liu ZL, Tian X (Feb 2008). "[Phenolic components from Rhodiola dumulosa]" (in Chinese). Zhongguo Zhong Yao Za Zhi 33 (4): 411–3. PMID 18533499. 
15. ^ Perfumi M, Mattioli L (Jan 2007). "Adaptogenic and central nervous system effects of single doses of 3% rosavin and 1% salidroside Rhodiola rosea L. extract in mice". Phytother Res 21 (1): 37–43. doi:10.1002/ptr.2013. PMID 17072830. 
16. ^ Darbinyan V, Aslanyan G, Amroyan E, Gabrielyan E, Malmström C, Panossian A (2007). "Clinical trial of Rhodiola rosea L. extract in the treatment of mild to moderate depression". Nord J Psychiatry 61 (5): 343–8. doi:10.1080/08039480701643290. PMID 17990195. 
17. ^ Effect of Rodiola on level of NO and NOS in cultured rats penile corpus cavernosum smooth muscle cell and artery endothelium cell Kong X., Shi F., Chen Y., Lu H., Yao M., Hu M. Chinese Journal of Andrology 2007 21:10 (6-11)
18. ^ De Bock K, Eijnde BO, Ramaekers M, Hespel P (Jun 2004). "Acute Rhodiola rosea intake can improve endurance exercise performance". Int J Sport Nutr Exerc Metab 14 (3): 298–307. PMID 15256690. 
19. ^ Walker TB, Altobelli SA, Caprihan A, Robergs RA (Aug 2007). "Failure of Rhodiola rosea to alter skeletal muscle phosphate kinetics in trained men". Metab Clin Exp. 56 (8): 1111–7. doi:10.1016/j.metabol.2007.04.004. PMID 17618958. 
20. ^ Screening of Korean plants against human immunodeficiency virus type 1 protease Min B.S., Bae K.H., Kim Y.H., Miyashiro H., Hattori M., Shimotohno K. Phytotherapy Research 1999 13:8 (680-682)
21. ^ Ganzera M, Yayla Y, Khan IA. (2001). “Analysis of the marker compounds of Rhodiola rosea L. (golden root) by reversed phase high performance liquid chromatography”. Chem Pharm Bull (Tokyo) 49(4): 465-7. PMID: 11310675
22. ^ Darbinyan, V.; Aslanyan, G.; Amroyan, E.; Gabrielyan, E.; Malmstroumlm, C.; Panossian, A. Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression Nordic Journal of Psychiatry, Volume 61, Issue 5 2007 , pages 343–348 ; accessed Dec 2008

Panossian, A., Wikman, G. 2010. Rosenroot (Roseroot): Traditional Use, Chemical Composition, Pharmacology, and Clinical Efficacy. Phytomedicine 17(5-6): 481-493. DOI 10.1016/j.phymed.2010.02.002

External links

• Flora of the Canadian Arctic Archipelago [1]
• Science News Online, Warming to a Cold War Herb
• Third Age, ThirdAge: Rhodiola rosea
• American Botanical Council, Rhodiola rosea: A Phytomedicinal Overview
• Whole Health MD, Reference Library
• Alternative Medicine, The Herb that Came In from the Cold

Critical of effects on mountain sickness

• Wilderness Medical Society, Lack of Effect of Rhodiola on Hypoxemia and Oxidative Stress
• Swedish Medical Center, Acute Mountain Sickness

Further reading

• Richard P. Brown, MD & Patricia L. Gerbarg with Barbara Graham. “The Rhodiola Revolution" Rodale Press, 2004. A discussion of the benefits of Rhodiola rosea.
• Saleeby,M.D., J.P., Keefer, A., "Wonder Herbs: A guide to three adaptogens", Xlibris, 2006. Entire chapter devoted to R. rosea.

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Dr. Saleeby contributes to Wikipedia - Eleutherococcus senticosus

Eleutherococcus senticosus

From Wikipedia, the free encyclopedia

Revision as of 14:44, 14 March 2011 by Jpsaleeby (talk | contribs)

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Jump to: navigation, search

This article needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed. (November 2010)

Eleutherococcus senticosus
Scientific classification
Kingdom:	Plantae
(unranked):	Angiosperms
(unranked):	Eudicots
(unranked):	Asterids
Order:	Apiales
Family:	Araliaceae
Genus:	Eleutherococcus
Species:	E. senticosus
Binomial name
Eleutherococcus senticosus (Rupr. & Maxim.) Maxim.[1]
Synonyms
Acanthopanax senticosus (Rupr. & Maxim.) Harms[1] Hedera senticosa Rupr. & Maxim.[1]

Eleutherococcus senticosus (formerly Acanthopanax senticosus) is a species of small, woody shrub in the family Araliaceae native to Northeastern Asia. It is often colloquially referred to as Siberian Ginseng or eleuthero, and is sometimes shortened to E. senticosus in medical literature. E. senticosus has been studied as an adaptogen, and has a history of use in Chinese medicine, where it is known as cì wǔ jiā (刺五加).^[1].
The herb grows in mixed and coniferous mountain forests, forming low undergrowth or is found in groups in thickets and edges. E. senticosus is sometimes found in oak groves at the foot of cliffs, very rarely in high forest riparian woodland. Its native habitat is East Asia, China, Japan, and Russia. E. senticosus is broadly tolerant of soils, growing in sandy, loamy, and heavy clay soils with acid, neutral, or alkaline chemistry and including soils of low nutritional value. It can tolerate sun or dappled shade and some degree of pollution. E. senticosus is a deciduous shrub growing to 2m at a slow rate. It is hardy to zone 3. It flowers in July in most habitats. The flowers are hermaphroditic and are pollinated by insects.^[2]
E. senticosus is a new addition to Western natural medicine, but has quickly gained a reputation similar to that of the better known and more expensive^{[citation needed]} Chinese Ginseng. Though the chemical make-up of the two herbs differs, their effects seem to be similar. An extensive list of research on E. senticosus with links to PubMed is available.^[3]
The herb is an adaptogen, is anticholesteremic, is mildly anti-inflammatory, is antioxidant, is a nervine, and is an immune tonic^{[citation needed]}. It is useful when the hypothalamic-pituitary-adrenal axis (HPA) is depleted. Symptoms of this condition include fatigue, stress, neurasthenia, and sore muscles associated with the hypofunctioning of the endocrine system, and adrenal exhaustion indicated by a quivering tongue, dark circles under the eyes, and dilating/contracting pupils. Eleuthero may alleviate these symptoms.^[4]

Contents [hide] 1 Synonyms 2 Ethnomedical use 3 Interactions and side effects 4 References 5 External links

Synonyms

E. senticosus was previously marketed in the United States as Siberian Ginseng because it has similar herbal properties to those of Panax ginseng. However, it belongs to a different genus in the family Araliaceae, and it is currently illegal in the United States to market eleuthero as Siberian Ginseng, since the term "ginseng" is reserved for the Panax species.^[4]

Ethnomedical use

Eleutherococcus senticosus leaves

E. senticosus is an adaptogen that has a wide range of health benefits attributed to its use.^{[citation needed]} Currently, most of the research to support the medicinal use of E. senticosus is in Russian or Korean.^{[citation needed]} E. senticosus contains eleutherosides, triterpenoid saponins that are lipophilic and that can fit into hormone receptors.^{[citation needed]} Supporters^[who?] of E. senticosus as medicine claim that it possesses a variety of medicinal properties, such as:

• increased endurance^{[citation needed]}
• memory improvement^{[citation needed]}
• anti-inflammatory^{[citation needed]}
• immunogenic^{[citation needed]}
• chemoprotective^{[citation needed]}
• radiological protection^{[citation needed]}

Eleutherococcus senticosis is more tonifying than the true Ginsengs (Panax sp.)^{[citation needed]}. Taken regularly, it enhances immune function, decreases cortisol levels and inflammatory response^{[contradiction]}, and it promotes improved cognitive and physical performance^{[citation needed]}. In human studies, Eleuthero has been successfully used to treat bone marrow suppression caused by chemotherapy or radiation, angina, hypercholesterolemia, and neurasthenia with headache, insomnia, and poor appetite.^[5][6][7]
The major constituents of E. senticosus are Ciwujianoside A-E, Eleutheroside B (Syringin), Eleutherosides A-M, Friedelin, and Isofraxidin.^[4]
Eleutherococcus senticosus has been shown to have significant antidepressant effects in rats.^[8][9]

Interactions and side effects

• People with medicated high blood pressure should consult their doctor before taking E. senticosus because it may reduce their need for medication.

• E. senticosus will enhance the effectiveness of mycin class antibiotics.
• E. senticosus, when purchased from non-GMP sources, has occasionally been adulterated with Periploca graeca, which can potentiate digoxin or similar drugs; however, this is not an interaction of E. senticosus.^{[4][unreliable source?]}

References

1. ^ ^{a b c d} "Eleutherococcus senticosus information from NPGS/GRIN". www.ars-grin.gov. http://www.ars-grin.gov/cgi-bin/npgs/html/taxon.pl?15004. Retrieved 2008-03-04. 
2. ^ "Eleutherococcus senticosus". www.ibiblio.org. http://www.ibiblio.org/pfaf/cgi-bin/arr_html?Eleutherococcus+senticosus#WEBREFS. Retrieved 2008-03-04. 
3. ^ List of Research on Eleuthero in PubMed
4. ^ ^{a b c d[unreliable source?]}Winston, David & Maimes, Steven. “Adaptogens: Herbs for Strength, Stamina, and Stress Relief,” Healing Arts Press, 2007.
5. ^ Halstead B, Hood L (1984). Eleutherococcus senticosis–Siberian Ginseng, OHAI. p.7.
6. ^ Chen JK, Chen TT. Chinese Medical Herbology and Pharmacology, Art of Medicine Press, City of Industry, CA 2004
7. ^ [David Winston. Native American, Chinese, and Ayurvedic Materia Medica, HTSBM, pp. 1-1
8. ^ Kurkin VA, Dubishchev AV, Ezhkov VN, Titova IN, Avdeeva EV (2006). "Antidepressant activity of some phytopharmaceuticals and phenylpropanoids". Pharmaceutical Chemistry Journal 40 (11): 614–9. doi:10.1007/s11094-006-0205-5. http://www.springerlink.com/content/t6512435001n1418/. 
9. ^ Deyama T, Nishibe S, Nakazawa Y (December 2001). "Constituents and pharmacological effects of Eucommia and Siberian ginseng". Acta Pharmacol. Sin. 22 (12): 1057–70. PMID 11749801. 

• Brunner, R., Tabachnik, B. (1990). Soviet Training and Recovery Methods, pp. 217–21. Sport Focus Publishing.
• Bohn B, Nebe CT, Birr C (1987). "Flow Cytometric Studies with Eleutherococcus senticosus extract as an Immunomodulating Agent". Drug Res 37 (10): 1193–6. 
• Saleeby, MD, J.P., Keefer, A., "Wonder Herbs: A guide to three adaptogens", Xlibris, 2006. Entire chapter devoted to E. senticosus.
• Winston, David & Maimes, Steven. “ADAPTOGENS: Herbs for Strength, Stamina, and Stress Relief,” Healing Arts Press, 2007. Contains Russian research on E. senticosus and a monograph on the herb.

External links

• Eleutherococcus senticosus Photos (PlantSystematics.org)
• Monographs on Selected Medicinal Plants - Volume 2: Radix Eleutherococci (World Health Organization)
• Siberian ginseng article
• Eleuthero article
• Donovan JL, DeVane CL, Chavin KD, Taylor RM, Markowitz JS (May 2003). "Siberian ginseng (Eleutheroccus senticosus) effects on CYP2D6 and CYP3A4 activity in normal volunteers". Drug Metab. Dispos. 31 (5): 519–22. doi:10.1124/dmd.31.5.519. PMID 12695337. http://dmd.aspetjournals.org/content/31/5/519.full. 
• University of Maryland Alternative Medicine Reference
• Kimura Y, Sumiyoshi M (December 2004). "Effects of various Eleutherococcus senticosus cortex on swimming time, natural killer activity and corticosterone level in forced swimming stressed mice". J Ethnopharmacol 95 (2-3): 447–53. doi:10.1016/j.jep.2004.08.027. PMID 15507373. http://linkinghub.elsevier.com/retrieve/pii/S0378-8741(04)00423-4. 
• Jung SM, Schumacher HR, Kim H, Kim M, Lee SH, Pessler F (2007). "Reduction of urate crystal-induced inflammation by root extracts from traditional oriental medicinal plants: elevation of prostaglandin D2 levels". Arthritis Res. Ther. 9 (4): R64. doi:10.1186/ar2222. PMC 2206389. PMID 17612394. http://arthritis-research.com/content/9/4/R64.

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Can TeleHealth Solve our Healthcare Crisis?

Can Telehealth Solve Our Healthcare Crisis?

To have or not to have healthcare? That is the question.

By: Yusuf M. Saleeby, M.D.


Access to healthcare in South Carolina is in need of a large band-aid. South Carolina happens to be one of the unhealthiest states in the Union by reports with a ranking of 46 out of 50 in the nation. This low ranking may be in part to the lifestyle and genetics of the population, but very likely the resident's poor access to quality healthcare is a determining factor. Poor dietary habits, a diet traditionally rich in fatty and fried foods along with the general lack of exercise by the vast majority contribute to this but can be overcome with proper preventive medicine interventions. Syndrome X (Metabolic Syndrome) is rampant in the southeast, hitting SC very hard with large populations of those suffering from hypertension (HTN) and diabetes mellitus (DM). Lack of access to basic healthcare mean hypertension, diabetes and other disorders go unrecognized and thus untreated. Ramifications of untreated HTN and DM alone can account for great morbidity among the population, leading to heart disease, renal failure, stroke, and blindness to name a few outcomes. This population of under-treated will eventually consume a greater healthcare dollar as their disease process worsens and sequelae materialize.


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The problem goes beyond the individual residents of the state. Almost 80% of businesses in SC, excluding self-employed and government workers have fewer than 10 employees and 53% of these "small employers" with a work force less than 10 employees do not offer group-sponsored health insurance to their employees because of cost issues.

Don't follow the flock, avoid the herd mentality, think hard about your own healthcare.

Now that the problem has been identified, what is the solution? Well it is a complex and multi factorial problem to solve. Should the government step in and cover the cost of supplying healthcare to all individuals at great expense to the taxpayer? I say no. A resounding no! For the most part we see the failures in the system of government sponsored or supplied healthcare with what is currently going on with Medicare and Medicaid.


Another example of mediocre healthcare delivery is with our nation's veterans. The Veteran Administration (VA) system of healthcare is increasingly slow, impersonal and cumbersome. Private sector delivery systems can provide an answer as long as they are regulated to eliminate unfair business practices and unscrupulous profiteering. To allow a system to become successful as a business model, it must keep overhead down, allow current advances in communication technologies to be at its disposal and become free from the blood letting of insurance companies and a legal system with no reforms to place a ceiling on monetary awards for malpractice claims. One way to solve issues of cost containment for delivery models that will allow savings to be past to consumers is the use of telehealth with self insurance and the passing of legislation for tort reform.

For a mere fraction of the cost of operating a brick-and-mortar typical family practice, telehealth can accomplish almost 70% of what can be conducted in an office setting without the cost prohibitive costs. End result is the savings passed along to the patient (consumer). Making routine and basic healthcare one again affordable.

Exploring this model are several telemedicine or telehealth services AtroGene Telemedicine Group is one in the forefront. The group of clinicians I am in association with have departed from the typical means of conducting business via a traditional office based practice and is exploring new ways of healthcare delivery via telephone and video-consulting.

The Internet savvy end-consumer will most likely embrace this new technology with offers great promise and practicality. This type of consumer-driven access to healthcare will be a force to be reckoned with. Older patients who are used to office based practice may find the task of trusting the Internet and telemedicine a daunting task. The younger patient, typically will have minor acute illnesses that have lower acuity and can be managed comfortably by practitioners well versed in telemedicine, knowing the abilities and limitations of the system.

Thousands of healthcare dollars can be saved if this new model is embraced. This will divert non-emergent or non-urgent patients from burdening our already overcrowded emergency departments and allow for better and more efficient management of higher acuity patients in true need of the ED.

Likewise access to online direct access blood testing (DAT) will allow astute consumers/patients direct-to-consumer ability to order lab and blood testing. Bypassing the traditional avenues to obtaining routine annual labs, they can once again drastically reduce their expenditures on the basic routine aspects of health and wellness. With only minor interventions and guidance by healthcare providers the vast majority of the public can obtain affordable healthcare tests they would have otherwise ignored or put off for lack of ability to pay a higher price tag.

Affordable and easily accessible telehealth may very well be the panacea to save the majority of uninsured clients in our state and the nation.

======================

Yusuf (JP) Saleeby, MD is an Emergency Medicine physician with a background in preventive and integrative medicine. He is a leader in the development of primary care initiatives in telemedicine and telehealth. He has developed a DAT lab testing site for the general public at eStatLabs.com. He is also associated with AtroGene Telemedicine Consultations as one of their clinicians and directors. RedBanyan.com is another of his pet projects, which in the future will offer corporate & charity sponsored Free Telehealth to the general population.


(c) 2011

Article Source: http://EzineArticles.com/?expert=Yusuf_M._Saleeby,_M.D.

Great Article by Dr. Davis Liu on Consumer Driven Healthcare

Consumer-Driven Healthcare: Why It Will Fail

February 23rd, 2011 by Dr Davis Liu in Health Policy, Opinion

With the creation of consumer-driven health plans and health insurance policies with high deductibles linked to a savings option, more financial responsibility shouldered by patients and employees and less by employers was completely inevitable. The American public likes to have everything, whether consumer electronics or other services, as cheap as possible. With escalating healthcare expenses rising far more rapidly than wages or inflation, it’s not surprising employers needed a way to manage this increasingly-costly business expense.

In the past, companies faced a similar dilemma. It wasn’t about medical costs, but managing increasingly expensive retirement and pension plan obligations. Years ago, companies moved from these defined benefit plans to defined contribution plans like 401(k)s. After all, much like healthcare, the reasoning by many was that employees were best able to manage retirement planning because they would have far more financial incentive, responsibility, and self-motivation to make the right choices to ensure a successful outcome.

How did that assumption turn out anyway? Disastrous, according to a recent Wall Street Journal article entitled “Retiring Boomers Find 401(k) Plans Fall Short.” An excerpt:

The median household headed by a person aged 60 to 62 with a 401(k) account has less than one-quarter of what is needed in that account to maintain its standard of living in retirement, according to data compiled by the Federal Reserve and analyzed by the Center for Retirement Research at Boston College for The Wall Street Journal. Even counting Social Security and any pensions or other savings, most 401(k) participants appear to have insufficient savings. Data from other sources also show big gaps between savings and what people need, and the financial crisis has made things worse.

In others words, a lot of people don’t have enough money to retire. The options they have are simply “postponing retirement, moving to cheaper housing, buying less-expensive food, cutting back on travel, taking bigger risks with their investments, and making other sacrifices they never imagined…In general, people facing problems today got too little advice, or bad advice.”

Though employers were able to manage retirement expenses, employees paid a significant price. This wasn’t intuitively obvious in the 1980′s when these plans became more commonplace. Over the past decade, the less than rational behavior by employees hasn’t gone unnoticed by those who study behavioral economics or those in the government. As a result, more organizations and companies are nudging employees into the right behaviors with auto-enrollment into 401(k) plans and auto-allocation of these funds with protection from any future liability as noted in the Pension Protection Act of 2006.

The analogies to healthcare and specifically consumer-driven health plans should be clear. Workers don’t save adequately for retirement even when in their best interest. It’s very likely that workers won’t save money adequately to fund future health expenses. After all, if people can’t fund retirement, something we undoubtedly all look forward to, which one of us is willing to saving for chemotherapy or open heart surgery, which no one wants? According to the annual Kaiser Family Foundation Employer Benefits Survey, the average annual deductible for single coverage and family coverage is nearly $2,000 and $4,000 respectively for health insurance plans that are health savings accounts (HSA) eligible. The deductibles are slightly lower in health insurance policies that are linked to health reimbursement arrangement (HRA). About 13 percent of employees are covered under either plan.

Unlike those in retirement planning who can work longer, even if not desirable, employees who are ill may not have an option to work to pay for their medical expenses. There continues to be evidence that people are curbing their healthcare due to the ability to pay.

Though experts debate on whether this is a good thing (patients are avoiding unnecessary and expensive therapies and opting for less pricey but equally as effective options) or a bad thing (patients are avoiding the preventive screening tests or therapies that overall can decrease future costs), the opportunities to ensure patients make the right choices should be clear from workers’ less-than-optimal experience with 401(k)s.

If employers wish to help curb medical costs, then they will need to engage workers with programs like employee wellness, assisted decision making (either as second opinions or patient-friendly informed consent), and access to medical experts, equivalent to personal financial advisors, who may be able to help workers make the right choices for their health. Within the business community, there is some acknowledgment that access to these tools will be necessary to not only manage costs, but keep employees healthy and productive.

Done correctly, consumer-driven healthcare can be what everyone hoped they would be, nudging healthy behaviors and slowing healthcare costs with workers selecting only cost-effective therapies. If implemented poorly and organizations simply shift healthcare costs and financial responsibilities to workers like retirement planning decades ago, the nation will need to accept more than ever that increasingly more people get the medical care based simply on their ability to pay and not on medical necessity.

As a practicing primary care doctor, I hope that day never comes.

----------------------------------------

*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
 

Source:  GetBetterHealth.com

Can TeleHealth solve our Healthcare Crisis?

Can TeleHealth Solve Our Healthcare Crisis?

by Yusuf Saleeby, MD

Access to healthcare in South Carolina is in need of a large band-aid.  South Carolina happens to be one of the unhealthiest states in the Union by reports with a ranking of 46 out of 50 in the nation.  This low ranking may be in part to the lifestyle and genetics of the population, but very likely the resident's poor access to quality healthcare is a determining factor.  Poor dietary habits, a diet traditionally rich in fatty and fried foods along with the general lack of exercise by the vast majority contribute to this but can be overcome with proper preventive medicine interventions.  Syndrome X (Metabolic Syndrome) is rampant in the southeast, hitting SC very hard with large populations of those suffering from hypertension (HTN) and diabetes mellitus (DM).  Lack of access to basic healthcare mean hypertension, diabetes and other disorders go unrecognized and thus untreated.  Ramifications of untreated HTN and DM alone can account for great morbidity among the population, leading to heart disease, renal failure, stroke, and blindness to name a few outcomes.  This population of under-treated will eventually consume a greater healthcare dollar as their disease process worsens and sequelae materialize.

Statistics show some 19.4% of those living in South Carolina are uninsured, having no type of health insurance at all.  From a 2002 report, the uninsured residents cost the healthcare system upwards of $1,936 per individual per year.  While 60% of the uninsured are hard working citizens, the vast majority (74%) when asked list "affordability" as the reason for not obtaining or purchasing health insurance.  About half the eligible individuals without health insurance do not enroll in public programs for two chief reasons; firstly, they don’t want to receive government support and secondly, they don’t want government to provide health coverage.

The problem goes beyond the individual residents of the state.  Almost 80% of businesses in SC, excluding self-employed and government workers have fewer than 10 employees and 53% of these “small employers” with a work force less than 10 employees do not offer group-sponsored health insurance to their employees because of cost issues.  Now that the problem has been identified, what is the solution?  Well it is a complex and multi-factorial problem to solve.  Should the government step in and cover the cost of supplying healthcare to all individuals at great expense to the taxpayer?  I say no.  A resounding no!  For the most part we see the failures in the system of government sponsored or supplied healthcare with what is currently going on with Medicare and Medicaid.  Another example of mediocre healthcare delivery is with our nation's veterans.  The Veteran Administration (VA) system of healthcare is increasingly slow, impersonal and cumbersome.  Private sector delivery systems can provide an answer as long as they are regulated to eliminate unfair business practices and unscrupulous profiteering.  To allow a system to become successful as a business model, it must keep overhead down, allow current advances in communication technologies to be at its disposal and become free from the blood letting of insurance companies and a legal system with no reforms to place a ceiling on monetary awards for malpractice claims.  One way to solve issues of cost containment for delivery models that will allow savings to be past to consumers is the use of telehealth with self insurance and the passing of legislation for tort reform.  For a mere fraction of the cost of operating a brick-and-mortar typical family practice, telehealth can accomplish almost 70% of what can be conducted in an office setting without the cost prohibitive costs.  End result is the savings passed along to the patient (consumer).  Making routine and basic healthcare one again affordable. 

Exploring this model is the AtroGene Telemedicine group.  This group of clinicians have departed from the typical means of conducting business via a traditional office based practice and is exploring new ways of healthcare delivery via telephone and video-consulting.  The Internet savvy end consumer will most likely embrace this new technology with offers great promise and practicality.  Older patients who are used to office based practice may find the task of trusting the Internet and telemedicine a daunting task.  The younger patient, typically will have minor acute illnesses that have lower acuity and can be managed comfortably by practitioners well versed in telemedicine, knowing the abilities and limitations of the system.  Thousands of healthcare dollars can be saved if this new model is embraced.  This will divert non-emergent or non-urgent patients from burdening our already overcrowded emergency departments and allow for better and more efficient management of higher acuity patients in true need of the ED.

Likewise access to direct access testing (DAT) will allow astute consumers/patients direct access to lab and blood testing.  By passing the traditional avenues to obtaining routine annual labs, they can once again drastically reduce their expenditures on the basic routine aspects of health and wellness.  With only minor interventions and guidance by healthcare providers the vast majority of the public can obtain affordable healthcare tests they would have otherwise ignored or put off for lack of ability to pay a higher price tag.  Affordable and easily accessible telehealth may very well be the panacea to save the majority of uninsured clients in our state.

 Source: www.covertheuninsuredsc.org

(c) 2011

AtroGene/ Carolina Mobile MD March 2011 Newsletter

3.2011




The year 2011 has brought much change to Carolina Mobile MD. After a brief period of opening up a brick-and-mortar location in Conway, SC, it was determined not to be an effective use of resources, thus CMMD merged with AtroGene Telemedicine and closed the Myrtle Beach area location. AtroGene provides strictly TeleHealth Consultations much like Carolina Mobile, yet without the house call service. Dr. Saleeby will continue to head the group of healthcare providers and additional services have been added. Online Lab Testing (www.eStatLabs.com) and a new practice web site (www.AtroGene.com coming soon) are a few new features that make it easier for patients to obtain routine preventive healthcare and fast and affordable access for acute illness.




In the works is a project called RedBanyan (www.RedBanyan.org) which will offer FREE healthcare for basic preventive and minor acute illness via telemedicine/Skype to NC, SC and GA residents who have NO health insurance.




We also had our inaugural Slow Food USA (Conway/Myrtle Beach) convivium meeting Feb. 17th at the Horry Co. Public Library. The meeting was a grand success drawing in excess of 20 people. Mr. David White (Oakland Farms Free-Range Chickens) was our guest speaker and our crowd came from a diverse backgroud of people interested in Safe, Good and Fair foods. For more visit http://www.slowfoodusa.org/ or our listing on Local Harvest: http://www.localharvest.org/slow-food-conway-myrtle-beach-convivium-M41976 Our next meeting will be held in Myrtle Beach in April.




------------------------



The Amazing Vitamin K

 by JP Saleeby, MD



In very recent years, the medical and scientific communities have begun to focus their attention on the benefits of Vitamin K. While not as popular as its big brother, Vitamin D, Vitamin K will no doubt come to the attention of mainstream media as soon as its many benefits are realized by the public. In the last five years, primary care physicians and specialists are testing Vitamin D levels on almost every patient. As research has poured in on the many health benefits in multiple arenas, from bone health to immune function, Vitamin D therapy is now considered standard of care. Likewise, Vitamin K is slowly gaining momentum in the public eye and in doctor’s offices.



Of historical interest, Vitamin K was first discovered as a compound in the 1930's. It was reported in a German science journal as koagulationvitamin for its control over coagulation, hence the letter designation “K” for koagulation. Newsworthy in the mid-20th century, Vitamin K made headlines when the 1943 Nobel Prize in Medicine was shared by American Dr. Edward A. Doisy and German Dr. Henrik Dam for their work with this vitamin. As early as 1938, the first report of using Vitamin K to treat a life threatening case of hemorrhage due to liver disease was documented. Its use as a therapeutic saved the patient from certain death.


Vitamin K is a lipophilic vitamin (meaning it is fat soluble) and is required chiefly for blood coagulation and metabolism of bone and other tissues. There are two natural forms of this vitamin and several synthetic versions. Vitamin K1, also known as phytomenadione, and Vitamin K2, menaquinone, are the two natural forms. Vitamin K2 is produced chiefly by bacteria in our large intestines. Vitamin K1 is found in green leafy vegetables such as spinach, turnip greens, Swiss chard, and the brassica vegetables like cabbage, broccoli, Brussels sprouts, and kale. Fruits like kiwifruit and avocado, as well as soybean oil are other food sources of Vitamin K.


The chief utilization of Vitamin K in medicine as a "therapeutic" is in its role with the coagulation of blood. It plays a key role in factors II, VII, IX and X as well as in protein-C and protein-S. All of these blood factors and proteins are linked to the clotting cascade that prevents us from hemorrhaging in the event of a severe traumatic injury. Additionally, Vitamin K has a significant role in bone metabolism with a relation to osteocalcin. It acts as a bone building hormone in a way, much like Vitamin D. Osteocalcin is synthesized by Vitamin K and is the "matrix" in bone that holds the calcium molecules together. Without Vitamin K, hip bone fracture rates increase despite adequate Vitamin D and calcium intake. In the 1998 Nurse’s Health Study, oral administrations of 110 micrograms per day of Vitamin K proved to decrease hip fractures when compared to control subjects.



Vitamin K is important in vascular biology as well, especially in the realm of artery plaque formation (calcification). There are Vitamin K dependent proteins involved in atherosclerosis or hardening of the arteries. The process of calcium plaque formation is hindered with adequate Vitamin K levels in circulation. Warfarin (Coumadin ®) is a drug often used to treat folks with coronary artery disease (CAD) and to prevent blood from clotting in heart chambers and deep veins where severe compilations may arise. However, while treating certain medical conditions with these blood thinners, which inactivate Vitamin K, we create other problems. Chief among these problems are an increase in our risk for developing arterial plaques, the possibility of affecting our immune system, and the likely impediment of bone mineralization.



Vitamin K's effect on coronary arteries goes like this. With low levels of circulating Vitamin K in the serum, there is an impact on the function of a protein within the endothelial lining of the arteries called the Matrix Gla protein (MGP). The effect of low Vitamin K on this protein is that it allows for an increase deposition of calcium in arteries. Drugs that lower Vitamin K's effect in a sense raise the risk for coronary artery disease. Vitamin K facilitates our immune system with positive links to phagocytosis and chemotaxis (the process by which “microorganism attacking cells" in our body find and eliminate infectious organisms). Furthermore, Vitamin K appears to have a role in apoptosis, the process of natural and desirable cell death. Apoptosis is the process by which our bodies can eliminate damaged, old or mutated cells thus reducing many forms of cancers.



Because Vitamin K2 is produced by bacteria in the human alimentary tract, the overuse of broad-spectrum antibiotics can wipe out this good type of bacteria in our intestines and may cause a relative deficiency. Poor nutrition with inadequate consumption of greens and fruit is another way to attain deficiency. Both means of deficiency can lead to clotting dysfunction, immune disruption, bone loss, and coronary disease. With a look at the latest research, it appears that Vitamin K2 is longer acting, has better bioavailability, and provides better bone strength when compared to Vitamin K1 supplementation. A subset of Vitamin K2 known as menaquinone–7, or MK–7 shows promise in current research as even a more potent form of Vitamin K. In the future, we may learn the better Vitamin K supplement to take is in fact MK-7.


There is no known upper limit or toxic level of the natural Vitamin K1 & K2, however, scientists show toxicity with the synthetic forms and that they should be avoided as a source of supplementation. This fact was demonstrated in a recent ban on synthetic Vitamin K3 due to the occurrence of hemolytic anemia and cytotoxicity. This is yet another example of how natural compounds often trump synthetics in nutritional medicine. It appears Mother Nature can rarely be outperformed in the lab.


How to get the most Vitamin K out of your veggies? Well, cooking them in water will yield less concentration due to the hydrophobic properties of this vitamin. You will probably throw out much of the Vitamin K in your vegetables when you pour off the cooking water. Cooking them in oil (sautéing in olive oil, for example) will retain the bioavailability of this vitamin three-fold. Eating meat, eggs, and dairy is another source of providing Vitamin K2 in addition to that produced by E. coli in our gut. But it is with a healthy gut microflora that we acquire most of our Vitamin K2.


Deficiencies can occur with Inflammatory Bowel Syndrome (IBS), cystic fibrosis, alcoholism, liver disease, in bulimics, and those taking chronic anticoagulants, antibiotic therapy, and salicylates. Bleeding and bruising disorders are signs of deficiency; osteoporosis and coronary artery disease (CAD) are also associated, but realized over the course of many years. Unlike many other vitamins, Vitamin K is recycled in our bodies, thus reducing the threat of deficiency, provided both enzymes responsible for this process in our bodies are working well. Warfarin (Coumadin ®) blocks Vitamin K epoxide reductase (VKOR), one of the two enzymes responsible for Vitamin K recycling and maintaining healthy levels. Interesting to note, long term use of aspirin (ASA) and cephalosporins (an antibiotic class) can lead to K1 deficiencies by interference with enzyme function. Furthermore, the drugs cholestyramine, cholestipol, orlistat, and the fat substitute, olestra, have been noted to decrease Vitamin K absorption, in all probability leading to a drop in serum Vitamin K levels that can affect health.

 Because newborns are susceptible to clotting abnormalities, due to immature livers and sterile guts (inability to have E. coli produce Vitamin K2), they are usually born deficient in varying degrees. There is a 1.5% incidence of unexpected bleeding in newborns due to low levels of Vitamin K. Mothers on anticonvulsants, rifampin and isoniazid (both antibiotics) while pregnant tend to have offspring with sterile guts and an even higher incidence of Vitamin K deficiency. Therefore, the American Academy of Pediatrics recommends about 1.0 milligram of Vitamin K1 be administered to each newborn.


There is a connection in theory with Alzheimer’s disease. The APOE4 gene that has been implicated in Alzheimer's disease seems to be responsible for low Vitamin K levels in this subset of patients. It is surmised that supplementation with Vitamin K may reduce the occurrence of Alzheimer's disease, but more research is needed. There also appears to be a connection with some types of cancers. Interestingly, there are two Japanese studies showing females with liver disease with a high risk for liver cancer, having a 90% reduction in development of liver malignancy if they were supplemented with Vitamin K. In a 2008 published German study of male subjects, there was a drop in prostate cancer risk with Vitamin K supplementation.


Vitamin K must be rather important to our body as there are at least three ways in which it is maintained; by diet (eating greens), by production in our gut (bacterial), and by enzymatic recycling. Sometimes the importance of a particular substance can be found in the redundancies our body creates to conserve it, such is the case with Vitamin K.


Pearls on Vit. K:

 Ø Vitamin D dependent osteoblasts effect production of osteocalcin, a Vitamin K dependent protein, leading to good bone health, as long as both vitamins are in adequate and balanced supply.


Ø Growth arrest specific gene 6 protein (Gas6) a Vitamin K dependent protein is responsible for cellular growth regulation factor found in nerve tissue, heart, lung, kidney and cartilage.


Ø Good idea to supplement with between 10 - 120 mcg/d of Vitamin K2 (providing Coumadin users are monitored closely under physician supervision).


Ø Large Vitamin A doses have been noted to affect absorption of Vitamin K, while large doses of Vitamin E can affect and antagonize Vitamin K enzymatic activity. We see a rise in bleeding risk with large doses of Vitamin E intake. There is a balance between the fat soluble vitamins that needs to be adhered to. It is unwise to guess and gamble with what you take and supplement.




Yusuf (JP) Saleeby, MD is an integrative and nutritional medicine practitioner. He has been the chief formulator for a number of independent nutraceutical companies. He is a medical writer / blogger and offers telemedicine consultations to his patients. Currently medical director of the AtroGene group.




=======================================


Pearls of the Month:


DID YOU KNOW:



· 19.4% of South Carolinians are uninsured (no health insurance).


· In 2002, uninsured South Carolinians cost the system $1,936 per uninsured individual.


· 60% of the uninsured are hard working citizens of South Carolina.


· 74% of the uninsured list affordability as the reason they have not purchased health insurance.


· 50% of eligible individuals do not enroll in public programs because they do not want to receive government support or don't want the government to provide health coverage.


· 78% of businesses in South Carolina, excluding self-employed and government workers, have fewer than 10 employees. And 53% of small employers with 1 to 10 employees do not offer group-sponsored health insurance to their employees.


· South Carolina is one of the unhealthiest states, ranking 46th in the nation.

Source: www.covertheuninsuredsc.org/

· A 2010 Press Ganey Pulse Report (survey) demonstrated the national average emergency room wait time was 4-hours and 7-minutes long.


· There are 123-million emergency room visits in America each year. The vast majority are considered non-emergent.


· There are an estimated 312,000 Primary Care Physicians (PCP) today, but the current need requires about 13,000 more.


· 65-million Americans live in areas without enough Primary Care Physician coverage.


· Wait times of about 2-months are routinely being reported for patients to see their physicians (PCPs).


Quote of the month:

“America has the best doctors, the best nurses, the best hospitals, the best medical technology, the best medical breakthrough medicines in the world. There is absolutely no reason we should not have in this country the best health care in the world.”                   – Dr. Bill Frist (US Senator Ret.)




# # #

Ten Questions you should ask your doctor.

There is a new advertising campaign on TV.  It pushes the patient/consumer to "Ask Questions" of his/her doctor.


It is a government sponsored TV ad and corresponding web site explores the questions.


http://www.ahrq.gov/questionsaretheanswer  is the link to the web site.  Have a look, it is helpful and informative.  An informed patient is a safe patient and ultimately fewer mistakes or untoward outcomes occur.


For those in need of answers and don't have a Primary Care Physician (PCP) don't despair, there are answers via telemedicine.  I recommend using the knowledgeable physicians at AtroGene Telemedicine group.  For first and second opinions on important matters concerning your health, this is an invaluable resource.  Affordable too.



Some of the questions you should ask your doctor:

1. What is the test for?
2. How many times have you done this procedure?
3. When will I get the results?
4. Why do I need this treatment?
5. Are there any alternatives?
6. What are the possible complications?
7. Which hospital is best for my needs?
8. How do you spell the name of that drug?
9. Are there any side effects?
10. Will this medicine interact with medicines that I'm already taking?