Glaxo Says It Will Stop Paying Doctors to Promote Drugs

This is some very good news that is long overdue! They are also going to no longer compensate sales representatives based on the number of prescriptions doctors write, a standard practice that some have said pushed pharmaceutical sales officials to inappropriately promote drugs to doctors.
Do you think this will help significantly decrease overprescribing of drugs?

http://www.nytimes.com/2013/12/17/business/glaxo-says-it-will-stop-paying-doctors-to-promote-drugs.html?pagewanted=2&_r=0&rref=business&hpw

6 Ways to Avoid Bad Posture

Here are some great tips that can save you some pain over the holidays.

http://www.realsimple.com/health/preventative-health/avoid-bad-posture-during-holiday-10000001688549/page7.html

Another research article showing benefit of chiropractic care for US veterans

Here is another research showing benefit of chiropractic care for veterans. It was recently published in the Veteran's Administration Journal of Rehabilitation Research and Development.
Were you aware that doctors of chiropractic now work at many VA clinics and the VA is starting a residency program for DC's?

http://www.rehab.research.va.gov/jour/11/488/page927.htmlAo

Special report: suicidal ideation among American surgeons

Here is a disturbing study from the Archives of Surgery Journal. We have known that surgeons have a higher rate of suicide than the general population. This study was a survey that found suicidal ideation (thoughts) was 1.5 to 3.0 times more common among surgeons than the general population. Even more disturbing was that only 26% of them had sought psychiatric or psychologic help, while 60% were reluctant to seek help due to concern that it could affect their medical license.

http://www.ncbi.nlm.nih.gov/pubmed/21242446

The back pain most surgeons won't find

Did you know that experts estimate that 20-25% of chrronic lower back pain comes from the sacroiliac joints ( the joints between the lower spine and pelvis)? This is one of the reasons there are so many unsuccessful low back/spine surgeries. 
Although fusion of the SI joints can be beneficial in a very small subset of patients, it to is a highly overperformed surgery.

http://www.cnn.com/2013/09/18/health/back-pain-misdiagnosis-shamie/index.html?hpt=hp_bn13

Bicycle and Sporting Helmets and Concussions

We have been hearing much recently about the new found awareness of the severity of concussions culminating with the recent $765 million NFL concussion settlement. I ran across this very well researched and informative Bicycling Magazine article discussing the poor ability of bicycle and other sporting helmets on preventing concussions. It is a rather long article, and even explains why woodpeckers do not get concussions :-)

Senseless

I just did an invitational bicycle ride a couple weeks ago and saw a rider limping very badly at one of the rest stops. He told me he had plantar fasciitis and meds and physical therapy had not helped. 
This is a condition that I frequently treat which is many times the result of biomechanical dysfunctions of the foot, ankle, knee, and/or hip. The incidence seems to be increasing probably due to the weight increase of Americans and the increased participation in sports and exercise.
Anyone experienced this condition?

http://articles.latimes.com/2013/mar/09/health/la-he-feet-20130309

Opioid (Narcotic) Use Common After Spine Surgery

Did you know that prescription drug abuse and addiction now kills more people than all the illegal drugs combined? Here is a new study from the North American Spine Society showed that 32% of patients were still using opioid (narcotic) drugs one year after back surgery. This is in spite of the fact that narcotic drugs have not been proven effective or safe for chronic back or joint pain! Nothing scientific about this medical practice.
Any thoughts on this?

Opioid (Narcotic) Use Common After Spine Surgery

A new study from the prestigious Spine Journal shows that more than one in five patients are so dissatisfied with the results of their spinal stenosis ( narrowing) surgery that they undergo the pain, expense, disability, and danger of another surgery within 10 years. Plus the authors state that the re-operation rate seems to be increasing.
The cumulative reoperation rate was 4.7% at 3 months, 7.2% at 1 year, 9.4% at 2 years, 11.2% at 3 years, 12.5% at 4 years, and 14.2% at 5 years. The adjusted reoperation rate was not different between decompression and fusion surgeries. The calculated reoperation rate was expected to be 22.9% at 10 years.
Would it be worthwhile to try chiropractic care before this surgery? What is your opinion?

http://www.sciencedirect.com/science/article/pii/S1529943013007729

Cracking Your Knuckles Can Give You Arthritis: Science or Myth?

Here is an article from the Atlantic. Several studies over the last few decades have concluded that this idea of knuckle cracking causing arthritis is another urban myth. A study last year by the Defense Dept using rays showed that knuckle crackers actually have slightly less finger arthritis. I always explain to my patients that the sound is just the collapse of gas bubbles in the lubricating fluid of the joint same as the sound made by carbonation when opening a can of soda pop :-) 

http://www.theatlantic.com/health/archive/2012/05/cracking-your-knuckles-can-give-you-arthritis-science-or-myth/257851/#comments

Research study on spinal manipulation for cervical disc herniation

Some people are concerned about chiropractic treatment of disc herniation. I treat many patients with disc herniation in my office. Here are impressive results in a new study from the Journal of Manipulative and Physiological Therapeutics on chiropractic manipulation (adjustments) on patients with MRI documented disc herniations.
At 2 weeks, 55.3% were “improved,” 68.9% at 1 month and 85.7% at 3 months.
Has anyone had chiropractic treatment for a disc herniation?

http://www.jmptonline.org/article/S0161-4754(13)00176-0/abstract

As we have seen so commonly in medicine, just because something is high tech and marketed aggressively does not make it better.http://well.blogs.nytimes.com/2013/09/09/new-concerns-on-robotic-surgeries/?src=rechp&_r=0

The $13,360.03 cat bite

Here is an article from the San Francisco Chronicle concerning the outrageous billing practices of hospitals.

http://www.sfgate.com/opinion/openforum/article/The-13-360-03-cat-bite-4744836.php

Back pain not treated scientifically

Unfortunately back syndromes are not commonly treated scientifically, as evidenced by the huge increase of prescriptions for narcotic drugs and MRI's ordered.
Back and neck pain are among the most common conditions physicians treat, accounting for 10% of office visits and $86 billion in health spending..
Did you know that prescription narcotic drugs are now the number one drug problem in the US killing over 10,000 people per year?

http://newsatjama.jama.com/2013/07/29/author-insights-despite-recommendations-increased-use-of-narcotics-and-imaging-for-back-pain/

Health Insurance Changes Coming Your Way Under the Affordable Care Act AKA Obamacare

I have maintained this page for 2 1/2 years and I have always focused on healthcare related education of my page fans. As everyone is aware big changes are going to occur January 1st with the largest part of PPACA AKA Obamacare taking effect and the insurance exchanges starting in about 6 weeks on Oct 1st. I am planning on devoting some a my future posts to this new law as many people are very unaware and confused about these changes. I realize the law is controversial to some people but please do not post any political comments. There are plenty of other more appropriate places for political discussions. With that said, here is a very good informational video from the Henry Kaiser Family Foundation. Let me know if you have any questions of the content?

http://kff.org/health-reform/video/youtoons-obamacare-video/

For a stiff neck, nearly $6,000 in physical therapy seemed too much

A couple of years ago, our insurance company was billed $13,000 for physical therapy for my wife's shoulder condition! Outrageous! I have been in practice 23 years and never billed out even a third of that even for my most serious cases. Now I know why so many MD's and clinics have PT's working at them. Has anyone had any experience with PT bills?

http://www.washingtonpost.com/national/health-science/for-a-stiff-neck-nearly-6000-in-physical-therapy-seemed-too-much/2013/08/05/5c6b9f52-e9af-11e2-a301-ea5a8116d211_story.html

High Cost of Joint Replacements

Most people are now aware that US citizens pay exorbitant prices for many drugs. Less well known and growing is the exorbitant prices for medical devices including joint implants. The cost of a total hip implant rose over 300% since 1998! In the United States, nearly all hip and knee implants are made by five companies, which some economists describe as a cartel.
Why do you think we pay so much more for prescription drugs, devices, and surgeries than any other country?

http://www.nytimes.com/2013/08/04/health/for-medical-tourists-simple-math.html?ref=health

Over 700 US doctors suspected of harmful excessive prescription practices - report

New report from the Dept of Health and Human Services identified doctors who are outliers in drug prescribing. The amount of drugs prescribed and paid for by Medicare by 736 docs is eye popping... $352 million in 2009! 

Over 700 US doctors suspected of harmful excessive prescription practices - report

Common Exercise Mistakes

I am board certified in chiropractic rehabilitation and spend much time instructing my patients proper and safe exercise technique.
Here is a very good article from my newsletter on this topic.
Let me know if you have any questions on this information.

http://www.toyourhealth.com/mpacms/tyh/article.php?id=1297

AMA votes to recognize obesity as a disease

Yesterday in Chicago, the American Medical Association’s House of Delegates voted for a resolution recognizing obesity as a disease, going against the AMA’s own Council on Science and Public Health’s recommendation.

http://www.usatoday.com/story/news/nation/2013/06/18/obesity-disease-american-medical-association/2435701/

Medical Doctors’ Lucrative Industry Ties

This is a very disturbing longterm and widespread practice in the medical profession. Unfortunately one has to be concerned how much their medical doctor's prescribing habits and their surgeon's choice of devices and procedures is influenced by money and gifts from the drug and device companies. Many recent studies have shown that this money does influence practice habits.

Doctors’ Lucrative Industry Ties

Drugs do not equal health

Great article by Dr. Peter Lind from the Washington Times.

*Acetaminophen (Tylenol ®) is the leading cause of acute liver failure in the United States resulting in approximately 140,000 poisoning cases, 56,000 ER visits, and approximately 100 deaths each year.
*Non-steroidal anti-inflammatory drugs (NSAIDs) (anti-inflammatories) are the second leading cause of peptic ulcers resulting in more than 100,000 hospitalizations at an estimated $2 billion in additional healthcare costs and 17,000 deaths yearly.
"*The US ranks last in health care outcomes of all other industrialized countries.

What do you think of these stats?

Drugs do not equal health

Drugs do not equal health

Great article by Dr. Peter Lind from the Washington Times.

*Acetaminophen (Tylenol ®) is the leading cause of acute liver failure in the United States resulting in approximately 140,000 poisoning cases, 56,000 ER visits, and approximately 100 deaths each year.
*Non-steroidal anti-inflammatory drugs (NSAIDs) (anti-inflammatories) are the second leading cause of peptic ulcers resulting in more than 100,000 hospitalizations at an estimated $2 billion in additional healthcare costs and 17,000 deaths yearly.
"*The US ranks last in health care outcomes of all other industrialized countries.

What do you think of these stats?

Drugs do not equal health

Manipulation shown to be better than drug for low back pain

New double blind comparison study from the prestigious Spine Journal showing manipulation ( adjustments) significantly more effective than an anti-inflammatory drug or placebo for low back pain.
There was also recent study showing manipulation was better than anti-inflammatory drugs for neck pain.

Spinal High-Velocity Low Amplitude Manipulation in Acute Nonspecific Low Back Pain: A Double-Blinded Randomized Controlled Trial in Comparison With Diclofenac and Placebo

Another Reason to Avoid Epidural Steroids

I occasionally send a patient for an epidural, but I feel they are significantly overused. There have been many studies showing them to be of little or no benefit in many populations of patients. Here is a new study from Spine Journal showing patients with spinal stenosis (narrowing) who had epidurals did significantly worse after 4 years than the control group! 

http://www.toyourhealth.com/mpacms/tyh/article.php?id=1740

Bitter Pill: Why Medical Bills Are Killing Us

This recent Time magazine article is opening the eyes of many people to hospital billing practices. This is a meticulously researched article that gives eight case studies along with comparisons of many hospital charges for non insured people compared to private and Medicare insured patients and the numbers are astounding! Also gives numbers on profits and CEO salaries which are also eye opening. No wonder medical bills cause 60% of the bankruptcies in the US.
For those of you without the fortitude to read the 24,000 word 36 page article below, I have also included a 3 minute video of the author Steven Brill discussing the book.

Bitter Pill: Why Medical Bills Are Killing Us author Steven Brill interview

Mediterranean Diet Shown to Ward Off Heart Attack and Stroke

Low-fat diets have not been shown in any rigorous way to be helpful, and they are also very hard for patients to maintain. “Now along comes this group and does a gigantic study in Spain that says you can eat a nicely balanced diet with fruits and vegetables and olive oil and lower heart disease by 30 percent,” he said. “And you can actually enjoy life.” 

http://www.nytimes.com/2013/02/26/health/mediterranean-diet-can-cut-heart-disease-study-finds.html?hp

America flunks its health exam

A just-released report from the Institute of Medicine and National Research Council is making news by clearly illustrating that Americans have "shorter lives and poorer health." This is somewhat shocking, given how much we spend on health care each year — more than any of the 16 other rich countries surveyed in the study. What's even more upsetting is that this report focused quite heavily on people who are young. In the United States, even that group fared poorly. 

http://www.cnn.com/2013/01/11/opinion/carroll-health-study/index.html?iid=article_sidebar

Starting next year, drug and medical device companies will be required to report gifts to doctors which will be listed on a website. I think this is a good step to discouraging this practice that many studies show influences prescribing behavior. What do think?

http://www.nytimes.com/2013/02/19/opinion/finding-out-who-pays-your-doctor.html?src=rechp&_r=0

Cancer tests you need – and those you don’t

As you know, I am a big fan of healthnewsreview.org, the free website that reviews media medical and health articles. Here is a summary of a new report by Consumer Reports which lists the eight cancer screening tests to avoid, the three tests to get, and the five questions you should ask before getting a screen. Please post any comments or questions including if you don't understand why some screening tests should be avoided.

http://www.healthnewsreview.org/2013/01/consumer-reports-cover-story-cancer-tests-you-need-and-those-you-dont/

Even most large disc hernitations do not need surgery

Here is another study showing good long term recovery of large disc herniations with non-surgical care. So don't let a surgeon say you need surgery just because the disc herniation is large.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025225/

Are You Suffering From the #1 Cause of Worldwide Disability?

This is the lead story on the current issue of my clinic newsletter. The Global Burden of Disease 2010 clarifies the worldwide health burden of musculoskeletal conditions, particularly back and neck pain, with low back pain identified as the number-one cause of disability worldwide and neck pain the number-four cause. 
Musculoskeletal conditions such as low back pain, neck pain and arthritis affect more than 1.7 billion people worldwide and have a greater impact on the health of the world population (death and disability) than HIV/AIDS, tropical diseases including malaria, the forces of war and nature, and all neurological conditions combined. 
The project's findings that should make it abundantly clear that conditions many people may consider relatively harmless actually have tremendous potential for long-term health consequences: In my 23 years of practice, I have seen many lives greatly damaged by back, neck, and other musculoskeletal disorders.
Please take these problems seriously.

http://www.toyourhealth.com/mpacms/tyh/article.php?id=1716

New study from the prestigious Spine Journal on active military personnel showed that chiropractic manipulation (adjustments) in conjunction with standard medical care offers a significant advantage for decreasing pain and improving physical functioning when compared to standard care alone, for men and women between the ages of 18-35 with acute low back pain.

Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: the results of a pragmatic randomized comparative effectiveness study.

http://www.ncbi.nlm.nih.gov/pubmed/23060056

High rate of MRI abnormalities in non painful knees

Yet another in a long list of studies showing high rates of MRI pathological/abnormal joint findings on people with no pain. This study from the "British Medical Journal found at least one abnormality in 86-88% of the group with no knee pain! Is this surprising to anyone?

http://www.bmj.com/content/345/bmj.e5339

Chiropractic care results in significantly reduced surgery rate in injured workers

Here is a recent study from Spine Journal on surgery rates for 1885 injured workers. It showed that even after adjustment for important variables, 42.7% of the patients that first saw a surgeon received surgery, compared to only 1.5% who first saw a chiropractor!

http://www.ncbi.nlm.nih.gov/pubmed/23238486

After dozens of people dying from meningitis due to the contaminated spinal epidural injections, many of the survivors are unfortunately now getting serious localized spinal infections that are often hard to detect until very progressed.

http://www.nytimes.com/2012/12/22/health/dangerous-abscesses-add-to-tainted-drugs-threat.html?hp&_r=2&