How Safeway Is Cutting Health-Care Costs

http://online.wsj.com/article/SB124476804026308603.html

Above is an article published by the Wall Street Journal written by the CEO of Safeway.

By all accounts, our health care is in deep trouble. The US spends the most of money in health care only to claim 37th in the world right after Costa Rica. There are growing population of the US, more than 48 million people, who does not have insurance. More and more businesses are not able to afford providing insurance to the employees.

The article points out how we can learn from the auto industry. Provide financial incentives for health associated behaviors and provide financial disincentives for illness associated behaviors. It's pretty simple really. When people realize preventive measurements such as blood pressure, cholesterol, and weight result in increased premiums, they have a tendency to want to self correct the behavior.

Safeway implemented this policy and found that they can save 40%. Perhaps, the rest of the U.S. can learn from this experience.

Cost-Effective Ways to Fight Insomnia

http://www.nytimes.com/2009/06/06/health/06patient.html?_r=1&scp=1&sq=insomnia&st=cse

Dalai Lama said "Sleep is best meditation." I agree.
Lack of sleep can easily account for many of the chronic illnesses in the U.S. While, I cannot say that lack of sleep or chronic sleep deprivation causes illnesses, it can contribute to the ill effects of chronic illnesses.

I find that sleeping problems are often the most sensitive indicator of overall health and wellness. Often times, sleep disturbances will precede an episode of illness or a bout of depression or anxiety.

A good sleep resets our body and mind and renews our spirit. I find good sleep to be most cost effective ways for wellness. Integrative Medicine is a wonderful asset to help people to restore a good sleep.

Dr. Rubin Naiman, a faculty at Dr. Weil's faculty, suggest below suggestions for improving sleep:

Recommended Lifestyle Changes for Insomnia Treatment:

from Dr. Weil's website: http://www.drweil.com/drw/u/ART02004/insomnia

The following are some of the best possible insomnia remedies:

• Establish a consistent bedtime routine. This is one of the most important factors in insomnia treatment and maintaining good sleeping habits. Routines may include taking a warm bath or a relaxing walk in the evening, or practicing meditation/relaxation exercises as part of your regular nighttime routine.
• Try to go to bed at the same time every night, and get up at the same time each morning. This includes weekends.
• Get plenty of exercise during the day. Studies have shown that people who are physically active sleep better than those who are sedentary. The more energy you expend during the day, the sleepier you will feel at bedtime. Just be sure not to engage in vigorous exercise too close to bedtime as that can make it more difficult to fall asleep.
• Reduce your intake of caffeine, particularly in the evening.
• Avoid stimulants like caffeine and limit alcohol. Both, even when consumed early in the day, can affect sleep and inhibit insomnia treatment.
• Use your bed only for sleeping and sex. Don’t use it to do work or watch TV.
• Avoid large meals late in the evening.
• If you can’t fall asleep within half an hour of going to bed, get up and read or do something calming until you feel sleepy.
• Learn and use a relaxation technique regularly.Breathing exercises, meditation and yoga are not insomnia cures, but do lead to a state conducive to sleep.
• Use “white noise” devices to block out surrounding environmental noise.
• Take a hot bath before bedtime. Try a few drops of relaxing oil of lavender in the water.
• Short naps are good. Try to get into the habit of napping for insomnia treatment: ten to twenty minutes in the afternoon, preferably lying down in a darkened room.
• Spend some time outdoors as often as you can to get exposure to bright, natural light. If you are concerned about harmful effects of solar radiation, do it before ten in the morning or after three in the afternoon or use sunscreen.
• Try to give yourself some time - up to an hour - in dim light before you go to sleep at night. Lower the lighting in your house and bedroom and if other members of the household object, wear sunglasses.
• The two best natural sleep aids are valerian and melatonin. Valerian is a sedative herb, used for centuries. You can find standardized extracts in health food stores and pharmacies. Take one to two capsules a half hour before bedtime. Melatonin is a hormone that regulates the wake/sleep cycle and other daily biorhythms. Try sublingual tablets (to be placed under the tongue and allowed to dissolve); take 2.5 mg at bedtime as an occasional dose, making sure that your bedroom is completely dark. A much lower dose, 0.25 to 0.3 mg, is more effective for regular use.
• Don’t obsess about not sleeping. Not surprisingly, studies have shown that individuals who worry about falling asleep have greater trouble dropping off. It may help to remind yourself that while sleeplessness is troublesome, it isn’t life-threatening and there are insomnia remedies.

If All Doctors Had More Time to Listen

http://www.nytimes.com/2009/06/07/health/07health.html?_r=1&em

Above is an article in NY Times on If All Doctors Had More Time to Listen.

I feel priviledged to be part of the team at Georgia Integrative Medicine. We make the time to listen to our patients. Patients have ready access to Dr. Kim. Patients spend about one hour being treated for each visit. For complex patients, we spend up to four hours performing a comprehensive evaluation known as the team visit.

We have patients who are choosing us over their regular physicians and over other integrative medicine physicians because we choose to listen to our patients. Even our growth is managed to ensure that our existing patients have a ready access to Dr. Kim.

At Georgia Integrative Medicine, we understand that our patients are the experts on their bodies and in order to help, we have to listen and understand to their healing journey. Carl Rogers was a humanistic psychologist who understood the importance of "client-centered" therapy. He understood the importance of listening mindfully to what his clients had to say. At Georgia Integrative Medicine, we honor the Rogerian tradition and perform that mindful listening to the best of our ability.

Jeanne Bowers
Clinic Manager

Helath Benefits of Omega 3 Fatty Acids

http://en.wikipedia.org/wiki/Omega_3_fatty_acids

Above is a link for Omega 3 fatty acids from Wikipedia.
Omega 3 fatty acids is all the rage these days. So, what is omega 3 fatty acids?

First of all, omega 3 fatty acids are essential fatty acids. That means our body is not capable of making them ourselves. We have to obtain it from our nutrition or supplements.

Below are from the Wikipedia article:

• The benefits of omega 3 fatty acids were discovered in the 1970s by researchers studying the Greenland Eskimos. The Greenland Eskimos consumed large amounts of fat from seafood, but displayed virtually no cardiovascular disease. The high level of omega-3 fatty acids consumed by the Eskimos reduced triglycerides, heart rate, blood pressure, and atherosclerosis.
• On September 8, 2004, the U.S. Food and Drug Administration gave "qualified health claim" status to eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) n−3 fatty acids, stating that "supportive but not conclusive research shows that consumption of EPA and DHA [n−3] fatty acids may reduce the risk of coronary heart disease." This updated and modified their health risk advice letter of 2001 (see below). Currently regulatory agencies do not accept that there is sufficient evidence for any of the other suggested benefits of DHA and EPA other than for cardiovascular health, and further claims should be treated with caution.

• The Canadian Government has recognized the important of DHA omega-3 and permits the following biological role claim for DHA: "DHA, an omega-3 fatty acid, supports the normal development of the brain, eyes and nerves."
• The 18 carbon α-linolenic acid has not been shown to have the same cardiovascular benefits as DHA or EPA. Currently there are many products on the market which claim to contain health promoting 'omega 3', but contain only α-linolenic acid (ALA), not EPA or DHA. These products contain mainly higher plant oils and must be converted by the body to create DHA and therefore considered less efficient. DHA and EPA are made by microalgae that live in seawater. These are then consumed by fish and accumulate to high levels in their internal organs. If a person is concerned about mercury and oceanborne contaminants in fish, DHA can be produced directly from microalgae as a vegetarian source.
• Some benefits have been reported in conditions such as rheumatoid arthritis and cardiac arrhythmias.
• Some research suggests that fish oil intake may reduce the risk of ischemic and thrombotic stroke. However, very large amounts may actually increase the risk of hemorrhagic stroke (see below). Lower amounts are not related to this risk, 3 grams of total EPA/DHA daily are considered safe with no increased risk of bleeding involved^[and many studies used substantially higher doses without major side effects (for example: 4.4 grams EPA/2.2 grams DHA in 2003 study).

At Georgia Integrative Medicine, the correct use of omega 3 fatty acids form an important part of the treatment protocol. Most plant sources yield ALA not EPA or DHA. Therefore, the preferred sources are from marine animals including Krill, Anchovies, Sardines, and Salmon. One potential problem taking marine based EPA/DHA is the exposure to heavy metal contaminants which can cause health problems. This can be avoided by buying from a reputable producer of omega 3 fatty acids with molecular distillation and asking to see the certificate of analysis.

Letting the Patient Call the Shots

http://www.nytimes.com/2009/06/04/health/04chen.html?em

Above is an article on the NY Times about the idea about collaborative approach to health care. As a physician in training, I was taught that physicians were the authority figure in health care. I also remember when I was providing primary care that I was taught to deny the patient "unnecessary" prescription of antibiotics.

Today, given the information revolution, I am not sure that a physician, even a specialist, can know better than a motivated patient who is well-read on the subject. I often share with patients that I can provide the perspective, knowledge, and experience. Patients provide the context and subjective experience of how their condition is affecting their life.

I view integrative medicine as not just a combination of Eastern and Western medicine. Rather, it is a transformative way of practicing medicine in a collaborative approach with patients being of assistance to them. Also it is about honoring patients' experience of their suffering of their ill-ness and guiding them back to well-ness. I recall Dr. Bernie Siegel, who helped me through the development of my career, stating that [as physicians], we are a privileged listener.

Medical bills prompt more than 60 percent of U.S. bankruptcies

http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/index.html

• Story Highlights
• Study: More than 60 percent of bankruptcies are linked to medical bills
• Three-quarters of people with a medically-related bankruptcy had health insurance
• Researcher: "You're one illness away from financial ruin in this country"
• Situation likely to worsen: study was done a year before recession

Above link is an article featured on CNN focusing on the the importance of medical health insurance issues in the U.S. We currently have the dubious honor of being the first in medical expenditures with health care results being rated 37 in the world after Costa Rica.

Above article states that we are all one illness away from financial ruin in the U.S. As we are discussing universal health care for the U.S., I invite everyone to be active in participating the development. The first step of participating is knowing what is being proposed and understanding how it affects you.