Tuesday, December 29, 2009

Obamacare and Bernie Madoff

December 29, 2009

Obamacare and Bernie Madoff

Sorry again about another healthcare reform related newsletter, but I get mildly agitated when people not in the healthcare field, especially politicians, try to tell me how to do my job.

We all have heard about Bernie Madoff, and his, how can I say it, not exactly stellar accounting. Bernie Madoff by way of his ponzi scheme, led what may soon be known as the second biggest swindle in the nation. The first will be either the Senates or House of Representatives healthcare reform bills, which if either of them becomes law, will forever be known as the ObaMadoff healthcare plan.

Understand that our politicians do not play by the same rules that ordinary citizens abide by. We put money in the bank, and can only withdrawal what we have. On the other hand, our politicians, both democrat and republican, spend our money, and more than we have.

Oh, but they can raise more money to pay for all their pet programs you say.

You are correct.

But the politicians do not earn money like we do. They raise money in a few ways.

1) They increase the taxes we have to pay.
2) They borrow money from other countries and ask we, the taxpayers to pay the interest.
3) They turn on the printing presses and print more money, diluting the worth of the dollar and making our money less valuable.

In other words, they spend our hard earned money like there is a never-ending supply!

So what does this have to do with healthcare?

I'll tell you.

Our country is deep in debt, due to all the money spent by our politicians over the past four decades. At last count, our country is over 12 trillion dollars in debt, not counting current and future entitlement obligations. So now, our politicians want us to go further in debt and add a new entitlement to reform the healthcare system, and they will raise the money to finance these reforms in the three ways mentioned above.

So how does this differ from what you and I do to access healthcare?

1) To pay for healthcare, we as individuals have to work and earn income. We can not collect tax money from others to pay for our care.
2) We can borrow money from banks and credit cards, but we are held individually responsible for our debt. Our politicians are not responsible for the debt they place our country in. We are, along with our children and grandchildren.
3) I think we would go to jail if we had a printing press printing money we did not earn. So why does our government get away with it?

This healthcare reform is not the change we believed we were getting during the 2008 presidential campaign. Let us take a look at the president's healthcare campaign promises and how they have changed by looking at the present healthcare bills, their costs and how they are paid for.

House Bill:

Who is covered?

It is estimated that about 94% of legal residents under the age of 65 will be covered. Presently about 83% are covered. There will still be about 24 million people under the age of 65 not insured, with an estimated 8 million of those being illegal immigrants.

Cost: 871 Billion dollars over ten years. That is $871,000,000,000 dollars. That's alot of zeroes.

How It's Paid For:

Fees or taxes on the following: Insurance companies, pharmaceutical manufacturers, medical device manufacturers, medicare payroll tax increase on income over $200,000 for individuals, or $250,000 for couples, 10% sales tax on tanning salons, excise tax on high cost insurance plans, and fees for employers whose workers receive government subsidies. I am certain there are more fees and taxes still hidden in the bill that have not yet been discovered.

Cuts to Medicare and Medicaid

Fines on people who fail to purchase coverage.

Senate Bill:

Who is covered?

About 96% of legal residents under the age of 65, leaving an estimated 18 million people under the age of 65 not insured, with an estimated 8 million of those being illegal immigrants.

Cost: 1.2 trillion dollars over 10 years. That is $1,200,000,000,000 dollars. That's even more zeroes.

How It's Paid For:

Taxes on the following: New income taxes on single people making more than $500,000/year and couples making more than $1 million dollars a year, an estimated $20 billion from new taxes on medical device makers, limiting contributions to flexible healthcare spending accounts. As with the House bill, I am certain there are more fees and taxes still hidden in the bill that have not yet been discovered.

Cuts of more than $400 Billion to Medicare and Medicaid.

Fines on individuals and employers who do not obtain health insurance coverage.


OK, so that is a synopsis, and definitely not the whole enchilada. But let me start breaking this down to what it means for you and how it differs from the 2008 promises made by the president during the 2008 presidential election campaign.

Promise #1 : No Individual Mandate

In both of the above bills, there is an individual mandate for insurance coverage or a fine is imposed. And as we still do not know the extent of government subsidies to help purchase insurance, it appears that many individuals will be coerced or forced by the government to purchase coverage that they may not want, or face the wrath of government fines. In essence, the government wants to pass a law forcing individuals to purchase something against their will.

Promise #2 : Complete Transparency

Need I actually go into this one?
Candidate Obama promised that health care deliberations with Congress and special interests would be transparent to the extreme. To quote candidate Obama: "That's what I will do in bringing all parties together, not negotiating behind closed doors, but bringing all parties together, and broadcasting those negotiations on C-SPAN so that the American people can see what the choices are," Mr. Obama said during his Jan. 31, 2008 debate with Clinton. "Because part of what we have to do is enlist the American people in this process. And overcoming the special interests and the lobbyists who -- Senator Clinton is right. They will resist anything that we try to do."


I had my TIVO set up as a season pass to record all healthcare negotiations on C-SPAN. Funny thing. Nothing recorded. I called TIVO and asked what the problem was with their service. I found out it was not TIVO. There were not any negotiations broadcast on C-SPAN.

So what actually occured?

Politics as usual, but on steroids. Both bills have been written along party lines, with mucho mucho special interests involved. These special interests do not represent you. They represent their corporations and their businesses. Now in a free market capitalistic economy, that is fair game. But were'nt we promised transparency and an overcoming of the special interests???

Promise #3 : Lower Premiums by $2,500 for a Family of Four

For this one, I'll believe it when I see it. I am pretty good at math, but not an accountant or mathematician. But to add 20-30 million more people into health insurance, and at the same time lower the cost of insurance premiums, you need to be a magician, not a mathematician.

Now back to who is covered, the cost and how it is paid for.

If we go midway between both the House and Senate bills, we will still be left with about 14 million uninsured, at a cost of over a trillion dollars over ten years, paid for by cuts to Medicare and Medicaid and large taxes on many segments of the healthcare industry and individuals. The healthcare industry segments will end up passing along the increased taxes as higher costs to you. As employers and individuals, who, unlike the federal government can not print money, will pay higher taxes, and they will have less money in their budgets to expand their businesses and hire more workers. So the trickle down effect of higher taxes ends up costing everyone, not just those who pay the taxes, while still leaving about 20 million people uninsured.

Question 1: If you are unemployed, do you prefer being forced to purchase health insurance, or do you prefer to get help finding a job?

Question 2: With cuts to Medicare and Medicaid, and more people enrolled in these programs, how do we improve care for individuals with these two government plans?

Now, I will attempt to do some math.

Assuming midway between the House and Senate plan, we add 34 million people to the health insurance rolls. The taxes and fines start in year one, while the insurance coverage does not start until years 4 through 6. I will estimate 6 years of insurance coverage for 34 million people at a cost of 1 trillion dollars. That comes out to about $5,000 per year for insurance coverage for each individual, or just under $420 per month. The premiums I pay now are much less than that, and I am not mandated by any government to purchase it!

Question 3: Is the healthcare reform debate about doing what is right, or more about politics?

I'll let you answer that one.

Call your Senator and congressmen and tell them to put a halt to this healthcare reform debacle before it is too late. The legislation currently before Congress was crafted more out of political desperation and not the needs and desires of the large majority of the American people.

One thing I have learned from this debate is that elections do mean something and they do have consequences. Sometimes good, sometimes not.

My hope is that these reforms get stopped, and we reboot the debate and start over. First step, follow the president's campaign guidelines for reforming the healthcare system with true transparency, and a lack of special interests at the table. The table should consists of patient's and healthcare providers and the reforms should focus on individuals and not politics. We can then reform the system one step at a time and move in a direction that helps everyone without adding any costs to the system.

I also truly, truly hope this debate ends so I can spend more time on medically relevant newsletter topics instead of the machinations of our politicians in Washington, D.C.
I previously wrote about a big conflict of interest concerning the American Medical Association and the current healthcare reforms. A recent Chicago tribune column goes into further detail corroborating my views.
Our Healthy Weight program will be available starting January 4, 2010. Info on the program and pricing can be found here. Wellness Plan members get a steep discount on this program.

This program combines physician supervision, internet guidance and communication, with optimum nutrition to not only help you attain a healthier weight, but at the same time help to prevent or treat other diet related disorders including Diabetes, High Blood Pressure, High Cholesterol, Heart and Vascular Disease, among many others.

I am excited to help you get a jump start on a healthier you for 2010!!

To Good Health!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311
Previous newsletters can be found at http://drhorvitz.blogspot.com/

Saturday, December 26, 2009

NJ Physicians views on healthcare

December 26, 2009

I hope everyone had an enjoyable holiday.

Today I would like once again to talk about healthcare reform and the disinformation about physicians views on this subject. The president and the congressional leaders like to say that the majority of physicians support healthcare reform. This is, unfortunately, very deceptive, if not an outright lie.

Please read below the Medical Society of New Jersey's letter on this subject from December 22. 2009.
Dear Colleagues:

The United States Senate has chosen to amass a “Health Care Bill” that, in our opinion, will quickly destroy the ability for physicians to continue the practice of medicine.

The Senate Majority Leader has locked in 60 votes to break a filibuster against the legislation. His reported tacit dealings with Louisiana, Vermont and Nebraska senators for votes are obviously “Washington politics business as usual”. This disrespect for the citizens of our country sickens the Medical Society of New Jersey.

• Lacks Any Tort Reform
• Doesn’t Permanently Fix the SGR Formula
• Will Break the Medicaid System in New Jersey (already the worst in the country)
• Lacks Transparency and Detail on the Effect on Physician Practices

The Medical Society of New Jersey is not supporting the American Medical Association’s position on this issue nor their ineffective approach to this major piece of legislation.
We personally want all physicians of New Jersey to know that the Medical Society of New Jersey is appalled at our representation by the AMA and are not supportive of their leadership.

Very truly yours,

Joseph H. Reichman, MD
To read more opinion from the MSNJ, please go here.

My opinion:

Point 1) National organizations have lost touch with their constituents.

American Medical Association is in favor of the present reform package, while the NJ state society is adamantly against.

Point 2) Our elected politicians have all elected to vote along party lines, instead of with their constituents. The latest Rasmussen Reports weekly tracking update shows that 41% of voters nationwide favor the bill and 55% are opposed. Yet the politicians still seem bent on voting for reform.

Point 3) Ethics - I know. It is strange to use ethics and politicians in the same sentence.

But I cannot even accept a pen from a drug rep, yet congress can bribe senators with hundreds of millions of sweetheart dollars to buy votes for a reform plan that will effectively decimate the future of american medicine in a very short time. And where does the congress get these hundreds of millions of dollars. I'll tell you where. From the taxes that we pay!

If we want the healthcare system reformed, it is time to ask individual physicians, not national organizations, hospital systems, Big Pharma, health insurers, medical suppliers, or even large physician groups. The larger the organization, the further away from individual thought we get. Large organizations tend to cater to themselves, instead of their customers, in this case, you, the patient. This is another of the reasons I founded The Institute For Medical Wellness, and have remained a solo family practice physician. In my practice, I only answer to you!

No politics.
No lies.
No deceptions.
High ethics.

I could go further, but I have said enough for now.

The Institute For Medical Wellness will continue to operate as it has since 2008. As we do not accept third party insurance, we are somewhat insulated from the Washington D.C. shenanigans. We do however still accept Traditional Medicare, as at present, the government bureaucrats stay out of patient care. But this reform bill may change that. Our participation with Medicare may end, leaving more Medicare patients less options for their care, unless they choose to join our Wellness plans or pay fully out-of-pocket. As many seniors are on fixed incomes, this could create an economic hardship. If that occurs, please feel free to thank Congress and the president for their meddling.


Enough about politics!

I am still a physician and providing healthcare is what I love to do.

So look soon for the rollout of our new wellness plans, along with our new Healthy Weight Program.

We also now have a list of the supplements we offer which can be found here.

To Good Health!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Friday, December 18, 2009

Take this healthcare plan or else !!

December 18, 2009

Caution: This newsletter may be a bit opinionated. But then again, people do pay me for my opinions, so here goes!!

Take this healthcare plan or else?

It seems that every day I watch the news, healthcare reform gets sicker and sicker. And now it appears that our elected officials think they know more about healthcare than doctors and patient's. The one thing our elected officials in both parties do know is how to spend money they do not have. And unfortunately, all this borrowed to be spent money will eventually be paid back on the backs of our children and grandchildren. This is just not right!!

Healthcare reform is supposed to bring down costs for everyone without raising taxes. The present Senate bill does not.

Healthcare reform is supposed to bring insurance to the majority of the 47 million temporarily uninsured. The present Senate bill does not.

Healthcare reform is supposed to bend the cost curve down. The present Senate bill does not. Especially when we get taxed for 2-3 years before any reforms start.

What does the Healthcare reform bill do?

It cuts Medicare. So for everyone on Medicare who has paid into the system for the past 20-40 years, tough luck!

It penalizes young healthy individuals who choose to take a risk and not purchase health insurance.

It will also raise the premiums on younger individuals to help subsidize others.

It creates multiple new bureaucracies that will put barriers between you and your doctor.

Now for the scariest part.

When the government puts their power and weight, otherwise known as coercion, into the healthcare system, they do so by telling doctors not only what to do, but what not to do. Health insurers try to do this, and they have partially succeeded. They coerce, also known as twist the arms of doctors to perform tests that may not be necessary, or use medications and treatments that may not work, usually on the basis of possible cost savings. Why would the insurers do this? That answer is simple and closes the loop on the problems with our helathcare system. Insurers are trying to stay in the good grace of Uncle Sam and the bureaucrats who think they know better. The only thing worse than a health insurer telling a doctor what to do, is a government bureacrat doing the same.

So who is left out and forgetten in this government-insurance dominated system?

I'll answer that. You, the patient are left out as you become a number, a statistic, a covered life!

I may be rambling a bit here, but I get very offended when anyone other than my patient tries to tell me how to do my job. When I founded The Institute For Medical Wellness, I went out on a limb professionally. It was my personal and professional risk and I chose to go full steam ahead with a health delivery concept that focuses on individuals, not insurances, and not government bureaucracies. When you are in my office, my attention is focused on you. So a healthcare bill that gives broad powers to the government to decide what care is and is not necessary is an extremely scary proposition. I fear that your care will suffer if you are forced into a government controlled system.

I do not expect everyone to feel the way I do. And I respect all points of view, especially those I do not agree with. I learn alot every day, from hearing how others view their health, what they are eating, how they are exercising, what works for their individual ailments and what does not. I have learned from my 15 years in practice that no two individuals are the same. So any healthcare plan that focuses on numbers and populations as opposed to individuals will never, ever have my support!

I want reform. But I want reform that gives patient's more choices in their healthcare, not less. I want reform that allows patient's and doctor's to decide what is needed for their care, without a 2000+ page federal healthcare bill getting in the way. I want a plan where everyone has access to healthcare not governed and controlled by Uncle Sam.

The Institute For Medical Wellness will thrive and expand regardless of healthcare reform because we focus our care on individuals and families, period. We have no ulterior motives, no insurance quotas in the back of our mind guiding our treatment. We will grow as more people are dissatisfied with the direction of government sponsored healthcare. But I would prefer that The Institute For Medical Wellness grows due to our outstanding care and committment to everyone who chooses us for their healthcare.

My promise to you. No matter what comes out of Washington, D.C., The Institute For Medical Wellness will continue to be where you can go for healthcare that is focused solely on you!

I will end with the mission statement that I wrote back in 2007, while putting the wheels in motion for the founding of The Institute For Medical Wellness. This mission statement describes how I want to be treated when I access medical care, and it is how I will always care for you!



To provide outstanding family medical care to our patients with a focus on comprehensive wellness and prevention.

To inform you of healthcare options that your health insurance carrier may not want you to obtain or know about.

To be an advocate for your medical care without regards to the health insurance bureaucracy.

Where patients go to be treated as a person and not as a commodity.

Where patients go to have a Physician who listens carefully and respects what the patient has to say and encourages the patient to say what is on their mind.

To give patients the ability to see their own Doctor and to make appointments without unreasonable waits.

To provide this care with an open mind, and to make your healthcare a team effort between Dr. Horvitz, his office staff, and you, the individual.


The Institute For Medical Wellness is now experimenting with Twitter.

If you "tweet" or follow others, you can find us at http://twitter.com/IMWHorvitz

Please email us at DrHorvitz@DrHorvitz.com to let us know what type of "tweets" you would find useful.

To Good Health!

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Monday, December 07, 2009

Prelude to your New Years Resolutions !!

December 7, 2009

Institute For Medical Wellness prelude to your New Years Resolutions!

The new year is almost upon us and I hope everyone is thinking about their New Year's Resolutions. As many resolutions revolve around health, at The Institute For Medical Wellness, we are putting the finishing touches on helping you with a common resolution, with our soon to released healthy weight program.

One of the most common New Years Resolution is to achieve a healthier weight. So we are putting together a program that will help you achieve just that. Many weight loss programs work for a short while, only to become too difficult to continue. These difficulties can be in the program itself, an early plateau of weight loss, or the return of intense hunger and cravings that sabotage your ability to achieve your goal. Our goal is to help you defeat the cravings by giving your body the nourishment it needs. And our program will achieve this with sound nutritional advice and supplements, but without prescription medications.

Why I am so positive about this program?

About four months ago, I tested it out on myself. Now I rarely hear anyone tell me I need to lose weight. But, any weight I would gain would always go to my midsection, the worst area for good health. For this I thank my genetics. I will not get myself into trouble by naming the family members responsible. I know better than that! But central obesity or abdominal obesity is a high risk factor for Diabetes and High Blood Pressure, among other ilnesses. Please refer back to a previous newsletter on how central obesity leads to a deterioration in health.

But let me move on to results. After about 3 months my weight loss peaked at 15 pounds, 10% of my body weight, and is still there today. My waist size is down, and my clothes all fit well again. In my case, 95% of my weight loss occurred from my midsection. The other 5% somehow came from my fingers, so if anyone finds my college class ring in my office, please let me know! My energy level is definitely up. In fact I increased my exercise after I lost about 12 pounds, not before. Exercise is important for good health, but when it comes to weight loss, your diet is the most important factor.

Now, not everyone has the same genetics or metabolism. But most people make the same mistakes when it comes to eating. Most diets revolve around menu plans and portion control. It becomes a mental exercise to determine what you can put into your mouth. It should not be that way, and this is where our new program will help. Our program will revolve more around teaching you what you should not eat, than what you should. Portions should not be an issue, for if you eat the proper types of food, hunger cravings go away. If you choose to follow the media's diet headlines or Oprah's latest diet sensation, then I wish you luck, and I'll still be here to help you when it fails. But I hope that you will give us a chance instead, to help you not only lose the excess weight, but to achieve an overall healthier you!

So look to a future newsletter for the roll out of our new Healthy Weight Program. And start thinking about how The Institute For Medical Wellness can help you achieve your upcoming New Year's resolutions!


Do you still have money left in a medical or healthcare flexible spending account (FSA) for 2009?

Many of these accounts enable you to put aside money for healthcare for each calendar year. One drawback is that you lose the money if it is not used at the end of each calendar year. Our Wellness Plans put this money to excellent use. So if you have an unused balance for 2009, or looking to budget your account for 2010, check out our Wellness Plans. You can use your 2009 remaining balance to prepay for a 2010 Wellness Plan!

To Good Health!!

Steven Horvitz, D.O.
Board Certified Family Medicine
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Please follow us on twitter at http://twitter.com/IMWHorvitz

Wednesday, November 18, 2009

Why I love my job!!

Why I love my job!!

Yea that's right. I love my job, because, if you have not yet noticed, I do it a wee bit different from my colleagues. You see, most of my colleagues practice what I call third-party healthcare, by contracting with HMO's or other insurers to provide your care. This keeps them very busy. A common misconception in primary care is that a busy office is a successful office and contracting with health insurers almost guarantees a busy office! Well, I have a different belief system. I believe that success in medical practice is based upon the good health and goodwill of your patient's. Do a good job, and you are a success. Do a good job meeting HMO criteria but not your patient's individual needs, and well, that is not so good!

HMO's, otherwise known as Health maintenance organizations, an oxymoron if I ever heard of one, may pay doctor's by what is called a capitated rate. This means that the HMO will pay a doctor a certain amount of $$ per month whether a patient is seen or not. This fee ranges from as little as $5/month to as much as $30/month, dependent upon your insurance plan. And by the way, the HMO insurance industry does not classify you as an individual, but as a "covered life". How icky is that??

The doctor also gets paid your copay if and when you visit the office, and occasionally an HMO bonus for meeting certain criteria. What many doctor's don't realize is that by trying to earn a bonus and meet the HMO criteria, their patient's become caught in a numbers game. For example: Did everyone get their cholesterol checked? Did everyone get a colonoscopy? No! Then call up these patient's and get it done. It doesn't matter whether the test is medically necessary, the HMO wants the test done to prove to another third-party, known as Uncle Sam, that it is providing good care. This is called population based care, and is what the present federal government wants to expand. Fit everyone into the same system, regardless of their individual history and needs. I am sorry, but this just does not work for me!! If I go to a doctor and they treat me as a number, or a statistic instead of as an individual, I am out the door quickly!

My colleagues sign 50-plus page contracts with insurers that they do not read. These unread contracts allow third parties power over your healthcare. Seems a little like the 2000+ page Congressional healthcare reform package that is alleged to be able to improve patient care. The only thing that 2000 page bill will cause is a hernia trying to lift it! And if you ever had a hernia, it hurts!! A 2000 page bill certainly will not improve patient care. But let me not digress. These insurance contracts allow the insurer to set up medical guidelines for your care, such as what type of tests to order, and what medications are covered. In essence they take the doctor and make him or her a robot. Now there are excellent doctor's who work within the system. In fact, I believe that 99% of doctors are highly skilled, competent and can do an excellent job. But if they put themselves in a system that restrains them from providing proper care, well, that is not a system that I care to be a part of!

I strongly believe in preventive care. It was one of the major factors in the founding of The Institute For Medical Wellness. But no two individuals are alike. Healthcare needs to be individualized to the patient's needs based on their personal and family health history. I do not allow any third party to tell me what to do for my patient's. If a doctor signs a contract with an insurer, that insurer is inside his head during every patient encounter. Not my idea of individualized patient-centered care.

So why do I love my job? The answer is fairly simple. I have designed a practice that caters to the individual, without any third party intrusions. I offer yearly wellness-retainer options, or payment at time of service for those that do not want a retainer. The retainer options can be paid all upfront, or with a down payment and monthly checking account debit. This monthly checking account debit is essentially a capitation for my services. But my services are spelled out in a simple easy to read and understand two-page contract between myself and my patient. There are no hidden clauses, no ulterior motives and no third party in my exam rooms. I am capitated, but to my patients, and not to any third party.

I average 10-15 patient visits a day, instead of 25+ when I went by the name of "insurance healthcare provider", which is actually pretty funny. When I was a kid, and people asked what I wanted to be when I grew up, I didn't say, "I want to be an insurance healthcare provider." I think, no, I am positive, I said I wanted to be a doctor!

And so I am, and I love my job!!

Now take a poll of other doctor's. Ask them if they love their job. You may be surprised at their response.
Healthcare Reform and the AMA

Yes, another healthcare reform piece. We hear all the time on the news how the AMA, (American Medical Association) supports the present healthcare reforms in Congress. As a doctor, I must ask myself why? My job is to do the best I can for my patient's. That is the oath I took when I graduated medical school. The AMA has no such oath. The AMA, by supporting the present reform bills, is watching out only for their corporate entity. I encourage you to read a short piece about why the AMA has thrown doctors and patients under the bus, in favor a huge income windfall from the government. You will be very surprised to find out who the AMA represents and where they get their revenues. I'll give you a hint. The first name in Uncle and the second name is Sam.

To Good Health !!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Thursday, November 12, 2009

H1N1 Revisited

H1N1 revisited

The H1N1 vaccine is now becoming available in many schools and community health centers. Whether to get yourself or your child immunized is a decision that has caused much angst. As I have stated in past newsletters, I have strongly supported the use of the yearly seasonal flu vaccine. But I had not, as yet, supported the use of the new H1N1 vaccine. I feel that building up your bodies immunity thorugh a healthy diet and lifestyle, along with an increase in Vitamin D is the best and safest way to prevent influenza. Please look at the following excerpt from the Vitamin D council website on Vitamin D and flu.

http://www.vitamindcouncil.org/newsletter/vitamin-d-and-h1n1-swine-flu.shtml .

New information has been gathered about the production and manufacturing of the H1N1 vaccine that has lowered my fears about this new vaccine.

So I am now led to believe that the H1N1 vaccine is another option in prevention of H1N1.

Why the change of heart?

A few of my earlier objections to the H1N1 vaccine were:
-the presumed quickened production cycle of vaccine production
-the possibility of untested and potentially unsafe adjuvants (additives that help provoke a stronger immune response)
-newer untested manufacturing processes
-low rate of hospitalizations and death did not warrant a new vaccine
-being a "testee" for a new vaccine

Let me explain how these concerns have decreased.

I viewed a letter from Margaret A. Hamburg, M.D., Commissioner of FDA which can be read in its entirety here. This letter calmed many of my objections about the H1N1 vaccine. It stated that the manufacturing process and production cycle of the H1N1 vaccine was followed almost identically to the production of the yearly seasonal flu vaccine. No new adjuvants or untested additives were used in the production. The hospitalization and death rate have not been higher in H1N1 influenza, but this virus strain appears to be more contagious than most. So as a percentage of the population infected, it does not appear more deadly. But as so many more people have become ill with H1N1 than with seasonal flu, there have been many hospitalizations and deaths. More worrisome is that the H1N1 flu is most dangerous to healthy children, due to their strong immune response. It appears that some children's immune response go into overdrive, which results in more hospitalizations and deaths. As with other flu's, it is also dangerous to individuals with weak immune systems, chronic medical conditions such as asthma, cancer or heart disease, and pregnant women. So as I recommend the seasonal flu vaccine each year, I no longer see a reason to oppose the H1N1 vaccine.

But as immunizations are a personal health matter, it is still up to each individual to decide for themselves if they want the vaccine. My office will not be ordering the H1N1 vaccine, as there will be many places in the community offering the vaccine in the future. To find a location please click here. At present, if you choose to get the vaccine, I would stick to the injectable version as I am not convinced that the nasal mist has enough data behind it to be pronounced safe or effective.

Again, whether to receive the H1N1 vaccine is up to each individual's philosophy on health, and I will support whatever decision you choose!

To Good Health !!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Tuesday, October 20, 2009

More on H1N1

The "Swine Flu" or H1N1 virus is here and still spreading.

The H1N1 vaccine is slowly becoming available as distributors have started shipping out the vaccine.

The question still stands: Should I get the vaccine and should I have my kids get the vaccine?

I had a call today from the mother of a family I have known for quite a while.

Here is a little of the conversation we had:

Mom: Thanks Doc for taking my call !

DrH: No problem! What can I do for you?

Mom: My child's school has been hit with the swine flu. Six (6) kids have already contracted the flu and the school will now be offering the vaccine to all student's, with parent's permission. What is your opinion doc?

DrH: Would you like the short or the long version?

Mom: I would like your answer as a parent first.


Score One for Mom!!!

Right to the point!

BTW, I try to make all my medical decisions as if I were treating my own family. I would not give you any treatment or medication that I would not take if I were sitting in your seat.

But back to the H1N1 question.

The H1N1 virus is here and spreading. So far, this virus has not been any worse than traditional seasonal influenza virus. In fact it seems to be less harmful. Unfortunately, any influenza illness will still cause hospitalizations and some deaths. But the H1N1 flu seems to cause more problems for children as opposed to adults. The theory behind this is that the H1N1 virus causes our immune systems to overcompensate. This overcompensation contributes greatly to the severe illness that can lead to bad outcomes. Children's immune systems appear more prone to overcompensation than adults.

That being said, I am not ready to give this vaccine to my child. This vaccine was rushed into production before proper testing. While I understand the "Why's" of it being rushed, that does not mean that I should recommend the vaccination to my family and my practice. If this vaccination program is a nationwide test of the vaccines ability to prevent H1N1 infection, I prefer not to be a "testee". Please, no puns intended!!

There are a few variables that can change my opinion.

1) If the H1N1 vaccine makes it through proper testing showing both effectiveness against contracting the virus and safety equivalent to or better than the seasonal flu vaccine, then I will advocate for vaccination.

2) If the H1N1 virus does morph or change into a deadlier strain, causing increased hospitalization and death, then the pros and cons of getting the vaccine may tilt towards receiving the vaccine.

As of today, neither of the above have occurred.

But, I do not expect everyone to agree with my views.

As George Patton once said, "If everyone is thinking alike, someone is not thinking!"

So if you want to receive the H1N1 vaccine, please click on the link to a Burlington County Health Department update on the H1N1 Vaccine distribution. It will indicate where you can go to receive the vaccine.

There are other options to help prevent contracting the H1N1 flu.

While not proven by large medical studies, Vitamin D has been shown anecdotally to help prevent and treat influenza.

We do have Vitamin D in the office for those that want to try this method.

We use RX Vitamins Liqui-D3, which is an oil based supplement that contains olive oil and Vitamin D3.

The usual dose is between 1-5 drops a day, equivalent to 2,000 to 10,000 iu per day. It is helpful to obtain a blood test to monitor Vitamin D levels if on this supplement, although I have not yet had anyone have harmfully high levels on the above doses.

To Good Health!!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Monday, October 05, 2009

Butter...... Parkay !!!

October 5, 2009

Butter..... Parkay !!!

Remember that commercial.

I do!

Here is a link to its youtube video !


I am often asked whether to eat butter or margarine.

Growing up it was cool to eat margarine instead of butter. Better eating through better science, or so we thought!!

Here is how butter is made.
Milk a cow.
Skim off the cream.
Add salt.
Churn the cream until it’s thick and chunky and tastes awesome.

Here is one of the processes for making margarine:
Farmers grow seeds.
The seeds are harvested.
The seeds are crushed to extract some of the oil.
The rest of the oil is extracted by mixing the seeds with hexane, a chemical solvent.
The hexane is (supposedly) all removed.
The oil is pumped full of hydrogen gas and nickel powder.
The remaining oil is subjected to heat and high-pressure CO2 gas.
The oil is mixed with sodium hydroxide and passed through a centrifuge.
The oil is mixed with water and passed through another centrifuge.
At this point, the margarine is a gray, speckled, oily mass that doesn’t smell so good.
The oil is mixed with hydrated aluminum silicate that binds to and filters out the unwanted pigments.
The mix is heated again and the oil is extracted.
The oil is passed through a steam distillation chamber to remove unwanted odors.
Yellow food coloring and artificial flavors are added.


Mmm Mmm good!!!

Not !!!

So what would you rather eat?

Most margarines are chemically altered vegetable oils and contain dangerous and unhealthy trans-fats otherwise known as trans-fatty-acids. While vegetable oils have received good press coverage, most contain an abundance of omega-6 fatty acids, which may counter the healthy effects of omega-3 fatty acids.

So what are we supposed to eat?

Cardiologists say butter is bad, because it contains saturated fat which they argue is responsible for an increased rate of heart disease.

But is this fact or fiction?

Let us look back at history for a moment.

In America, the rate of heart disease soared during a period when saturated fats consumption fell sharply while cholesterol intake remained roughly unchanged.Before 1900, heart disease was rare in America, affecting about 8 percent of the population.

By 1950, heart disease caused 30 percent of all deaths in America. Today, it causes about 45 percent of all deaths.During this period, consumption of butter, which is high in saturated fats, fell from over 18 lbs per person per year at the turn of the century, to about 10 lbs per person per year by 1950.

Today it is even lower, yet the rate of heart disease continues to escalate.In the same period, Margarine consumption rose from about 2 lbs per person at the turn of the century to about 8 lbs per person.

Ok now.

Do we follow the advice of clever advertisers and marketers?

Or do we follow the logic of our ancestors who relied on a very low processed foods diet?

Listen to your ancestors !!!

They ate saturated fats.

They did not eat processed food.

Pass on the Parkay and vegetable oils.

Eat butter!!

To Good Health!!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Tuesday, September 29, 2009

Hey Ma, No more Foie Gras !!

What is Foie Gras and how will reading about it help me to understand improved nutrition?

Should we ask The Donald?

Or maybe this Donald would be more apropo!!

Well, my guess is that "The Donald" partakes in foie gras, while "Donald Duck" hopes not to be on the menu.

From wikipedia: Foie gras (pronounced / fwa:gra:/ in English; French for "fat liver") is a food product made of the liver of a duck or goose that has been specially fattened. This fattening is typically achieved through gavage (force-feeding) corn.

When ducks, are force fed a starchy carbohydrate such as corn, their livers fill up with fat.

Does a similar mechanism occur in humans?

I am so glad you asked!!

There is a medical disorder called, Non-alcoholic fatty liver disease.

Otherwise known as NASH, this is a chronic condition that affects 2 to 5 percent of people in the United States. NASH involves inflammation or damage to the liver that can be severe and may lead to cirrhosis, liver failure, or liver cancer. What I find especially concerning is that NASH may affect about 70 percent of people with Non-insulin dependent Diabetes (Type 2 Diabetes).

The liver has many functions in our body. One of the most important is as a major detox center or sewage treatment plant, helping to remove and make less harmful, many substances in our body. Our liver also plays a part in sugar metabolism. If our bodies sense we do not have enough sugar or glucose to burn, our liver can manufacture glucose for use.

Sounds like a good thing!

It is unless it starts over-manufacturing sugar that we do not need and is one of the mechanisms involved in Type 2 Diabetics and why they have a high incidence of fatty liver. In Type 2 Diabetics, even though they have plenty of excess energy stored in their bodies fat cells, they have trouble converting this fat to energy for use inside their cells. So their liver starts producing more sugar- glucose, which gets into their bloodstream, raising their glucose levels even further, in the hope that their cells can make use of this energy. A big problem with this mechanism is that the now higher levels of sugar in the bloodstream then gets converted into triglycerides (fat) and once again get stored in the liver, furthering the fat accumulation problem. Talk about spinning in circles!!

Sometimes a picture helps to get a point across.

Caution- some pictures below may not be suitable to view prior to a meal.

Below are three different livers which show the progression of fatty liver disease.

normal->--fatty-> Cirrhotic liver

The liver furthest to the left is a normal liver. It is smaller in size and has a deeper-rich and healthy color.

The center-middle liver is a fatty liver. It is somewhat bloated and misshapen, with a dull yellowish color.

The liver furthest to the right is a cirrhotic liver. It is huge and misshapen, with a pebbled appearance and coarser in texture.

OK, ugly pictures to look at, especially before eating!

So what can we do to prevent NASH or reverse it?

1) We must lower the amount of processed carbohydrates we eat to an amount that our bodies can handle. We accomplish this by closely monitoring diet, weight, waist size, and metabolic parameters. Each and every individual has a different "carb-tolerance", so to be succesful you need to find your own.

As we read earlier, to make Foie Gras, ducks are force fed large amounts of corn, a very starchy carbohydrate. In real life, we are feeding ourselves large amounts of processed carbohydrates such as cereals, breads and soft drinks, which act in our bodies just like corn!

2) Increase the burning of excess fat cells by change to a lower carbohydrate diet and if possible an increase in exercise. In other words, change your metabolism from a storer of excess energy (storing fat) to one that burns more energy than it stores ( a burner of fat).

The key to burning fat for fuel, is to limit the amount of glucose available. We accomplish this by a low processed carbohydrate diet.

If you are succesful in this dietary approach, the excess fat stored in your organs may diminish and hopefully allow your organs to once again work efficiently.

So let's recap:

If our bodies are overburdened by carbohydrates and sugar, excess carbohydrates get converted into sugar which gets converted to triglycerides which gets stored in our liver and other internal organs, eventually "gumming up" their efficiency. Consider it like rust occuring on metal. Just as the rust will destroy the metal, the excess fat will prematurely age and destroy our organs.

So that ends this lesson in, Hey Ma, please no more Foie Gras !!!

So hopefully Foie Gras gives you some added motivation to start a low processed carbohydrate diet. As mentioned in my previous newsletter, we have wellness programs set up to help you with the transition and also to provide extra guidance.
Other Institute For Medical Wellness Events

Our massage therapist, Julie, is limbering up for the fall season.

If you are enrolled in a Wellness plan, and have not yet experienced the benefits of massage, you can receive one one-hour massage for $35, or one 1.5 hour massage for $50. That is 50% off regular prices.

Package discounts are also available:

A 3 hour massage package, regularly $210, is now available at a 10% discounted price of $189.

A 5 hour massage package, regularly $350, is now available at a 15% discounted price of $299.

One of our newer network affiliates is Master Ting, from Silver Tiger Tai Chi in Hainesport. Master Ting is now offering one complimentary Tai Chi session for individuals enrolled in any Institute For Medical Wellness plan. More information on Master Ting can be found here.

One of Master Ting's long time students, David, is also offering a Tai Chi class. The Tai Chi classes begin October 1, running from 7pm to 8:30pm.

Classes will be held at the Boudinot Elementary School, corner of Pearl and Ellis Streets in Burlington, NJ.
Call 609-387-5895 to register.

To Good Health!!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-031

Fall is here and the time is right for....

Hear ye, Hear ye !!

I have hereby proclaimed October 2009 as Healthy Weight and Lifestyle month at the Institute For Medical Wellness.

Achieving a healthy weight is more than diet and exercise. It takes skill and good sound advice.

Many an individual presents to my office wanting to lose weight.

The most common phrases I hear include, "But my metabolism is slow", or "I am metabolically challenged".

For these "metabolically challenged" individuals or anyone looking to get to a healthier weight, our wellness plans are a "perfect fit" to convert you to a more metabolically energized life!

The following wellness plans are available:

1) Our Traditional Wellness Plan- $525 yearly fee.

2) Traditional Weight Loss Plan- $750 yearly fee includes our traditional wellness plan along with 5 hours of personal exercise training.

3) Holistic Weight Loss Program- for $999 yearly fee, includes our traditional wellness plan along with our Naturopathic physician Dr. Jennifer Phillips to help you achieve your healthy weight and lifestyle needs.

4) Healthy Weight, Body and Life Program- $1500 yearly fee, being reduced to $1400 thru October 31, 2009. This program includes the Traditional Wellness Plan along with 5 hours of personal exercise training, holistic nutritional guidance from our Naturopathic physician Dr. Jennifer Phillips, a one hour introductory acupuncture session with Paula Andersen, and 3 hours of therapeutic massage with Julie Fischer.

All of the above yearly plans are also available with affordable monthly payment options.

So if you have some excess pounds to lose, and need help or guidance without gimmicks,
look no further than The Institute For Medical Wellness.
As part of proper diet and nutrition, the Institute For Medical Wellness is proud to offer the following nutritional supplements, available individually or in grouped packages. You can view these supplements here.

Supplements available at The Institute For Medical Wellness include:

Multivitamin: RX Vitamins ReVitalize Iron-free 90 caps - $30

Vitamin-minerals: Carlsons Labs B-12-SubLingual 1000 mcg 90 tabs - $15
Douglas Labs Amino-mag magnesium chelate 100 tabs - $12
RX Vitamins Liquid-D3 2000 IU 1 oz - $18

Fish Oils: Carlson's Labs Finest Fish Oil Omega 3 200 ml - $18
Carlson's Labs Finest Fish Oil Omega 3 500 ml - $36
Carlson's Labs Finest Fish Oil Omega 250 capsules - $42

Probiotics: Integrative Therapeutics Probiotic Pearls Pro Flora Immune 30caps - $15

Urinary Tract: Bio-Tech d-Mannose 50 caps - $15

Misc: Coenzyme Q10- 200mg - 60 tabs-capsules or lozenges - $50

We also have supplement packages available at a discount:

General Health Package:

RX Vitamins ReVitalize Iron-free 90 caps
RX Vitamins Liquid-D3 2000 IU 1 oz

Buy these together for $43, a $5 savings

Healthy Immune System Package- may help you get ready for the cold and flu season.

Integrative Therapeutics Probiotic Pearls Pro Flora Immune 30caps
RX Vitamins Liquid-D3 2000 IU 1 oz

Buy these together for $28, a $5 savings

Healthy Heart Package:

Coenzyme Q10- 200mg - 60 tabs-capsules or lozenges
RX Vitamins Liquid-D3 2000 IU 1 oz
Carlson's Labs Finest Fish Oil Omega 3 500 ml or Carlson's Labs Finest Fish Oil Omega 250 capsules.

Buy these together for $97, a $10 savings
Our massage therapist, Julie, is limbering up for the fall season.

If you are enrolled in a Wellness plan, and have not yet experienced the benefits of massage, you can receive one one-hour massage for $35, or one 1.5 hour massage for $50. That is 50% off regular prices.

Package discounts are also available:

A 3 hour massage package, regularly $210, is now available at a 10% discounted price of $189.

A 5 hour massage package, regularly $350, is now available at a 15% discounted price of $299.
One of our newer network affiliates is Master Ting, from Silver Tiger Tai Chi in Hainesport. Master Ting is now offering one complimentary Tai Chi session for individuals enrolled in any Institute For Medical Wellness plan. More information on Master Ting can be found here.

One of Master Ting's long time students, David, is also offering a Tai Chi class. The Tai Chi classes begin October 1, running from 7pm to 8:30pm.

Classes will be held at the Boudinot Elementary School, corner of Pearl and Ellis Streets in Burlington, NJ.
Call 609-387-5895 to register.

To Good Health!!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311
I would like to thank everyone for sending me topics for future newsletters. While I am not able to accommodate all the requests, I will continue to try. So keep em coming!!

Please feel free to forward these newsletters to friends and family.

Friday, September 04, 2009

Lies and Thighs.....

September 4, 2009

Lies and Thighs .........

First the Lies !!!!!

Pfizer pharmaceuticals pleads guilty to a felony for fraudulent marketing of some prescription medications and will pay record fines amounting to over two billion dollars.

You can read the Department of Justice (DOJ) documents describing the settlement here .

Here are some quotes from our federal government gloating over this news:

First, Kathleen Sebelius, Secretary of Department of Health and Human Services was quoted as saying:

"This historic settlement will return nearly $1 billion to Medicare, Medicaid, and other government insurance programs, securing their future for the Americans who depend on these programs. The Department of Health and Human Services will continue to seek opportunities to work with its government partners to prosecute fraud wherever we can find it. But we will also look for new ways to prevent fraud before it happens. Health care is too important to let a single dollar go to waste."

Next we have Michael L. Levy, U.S. Attorney for the Eastern District of Pennsylvania. He is quoted as saying:

"This resolution protects the FDA in its vital mission of ensuring that drugs are safe and effective. When manufacturers undermine the FDA’s rules, they interfere with a doctor’s judgment and can put patient health at risk. The public trusts companies to market their drugs for uses that FDA has approved, and trusts that doctors are using independent judgment. Federal health dollars should only be spent on treatment decisions untainted by misinformation from manufacturers concerned with the bottom line."

Now I have also complained about some of the practices of Big Pharma.

Some of my past newsletters on this subject can be found below:
If you think I am skeptical that this will help individuals, then it proves that great minds think alike.

But Why????

Here are questions I would like answered.

Will other pharmaceutical companies change their ways as a result of this judgement?
What will happen to the 2 billion dollars the government receives?
Will the money go where it is intended, back to Medicare and Medicaid???
Are other pharmaceutical companies being investigated as part of a shakedown, and being forced to strike a deal with the federal government to help pass healthcare reform legislation?
Are the Food and Drug Administration's (FDA's) guidelines too difficult and bureaucratic to allow new medications to be brought to market?
Is the FDA itself corrupt?

The timing of this announcement, as the White House likes to say, seems "a little fishy" to me. While Pfizer did break the law, and deserves to be dealt with, I am not so sure there are not other motives.

My solution would be to end third party payment systems that use "other people's money". These systems invite fraud and abuse. Just look at our ever growing federal debt as an example. It is time to bring power away from Big Govt, away from Big Business and Big Corporations, away from Wall Street, and give it back to the individual. Individuals are better at sniffing out fraud, as it is their own money on the line, not "other people's money"! The real problem is how prescriptions are paid. As long as there are third party middlemen with all their rules and regulations, then fraud will occur. The government can better help individuals in need by setting up a "medical food stamps" program, that puts money to be used specifically for healthcare into a bank account for the individual. This would streamline healthcare transactions, and get rid of the third party bureaucracy that invites fraud. If it works well for food, why not healthcare?

But enough about Big Pharma, Big Government and conspiracy theories..........

Bring on the Thighs !!!!!

If you receive this email on your "blackberry", for the best visual effects, please also view on your computer email.

Take a look at the two pictures below. Who has the better chance of living longer?

To help determine the answer, I will refer you to the following article, Thin thighs - maybe not your heart's desire

This article comments on a study which showed that individuals with bigger thighs lived longer than those with smaller thighs. Now the pictures above may be a bit of a stretch when comparing thin thighs to, shall I say, thick thighs, but my take on this study goes back to not how much weight you carry, but where you carry it.

Many of you have heard the distinction between having an apple or pear shaped body. The difference can be seen in the pictures below.
This first side angle picture shows the apple shaped man on the left, with all of his excess weight stored in his abdomen and trunk. Note that his thighs are very thin compared to the rest of his body. The person to the right in the first picture has a pear shaped body, with excess weight more evenly distributed throughout their body.

This middle picture I included just because I liked the picture !!

The third picture shows a frontal view of an apple and pear shaped body.

While many would argue that the thin thighed women is more attractive and healthier, that may not be the case. If you want to read further about this study, it can be found here. Pear shaped bodies tend to live longer as they distribute their fat away from the major vital internal organs, such as the liver and heart.

Pearl from this article: Having a supermodels figure is not always healthy. A healthy weight can not be determined just by getting on a scale. There are many factors that come into play. Here is a previous newsletter about a healthy weight.

So before you say you are unhealthy and put yourself on a diet to "improve your health", look to The Institute For Medical Wellness to make sure you are on the right track. Our goal has always been to give you individualized, non-biased health guidance, regardless of what the so-called experts or majority say.

When we are working with you, only two votes count, ours and yours!!

Best Wishes to All for a happy, healthy and safe Labor Day weekend!!

To Good Health!!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

Also please check out our new Wellness Plans offering more holistic and heart healthy options.

I would like to thank everyone for sending me topics for future newsletters. While I am not able to accommodate all the requests, I will continue to try. So keep em coming!!

Saturday, August 29, 2009

Bladder Infections and other things that make me want to ....

August 29, 2009

One of the more common reasons patient's visit my office is due to bladder infections, otherwise known as cystitis or UTI (urinary tract infection). These infections are much more common in women than in men until later in life and account for over 8 million doctor visits each year.

Symptoms of bladder infections can include:
-Pain or a burning feeling during urination
-A feeling of urgency, or feeling the need to urinate frequently
-An altered appearance of the urine, either bloody (red) or cloudy (containing pus)
-Pain or pressure in the rectum (men) or in the area of the pubic bone (women)
-Passing only a tiny amount of urine even when the urge to urinate is strong

The most common traditional evaluation for these infections include a history and physical exam, along with a urine sample that is tested for signs of an infection.

The most common traditional treatment includes antibiotics to sterilize the bladder contents. While antibiotic treatments usually work, they are not without potential side effects, which can include but are not limited to allergy to the medication, drug interactions, diarrhea and yeast infection.

But what can be done to prevent these infections from occurring in the first place?

-Everyone should drink plenty of water to dilute your urine and help flush out bacteria.
-Avoid coffee, alcohol, and soft drinks containing citrus juices and caffeine until your infection has cleared. They can irritate your bladder and tend to aggravate your frequent or urgent need to urinate.
-Empty your bladder frequently. "Holding in" your urine allows bacteria more time to cause trouble in your bladder before you empty.

For women the following is especially important:
-Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
-Empty your bladder as soon as possible after intercourse. Also, drink a full glass of water to help flush bacteria.
-Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
-Avoid wearing tight clothing such as swimsuits and leotards for long periods.

But if all the above has not worked to prevent an infection, is there something else that can be done without needing antibiotics?

To answer this question, first I must let you know that about 90% of bladder infections are caused by a bacteria called E. Coli.

E Coli causes urinary tract infections by attaching itself to the wall of the bladder. Once stuck, it can reproduce and cause an infection.

So other than antibiotics, is there a way to remove the E. Coli form the bladder wall?

There just happens to be a way to trick the E. Coli into detaching itself from the bladder wall, thereby allowing you to empty your bladder of urine and this pesky bacteria.

This solution is to use a simple sugar called D-Mannose.

This sugar, when ingested, is processed through the body and stored in the bladder. Once in the bladder, D-Mannose makes the bladder wall more difficult for E. Coli to attach to. It is also thought that bacteria enjoy feeding on D-Mannose and detach from the bladder wall to better feed in the urine. The next time you urinate, the E.Coli along with the D-Mannose is flushed out of your bladder.

I have used this treatment in about half a dozen patient's so far with excellent results. Further research has indicated that D-Mannose can be used not only for treatment, but also for prevention of bladder infections.

If you are interested in trying this natural treatment, we now have this nutritional supplement at our office.
Now what would a newsletter be without another opinion on healthcare reform. I would ask that you read the following opinion article linked here. It describes how the present healthcare reform bill WILL ration care, and will attempt to change the healthcare system to a population or community based system, instead of one that focuses on the individual.

In 2008 I terminated my participation with health insurers, and founded the Institute For Medical Wellness to provide patient-centered healthcare. Any system that puts more power to any third party, whether it be government or an insurer, and away from the individual is a system doomed to fail, as this type of government dominated system will put doctors and patient's on opposing sides. We need a more just system that will extend coverage to the uninsured without degrading quality for everyone, while keeping doctor's and patient's united for better health.

My opinion.

Throw the present proposals and bills in the trash.

The two political parties are diametrically opposed on too many aspects contained in the present bills under review.

Why not instead, have both political parties sit down and write a proposal in no more than 2-3 sentences that they both can agree upon.

Yes I said 2-3 sentences, not over 1000 pages!!

Read the 2-3 sentences, then vote!!

How about these four for starters:

1) End pre-existing conditions- Have the government start a high-risk pool for everyone with pre-existing conditions. Once individuals have health insurance, if they have a pre-existing condition, the government high risk insurance pool will cover those pre-existing conditions for one year, and after one year the private health insurer will again be responsible. This would bring some of the uninsured back to being insured.

2) Allow employers to give tax free money to employees to buy their own coverage. Employers can offer a company plan, but employees may group together with whoever they want to form their own group. This puts the individual in control of their own healthcare, without destroying employer participation. And this makes insurance portable, as it is owned by the individual.

3) Increase competition by allowing individuals and groups to purchase insurance coverage across state lines. If a policy in Nebraska costs $200/month and a policy in New Jersey costs $500/month, let people purchase the Nebraska policy. I do not know the actual rates for either state, but I have seen insurance rates differ dramatically between states.

4) Allow individuals the same tax benefits for healthcare that corporations have.

If we can start with areas we agree, it will be easier to find solutions to those we do not!!

To Good Health!!!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311

To view previous newsletters

Friday, August 21, 2009

Swine Flu - Should we be worried?

August 21, 2009

Swine Flu- Should we be worried?

The Swine Flu, now known as the H1N1 flu has already hit our area, and so far has been no worse than the normal seasonal flu. This may be due to the outbreak beginning in the spring, as the weather was warming up. The flu is always at its peak in the winter months, so a springtime start to a flu helps to slow its spread. There are different theories on why the winter months are worse for the flu. One theory I believe has to do with Vitamin D and our immune system. Vitamin D, which our bodies manufacture in response to strong sunlight, is at it highest level during the summer months and at its lowest level during the winter months. Higher Vitamin D levels have been shown to enhance our immune systems abilities to fight off infections, including influenza. So flu's generally hit when our Vitamin D levels are at our lowest level, in the winter months.

There are many questions yet to be answered about this potential outbreak.

1) Is this flu similar or different to the 1918 version?

Some scientists believe the H1N1 flu is similar to a 1918 flu outbreak that killed 50-100 million people worldwide. But, if you ask 5 experts on this subject, you will probably get 7 different answers. What we do know, is that the virulence of the H1N1 flu may be higher than seasonal flu as it is much more capable of reproducing in lung tissue, and thus responsible for the increased hospitalization rates due to pneumonia.

I am waiting on data from the southern hemisphere, where the winter season should be more conducive for the H1N1 virus. If the flu is causing widespread hospitalizations and deaths, moreso than the normal "flu", then I will take it a bit more seriously. Until then, I am cautiously waiting for more true data that I can analyze.

2) Is the government hysteria over this flu warranted and are they giving any recommendations to decrease its spread?

The CDC (Centers for Disease Control), has issued guidelines for businesses and employers to respond to the anticipated 2009-2010 flu season and can be found here. These guidelines deal with workplace recommenddations to reduce the spread of the H1N1 flu. Again, I am waiting on data from the southern hemisphere, where the winter season should be more conducive for the H1N1 virus. If the flu is causing widespread hospitalizations and deaths, moreso than the normal "flu", then I will take it a bit more seriously. Until then, I am cautiously waiting for more true data that I can analyze.

Never letting a potential crisis go to waste, our government has contracted with pharmaceutical companies to ramp up production of an H1N1 vaccine.

I recently came across a quote from the late Robert Novac, which sums up my views on government involvement in healthcare issues.

"Always love your country — but never trust your government!"

There are many more questions I must answer before advising on the need for the H1N1 vaccine, including:

3) Is the vaccine safe?

This question has not been answered because it has not been thoroughly tested. The swine flu vaccine of 1976, caused more problems than the flu did. The British government, aware of those issues, recently wrote a letter to neurologists to be on alert for Guillain-Barre Syndrome (GBS), a rare nerve disorder which could be triggered by the vaccine. The 1976 swine flu vaccine caused an eight-fold increase in Guillain-Barre cases in the United States, which at its worst can cause respiratory failure and even death. More information about this government letter can be found here.

4) Is the vaccine effective?

Again, this question has not been answered because it has not been thoroughly tested.

5) Are there side effects, and if so what are they?

Again, this question has not been answered because it has not been thoroughly tested.

The World Health Organization, has posted some information on their website as it relates to side effects. One part in particular concerns me, and the quote is as shown:

"Since new technologies are involved in the production of some pandemic vaccines, which have not yet been extensively evaluated for their safety in certain population groups, it is very important to implement post-marketing surveillance of the highest possible quality. In addition, rapid sharing of the results of immunogenicity and post-marketing safety and effectiveness studies among the international community will be essential for allowing countries to make necessary adjustments to their vaccination policies."

Does the word guinea pig strike a chord?

6) Does the vaccine benefit my patients?

Again, this question has not been answered because it has not been thoroughly tested. I am not anti-vaccines, nor am I anti-pharmaceutical companies. I do my best to research each vaccine and company and make my own independent opinion. However there are some physicians who do not like flu vaccines. To present an anti-vaccine physicians opinion, please visit the following website.

7) Are we to ASSUME that this flu season will be better or worse than in previous years?

Have you ever heard the saying, never assume anything, or you could make an -ass- out of -u- and -me-.

8) Do we trust the pharmaceutical companies to produce a safe and effectice vaccine on short notice?

I'll leave you to decide if you have faith in the pharmaceutical companies. I have received the seasonal flu vaccine each of the past fifteen years, and other than some male pattern baldness, have not had any adverse effects. But this is not the seasonal flu vaccine. This is a new vaccine that is being rushed to market. And to increase production in a quick fashion, the vaccine manufacturers are using experimental additives. More on the additives can be found here. This sounds an awful lot like Congress and the Senate trying to rush through health reform without thinking about the consequences. My solution is to first give this new vaccine to all of our elected officials and politicians. Why not use them as the guinea pigs for once?

I prefer to practice medicine on facts, not on fear or emotion. A little extra time spent talking, researching and thinking, can prevent and even cure many problems. So are there other
ways to protect yourself from the flu or from its complications, until we find out more about the swine flu vaccination?

Steps to enhance your immune system such as stress reduction and an increase in exercise may be beneficial.

Many flu related deaths are caused by a secondary pneumonia infection. Recent evidence has shown that decreased stomach acid, resulting from the use of prescription acid reducers, may increase your risk of pneumonia. Please talk to your physician if you are on one of these medications.

Earlier in this newsletter, I wrote about a benefit of Vitamin D. I have been testing vitamin D levels for many years now, and have found the optimal range for good health and hopefully flu prevention is a Vitamin D3 level of greater than 50 ng/ml. If you have not yet had your Vitamin D level tested, please call our office to schedule. If your Vitamin D level is sub-optimal, summertime sun exposure is a cheap and effective way to increase your levels. It only takes about one hour of daily summertime sun exposure to produce Vitamin D.

If you are unable to get adequate summertime sun exposure, my office sells a Vitamin D3 supplement that is cheap and effective. Call for more details.

In conclusion, it is a personal decision about whether to get a swine flu vaccine. At this point I am not recommending them, although I do recommend the seasonal flu vaccine. Hopefully my shipment of seasonal flu vaccine will arrive and be ready in October. I'll be sure to send out an email alerting everyone when they arrive.

I would also like to thank everyone who has forwarded my newsletters to friends and family. We are adding more readers with every edition.

Let me also wish everyone an enjoyable end to the summer, and to getting as much natural Vitamin D production as you can.

To Good Health!

Steven Horvitz, D.O.
Board Certified Family Practice
Founder of The Institute For Medical Wellness
128 Borton Landing Road, Suite Two
Moorestown, NJ 08057
Phone 856-231-0590
Fax 856-294-0311