Sunday, February 28, 2010

Heart Attacks and Healthcare reform- What truly causes them and can we prevent either??

February 28, 2010

Institute For Medical Wellness Healthy Living Report


Heart Attacks and Healthcare reform- What truly causes them and can we prevent either??

This will be the first in a series about cardiovascular disease testing.

Today will focus on total cholesterol measurements and what it really means.

When I first meet a patient, I generally spend a good deal of time reviewing their medical history. This generally accounts for about 20 minutes of our first visit. And what makes the Institute For Medical Wellness distinct from other offices, is that it is I, Dr. Horvitz, that takes the history. I do not rely on paperwork, assistants, or prior records. It is extremely important to get to know each patient, and the initial medical history is the most important step in that process.

What I always find amusing about the initial history, is when I question about previous testing.

Can you guess what testing patient's almost always bring up first?

It is none other than one of my favorite topics, cholesterol!!!

I have had patient's come in to my office scared because they were told their cholesterol was over 200. I have had patient's smile proudly and announce that their cholesterol levels were under 200. I always ask why that is important, and the routine response is, "Well isn't cholesterol bad for me, and shouldn't I try to lower it?"

Many still believe that they need to lower their Total Cholesterol below 200 to reduce their risks of heart attacks, strokes, and other vascular disease. Now, what would you say if I told you that:

Of all people who suffer heart attacks, 50%, that means half, have Total Cholesterol levels above 200 !!!

Sounds pretty ominous ????

OK, then let me take it one step further, by asking what about the other 50% who suffer heart attacks?

Of all people who suffer heart attacks, 50%, that means half, have Total Cholesterol levels below 200 !!!

So how accurate is a Total Cholesterol level in calculating your risk for a heart attack?

It is as accurate as guessing heads or tails when flipping a coin !!!!

I will continue with cardiovascular disease testing in a future newsletter. I hope to show what truly predicts your future risk and what does not!!

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Healthcare Reform Update:

The healthcare summit is over. For those of you who watched it, What did you think?

I'll tell you what I think, but first go back to my previous newsletter with my prediction about the summit. As of now, most of my predictions have come true. Everyone had their talking points, with the president, as usual, speaking the most. But he has that right, because, if I can quote him, "I am the President".

Unfortunately, the two political spectrums are diametrically and philosophically opposed to each other in respect to healthcare.

The democrats want government to exert more power and control over the system.
The republicans want the government to set up rules that would allow individuals and businesses greater leverage when purchasing health insurance and healthcare.

The democrats want a system where politicians and bureaucrats will have the ultimate decision making authority about what type of health insurance is available to you, which leads in the future to what type of treatments will be available.

The republicans want a system left open to the free market, with less political mandates from Washington and state governments. This would allow insurance companies to develop insurance plans that better meet the needs of its subscribers, and lowering the costs.

There is more but I prefer to sum it up this way.

The president wants a plan with heavy, heavy control of your healthcare choices residing in Washington. The president believes that government knows better what you need, and will make better choices for you, than if you could make them yourself. The president wants a healthcare plan where you need to rely on Washington and all of its politics.

The republicans do not want a big reform plan. They want small incremental changes that would allow the power of healthcare decision making to remain with individuals. They want reforms that promote true competition for your healthcare dollar, thereby lowering your costs and improving innovations in treatment. The republicans want a healthcare plan where you rely on yourself and your community, not on Washington politics!

Now to be fair, everything does not always work out exactly as feared or planned.

But it is "intentions", that affect our behavior and beliefs.

It is my view that the president's intentions are to set the stage for a future full government takeover of the healthcare system. It may not occur during his presidency, but he wants to start pushing the car without brakes down the hill towards a full government system. The problem I have, is that once the car starts moving downhill, it becomes very, very hard to stop!

If you did not watch the summit, or the follow-up media highlights, I urge you to watch the following video. Dr. Tom Coburn, a republican senator and physician, gave a republican address concerning the aftermath of the summit. It can be viewed here.

As a disclaimer. I do not like any politician or political group that puts themselves or their party ahead of the constituents they are meant to represent. That is why I am a registered as neither a republican or a democrat, but as an independent.

My views on healthcare has not changed. Please read a newsletter from two years ago, prior to today's healthcare debate.

If you are against the present reforms, click here to sign one of the many petitions seeking a total fresh restart of the reform debate.

No matter what your views on healthcare reform, speak up and contact your political representatives!!

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
www.drhorvitz.com

To follow The Institute For Medical Wellness on Twitter.

If this newsletter was forwarded to you, and you would like to receive future editions in your email box, please sign up here.

Wednesday, February 24, 2010

Healthcare Words Of The Day

February 24, 2010

Institute For Medical Wellness Healthy Living Report

First word of the day is oxymoron.

An online definition:

oxymoron
a rhetorical device or figure of speech in which contradictory or opposite words or concepts are combined for effect. — oxymoronic, adj.

Now please read the following segment below:

In a previous newsletter, I wrote about a French premier who traveled to our country for healthcare. In particular, he had heart surgery in Florida after his Canadian doctor's recommended it. As per a Canadian Press article, Mr. Williams was quoted as saying,

“My doctors in Newfoundland indicated to me that I should go out of the province to get it done,” Williams said in an interview broadcast yesterday with the NTV network. “This is my heart, it’s my health, and it’s my choice.”

So a French Premier chose, of his own volition, to come to America for healthcare, more specifically, heart surgery. There are heart surgeons in Canada. But they did not perform the less invasive type of surgery performed by some surgeons in America.

But that may not have been the only reason Mr. Williams came to America, according to the Canadian press article.

"Williams said he didn't announce his departure south of the border because he didn't want to create "a media gong show," but added that criticism would've followed him had he chose to have surgery in Canada. "I would've been criticized if I had stayed in Canada and had been perceived as jumping a line or a wait list. ... I accept that. That's public life," he said. "(But) this is not a unique phenomenon to me. This is something that happens with lots of families throughout this country, so I make no apologies for that."


OK. He could have had the surgery in Canada. But the surgeons would have cracked open his chest, instead of going in laparoscopically, a much less invasive procedure. And, if he stayed in Canada, and had the surgery, he either would have had to wait in line, and risk permanent heart damage, or use political connections to get pushed to the front of the line.

Things that make you go Hmmm....

A politician using political connections to get special favors. That could never happen in this country??? I also have a bridge in New York to sell you!!

But he chose to have treatment in our country, yet still believes the Canadian system is better??

Can you say oxymoron???

So while I truly respect our neighbors to the north, I want no part of their top-heavy government controlled healthcare system. Our system may be expensive, but that is a result of too much government, third party and political intrusions into the system, not too little. So anyone who wants to debate where to get the best and most advanced medical care in the world, get in line behind Danny Williams from Canada.

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OBama's Healthcare Summit

That brings me to the second word of the day, Summit.

An online definition of summit.

sum·mit (smt)
n.
1. The highest point or part; the top.
2. The highest level or degree that can be attained.
3.
a. The highest level, as of government officials.
b. A conference or meeting of high-level leaders, usually called to shape a program of action.
v. sum·mit·ed, sum·mit·ing, sum·mits

If we actually believe that politicians meet the above definitions and that they can fix the healthcare system, then, well ......

Here is my prediction for how the healthcare summit will go.

President Obama will thank everyone for attending the first ever televised and transparent healthcare summit to attempt to solve our nations healthcare crisis. He will mention how we have the best doctors and hospitals in the world, but are trapped in a system that costs too much and leaves many without healthcare. He will then demonize special interests, especially the health insurance companies and Big Pharma. He will take a stand and review his proposal for reform, that is a compilation of the Senate and House's bills that, if you follow public opinion polls, has been widely rejected by a majority of Americans. He will talk about bending the cost curve of healthcare, and making doctors and hospitals more efficient through the use of electronic health records and a comparative effectiveness research commission. He will ask that his proposal be the framework or template that the rest of the day's summit focuses upon. He will call for an end to bickering and political games and ask that the republicans end their partisanship in the name of healthcare reform.

Boy would I love to be at this summit, and debate the president on healthcare reform. I am so, so tired of politicians screwing up the healthcare system, blaming doctors and hospitals for increasing costs, and then making it worse with more political rhetoric.

So since I will instead, be working at my office, providing healthcare, let me rebut some of the above statements.

1) There is no healthcare crisis. There is a political crisis on what to do to fix a system that previous governments also screwed up, yet they will use the word crisis as a way to have the government exert even more control.

We do not need more government control of healthcare, but less. Everyone has access to healthcare. No one can be turned away from an emergency room. The real issue is the cost of health insurance, not actual healthcare. To lower the cost of health insurance, we need to get rid of government mandates, encourage high deductible insurance policies with tax free medical savings accounts to promote some individual responsibility for one's own health, and enable more competition among insurers by allowing real competition across state lines. By freeing the insurance companies from political state mandates, the cost of insurance premiums will decrease. The states with the fewest mandates, have the lowest insurance premiums. Yet the presidents reform proposals will likely increase mandates on insurance companies, which will only lead to higher insurance premiums. That is why Massachusetts, with a state sponsored system, has one of the highest insurance premiums in the nation. The president's proposals will result in a "bending of the cost curve" in the wrong direction.

2) Big Pharma is not one of my friends, but they are also not one of my enemies. Their marketing schemes leave alot to be desired, and I call them on it all the time. But they do produce medications and treatments that prevent illness and save lives. Instead of demonizing them and calling their profits obscene, change the system to make them deal directly with individuals. At present, they do not sell their products to individuals. They sell them to insurance plans and pharmacy benefit companies. If they had to sell their products direct to you, don't you think they would have to lower their prices to stay in business? You can still have a prescription plan, if you choose. But the plan would reimburse you after you bought your medication, thereby ending the backroom wheeling and dealing that drives the costs of medications higher. The presidents plan is for more third party intrusion into your prescriptions, which will only make the costs higher in the end. Again, the president's proposals will result in a "bending of the cost curve" in the wrong direction.

3) Electronic health records (EHR) do not make doctor's more efficient, nor do they save money. Doctors spend so much wasted time documenting every little hiccup, that they lose focus on the patient. EHR's only make the matter worse as the learning curve for these systems can be pretty steep, as well as the operating costs being very high. The return on investment for most doctor practices is negative. The president's proposals will result in a "bending of the cost curve" in the wrong direction.

4) The Comparative Effectiveness Research panel was put into law at the time of the first "stimulus bill". This panel is actually a ploy to put the government in charge of deciding what treatments are worthwhile and will lead eventually to what treatments will be covered. So the newer, higher priced treatments and procedures will eventually be stymied by lack of coverage. For example, let us go back to Premier Danny Jackson. If the heart surgeon was not able to learn to perform the less invasive surgery, due to the higher initial costs during the early years of the procedure, Mr. Jackson would still be in Canada, waiting to have his chest cracked open. Mr. Jackson's choices that he was quoted above would have been limited. Is that the type of healthcare system you want??

I could go further, probably to number 212, but then this would be more like a book, then a newsletter.

So let me conclude by stating my hope, as a physician who prefers to have third party government and insurers out of my exam rooms, is for the Republican party to stand strong against the President's proposals. I also hope they are joined by Democrats to demand the summit start fresh with a totally open slate, and begin again with reforms that give freedom and choice to individuals, with a system designed to lower both insurance premiums, individual costs, and government costs. This will allow the continuation of the best healthcare the world has ever known, while truly bending the cost curve downward.

Unfortunately, I believe the Democrats in Congress, believe they know better than the American public, and will still try to shove this reform plan down our throats. If they do, they will certainly pay the price during the November 2010 elections!! So let us hope they come to their senses, and end the present reform charade.

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Wellness Network Update:

Just a reminder. Everyone enrolled in a Wellness Program can receive one therapeutic massage at half price. That is $35 for a one hour massage, and $50 for an hour and a half.

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Institute For Medical Wellness New Offers:

Our supplement of the month for February 2010 is Revitalize. Revitalize is our once daily multivitamin that contains an abundance of vitamins and minerals, along with small amounts of antioxidant, and liver detoxifying herbs. Revitalize comes in a bottle of 90 capsules, with most people taking 1-3 a day. I find that one a day is sufficient for most, and also allows the bottle to last for 3 months. Through the end of this month, Revitalize will be available for $5 off its regular price. For more information on Revitalize and the other supplements we offer, please visit here.

I have not yet decided on a supplement of the month for March.

Any ideas or suggestions???

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
www.drhorvitz.com

Monday, February 22, 2010

What do you eat Doc?

February 22, 2010

Institute For Medical Wellness Healthy Living Report

What do you eat Doc?

I often get asked, "What do you eat Doc?" What type of food do you eat?

The question should really be, "Doc, what do you not eat?"

The answer has changed over the years. But over the past ten years or so, I have come to the conclusion that a more natural, ancestral or "caveman" based diet is the healthiest way to eat.

No, I do not have Fred Flintstone as my personal chef, and I do not eat Brontosaurus burgers. Although I have been known to have a Five Guys burger, minus the roll of course!

When I go grocery shopping, I always read the ingredients. I refuse to eat food with ingredients I can not pronounce, or that I would not eat by itself. That goes for beverages as well.

So here is a quick quiz. I am going to list the ingredients of 5 popular beverages. See if you know the name of each. Answers will be at the end of the newsletter.

A: Carbonated water, high fructose corn syrup, caramel color, sugar, phosphoric acid, caffeine, citric acid, natural flavor.

B: Carbonated water, caramel color, aspartame, phosphoric acid, potassium benzoate (preserves freshness), citric acid, natural flavor.

C: Carbonated water, caramel color, aspartame, phosphoric acid, potassium benzoate (to protect taste), natural flavors, citric acid.

D: Carbonated water, high fructose corn syrup, citric acid, sodium benzoate( preservative), natural flavors, caramel color.

E: Vapor distilled deionized, and/or reverse osmosis water, cane sugar, crystalline fructose, citric acid, vegetable juice (color), abscorbic acid (vitamin C), natural flavor, berry and fruit extracts (acai,blueberry, pomegranate and apple), magnesium lactate (electrolyte), calcium lactate (electrolyte), monopotassium phosphate (electrolyte), niacin (B3), pantothenic acid (b5), pyridoxine hydrochloride (b6), cyanocobalamin (b12).

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Interesting Article:

Please click on the link below for an interesting article.

Being happy, contented linked to reduced CHD risk

We have known for a long time about the link between depression and early heart disease, so this study is no surprise. I guess it is easier to study happy, contented people, than grumpy old men ;)

Click on this link for some audio to help get you in the right frame of mind!

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Healthcare Reform Update:

This week President Obama is hosting a Healthcare summit. At this summit, republicans and democrats will be putting forward their ideas on reform. Good idea, but terrible execution. If this summit is truly to be bipartisan, and is in response to the publics wishes for reform, then there should be no predetermined plan or template to start debate. The debate should be started with a totally clean slate. Then put everything on the table and hash things out to see if an agreement can be reached.

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Wellness Network Update:

Just a reminder. Everyone enrolled in a Wellness Program can receive one therapeutic massage at half price. That is $35 for a one hour massage, and $50 for an hour and a half.
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Before I give away the answers to the earlier beverage quiz, let us look at some of the ingredients, and I urge you to ask yourself, would you eat or drink any of these ingredients alone??

1) high fructose corn syrup- In my view, one of the worst types of sweeteners
2) caramel color- I wonder what this beverage looks like without it??
3) sugar- natural/, or heavily refined and processed??
4) phosphoric acid - yummy, that must taste good all by itself.
5) caffeine- natural, but this was an additive into the beverage, not present in its natural state.
6) citric acid - found in most citrus fruits.
7) aspartame- otherwise known as Nutrasweet
8) potassium benzoate- a preservative- what exactly are they preserving?
9) natural flavors- just what is "natural flavors" and why don't they list what they really are?

OK.....

I have made you wait long enough.

The answers are below:

A: Pepsi --- carbonated water, high fructose corn syrup, caramel color, sugar, phosphoric acid, caffeine, citric acid, natural flavor.
Not a significant source of other nutrients. What is it a significant source of????

B: Diet caffeine free pepsi ----carbonated water, caramel color, aspartame, phosphoric acid, potassium benzoate (preserves freshness), citric acid, natural flavor. 0 calories; states on label- Not a significant source of other nutrients. What is it a significant source of????

C: Diet caffeine free coke ----- carbonated water, caramel color, aspartame, phosphoric acid, potassium benzoate (to protect taste), natural flavors, citric acid. --- 0 calories; states on label- Not a significant source of calories from fat, saturated fat, trans fat, cholesterol, dietary fiber, sugars, Vit A,C, calcium and iron. What is it a significant source of????

D: Canada Dry Ginger Ale ----- carbonated water, high fructose corn syrup, citric acid, sodium benzoate( preservative), natural flavors, caramel color. 12 oz can = 140 calories- 36 grams of carbs

E: Vitamin Water-XXX ---

vapor distilled deionized, and/or reverse osmosis water, cane sugar, crystalline fructose, citric acid, vegetable juice (color), abscorbic acid (vitamin C), natural flavor, berry and fruit extracts (acai,blueberry, pomegranate and apple), magnesium lactate (electrolyte), calcium lactate (electrolyte), monopotassium phosphate (electrolyte), niacin (B3), pantothenic acid (b5), pyridoxine hydrochloride (b6), cyanocobalamin (b12) - contains less than 1% juice- in a 20 oz bottle- 2.5 servings gives you 125 calories, all as carbohydrate, 25% of RDA of Vit B3,5,6,12, 250% of Vit C, and 50mg of berry and fruit polyphenols.

I have also included some other labeling from the beverage containers. Look at Pepsi and Coke.

Just what type of nutrition do they add to our bodies? The diet products contain no calories, but plenty of acid and artificial sweeteners.

Yuck!!

Ginger Ale and Vitamin Water provide calories, but all, 100% from carbohydrates, which as we all know now is sugar!!

I remember an ad campaign for Coca Cola in 1980.

"Coca Cola. It's the real thing". Now look at the ingredients above for Coke or Pepsi, as they are virtually identical, and tell me one thing that is real about either of them!

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
www.drhorvitz.com

Sunday, February 14, 2010

The Verdict on Artificial Sweeteners

February 14, 2010

Institute For Medical Wellness Healthy Living Report

The Verdict on Artificial Sweeteners


Sugar became very popular with the song lyric, "A spoonful of sugar helps the medicine go down."

But spoonfuls of sugar also goes down to your abdomen, hips and thighs.

From previous newsletters, you may remember that all carbohydrates get converted to glucose, or sugar. Insulin then acts to store the excess sugar in our cells, by converting them into triglycerides and then fat.

I'll say it again.

It is excess carbohydrates and insulin that causes fatty weight gain.

So when I tell my patient's this, they respond with:

"O.K. That means no sugar. Can I use Sweet-N-Low, Splenda or Equal? You see Doc, I have a sweet tooth, and I need my sweets!!"

Boy do I hate being the bad guy!

But for now, I need to play the Good Doc, even if it means telling you that both sugar and artificial sweeteners are not good for your bottom line, your hip line, or your waist line!!

You see, our brains are interesting organs. It seems they only need to sense a sweet taste, to increase the release of insulin, even if the sweet taste is artificial.

So eating or drinking anything with a sweet flavor, regardless of whether the sweet is natural or artificial causes the insulin-->fat deposition-->weight gain, and usually an increase in the production of cholesterol, especially the more harmful small LDL cholesterol.

So the pattern is now:

Carbohydrates or sweet tastes --> increased insulin--> increased fat deposition --> increased weight gain--> increased bad cholesterol --> increased risk of heart and vascular disease.

Sounds promising? NOT !!!!

The next question or statement is usually: "Well fruit must be O.K. I mean, fruit is natural, and I have always been told that fruit is good for me."

My answer.

Yes and No!

First- Yes.

There are many vitamins and minerals in fruit.

Second- No!

Unfortunately, for those of us who do not tolerate excess carbohydrates, too much fruit gives us the apple body shape, with abundant weight gain around our middles. There are some tricks to prevent weight gain, but it entails keeping an accurate account of your food intake. That is why the food diaries in our Healthy Weight Program are so important. Individuals in this program use the diaries to find the weak parts of their diets, and learn how to change or alter these choices and poor food seeking behaviors.

But let me get back on the topic of the newsletter.

I am not a fan of any artificial sweetener!!!


No pink packet!! No Blue packet!! No yellow packet!!

Sugar?? No way!!

The verdict on artificial sweeteners is guilty. They are guilty of causing the same metabolic changes that sugar causes, including, obesity, high cholesterol, and increased risk of diseases caused by increases in insulin.

But we can change the outcome. By changing your diet, either on your own, or through our Healthy Weight Program, you can get your sugar and sweet cravings under control, lower your insulin levels, and start on your way to better health!!

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Link section- where you find more info and articles to guide you to better health.

In the past, I have also complained about so-called experts giving out advice, when the logic and facts do not back up their advice.

Here is a link to an article on diet, diabetes and the diet war.

And here is another link about all calories not being equal, and discusses the carbohydrate-protein-insulin response in weight management.

There is a website called Sweet Poison , great name, isn't it?, with more information on the potential dangers artificial sweeteners.

And saving the best for last, please go here for last years Valentine's Day newsletter.

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
www.drhorvitz.com
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I would like to thank everyone for their confidence in my professional abilities and referrals of new patient's to the practice as well as to the Wellness Plans. If you are presently in the Traditional Wellness Plan, and refer a new patient to this plan, you will receive 1 month added on to your plan for the first referral, and two months added on for every other new patient you refer. Just my way of saying Thank You for your confidence!!

It is always nice to get good feedback. Good feedback tells me that I am definitely moving in the right direction! So please check out our patient testimonials.

Friday, February 12, 2010

President Clinton and Heart Disease

February 12, 2010

President Clinton and Heart Disease

With Presidents Day just a few days away, former President Bill Clinton is not celebrating. Unfortunately, he is having heart issues again. About six years after having quadruple bypass surgery, he went back to the operating room. This time he avoided open heart surgery, but did have 2 cardiac stents placed to open a blocked artery. I wish him well and a speedy recovery. But I also hope he does not listen to the advice I heard from the media pundits and television docs. These TV docs have decided to blame the former president's high cholesterol levels as the cause of his recent heart trouble. Furthermore they advise that he go on cholesterol reducing medications to lower his risk of further problems.

But before we condemn cholesterol, perhaps we should first understand the role of cholesterol in our bodies. Cholesterol performs many important functions in the body including:

*forming and maintaining cell walls and structures
*helping cells adjust to changes in temperature, as well as being used by nerve cells for insulation.
*Cholesterol is also essential for synthesizing a number of critical hormones, including testosterone, progesterone and estrogen.
*Bile, a fluid produced by the liver from cholesterol, aids in the processing and digestion of fats.
*My favorite vitamin, Vitamin D, is made from cholesterol and sunlight.

It sometimes makes me want to bang my head against a wall that the majority of doctors still believe that the lowering of cholesterol, by pharmaceutical means, is helpful.

Why???

I'll tell you. While cholesterol is present in cardiac blockages, so are other inflammatory substances. A very important, but not well known fact is that heart disease is influenced by many factors other than cholesterol including:

*age
*gender
*smoking
*physical inactivity
*obesity
*low serum antioxidant levels
*elevated levels of inflammatory substances
*among many other more technical factors.

But we do not always hear much about these!! All we ever hear about is cholesterol is bad, cholesterol is bad!! Too many people in the healthcare field have been brainwashed by Big Pharma and their demonization of cholesterol.

Now let's get back to former President Clinton. After going through bypass surgery, don't you think his cardiologist already placed him on cholesterol lowering medications, as that was and still is the standard of care?

It worked real well for him, didn't it??

The standard of care needs some fixing!! Lowering cholesterol by pharmaceutical means may make lab reports look pretty, but it does not prevent heart disease. To get my point across, I'll use a high school SAT tactic.

Elevated cholesterol on a lab report is to seeing a blizzard on radar

as

the use of cholesterol medication to lower cholesterol is to turning off the radar.

The blizzard or snow storm is still approaching, but with the radar turned off, we just no longer see the warning sign. So when we use cholesterol lowering medications, we no longer see a risk factor as most medications are potent enough to "normalize" our levels,

So why do we even check cholesterol levels?

Cholesterol levels are important and should be used, but as a marker for heart disease, as opposed to a cause of heart disease.

If cholesterol levels are at an unhealthy level, we should try to lower them, but by dietary and lifestyle changes, not with medication. At the Institute For Medical Wellness, we have been successful in teaching and promoting these dietary changes, and have seen many lab results improve dramatically. I will be sharing some of these results with you in a future newsletter. If you wish to get started on lowering your risk of heart disease, without the use of medications, please consider our Healthy Weight program, which provides in depth analysis of your diet patterns, to help lower your future risk of disease.

Many of you reading this newsletter may believe I am skeptical about cholesterol causing heart disease. You are probably correct. But I am not alone. Please consider the following link, The International Network of Cholesterol Skeptics, composed of a society of cholesterol skeptics who have been around a lot longer than I.
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Wellness Network Update:

Just a reminder. Everyone enrolled in a Wellness Program can receive one therapeutic massage at half price. That is $35 for a one hour massage, and $50 for an hour and a half.
--------------------------------------------------------------------------------

Institute For Medical Wellness New Offers:

Our supplement of the month for February 2010 is Revitalize. Revitalize is our once daily multivitamin that contains an abundance of vitamins and minerals, along with small amounts of antioxidant, and liver detoxifying herbs. Revitalize comes in a bottle of 90 capsules, with most people taking 1-3 a day. I find that one a day is sufficient for most, and also allows the bottle to last for 3 months. Through the end of this month, Revitalize will be available for $5 off its regular price. For more information on Revitalize and the other supplements we offer, please visit 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
www.drhorvitz.com

Saturday, February 06, 2010

Diabetes Guidelines- Are they behind the times?

February 6, 2010

Institute For Medical Wellness Healthy Living Report

Interesting Article of the Week:

Diabetes Guidelines- Are they behind the times?

Here is a link to a recent article on new diabetes guidleines from the American Diabetes Association (ADA). In skimming through this article, it reinforced to me how slow big corporations are to change paths, even when behind the times. It also makes me very happy that I work for you, and not any large group practice or corporation.

I'll write about one of the guidelines the ADA has revised. It concerns the use of the Hemoglobin A1C (HbA1C) test for the diagnosis of Diabetes. HbA1c is a test that measures the amount of glycated hemoglobin in your blood. Glycated hemoglobin is a substance in red blood cells that is formed when blood sugar (glucose) attaches to hemoglobin. The higher your blood sugar over time, the higher your HbA1C. So diabetics who average higher sugar levels will have a higher HbA1C level than a non-diabetic. Now it does not take an ocean and aerospace engineer, otherwise known as a rocket scientist, to realize that HbA1C levels in pre-diabetics are higher than non-diabetics, and that diabetics HbA1c levels are higher than pre-diabetics. So I have been using HbA1c levels to monitor individuals who are trending towards diabetes for over a decade, against the recommendations of the ADA.

Why go against the ADA? Because it made logical sense!! Catching prediabetes at an earlier stage allows for proper time to help reverse the trend away from overt diabetes. But if you look at the ADA guidelines, they just decided that what I have been doing for the past decade works. Why did it take them so long?

Here is a quote from their revised guidelines concerning the treatment of diabetes.

"The most successful practices have an institutional priority for quality of care, involve all of the staff in their initiatives, redesign their delivery system, activate and educate their patients, and use electronic health record tools," the guidelines authors conclude. "It is clear that optimal diabetes management requires an organized, systematic approach and involvement of a coordinated team of dedicated health care professionals working in an environment where quality care is a priority."

Pardon me, but what a crock of patronizing B.S. IMHO, they are trying to make Diabetes sound like rocket science. Is this to make their business entity more relevant? Diabetes is not rocket science. Diabetes treatment in the early stages is fairly straight-forward, especially if you are willing to make the necessary diet and lifestyle changes. I have advised and treated many diabetics. My patient's who followed my advice would end up lowering their medication, if they were on any, all while delaying progression of their disease. I do all of the diet counseling. My medical assistant helps with the in office testing. We do not need an institution, multiple staff, or a complicated delivery system. I use electronic health records, but they do not make diabetic treatment any easier. The ADA's statements about diabetes treatment seem to serve the purpose of their organization, corporation, and all the bureaucracies they encompass, but tend to be behind the times in terms of treatment recommendations.

One of the simplest treatments for Diabetics is proper diet. But please do not follow the ADA's diet recommendations. They are behind the times on diet as much or more than they were behind the times on the use of HbA1C testing. If you are a Diabetic, or prediabetic, our Healthy Weight program is ideal to help you get your disease under control. For more information, please call our office and schedule an appointment to discuss this further. If I can help one person avoid the long term complications of Diabetes, than I am doing my job!

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Big Pharma segment

One of the many reasons that I founded the Institute For Medical Wellness was to be able to maintain a focus on the individual. I wanted to be free of healthcare distractions that offer nothing to help with patient care. The major distractions include health insurers, government regulators and bureaucrats.

Now I will let you inside my head a little more. OK, my mother may say that is dangerous, but we will not get into that now. But time to get my ADD brain back on topic.

When I consider treatment options, I do not first think about insurance medication formularies, whether a test needs insurance approval or if a consulting doctor is in the insurance network. These intruders just get in the way of good patient care, and I want none of them!

But one of my bigger pet peeves lately has not been with insurers or government, but with the training and sales techniques that Big Pharma uses for their pharmaceutical representatives. This is not a shot at the reps themselves. I get along very well with most of them that call on my office. I know they are only doing what they are told and trained to do.

This is a shot at Big Pharma management, and how they let the government and health insurers corrupt how they interact with physicians, thereby sending many reps to our offices with little actual pharmaceutical training.

In the good old days, before health insurers took control of prescriptions, pharma reps would discuss the inner workings of their medications, as well as the costs to patients. Many of the reps were pharmacists prior to taking a sales position and came with an excellent pharmaceutical and medical background. I used to learn alot from our interactions.

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Fast forward to today's physician-pharma reps dialogue:

Rep: Good afternoon Doctor Horvitz. I am here to discuss Drug Costoomuch.

Doctor Horvitz: OK, I have read about Drug Costoomuch and I am familiar with it. I hear it can't be used with drug Muchosideffex.

Rep: Yes, doctor you may be correct, but let me send in an inquiry to my research department about your question.

Doctor Horvitz: No thank you. That information is already available to me. Do you have anything new to tell me about how Costoomuch works, or any new indications for its use?

Rep: No I have nothing new in that department, and government regulations forbid me from answering many of your questions. I can't even give you a cool little pen with Costoomuch on it anymore due to regulations. But may I please show you a list of insurance formularies that Costoomuch is available on?

Doctor Horvitz: NO. I really do not care about insurance formularies. I pick a medication based on how well it will work for my patient. And I always like to know the cost of the medication so the patient can help to make an educated decision on his preference of treatment.

Rep: But the formularies tell you what it will cost a patient for drug Costoomuch.

Doctor Horvitz: No, the formularies tell me what Pharmaceutical companies made backdoor private deals to get their product on a formulary. Now I know where the Senate learned how to negotiate health care reform. But in my opinion, formularies are not based on efficacy or safety, but on cost and profit.

Rep: Thank you for sharing Doctor Horvitz. All I can tell you is that drug Costoomuch is on most of the insurance formularies in South Jersey.

Doctor Horvitz: How much does Costoomuch cost to a patient without health insurance? In other words, what is the cash price at the pharmacy?

Rep: Cash price? Do people actually pay cash price today? Oh, I am not sure. Not many doctors ever ask me that question. I'll have to ask my manager and get back to you. BTW, would you like me to schedule a lunch for your office to discuss this further?

Doctor Horvitz: No thank you. You really do not know how much Costoomuch actually costs?

Rep: No. I am supposed to inform you of formularies, not cash prices, as most patients do not pay full price for their medications.

Doctor Horvitz: Yes, I understand that. And that is one of the big reasons that Costoomuch costs so much, as nobody really knows the actual price, even the reps who sell them. May I sign for some samples now? Thank you for your time. Have a nice day!

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I could go further, but I think you get my drift. When true costs are hidden, as Big Pharma and Big Government like to do, it usually means that prices will be high. When true costs are out in the open, the price will usually be lower. Look at the prices of generic medication today. Many can be purchased for $4 a month or $10 for 3 months, without a prescription plan, and without the many layers of bureaucracy involved with insurance and government formularies.

*Every layer of bureaucracy and management increases the cost of a product or service.
*Every layer of bureaucracy and management increases the time it takes to get a product or idea to market or utilization.
*Every layer of bureaucracy and management adds greatly to the hassle factor of ever using the product or service well.

Pearls of the Day:

Get the third parties out of our everyday healthcare interactions, other than the big ticket items, and you will see healthcare costs decrease dramatically!!!

And maybe, just maybe, I'll get another free pen with the drug name "Costoomuch" on it ;)

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
www.drhorvitz.com

Thursday, February 04, 2010

Heart and Vascular Disease: Is cholesterol the culprit?

February 4, 2010

Institute For Medical Wellness Healthy Living Report

Heart and Vascular Disease: Is cholesterol the culprit?

For those of you who have had an Institute For Medical Wellness full history and physical, along with complete lab testing, you have had the honor of hearing my speech on cholesterol and heart disease. For those of you who have not, what are you waiting for??

Just kidding.....

Regardless of what you hear from the media, government, insurance companies, or other less than stellar pundits, cholesterol does NOT cause heart disease.

Let me repeat myself.

Cholesterol does NOT cause heart disease.

As with most government-industry partnerships in our country, the advice they have given us about cholesterol is just plain wrong. Now, don't take home the wrong message. It is still important to measure your cholesterol levels. In fact, I prefer to use a more sensitive type of cholesterol test, to better stratify your risk of disease. But the key is not to lower your cholesterol, but whether you need to, and if so, how you lower your cholesterol in the safest and most effective manner.

More on the above is part of our yearly wellness plan physical, which is structured for real life results, instead of the propaganda, fear tactics and rhetoric you hear from the government-insurance partnerships. There are many so called experts out there. Make sure you choose your experts wisely, as not everyone fits into the same mold.

For information on what some of the more likely risks of vascular and heart disease, please visit here, for a very informative article.
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Healthcare Reform Update:

Speaking of heart and vascular disease...................

There are many healthcare reform advocates who complain and complain again about our healthcare system. We spend too much! There are too many uninsured. Healthcare should be government run or non-profit! We should use Canada as a model for our healthcare system, after all, healthcare is free up there, and no one is turned away!!

To all the people who claim Canada has better healthcare than the United States, I highly recommend you read the following article, about a Canadian Premier, would be a state governor?? in the USA, who will be undergoing heart surgery later this week. Now I do not live in Canada, and for all I know, their doctors and hospitals may be wonderful. A Canadian Premier should be able to attest to the fact that his country's healthcare system can provide all the necessary care for its citizens.

So what I am getting at??

The Canadian Premier is having his heart surgery in the United States !!!

What does that tell you?

I'll speak for myself instead. When a high ranking elected official of a nation with a government run healthcare system, crosses the border into our country to obtain healthcare, I would say that our doctors and hospitals, stuck in a flawed system, is still the best place to receive the most advanced care in the world!!!
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Interesting Article:

Autism article retraction..

I need to reread this article again. I would advise anyone who has lingering questions on the safety of vaccines to also read this article. On my first read through, I became angry. If a doctor fudged data to help a legal case against a vaccine manufacturer, the doctor should have his license revoked, at a minimum. The study results suggesting an autism link to a vaccine set up an enormous fear of vaccines in general, that may have been unfounded. Parents are always looking to protect their children. Prior to the perceived autism link, vaccines were considered a parent's duty to protect their children. That all changed when the fear of autism arose. Talk about unintended consequences!!

I have seen many vaccines come and go. Most vaccines that have been around for ten years or more are safe for use. Postmarketing surveillance of vaccines has taken many vaccines off the market. But the vaccine fight will not end with the apparent autism retraction. There are still other factors we need to think about before getting a vaccine. Even if an autism link is proven false, other factors such as chemicals and preservatives in vaccines, spacing of vaccines in infants, and proper regulation of the vaccine production will always be an issue. That is why, regardless of the above autism retraction, I only recommend vaccines once they have been available long enough to prove their safety and efficacy.
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Healthy Weight Program Update:

One of the unique aspects of our Healthy Weight Program is our use of a private shared internet document. This document allows for increased communication between our office and you. The document is used for food diaries, diet and nutrition articles, as well as links to other research and helpful dietary information. My hope is that each Healthy Weight Program enrollee, with the use of this document, will learn enough about proper nutrition, that this will be the last weight program they need to enroll in.
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Wellness Network Update:

Just a reminder. Everyone enrolled in a Wellness Program can receive one therapeutic massage at half price. That is $35 for a one hour massage, and $50 for an hour and a half.
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Institute For Medical Wellness New Offers:

Our supplement of the month for February 2010 is Revitalize. Revitalize is our once daily multivitamin that contains an abundance of vitamins and minerals, along with small amounts of antioxidant, and liver detoxifying herbs. Revitalize comes in a bottle of 90 capsules, with most people taking 1-3 a day. I find that one a day is sufficient for most, and also allows the bottle to last for 3 months. Through the end of this month, Revitalize will be available for $5 off its regular price. For more information on Revitalize and the other supplements we offer, please visit 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
www.drhorvitz.com