An ounce of prevention is worth a pound of cure!

Institute For Medical Wellness Healthy Living Report

At The Institute For Medical Wellness, we know how to "put out the fires" when it comes to your health. But as Smokey the Bear always said,

"Only you can prevent forest fires"

Hey Doc, "What have you been smoking? What does smokey the bear have to do with my health?"

Let me explain.

When I was in my residency, and cruising the hospital floors, I was often called to "put out the fires". In layman's terms, that meant treating diabetics with high sugars, the elderly with complications of pneumonia, and post-surgical patients with complications or increased pain. My training taught me well and laid the foundation for my further professional skills.

But it is now 19 years since I graduated from medical school, and 16 years since I completed my family practice residency, and I have seen the healthcare system become more and more bogged down, by focusing almost solely on putting out the fires. What I did not see was preventive healthcare. What I did not see was a Smokey the Bear in healthcare helping people to prevent illness.

How bout another quote. This one from Benjamin Franklin.

"An ounce of prevention is worth a pound of cure"

In 2008, with the founding of The Institute for Medical Wellness, I decided to bend the curve towards more prevention of disease as I believe that prevention should be the hallmark and the future of family practice. The affordable Wellness Plans we offer are geared towards helping you work on lifestyle changes to prevent further and future illness. Wellness Plans are especially helpful in patient's with Diabetes, Hypertension, Obesity, High Cholesterol, or any other healthcare condition that requires more attention.

How about cancer prevention?

The Institute for Medical Wellness has teamed with Myriad Labs to offer genetic testing for patient's with a history of Breast, Ovarian, Endometrial or Colon Cancer.

In fact, Myriad Labs has offered to perform these tests on five (5) patient's at no cost.

Before you get too excited, there are limits and exclusions to this offer.

1) First, you must be an established patient of our practice,

2) Second, you also have to fit certain criteria listed below:

Patients with any of the following personal or family history features may be candidates for hereditary cancer testing:

Hereditary Breast and Ovarian Cancer Syndrome (HBOC)
•Breast Cancer before age 50
•Ovarian Cancer at any age
•Both breast and ovarian cancer
•2 or more breast cancers, one under age 50
•Male breast cancer
•Bilateral breast cancer
•Women of Ashkenazi Jewish descent with breast or ovarian cancer at any age
•A previously identified BRCA mutation
Lynch Syndrome/Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
•Endometrial cancer before age 50
•Colorectal cancer before age 50
•2 or more Lynch syndrome cancers, including ovarian, stomach, kidney/urinary tract, brain, or small bowel cancer, in an individual or family
•A previously identified mutation
If you feel you meet the criteria above, please call our office at 856-231-0590 to schedule an evaluation. If you are one of the first five to meet the criteria, we will set you up for testing.
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Interesting Article:

I came across this article the other day. The title was "California First State to Shorten Wait Times for Doctor Appointments". It made me laugh pretty hard. It appears that the State of California believes that by mandating insurance companies to shorten the waiting time for patient's to be able to see their doctor's, that it would magically happen.

Examples of the new standards include:
•48 hours for urgent care appointments that do not require prior authorization.
•96 hours for urgent care appointments requiring prior authorization (including specialists).
•10 business days for non-urgent primary care appointments.
•15 business days for non-urgent appointments with specialists.
•10 business days for non-urgent appointments with a mental healthcare provider.
Why do I find it so funny? I do not participate with any of the insurers or their regulations. Yet if you call my office in the morning of a workday, you will be offered a same-day appointment 99% of the time. That is what happens when a physicians office decides to cater to patient's, not insurers or government regulators!

Healthcare Reform Update:

Please click here to read a letter to the editor I wrote that was published in the Burlington County Times on January 22, 2010.

Quote of the day from Massachusetts newest Senator Scott Brown about Washington D.C.

"This is the best place in the world when it comes to solving problems"

While I may not totally agree that Washington D.C. is the best place when it comes to solving problems, I do believe that The Institute For Medical Wellness will continue to grow into being the best place in the Moorestown and the South Jersey area to help you solve your healthcare problems, but always with a strong focus on wellness and prevention.

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.

Prostate Cancer Screening. Is it Worthwhile?

March 28, 2009

Dr. Steven Horvitz- Reading between the Lines:
Bringing you healthcare information you can trust!

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There has been a recent hubbub about prostate cancer screening. For many years, men over the age of 40 have been advised to have an annual PSA (prostate specific antigen) blood test along with a digital rectal exam.

In theory, PSA screening would detect prostate cancer at an early and more treatable stage. If the PSA level was above normal, or increasing quicker than expected, further evaluation for prostate cancer was begun. Ask any man who has undergone further evaluation. It is neither fun, nor pleasant.

Yet screening for prostate cancer via the PSA test seems worthwhile, if the alternative is a higher risk of prostate cancer. But two recent studies raise questions concerning the PSA tests effectiveness.

The first involved over 76,000 men. These men were divided into two groups. The first group had annual PSA and digital rectal exams for six years, while the second group had usual care. Although more prostate cancer was diagnosed in the first group, they did not have more prostate cancer related deaths after both seven and ten years.

The second study, involved 182,000 men followed over nine years. The first group had PSA screening every four years, while the second group did not. There were 20% more prostate cancers diagnosed, and slightly fewer prostate cancer deaths in the first group. But as we look closer at the studies statistics, for every 1,410 men screened with the PSA test, only 48 would be treated, or just over 3%. Of the 48 men treated only one cancer death would be prevented, or just over 2%. Of the 1,410 men screened, prostate cancer death would be decreased by less than 1/10 of one percent. There was no difference in overall death rates between the two groups.

So let us analyze this conundrum by going from point A to point B.

Point A is PSA testing. We want to get to Point B, which is prevention of prostate cancer deaths, while causing little or no harm. Yet, neither of these studies showed a significant decrease in prostate cancer or other causes of death.

A (PSA testing) -----XXX------>>>> B ( Decreased Prostate Cancer Deaths)

Most men identified as having abnormal tests will probably never develop a prostate cancer that will kill them. Some will say that the risk is worth it, and that is a valid opinion. But tell that to the men who had an abnormal PSA test, underwent further testing, biopsy and/or treatment, ended up impotent or incontinent, and were found not to have prostate cancer. Sometimes the investigation and treatment of a disease is worse than the disease itself.

Now, by sending out this newsletter, I am not advocating for the end of the use of PSA testing. PSA testing is especially useful in men with a family history of prostate cancer. It may also be useful for men between the ages of 40-60, as prostate cancer at a younger age tends to be more aggressive. But we need to further understand who and how often we need to screen. Should we screen yearly, every 2-3 years or every 5 years? Should we screen men over 70 or 80 years of age, when their risk of dying from other causes is higher than their risk from prostate cancer? The decision to screen should be left to each individual. Diagnosis of any disease at an early stage is a worthwhile goal and is something I strive for in my medical practice. But it must be accomplished without causing harm. The two studies mentioned above indicate that a harmful outcome is just as likely as a good outcome in PSA screening for prostate cancer. So what do we do to improve our odds of not having a bad outcome from prostate cancer without causing harmful side effects? How about teaching lifestyle modifications that can decrease your overall risk. Let me point to another recent study. In this study, intake of 500mg of omega-3 fatty acids daily, like those found in dark fish like salmon, reduced the death rate from advanced prostate cancer by up to 63%. Eating salmon sounds a bit more pleasant than a prostate biopsy ; ) I, for one, will eat more salmon and continue with my omega-3 fatty acid supplementation.

On another note, our politicians are debating about an overhaul of our healthcare system. My fear is that they will try to change the system to a cookbook style that is more concerned with costs than on good health outcomes. If that turns out to be the case, a less expensive alternative for prostate cancer screenings may soon look like the picture below.

I can hear it now.

Attention Wal*Mart shoppers.

Please head over to aisle four for your free prostate check ; )

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Please note that next week, Julie Fischer will begin performing massage therapy in my office on Tuesdays and Thursdays. She performs Thai, swedish and deep tissue massage, as well as hot stone massage. For the month of April, Julie's massage services will be offered at a 10% discount. Wellness Plan members get even better pricing. Please click on the above link for more information.

If you have any suggestions about topics for future newsletters, or how to make the newsletter better, please send me an email at DrHorvitz@DrHorvitz.com.

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

For more information about Dr. Horvitz and The Institute for Medical Wellness, please visit our website at http://www.drhorvitz.com/

To view upcoming Wellness Network Events, please click here.