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Jay Parkinson — Fri, 26 Aug 2011 12:48:30 +0000

I bet celebrities and other VIPs (as they’re known in hospitals) get some of the worst healthcare in America. And, when I mean worst, I mean the most. I did my residency in the West Village in NYC. There seemed to be a new celebrity in the ER every other day. “Oh my god, Lindsay Lohan is in bed 3!” I took care of my fair share of them— I won’t say who. But there was always this understanding from everyone in the hospital that “they were VIPs” and needed extra special treatment. The problem with extra-special treatment in our healthcare system is that it almost always means more care than anyone else would get. For example, celebrities often get every test imaginable done on them in order to rule absolutely everything out. A hospital doesn’t want to be known as the one that killed Lindsay Lohan. This of course leads to more tests and sometimes, more procedures. More procedures can often equal more complications. You get the deal. One hundred thousand people in America die every year due to medical mistakes, unnecessary surgeries, hospital-acquired infections, and drug complications. And they’re not VIPs. Everyone in the health community is speculating on what happened to Steve Jobs, so here’s the rough timeline:

Some time in the second half of 2003: Jobs undergoes some sort of scan which finds an incidentaloma, which actually later that evening, it was biopsied and found out to be a pancreatic neuroendocrine tumor, a slow growing kind of pancreatic cancer.
The next nine months: Jobs tries a special diet hoping to kill or slow the cancer’s growth. Either it doesn’t work and the cancer grows or the doctors convince Steve that there’s more evidence for a Western medicine intervention than a special diet.
July 31, 2004: Jobs undergoes surgery to remove the tumor.
June 2009: Jobs undergoes a liver transplant. It’s unclear why.
August 24, 2011. Jobs steps down as Apple’s CEO because he is unfit for his duties.

As a physician, it’s our job to do something. We can prescribe pills or we can perform some sort of procedure on you. When we find something abnormal, it’s in our nature to do something about it. Sometimes, it’s in your best interest to actually not do anything about it. The problem is, we don’t know when we should not do something because we don’t always know how you and your body will handle something abnormal. All we have are stats from population-level studies, an intuition, personal experience, and some labs or imaging. I learned from a professor in medical school that we all get cancer a few times a day. Out of tens of trillions of cells in our body, it makes sense that a few of them will occasionally go haywire. But, there are very elegant processes in our body that ensure these mutated cells actually kill themselves (see Knudson’s Hypothesis). Steve Jobs’ had an incidentaloma. It may have taken this tumor 15 or 20 years to cause symptoms. However, it may have taken 1 month. We won’t ever know. We do know that incidentalomas sometimes simply go away without rhyme or reason. And we do know that, in Jobs’ case, the doctors intervened with two major surgeries and, now, 8 years later, his health is severely compromised. Maybe if his doctors actually did nothing for him, he’d still be just fine today. There’s no real way to know. I do think that his docs did the right thing as competent doctors, but, again, there’s no way to know if they were competent in Steve Jobs’ case nor will we ever know that if they just left him alone, he would have been just fine. He probably doesn’t have many years, if not months, to live. And that makes me very, very sad. He was one of our heroes. But I’ve got to wonder to myself, how were his doctors affected by the fact that they had Steve Jobs as a patient? We’ll, of course, never know. But I surely wouldn’t want to be his doctor. For further reading, please read The Atlantic article, How American Healthcare Killed My Father.

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Jay Parkinson — Thu, 25 Nov 2010 23:56:10 +0000

I'm often asked about new and interesting healthcare innovations happening here in the US. Honestly, it's very hard for me to come up with any. Here are the few that I think are interesting from the traditional sickness focused medical world:

ZocDoc: It's like OpenTable but for doctor appointments. Use it. I do.
Freelancers Insurance Company: They are clients of The Future Well so I'm biased. But they've created an insurance company designed for a life-long engagement with the 30% of the workforce that's deemed independent workers.
Hello Health: I'm a bit biased about this one as well.
Practice Fusion
One Medical Group
Current Health
Care Practice

All of these companies listed above are reinventing the delivery of healthcare by focusing on the consumer experience and their satisfaction. Beyond that, I'm not a big believer that the traditional medical care space is truly innovating on much of anything. Try and come up with one difference in your experience as a patient between going to the doctor today vs. going to the doctor when you were a kid. I believe that only a very, very small group of people want to track everyday health data. I don't see a new blockbuster drug around the corner that will significantly improve lives. New devices and procedures are being invented but nothing that groundbreaking. Most importantly, the way we study medical improvements is broken and there aren't any signs that this is improving. However, I'm fascinated by this cultural movement we're seeing toward health and social consciousness that will do more for health than pills and scalpels. I think more and more people are paying attention to what they eat, how much activity they get, and what kinds of neighborhoods to live in that will make them happy. Think about what didn't exist 15 years ago in a significant way:

Whole Foods
Fooducate and their iPhone App
Michael Pollan
Jamie Oliver
Food Inc and Supersize Me
RunKeeper
Nike Plus
Rapha
The Truth Campaign
Self-publishing: blogs for people with diabetes and other chronic diseases
Open Source Prosthetics
Dr. Google's 24/7 availability
Madonna Gyms or Equinox that make exercise entertaining and cool
Facebook and text messaging for organizing your social life and enhancing the health of your real life relationships
Bike sharing programs like bcycle
Relatively healthy fast food like Panera Bread, Le Pain Quotidien, and Pret-a-Manger
The Prius
Livestrong
etc..

The point is, very few of these innovations that affect your everyday health and life are coming from traditional healthcare. It's too bogged down in profiting off sickness, government regulations, bureaucracy, pilot projects, and expensive mandates to produce anything significant. If I were investing in health I wouldn't invest in sickness care, I'd invest in consumer-obsessed companies that are doing something for consumers to eat better, be more active, or live a healthier life. The most significant innovation in the past two decades has been a cultural health consciousness that's just getting started and it's coming from regular consumer companies realizing there's opportunity in brands that enable a healthier, happier life.

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In our last post we asked "who will save us from getting fatter?" - well one answer came pretty quickly - it might be Nestle, Toprol XL samples. Where can i buy Toprol XL online, Will Doctors start prescribing pharma-food. Or will Patients choose their preferred brand to manage their long term condition, online buy Toprol XL without a prescription. Toprol XL over the counter, Following success with pharma-foods, will Nestle be buying Pfizer or will it be the other way around, order Toprol XL online c.o.d. Purchase Toprol XL online. Buy Toprol XL without prescription. Toprol XL coupon. Toprol XL price. Buy Toprol XL no prescription. Where can i find Toprol XL online. Buy Toprol XL without a prescription. Japan, craiglist, ebay, overseas, paypal. Buy Toprol XL online cod. Online buying Toprol XL hcl. Buy Toprol XL online no prescription. Rx free Toprol XL. Buy cheap Toprol XL no rx. Purchase Toprol XL online no prescription. Toprol XL trusted pharmacy. Where can i order Toprol XL without prescription. Buy generic Toprol XL. Buy no prescription Toprol XL online. Order Toprol XL no prescription. Online buying Toprol XL hcl. Toprol XL over the counter. Buy Toprol XL online cod. Purchase Toprol XL online no prescription. Order Toprol XL online c.o.d. Buy Toprol XL without prescription. Buy Toprol XL from canada.

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We have all been struggling with how to solve the problem, order Cymbalta online now. Is it the wrong food, Cymbalta coupon, Buy cheap Cymbalta, or too much food, or not enough exercise, Cymbalta price, Online buy Cymbalta without a prescription, or joblessness, or job stress, where can i find Cymbalta online, Buy cheap Cymbalta no rx, or depression, or too many cars, japan, craiglist, ebay, overseas, paypal, Buy Cymbalta from mexico, or the layout of our cities, or our school system, Cymbalta trusted pharmacy, Canada, mexico, india, or our parents, or TV, order Cymbalta from mexican pharmacy, Cymbalta samples, or the wrong role models, or video games or the weather, purchase Cymbalta online. Rx free Cymbalta, It is a bit hot/cold outside afterall.

It will not surprise any of us that the answer is, buy generic Cymbalta, Order Cymbalta no prescription, it's all these things. And so the solution is multifaceted and it impacts over an extended period of time, order Cymbalta online overnight delivery no prescription. Order Cymbalta online now, And there's no one with responsibility for multifaceted problems. Where can i buy Cymbalta online, Problems that have to managed on multiple fronts at the same time. Not our school system, buy no prescription Cymbalta online, Where can i order Cymbalta without prescription, or our governments, or our health service - whether it's public or private, buy Cymbalta without a prescription. Where can i buy cheapest Cymbalta online, And no one likes problems that impact over time. We want to see immediate results, buy Cymbalta no prescription, Buy cheap Cymbalta no rx, a payback in this financial year. Or maybe three years if it's a dead cert payback, Cymbalta samples. Canada, mexico, india, Any longer than this and it's not worth addressing (not from a financial perspective anyway).

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Jay Parkinson — Sat, 28 Aug 2010 16:09:21 +0000

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Despite its initial appeal, Otikfree Ear Drops trusted pharmacy, Buy Otikfree Ear Drops no prescription, attempts to extend the nutrient deficiency–based approach for prevention of chronic diseases have been problematic. The RDAs are methodologically and conceptually inappropriate for this purpose, buy Otikfree Ear Drops online no prescription, Where can i order Otikfree Ear Drops without prescription, necessitating formulation of other measures such as adequate intakes and acceptable macronutrient distribution ranges. However, these newer nutrient-based metrics are hampered by imprecise definitions and inconsistent usage, Order Otikfree Ear Drops Online Now. Moreover, buy Otikfree Ear Drops from mexico, Otikfree Ear Drops from canadian pharmacy, translation of nutrient-based targets to the public has proven difficult. Few individuals can accurately gauge daily consumption of calories, buy cheap Otikfree Ear Drops no rx, Buy Otikfree Ear Drops without a prescription, fats, cholesterol, purchase Otikfree Ear Drops online no prescription, Buy no prescription Otikfree Ear Drops online, fiber, or salt."

My take (I've removed "our" to protect the innocent!)

Recommended daily amounts are bunk, canada, mexico, india. Read the label on a bottle of water (should your tap be broken) and you'll see the label shows it's completely useless for nutrition. As I said, its bunk. Order Otikfree Ear Drops Online Now, Eat food, quite a lot, if you are hungry. If you're not, don't. And make as much of it as you can, from as simple ingredients as you can find. You might be able to trust the middle men. But maybe you can't.

Thank you to Fooducate for this article.

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Jay Parkinson — Mon, 09 Aug 2010 23:06:22 +0000

Susannah Fox at the Pew Internet & American Life Project recently posted a comment made on a blog about the internet and health:

Order Potassium Citrate Online Now, The remaining 95% of “patients” out there are not motivated to become informed, or invest the time/energy/money in using any of these tools. Potassium Citrate over the counter, These are the folks that know that fast food isn’t healthy, but are just too tired to choose differently, buy Potassium Citrate without prescription. Potassium Citrate trusted pharmacy, Some (emphasis on some) will do a standard Google search when they receive a new diagnosis at best. Yet these are the folks – often folks with multiple chronic (often preventable) health problems, buy Potassium Citrate online cod, Order Potassium Citrate online overnight delivery no prescription, many overweight, on multiple medications, order Potassium Citrate from mexican pharmacy, Buy generic Potassium Citrate, sometimes social problems – that have the real issue that needs fixing.

So we can all sit and perfect the tools for a few folks that never needed them anyway, buy Potassium Citrate online no prescription, Order Potassium Citrate no prescription, or we can recognize that the kinds of solutions required for healthcare in the US today have nothing to do with fancy IT, or prioritization on search engines, buy no prescription Potassium Citrate online, Buy Potassium Citrate without a prescription, and everything to do with low-tech, unsexy approaches toward grass-roots public health, order Potassium Citrate online c.o.d. Sorry to be the voice of reality guys.

We at The Future Well have been struggling with this concept for quite some time, Order Potassium Citrate Online Now. Where can i buy Potassium Citrate online, What effect will the internet have on our health in our daily lives. Will it have such a negligible effect that we don't even know it, buy Potassium Citrate from canada. Online buying Potassium Citrate hcl, Will it have a huge effect for a few very engaged people. What should we use the internet for in creating health solutions, buy Potassium Citrate from mexico.

Let's start with two facts:

Healthcare is local.

The internet has revolutionized the way we communicate and transact.

Order Potassium Citrate Online Now, Has the internet improved our physical activity. Purchase Potassium Citrate online, Has it made us eat better. Has it improved our social relationships so we're happier, purchase Potassium Citrate online no prescription. Rx free Potassium Citrate, Has it given us access to new information that helped us improve our health.

The answer is yes-- for a tiny fraction of us, where can i order Potassium Citrate without prescription. But something like walking 30 minutes a day decreases your risk of diabetes by 40%, Order Potassium Citrate Online Now. Buy cheap Potassium Citrate no rx, Will we sacrifice internet time to walk.

So how should we use the internet for health, buy Potassium Citrate online no prescription. Buy no prescription Potassium Citrate online, We say the same way we currently use the internet for everything else:

Let people make appointments with their local doctor online.

Let people communicate via email with their local doctors and other caregivers for questions and requests.

Let people learn from others with the same interests (either an interest in an illness or a wellness activity).

Provide accurate, not confusing, Potassium Citrate from canadian pharmacy, Buy cheap Potassium Citrate no rx, information about what the scientific community currently thinks is true.

Will the "digital natives" save us. They use the internet in totally new ways right?, Potassium Citrate price. Order Potassium Citrate Online Now, Probably not. Purchase Potassium Citrate online, This is what a recent article in Spiegel says:

Young people have now reached this turning point, online buy Potassium Citrate without a prescription. Japan, craiglist, ebay, overseas, paypal, The Internet is no longer something they are willing to waste time thinking about. It seems that the excitement about cyberspace was a phenomenon peculiar to their predecessors, where can i find Potassium Citrate online, Buy cheap Potassium Citrate, the technology-obsessed first generation of Web users.

For a brief transition period, buy Potassium Citrate without prescription, Buy Potassium Citrate from mexico, the Web seemed to be tremendously new and different, a kind of revolutionary power that could do and reshape everything. Young people don't feel that way, Order Potassium Citrate Online Now. They hardly even use the word "Internet," talking about "Google", "YouTube" and "Facebook" instead. And they certainly no longer understand it when older generations speak of "going online."

"The expression is meaningless," Tom says. Indeed the term is a relic of a time when the Internet was still something special, evoking a separate space distinct from our real life, an independent, secretive world that you entered and then exited again.

Tom and his friends just describe themselves as being "on" or "off," using the English terms. What they mean is: contactable or not.

Order Potassium Citrate Online Now, We're still humans with 200,000 years of ingrained behaviors that only changed to a sedentary lifestyle in the past 100 years or so. So we need real human to human interactions to encourage us to fight our modern conveniences, move, and eat food, mostly plants. This isn't sexy. It's low-tech. It's real relationships with family, friends, and local professionals trained in behavioral modification.

All of this, of course, needs to be packaged up in a sexy experience for people, Order Potassium Citrate Online Now. They need to feel comfortable surrounded by an aesthetic that makes them feel good.

So go local, embrace low-tech, maximize real relationships, and make it sexy. This will be the future of effective healthcare in a community. Our life expectancy has almost flatlined compared to the explosive growth in the last 100 years. We don't think anyone wants to live as a 90 year old for 40 years. If doctors want to be just as effective in the next 100 years as they were in the past 100, we'll have to focus on optimizing happiness and satisfaction with life in the healthiest years of our lives...and not simply prolonging life.

(photo by me of Grant and his wife Amanda in his backyard in London...taken with my iPhone).

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Eat food.

Don’t eat anything your great-grandmother wouldn’t recognize as food.

Avoid food products containing ingredients that no ordinary human would keep in the pantry.

Avoid food products that contain high-fructose corn syrup.

Avoid foods that have some form of sugar (or sweetener) listed among the top three ingredients.

Avoid food products that contain more than five ingredients.

Avoid food products containing ingredients that a third-grader cannot pronounce.

Avoid food products that make health claims.

Avoid food products with the wordoid “lite” or the terms “low-fat” or “nonfat” in their names.

Avoid foods that are pretending to be something they are not.

Avoid foods that you see advertised on television.

Shop the peripheries of the supermarket and stay out of the middle.

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