Sunday, February 28, 2010

FDA Considers Regulating Safety of Electronic Health Systems

By Fred Schulte and Emma Schwartz
Huffington Post Investigative Fund

Concerned about potential safety risks in health information technology, the U.S. Food and Drug Administration may be moving closer to regulating the systems for the first time.

In the past two years, the agency has received reports of six patient deaths and several dozen injuries linked to malfunctions in the systems, Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, said in testimony prepared for a government hearing on Thursday.

"Because these reports are purely voluntary, they may represent only the tip of the iceberg," Shuren said.

The FDA has been studying the issue for several years. Its latest concerns are surfacing as the government ramps up an ambitious plan to spend as much as $27 billion in stimulus money helping doctors and hospitals across the country purchase electronic medical records systems that rely on digital software rather than paper medical charts.

Many health policy experts believe that fostering greater use of health information technology, which officials refer to as HIT, will significantly improve the quality of medical care, cut costs and reduce medical errors and waste. The government hopes to have an electronic medical record for every American by 2014.

But digital medical systems are not risk-free. Over the past two years, the FDA's voluntary notification system logged a total of 260 reports of "malfunctions with the potential for patient harm," including 44 injuries and the six deaths. Among other things the systems have mixed up patients, put test results in the wrong person's file and lost vital medical information.

Story continues below

In one example cited in the FDA testimony, an operating room management system frequently "locked up" during surgery. Lost data had to be re-entered manually "in some cases from a nurse's recollection." Another system failed to display a patient's allergies properly because of software errors. In another case, results from lab testing done in a hospital emergency room were returned for the wrong patient. None of the patients, hospitals or clinics are identified in the reports.

"The FDA recognizes the tremendous importance of HIT and its potential to improve patient care. However, in light of the safety issues that have been reported to us, we believe that a framework of federal oversight of HIT needs to assure patient safety," Shuren said. He said that to date the agency has "largely refrained" from regulating the industry. Through an FDA spokesman, Shuren declined a request for an interview.

The FDA official outlined three possible approaches for tighter scrutiny. The agency could require makers of the devices to register them with the government and to submit reports on safety issues and correct problems that surface. The FDA could track this information "to help improve the design of future products."

In a second scenario, the agency could require manufacturers to report safety concerns and set minimum guidelines to assure the quality of products on the market. In a third approach, the systems could be subject to the broader regulatory actions that new medical products must face before they ever reach the market.

Though the FDA didn't specify which approach it favors, Shuren said that at a minimum the agency could "play an important role in preventing or addressing HIT-related safety issues, thereby helping to foster confidence in these devices."

The manufacturers of the systems generally have opposed regulation by the FDA, arguing in part that imposing strict controls would slow down the government's campaign to spur widespread adoption of the technology.

Regulation will not necessarily create a "safer" electronic medical record "and might actually limit innovation and responsiveness when it is needed most," Carl Dvorak, executive vice president of Epic Systems Corporation, a Wisconsin-based company that builds the systems mainly for hospitals and large medical practices, said in his prepared testimony for Thursday's hearing. The hearing is being held by an advisory group created by the stimulus law.

Yet some inside the industry favor stepped-up scrutiny. One major vendor, Cerner Corporation, which has voluntarily reported safety incidents to the FDA in recent years, signaled its support for a rule that would make those reports mandatory. Cerner has reported potential safety concerns because it is the "right thing to do," a company official said. 

"This transparency is especially important at a time when the federal government--and the American public--are investing heavily in HIT," wrote Gay M. Johannes, a Cerner vice president and chief quality officer.

Others inside the industry have argued for approaches that don't involve FDA oversight. James Walker, chief medical information officer at Pennsylvania's Geisinger Health System, said in prepared testimony for Thursday's hearing that a "patient safety organization" should be created to collect "automatic, anonymous reporting of potential hazards" in electronic health systems.

Federal officials in late December issued a set of draft guidelines doctors and hospitals must meet to collect stimulus money as reimbursement for investing in digital records systems. Fewer than one in five of the nation's approximately 600,000 doctors and 5,000 hospitals now use the technology, but officials expect the numbers to grow rapidly as the stimulus money kicks in.

U.S. Sen. Charles E. Grassley, R-Iowa, has asked some of the nation's largest electronic medical records vendors and most prestigious health care providers about possible safety flaws and other problems with the systems. The hospitals include the Mayo Clinic and some of the country's pioneers of digital records, such as Kaiser Permanente, a California-based health system with more than eight million members. Grassley has raised questions about a lack of a national system for reporting "product errors or failure and adverse events associated with the use of such products."

The federal government's Office of the National Coordinator for health information technology also has recognized the need for better surveillance. In January, the office issued a contract to address "undesirable and potentially harmful unintended consequences" of the systems.

One industry critic said Tuesday that she hoped the FDA would follow through on its concerns. "We need monitoring and reporting systems for problems," said Sharona Hoffman, a professor at Case Western Reserve University School of Law. "It has to go through the highest level of oversight and regulation. Every American who goes to a doctor will be affected."

Even those who advocate tighter oversight agree that the technology has the potential to revolutionize health care. The systems could eventually link doctors with hospitals and federal health data banks. Doctors would be able to send and receive medical test results online. Most systems have built-in alerts and alarms to warn doctors of potentially dangerous drug interactions and boast other safety features to assist them in caring for patients.

Though officials in some other countries have tightened oversight of the systems, U.S. manufacturers have managed to stave off formal regulation, telling the FDA in May 2008 that their products should be excluded from review partly as a means to speed up their adoption.

But critics argue that tighter scrutiny is needed to protect the public. "Oversight and quality control may slow things down, but it's absolutely critical," said Hoffman, the law professor. "Patients' lives are at stake."

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Interesting...

In the hectic pace of primary care nowdays, I can see the risk here. One must attentively be sure one is inputting data on the correct patient. Scanning labs into the correct chart, etc. The beauty of #housecalls is that you are moving through your day, making six or seven house calls rather than spreading yourself thin over 30 patients in the office. We like the quote from Jerome Groupman's book. by Dr Mc Evoy.." The Great Danger is that you stop caring... The goal of each day and each night is to simply to move everyone through, to clear the decks rather than to deliberately and expertly care for those who need it and to reassure those who do not"

To Your Best Health,

The Personal Medicine Team

Posted via web from Personal Medicine

The Cost of Doing Nothing on Health Care

But what if?

Suppose Congress and President Obama fail to overhaul the system now, or just tinker around the edges, or start over, as the Republicans propose %u2014 despite the Democrats%u2019 latest and possibly last big push that began last week at a marathon televised forum in Washington.

Then %u201Cmy health care%u201D stays the same, right?

Far from it, health policy analysts and economists of nearly every ideological persuasion agree. The unrelenting rise in medical costs is likely to wreak havoc within the system and beyond it, and pretty much everyone will be affected, directly or indirectly.

%u201CPeople think if we do nothing, we will have what we have now,%u201D said Karen Davis, the president of the Commonwealth Fund, a nonprofit health care research group in New York. %u201CIn fact, what we will have is a substantial deterioration in what we have.%u201D

Nearly every mainstream analysis calls for medical costs to continue to climb over the next decade, outpacing the growth in the overall economy and certainly increasing faster than the average paycheck. Those higher costs will translate into higher premiums, which will mean fewer individuals and businesses will be able to afford insurance coverage. More of everyone%u2019s dollar will go to health care, and government programs like Medicare and Medicaid will struggle to find the money to operate.

Policy makers, in the end, may be forced to address the issue.

%u201CIt will break all of our banks if we do nothing,%u201D said Peter V. Lee, who oversees national health policy for the Pacific Business Group on Health, which represents employers that offer coverage to workers. %u201CIt is a course that is literally bankrupting the federal government and businesses and individuals across the country.%u201D

Even those families that enjoy generous insurance now are likely to see the cost of those benefits escalate. The typical price of family coverage now runs about $13,000 a year, but premiums are expected to nearly double, to $24,000, by 2020, according to the Commonwealth Fund. That equals nearly a quarter of the median family income today.

While some employers will continue to contribute the lion%u2019s share of those premiums, there will be less money for employees in the form of raises or bonuses.

%u201CIt%u2019s also cramping our economic growth,%u201D said Frank McArdle, a consultant with Hewitt Associates, which advises large employers and reported on the need for change for the Business Roundtable, an association of C.E.O.%u2019s at major companies. Spending so much on health care is %u201Creally a waste of people%u2019s money,%u201D Mr. McArdle said.

The higher premiums will also persuade more businesses, especially smaller ones, to decide not to offer insurance. More people who buy coverage on their own or are asked to pay a large share of premiums will find the price too high. It doesn%u2019t take too many 39-percent increases, like the recent one proposed in California that has garnered so much attention, to put insurance out of reach.

%u201CWe have an affordability problem that is moving up through the middle class now,%u201D said Paul B. Ginsburg, the president of the Center for Studying Health System Change, a nonprofit Washington research group.

While estimates vary, the number of people without insurance is expected to increase by more than a million a year, said Ron Pollack, the executive director of Families USA, a Washington consumer advocacy group that favors the Democrats%u2019 approach. The Urban Institute, for example, predicts that the number of uninsured individuals will increase from about 49 million today to between 57 million and 66 million by 2019. The Democrats%u2019 plan is expected to cover as many as 30 million individuals who now are uninsured.

There will be a cost in lives, too. Mr. Pollack%u2019s organization estimates that as many as 275,000 people will die prematurely over the next 10 years because they do not have insurance. Even people with insurance will find their coverage providing much less protection from financial catastrophe than it does now. Individuals will pay significantly more in deductibles and co-payments, for example. %u201CMore and more families will experience huge debts and bankruptcies,%u201D Mr. Pollack said.

Federal and state governments will also feel the squeeze. Medicare, the federal program for the elderly, is already the subject of much hand-wringing as its spending balloons. Medicaid, a joint program of the federal government and the states, is already struggling as states try to balance budgets hit hard by the economic downturn. Many states may be forced to cut benefits sharply as well as reduce financing for community health centers and state hospitals that serve the poor.

%u201CI think we%u2019ll just see the decline of public services,%u201D said John Holahan, the director of the Health Policy Center at the Urban Institute.

Exactly how politicians, or anyone else, will react to the increasing pressures on the system is anyone%u2019s guess. If the system actually collapses, could there be a movement to adopt a government-run system, something like Medicare for all, where the whole health care system would be much more heavily regulated?

Or maybe employers would take up the effort to figure out a better way of providing coverage.

The states may also step up their role. Some may try to follow the lead of Massachusetts, which overhauled its own insurance market for individuals and small businesses, while others may try a series of regulatory fixes. A state senator in New Hampshire, for example, recently introduced legislation that regulates hospital prices in a fashion similar to an approach favored in Maryland.

What seems unlikely, say policy analysts, is that Congress would try to pass anything nearly as ambitious as the bills that went through the House and Senate last year.

%u201CIf we fail this time, you%u2019re not going to get this Congress to take this up on a big scale,%u201D said Len Nichols, a health policy analyst at George Mason University who says he thinks the Democrats should go ahead and pass legislation.

But few policy analysts think Congress can afford to do absolutely nothing. Lawmakers are instead likely to try a series of smaller fixes, said Stuart Butler, a health policy analyst at the Heritage Foundation, a research group that favors market solutions over a larger government role.

After President Bill Clinton failed to get Congress to pass his health care bill in 1994, Republicans, who then had substantial victories in the House and Senate, worked with him to pass legislation like the health care privacy bill, a children%u2019s health insurance program and the Balanced Budget Act, which contained significant changes to the Medicare program. Under President George W. Bush, the Republicans went on to pass a drug benefit under Medicare. %u201CIn the space of less than 10 years, you have several major bills,%u201D Mr. Butler said.

If nothing passes now, Mr. Butler says he thinks Congress will tackle narrower areas, like insurance regulation, to make it easier for people with pre-existing medical conditions to find coverage, or maybe it will try another expansion of Medicaid or the children%u2019s program.

But President Obama clearly prefers passage of a broader bill. In wrapping up Thursday%u2019s session with lawmakers, he and other Democrats warned that an incremental approach was likely to provide too little relief to the people already feeling the effects of a broken system. %u201CIt turns out that baby steps don%u2019t get you to the place that people need to go,%u201D he said.

And even some people without a partisan point to make argue that the series of bills passed in the last 15 years have not made enough of a dent in slowing down medical costs. %u201CWe%u2019ve had a lot of incremental reforms already,%u201D said Mr. McArdle, the Hewitt consultant.

And many argue that putting off the inevitable has an additional cost. The Commonwealth Fund estimates that the nation would be spending hundreds of billions of dollars less than it does today if any of the health care legislation proposed by previous administrations had been enacted, assuming that they reduced costs by about 1.5 percentage points. If President Nixon%u2019s plan had passed, the United States might be spending a trillion dollars a year less than it does now, and President Clinton%u2019s plan would have reduced spending by some $500 billion a year.

%u201CIt makes a huge difference over a long period of time,%u201D said Ms. Davis of the Commonwealth Fund.

NY Times today on Costs of Doing nothing on Healthcare...

To Your Best Health,

The Personal Medicine Team

Posted via web from Personal Medicine

Saturday, February 27, 2010

Journal of Participatory Medicine | Society for Participatory Medicine

Lovely to learn more about the early Society for Participatory Medicine. Exploring how deeper patient engagement may be facilitated with Ecommunication strategies combined with Consumer Facing PHR's. Looking forward to hearing EPatient Dave Keynote at ICSI.org in May.

To Your Best Health,

The Personal Medicine Team

Posted via web from Personal Medicine

Roast Turkey with Oranges, Bay Leaves, Red Onions, and Pan Gravy Recipe at Epicurious.com

Preparation

Roast turkey:
Preheat oven to 425�F.

Rinse turkey inside and out and pat dry. Sprinkle turkey inside and out with salt and pepper, then fold neck skin under body and secure with small skewer. Stuff large cavity with oranges, 1 onion, and bay leaves. Tie drumsticks together with kitchen string and secure wings to body with small skewers.

Put turkey on a rack set in a large flameproof roasting pan and roast in middle of oven 30 minutes.

While turkey is roasting, toss remaining 2 onions with 2 tablespoons melted butter.

Reduce oven temperature to 350�F. Brush remaining 1/4 cup butter over turkey and roast 30 minutes more. Baste turkey and scatter buttered onion wedges around it, then roast, basting turkey every 30 minutes (add a little water to pan if onions get too dark) until an instant-read thermometer inserted into fleshy part of a thigh (do not touch bone) registers 170�F, 1 1/2 to 2 hours more (total roasting time: 2 1/2 to 3 hours). Transfer turkey to a platter (do not clean roasting pan) and let stand 25 minutes (temperature will rise to 180�F).

Make gravy:
Transfer pan juices with onions to a 2-quart glass measure, then skim off and reserve 1/4 cup fat. Add enough turkey stock to pan juices to make 4 1/2 cups total. Set roasting pan across 2 burners, then add 1 cup stock mixture and deglaze pan by boiling over moderately high heat, stirring and scraping up brown bits. Add remaining stock mixture and bring to a simmer. Pour stock through a fine sieve back into glass measure and discard onions.

Whisk together reserved fat and flour in a large heavy saucepan and cook roux over moderately low heat, whisking, 3 minutes. Add hot stock mixture in a fast stream, whisking constantly to prevent lumps, then simmer, whisking occasionally, until thickened, about 10 minutes. Stir in any additional turkey juices accumulated on platter and season gravy with salt and pepper.

Serve turkey with gravy on the side.

add your own note

Here is a great dinner recipe from epicurious.

To Your Best Health,

The Personal Medicine Team

Posted via web from Personal Medicine

Friday, February 26, 2010

Patient testamonial Personal Medicine Affiliate program

Natalie Hodge MD FAAP Breastfeeding

Here is what hospitals should be doing to facilitate breastfeeding and reduce obesity rates.

To Your Best Health,
The Personal Medicine Team

Posted via web from Personal Medicine

Thursday, February 25, 2010

Healthcare Costs & Defensive Medicine Study | Jackson Healthcare

Check out this website I found at jacksonhealthcare.com

This is a nice well done physician survey quantitating the costs of defensive medicine. 650 to 850 billion dollars a year. Wow that's a nice big round number. Want to reduce your malpractice costs by making house calls? Come to our webinar Saturday and see the platform in action!!

https://personalmedicine.com/pmi/index.php?option=com_ip3forms&cType=1

To Your Best Health,

The Personal Medicine Team

Posted via web from Personal Medicine

Wednesday, February 24, 2010

amednews: Health plan requirements cost practices billions, with the per-doctor average near $70,000 :: June 1, 2009 ... American Medical News

A study published online May 14 in Health Affairs estimates that practices' interactions with insurers cost $23.2 billion to $31 billion a year. The average physician spends 43 minutes per work day -- more than three hours a week -- dealing with health plan administrative requirements.

The time physicians, nurses and other practice staff spend interacting with insurers costs an average of $68,274 per physician per year.

Physicians take a look at this study... and don't forget to look over to the right at that nice circular graph with all the payor profit margins... Don't forget my friends WE are the ones providing the health services. Check out the webinar tomorrow to see the ecommerce platform in action.

To Your Best Health,

The Personal Medicine Team

Posted via web from Personal Medicine

Tuesday, February 23, 2010

Recipe for Sichuan Beef Noodle Soup with Pickled Mustard Greens from Epicurious.com

Here is a great low fat recipe for dinner tonight!! 

To your best health,

 the personal medicine team

This Epicurious.com recipe:
Sichuan Beef Noodle Soup with Pickled Mustard Greens
has been sent to you by a friend.

You can view the complete recipe online at: http://www.epicurious.com/recipes/food/views/357515?mbid=ipapp

Sichuan Beef Noodle Soup with Pickled Mustard Greens
5 pounds boneless beef shank
1/4 cup vegetable oil
1 2 1/2-inch piece fresh ginger, peeled, cut into 1/3-inch-thick rounds, each smashed with flat side of knife
3 large garlic cloves, coarsely chopped
2 cups chopped onions
2 1/2 tablespoons chili bean paste (Sichuan hot bean paste; dou ban jiang)
3 whole green onions, trimmed, plus 2 cups chopped green onions (for garnish)
1/2 cup (or more) soy sauce (do not use low-sodium)
2 tablespoons (or more) salt
6 whole star anise
2 1 1/2-inch cubes Chinese yellow rock sugar (about 2 1/2 ounces) or 2 1/2 tablespoons sugar
1/2 tablespoon Sichuan peppercorns
2 large plum tomatoes (about 8 ounces), each cut into 4 wedges
Freshly ground white pepper or black pepper
1 pound eggless Chinese wheat noodles (Shandong la mian)
3 baby bok choy, each halved lengthwise, bottom 1 1/2 inches trimmed, rinsed (optional garnish)
Chopped fresh cilantro (for garnish)
Pickled Mustard Greens


Bring large pot of water to boil over high
heat. Add beef; return water to boil. Reduce
heat. Simmer until beef is brown on outside,
turning occasionally, about 8 minutes;
drain. Rinse beef under cold water until
cool; cut into 1 1/2-inch cubes. Wipe out pot.


Heat 1/4 cup oil in same pot over medium-high
heat. Add ginger and garlic. Sauté 1
minute. Add chopped onions; sauté until
translucent, about 3 minutes. Add chili bean
paste; stir 30 seconds. Add 16 cups water,
whole green onions, 1/2 cup soy sauce, 2
tablespoons salt, star anise, and rock sugar.
Mix in beef. Tie peppercorns in cheesecloth;
add to pot. Bring soup to boil. Reduce heat
to medium-low. Gently simmer uncovered
1 hour, adjusting heat to avoid boiling.


Add tomatoes to pot. Continue to
simmer soup until beef is very tender, 45 to
60 minutes. Adjust seasoning, adding more
soy sauce by tablespoonfuls and more salt,
if desired. Season with pepper.


Meanwhile, cook noodles according to
package directions. Drain well.


Divide noodles among large soup
bowls. Add some bok choy to each, if
desired. Ladle soup and meat over. Garnish
with chopped green onions and cilantro.
Serve with Pickled Mustard Greens
.

Ingredient tips: Chili bean paste
is a spicy, fermented soybean paste. Star
anise—
a star-shaped seedpod—is available
at some supermarkets. Chinese yellow
rock sugar
is made from raw sugar; it is
often used in Chinese sauces and teas.
Despite their name, Sichuan peppercorns
aren't related to regular peppercorns; the
mildly hot dried berries, which resemble
split peppercorns, come from the prickly
ash tree. Shandong la mian are Chinese
wheat noodles. Look for these ingredients
at specialty foods stores and Asian markets.

Bon Appétit
March 2010
by Shih Yu Chen Kuo

Want to see how other cooks rated and reviewed this recipe? Go to http://www.epicurious.com/recipes/food/views/357515?mbid=ipapp

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Sunday, February 21, 2010

Recipe for Turkey Meatballs from Epicurious.com

Here is what we are having for dinner! 

To your best health, 

The personal medicine team

This Epicurious.com recipe:
Turkey Meatballs
has been sent to you by a friend.

You can view the complete recipe online at: http://www.epicurious.com/recipes/food/views/357009?mbid=ipapp

Turkey Meatballs
1 lb ground turkey
1 egg
1/2 cup seasoned bread crumbs
1 tsp chopped onions
1/4 tsp garlic powder
1/8 tsp black pepper
1 tbsp tomato paste or 2 tbsp ketchup


Preheat oven to 400 degrees. Combine all the ingredients and mix thoroughly. Form meatballs from 1 tbsp of mixture mold into the shape of a ball. Bake 15 to 20 minutes on a lightly oiled 10 x 15 x 1 inch pan, or until the meatballs are no longer pink in the center.


Note:
This recipe yields more meatballs than just two, but it's so good you might want to share it with friends or save half of the meatballs in the freezer for another meal.
The SuperStress Solution
January 2010
by Roberta Lee, M.D.

Want to see how other cooks rated and reviewed this recipe? Go to http://www.epicurious.com/recipes/food/views/357009?mbid=ipapp

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Device Helps Kids With Single-Sided Deafness - Yahoo! News

THURSDAY, Feb. 18 (HealthDay News) -- Bone-anchored hearing aids provide noticeable hearing improvement for children and teens with single-sided deafness, a new study finds.

Between 0.1 percent and 3 percent of children have deafness on one side, which is often associated with poor school performance, learning difficulties and behavioral problems. Traditional external hearing aids are effective, but compliance is low among children, particularly outside the classroom, according to background information in the study.

"Thus, treatment options for [single-sided deafness] in children are limited, thereby creating a source of frustration and a need for alternative treatments," wrote Lisa Christensen, of Arkansas Children's Hospital in Little Rock, and colleagues.

The researchers reviewed the cases of 23 children and teens, aged 6 to 19, with single-sided deafness who received a bone-anchored hearing aid. After the procedure, the patients showed significant improvements in hearing. The rate of complications, such as skin reactions and lost fixtures, was 17 percent.

"These findings are helpful in counseling children 5 years and older and their families regarding treatment options for single-sided deafness," the researchers concluded.

The study appears in the February issue of the journal Archives of Otolaryngology -- Head and Neck Surgery.

Christensen is a consultant for Cochlear Americas, which makes bone-anchored hearing aids.

More information

Hear-it has more about http://www.hear-it.org/page.dsp?page=2020">bone-anchored hearing aids.

Interesting article on hearing aids in pediatric populations

To Your Best Health,

The Personal Medicine Team

Posted via web from Personal Medicine

Saturday, February 20, 2010

Most Innovative Companies - 2010: PatientsLikeMe | Fast Company

Nice Article on Patients Like Me dot com from Fast Company

To Your Best Health,
The Personal Medicine Team

Posted via web from Personal Medicine

Friday, February 19, 2010

Recipe for Low-Fat Carrot Ginger Soup from Epicurious.com

Here is a great dinner for your family tonight... Roast a chicken and toss a salad!  

This Epicurious.com recipe:
Low-Fat Carrot Ginger Soup
has been sent to you by a friend.


Low-Fat Carrot Ginger Soup
1 package frozen carrots
1 1/2 cup hot water
1 cube vegetable or chicken bouillon
1/2 cup of skim milk
1 tsp ginger, grated
1 tsp honey


In a blender put 1 package of frozen carrots, hot water, 1 cube vegetable or chicken bouillon, skim milk, grated ginger, and honey. Puree and warm in microwave for 2 minutes.

The SuperStress Solution
January 2010
by Roberta Lee, M.D.

To your best health, 

The personal medicine team

Sent from my iPod

Posted via email from Personal Medicine

Wednesday, February 17, 2010

Recipe for Dr. Lee's Red Wine Chicken Stew from Epicurious.com

Here is what we are cooking for dinner tonight at our house!! 

Family dinners are good for families! 

To your best health, 
The personal medicine team

This Epicurious.com recipe:
Dr. Lee's Red Wine Chicken Stew
has been sent to you by a friend.

You can view the complete recipe online at: http://www.epicurious.com/recipes/food/views/357010?mbid=ipapp

Dr. Lee's Red Wine Chicken Stew
1 tbsp olive oil
2 cloves of garlic, mashed
1/2 cup chopped tomatoes
2 boneless chicken breasts
1 cup sliced onion
1 cup sliced mushrooms
1 cup full-bodied red wine
1 cup chicken stock (1 cup water plus 1/2 chicken or vegetable bouillon cube)
1/4 tsp thyme


In a Dutch oven at medium heat, combine olive oil and garlic and sauté briefly. Then add tomatoes and cook for five minutes. Add chicken breasts, onion, mushrooms, wine, chicken stock, and thyme. Lower heat and cook for 40 to 50 minutes until chicken breasts are done.

The SuperStress Solution
January 2010
by Roberta Lee, M.D.

Want to see how other cooks rated and reviewed this recipe? Go to http://www.epicurious.com/recipes/food/views/357010?mbid=ipapp

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Tuesday, February 16, 2010

NYTimes: Surgery for Obese Children?

Sad that we have come to this... Prevention folks!!


From The New York Times:

Surgery for Obese Children?

Though still considered experimental, bariatric surgery is fast becoming the next front in the battle against pediatric obesity.

http://s.nyt.com/u/BGb

Get The New York Times on your iPhone for free by visiting http://itunes.com/apps/nytimes


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Sunday, February 14, 2010

Recipe for Wilted Watercress with Garlic from Epicurious.com

Try this one at home...

This Epicurious.com recipe:
Wilted Watercress with Garlic
has been sent to you by a friend.

You can view the complete recipe online at: http://www.epicurious.com/recipes/food/views/350213?mbid=ipapp

Wilted Watercress with Garlic
2 tablespoon corn oil
12 garlic cloves, peeled and smashed
4 bunches watercress (about 20 ounces), trimmed (about 12 packed cups)
1 1/2 teaspoon kosher salt
1/4 cup chicken stock or reduced-sodium broth


Heat a dry 12-inch heavy skillet or wok (not nonstick) over medium heat until hot. Add oil, then garlic, and cook, tossing constantly, until garlic is deep golden. Add watercress and salt, then reduce heat to medium-low and cook, tossing constantly, 45 seconds. Add stock and toss again, then cook, covered, until stems are crisp-tender and leaves are just wilted, about 20 seconds.


Serve with garlic cloves arranged on top.

Cooks' note:
Watercress can be washed and trimmed 1 day ahead and chilled in a sealable bag.
Gourmet
October 2008
by Andrea Reusing

Want to see how other cooks rated and reviewed this recipe? Go to http://www.epicurious.com/recipes/food/views/350213?mbid=ipapp

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Personal Medicine International - FOR PATIENTS

Personal Medicine International - Nutrition News

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Login

Our nutrition news from today!

Secure login for your free patient health records today!

The Personal Medicine Team

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A Pediatrician’s Advice on ‘Green’ Parenting - Well Blog

Here's a nice article on " Green Parenting" from Dr Greene.

To Your Best Health,

The Personal Medicine Team

Posted via web from Personal Medicine

Recipes for Health - Bulgur and Lentil Salad

Here is a nice one from NY Times today. Great Protein source.

To Your Best Health,
The Personal Medicine Team

Posted via web from Personal Medicine

Personal Medicine International - Pediatrics / Children's Health News

Here is today's Children's Health News! To Your Best Health, The Personal Medicine Team


Personal Medicine International - Pediatrics / Children's Health News http://bit.ly/5TRLyL

Link: http://bit.ly/5TRLyL
Title: Personal Medicine International - Pediatrics / Children's Health News
Source: http://personalmedicineinternational.com/pmi/index.php?option=com_newsfeeds&view=newsfeed&id=15&Itemid=78
See who is talking about this page: http://bit.ly/5TRLyL+
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Saturday, February 06, 2010

NYTimes: Fighting Denied Claims Requires Perseverance

Why fight with your insurer? Contract directly with your housecall physician and reap big savings!


From The New York Times:

PATIENT MONEY: Fighting Denied Claims Requires Perseverance

Following a few steps can make the process of appealing insurance denials easier and increase the likelihood of success.

http://s.nyt.com/u/e0-

Get The New York Times on your iPhone for free by visiting http://itunes.com/apps/nytimes


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NYTimes: Journal Retracts 1998 Paper Linking Autism to Vaccines

Not to beat a dead horse, but...

From The New York Times:

Journal Retracts 1998 Paper Linking Autism to Vaccines

The paper in The Lancet, which was retracted after years of reassessment, caused a sharp decline in vaccinations in Britain after its publication.

http://s.nyt.com/u/eDe

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NYTimes: Slimmer Doesn’t Always Mean Fitter

Nice article about fitness...


From The New York Times:

PERSONAL BEST: Slimmer Doesn’t Always Mean Fitter

Exercise physiologists encourage athletes to be aware of the point at which weight loss hinders performance.

http://s.nyt.com/u/eWV

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Thursday, February 04, 2010

Recipe for Low-Fat Carrot Ginger Soup from Epicurious.com

This Epicurious.com recipe:
Low-Fat Carrot Ginger Soup
has been sent to you by a friend.

You can view the complete recipe online at: http://www.epicurious.com/recipes/food/views/357030?mbid=ipapp

Low-Fat Carrot Ginger Soup
1 package frozen carrots
1 1/2 cup hot water
1 cube vegetable or chicken bouillon
1/2 cup of skim milk
1 tsp ginger, grated
1 tsp honey


In a blender put 1 package of frozen carrots, hot water, 1 cube vegetable or chicken bouillon, skim milk, grated ginger, and honey. Puree and warm in microwave for 2 minutes.

The SuperStress Solution
January 2010
by Roberta Lee, M.D.

Want to see how other cooks rated and reviewed this recipe? Go to http://www.epicurious.com/recipes/food/views/357030?mbid=ipapp

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NYTimes: Hospital Chain Withdraws St. Vincent's Offer

Another hospital bites the dust... Innovation is the only thing to save healthcare...

From The New York Times:

Hospital Chain Withdraws St. Vincent's Offer

The withdrawal by Continuum Health Partners further harms the nearly bankrupt hospital's prospects for survival.

http://s.nyt.com/u/eIm

Get The New York Times on your iPhone for free by visiting http://itunes.com/apps/nytimes


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NYTimes: Insulin Study Could Lead to New Dosage Devices

New hope for parents of kids with diabetes... Now to import glucose data into our electronic medical records...

From The New York Times:

Insulin Study Could Lead to New Dosage Devices

A new study points towards a different way of regulating children’s glucose levels by using a continuous glucose monitor instead of the standard diabetes management system.

http://s.nyt.com/u/eGO

Get The New York Times on your iPhone for free by visiting http://itunes.com/apps/nytimes


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