Monday, January 31, 2011
Thursday, January 27, 2011
(11/2) Are pacifiers good for infants? - Quora
There is one aspect in which one might say yes to this question. Pacifiers have been shown in sme studies to slightly reduce the risk of SIDS for babies that are at risk. the caveats are that you don't want to start in the first month until breastfeeding is firmly established. And around six months of life ( concurrent with the timing that the risk of SIDS drastically reduces) you want the baby to learn how to self soothe at night and put himself to sleep. There is no greater gift that you can give your child than this!
Great community here on quora. Having fun answering questions!
To Your Best Health,
The Personal Medicine Team
Wednesday, January 26, 2011
Obama gives HIT the nod in State of the Union speech | Healthcare IT News
WASHINGTON – In a broad State of the Union speech Tuesday night, President Obama hailed the information age in America and the need for the federal government to support IT innovation.
"In America, innovation doesn’t just change our lives, it’s how we make a living," he said. "Our free enterprise system is what drives innovation. But because it’s not always profitable for companies to invest in basic research, throughout history our government has provided cutting-edge scientists and inventors with the support that they need. That’s what planted the seeds for the Internet. That’s what helped make possible things like computer chips and GPS."
In 2009, Obama signed the American Recovery and Reinvestment Act into law, supporting healthcare IT innovators for developing and healthcare providers for adopting healthcare IT. Many observers have said without this support, the healthcare industry would not make it over the tipping point to health information exchange.
[Read more about ARRA funding for healthcare IT.]
The Obama Administration has faced a steep uphill battle with Republicans over the federal deficit, and he took the issue head on in his speech, siding with Republicans in the need for fiscal responsibility. As in the past, he nodded toward keeping programs that could help to lower costs in the future. For healthcare, this means the advancement of healthcare IT to lower costs and increase quality of care. It also means retaining grant programs such as the Beacon Communities, state HIE exchanges and accountable care organization pilots – all funded as part of the Accountable Care Act.
"I recognize that some in this Chamber have already proposed deeper cuts, and I’m willing to eliminate whatever we can honestly afford to do without," he said. "But let’s make sure that we’re not doing it on the backs of our most vulnerable citizens. And let’s make sure what we’re cutting is really excess weight. Cutting the deficit by gutting our investments in innovation and education is like lightening an overloaded airplane by removing its engine. It may feel like you’re flying high at first, but it won’t take long before you’ll feel the impact.
Obama called for the expansion of America's infrastructure, including high-speed wireless connection in rural areas. "Within the next five years, we will make it possible for business to deploy the next generation of high-speed wireless coverage to 98 percent of all Americans," he said. "This isn’t just about a faster internet and fewer dropped calls. It’s about connecting every part of America to the digital age. More broadband access means patients will be able to have face-to-face video chats with their doctors."
[See more ways the digital age has improved patient care.]
Obama said America has made great strides over the last two years in using technology and getting rid of waste. "Veterans can now download their electronic medical records with a click of the mouse," he added.
Justin Barnes, chairman emeritus of the Healthcare Information and Management Systems Society's EHR Association and vice president of government affairs at Greenway Medical, has been closely tied with advising the White House and Congress on healthcare IT since 2003.
"This is the eighth year in a row that healthcare IT has been a part or prominent part of the president’s State of the Union Address," Barnes noted following the speech. "While the debate will certainly continue on exactly how we go about creating and implementing policy, it was very encouraging to hear the increased vigor supporting additional investments in innovation around biomedical research and information technology."
Despite a rousing speech, the proof will be in the policies, Barnes said. "That is certainly what keeps many of us engaged to collaborate and help educate while watching out for how these policies can effect care providers, patients, hospitals and all of us as taxpayers. I believe we all have the common goal though to create a smarter, more sustainable healthcare system in America."
Great to see Obama's support of Health IT and increasing broadband access. We are excited to work with our physician customers and learn how we can support their integration of telemedicine into their mobile practices. The options are limitless. We can only drive so far for a house call, but telemedicine membership add ons may help us extend the reach of our care further into rural and underserved areas, as well as potentially add a philanthropic arm to our membership practices!
To Your Best Health,
The Personal Medicine Team
Sunday, January 23, 2011
Lifting a Veil of Fear to See the Benefits of Child Fever
Great article on fever by a pediatrician Dr Klass in NYC.
To Your Best Health,
The Personal Medicine Team
Friday, January 21, 2011
amednews: Doctors win 3-month reprieve from home health documentation rule :: Jan. 17, 2011 ... American Medical News
Physicians if you are tired of CMS overregulating the way that you take care of patients, you might consider direct practice. It's a much easier way to give your patients what they need in terms of care and not worry about getting paid. Also the fear that providers have of committing fraud is real.
To Your Best Health,
The Personal Medicine Team
Thursday, January 20, 2011
Alexa - Top Sites by Category: Health
Here are the top sites on the web for health as represented by Alexa Rank. Physicians are you happy with this? Here is where your families go to find out information on their health BEFORE they will communicate with you, as of last year. Note this does NOT include the health presence of Wikipedia and Google, which we should consider review and use of appropriate content for our patients.
To Your Best Health,
The Personal Medicine Team
Saturday, January 15, 2011
Patient testamonial personal_medicine_affiliat
Here is a Mom talking about what she likes about house calls for her family.
To Your Best Health,
The Personal Medicine Team
Wednesday, January 12, 2011
Study: Consumers not fazed by DNA health results
Some reassuring results here on consumer's level of anxiety when receiving genetic test results, see we are making progress! Navigenics testing is the company used in the study.
To Your Best Health,
The Personal Medicine Team
CDC Winter Weather | FAQ
What is hypothermia?
When exposed to cold temperatures, your body begins to lose heat faster than it can be produced. The result is hypothermia, or abnormally low body temperature. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know it is happening and won't be able to do anything about it.
Hypothermia occurs most commonly at very cold environmental temperatures, but can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water.
Who is most at risk for hypothermia?
Victims of hypothermia are most often:
- elderly people with inadequate food, clothing, or heating
- babies sleeping in cold bedrooms
- children left unattended
- adults under the influence of alcohol
- mentally ill individuals
- people who remain outdoors for long periods—the homeless, hikers, hunters, etc.
What are the warning signs for hypothermia?
Adults:
- shivering/exhaustion
- confusion/fumbling hands
- memory loss/slurred speech
- drowsiness
Infants:
- bright red, cold skin
- very low energy
What should I do if I see someone with warning signs of hypothermia?
If you notice signs of hypothermia, take the person's temperature. If it is below 95°, the situation is an emergency—get medical attention immediately.
If medical care is not available, begin warming the person, as follows:
- Get the victim into a warm room or shelter.
- If the victim has on any wet clothing, remove it.
- Warm the center of the body first—chest, neck, head, and groin—using an electric blanket, if available. Or use skin-to-skin contact under loose, dry layers of blankets, clothing, towels, or sheets.
- Warm beverages can help increase the body temperature, but do NOT give alcoholic beverages. Do not try to give beverages to an unconscious person.
- After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck.
- Get medical attention as soon as possible.
A person with severe hypothermia may be unconscious and may not seem to have a pulse or to be breathing. In this case, handle the victim gently, and get emergency assistance immediately. Even if the victim appears dead, CPR should be provided. CPR should continue while the victim is being warmed, until the victim responds or medical aid becomes available. In some cases, hypothermia victims who appear to be dead can be successfully resuscitated.
What is frostbite?
Frostbite is an injury to the body that is caused by freezing. Frostbite causes a loss of feeling and color in affected areas. It most often affects the nose, ears, cheeks, chin, fingers, or toes. Frostbite can permanently damage the body, and severe cases can lead to amputation.
What are the warning signs of frostbite?
At the first signs of redness or pain in any skin area, get out of the cold or protect any exposed skin—frostbite may be beginning. Any of the following signs may indicate frostbite:
- a white or grayish-yellow skin area
- skin that feels unusually firm or waxy
- numbness
Note: A victim is often unaware of frostbite until someone else points it out because the frozen tissues are numb.
What should I do if I see someone with warning signs of frostbite?
If you detect symptoms of frostbite, seek medical care. Because frostbite and hypothermia both result from exposure, first determine whether the victim also shows signs of hypothermia, as described previously. Hypothermia is a more serious medical condition and requires emergency medical assistance.
If (1) there is frostbite but no sign of hypothermia and (2) immediate medical care is not available, proceed as follows:
- Get into a warm room as soon as possible.
- Unless absolutely necessary, do not walk on frostbitten feet or toes—this increases the damage.
- Immerse the affected area in warm—not hot—water (the temperature should be comfortable to the touch for unaffected parts of the body).
- Or, warm the affected area using body heat. For example, the heat of an armpit can be used to warm frostbitten fingers.
- Do not rub the frostbitten area with snow or massage it at all. This can cause more damage.
- Don't use a heating pad, heat lamp, or the heat of a stove, fireplace, or radiator for warming. Affected areas are numb and can be easily burned.
Note: These procedures are not substitutes for proper medical care. Hypothermia is a medical emergency and frostbite should be evaluated by a health care provider. It is a good idea to take a first aid and emergency resuscitation (CPR) course to prepare for cold-weather health problems. Knowing what to do is an important part of protecting your health and the health of others.
What is the wind chill effect?
As the speed of the wind increases, it can carry heat away from your body much more quickly. When there are high winds, serious weather-related health problems are more likely, even when temperatures are only cool.
For a Wind Chill Chart (shows the difference between air temperature and perceived temperature and amount of time until frostbite occurs), Wind Chill Calculator, and information on the updated Wind Chill Temperature Index, see www.nws.noaa.gov/om/windchill.
Why are infants and older people most at risk for cold-related illness?
Infants lose body heat more easily than adults; additionally, infants can't make enough body heat by shivering. Infants less than one year old should never sleep in a cold room. Provide warm clothing and a blanket for infants and try to maintain a warm indoor temperature. If the temperature cannot be maintained, make temporary arrangements to stay elsewhere. In an emergency, you can keep an infant warm using your own body heat. If you must sleep, take precautions to prevent rolling on the baby. Pillows and other soft bedding can also present a risk of smothering; remove them from the area near the baby.
Older adults often make less body heat because of a slower metabolism and less physical activity. If you are more than 65 years of age, check the temperature in your home often during severely cold weather. Also, check on elderly friends and neighbors frequently to ensure that their homes are adequately heated.
What should I do if I get stranded in cold weather?
- Tie a brightly colored cloth to the antenna as a signal to rescuers.
- Move anything you need from the trunk into the passenger area.
- Wrap your entire body, including your head, in extra clothing, blankets, or newspapers.
- Stay awake. You will be less vulnerable to cold-related health problems.
- Run the motor (and heater) for about 10 minutes per hour, opening one window slightly to let in air. Make sure that snow is not blocking the exhaust pipe—this will reduce the risk of carbon monoxide poisoning.
- As you sit, keep moving your arms and legs to improve your circulation and stay warmer.
- Do not eat unmelted snow because it will lower your body temperature.
What is the best clothing for cold weather?
Adults and children should wear:
- a hat
- a scarf or knit mask to cover face and mouth
- sleeves that are snug at the wrist
- mittens (they are warmer than gloves)
- water-resistant coat and shoes
- several layers of loose-fitting clothing
Be sure the outer layer of your clothing is tightly woven, preferably wind resistant, to reduce body-heat loss caused by wind. Wool, silk, or polypropylene inner layers of clothing will hold more body heat than cotton. Stay dry—wet clothing chills the body rapidly. Excess perspiration will increase heat loss, so remove extra layers of clothing whenever you feel too warm. Also, avoid getting gasoline or alcohol on your skin while de-icing and fueling your car or using a snow blower. These materials in contact with the skin greatly increase heat loss from the body.
Do not ignore shivering. It's an important first sign that the body is losing heat. Persistent shivering is a signal to return indoors.
What should I eat and drink during periods of extreme cold?
Eating well-balanced meals will help you stay warmer. Do not drink alcoholic beverages—they cause your body to lose heat more rapidly. Instead, drink warm, sweet beverages such as hot chocolate to help maintain your body temperature. If you have any dietary restrictions, ask your doctor.
How can I heat my home safely?
If you plan to use a wood stove, fireplace, or space heater, be extremely careful. Follow the manufacturer's instructions as well as the advance home safety measures on page 4 and remember these safety tips:
- Store a multipurpose, dry chemical fire extinguisher near the area to be heated.
- Do not burn paper in a fireplace.
- Ensure adequate ventilation by opening an interior door or slightly opening a window if you must use a kerosene heater.
- Use only the type of fuel your heater is designed to use—don't substitute.
- If your heater has a damaged electrical cord or produces sparks, don't use it.
- Use fireplaces, wood stoves, and other combustion heaters only if they are properly vented to the outside and do not leak flue gas into the indoor air space. Make sure chimneys and flues are cleaned periodically.
- Do not place a space heater near things that may catch on fire, such as drapes, furniture, or bedding.
Here is a nice piece from the CDC on hypothermia. Watch out everyone and take care during these extreme temperatures!
To Your Best Health,
The Personal Medicine Team
Tuesday, January 11, 2011
PATIENT SIGN UP
How easy is this patient signup form? We've redone it to make it less than a minute!
What do you think?
To Your Best Health,
The Personal Medicine Team
Monday, January 10, 2011
WSJ: Verizon will offer unlimited data plans with iPhone 4 | ZDNet
Now excuse me while I go kill myself...
Just Kidding.
Mobile Personal Medicine Physicians! Now is the time to go 4G and Unlimited Data with Verizon. The mobile ap is in private beta, we'll be wanting feedback on it soon!
To Your Best Health,
The Personal Medicine Team
Children's Hospital Boston doc developing handheld device to detect 'lazy eye' | MassDevice - Blog entry
Great post here today about some emerging technologies in the detection of ambylopia, or " lazy eye" in kids. Scroll down and read the comment of a renoun and influential pediatrician Hershel Lessin on his feelings about how payors may slow the adoption of new technologies in medicine. We'd love to hear other physicians chime in on this issue!
What if services in healthcare could be validated by the Market rather than third party payors? How might this affect the adoption of new technologies in your practice? I could EASILY fit this handheld device in the back of my car folks...
To Your Best Health,
The Personal Medicine Team
U.S. lowers limits for fluoride in water | Reuters
Here is a nice article from Reuters on the lowering of the flouride limits for water supply.
To Your Best Health,
From The Personal Medicine Team
Thursday, January 06, 2011
Physicians Benefits | Presentation
An Oldie but a goodie!!
If you know a passionate primary care doc who seems frustrated with third party payors. Send this to her.
Patient testamonial personal_medicine_affiliat
Cool video testamonial from a patient of ours about the value of house calls to her family. Sign up for our Free PHR today. We'll have a housecall to your doorstep shortly!
To Your Best Health,
The Personal Medicine Team
Wednesday, January 05, 2011
Retracted autism study an 'elaborate fraud,' British journal finds - CNN.com
Natalie hodge md faap
Www.personalmedicine.com
Childhood Obesity Rooted In Fat Babies | Latest Endeavor
Tuesday, January 4th, 2011 | Posted by Fiona NiguidulaEND hiding original author, date and time -->Childhood Obesity Rooted In Fat Babies
Tuesday, January 4th, 2011 | By Fiona NiguidulaObese babies are leading to obese children, it has been published in the recent January/February issue of American Journal of Health Promotion.Nine-month olds at the 95th percentile for weight for their age group are at risk for childhood obesity.
The study was led by Dr. Brian G. Moss of Wayne State University, Detroit, Michigan and Dr. William Yeaton of the University of Michigan, Ann Arbor. The source of data was the national Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) drawn in 2001.
The study looked at the weights of more than 7000 babies at the age of 9 months and again at 2 years. Demographic statistics were analyzed also to look for relationships.
Children at the 85th to 95 percentile for their weight were thought to be at risk for obesity and above 95 percent were considered obese. Nearly 32 percent of the babies fell in these categories at the age of 9 months with the number increasing slightly at 2 years.
Those infants who were above 95 percent when they were 9 months old were the most likely to be obese at 2 years.
Specific demographics that had the highest risk for obesity were those of Hispanics and families with low income. Those demographics that seemed to have the lowest risk were females and Asian/Pacific Islander babies.
Moss concluded that the study shows no relationship between infant or childhood obesity and adult obesity. However, the relationship between higher percentile weights in babies seems to greatly increase the risk of childhood obesity. Also there were definite demographic patterns that educational efforts could target to assist those most at risk for childhood obesity.
Image Credit: Wikipedia
Parents we are looking at an epidemic which will change the lives of our children. Pregnant mom's if you are on the fence about your commitment to breastfeeding, we have evidence it will help your child avoid obesity later in life. What are the obstacles you see in breastfeeding today? We'd like to help you overcome those!
Dr Hodge and the Personal Medicine Team
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