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"Hop up on the table, Honey." mThat's how an x-ray technician addressed my 89-year-old mother-in-law in 2001, when we took her for knee x-rays. Mom, who had advanced osteoporosis and arthritis as well as confusion and heart problems, had long since given up hopping. When it became obvious that she needed assistance, the technician grabbed her arm -- as if pulling on another sore appendage would magically raise the rest of her onto the table. It didn't. This incident has become our personal mantra for expressing what is wrong with America's health care system. Having helped our four parents during their final years and having both had cancer ourselves as well as other medical problems, we have had experiences with five nursing homes, two personal care facilities and a half dozen hospitals. We've lost count of the doctors, drugstores and health insurance plans. All of us have had health insurance, though some policies were better than others. Nonetheless, we have experienced incident after incident demonstrating the waste, ignorance and apathy which is rampant in the system. Unable to list them all, I have been heretofore reluctant to write about a handful of them lest the reader be persuaded that the problem is with only that hospital, only that nursing home or only that doctor. There is, however, an increasing crisis of confusion, mismanagement and ill-preparedness which is at the core of our healthcare system. We are all familiar at least with the trend line if not the specifics for healthcare costs. According to WhiteHouse.gov, "The United States spends over $2.2 trillion on health care each year-almost $8,000 per person." That's sixteen percent of the economy. Healthcare costs are projected to increase to almost twenty percent ($4 trillion a year) by 2017. Meanwhile forty-six million Americans are without health insurance (14,000 more each day), premiums and co-pays are rising and more reasons are used to refuse coverage both to those willing to pay and thos

"Hop up on the table, Honey." mThat's how an x-ray technician addressed my 89-year-old mother-in-law in 2001, when we took her for knee x-rays. Mom, who had advanced osteoporosis and arthritis as well as confusion and heart problems, had long since given up hopping. When it became obvious that she needed assistance, the technician grabbed her arm -- as if pulling on another sore appendage would magically raise the rest of her onto the table. It didn't. This incident has become our personal mantra for expressing what is wrong with America's health care system. Having helped our four parents during their final years and having both had cancer ourselves as well as other medical problems, we have had experiences with five nursing homes, two personal care facilities and a half dozen hospitals. We've lost count of the doctors, drugstores and health insurance plans. All of us have had health insurance, though some policies were better than others. Nonetheless, we have experienced incident after incident demonstrating the waste, ignorance and apathy which is rampant in the system. Unable to list them all, I have been heretofore reluctant to write about a handful of them lest the reader be persuaded that the problem is with only that hospital, only that nursing home or only that doctor. There is, however, an increasing crisis of confusion, mismanagement and ill-preparedness which is at the core of our healthcare system. We are all familiar at least with the trend line if not the specifics for healthcare costs. According to WhiteHouse.gov, "The United States spends over $2.2 trillion on health care each year-almost $8,000 per person." That's sixteen percent of the economy. Healthcare costs are projected to increase to almost twenty percent ($4 trillion a year) by 2017. Meanwhile forty-six million Americans are without health insurance (14,000 more each day), premiums and co-pays are rising and more reasons are used to refuse coverage both to those willing to pay and thos

Natural Standard Herbal Pharmacotherapy: An Evidence-Based Approach is now available for purchase. The book provides practical guidance on the use of herbal therapies for medical conditions. This reference tool will be an essential part of herbal pharmacy core curricula for all healthcare disciplines. Chapters are organized by medical condition and present supportive evidence, including potential mechanisms of action and dosing, for selected herbal therapies. The chapters also include integrative therapy plans to help clinicians quickly assess patient needs and create cohesive treatment plans. In addition, adjunct therapies, including herbs, supplements and modalities, that are commonly used in combination with primary treatments are discussed. Case studies, which summarize efficacy, safety, dosing and interactions for high-utilization products, help prepare healthcare providers for patient counseling in clinical practice. Review questions, similar to those on national board exams, allow readers to evaluate their learning and identify areas for further study. The book also includes several appendices, which provide information about lab values as well as the safety, interactions and pharmacokinetics of select herbs.

A $10 billion investment in community health centers, expected to go to $14 billion when Congress completes work on health care reform legislation, was included in a final series of changes to the Senate bill unveiled today. The provision, which would provide primary care for 25 million more Americans, was requested by Sen. Bernie Sanders (I-Vt.).

Raasch B. Clinical, Cosmetic and Investigational Dermatology. 9 June 2009.  There is reasonable evidence that the use of imiquimod for small (<2 cm) superficial BCC that occur other than on the face provides  outcomes only marginally less satisfactory t

There is reasonable evidence that the use of imiquimod for small (<2 cm) superficial BCC that occur other than on the face provides outcomes only marginally less satisfactory than surgery. There would be a place for imiquimod in treating patients with frequent multiple primary lesions when access to surgery is difficult or where clinical judgment may be influenced by patient factors as reported in some of the studies, eg, where patients may have contraindications to surgery.  It was noted that if recurrences occurred in this study they mostly occurred during the first 9 months after the end of treatment. The initial response was therefore predictive of long-term outcome so these authors recommend and encourage continued monitoring of skin lesions.

Providers, payers, and patients - do what is in their best interest without concern for cost or effectiveness. This focus is appealing in the short run but leads to a destructive endgame.

Americans conduct their own online medical information research--many as a short-term replacement for visits to providers. Is this a sign of the new peer-to-peer, participatory healthcare?

Can health care organizations and physicians be incented to deliver the highest quality, safest, most reliable, most patient-centric care at the lowest possible cost without Atul Gawande reading the findings of the Dartmouth Atlas into the Congressional Record? I think they can, if they have a strong hospitalist program.

Mice fed fish oil and curcumin showed a significantly reduced tumor volume, 25% (P < 0.04) and 43% (P < 0.005), respectively, and importantly, a combination of curcumin and fish oil diet showed > 72% (P < 0.0001) tumor volume reduction. Expression and activity of iNOS, COX-2, and 5-LOX are downregulated, and p21 is upregulated in tumor xenograft fed curcumin combined with fish oil diet when compared to individual diets. The preceding results evidence for the first time that curcumin combined with omega-3 fatty acids provide synergistic pancreatic tumor inhibitory properties. \n\nPrevention and treatment of pancreatic cancer by curcumin in combination with omega-3 fatty acids.\nSwamy MV, Citineni B, Patlolla JM, Mohammed A, Zhang Y, Rao CV. \nNutr Cancer. 2008;60 Suppl 1:81-9. \nPMID: 19003584

Study provides the first evidence of a direct relationship between the depression of protein synthesis in skeletal muscle by PIF and Ang II, through activation of PKR, and eIF2{alpha} phosphorylation, and the enhanced degradation of the myofibrillar protein myosin, through activation of NF-{kappa}B resulting in an increased expression and activity of the ubiquitin-proteasome proteolytic pathway. This suggests that agents that target PKR may be effective in the treatment of muscle atrophy in cancer cachexia or other wasting conditions.

The AARP just met with the leadership of the Mayo Clinic, one of the most outstanding medical institutions in the country. They provide excellent care at a cost that is less than most other parts of the healthcare system - and with improved outcomes. We asked them about their secret to success.\n\nMayo has an electronic medical record and all their patients have their information online. The physicians are on salary, so there's no incentive to order unnecessary tests or procedures, and Mayo has an ethic of patient-centered care, with a long history of attracting the best people and rewarding them.\n\nIf Mayo can do it, why can't everyone else? The AARP believes that the potential is there for most communities to have excellent care - we must emulate the care delivery of institutions like the Mayo Clinic, and put in place payment and information systems that will coordinate care management better. It's a big job and will take some investment, but we have many opportunities to do a better job than we're doing today.

Every time you need to use health care in today's world, a gauntlet of obstacles stands between you and the service. Not much different than visiting Dr. Hippocrates, way back when...

A medical village expands on the concept of a patient's medical home to include providers outside of the "home" practice (hospitals, specialists, etc.). The medical village will rely on several important concepts, including collaborative and coordinated care and shared responsibility: PCP-to-specialist, specialist-to-PCP and specialist-to-specialist.

Government portal for the CDC. Provides medical and health care information, research, policies, reports, agencies, experts, tools, resources, contacts, and news.

For medical professionals, health care providers, industry leaders, medical students, professional and non-professional researchers, academic and medical librarians, patients, healthcare consumers, and physicians looking for CMEs and conference recaps.

Reference portal largely directed at medical professionals and health care providers, this site has articles, clinical guidelines, workups, drug databases, algorithms, CMEs, and other educational tools and resources.

Professional medical journals that provide full text articles or entirely open access to non-subscribers.

A portal directed at consumers of medicine and health care, this website also has CMEs, references, and databases that any health care provider or medical professional would find useful.

Access research studies, publications, conference proceedings, reference materials, databases, tools, and other resources of interest to medical researchers, health care providers, patients, consumers, citizens, and policymakers.