Wednesday, November 1, 2017

The Importance of Physician Leadership

The goal of many healthcare providers is the Triple Aim-better care at a lower cost with a focus on a positive patient experience. Providers with these goals need strong physician leaders to help them reach the goals. More provider organizations are beginning to recognize the importance of physician leadership to be successful.

The American Medical Association states in its whitepaper Integrated Leadership for Hospitals and Health Systems: Principals for Success that healthcare administrators must work with physician leaders to reach their goals. A relationship based upon mutual trust between physicians, clinical staff and administrators is vital to deliver care that focuses on the patient. To quote the article: "It is possible that integrated leadership would benefit patients by focusing on developing new channels for patient engagement, and delivering care in a manner that eliminates overuse, underuse and misuse of resources while increasing physician professional satisfaction, building trust relationships and financial stability for both physicians and hospitals."

It is a principal of lean healthcare and lean manufacturing that the best measurable outcomes occur when those closest to the patients or clients provide input into the process of care or manufacturing. It is sensible, then, that physicians, who along with other clinical staff are closest to patients, can provide significant insights into the best processes to deliver care that is effective while preventing waste and duplication, thus saving costs. Integrating physicians into leadership positions ensures that such insights are incorporated into care processes.

Recently I was discussing physician leadership with my own primary care physician, Dr. Daniel Harro of Mercy Health Physicians Partners. He said that it has been important to him and his fellow physicians that they are represented by Dr. David Blair as president and chief medical officer of Mercy Health Physician Partners. They find it important that he still meets patients weekly. Dr. Blair has helped this group navigate from being a group of independent physicians to a partnership with Trinity Health of Livonia, Michigan. He has also guided the primary care physicians into becoming accredited as patient-centered medical homes with many of the offices achieving level 3 designation.

In December, 2016, the Harvard Business Review in an article titled Why the Best Hospitals Are Managed by Doctors noted that the best quality hospitals are led by physicians. According to U.S. News and World Report the best hospital is Mayo Clinic. It is run by highly skilled physician John Noseworthy. The second highest ranking hospital, Cleveland Clinic, is run by physician Delos "Toby" Cosgrove. The article states further that of the top 100 hospitals in the U.S. the ones that are led by physicians have a 25% higher quality score than those that are not.

The Medical Group Management Association emphasizes the importance of physician leadership too. In a survey of its members it found that about 60% of those responding stated that they use a dyad management style at their sites. The leaders are a practice manager and a physician. Because each share responsibility for the success of the group, it is extremely important that the two integrate effectively to provide leadership and direction to the sites, most of which are ambulatory. MGMA suggests that the two leaders first consider how their leadership styles complement each other and where they might conflict. In doing so, they should strive to present a united front to staff. As Stephen Covey states in The 7 Habits of Highly Effective People the two leaders should Think Win-Win when considering what direction to lead the staff of the practice. MGMA recommends that the two leaders focus on several skills in order to be successful:

· Have a vision and stick to it. As Stephen Covey says, Begin with the End in Mind

· View change as an opportunity. Change seems to be accelerating presently and leaders must be nimble in adapting to responding to changes thrust upon the practice and should also explore what changes can improve the outcomes for the practice.

· Understand risks. Leaders should be able to assess the risks facing the practice and should lead the practice in overcoming risks and profiting from the risks.

· Unify the staff. Be sure that each staff member understands the importance and responsibilities of their roles in the practice. The leaders should develop teamwork among the staff.

· See the practice as a business. In order to provide the best care at a lower price the leaders need to see that the practice is run as an efficient business. The healthcare business model is unique and complex.

Physicians as leaders must see the whole structure of the organization that provides the care. At an ambulatory site, for instance, the physician leader must see beyond the clinicians providing direct care to patients. They must also understand the processes of the front office-the receptionist and sign-in personnel-the billing and collection staff, the administrative leaders and other staff that are important in providing services that support the clinicians and the business structure of the organization. While understanding and being involved in the processes outside of clinical care, the physician leader also needs to assert that the physician staff be able to provide effective care to patients without interference from administration. That is, the physicians need to feel free to provide clinical care that is patient-centered and conforms to best medical practice using the unique skills of each physician. Physician leaders need to build trust among administrative leaders that the clinical staff is providing patient-centered care.

Wednesday, October 4, 2017

How Hypnosis Could Drastically Cut the Costs of Canada's Medicare

What if there was a simple, effective way to drastically reduce the costs of Canada's Medicare program? There is. It's called hypnosis.

Hypnosis could:

Lower the number of patients
Shorten hospital stays
Reduce the amount of prescribed medications

Hypnosis, or more precisely, hypnotherapy, is an ideal complement to medical care. Here are some of the ways in which it could drastically reduce visits to family doctors, emergency rooms and hospitals:

Stop smoking
Lose weight
Reduce anxiety (including panic attacks)
Compliance with prescribed meds
Reduce stress (and therefore heart attacks etc)
Encourage exercise
Change eating habits
End phobias of needles and MRIs

For example, a study conducted at Mount Sinai School of Medicine in New York found that when women participated in a hypnosis session before breast surgery, they experienced less nausea and required less pain medication than the control group. Patients in the hypnosis group also cost the hospital $772 less.

Potency

What a doctor or nurse says to her patients carries a powerful impact. When medical professionals learn how to talk in a positively hypnotic manner to patients:

Conversations will be quicker, thus saving the health care people time.
Patients will better absorb information about their prognosis.
Pre-operation hypnotic explanations will reduce patients' anxiety.
Patient anxiety and blood pressure will be significantly reduced.
Patients will be more compliant.
Nurses and doctors will be less stressed, and
Most of all, patients will recover faster.

Hypnotic Self-help for Patients and Staff

Patients who are taught simple self-help hypnotic techniques will have less need for medical aid and hospitalizations.

Similarly, doctors and nurses who use hypnosis to relax themselves, to handle stress on the job, to deal with difficult patients and colleagues, will be more efficient. Thus time will be saved, less overtime required and staff will enjoy their work more.

How To Implement This Safe, Simple Solution

Twenty-two years ago while I was recovering from an 8-bypass operation I listened to a hypnotic recording created by a colleague. The Head Nurse told my wife "I don't know what he's listening to, but everyone should have one." Sadly, the Head Nurse never followed up.

But now, as the health care crisis heats up in Canada and we can look forward to either the collapse of a Medicare overburdened with elderly people, or increases in taxes on an already heavily-taxed population, surely the time has come to apply the safe process of hypnotherapy to the sick vehicle of social medicine.

An easy way to train doctors, nurses and the public at large in the easy-to-learn hypnotic techniques that could revolutionise health care in Canada would be to ask hypnotherapists across this great country to put on free workshops in hospitals and clinics.

A second tactic would be to teach high school students (the medical professionals and patients of the future) the benefits of lowering their own stress levels and building healthy habits with self-hypnosis.

The Internet is awash with hypnotic MP3s, DVDs, eBooks and CDs, many of them free. This is the 21st century way for patients and health care providers to enjoy self-hypnosis -- and therefore better physical and mental health.

All it would take for students, nurses and doctors is one hour to acquire hypnotic self-help techniques that would last a lifetime.

Monday, September 18, 2017

10 Life Hacks for Seniors Which May Prevent Insomnia

1. Make Changes in the Bedroom
Family caregivers should make sure their loved one`s bedroom is the most comfortable place for them. Your loved one`s sleeping area should be comforting and all the outside lights should be blocked by using curtains which may not cause sleep disruption.

2. Don`t Consume Heavy Meals
Eating heavy meals and high fat foods may leads to a distressful sleep in some seniors. Your loved ones can choose whole grain foods, smoothies, and drink more water which may provide a comforting sound sleep.

3. Avoid Electronic Device around the Bed
Seniors may have a hard time sleeping if they have a TV or laptops in their bedroom. These electronic devices may distract your loved one`s sleep and may change their sleeping patterns. These devices may also enhance stress level of your loved ones.

4. Create a Routine before Going to Bed
To enhance melatonin which is a sleep inducing hormone, your loved ones may create soothing changes every night before going to bed. Yoga may help some seniors in getting their body and mind relaxed. Family caregivers can also suggest their loved ones to have a warm shower which may boost a comforting sleep.

5. Avoid Stimulants if Not Necessary
Caffeine, alcohol, energy drinks and high sugar foods are some of the stimulants which may cause insomnia in some seniors. Drinking coffee or black tea may prevent your loved ones from having a good night sleep. If your loved one has a habit of drinking tea everyday then he or she can consume it 6 hours before going to bed. In this way their habit may not cause sleep disruption.

6. Reduce Stress
Minimize the things which may cause stress and anxiety in your loved one`s life. Family caregivers should not put things in their loved one`s bedroom which are work reminders or sleep distracters. Stress and depression may also cause insomnia in some seniors and may make it difficult for them to sleep longer.

7. Consult a Doctor
One of the best ways to decrease insomnia in seniors is to consult a doctor. In this way your loved ones can receive an expert`s advice on treating insomnia and may reduce the stuff that is enhancing it. The doctor may go through your loved one`s medications and can provide a tailored routine and lifestyle changes for them to follow to decrease insomnia.

8. Limit Sleeping During Daytime
Senior adults who may face difficulties in sleeping at the night can limit their afternoon sleep. This may help them in feeling sleepier during the night. Your loved ones can avoid daytime sleep entirely which may make them more likely to sleep longer at night.

9. Exercise
To reduce insomnia in seniors, exercise may help in regulating their sleeping patterns. Your loved ones can start aerobic exercises such as running, cycling, and doing sports which may assist them in decreasing insomnia.

10. Adapt Ways to Slow Down Brain Activity
Your loved ones can avoid mind stimulating things like TV, computer, work load pressure, and stress to ensure good sleep and to tackle insomnia. Seniors can perform calming activities before going to bed which may help in turning off their brain.

Medicaid Targets Physicians Offering Low Cost Options for Patients

The medical practice I began using in 2010 set up a discount plan to provide better care for patients and to help them save money, especially those customers without insurance. I pay a fixed monthly fee to be a member. That membership allows me to go in for any service offered, including yearly physical examinations, mammograms, pap tests, immunizations, blood tests, X-rays, casts for broken limbs, even minor surgery, for less than $30 a visit. The practice hired extra medical professionals, such as a psychologist and a physical therapist, to meet a wide variety of needs. They also provide extended hours.

As the saying goes, however, "No good deed goes unpunished." Two days ago, the state made sudden rule changes affecting Medicaid patients who are not participants of the discount membership at their practice or any others with similar affordable plans. Medicaid allegedly claims these clinics are offering health insurance.

As a result, the state refuses to reimburse such clinics for many medical services rendered to their Medicaid patients, even long-established ones. Need immunizations? Go to the health department. Blood work? Go elsewhere for a draw. Sick after hours? Go to one of the few Medicaid-approved clinics or the ED (Emergency Department). This is a special hardship for sick, elderly, or disabled patients who must go to different locations for tests offered on site by their chosen physicians.

My current health provider offers the best care I remember receiving in my many adult years. The practice tries to help patients falling between the cracks of our increasingly inefficient health care system. These individuals don't have employer-based coverage and can't possibly pay the ACA's high premiums and deductibles.

Yet the government allegedly targets these clinics with innovative plans to meet customer needs, including those of their Medicaid patients. Is it any wonder that many more physicians and facilities are refusing Medicaid patients?

Why punish low-income patients eligible for Medicaid coverage and the shrinking numbers of caring, competent providers still willing to accept them as patients? Why shouldn't individuals be allowed to purchase discount plans? The clinic memberships and co-pays are drastically less expensive than the skyrocketing deductibles of coverage they can't otherwise afford.

I want to do just that - buy into Medicaid for catastrophic care, and keep my doctor (remember that promise?) and clinic discount plan. I would only use Medicaid for any needed surgeries, hospital stays, or dental and vision care exceeding cost limits. Why shouldn't patients be allowed to make such decisions? Is it because they make common sense?

Across the state, Colorado physicians and clinics have designed flexible, affordable discount plans for low-income patients. Many of those same practices want to continue serving those with Medicaid coverage. The state's inexplicable overreach will not only penalize those patients and providers. It will drive more qualified physicians and clinics from accepting Medicaid customers at all.

Wednesday, August 9, 2017

Top 7 Proven Home Remedies for Leucorrhea Treatment

Excessive vaginal discharge, foul smell, spotting on underwear - yes we are talking about the leucorrhea. Leucorrhea is one in most filthy female vaginal infections. This condition is enough to make the women feel peeved and uncomfortable. It is awful but these days it has become a common problem among the females. To manage this vaginal infection, leucorrhea natural treatment is fruitful.

It is scientifically proven that to treat the leucorrhea naturally, use of home remedies is quite effective.

Why does leucorrhea haunt the females?

Female's genital parts are moist and covered most of the times that's why females are highly prone to this infection.

Possible causes of leucorrhea

Poor genital hygiene
Hormonal imbalances
Improper lifestyle
Unhealthy eating habits
Bacterial and fungal infections
Genital wounds due to excessive itching
Diseases like menorrhagia and diabetes
Indigestion
Constipation
Anemia
Stress and anxiety
Here we are listing the Top 7 Proven home remedies for Leucorrhea Treatment

Banana

Bananas are considered as an effective home remedy to treat leucorrhoea naturally. Being disinfected in action Banana helps to extrude the harmful microorganism from a vagina.

Directions to use

One can consume one to two overripe bananas daily.
Repeat it until you observe the noticeable change.
Ladyfinger (Okra)

Ladyfinger also comes in the category of effective home remedies for leucorrhoea. Mucilaginous nature of ladyfinger helps in the elimination of mucus from a body. In leucorrhea, it works well to reduce the vaginal discharge.

How to use

Take ladyfingers, wash them and cut into small pieces.
Boil these pieces 15-20 minutes in the water until water is reduced to half.
Allow cooling and strain it.
Add some honey and consume 2-3 times in a day.
Pomegranate

Therapeutic properties of this fruit help to ward off the vaginal infections. Fruit, its leaves, and rind are very helpful to treat the leucorrhea. Hence, it is an effective home remedy to treat leucorrhoea naturally.

How to use

Consume one glass of fresh pomegranate juice daily for one month.
Grind 25-30 fresh pomegranate leaves with 8- 10 black pepper.
Add this mixture in half glass of water.
Strain and drink it two times every day until you observe a noticeable change.
Another option makes powder of dried rind of a pomegranate.
Make the powder of dry the rind of pomegranate.
Mix 1/2 to one tablespoon of this powder in 3-4 cups of water.
Use this solution as a vaginal spray.
Fenugreek Seeds

Fenugreek seeds are loaded with the immunity booster properties. In leucorrhea, this helps to balance the pH level and micro flora in a vagina.

Directions to use

Take two- three teaspoons of fenugreek seeds in 3-4 cups of water and boil for 25-30 minutes.
Strain and let it cool.
One can use this water as a vaginal wash many times daily until the symptoms get lessen.
Indian Gooseberry (Amla)

Being a good source of vitamin c, it helps to boost up the immune system. Moreover, Amla is loaded with the antimicrobial properties that help to ward off vaginal infections.

How to use

Make a thick paste by mixing one - two teaspoons of Indian gooseberry powder with honey. Consume it two times in a day.
Another option is to boil one teaspoon of dried Indian gooseberry root powder in one cup of water until it reduced to half. One can add little sugar or honey as per taste. Eat it on an empty stomach every morning.
Cranberry

Cranberries packed with the antimicrobial, antifungal and antioxidant properties. These properties help to fight against the bacterial, viral and fungal infections. In leucorrhea, cranberry helps to eliminate the bacteria from vaginal wall.

How to use

Drink one glass of fresh cranberry juice once or twice for best results.
Fig

To manage the leucorrhea, consumption of figs is very good. Laxative action of figs helps to eliminate the toxins and waste materials from the body. They work in an amazing way to resolve the problem of excess white vaginal discharge.

How to use

Soak 5-6 figs in overnight in one cup of water. Next step in morning is to blend the soaked figs in water. Consume this solution on an empty stomach.
Alternatively, you can grind the equal quantities of the bark of the fig tree and banyan tree to make a fine powder. Add half -one tablespoon of this powder in two-three cups of water. Use this solution as a vaginal wash.
Additional tips

Maintain the proper hygiene.
Wash your undergarments daily and let them dry under the sun.
Don't wear dirty, tight or synthetic undergarments
Change undergarments at least 3-4 times daily.
Wash the vaginal area and surrounding area.
Wipe from front to back after using the toilet.
Avoid oily foods.
Avoid coffee, alcohol and aerated drinks.
Dr. Vikram Chauhan (MD - Ayurveda) Is an expert herbal practitioner based in Chandigarh and participating in Mohali, India. He is spreading the knowledge of ancient healing treatment of Ayurveda not only in India but also abroad. He has researched age old formulas from ancient Ayurvedic text books to restore health and save human beings from the worst side-effects of chemical based treatments. He is the author of 'Ayurveda- God's Manual For Healing', an informative book for people interested in learning the basics of Ayurveda, diet and principles of healing according to Ayurveda.

Guide To Finding The Best Hospital

When you get sick, you want the best healthcare. To help you out, here are some of the factors you should consider when choosing a hospital:

Nature of the facility

How does the facility look like? As rule of thumb, it should be equipped with all the necessary equipment. It also should have fully functional laboratories. The hospital will be better off if it has laboratories that cater for a particular condition. For example, if should have an ear laboratory, abdominal laboratory and so on. Some of the must have facilities include: CT scan, dialysis, and cardiac catheterization lab.

You also should consider the quality standards of the hospital. For peace of mind that the facility provides you with the best care, ensure that it meets the quality standards. If you are looking for a hospital for a loved one, ask for brochures that show the facility's credentials.

The other thing you need to consider is the reputation of the hospital. The cool thing is that you can tell this by simply reading the online reviews of the institution. If there are many negative reviews, avoid the hospital.

Patient infections are common in hospitals. To avoid the infections, you need to ensure that the hospital you are looking to go is clean.

It's common for patients suffering from complex conditions to be admitted. To make sure that you get the best care, take a look at the nature of the wards. Are they clean? Is there enough food? How many people sleep on the same bed at the same time?

Quality of the doctors

The quality of the doctors is critical for your well-being. The last thing you want is to work with an unqualified doctor. You should research the qualifications of the doctors before you attend the facility. The cool thing is that you can easily tell the skills of the doctors by simply reading the information given on the hospital website.

In addition to the qualifications, also consider the ratio of the physicians to patients. While the doctors might be qualified, they won't give you a great service if there are many patients to attend to. In addition to the doctor being overworked thus tired, he/she might not have enough time to work with you. To get excellent and personalized care, join an institution with enough doctors.

Ease of access

This comes in handy when the patient is too sick. A hospital that is easy to access also makes it easy for patient visits. Although, not mandatory, you will be better off working with a hospital that is close to the main road.

Cost

How much does the hospital cost? This is crucial. While quality service always comes at a cost, you don't have to spend a lot of money all the time. There are many good quality hospitals that charge less. All you need to do is to do enough research to identify them.

Conclusion

These are some of the factors you should consider when choosing a hospital for yourself or a loved one. For a great service, work with a reputable health facility.

Thursday, July 6, 2017

Important Factors You Cannot Forget When Buying An Essential Oil Diffuser

Essential oils have gained so much popularity because of their numerous benefits. They are largely used for aromatherapy and this kind of therapy is no longer limited to spas, but has found its way into homes. Most people love the calming effects of essential oils and use them not only to control moods, but to also enjoy restful peaceful nights.

A diffuser is used to release the selected essential oil or oils in just the right amounts and intervals depending on the preferences of the user. With the increased popularity of the oils, different kinds of diffusers have been created. It can be confusing if you are not very familiar with the diffusers, but using a few helpful factors it becomes easy to select the best.

Diffuser type

The mode of operation is what determines the type of diffuser. Generally there are ultrasonic diffusers which create ultrasonic vibrations that break down essential oil particles released into the air; nebulizing diffusers which work by blowing air on the surface of the oil creating fine spray or mist. There are also heat diffusers which heat the oils leading to their dispersal and evaporation at rapid rates and evaporative diffusers that blow air on pad saturated with the essential oils. Look at each of the options and the advantages of each to make an informed decision in the end. It is also important to remember that some of the diffusers work silently whereas some may produce noise as they operate.

Area coverage

Diffusers are not as large and hence finding the right spot for them in your home should not be that hard to do. However, it is important to consider how much of the space in the room they will be able to diffuse and circulate the essential oils to. A diffuser that covers a considerable amount of space is better than getting multiple devices to cater to your needs. Know the exact needs you have as far as coverage goes and you will be able to select the device that suits your space best.

Cost

When it comes to cost, the type of diffuser, the brand and the size may determine the prices attached. The design of the diffuser can also determine the amount you pay for it. It helps to do a comparison between the best essential oil diffusers so you are able to choose one that falls within your budget and one that is also bound to serve all your needs effectively.

Quality

Aromatherapy is something you may want to enjoy for a long time to come and this means that you need to settle for a high quality diffuser. Look at the materials used in making the diffuser so you can choose a durable piece. It may not be very advisable to go for very fragile materials considering you are prone to knocking it over, especially if you love it on your bedside stool. Think long term when weighing between best oil diffuser options.

Essential oil diffuser reviews can be helpful in getting you the best one for your home. Consider all options when looking for the best aromatherapy diffuser including the mode of operation and it will be easy to settle for a good device.

Tuesday, July 4, 2017

Analytics and Value Based Care

In order to move further towards value based care it is necessary for organizations to make more use of data analytics. In order to improve outcomes for patients at a lower cost with higher patient satisfaction, it is necessary to collect data and analyze it. There are many ways to do this and I will point out a few, including some that I use.

Healthcare is awash in data. There is data from billing, including diagnostic and procedure codes. There is claims based data from payers. There is much more detailed data in EHR's, such as test results. This data is clinical data. Financial data is also important. Much of this data can be found in financial software such as QuickBooks and patient management software.

To make effective use of this data it is necessary to organize it, graph it, and investigate for significant changes. Each of these requires the use of statistics, either at an elementary level for spotting trends or at an advanced level to see if there are real and significant changes that indicate that the provider is moving towards providing better care at a lower cost. The examination and analysis of data gathered from patients and grouped by patient characteristics is termed population level health management.

One approach to using analytics to improve patient health is examine and track key indicators for patients with chronic diseases, usually the patients that incur the greatest cost in a practice. For instance, a practice can collect and analyze the A1c levels of all patients diagnosed with diabetes. This data can be collected each month and a mean and standard deviation determined. A month by month graph using an Excel spreadsheet will help visually indicate any trends that are occurring. If over a period of several months there is an upward trend, action can be taken to disrupt the trend. This could be making use of a nurse coordinator to help patients better manage their diabetes. One could use Control Charts from engineering statistics to better analyze whether trends are real or due to random fluctuations which are normal in any data collection over a time period. One could also use statistical t-tests to determine whether the changes are truly significant or not.

It can be very useful to graph data collected such as A1c levels, plotting the means over time as indicated above, and present them in a Dashboard with brief descriptions and analysis. These dashboards can be shared in a practice in order to drive improvement. This can be very effective in making improvements with a care team. I recently listened to a NPR podcast from 'The Hidden Brain' that described how a hospital in Pittsburgh improved its handwashing by care givers before entering patient rooms. The rate hovered around 10% for a long time in spite of repeated education of care givers. Then, the hospital started displaying monthly statistics of handwashing in a dashboard that all could access and see. Management focused care givers attention on the dashboards. Handwashing rates quickly improved to 90% and stayed there. The visuals made a significant impact on awareness of handwashing by providers.

Analytics can also be used to make improvements in patient satisfaction scores. The Medical Group Management Association (MGMA) provides a very good patient satisfaction survey for its members. I have adapted it to different providers depending upon their demands. The survey covers 36 basic questions and ends with "Would you recommend the provider to other?", a very good ending question. I also add demographic questions. Providers can use the survey with patients and track performance in five areas-making the appointment, quality of front office staff and billing, ease of communication, visit with clinicians, and state of facilities. The goal is to have as a high as possible composite score for each of these areas. With advanced analysis more can be found out to improve satisfaction. It is possible to identify which of the questions have the most impact on the last question. It has been found that patients who are most likely to refer a practice to friends and family are usually the most satisfied. Thus, finding out which of the many questions have the most impact on this can help identify which areas need improvement. Analysis of which questions have the greatest impact should be carried out on a regular basis as the ones that have the greatest impact can change over time.

Of course, a dashboard should be created to report to staff the results of the surveys each month or so. This will help incentivize the staff to perform even better. If management likes it may break down the results by staffing area or by provider to help identify where individuals may improve. Individual coaching can then be used to help staff make improvements. Never should the dashboards be used to berate staff though. Whether individual dashboards are shared with other staff depends upon how well the staff functions as a team, how mutually supportive they are.

The MGMA collects a lot of data from its members through surveys. It then provides data for benchmarking to its members, some for free and some for costs. Providers who participate in their surveys can often get the results for free. In a recent article in its monthly publication Connection it provided a dashboard of data on the most profitable independent practices. It found, contrary to common sense, that those organizations with the highest median costs per FTE physician also were the most profitable. Some of the data in the dashboard follows:

· Median total medical revenue per FTE physician = $1,169,542

· Median total operating cost per FTE physician = $630,680

· Median total physician compensation and benefit = $462,722

· Median total support staff per FTE physician = 5.12

The article, Designing the practice of the future, found in the March 2017 issue of the magazine, also provided the benchmark data for all multispecialty practices. This data along with other data in the article and the article analysis can help providers develop long term strategies to improve the profitability of their practice.

As you can see there are many ways to use data and data analysis to improve the outcomes at your care site. It is important to identify which data to collect and analyze to make the most significant impact. As I said care providers are awash in data and trying to analyze it all would be a waste of time and energy. Those just beginning to use advanced analytics should start off with a few data projects and expand as time goes on. Intelligently using data and analysis can make a significant impact on the care that you provide and on your bottom line.

Thursday, June 15, 2017

Acidity - Home Remedies

If you are suffering from acidity, then you can try some home based remedies to obtain instant relief from it. Therefore, below we are mentioning some home based remedies to cure acidity problems.

Following are the Home Remedies for Acidity:

Consume water:

Water is considered as a natural remedy, and consume a minimum two glasses of water in the early morning on a regular basis. This will be useful to maintain the acids level in the stomach.

White Vinegar:

Whenever you consume meals then add white vinegar, which is useful to lessen the acidity and also useful for the better digestion of food. It is suggested to take 2 spoonfuls of white vinegar with your meals.

Jaggery:

Consume jaggery in appropriate quantity is one of the most effective home based remedies to cure acidity. It really works out if you consume a small quantity of this product i.e. near about 10 grams along with your meals.

Holy Basil:

Holy basil is regarded as an effective way to treat the acidity problem. The persons who are suffering from that, it is advised to consume holy basil leaves on a regular basis.

Milk:

Another remedy to cure acidity is milk, which is a popular way to treat acidity problem. You can also consume other dairy commodities so as to keep it away the problem. It is recommended to consume the milk after your meal.

Ginger:

Ginger is a natural remedy to obtain relief from acidity. Actually, it is advised to add flavor of ginger to each and every food product to stay away your body from acidity problem.

Mint Leaves:

Mint leaves, which is an ideal thing to chew with boiled water to keep acidity at bay. Additionally, mint juice is also great thing to obtain a relief from acidity.

Anise Seeds:

Anise seeds along with boiled water are the best way to cure or treat the acidity. Afterwards, allow the mixture to leave it for some time and then add a spoonful of honey to increase its effectiveness in curing the problem.

Juice of Ginger:

A juice of ginger mixed with roasted cumin seeds and rock salt can be considered as the best choice to treat the acidity.

Coconut Water:

Coconut water and aerated drinks are keenly useful in targeting acidity and reviving the normal secretion of stomach acids.

Aloe Vera:

Aloe plant can also be regarded as the best home based remedy to cure the acidity, according to the experts.

Pineapples and oranges:

By adding salt in pineapple and orange juices is also an effective way to obtain relief from acidity.

Tuesday, May 23, 2017

9 Months in, Stem Cell Therapy for Spinal Cord Injury Continues to Improve Paralyzed Patient's Life

Asterias Biotherapeutics is a biotechnology company, which is dedicated to regenerative medicine. Recently they have launched a new medicine AST-OPC1 that offers embryonic stem cell based treatment for patients with spinal cord injuries. The medicine was under trail for a while and now it has been declared completely safe and highly effective for patients with spinal cord diseases.

The trial involved injecting the medicine into the affected area and patients showed improvement in their upper body function within 3 to 6 months after the therapy. Asterias Biotherapeutics conducted a press release in June, 2017, in which they have clearly stated the effectiveness of the medicine. It also recorded the detailed results after 9 months of the trial.

It was conducted on 6 patients. Each one of them received an injection of 10 million AST-OPC1 cells after 2 to 4 weeks of their injury. After 9 months, it had been noticed that all the patients showed improvements in their finger, arm, and hand movements.

Spinal cord injuries affect more than 17,000 people around the world every year. With the announcement of AST-OPC1, certainly they now have hope to restore their upper body movements. Dr. Edward Wirth, Chief Medical Officer of the trial said, "The new efficacy results show that previously reported meaningful improvements in arm, hand and finger function in the 10 million cell cohort treated with AST-OPC1 cells have been maintained and in some patients have been further enhanced even 9 months following dosing."

Coming back to the trial, it involved patients who were suffering from severe spinal cord injuries in the neck that resulted into lack of feeling and loss of neck down upper body movement. The team at the Asterias Biotherapeutics quantified the results of the therapy by referring them as "motor levels" of improvements. These motor levels were associated with different levels of movement abilities. In the press release, the team confirmed that restoring the movement abilities, "can result in lower healthcare costs, significant improvements in quality of life, increased ability to engage in activities of daily living, and increased independence."

After 9 months of clinical trial, the researchers at the Asterias confirmed that 50% of the patients (3 out of 10 patients) showed two motor levels of improvement. And all the 6 patients involved in the trail, showed at least one motor level of improvement. However, some of the experts might say that recovery from spinal cord injuries is possible without stem cell therapy. This is true. But no other study or therapy showed patients regaining their two motor levels of improvement within 9 months of the treatment.

Earlier data from 62 untreated patients showed that 29% patients got back two motor levels of improvement with 1 year whereas AST-OPC1 promises massive improvements within 9 months. Dr. Edward Wirth also confirmed it when he said, "We are increasingly encouraged by these continued positive results, which are remarkable compared with spontaneous recovery rates observed in a closely matched untreated patient population."

Two motor levels is equivalent to higher quality life. For any person suffering from spinal cord injuries or upper body paralysis, achieving two motor levels is a dream and with AST-OPC1 it does not seem a distant dream at all.

Tuesday, May 2, 2017

What Americans Should Know About the Canadian Medical System

I'm not sure if the Canadian medical system is as perfect as some Americans might believe. As an example, we have one hospital in our city with 36,000 people. This facility services surrounding areas with a total of approximately 100,000 people. The federal and provincial governments have drastically reduced funding for hospitals. Here is what happens when you go to the emergency here...

One enters the building and takes a ticket waiting for triage nurse to assess, then your sent to a registration area to check in. If you're sick or wounded but not life threatening a 4-10-hour wait is normal. Once ten or eleven P.M. comes around there is one doctor to take care of everyone. If an ambulance comes in then you just wait longer. If there is a serious injury our hospital is not equipped to handle the emergency, a helicopter comes to air lift people to anther facility. This is unfortunate because they are not saving lives, but stabilizing while waiting to air lift them. If it is a car accident or serious injury the police are involved, ambulance drivers, maybe even child protective services. The problem is this one Doctor is stuck doing paperwork while so many other people need attention. The question is what happens when there are multiple people in an accident with life threatening situations? There is only one physician there, and now according to what I hear they are making them do 16 hour shifts. This hospital invested millions of dollars in updating the building to look modern, but cutting back on doctors.

Anyways, once you are called in your put in a room where the wait can be hours before the doctor actual comes in to see you. Again, if an ambulance happens to arrive at that moment understandably you are there in the room for a very long time. Nobody goes to the hospital as an outing, they are there for medical attention, and if you're sick or wounded it is grueling. This is indirectly mental torture, and there are signs if you become aggressive or rude they can refuse service. Wait your ten hours suck it up butter cup. When the doctor finally arrives if you need x-rays or blood work that takes time, and many instances even longer to get results.

The advantage of our medical system is you don't pay for the service, each citizen has a medical card that covers all this care through our outrageous taxation? To add insult to injury many communities must raise money to get the proper medical equipment for their hospitals. I don't blame the doctors or nurses but our governments not funding hospitals properly. Maybe it's me, but we keep bringing in people from other countries, supporting them when we can't even provide swift or at times proper medical service to our own citizens.

I understand that so many people are complaining in the states about the costs of medical insurance. The Canadian system has many flaws as well, where people have died in the emergency rooms waiting for help. I believe if you're Canadian or American there needs to be a solution were every citizen receives the care needed.

Friday, April 14, 2017

Does Your Heart Stop When You Sneeze: What's the Truth?

You already know how it feels to sneezing - you sense that threatening tickle in the back of your nose first followed by the gasping intake of breathing and a cathartic blast in the end. Anything that irritates your nasal passages could allow you to sneeze. Discomfort in your nasal passages signals the brain, and then your body responds by managing the muscle tissue in your nasal passages to expel air powerfully. There are several myths and interesting facts associated with sneezing. Some people say sneezing makes your heart stop. Is it true?

Does Your Heart stop when you sneeze?

The simple reality is no! Sneezing does not make your heart stop. There is an increase in the intrathoracic pressure when you sneezing. When this happens, the blood circulation to your heart is decreased. This consequently creates your heart modify its regular heartbeat for a short time to adjust. What it means is that your heart does not stop when you sneezing, and actually, there is a change in the rhythm of your heartbeat, which may make you feel that your heart has skipped a beat. Does your heart stop when you sneeze? Now you know the response.

A sneezing is an involuntary nasal reaction caused by irritation to the mucous membranes. There are many traditional beliefs about sneezing, such as the notion that the heart stops beating momentarily during a sneeze, essentially "killing" you for an instant, which is why it's common for someone to "bless you" after a sneezing. The truth, though, is a little different.

Just before sneezing, a lot of people relax slowly. This improves pressure in the chest and briefly inhibits the blood flow to the heart, which can reduced hypertension and boosts the heart rate. But as you exhale, your blood pressure improves and heart rate, consequently, goes down. At one time, sneezing arouses the vagus nerve, which operates from the brain through the stomach. In general, any moment the vagus nerve is stimulated, the body's reaction is to reduce the heart rate. The effect of this is minimal, however, slowing the heart perhaps only a single beat.

• No Sneezing with Sight Open

Have you ever asked why you can't be on the lookout while sniffling? Your eyes reflexively shut every time you have a coughing scene, and specialists have diverse clarifications for this. Some belief in it is a transformative modification primarily to defend your eyes from anything that leaves your nose or mouth as a result of coughing. Others are from the perspective that it happens because of muscle withdrawal. At any rate, the old spouses' story about eyelids shutting to defend your eyes from taking out is surely not genuine.

• Numerous Factors can Cause Sneezing

You may think just dirt and spice up could allow you to sniffle, yet the truth is several elements could allow you to wheeze.

Dust, clean, and spice up are the typical guilty parties, however, you may wheeze when you sniff impactful smells. Any modification in temperature, particularly colder air could allow you to wheeze. You may furthermore sniffle while culling your eyebrows predominantly in light of which it bothers the nerves associated with your nose. Many people may furthermore wheeze while popping pimples or rubbing their eyes. A number of people even wheeze when they are presented to brilliant lights, and this is because of an acquired characteristic called photic sniffling.

• Sniffling and Superstitions

Strangely, significant amounts of superstitions are connected with wheezes. The old Romans and Greeks were of the viewpoint that coughing to the privilege would bring you luckiness, while something awful would happen for sniffling to one side. Many people say "favour you" when they hear somebody wheeze, while others may say "to your wellbeing" in the same circumstance. Those people believe in that coughing is your spirit's approach to leave your body, however, it packs back in when somebody says "favour you".

• No Sneezing in Sleep

The mucous layers swell when you rest, which allows you to touchier to the dust particles noticeable all around, so you should sniffle more in relaxing. In nevertheless, all muscle tissue other than the ones that management your eyes get to be deadened when you enter profound relax, such as muscle tissue that management a sniffle. Amid superficial relax, the nerves that cause a sniffle are furthermore stifled, so you are additionally not prone to wheeze in shallow rest.

For a lot of people, this goes unnoticed. But in certain cases, when you sneeze, it can slow the heart rate or lower the blood pressure to such an extent that it causes a person to pass out. In the medical literature, this is known as sneezing syncope. Some people may also have an exaggerated reaction to a sneezing or a cough if they have a genetic heart abnormality, or if they are taking medications affect their heart rate, like beta blockers.

Thursday, March 9, 2017

Who Should Pay For Our Health Care?

The debate goes on, should the government be responsible for providing our health care?

There are many arguments for and against national healthcare.

At one time, everyone was responsible for their own health, there was no insurance. In that day and age, medical care was a lot less expensive than it is today, even taking into account the rate of inflation over the years.

The rise in cost has in part is because of all the new technology available today, but to a large degree, the rising cost is due to increased demand.

Because of the change in our national mentality, in a large part due to negotiated union contracts, everyone thinks their health care is free. Most have come to believe it is a right, a right no one pays for.

I'm a firm believer that affordable healthcare should be available to everyone.

However, because of the present system, very few people realize the cost of health care, and because it is presumably free to them, they go to the doctor for every little sniffle they get. Many visits are unnecessary and costly. People go to the emergency room for a skinned knee, or a splinter in their hand, these emergencies could be taken care of at home.

It has become "fashionable" to go to the emergency room.

Health insurance should be paid for by the individual. If each individual was responsible for their healthcare, they would become more knowledgeable on what "works" and what doesn't.

Most companies that provide health insurance allocate a certain amount of wages for the payment of benefits including health insurance, whether they tell the employee or not.

The individual employee should be made aware of this, that money should be allocated to the individual so they can purchase their health care on an individual basis.

Thereby eliminating any corporate influence the company could exert on the insurance company, and it would open the insurance industry to more competition, that is always a good thing.

That would enable the individual to have more control over his health care and ensure his right to have or not have insurance.

In some cases, when both spouses work and are covered by their individual company insurance, both companies are providing and paying for health insurance and only one health plan is needed.

Therefore, money is wasted by the couple because they don't use the insurance provided by one company. If the money was allocated to the employee, he or she could decide how to best use the money in a way that would benefit the couple instead of the money being flushed down the drain.

It would make the individual more responsible for his own health and welfare, and it would be his choice to have or not have health care.

If he chooses not to have health insurance, then he would be responsible for any charges incurred, and pay the consequences for not having insurance.

By cutting down on the demand by eliminating people going to a doctor or emergency room unless necessary, then the cost would naturally come down, and people would find the alternative, less expensive, better forms of treatment.

Of course, there will always be an element of society who are unable to care for themselves and they should be provided for, but there are far too many people abusing the system.

The only way to prevent that is for people to be in charge of their own health. Regardless of what you believe, no one, including the government will look after you like you will.

This is America, our country was founded on the idea of the individual being able to make his or her own choices concerning how to run their lives, it's time we returned to those ideals and get government out of life management.

I have traversed the globe in search of truth, my truth, during which time I have had an opportunity to study with Aborigine elders, native American Indians, and some of the world's finest intuitive. All of this has lead me to better understand our world and all things therein contained.

Tuesday, March 7, 2017

Improving Digestion - Tips, Tricks and Essential Facts

Given the important role played by the digestive system in ensuring proper functioning of the human body, every individual must take an interest towards improving digestion.

While a good digestive system has a positive impact on the overall functioning of the body, the reverse is equally true. There are several ways in which poor digestion can throw your system out of gear and this in itself should provide sufficient motivation for you to learn how to improve digestion.

Poor Digestion - Causes and Effects

Digestion is described as being poor if it is slow and this has two-fold implications. Firstly, the body is unable to absorb nutrients from the food in quantities that it should, eventually leading to deficiency within the body. Secondly, food left undigested in the stomach for longer duration soon becomes a breeding platform for harmful bacteria which in turn can lead to several illnesses.

If ignored over a period of time, poor digestion assumes a chronic nature and can lead to problems like fatigue, constipation, bloating and even allergies. But what causes digestion to slow down? Some factors that contribute towards poor functioning of your digestive system are -

· Eating habits - Living in an era which is dominated by fast foods and processed foods has its repercussions in form of inefficient digestion. On being constantly bombarded with excess sugar, salt and unhealthy oils your digestive system has little choice but to slow down.

· Lack of exercise - Given the sedentary nature of contemporary lifestyle, most people do not indulge in as much physical exercise as they should. This causes their metabolism to slow down which in turn has an adverse impact on digestion.

· Insufficient water and fiber intake - Water is the best catalyst for your digestive system in addition to being the ideal cleansing agent. From this it draws that drinking insufficient water would interfere with proper breakdown of food and also flushing out of toxins. Likewise, not consuming fiber in sufficient quantities has been found to lead to constipation which is indicative of poor digestive health.

Ways of Improving Digestion

An ideal digestive cycle is defined by four Rs', namely remove-repair-restore-replace. Removal entails flushing out of toxins from within the body followed by repairing of tissue and digestive track. Next, you must try to restore digestive health by including probiotics and fiber in your diet and making it a point to drink water in sufficient quantities. Having restored it, further improving your digestive system entails replacing unhealthy food groups with organic and healthy choices.

How About Using Digestive Health Supplements?

Diet and lifestyle changes notwithstanding, another way by which you can improve digestive health entails using digestive supplements, preferably those that are based on natural elements. There are indeed natural ingredients, like licorice, chamomile, peppermint and ginger that are capable not just of sorting out your digestive problems but also improving the overall condition of your digestive system. Mint and cinnamon are other natural products that soothe your digestive system and hence are recommended for improving digestion.

How would you react if told that many of these natural ingredients can be combined to form an effective digestive? Yes, it is indeed possible to combine several ingredients like licorice, black salt and certain species of leaves to form a powder that can play the role of a digestive. All you need to do consume a teaspoon or two with a glass of hot water for improving digestion and enjoy the benefits without any fear of side effects.

Final Word

Natural digestive supplements are based on the premise that the best way to restore good health is for the body to be as close to its original mechanism as possible. Combine this with the fact that digestion is one of the most important processes that can ensure good health for many long years to come. So, to use one to achieve the other does seem to be the logical path to take to enjoy long-term benefits.

Tuesday, February 21, 2017

Why You Need The Services Of Internists In Health Care

Internists in health care are popular as primary health care givers to lots of people. You could be a regular patient to an internist but have no idea simply because it's a foreign term to many. Some people confuse this professional for an intern or medical professional in the early years of medical training. However, that is wrong.

What is an internist?

An internist is an internal medicine doctor who is a medical professional that specializes in adult medicine. He/she focuses on treatment and prevention of diseases in adults. Such a medical professional is qualified to treat anyone from teenagers to the elderly. They are familiar with the treatment of all manners of illnesses from chronic to multi-system diseases. So you can see that an internist in health care will help you deal with any disease you are dealing with professionally and with great care.

An internist is not a family practitioner

Also, an internist is not to be confused with a family practitioner. A family physician can tend to individuals of all ages from babies to the elderly. However, they mostly focus on giving out- patient services. On the other hand, internists focus on patients 18 and over. They also emphasize on inpatient medical services to their clients.

Services provided by an internal medical practitioner

You can use an internist in health care as your primary health care giver just as you would a general practitioner. So, if you have to take screenings for cholesterol, blood pressure and blood sugar among other medical issues they will help you just like any other professional health practitioner.

They also communicate with other medical experts so that if you need extra professional medical help from other doctors, they will recommend you to the best ones. They have an excellent network of medical professionals such as cancer experts, pediatricians, dermatologists, nutritional experts and more at hand that they recommend their patients when necessary. However, you can be sure that expert internists are trained to handle the majority of medical conditions that do not require surgical or procedural intervention.

Reasons to get an internist

Now that you know what an internist is you need to know why you should sign up with one. Internists in health care provide you with some benefits.

- Personalized service

When many people get ill unexpectedly, they often have to visit emergency medical care centers for treatment. Such facilities often have no record of your medical history at hand. You will end up in the hands of a medical professional that you are unfamiliar with and who is unfamiliar with you.

However, if you subscribe to the services of an internist in health care, you are treated by someone familiar with you and your medical history. They often have all your information right down to your family history and are doctors you are familiar with so that you feel you are in safe hands.

Wednesday, February 15, 2017

Natural Trauma Care

What if the unthinkable happens? You have an accident, but you are nowhere near a hospital. What do you do?

Is there such a thing as "natural trauma care"? The answer is a resounding YES.

1. Small nicks, cuts or scratches: You can dab on cornstarch. It will stop the bleeding almost immediately. Additionally, oddly enough, spider webs work very well if you can find some. Grab a good sized spider web, blow off the spider and any other bugs or debris and wrap it around or place over the injured area. Once the bleeding stops, remove the web and clean the cut thoroughly.

2. A bloody nose: If you are experiencing a bloody nose open a bottle of vinegar and inhale deeply through your nose. Keep doing so and the bleeding should stop within a short time. Vinegar burns the blood vessels cauterizing them closed.

3. For a bleeding wound: Apply a little sugar and let it melt over the wound. This will stop the blood from continuing to flow.

4. If you suspect a blood clot: You can take the herb Dong Quai to help break up the clot but do try and seek out medical attention as soon as possible as blood clots can be incredibly dangerous depending on location.

5. Ice: Reducing the temperature drastically slows bleeding as well as helps prevent future inflammation and bruising at the site of injury.

6. Small wounds: Cayenne pepper sprinkled into the wound will help to stop the bleeding as well black pepper.

7. Splinters: To remove small splinters from the skin easily, wet a bar of soap and rub the sharp end of a sewing needle in it, so that the needle has a liberal coating of soap. Then rub the soapy needle in the opposite direction of the splinter. As soon as the splinter has some soap in it, squeeze it, and it should come right out. This method is painless and is good for use on children. For removing splinters of glass from the skin pour some hydrogen peroxide on the skin. The splinter will bubble itself out after a few minutes. Do not squeeze as more tissue damage may occur.

8. Burns: The best thing for a burn is to apply cool water liberally. Do ensure that the water is not too hot or too cold. Blisters will be formed, but that is a part of the natural healing process. If you want to avoid blisters you could try one of these home remedies. Cut a tomato into wedges and rub one slice on the burn. The acid from the tomato takes the pain away and the burn will not blister. You can also use cold water and vinegar compresses until the pain goes away and then apply potato slices on the area.

9. After any injury for overall healing - Arnica Montana 1M (trauma care blend) Specifically designed to speed recovery from a major physical trauma, TraumaCare™ is generally considered too strong for a minor bump or bruise.

Thursday, January 12, 2017

Tribal Healthcare - Links to Malnutrition

Despite factors such as nutritional deficiencies, seasonal migration, erratic meal timings and a myriad of other factors elucidated in my earlier blogs that result in the proliferation of malnutrition in the tribal villages and districts, the issue of malnutrition can relatively be easily controlled to a great extent with adequate delivery of healthcare services and provision of affordable and accessible healthcare in the tribal areas. I will touch upon the major aspects of tribal healthcare services, its links with the issue of malnutrition and inherent limitations of the same to counter the issue. In the process, I have also made an attempt to make some suggestions with respect to each of these factors that contribute in the spreading of malnutrition.

Tribal Hospitals - Links to nutrition

Most tribal hospitals can prove to be lifesavers with respect to the life threatening health problems faced by tribals in the villages in Maharashtra and elsewhere in India. The single biggest factor that leads to malnutrition is the lack of proper food and nutrition. Part of the problem is also the lack of awareness regarding the importance of balanced diet and other daily dietary and nutritional requirements. For this, perhaps, if the tribal hospitals in these regions can be equipped with a nutrition rehabilitation unit, then a very critical source of this life threatening issue can be curbed. The nutrition rehabilitation units could help address the nutritional imbalances in the daily food intake of the tribal population suffering from malnourishment. The purpose of these nutrition units could be to dole out special therapeutic foods that contain macronutrients such as proteins, fats and carbohydrates and also very important micronutrients such as the essential vitamins and minerals. The therapeutic food can be made from local food sources and using local manpower itself. In addition to this, the primary health centre (PHC) too must be equipped with specialised child healthcare treatment centres that provide this essential therapeutic diet to the malnourished (target) population.

Paucity of Primary Health Centres

Primary health centre (PHC) or public health centre is the backbone of healthcare service delivery in India, especially urban slums and rural areas. PHCs are the basic structural and functional unit of public health services. The main objective behind a PHC is to provide accessible, affordable and available primary healthcare to the rural population. The numbers of PHCs in rural India and especially in tribal areas are themselves not adequate. At present, there is only one PHC serving approximately 35,000 tribals, on an average. The lack of adequate number of PHCs relative to the tribal population in these areas is quite alarming. In an ideal situation, one PHC can serve a population of around 10,000 people only and covering an area of 5-8 kilometres, at most. However, at present, a tribal has to travel up to 20-25 kilometres to reach the nearest PHC.

The State government must ensure adequate number of PHCs at an approximate 8-10 kilometre radius of the tribal village. CHCs (Community Health Centre) and PHCs need to be made more accessible for the villagers. In case a specialised CHC and PHC cannot be erected at all the required locations, then the Government must ensure at least one health sub-centre in all the tribal villages.

Non-availability of Doctors and Nutrition experts

Even with these PHCs in place, healthcare service delivery in tribal areas faces other major problems. That is, extreme shortage of medical personnel. Medical doctors, nurses, nutrition experts and other medical personnel are unwilling to relocate to tribal areas in order to practice medicine and serve the tribals. In the tribal belt of Maharashtra, the doctors are not ready to go and work in the hospitals in these areas. So, most of the hospitals in the tribal areas remain under-staffed most of the times. There is particular scarcity of maternal and child health (MCH) specialists and other medical specialists such as paediatrician, nutritionists, anaesthetics, among others, in the tribal hospitals. Further, due to severe lack of paediatricians in government hospitals and PHCs in such tribal areas, if the infant/child is suffering from chronic malnutrition, the risk of the child succumbing to death during the first 1,000 days (of birth) increases manifold. Thus, there is definitely a strong correlation between lack of trained medical specialists and malnutrition deaths.

We are well aware of one of the age-old superstitions related to pregnancy and food intake. That is, the tribal women follow the practice of low food intake during pregnancy for easy and comfortable delivery of the newborn (resulting in anaemia among mothers and malnourishment among the infants). The intake of nutritious diet is the least among women when they actually need the most!

Another critical hurdle that healthcare faces are that the local population usually don't want to admit their children to hospitals due to superstition, cultural barriers and various other socio-economic factors. Since these tribals often don't admit their malnourished children to hospital, children are dying at home.

The state governments can perhaps start a home based 'Child Healthcare Program'. For instance, I think the government of Delhi has done well by introducing Mohalla clinics. This is a very clear signal of why primary healthcare must be delivered as close to home as possible.

In such aforementioned programs, the respective malnutrition cases can be treated in the comforts of their home and village by a trained female health worker. This female health worker could focus on special healthcare needs of a pregnant woman; help provide ante-natal care (ANC), post-natal care (PNC), provide guidance and assistance to young mothers, newborn and infants. Perhaps, the Maharashtra Government can start such a program wherein all the underserved rural areas, especially the tribal areas, are provided essential maternal and child health care facilities. Here, government health officials and staff such as the Accredited Social Health Activist (ASHA) workers, Integrated Child Development Service (ICDS) scheme workers, Auxiliary Nurse Midwives (ANM), among others, can be roped in to provide such dedicated and specialised care to the focus groups.

Furthermore, health counsellors can be roped in to advocate and promote the provision of institutional deliveries. The counsellors can ensure 24 hour care and counselling services, especially in the most underserved tribal regions. The state governments can invest and develop such 'Health Counselling Programs' via the support of local Non-Governmental Organisations, etc. This will further ensure affordable, accessible and equitable health care delivery among the rural and tribal populace.

Government Failures - Under-reporting of malnutrition cases

Under reporting of malnutrition and child deaths is a very big issue. The average Infant Mortality Rate (IMR), that is, the number of child deaths per thousand live-births, is close to around 60 in all tribal areas. But this is reported as less than 40. Similar condition is for reporting of the severe acute malnutrition (SAM) cases. The prevalence of SAM is approximately 20% of the total malnourished children, which is very high. But as per government figures, it is regularly reported as less than 10%! In essence, suppose there are 1000 children who are severely malnourished, but only half of them are reported as SAM cases. The remaining (estimated around 50 percent) children suffering from SAM thus get excluded from specialised care and treatment, if any. These are essentially the 'missing SAM' cases. These excluded/missing/neglected children are thus more prone to succumbing to death in the absence of the much needed care.

Thus, correct statistics, correct recording of the facts and figures and correct reporting can go a long way to at least move in the right direction and thereby to solve the severe malnutrition prevalent in these tribal areas. This will ensure proper planning, implementation and execution of targeted treatment and care for both the severely and moderately acute malnutrition cases in the tribal villages.

In conclusion, I would like to lay greater emphasis on the present health systems in place at the central, state, village, and district and block level to work in tandem rather than independently. There is a dire need to strengthen the linkages and synergies of all the major stakeholders of heath care in India, especially in the most underserved rural and tribal regions of our country. The State government needs to commit greater investments towards the tribal healthcare ecosystem. Tribal hospitals need to be equipped with state of the art facilities, focussing especially on the most vulnerable sections of the society such as the young mothers, pregnant and lactating women (PLW) and newborn and infants and children below the age of 5 years. Furthermore, there is an urgent and persistent need to devise formal behaviour change communication (BCC) and community mobilisation (CM) strategies by the CHC, PHC and health sub-centres to comprehensively address the cultural barriers prevalent among the tribal population.

Lastly, relationships between tribal cultures, behaviours, government interventions (such as subsidies), health system and policies and malnutrition need to be studied in detail. The solution to address such a huge problem like malnutrition cannot be generalised. That is because the demographics of the tribal community very dynamic and varies region wise. Thus, focussed ingenuous interventions need to be carried out at the micro level, specific to that very district, that very block and that very village or hamlet.

Monday, January 2, 2017

The Value of a Pediatric Endocrinologist

Pediatricians are an important part of the society and they come in handy in any place where there are children in need of medical assistance. Just like different physicians, a pediatrician needs to have traits such as patience, dedication, perseverance and so on.

Extra traits for pediatricians

There are other traits that pediatricians should possess so as to make them ideal for their post. They should be easy going in their profession, sensitive, a personality that is good-natured, outgoing, enjoy activities, comfortable with children even when they are sick, tolerant of the faults they may see in others, enjoy interacting at a very high level, be willing to give direct care, able to accept gratification even when it is delayed, enjoy teaching and also they should be able to accept any kind of schedule disruptions. The above are some of the qualities you should look out for when you are choosing the ideal pediatrician.

Pediatric Endocrinologist

As with other areas of medicine, there are pediatricians who are able to specialize in different areas. If your child has got specific issues, then specialized treatment may be recommended by your doctor.

Just like other people, children sometimes suffer from very specific ailments. Endocrinology is a medical specialty that deals with endocrine system kind of disorders that may affect human beings. There are pediatric endocrinologists that handle this particular area and who should be contacted should your child be in need of such services.

Endocrine system comprises the thyroid, pituitary, hypothalamus and the parathyroid glands. The adrenal cortex, gonads, and pancreas are also a part of the system. These are actually glands that are responsible for the production of hormones and they are also responsible for a set of different functions like growth, metabolism, and sexual development and so on. If the hormones were to fall out of balance, then abnormalities may occur. Disorders can also occur and they can be fatal at times.

If your child is diagnosed with such issues, then you may be redirected to a pediatric endocrinologist. The child will be diagnosed, evaluated and then treated for the specific condition that they may be having. Most of the conditions come as a result of a deficiency in the endocrine system as well as overactivity.

You need to choose a specialist or hospital that has all the facilities that are needed for the investigation as well as the treatment of the issues in pediatric patients.

Why they are important

Pediatric endocrinologists are very important especially when a child has hormonal conditions that need to be handled. This is not the kind of scenario where you stick to the primary doctor and if a suggestion is made to see a specialist, then the step should be taken as quickly as possible.

Endocrinologists are true specialists and they have had time to study different hormonal conditions and so they are well capable of giving the best treatments. The best professional in the filed should be aware of all the latest developments in his area of specialization and be able to offer this and so much more to the pediatric patients.