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Who Broke The American Healthcare System?

Who Broke The American Healthcare System?

Healthcare is a hot topic in the media these days. Yet, few people are satisfied with the way it is working. Many claim that the American healthcare system is broken. Patients are increasingly frustrated with finding a doctor, getting tests and medications they need, and paying for out-of-pocket expenses. Numerous doctors are disenchanted with their career choice, and burnout is a common complaint. Frequently, doctors are now looking to retire early or for alternate career paths. Treating patients has become unfulfilling for many due to administrative burdens, increasing government regulations, and overbearing insurance over-sight. Doctors fight daily to get procedures and medications covered that their patients need. Most often, the battle is with someone who is not even a doctor or has any clue about the patient. These daily battles become wearing. Additionally, doctors now have to fight on a more abundant basis to get paid for services they provided. Their incomes are stagnant or shrinking while overhead costs are soaring. Increasingly, doctors are selling out their practices and joining large groups and hospitals. “When I go in the exam room and close the door, I face my patient and am again reminded of why I became a doctor: to alleviate suffering.”   Many people look to put blame on doctors for the broken healthcare system. Yet, it has been years since doctors truly had any control over it. More often these days, doctors are treated like pawns and servants, our independence and integrity being worn away and questioned. But, who really is to blame for the broken healthcare system? 1. Commercial insurance companies who have no oversight and...
Lifestyle Strategies for Heart Risks

Lifestyle Strategies for Heart Risks

In 2013, the American Heart Association and the American College of Cardiology published a first-ever joint clinical practice guideline on lifestyle management to reduce cardiovascular disease (CVD) risks. Published simultaneously in Circulation and the Journal of the American College of Cardiology, the guideline is based on a systematic evidence review from studies published between 1990 and 2012. It summarizes key nutrition and physical activity topics for managing blood pressure (BP) and cholesterol. Healthy Eating & Physical Activity “To lead a lifestyle that can reduce CVD risks, heart-healthy eating habits and physical activity are paramount,” says Robert H. Eckel, MD, who co-chaired the expert writing group that developed the guidelines. To lower cholesterol, the guideline strongly recommends limiting saturated fat and trans fat. To lower BP, an emphasis is placed on restricting sodium to no more than 2,400 mg/day. Further reductions of sodium intake to no more than 1,500 mg/day are linked to an even greater reduction in BP. “Eating a heart-healthy diet is more about the overall diet rather than isolating specific foods that are eaten,” adds Dr. Eckel. A heart-healthy diet should focus on fruits, vegetables, and whole grains and include low-fat dairy products, poultry, fish, and nuts. It should also limit red meat, sweets, and sugar-sweetened beverages. “Following this pattern should help limit the intake of saturated fat, trans fat, and sodium to the recommended levels,” Dr. Eckel says. Adaptations to heart-healthy diet plans should be considered based on each person’s caloric requirements, personal and cultural food preferences, and nutrition therapy for other health conditions, such as diabetes. The guideline also recommends moderate- to vigorous-intensity aerobic exercise,...
Updated Guidelines for Assessing Cardiovascular Risk

Updated Guidelines for Assessing Cardiovascular Risk

Cardiovascular disease (CVD) caused by atherosclerosis continues to be the leading cause of death and is a major cause of disability as well as a significant source of healthcare costs in the United States. In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) released an updated clinical practice guideline to help clinicians better identify adults who may be at high risk for developing atherosclerotic CVD. The update, published jointly in the Journal of the American College of Cardiology and Circulation, also provides recommendations for identifying patients who could benefit from lifestyle changes or drug therapy to help prevent CVD. “These guidelines were last updated about 10 years ago,” says David C. Goff, Jr., MD, PhD, who co-chaired the ACC/AHA risk assessment guideline writing group. “Since that time, we have collected a large amount of research that has further enhanced our understanding of how best to care for these patients and improve our approaches to determining who should get specific types of preventive treatments.” Risk Assessment A key goal of the ACC/AHA guideline is to ensure that preventive treatments—especially lifestyle changes and drug treatment—are used in those who are most likely to benefit from them. To do this, the guideline includes high-quality risk assessment methods that use risk factors that are known to lead to atherosclerosis (Table 1). Factors such as age, cholesterol levels, blood pressure, smoking, and diabetes can be easily collected by clinicians and then integrated into a risk score to guide care and prompt discussions with patients.   “The vast majority of heart attacks and strokes could be prevented if patients knew...
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