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Fixin' Healthcare

Sunday, November 27, 2005

This Article Speaks for Itself

I don't bike. The seats are uncomfortable to the point of numbness from the hips to the midthighs. Nevertheless, this article says it all for physical activity and the modern life around us. Include walking and the concept can cover almost all of us. Give it a try!

Nobody Bikes in L.A. - But they'd be a lot happier if they did. By Andy´┐ŻBowers

Now I Am Truly Preaching

Nothing worse than a zealot but today is my day for extolling the benefits of physical activity. I hear so many excuses as to why people cannot be more physically activity. The main reason is that people are lazy and the laziness starts in the head with the lack of will to develop a plan for physical activity that is enjoyable and beneficial. Don't stop working on the plan until you show that you can walk 10,000 steps in a day. Otherwise, tell me why I should help pay for your health insurance because sharing risk is what insurance does.

Do exercise and you will live longer and enjoy better health as well

Fitness and the Risk of Death

Not that it is needed but here is more evidence that physical fitness is related to health risk. The maximum consumption of oxgygen during an exercise test is a reliable measure of physical fitness. This study links the results of the test with the risk of death for patients with coronary artery disease. Low levels indicate greater risk of death and improvement of the measure reduces the risk of death. A plan that gradually increases walking to 10,000 steps daily will improve fitness and reduce health risk.

Results of exercise test may predict death in patients with coronary artery disease

Walking Helps, So Does a Plan

It may appear that I am belaboring the point that physical activity benefits fitness, performance and health but I labor under the conclusion that the point cannot be emphasized too much. Physical activity is the aspect of lifestyle that starts the cascade toward health and it is the matrix that holds everything together. Increased physical activity leads to cessation of smoking, better nutrition, better sleep and decreased impact of stress. I cannot possibly emphasize enough the necessity of a plan to motivate and discipline the effort. Don't forget the motivational value of a simple, inexpensive pedometer that gives a reliable representation of steps taken throughout the day. See you out there. I'm the guy with the 12 year old 60 pound husky.

Prescribed walking can improve physical fitness

Health and Nature

Recently there have been articles relating good health status to contact with nature and animals. Most of us would accept these assertions on faith and could give several explanations for the beneficial relationship. The one point I would emphasize is how an appreciation of nature requires physical activity to get out and enjoy it. That gives a simple explanation but I am sure it goes so much further.

Human health and nature conservation -- Burls and Caan 331 (7527): 1221 -- BMJ: "Human health and nature conservation "

Looking For Health in All the Right Places

Health comes from how life is lived all day and everyday. It comes from the smallest and the biggest things. It is the deepest and the passing thoughts. It is happiness and satisfaction. It is lifestyle and it is everything.

Courtesy is respect for the being of another human and it is self-respect. A greeting given to a stranger in passing is courtesy. Slowing and/or giving room when driving past a pedestrian on a road with no sidewalk is courtesy. Being prepared to dispose of trash without throwing it beside the road is courtesy. All of these things and more are how we treat others and how we treat ourselves.

How we treat others is a basis of how they treat us. These matters are vitally important for the health of individuals and the community. Such matters cannot replace surgical suites or prescriptions for medications but they are intinsically more important. Think about it the next time you pass a pedestrian or biker, or the next time you have a scrape of paper or empty can in your hand. Get out there and be a pedestrian or biker and make the community have more sidewalks and bike paths. It all starts with each and everyone of us.

Thursday, November 24, 2005

Fixing Healthcare

Fixing healthcare is fixing health
Fixing health is fixing lifestyle
Lifestyle is not just one thing; it is everything
  • Physical activity
  • Sleeping well
  • Managing stress
  • Eating whole foods and drinking water
  • Avoiding exposure to cigarette smoke

A bunch of not so simple things that add up to everything.

Wednesday, November 23, 2005

Motion is Lotion

Of all the things that someone can concentrate on or emphasize for healthy lifestyle, physical activity has the broadest positive influence and benefit. Physival activity builds stronger bones and inactivity leads to mineral loss from bones regardless of calcium intake. An inactive joint becomes less and less useable. Physical activity builds stronger muscles, improves cardiac and pulmonary function and increases endurance. Physival activity raises "good" cholesterol and prevents and reverses cardiovascular disease. Physical activity increases sensitivity to insulin that prevents and reverses Type-2 diabetes mellitus. Physical activity is linked with the prevention of breast cancer. Physical activity reduces stress hormones and relieves stress. Physical activity helps sleep and relieves constipation. Physical activity improves fat metabolism and assists with weight management.

There is more, but need I say more? Yet, with all these benefits people do not comprehend prevention. Not having a problem tends to place it out of mind. Also, people are oriented to short time cycles and do not respond well to long time cycles. People are more likely to respond to physical activity on the basis of "feeling good" and "looking good". The challenge is to present physical activity so as to make it "doable". Additional goals would be to make physical activity enjoyable (groups or a game) or make it accomplish an immediate purpose (walking to work or a nature tour) or create a challenge (competition or personal best).

With all due respect to those who believe humans sprang from the dust 10,000 years ago, all the evidence indicates the presence of humans on earth for over one million years. For hundreds of thousands of years our ancestors ate whole food and drank water as found in nature, and they walked. Frequently, the walking was carrying a load. There were bursts of strenuous activity that might involve catching something or getting away from something. Metabolism is geared to this pattern of physical activity.

Walking is the best place to start physical activity. A comfortable pair of shoes and a little time is all that is needed. Do not underrate walking. Start slow and build up. But, in the final analysis most people underrate the amount of walking they need to do. It has been demonstrated that walking 10,000 steps daily accomplishes the benefits listed in the first paragraph. If someone takes a long stride, 10,000 steps might represent five miles while a short stride would be closer to four miles. Both are 10,000 steps and both achieve the benefits. Also, the 10,000 steps do not have to be in a single session of sustained walking but can be accumulated throughout the day.

People who wear a pedometer walk more than those without a pedometer. The basic Sportline pedometer counts only steps and it is reliable and inexpensive. The price is $9.99. At the end of each day take a reading and place the pedometer with things that wil be picked up beginning the next day (a belt, watch or keys). Beginning each day zero the pedometer and attach it to a belt at the waist on either hip.

After a while the number of daily steps will become like the song by John Hartford (recorded by Glenn Campbell) entitled "Gentle On My Mind". It will make more sense to walk to the mailbox and to leave the car at the other side of the parking lot. It becomes less of a chore by making a game out of it.

Most people will walk between 2,000 and 4,000 steps during a routine day. With some thought this can be increased to 5,000 or 6,000 steps. Reaching 10,000 steps requires some dedicated walking. Interestingly, people who live in large cities are more likely to use public transportation and walk more than people who live in the suburbs or smaller communities. Walk with friends, walk the baby in a stroller, walk the dog, walk to the bank. When the weather is bad, use a treadmill or walk in the mall. THINK WALKING.

After developing some consistency with the walking, consider doing something more strenuous for twenty to thirty minutes once, twice or three times weekly. This could be walking rapidly uphill, hiking in the mountains, a treadmill elevated to an incline, a stairmaster, running or lifting weights.

This routine can be developed over time by almost everyone. And, it is a routime that can last as the years pass. In fact, physical activity is the closest thing to a Fountain of Youth. Motion is lotion for both the joints and the skin. Will it make you happier? I think so.

Monday, November 21, 2005

A Sense of Happiness

Lately, I have been struggling with the concept of happiness. It is not so much a personal consideration as it is about the conditions in society and the community that influence happiness. Because happiness and health are related there is reason to be concerned about conditions, attitudes, public policies and laws that influence happiness.

A growing body of knowledge links stress, happiness and health status. The biochemical and physiologic basis for this linkage was considered previously in the post on 11/05/05. This consideration is about those aspects of life in the community that promote or interfere with happiness.

Health care is undergoing a major shift of focus that expands the boundaries beyond the diagnosis and treatment of illness and disease to include achieving and maintaining optimum health status. The basis for this shift is the growing body of evidence that lifestyle is the major cause of many chronic diseases, and changing lifestyle can prevent and reverse chronic diseases.

How this transformation will progress and where it will lead cannot be determined at the present. However, many considerations will be included that were not previously mainstream medical thought. Greater personal responsibility for health and increased community commitment to healthy lifestyle are examples. These are not simple issues and there is much to be learned. Not the least of the possibilities is that personal health is more dependent upon community health than personal medical care.

The Declaration of Independence proposed the pursuit of happiness as a basic human right. There were no definitions or guarantees of happiness, just the right to pursue happiness. It is doubtful the founding fathers could have envisioned the complexity of modern society or the struggle for expression by the individual. Some would say the proposed pursuit of happiness has been forgotten but others would say it has been taken to the extreme.

The theory of government includes a balance between individual and community welfare. In all likelihood the Declaration of Independence expressed a view of the pursuit of happiness based upon freedom from oppression. Even today happiness as a personal emotion would not be a consideration for a community or the country. Yet, it is the community and community life that determine the background from which a sense of security, expression, accomplishment and well-being are derived.

Happiness is often equated with money and the well-being of a nation is most often measured by the gross domestic product. But around the world a growing body of thought is trying to develop measures that take into account not just the flow of money. The small Himalayan kingdom of Bhutan wants to ensure that prosperity is shared across society while preserving cultural traditions, protecting the environment and maintaining a responsive government.

Recently, 400 people from a dozen countries gathered at St. Francis Xavier University in Nova Scotia to consider new ways to define and assess prosperity. There were many thoughts relating to the observation that economic growth does not always equate with happiness, a sense of well-being or improved health status. Several countries, including the United States, Canada and Great Britian, have launched studies to determine whether a better understanding of well-being and happiness can be achieved.

What is happiness? Is happiness solely a personal matter or does it involve the community? Does happiness make a difference? Are the prosperous happier than the poor? To what extent is happiness dependent upon a sense of purpose, accomplishment, the community, social structure, security, justice and the environment? Is the United States a happy country?

So many questions, but life does not seem to wait around. Life moves on and it is continuously giving answers. Understanding the answers is dependent upon the nature of the questions. Do I know what makes me happy or unhappy? Am I prepared to do something about it? Are my actions contributing to continued happiness? Am I alone in this quest?

The recent study from King County, Seattle, Washington indicates how county planning for land use and transportation can influence physical activity and health status (see post from 10/31/05). It was accomplished by making health status a basis for county planning. And, if health status is improved, would the sense of happiness be elevated and could the economy be strengthened? And/or, if there is an increased sense of happiness, would health status be improved?

Wednesday, November 16, 2005

The Quest for Happiness

Six specialists including a psychologist, psychotherapist, work place specialist and social entrepreneur with expertise spanning philosophy, public policy and economics conducted a three month experiment to improve happiness levels of a town in Great Britian. The intent was to instill 10 steps to happiness with fifty volunteers who spread this to others in a ripple effect. The 10 steps to happiness are based upon best knowledge and research.
  • Plant something and nuture it
  • Count your blessings - at least five - at the end of each day
  • Take time to talk - have an hour-long conversation with a loved one each week
  • Phone a friend whom you have not spoken to for a while and arrange to meet up
  • Give yourself a treat every day and take time to really enjoy it
  • Have a good laugh at least once a day
  • Get physical - exercise for half an hour three times a week
  • Smile at and/or say hello to a stranger at least once each day
  • Cut your TV viewing by half
  • Spread some kindness - do a good turn for someone every day

The results will be reported in a documentary series on BBC Television.

http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/4436482.stm

Monday, November 14, 2005

Lives of Quiet Desperation

Eureka! Stress is on everyones's mind as if suddenly it has been discovered. Could this be the reason that so many people are overweight? And, of course, there follows the marketing of miracle products that claim to transform all who are stressed and overweight into slim, athletic and vivacious beings.

How important is stress? Stress causes increased appetite with sugar craving and increased body fat mostly deposited in the abdomen. Stress interferes with sleep. Stress alters normal immune response. Stress can be a basis for allergies, asthma, chronic fatigue, fibromyalgia, irritable bowel, cardiovascular disease and increased risk for cancer. Stress is a dangerous aspect of unhealthy lifestyle and a common cause of accelerated aging and chronic disease. Stress makes people sick and stress kills.

Acute stress is the metabolic response to danger and surprise. Adrenalin, cortisol and insulin act in a related fashion to prepare and support the body for "fight or flight". Usually, the metabolic response resolves when the danger or surprise is past. Repeated acute stress and chronic stress alter metabolism on a prolonged basis and cause accelerated aging and chronic disease. The mind-body link is expressed through metabolism. The central nervous system controls the hormones that manage metabolism.

It is a serious and even fatal mistake to think that stress cannot be controlled or that medications will resolve stress. Those conclusions lead to suffering from the metabolic consequences of repeated acute stress and chronic stress. Managing stress requires a direct response and the pathway is identified by old fashioned values. A sense of accomplishment, service and control are important. An organized mind, focus and commitment are required. Remove some of the clutter from life.

Identify those things that bring happiness or satisfaction and those things that do not. Where possible pursue and avoid situations as they are appropriate to well-being. Engage in physical activity (walking and moving around) throughout the day and slowly increase exercise (dedicated walking or running, stretching and resistance training). Avoid fatigue from a lack of sleep. Get to bed at the same time every night and sleep seven to eight hours. Get some down time to engage in activities that are fun and/or stimulating. Spend time with family and cultivate a circle of friends. Share experiences. Participate in church. Consider public service activity that helps others. Praise others without expecting praise in return. Learn relaxation, breathing and meditation techniques to determine if they are helpful.

"The mass of men lead lives of quiet desperation." Those words by Henry David Thoreau appeared in Walden in 1854. Do you suppose people crossing the country in wagon trains did not have stress? Was the Great Depression stressful? How about World War I and II? Has no one before had a close relative or fiend become sick, disabled or die? Yet, the current magnitude of the national problem with overweight and obesiy did not appear until the 1970's.

Stress has always been there and always will be. It is not new. Eating highly processed food, inactivity, lack of sleep, ingesting large quantities of chemicals such as artifical sweetnerers and taking multiple drugs are new. You and no one else are in control of the basic and important aspects of lifestyle. Your motivation, focus, planning and daily commitment to a healthy lifestyle will lead to weight reduction, improved performance and feeling better with more energy and less fatigue. Stress management starts there.

Sunday, November 13, 2005

How About That?

The post on November 6th was a general consideration of the essential fatty acids. As follow-up there was a recent news article of a man with terminal lung cancer who received significant improvement attributed to increased ingestion of Omega-3 essential fatty acids in the form of fish oil coupled with reduction of corn products to limit Omega-6 essential fatty acids. The nude mouse tale: Omega-3 fats save the life of a terminal cancer patient

It is a dietary model that should contribute to achieving and maintaining optimum health while preventing illness and disease. Eating cold water fish at least twice weekly is one way to accomplish this. Coromega is a tasty form of fish oil.

Friday, November 11, 2005

And All That Fizz

Traditional wisdom and common sense are overwhelmed by marketing and freshly minted experts. Yet, scientific discovery continues to provide explanations and support for traditional wisdom and common sense when it comes to lifestyle and nutrition.

Hippocrates around the year 450 B.C. and your grandmother were in agreement about the value of balance and moderation in diet and exercise.

Drink plenty of water and don't fill up on sodas is something most people have heard in their lifetime. Many patients have told me how they were able to control their weight when they began drinking water. In most of these situations the water was replacing sodas.

The results of two recent studie would not surprise our grandmothers. The University of Texas followed the weight of 1,550 people over eight years and found that being overweight was more likely to be associated with drinking diet sodas than beverages sweetened with sugar. The Harvard School of Public Health found that elevated blood pressure is associated with sodas containing caffeine but not coffee containing caffeine.

Neither of these studies demonstrate a cause and effect relationship or a mechanism with sodas. However, they do show the consumption of sodas at the center of lifestyle and diet that result in weight gain and elevated blood pressure. It is not likely that someone will eat the same food all day, everyday but it is not unusual for someone to drink sweetened or diet sodas all day, everyday. That can be a lot of calories, fructose, salt and artifical sweetener.

Hippocrates and our grandmothers would not approve of drinking sodas instead of water. We might not want their approval but certainly we do not want to be fat and sick.

Tuesday, November 08, 2005

Some Things Count More Than Others

A US Government survey reported that 22.3% of high school students and 8.1% of middle school students said they smoked cigarettes in 2004. Research from Dartmouth Medical School reported that 40% of US adolescents who gave smoking a try did so because they saw it in a movie. Health News Article Reuters.com

Optimum health is never just one thing. Each thing counts and some count more than others. Among the unhealthy habits smoking ranks at the top for harm to health status. To cease smoking and start daily physical activity rank at the top of things to improve health. These are things that require attention early in life. Do your part with the children close to you.

Sunday, November 06, 2005

Does Insurance Cover These Things?

The previous post considered how stress, physical activity and macronutrients in food (carbohydrates, protein and fat) influence the hormones insulin, adrenalin and cortisol, and how the relationships between these hormones influence metabolism. This post considers how the dietary essential fatty acids regulate crucial balances within the human body. Both postings are intended to convey the substantial amount of science that supports the validity of lifestyle, health promotion and disease prevention as a basis for optimum health.

The essential fatty acids are necessary for good health but human metabolism cannot synthesize them. They are divided into two groups: Omega-3 and Omega-6 fatty acids. The grouping depends upon the location of a double bond due to the absence of a hydrogen atom in the carbon chain backbone. The double bond determines where the carbon chain can bend or fold. Omega-3 fatty acids have fewer hydrogen atoms than Omega-6 fatty acids resulting in increased bending of the carbon chain backbone. This means that Omega-3 fatty acids are more fluid than Omega-6 fatty acids at any given temperature.

The primary Omega- 3 is alpha linolenic acid (ALA) that is found in flaxseeds, flaxseed oil and green leafy vegetables. Plants that grow in colder weather contain more ALA. Human metabolism can convert ALA into eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Ocasionally, some people cannot convert enough ALA into EPA and DHA to supply increased needs. A pregnant woman has increased needs for herself plus the requirements of the fetus for growth and brain development.

Dietary sources of EPA and DHA are cold water fish (salmon, albacore tuna, herring, black cod, mackerel, sardines, anchovies) and wild game. Cold water fish need more flexibility in their cell membranes and they make EPA and DHA in generous amounts. Most fish oil supplements contain 18% EPA and 12% DHA, which is sufficient as a supplement. The fish get their ALA from algae and wild game from grass and leaves.

The primary Omega-6 is linoleic acid that is found in plants (corn and wheat), vegetable oils, organ meats, egg yolks, baked goods and margarine. Modern diets have shifted drastically in the ratio of Omega-6 to Omega-3 from 4:1 to as high as 20:1. This is the result of more corn and wheat, less green leafy vegetables, little or no flax seeds, more corn and grain fed beef and less fish and wild game.

Omega-3 and Omega-6 fatty acids are contained in every cell membrane in the body and influence every process in the cells. Sixty percent of the DHA is found in the central nervous system. DHA is essential for brain development, especially vision, in infants and it has been associated with improvement of depression in adults.

Omega-3 and Omega-6 fatty acids are the source of the different classes of eicosinoids that are a family of cellular bound, short lived and very powerful hormones that influence a tone and balance throughout the body. Eicosinoids formed from Omega-3 fatty acids are anti-inflammatory, relieve pain and relax smooth muscle. Eicosinoids fromed from Omega-6 fatty acids are associated with inflammation, pain and increased smooth muscle tension. The amounts and balance of Omega-3 and Omega-6 fatty acids influence acute and chronic pain, asthma, hypertension, insulin sensitivity, arthritis, blood cholesterol and triglyceride levels, development of the central nervous system and learning and psychological depression.

Saturday, November 05, 2005

The Dance of the Hormones

The ability to survive long periods without food favors a strong appetite and eating heartily when food is available. Eating carbohydrates produces elevation of blood sugar that stimulates release of insulin from the pancreas. Insulin transports glucose into the cells of muscle and liver tissues where it is used to produce chemical energy. The liver is influenced by insulin to synthesize fat and protein from glucose. Fat and protein are used to produce biochemical components, hormones and tissues. Unprocessed carbohydrates (vegetables, fruit and grains) contain lower concentrations of sugar than processed carbohydrates (crackers, chips and candy) and the presence of fiber slows the absorption of sugar from the gut. This reduces the level of blood sugar and insulin secretion.

The large human brain is important for adaptation and survival. The brain utilizes only glucose for energy and brain cells have priority since the hormone insulin is not required for glucose to cross the cell membrane. Muscle and liver cells can utilize fat and protein as well as glucose for energy, and insulin is required for glucose to pass the cell membrane. Survival in an environment with low carbohydrate but adequate protein and fat favors selection for insulin resistance in order to conserve glucose for the brain. These were the conditions of the Ice Age. However, insulin resistence in a carbohydrate rich environment results in metabolic syndrome and Type-2 diabetes mellitus. These are the conditions that exist today.

Most of the stored energy reserve is fat. It is the most efficient storage of energy at nine calories per gram versus four calories per gram for protein and glucose, and it serves as insulation for the body. Very little excess glucose is stored in the form of glycogen as energy reserve. Glycogen is the most ready source of energy reserve, then fat and protein serve as fuel. The utilization of reserve energy is under the influence of the hormone cortisol from the adrenal glands. The loss of body fat slows metabolism and conserves energy stores. This is an example of the protective and buffering systems that are intrinsic to metabolism.

Adrenalin and cortisol are the stress hormones. They prepare the body for physical activity by maintaining blood pressure, mobilizing glucose from the small quantities of stored glycogen and influencing the conversion of fat and protein into glucose. Mobilization of glucose in this manner provides fuel to muscle for physical activity. Chronic stress with elevation of cortisol contributes to insulin resistence that returns top priority for glucose to the brain. Starvation and very low calorie diets are examples of chronic stress that result in the body consuming fat and protein to sustain blood glucose levels for the brain.

Nutrition, physical activity and metabolism are related in a purposeful way mediated by the major hormones. Humans are adapted to be physically active for long periods with capability for brief periods of extreme intensity of effort that results in many influences upon metabolism. For example, physical activity reduces the influence of cortisol and increases insulin sensitivity. This makes glucose more available to muscle cells for physical activity. Adequate nutrition is necessary to provide fuel and the building materials to restore biochemical compounds and rebuild tissue worn down by physical activity. Excessive exercise and exercise without adequate nutrition are examples stress that result in the body consuming itself (loss of muscle).

Chronic stress associated with a high calorie, carbohydrate rich diet and physical inactivity create an abnormal state of metabolism with concurrent elevations of the stress hormones and insulin. The result is obesity with muscle wasting and fat deposition in the abdomen. Chronic elevation of cortisol has a negative impact upon immunity that contributes to development of chronic diseases.

Thursday, November 03, 2005

Boutique Doctors

The current state of healthcare in America is creating a high level of frustration. The complaints and concerns have been answered and the responses are revealing.

Boutique doctors are practitioners who limit their number of patients in return for increased fees or retainers. Patients do not have to wait and the visits with the doctor are longer. The physician income usually increases, the insurance companies may not be involved with the encounter and life is less hectic. Although patients may receive better care, this is a convenience and financial arrangement with medical and health objectives secondary.

Some speciality physicians have established free standing centers containing the technology they utilize. The technology is usually available elsewhere in the community but it may not be as convenient for the physician or the patient. If there are medical and health objectives, these are secondary to convenience and financial considerations.

Hospitals have developed more private rooms, provided valet parking and arranged champagne dinners after birthing. They have deployed increasing levels of technology and promoted increased utilization. Hospital purchase of physician practices creates a network whose primary mission is to maintain patient flow (admissions and ancillary services) for the hospital.

These activities cast medical care in the light of a retail business responding to competition by emphasizing convenience and technology. It is difficult to hear the emphasis on health promotion and disease prevention. The emphasis is there but it needs to be louder.

Wednesday, November 02, 2005

It's A Start

The Australian Commonwealth Government recently launched a preventive health program to encourage doctors to advise patients on how to change lifestyles to improve their health. The Lifescripts Program shifts the emphasis in primary health care from management of illness and disease to health promotion and disease prevention.

The targets are five lifestyle risk factors that are very common in Australia - smoking, poor nutrition, risky alcohol use , physical inactivity and excess weight. Together they comprise the largest group of preventable risk factors for death in Australia.

A person who has more than one of these risk factors has a higher likelihood of developing chronic health disorders such as diabetes, stroke, mantal illness or heart disease. Among patients visiting a general practice in 2002-2003 more than half were overweight, more than a quarter drank at levels considered to be risky, 17 percent were daily smokers and two-thirds were physically inactive.

There is strong evidence that positive lifestyle changes can significantly improve a person's health. Good advice from a doctor can help a person change an unhealthy lifestyle. It's a start and it certainly can't hurt.

Next we will consider the trend in America for boutique doctors.

Tuesday, November 01, 2005

Purpose and Direction

From time to time I will revisit my purposes for maintaining this site and I am always seeking direction from anyone who is willing to help.

Blogging is new to me and I have not yet grasped how to use all the available internet tools. In particular, I want to know more about organizing links, how to use bloglines and blogroll and how to insert a link to a reference into the text.

I want to network with more people and groups. My home is in Burnsville, NC and the BlogAsheville Group has been kind to include me. NC Bloggers and The Tarheal Tavern look like good activities to be involved with. Perhaps Greenville and South Carolina have similar groups or should start them. I will explore that possibility.

The blogs I have been reading are informative and entertaining. Perhaps I will contact some of these people for tips on the technical aspects of this medium.

Fixin' Healthcare will review and discuss health promotion and disease prevention from the perspective of individual responsibility and community commitment. Usually my definition of a community is a neighborhood or town, but there are a variety of communities these days. A group of bloggers who communicate regularly is a community.

I am very interested in any thoughts and activities related to health promotion and healthy lifestyles. This is a learning process with the intention to identify and implement effective means of promoting healthy habits.

Fixing Health and Fixin' Healthcare are titles chosen to signify that I believe the best way to reform health care is to promote healthy lifestyle and disease prevention. There will always be a need for health care (medical care) but far too many people have health problems that could be prevented or relieved by changing their habits.

It might be helpful for readers to know something about my background and a summary is listed for that purpose.

  • BA degree from Northwestern University
  • MD degree from Emory University
  • Residency in internal medicine at Barnes Hospital (Washington University) in St Louis
  • National Center for Disease Control and Prevention, Epidemic Intelligence Service
  • Faculty appointments at the University of Texas in Dallas (Parkland Hospital) and the Medical University of South Carolina (MUSC)
  • Dean of the College of Medicine, interim President and Academic Vice President and Provost at MUSC
  • Interim President at Winthrop College
  • Founder of the Cooper River Bridge Run in Charleston (3rd largest 10K in the US) and Prime Time Festival to promote healthy lifestyle for retirees in the Lowcountry of SC
  • Initiated a consortium of institutions in Greenville County to promote healthy lifestyle as a challenge to a similar project in Olmsted County, MN directed by Mayo Clinic

City of Greenville

Furman University

Greater Greenville Chamber of Commerec

Greenville Technical Education College

School District of Greenville County

The Greenville News