Dr. Erika | Bioidentical Hormone Expert

New Guidelines for Mammography : A Reason For Celebration

Last week the US Preventive Services Task Force came out with new guidelines for mammography. Simply stated, the new guidelines recommend that:

1.    Routine mammography screening start at age 50 instead of 40  (guidelines provided in 2002).

2.    Frequency of screening to be reduced to every two years rather than the previously recommended
       every year.

3.    Breast self-examinations are no longer recommended.

4.    Clinical breast exams (performed by physicians) only minimally improve outcome in patients who
       have mammograms.

These guidelines encountered a furious backlash in the media immediately after its publication in the Annals of Internal Medicine from special interest groups, patient groups and politicians with special agendas.

As a practicing physician, women’s health advocate and opinion leader in the prevention movement and a healthier America, I welcome the guidelines and would like to share with you my personal and clinical understanding of their meaning.

Guidelines represent recommendations to be used by the medical community, researchers and public health officials to analyze outcome. Guidelines do not necessarily apply to the individual and should be used to guide the physicians and the patient to a well informed position from which individualized decisions should be made.

For those of us who are in primary care, who see patients every day with various questions about choices and options in health care, guidelines serve as resources to provide better patient care.
Guidelines are developed as a result of years of extensive research by intelligent, physicians and researchers who are assigned the task of reviewing the entire scientific literature on a particular topic and to provide unbiased data on a particular subject matter.

To better clarify the situation with mammography:   

1.    The members of the US Preventive Services Task Force are all doctors, MDs and PhDs who work at academic institutions around the country. They are not government employees.  They are not oncologists or radiologists or breast cancer surgeons who may have a biased perception of the realities of breast cancer. The US Preventive Services Task Force spent almost 2 years reviewing all the studies on mammograms, biopsies, treatment, risks and benefits and prevention since the last guidelines were issued in 2002.

2.    Dangers of mammography and biopsy are generally overlooked and minimized in our present healthcare system. Marketing of the business of medicine does not include the downside of too much testing and treating associated with millions of yearly mammograms, biopsies, chemotherapies and radiation therapies. Rarely if ever does a woman get informed of the risks of mammograms and biopsies in the mainstream media, from cancer groups, radiology clinics or academic center physician groups which specialize in the diagnosis and treatment of breast cancer. 

    - The potential dangers of mammograms occur from too much radiation to the most radiosensitive tissue of the body which does increase breast cancer risk as more mammograms are given to women over extended periods of time 

   - False positive mammograms prompt unnecessary procedures, fears and treatments which include biopsies, chemotherapy and radiation for often precancerous lesions or slow growing cancers which do not warrant treatment. These procedures carry risks of their own rarely addressed.

   - Biopsies disturb breast architecture and body immunity preventing the body from healing itself which scientific data support as a safe and previously unaddressed option.

   - Emotional stress caused by all of the above and the fear of cancer increases risk of cancer.

Women are scared to death by the prospect of being diagnosed with breast cancer. In our society women have been taught to believe that the sooner they are diagnosed and the cancer is removed, the better their chances for survival. That is not always true. Deciding to delay treatment or not have mammograms is met with disapproval by conventional physicians even if there is no scientific basis for pushing the patient into mammograms and biopsies.

The Task Force has taken the first significant step toward cutting down cost of healthcare and helping the economy. This is a major step forward in prevention and the change of the health care paradigm.  It cannot and should not be perceived as a personal attack on women. Politics cannot be allowed to taint this immense positive step forward.

I am not against mammograms or biopsies. Women at high risk by virtue of genetic factors, environmental exposure and other factors must be addressed under a different category which only serves to reinforce the importance of the connection between the doctor and the patient and the need for women to take responsibility for their own health.

Self-examinations are important since women need to know how their breasts feel and they are most likely to find the breast mass first. Physician examinations are important but caution has to be exerted that the doctor represents the patient’s best interest and is not afraid of malpractice suits. When the physician and the patient are aligned philosophically, women will benefit the most.

While everyone is worrying about swine flu, let's make sure you know the difference between Common Cold or Fall Allergies? Learn the Difference to Feel Better Faster

It's that time of year again when ragweed pollen and mold spores fill the air leaving millions of Americans suffering from fall allergies. Allergy symptoms present in a similar fashion to the common cold: runny nose, itchy eyes, sneezing, wheezing, sore throat, coughing and nasal congestion. Similarly to a cold, often only 1 or 2 of these symptoms appear, making it even more difficult to decipher between the two. And not to mention the fact that this year, every time you get a sore throat or feel a little bit under the weather, the media hype makes you think you have the swine flu. In fact, most people don’t have the swine flu but rather suffer with either the common cold or fall allergies or a combination of the two.

 

To protect yourself best is to understand how to differentiate between colds and allergies and then treat them without delay.

 

Keep in mind the main points of differentiation are that the common cold lasts about 1 week while seasonal allergies linger for several weeks to months and that most allergies symptoms are not associated with muscle aches, pains and fever while colds can be without being diagnosed as flu.

 

If you think your symptoms are fall allergies here are several tips to keep allergies at bay as much as possible.

• Keep your windows closed and use air conditioning.
• Don’t mow your lawn or rake the leaves in the yard.
• Keep outdoor activity to a minimum; especially during morning hours when allergens peak.
• Take a shower after spending time outside.
• Drink lots of water and green tea
• Exercise regularly
• Avoid food allergens
• See an allergist to determine what you are most allergic to and follow the recommendations of staying away from allergy causing foods
• Change detergents and soaps if allergies commence or are worsened by introduction of new products
• Do not leave clothes you used outside in the closets or laying around your home. Shake them out outside first.
• Make sure ventilation in your house is good
• Eliminate dust from your home. Keep it clean with natural cleaning products
• Change air conditioning and heating filters regularly at least twice a year.

 

 

Should your allergies continue to be a nuisance try using a mild decongestant or Benadryl at night. And don’t forget fall allergy season ends with the first frost or by the end of November/December.

Stay away from decongestant nasal sprays as they can often aggravate your other symptoms, leaving you feeling worse and even increasing the chance of respiratory infections. Decongestants decrease your immune system’s ability to fight infections so avoid them. Your body actually does get rid of allergens by giving you a runny nose and runny eyes. Stopping that reaction stops your body from fighting the allergen and you may not want that.

A cold is usually associated with sore throat, feeling sick (malaise), runny nose, headaches, muscle aches and even a low grade fever.

 

If you think your symptoms are caused by a cold here are some tips for nipping the cold in the bud:

·       Start taking Lactoferrin 3 capsules twice a day for five days at the first sign of the cold. Lactoferrin is a natural immune booster that supports and enhances your body’s own immune function. ( for more information go to www.drerika.com)

·       Take EmergenC- 1 packet in a glass of water 5 times a day for the first three days of the cold (You can always buy EmergenC at the drugstore, gas station, deli, etc.)

·       Vitamin C 5000-10,000 mg a day for five days)

·       If you have a sore throat take a tip of a teaspoonful of cayenne pepper and mix it with a tablespoon of water and drink it fast.

·       Take a tip of a teaspoonful of powdered ginger and mix it with a tablespoon of water and swallow it in one gulp.

·       Soak your feet in hot water for 15 minutes the first evening you feel crummy. Put on a pair of socks and go to bed early. Do not watch TV.

·       Increase your intake of protein (chicken soup, Detoxification Powder, tofu)

·       Drink 5 cups of green tea or Throat soothing teas

·       4 Glasses of room temperature water ( avoid iced drinks)

·       Spend 10 minutes in the shower in the morning and breathe in that great healing steam!

·       Stay away from junk food, alcohol, soda or caffeine. They will only delay your body’s healing powers

·       Stay home from work or school so you do not infect your colleagues.

·       Unless you have a fever, do not take medications like ibuprofen or acetaminophen.

There is no such thing as medication without side-effects.

Give your body a chance to heal itself, it usually does a really good job with minimal support from us in the health care system.

 

 

Bogged Down By Special Interest, Health Care Reform Becomes A Political Tool Instead Of A People's Right

Prevention is a crucial element of healthcare reform. President Obama said that through prevention, Americans will become healthier and thus substantially reduce the costs of healthcare. He extolled the importance of training more primary care physicians, encouraging each and every one of us to take responsibility for getting and staying healthy and focusing on prevention.

But that was a few months ago when the president first presented his plan for a government run overhaul of our severely ailing healthcare system.

I for one, along with many of my patients, applauded the president.

We who live and work in the trenches where healthcare actually happens know how desperately needed a change of direction is.

We know first hand that all too often our hospitals are sources of more disease than cures, that patients get shuffled from specialist to specialist and test to test for years without improvements in their condition, that the insured are often treated just as poorly as the uninsured. We in the trenches watch in horror as some of our peers care more about how much money they make from a particular test, by prescribing a particular drug or by giving a lecture for a drug company, then spending an extra 5 minutes with a patient listening and caring. We in the trenches know that the system is overtaxed and the training of physicians is not of the quality or purity we need to keep the country healthy and thriving. We also know that the most advanced technologies or drugs will never make up for the humanity and care we are often unable or unwilling to give our patients for lack of time or maybe fear of getting sued.

Of course, each one of us is responsible for creating a positive outcome in our own lives, but in the case of healthcare we need a little more than good attitudes and perspective. We need some serious support. Support from our government was promised by President Obama during his campaign. We agreed it was needed. We needed change and voted for it.

Unfortunately, not much of what we truly need is included in the HS 3200 plan and the increasingly heated discussions we are faced with today.

Personally, as a practicing physician for more than 30 years, I felt betrayed and horrified to read the President had gone back on his word to avoid involvement with special interests by making a deal with the pharmaceutical lobby.

The White House secretly made a pact with the drug companies that was hammered out several months ago but only came to light a few weeks ago in all too few media outlets.

Although quite sketchy, this much we know: The drug companies, through their powerful lobby, agreed not to oppose any form of healthcare reform and offered $80 billion in cost savings over 10 years if the White House would protect them from having to shoulder additional financial burden in upcoming legislation.

Please note this is not about giving free drugs to poor people who cannot afford them and actually need them -- this is about keeping the drug cartel running the healthcare system.

This type of deal will make drug companies even more powerful and the country more addicted to prescription and other forms of "legal" drugs. Not exactly a promising start for a trend towards prevention. True prevention is about preventing disease and inherently diminishing the need or more drugs, regardless of cost.

The $80 billion "giveback" deal is a drop in the ocean for drug companies. If healthcare reform legislation is passed as is, it will give millions more American access to their products and result in windfall profits. That is, as long as the health care system continues on the path of status quo: more disease diagnosing, more testing, more drugs, less doctor-patient interaction.

The deal with the Administration guarantees drug companies a "seat at the table" as the reform process plays out and perpetuates their position as one of the most powerful lobbies in Washington regardless of which political party is in power. This does not bode well for the American public.

Never mind that too many drugs are proven to harm people more than help them, that drug companies influence physician practice, not only by paying for medical education but also through ghostwriting scientific articles published in respected medical journals. Never mind that drug companies advertise their drugs directly to the public while also sponsoring some of the most senior and highly respected medical groups and academic centers in this country.

Increasing access to drugs takes the focus off the real problem and allows the drug companies which already have destroyed the concept and reality of a free and safe health care system to continue their plan to benefit from America being sick and using drugs instead of shifting the focus to eating right, exercising and preventing disease.

Instead of worrying Americans about "death panels" and rationing of health care which is already in place with HMOs and other large insurance carriers, let's put the focus back where it belongs.

Do not allow America to continue being manipulated by special interest groups and help the people of America understand that they must control their own fate.

Let them start by learning how to eat right, exercise, sleep and be kind to themselves. Once these basic health care tips become part of the fabric of our society, we can focus on demanding that physicians and other health care providers work for us.

Healthcare is the ultimate service industry and should become exactly that. Once healthcare becomes solely about serving the public and not special interests, the solution to all our health care problems will be found.

WHY STRESS MAKES YOU FAT

A recent study in the American Journal of Epidemiology looked at data on 1,355 men and women who had their weight and stress levels measured in 1995 and again in 2004.

The findings showed that those who were overweight and obese packed on the pounds even more as time went by and stressors continued and increased.

Those who were thin stayed thin and according to the lead author Jason Block on faculty at Harvard, “The stress effect didn’t appear to impact normal-weight people, just those who were overweight and obese from the beginning of the study.”

The results of this study may be true but as Americans are getting fatter and sicker, we are faced with more problems than ever before.

We are suffering ever-growing rates of obesity and worsening health caused by weight problems.

Stress is a leading cause of this modern-day epidemic – brought about by our frenetic lifestyles or by financial worries from the economic recession.

Stress comes in two varieties:

Acute stress is when you are running to catch a plane, your work is past deadline, the kids are calling for help and you feel like the world is crashing down on your little shoulders.

Chronic stress is what we live with every day without any hope of it loosening its grip on us.

Doctors and scientists analyze the metabolic and hormonal basis for our stress reactions. Nutritionists, exercise experts and other clinicians help us deal with its undesirable effects.

One thing that doesn’t work is being told that the problem is in our head and that if we watch our diet we will lose weight. And, the second is when doctors discard the problem and recommend a blood test at some point in our downward spiral.

The best way to deal with problems from my perspective of 30+years of practicing medicine and experiencing stress first hand is to understand the causes of the problem. So here is a primer on what stress does to our body and soul:

1. Metabolism - Stress stimulates the production of the hormone cortisol which slows down metabolic function. Normal, healthy metabolism helps us digest process and detoxify our system from foods while absorbing the nutrients we need.

2. Blood sugar levels and Insulin - Stress causes insulin levels to fluctuate wildly and the blood sugar levels follow. When insulin levels are high and sugar levels are low we crave foods - fatty, salty and sugary ones in particular.

3. Cravings regardless– Our desire to eat junk is directly connected to hormone levels and chronic stress worsens the problem. When stress is the core issue, people do not run for vegetables and fruit, they hit the chips, fast food and junk.

4. Fat storage especially around the belly and hips – When you are stressed, you eat junk which accumulates in fatty deposits around the waist and abdomen. As women age the middle section of the body becomes heavier - an esthetically displeasing sight with dangerous health consequences: higher risk for heart attacks, strokes and diabetes.

5. Emotional Eating – Stress and increased levels of cortisol plunge us into a cycle of eating badly, drinking too much caffeine and alcohol, not exercising and being unable to sleep. But there is always a way to take control of our lives. If you let stress make get you down, you won’t be able to enjoy the upside of life.

Here are a few ways to NOT let stress make you fat:

1. Don’t isolate yourself. Reach out to friends, family and others who are truly doing well and who have positive recommendations and are a positive example.

2. Stay away from critical and negative people. Pay attention and you will figure out who is good for your health and who isn’t. Sarcasm is always a negative.

3. Exercise. Unless you find that you feel worse after exercising, which is usually a sign of illness, start a serious daily little-at-first, build as you go, program. You will feel better and crave more exercise not junk food.

4. Relax. When I hear someone say relax, I immediately tighten up. The best way to relax is to focus on beautiful times and places. Imagine a place and time when things worked well for you. Stay with that thought for a while and see how quickly you really relax.

5. Sleep is the key ingredient to feeling better and losing weight. During sleep, hormones are made that help your entire system renew and strengthen. Get 8 hours of sleep a night and watch the weight drop.

6. Balance your hormones. If you are over 40, male or female, your hormones need help. Menopause and low thyroid are major contributing factors to our inability to deal with stress. Find an experienced doctor who knows about hormones and listens to you. Take bioidentical hormones if you need them, get your thyroid treated, take the right supplements to support your immune system and hormones and watch how quickly you shed stress and lose weight.

7. Do not focus on diet alone. When trying to loose weight incorporate all the above into a healthy diet, exercise and stress management program.

Sun Protection

Finding the perfect balance between getting enough sun exposure to get enough vitamin D in your system and protecting yourself from potentially dangerous sun UVA and UVB rays is often a tall order.

Before you run for cover you need to understand the importance of getting enough sun for your health.

Exposure to sun daily up to 30 minutes is crucial to getting enough vitamin D which protects you from cancer, boosts your immune system and as you well know is a key ingredient for healthy bones.

Covering yourself up and slathering on the highest SPF lotion is not always the protector you may think it is.

The growing deficiency of vitamin D among the population of the US is often attributed to extensive use of high SPF lotions that prevent the sun’s beneficial rays from reaching our skin and providing us with the much needed vitamin D.

To balance the need for sun and the protection from sun here are some tips you may find handy:

1.    Make sure you use SPF 15+ moisturizer on your face every day. Protection from UVA rays is  
       crucial to keep skin from sagging and wrinkling. 

2.    Note, most SPF lotions and creams do not protect from UVA rays because UVA rays are not
      routinely associated with skin cancer.

3.    Read the label. The higher the SPF is not a guarantee for skin protection. Make sure the ingredients 
       are not all chemicals. You can get protection from the sun without all chemicals.

4.    Avoid products that contain oxybenzone. It may interact with your hormone balance.

5.    If you get a rash after applying a product, wash immediately with water, make sure you pay attention
       to the main ingredient in the product that caused you the reaction and avoid using it again. ( PABA  
      is often an allergen)

6.    Do not buy the most expensive or the cheapest products. Find a product in the middle range and 
       read the label to make sure

7.    Beware products that over state promises. No sunscreen will last all day if you are at the beach, or
       playing tennis. As a matter of fact, no sunscreen will last all day.

8.    Reapply if you spend the day at the beach, sunbathing or playing an active sport

9.    Use common sense: do not fall asleep in the sun, do not spend endless hours tanning. The benefits
       of short periods of time in the sun outweigh the problems caused.

10.    Be cautious but do not be fearful. Strike the right balance for you and your skin type. Know your
        risk factors and act accordingly.

Here are some products I recommend. They were vetted by the Environmental Working Group which is a watchdog organization without financial ties to the industry.

Best Sunscreen:
-    Soleo Organics Sunscreen- Organic chemical free sunscreen SPF 30+
-    Badger Sunscreen, SPF 30
-    UV Natural Sunscreen, SPF 30+

Best Lip Balm:

-    Fallene Cotz Lip Cotz, Ultra High Sun Protection, SPF 45
-    Jane Iredale Lipdrink , SPF 15
-     Badger Lip Balm, SPF 15

Best SPF Moisturizers:

-    Keys Soap Solar Rx Cosmetic Moisturizing Sunblock, SPF 30
-    Marie Veronique Organics Creme Du Jour Tinted SPF 30
-    Devita International Daily Solar Protective Moisturizer SPF 30

The above can be purchased on the internet.  Have fun in the sun and keep safe!

TRUE PREVENTION IS THE SOLUTION TO OUR HEALTHCARE CRISIS

TRUE PREVENTION IS THE SOLUTION TO OUR HEALTHCARE CRISIS

“An ounce of prevention is worth a pound of cure”, noted Benjamin Franklin. Too bad the founding father is not here to help clarify and guide us with our much needed healthcare reform.

The fact is unless you’ve been living under a rock for the past decade or so, we all know prevention reduces disease rates and promotes good health. Yet surprisingly a mere 2-3% of today’s healthcare expenditures are directed toward prevention. We are painfully aware that America is obese, stressed, sedentary and doesn’t get enough sleep yet, we don’t spend money on improving the situation and preventing diseases caused by these problems.

Instead of expanding true prevention programs, our present healthcare system is focused on diagnosing and discovering more diseases, testing ad nauseam, creating new and highly expensive technologies and developing an infinite array of drugs.

Conventional medical training and treatments are solely aimed at searching for disease. Success in our healthcare system is achieved when the patient, spends their life caught in the spin cycle of doctor visits and never ending testing leading to finding the disease that will eventually “express” itself and give the system a raison d’etre.  

Providing true prevention is not even a consideration – our present healthcare industry is programmed to swing into action with its high-tech, high-cost arsenal of disease “fighting wars”. Peace and cooperation is not part of this equation. 

No wonder the system is costing us $1.8 trillion a year – and is certain to get more expensive.

There’s an army of special interests in Washington – drug companies, hospitals and the medical establishment – lobbying like crazy to make sure Congress doesn’t disturb the status quo. Too bad if the country goes broke! Too bad if instead of enjoying life, we spend our time terrified of being sick.

The discussion about prevention has been going on for decades, but it has nothing to do with early diagnosis of disease which is what most conventional doctors and patients have been taught it is.

A patient of mine went for a physical at her local internist last week. As a courtesy, the doctor sent me the report from her chart. In a newly developed section under the heading Prevention, the doctor recorded the following list of tests he recommended for the patient:

•    Mammogram
•    Pap smear
•    Colonoscopy
•    Bone density
•    Immunizations for pneumonia and influenza

Not one of these tests will prevent anything.  They are all part of the health care system’s early diagnosis of disease branch. My patient was scared that if she didn’t do all the tests immediately, she would further endanger her health.

Another of my patients brought me a report from her annual physical conducted by an expensive executive physical company. The report was a five page list of everything done to the patient in the exam and panoply of scary recommendations of possible dangers awaiting her due to her rising age of 42, borderline cholesterol, possible high blood pressure and of course weight problem (10 lbs overweight). Recommendations included more testing and follow up with more doctors. If she did not follow the advice, implied threat of serious disease was found in every paragraph. Nowhere in sight was there mention of diet and exercise lifestyle and sleep recommendations that would really help her stay healthy.

Both patients came to see me asking for reassurance in the face of scare tactics and lack of direction for prevention.

Prevention is about staying healthy and not being scared into having tests done for the sake of doing them. It is about spending fewer dollars on health care and more on good, clean, healthy living.

For people who are focused on prevention, much of their personal health care dollars are spent outside the conventional system. People and physicians focused on prevention spend money on supplements, organic foods, bioidentical hormones, acupuncture, gyms and even yoga classes. These expenditures are not even considered in the healthcare system budgets we are trying to fix.

This bird’s eye view of our present healthcare leaves us in a quandary. How can we fix a system that is about increasing technology, drugs and people all focused on disease when the answer is clearly outside the system and in the area of prevention?

The answer is: you cannot.

The way to fix the system is to take a more in depth look at what works for the people who are healthy and stay healthy.

Health isn’t about early diagnosis of disease. It is about teaching every one of us to take responsibility for leading healthy lives before there are any problems.  Spending less money on looking for disease and focusing on eating right, exercising and leading healthy lifestyles is the real solution to the healthcare crisis.

May be we should listen to Benjamin Franklin who also said: “A penny earned is a penny saved.”

It's all about the doctor-patient relationship!

More than thirty years of practicing medicine, significant personal media exposure and being an avid listener of those who deliver the care and those who debate it, I wonder what exactly is wrong with our country.

We are the leading industrialized nation in the world. Or are we? We boast the best standard of living, yet we have fallen behind in all health care parameters except spending.

A few nights ago I watched the CNBC program Round Table on Health Care and it was mostly more rhetoric and pundits listening to themselves talk. Unfortunately that is about all you get these days in the media when speaking of health care reform.

One exception at this round table was Michael Milken. Among doctors and politicians he told the truth, it’s all about Prevention.

Health care is never going to really help the millions of Americans who are obese, who smoke, who drink and don’t take care for themselves. Lack of Prevention will only help the drug companies, insurance company trusts, surgical suppliers and technological testing companies make more money at the public’s expense.

It’s all about prevention, but how can you even begin to address prevention when the real implementers of prevention aren’t even part of the discussion?

I’m referring to the doctor-patient relationship which ultimately makes or breaks the entire system. Remember Dr. Welby? Remember when doctors were beloved and patients were respected and cared for? Those were the days when the cost of healthcare was not prohibitive. In those days genomics and MRIs were scarce but good will and health were abundant. What changed?

Medical training in the US is funded by a combination of federal, state, endowments and special interest (primarily drug company) monies.

To become a doctor you have to work extremely hard for 4 years, then a few more years to train to be a clinician and specialist, you work non-stop, rarely sleep, eat junk foods and just try to survive. When you have completed this insane amount of training you are faced with a sad state of affairs. You have a pile of debt and work options are often decided on how much money you can make to catch up. Remember that at this point you are at least 30 years old.

While you were training to be a doctor something very important happened. A paradigm shift took place in your brain.

By the time you finish your training you no longer see the world from your original perspective of saving the world.  While you weren’t sleeping and diligently trying to be the best student and resident in your program, the indoctrination from the special interest groups who were paying for your education was going on full force.

The result: gradually you became a prescription drug pusher, a product utilizer, a physician who will send every patient for myriad of senseless and intimidating tests, surgical procedures and the ubiquitous hospital stay. Within 10 years from starting medical school you become a robot in the service of special interest.

I know it, I lived it and I watched all my friends live it also. I speak from a position of deep understanding, knowledge and experience. The outcome is often devastating.

While many physicians do not fall prey to this exact sequence of events, there are far too many who do. Fully trained doctors no longer see patients as human beings.

Malpractice threats, the business and politics of medicine have only served to rob too many a doctor of his/her most powerful healing tool, their humanity and have permanently changed the interaction with the patient.

The patient is another symptom or disease, a nuisance, someone to protect yourself from, to get rid of as fast as possible until the entire profession becomes a mere conveyor belt of human parts.

Bedside manner, listening to the patient and caring are not on the medical school curricula.

Medical training isn’t focused on encouraging physicians to become primary care practitioners, internists focused on preventing disease and maximizing health. There is no course in medical school on doctor-patient relationships, patient advocacy, compassion or learning how to listen to your patients.
I wonder why? Certainly the outcome is scientifically and common sense proven to be better when the doctor and patient work together and trust each other. It certainly is a lot less expensive to listen than to do lots of testing and write prescriptions for every patient we see…

Physicians have a one master; the patient. To serve the patients and no one else, to refuse to be brainwashed and to open our minds and hearts to providing the best care in kindness will save the healthcare system. Didn’t we become physicians to save, after all?

To change the present predicament physicians must focus on keeping the patients healthy, on prevention.

This involves learning nutrition to provide nutritional advice, lifestyle and exercise advice as well.  And one more thing: physicians must learn to take care of themselves. They must start to address their own diet, exercise, sleep, stress and lifestyle issues to become examples of healthy living and prevention. I bet that approach will help improve the health care system in a heartbeat.

Now let’s look at the patient for a moment.

When I went into private practice more than 20 years ago, a man came to see me. When I asked him what I could do for him, he said” how should I know? You are the doctor.” Herein lies the biggest problem the present healthcare system capitalizes on.  No one knows how you feel and what goes on inside your body better than you do.

No doctor will ever know you better than you know yourself. Until we know that fact, we will not be able to command better health for ourselves, and will run the risk of becoming victims.

If you want to learn please hear me!

The doctor has no idea how you FEEL.

The doctor has a lot of information that he/she learned in medical school, training and practice but all that information does not necessarily apply to you.

If you don’t explain how you feel and your doctor doesn’t hear you, you will never get the right care. That is an absolute fact.

No matter how great the doctor is, if you don’t take responsibility for creating a positive outcome you are at risk. If the doctor doesn’t listen to you and doesn’t pay attention to your complaints, leave. You are better off with no care than with bad, sloppy or uncaring care.

It all goes back to the doctor-patient relationship. Like every other relationship in your life, you must work at it and you cannot ignore it.

Your doctor must be your advocate, you two must be philosophically aligned.

If you believe in alternative medicine and your doctor doesn’t you are with the wrong doctor.

If you want to take bioidentical hormones and your doctor tells you they are a marketing term, don’t argue, change doctors.

If you trust conventional medical treatments and your doctor wants to give you supplements and herbal remedies leave.

If you are on the same page with your doctor you’re heading in the right direction.

Life is to be lived outside the confines of the health care system. The right doctor will understand that, help you stay healthy and live your life without fear or doubt.

If most of us doctors and patients heed this advice we will implement the health care reform we need in this country and set an example for the world to follow.

Then when we can say the US is the leading industrialized country in the world.

SHOULD THE THREAT OF SWINE FLU KEEP YOUR CHILD AWAY FROM CAMP THIS SUMMER?

Patients have called, community members have sent e-mails asking my opinion about the dangers of sending kids to camp amid the fear of swine flu.

Here’s what we all need to know about the topic and how the information will help you make safe, sound and fearless decisions.

Swine Flu caused by H1N1 virus is a mild flu with a name.

Regular flu kills up to 30,000 people a year. In the case of swine flu, 170 people have died in the US and approximately 300 globally. This is not a virulent flu. For those who have lost loved ones, statistics are meaningless and will never make things better. Statistics are useless when we are looking at each and every one of us as individuals. Do not use statistics when making health decisions. They only serve to scare us and most likely do not apply to the individual. The goal is to do everything we can to stay healthy and help raise healthy children.

Regardless of year, every time you send your kid to camp or any group activity that involves sleeping in close quarters away from home, the child will be exposed to many contagious agents. No matter how well protected, close living quarters cannot maintain the same levels of sanitation as individual living arrangements.  Small children living in the woods with lots of physical activity, water sports, heat and sun  are higher sources of risk then sitting locked up in an air conditioned room. Forget the risk being lower, the lack of fun alone is a killer.  If you can afford to send the children to camp to have fun and share summer time with their friends, there is no need to start worrying now. It may be the appropriate time to focus on prevention and information.

For years, I used to be camp physician at my youngest daughter’s camp. It was the only way I could spend time near my child without appearing too clingy a parent.

The camp had an infirmary and two nurses. As part of my job, I had to make rounds on a group of three camps every day (you can be sure my daughter’s camp got me there more than once a day….).

When a child came down with a cold, a sore throat or a fever, the child was immediately isolated. That was why there was an infirmary. Once, the kids got lice and the nurses scrubbed their hair and made sure the lice was gone before returning them to their bunks. That was a big emergency.

I did send a few kids home in my three years as camp doctor, but it was never for a serious contagious illness. We taught the kids to wash their faces and hands every morning, to take a shower every day, to brush their teeth after every meal and to wash their hands before each meal and after going to the bathroom. We taught kids to never drink from each other’s glass or cup. We taught them to go to sleep early and get up early.  We did not have Swine flu then, we just practiced prevention.

How can you protect your children and still let them enjoy the summer?

Do your homework and make sure the camp is clean and safe. No need to overdo hygiene, just clean water and plenty of soap will do. No need to disinfect every door knob.

Healthy kids are not bacteria or viruses, They don’t need disinfecting. Send your kids to camp when they are old enough to enjoy it. Sending kids to camp should not be your way of getting rid of the kid for the summer. Keep in mind camps are for the benefit of kids.

Make sure the camp feeds your kids healthy fresh foods. Stay away from camps that are junk food friendly. In my experience the camps with the healthiest fresh food are usually the ones with the healthiest kids.

Do not scare your kid. Tell her/him the swine flu is just the name for this season’s flu. Make sure the infirmary at camp is focused on helping kids feel better and has enough beds and lots of love.

Then, make sure your kid is healthy and excited to go to camp.  If he is well and sees you excited about his camp experience, send him to camp with a smile. This is just another summer and fun and learning good things is what childhood is about. Forget about the swine flu!

Cinergy Health

Dear All:

I am attaching a press release regarding my appointment as Medical Director to Cinergy Health.

I am very excited to team up with Cinergy. Together we will improve the health care system and help the public focus on prevention and patient advocacy.

Please read the release, and check out their website www.cinergyhealth.com.  I am happy to be affiliated with an insurance company who puts the patient first and has the goal of helping people focus on prevention.

My first media opportunity through Cinergy came last Friday and I would like you to watch it: Industrialized Health-Care Mess .

My clinical practice and contact with the patients and public will not be affected by this appointment.

To your health,
Dr. Erika

Cinergy Health Appoints Dr. Erika Schwartz as Medical Director

Provider of Affordable Health Care Insurance Will Draw on Physicians' Expertise in Preventative Medicine and Patients' Health Advocacy to Enhance Health Plans

AVENTURA, Fla., June 15 /PRNewswire/ -- Cinergy Health, a nationwide provider of affordable health insurance benefit programs for the consumer market, today announced Erika Schwartz MD, as the company's medical director, a new position. As Cinergy Health's medical director, Dr. Schwartz will provide guidance on health care issues, ranging from the efficacy of emerging medical procedures to so-called non-traditional treatment methods, such as the use of nutriceuticals. In addition, she will engage the public in a dialog on ways they can optimize relationships with their own health care professionals.

"We are excited to have Erika join the Cinergy Health team, especially given her broad and deep experience as a patients' health advocate," said Daniel Touizer, CEO of Cinergy Health. "Her work in both hospital-based and private practice gives her a powerful perspective on the entire health care delivery system and what constitutes a proper and effective level of service - all for the benefit of Cinergy Health Plan members."

Over the past 30 years, Dr. Schwartz has personally taken care of more than 100,000 patients, treated more than 15,000 patients with various formulations of bioidentical hormones and has written four best-selling books published by Warner Books, Putnam and HarperCollins. In December 2008, the Medical Clinics of North America published an entire chapter written by Dr. Schwartz on the use of hormones in wellness and disease prevention, a first in the field of conventional medicine. She was invited by the chair of Obstetrics and Gynecology at Harvard to lecture at Massachusetts General Hospital on the topic of bioidentical hormones in February 2009.

"Cinergy Health is an insurance benefits company that actually puts the individual first. Its affordable health insurance coverage is as innovative as any medical breakthrough I've seen," Schwartz said. "Further, Cinergy Health plans are designed to encourage people to seek care, not delay it such that their condition could worsen. As someone who's been involved in patients' rights for years, I am proud to be associated with this company."

Schwartz received her MD from State University of New York Downstate College of Medicine, graduating cum laude, as a member of the prestigious AOA academic honor society. She served as Director of Emergency Medicine at Westchester County Medical Center (University Hospital of New York Medical College) in Valhalla, NY, a world-renowned trauma center. She has been in private practice, in Internal Medicine, for the last 17 years.

As one of the nation's most widely-recognized experts in the field of bioidentical hormones and an outspoken advocate for patients' rights, Dr. Erika Schwartz has testified before Congress, appeared on CBS News, Larry King Live, The View, The Montel Williams Show, CNN, MSNBC, Oprah Satellite Radio with Dr. Oz and many others. Her affiliations include: Board of Managers at SUNY-Downstate College of Medicine, the American Society for Internal Medicine, National Association of Medical Communicators (AMA), International Coenzyme Q10 Society and the Bioidentical Hormone Initiative.

About Cinergy Health

CINERGY HEALTH, Inc., with headquarters in Florida, is a nationwide provider of innovative and affordable health insurance solutions designed to meet the changing needs of American families. Recognizing the financial challenges for people who cannot afford or qualify for costly major medical insurance plans,

Cinergy Health designs and delivers lower cost alternative health plans that facilitate access to quality healthcare services and enable people to maintain better health. Cinergy Health Preferred Insurance Plans are limited medical benefit plans, which provide first dollar coverage for the predictable medical care people need most frequently. These insurance plans provide coverage starting with a member's very first doctor's visit without a deductible so that s/he doesn't put off important medical care. From doctor visits and diagnostics to maternity and surgery, Cinergy provides essential coverage that's easily within most people's budgets. Further, plan member can choose doctors and hospitals of their choice without being confined to a list.

PERSPECTIVE ON SWINE FLU

The recent outbreak of swine flu and its rapid spread from Mexico into the US and other countries has caused many of our community members to ask what I think about the dangers of this new disease and the risk it poses to the population at large?

Here's what I know and think about it.

Swine flu is not a new type of flu. It is a known and recognized flu virus that causes pigs to suffer with symptoms similar to those that affect us humans when we get the flu. Most pigs just get over it the same way most of us get over the flu even if we are not immunized against it.

Transmission of the swine flu from pigs to humans occurs only rarely and it happens by droplet transmission. That means you have to be in contact with a pig who has the flu and sneezes on you. That situation is a very rare occurrence. But once humans do catch the swine flu from the pig, the disease spreads because humans transmit it to other humans much faster than the pigs do.

Swine flu is like other flu. It is characterized by fever, malaise, generalized pains and aches, sneezing. Runny nose, sore throat and occasionally diarrhea, vomiting and abdominal pains. Overall the duration of the swine flu is the same as other flu 5-7 days.

Humans can protect themselves and everyone else from spreading the swine flu the same way we can protect ourselves from spreading communicable diseases in general.

To protect yourself from the swine flu you need to take the same measures you take to maintain a hygienic and clean lifestyle that support your immune system's optimal function: eat healthy foods, do not drink alcohol or other immune depressants, get 7-8 hours of sleep a night, exercise regularly, wash your hands frequently, do not come into contact with people who are sick and stay away from other people when you are sick. Common sense goes a long way and saves everyone who practices it.

A little perspective on the swine flu can help us learn not to react to the sensationalism associated with it:

1. In 2008- 37,313 people died in car crashes in the US.
2. More than 20,000 people die of the common flu in the US yearly in spite of flu immunization
3. There are approximately 15,000 murders in the US every year.
4. On the average 90 people die of lightening every year
5. Remember Anthrax? In 2001 we were all scared to death by it and 5 people actually died from the disease. I wonder how many died with heart attacks and strokes caused by the fear of Anthrax?

I am not being cavalier or trying to make light of a source of fear and confusion. I just want you to be smart and put things into perspective. Good attitude and good perspective are great tools for survival.