The Dr. B Health Blog

We have seen these faces- beautiful children without food- hungry. Starving for knowledge and education, health care and shelter. Whether the need is around the world or right here at home there are many legitimate causes that are worthy of your consideration and if possible, your charity. The problem is which ones are legit and which are not. How do you know that your money is going to the people or cause that you have intended for your hard earned cash.

First, DO NOT assume that since the cause is linked to your church, a friend, a celebrity, a relative, a “sister” program in your neighborhood, etc. that it is actually reaching the people or communities that it was intended for!  I have worked and lived for a long time internationally in other countries and in the ravaged parts of America (I worked and was raised in the South Bronx.) There are whole industries preying upon the generosity of Americans and those who really need our charity. First, you may have NO idea of how money is being diverted to foreign banks accounts and not converted to food, education, shelter and health care of those who need it most. But, by far the way that most soaks up money BEFORE helping the target group is “overhead”! This is the cost of doing business as a charitable organization. I remember one very popular and powerful charity (name is withheld to protect my butt) whose overhead in the name of God was 75%!!!! That means for every dollar that was donated, 75 cents went to the “cost” of operations. So, my first point is be skeptical. However, I am not suggesting that you should not give to charities if you can. Trust me, it is a really good feeling to know that your contribution will feed some hungry child or family, maybe help them sleep on a mattress with a roof over their heads rather than in the street, etc. Even if what you do helps just one soul, it counts!!!!!!!!!! If there is a heaven, then your act echoes through its fields- an act of love. For the giver, it is a good feeling- a feeling of being complete. It is important lesson for your children (i.e. the act of caring for others- not just for yourself).

Dr. Mehmet Oz has claimed that taking 100 mg of raspberry ketone  will help burn fat. Mehmet is being attacked by mainstream medicine with regard to his comments in this regard. First, I must admit that I am with the mainstream scientifically on this one. The research on this product is from animal testing- NOT in humans. Now, being an alternative medicine guy, I am used to unproven therapies and I advise my patients when using supplements if there is no good research to prove that it works or that it is not dangerous. However, this is NOT new in medicine. MANY products (pharmaceuticals, medical devices and procedures) are used- off label- namely, they are being employed by physicians for a medical problem that they THINK could get better EVEN THOUGH the FDA does not approve of its use for that problem because it deems that there is NOT ENOUGH data to support its use for that problem. Get it? MANY products being used by physicians for specific diagnoses in the mainstream are UNPROVEN to be beneficial for that indication. They were approved by the FDA for something else. So, I am not shocked that Oz would make a claim about an unproven substance- doctors (including yours truly) do it every day.

What is at issue is the safety of the product in humans. There are reports of palpitations and reduced effects of a blood thinner which is prescribed by physicians when the raspberry ketone is consumed. The structure of the ketone is synephrine which could indeed have cardiovascular effects! So, my best advice is to STAY AWAY from this product until we have more information and try a novel approach to fat burning- DIET AND EXERCISE !!!!!!!  It is STILL the best way to keep off weight.

The age of pharmacologic medicine continues its’ downward slide. If you are or have taken a class of drug called an alpha blocker it can cause serious complications years later during cataract surgery called floppy iris syndrome (pictured above). Perhaps the most common alpha blocker used today is tamsulosin (Flomax). Remember the ad? “If you gotta go, you gotta go!!!” Flomax helps men with enlarged prostates with symptoms of urgency. There are yet others that can cause floppy iris syndrome including Coreg (carvidilol) and Trandate (labetalol)- both with alpha blocking effects. Even if you stopped taking the drugs right now, the syndrome could occur years from today because of atrophy of the muscle that dilates the pupil.

Whether one agrees or disagrees with Obamacare in the United States, the amount of paperwork for primary care doctors is diminishing their ability to deliver the best care. The Affordable Health Care Act (a dizzying patchquilt, of regulations that was fashioned by those who never spent time “in the trenches” as primary care providers except in academics ) adds yet more paper burden to the practice of medicine and when coupled with the demands of insurers (each insurer has different forms, etc.) offices are being crushed by the volume of work that has NOT been demonstrated to make one iota of difference in patient care and outcome. Added to this is the ever increasing demand by patients for FMLA (forms) which leads to short term disability forms (more forms and each one coming from a different insurer and requiring different information) which in many cases leads to long term disability requests (even more and varied forms). As if not enough, office staff must deal with referrals, billing, collections, refilling of bills to insurance companies denying payment for various reasons, scheduling of appointments to specialists, refilling prescriptions, paying bills and answering routine patient questions. Specialists demand referral approval before they will see patients- even if they are not required to have it just to cover their backsides if a billing issue occurs so they can point to the lowly primary care provider- “it was his/her fault”- more work yet for the frazzled primary care doctor and staff.

I am not advocating one form of care or another but, in a study published in Health Affairs ( a prestigious health care publication) physician practices in the United States spend four times as much money as do those in Ontario, Canada, to cope with paperwork and communications involving health insurers and payers, according to a study published Aug. 4, 2011. In many practices, overhead has soared to nearly 80% of revenues. Do not fool yourselves into thinking that free market forces will cut the cost of care. That is an uninformed pipe dream. Insurers (private business) is just as responsible as the Feds for adding to the unbelievable burden of bureaucracy that we face in health care in general and in primary care specifically. One of the main reasons that you are seeing nurse practitioners take over primary care is because there are not enough primary care doctors and I cannot imagine why an intelligent and committed physician after so many years of training would even consider becoming a primary care doctor. I am sooo happy that my kids are not going into medicine! Now, to be sure, most primary care doctors are employed by large groups. The groups supposedly will be able to manage the volume of paper work. (I doubt it.) Theoretically, they will manage the bureaucracy better because of economies of scale. (I have heard that fantasy before as well.) The “new” docs are salaried and so they are less worried about paying the rent. In theory system staff will fill out the never ending sea of forms. BUT, they are more removed from you as well. They have a job- 9 to 5. They are not answering directly to you as one might in private practice. They get their paychecks from large groups, insurers or hospital institutions and this means NUMEROUS conflicts of interest with regard to what is best for you. If you are employed by hospital system X and the patient requires a surgery better done in hospital system Y where are you sending the patient? X of course! (It may not be better for you, but it is best for the system!) By the way, like in any job, doctors transfer, get fired and businesses fail. That is just starting to happen in the world or corporate health care encouraged by Obamacare.