Drowning in the Fountain of Youth - Genetic Predisposition

Recently I read in a New York Times magazine article that the 130th richest man in the United States wants to match his age with his Forbes magazine wealth ranking. His riches have not bought him a unique, scientifically-formulated elixir for immortality; nor is he a wacky proponent of perpetual hyperbaric oxygen chambers or cryogenics. What he does do is carry the lifestyle modification of a healthy diet, adequate exercise and an avoidance of toxic substances-- from the reasonable to the obsessive. He has funded, to the tune of $500 million, a brick-and-mortar research institute with M.D.’s and PhD's, dedicated to his conviction that if you eat the right plants in copious amounts the ravages of cardiovascular disease can be eliminated and life spans exceeding a century become universally attainable. This is not your father’s health care nut, but he is one of the most compulsive and deluded.

            Let me emphasize a critical distinction-- losing weight, aerobic activity, avoiding nicotine and environmental toxins, a low fat diet and limiting salt and refined sugar ingestion are extremely important; but you cannot vege-matic, yoga, step aerobic and meditate yourself into everlasting life. Physical and mental health are determined not only by nurture, but also by nature. The DNA that we inherit in our genes is what our eccentric billionaire has chosen to ignore. This DNA provides the information as to which enzymes, proteins and receptors our body’s cells manufacture and thereby determine the metabolic pathways that influence our susceptibility to disease, toxins, aging and infection. Few diseases are entirely determined by a specific genetic code and, similarly, there is not a specific “longevity” gene.

             The fallacy of our modern Ponce de Leon’s quest is what I term the paradox of genetic predisposition for cardiovascular disease. In prehistoric times, our hunter-gather ancestors had a survival advantage because of the fright/flight/fight response of the hypothalamic-pituitary-adrenal axis. In simple English, when confronted with danger, it was advantageous for the neural and hormonal output of these organs to cause our attention to become strictly focused, increase blood sugar and fats to allow energy for muscular exertion, conserve salt and water to maintain blood volume and increase adrenalin for strength of action. In a world of sudden death threats, this response improves your chance of living another day. Mankind today has maintained this genetic makeup, but now we live in a world  of chronic stress, environmental toxins, sedentary lifestyle and atherogenic foods that turns this metabolic response against us. As opposed to longevity, the same neurohormonal output leads to high blood pressure, diabetes, Type A personality and high cholesterol. We were not genetically selected to live in 2015 as we know it, and no lifestyle alteration can change our DNA.

            Let us imagine that we do find the fountain of youth and there is water for all to drink, this may not necessarily be a good thing. Practically, how will we feed, house, educate and medicate this exploding population of very old people? How do we redefine the traditional passages of life? At what age do we retire? When can we vote? What incentive is there in the workplace for productivity and innovation if it will be another 40 years before your boss dies and you get promoted? How do you remember the names and birthdays of all your great-great-great-great grandchildren (and afford birthday presents)? Quite seriously, aging is what makes us human and mortality is the one common bond shared by all mankind. Breaking that bond may provoke the highest peril.


By Norman Silverman, MD, with Ryan McKennon, DO and Ren Carlton


Cutting Healthcare Spending - Big Data, Hospital Costs, and Outcomes

According to the federal Agency for Healthcare Research and Quality (AHRQ), inpatient hospital costs account for nearly 30% of healthcare spending in the United States and are increasing by about 2% per year over inflation. This cost issue is a focus of the Affordable Care Act, which is accelerating the move away from fee-for-service to a single, diagnosis-related comprehensive payment, similar to Medicare reimbursement. Such payment systems punish unnecessary testing, prolonged hospitalization, and readmissions.

Is Medical Science Dead? - Art, Science, and Quackery

On April 8, 1966, Time Magazine caused a national commotion when the issue’s cover was emblazoned with the question, “Is God Dead?” The Time article was a measured consideration of how society was adapting to the diminishing role of religion in an age of stunning scientific advances. The writer posited that people would no longer believe things out of received doctrine, but faith would steadily succumb to the scientific method as mankind unraveled the truths of the physical world at the expense of the myths of the metaphysical.

IMPACT OF ICD-10 - Increases Billing Accuracy, Headache for MDs and Patients

I strongly suggest that a pledge to read a synopsis of the philosophy of the 13th century Franciscan William of Ockham on a weekly basis be inserted in the oath of office taken by every government employee. Clearly highlighted should be his nominalist doctrine, Ockham’s razor, which avows that the best solution to a problem is usually the simplest. Pare to a minimum the number of confounding variables.

How do we treat pain? - Unrealistic Goals Leading to Opioid Addiction

In the weekend review from ACEP, two articles caught my attention. The first one was on new guidelines from the American Society of Addictive Medicine on the use of prescription medication to treat opioid addiction. These guidelines were created soon after the Centers for Disease Control and Prevention (CDCP) declared opioid use and resultant death as an epidemic. The second article refers to a study showing that pain is underdiagnosed and undertreated in the ED. This is the challenging dichotomy we live and work in.

Yelp May Not Help

Concomitant with the metamorphosis of the practice of medicine into the business of healthcare delivery, patients have been transformed into customers. Healthcare providers compete not only on the basis of outcomes, best practices, centers of excellence, advanced technology and cost, but also on customer service

Find and Replace: Genetic Engineering in Science and Medicine

Shakespeare’s Hamlet proclaimed, “What a piece of work is a man,” but now, almost half a millennium later, this could be amended to what a set of sequences is man. The nobility, reason, infinite faculty and admirable form can be attributed to the 20,000 or so genes that contain the chemical code for specific protein formation

HIPAA Protects Millions with Unintended Consequences

The Health Insurance Portability and Accountability Act (HIPAA) was endorsed by Congress in 1996 and was the last significant legislative legacy of Senator Ted Kennedy. It is enforced by the Office for Civil Rights and mandates nationally recognized regulations for use and/or disclosure of an individual's health information by a “covered entity”. Such an entity is a health plan, healthcare clearinghouse or healthcare provider.

Studies Prove Communication and Teambuilding Training a MUST for Surgical And Hospital Staff

Although individual judgment and technical dexterity are obviously important, best surgical outcomes, particularly for complex procedures, reflect the performance of many medical providers before, during and after an operation. Professionalism and a competitive business environment both stimulate medical centers to continuously focus on quality assurance programs, and to improve patient safety.

Death Rates Plunge Due to Following Protocols, Not New Technology

We are regaled in the lay press about new medical breakthroughs a novel cholesterol-lowering drug mimics the effects of a genetic mutation and improves lipid profiles when conventional treatment is ineffective; new cancer therapies are tailored medications designed to specifically attack tumor cells without the nonspecific toxicity of conventional chemotherapy; hepatitis C can be cured by short-term oral agents, not prolonged courses of parenteral infusions; mitral valves can be repaired percutaneously without the potential risks of extracorporeal circulation.

How to Grow Your Medical Practice Online

Here at Michigan Physicians Society, we’re dedicated to the financial betterment of physicians by providing continuing education and technology, along with an extensive network of other like-minded professionals in our space....
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