Dr. Darshan S. Khalsa's Blog

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Sunlight, Vitamin D, and Heliotherapy May 4, 2010

Filed under: Uncategorized,wellness — Dr. Darshan S. Khalsa @ 9:58 am
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It is well established science that our bodies manufacture Vitamin D when exposed to sunlight and that Vitamin D serves many important health functions with our cells and organs. It is becoming well established science that supplementing with Vitamin D has numerous benefits. It is not yet established science (but I believe that it someday will be) that receiving sunlight is far superior to taking Vitamin D supplements.

First some background: Vitamin D does not meet the technical definition of a vitamin as something that is essential to human health but that cannot be produced by the body. Vitamin D is essential to our health (used in calcium and phosphorous metabolism, a strong role in the immune system, anti-cancer properties, and much more); however it can be produced by our bodies when we are exposed to the UVB rays of the sun. This role of sunlight was not known when the substance was first discovered and named. Once something is named, the name usually sticks, so Vitamin D it is and will remain.

Cholecalciferol or Vitamin D3, is the natural form of vitamin D for humans. Vitamin D3 is produced in the skin with sunlight exposure. Vitamin D2, known as ergocalciferol, is a compound produced by irradiating yeast with ultraviolet light. As a supplement, Vitamin D3 is much easier to metabolize than the D2 form.

There is some controversy over the optimal amounts of Vitamin D. The 400 IU amounts of Vitamin D found in many multiple vitamins are usually sufficient to prevent severe deficiencies but are usually not enough to provide optimal amounts. 2000 IU is usually taken as a safe optimal daily dose when supplementing; the only way to know for sure is have your Vitamin D levels tested. Blood levels of Vitamin D less than 20 ng/ml (nanograms per milliliter) is considered deficient while somewhere between 40 ng/ml and 70 ng/ml is considered optimal

Now for sunlight: 30 minutes of summer sunlight can produce up to 20,000 IU of Vitamin D for someone exposed to the mid-day sun while wearing a bathing suit without sunscreen. However, at our latitude, little or no Vitamin D will be produced by sunlight exposure from November through March. I had my Vitamin D levels tested in early April which should be somewhere near the annual low—mine was at 17 ng/ml which is just below the minimum recommended 20 ng/ml. Now it is May, and sunlight is abundant so I expect my levels by the fall will be quite high again. I think I’ll get retested then just to see…

The latest research shows that the dangers of too little sunshine exposure with subsequent low Vitamin D levels far exceed the dangers of too much sunlight exposure. (Don’t get sunburned though!) This leads to the following question: Why not simply supplement with vitamin D3 and not worry about getting sunshine? To me, this is similar to the question of why not just supplement with vitamins and ignore what we eat. I think that just as we are discovering that there are many previously unknown micro-nutrients that our bodies need in foods, we will discover that sunshine helps our bodies produce far more than simple Vitamin D.

Science is beginning to show this. Here’s a link about a study showing that the effects of sunlight were greater than the effects of Vitamin D in reducing the incidence of multiple sclerosis symptoms: http://www.eurekalert.org/pub_releases/2010-03/uow-sel032210.php

Over time, I think that many other studies of this nature will be performed. In the meantime, heliotherapy (therapy with sunshine) has a long and successful history of promoting wellness and curing disease. Sunshine is cheap and abundant this time of year, so get out in the sun! Start with 15 or 20 minutes at a time with no sunscreen, but don’t let yourself get sunburned. For most of you, 90 to 150 minutes per week of direct mid-day sun should be sufficient. You will feel so much more relaxed!   In October, when the sun starts to get lower in the sky, I’ll recommend some vitamin D3 supplementation for many of you.

 

Updated IPhone App version coming soon February 26, 2010

Filed under: stress,Uncategorized,yogic breathing techniques — Dr. Darshan S. Khalsa @ 7:11 pm
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An updated version of our Long Deep Breathing Application will be available soon…

In response to your requests, we will be including a way to do more advanced breathing exercises (called pranayams in the yogic tradition) by individually adjusting the inhale, hold-in, exhale, and hold-out times.  I’ll let you know when it is ready.

There are many wonderful ways to do breathing exercises and each has slightly different effects.  The simple and basic Long Deep Breathing exercise remains the best for beginners and those who want to reduce their stress levels, lower blood pressure, and improve their overall health.

Here are some instructions on how to do Long Deep Breathing:

Sit with your spine straight or lay on the floor with your spine straight. All inhaling and exhaling is through the nose.
Exhale all the air out of your lungs through your nose by contracting your navel point back toward the spine. Now inhale deep, pushing the navel point out and expanding the lower one-third of your lungs. Then consciously expand the middle portion of your lungs by expanding your chest. Finally expand the upper third of your lungs. Your collarbone will lift slightly and your shoulders may go back slightly. Once you have reached the full inhale, hold for a second or so, and then reverse the process. Exhale first the top, then the middle, finally the bottom. At the end of the exhale, immediately begin the next inhale.
This process will feel very natural after a little practice.
If the breath feels jerky, you are probably trying too hard. Just relax and continue practicing. Here is a simple fix: put a finger about four inches in front of your torso. As you breathe, move your finger smoothly up and down, from the level of your navel to your chin. Let this be a guide, raising the finger as you inhale and lowering as you exhale. You will soon be breathing smoothly. Think of a big pitcher slowly filling with water, starting at the bottom and slowly filling to the top, with the opposite on the exhale.

 

Another Long Deep Breathing Newpaper Article!

This article form the Fairfax Times actually came out in December, 2009.   In addition to talking about the Long Deep Breathing App, it talks  about our practice.

Here’s the link:

http://www.fairfaxtimes.com/cms/story.php?id=779

Here’s the article:

by Gregg MacDonald | Staff writer

Shamus Ian Fatzinger/Fairfax County Times
Darshan S. Khalsa, of Reston’s Khalsa Integrative Medicine, LLC, displays the iPhone application he helped design to lead users through a series of deep breathing exercises.
A Reston alternative healer has teamed up with a Herndon software developer to create an iPhone software application that helps people practice holistic deep breathing techniques — and it is selling all over the world.
 

Today’s front page in the Washington Business Journal is about the new Long Deep Breathing iPhone App December 4, 2009

Today’s Washington Business Journal put us on the front page!  Here’s the link:
 
 

Holistic medicine practice puts deep-breathing app on iPhone to draw in new customers and revenue

Washington Business Journal – by Melissa Castro Staff Reporter

Joanne S. Lawton
Dr. Darshan Khalsa has launched a “Long Deep Breathing” mobile application to spread holistic medicine techniques.

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A Reston-based alternative medicine practice is launching ancient spiritual concepts into the frenetic world of iPhone apps, in yet another sign of technology’s steady march into pretty much every fiber of our existence.

Dr. Darshan Khalsa and his wife, Carol O’Donnell Khalsa, went live this month with their first app, “Long Deep Breathing.” It’s a stress relief technique that is part of the Kundalini yoga that Darshan Khalsa has practiced since the early 1970s.

The Khalsas’ collaborative project hints at the limitless opportunity behind smart phones and the app craze, a no-barriers-to-entry industry that has made millionaires out of entrepreneurs peddling everything from flatulent noisemakers to imaginary farms that sell imaginary seeds for genuine money.

If expelling air can make big bucks, there has to be a market for inhaling.

“Apps,” or applications, are tiny software programs that give smart phones the power to find a restaurant, hail a cab and identify the song playing on the cab’s radio.

Khalsa, a quiet Sikh convert whose gentle hazel eyes and impossible stillness of being inspire healing in his 1,500 or so patients at Khalsa Integrative Medicine, is an unlikely prophet for technology and social media. He rises at 4 a.m. to do yoga and pray for world peace, then tends to 10 or 12 patients a day.

If Khalsa were left to his own devices, “I’d have just four or five patients — she’s the one who brings in the patients,” he said in his Reston office, surrounded by Chinese herbs, maps of the body’s energy meridians and dozens of certificates affirming his training in alternative and Oriental medicine.

O’Donnell Khalsa handles the marketing for her husband’s practice with a muscular New York brassiness that grabs you by the collar and demands your attention. She has her own long history with alternative medicine, but that’s not the contribution she makes to their relationship. “My background is health care marketing, yours is healing the world and together we co-create that,” O’Donnell Khalsa said to her husband.

Thanks in part to his wife’s tenacity, Khalsa could soon have millions of patients from around the globe, although none will pay more than a dollar for his advice.

In just five days — despite snafus in the initial launch — the breathing app had already been downloaded 46 times. Without a single act of marketing by either Khalsa, iPhone users from as far away as Australia have downloaded the breathing app.

Even the app’s developer, George Churchwell, the president of Herndon-based Tech 2000 Inc., was surprised by its early success. “If they had asked me my opinion, I would have said, ‘Eh, I don’t know. Do people really need to learn how to breathe?’” Churchwell said. “But Darshan hit on something that resonates with many people.”

While Long Deep Breathing is no iFart Mobile — which has been downloaded half a million times since December 2008 and has frequently pulled in as much as $10,000 a day — it’s a reminder of the app craze’s unlimited opportunity for entrepreneurs.

“This is the third wave,” said Churchwell, who launched Tech 2000 as a software and computer training company in 1984. (The company started writing apps in January.)

Before Google’s search engines, Churchwell says, most companies were invisible on the Internet. After Google took over the Web and began charging for prominent placement in its search results, “the big guys crawled to the top and owned the Internet again,” Churchwell said.

But Apple Inc.’s App Store has leveled the playing field once more, creating a space where placement is based on the number of downloads and the level of positive feedback an app has received.

If you’re creative and already tech-savvy, it could cost you as little as $99 to write your own app and put it in the App Store. Last summer, Churchwell’s Tech 2000 trained high school students at Woodson High in Northeast Washington to create a basic

iPhone home page for their schools.

Not only does Churchwell believe anyone can write an app, he’s also developed a business model to prove his own theory true. By creating engines that can easily program apps for any sort of educational content, Churchwell is now willing to develop any well-conceived app for anyone, free of startup costs. Instead, Tech 2000 takes a 50 percent cut of all sales revenue left over after Apple takes its own 30 percent slice of total revenue.

“We’re like mini-venture capitalists,” Churchwell said.

The Khalsas’ breathing app didn’t fit into the existing templates offered by Tech 2000, so it was built from scratch and paid for on a flat-fee basis. (The Khalsas declined to say how much the app cost to develop.)

The Khalsas are already working on developing their next two holistic health apps, including a wellness assessment that will be a free download.

At its current sales clip, the Churchwells expect that Long Deep Breathing will pay for itself within six months. But that’s hardly the point.

It’s more about seva — the Sanskrit word for selfless service. “The cost is irrelevant — it’s about putting our energy into something,” O’Donnell Khalsa said. “The goal of our relationship is to transform the health of as many people as we can.”

 

 

 

Our new Long Deep Breathing iPhone App is ready! November 22, 2009

Our new Long Deep Breathing iPhone application is now available on the iTunes App store! 

This link will take you to the iTunes store where the App is described and can be purchased:

 http://itunes.apple.com/us/app/long-deep-breathing/id337291691?mt=8

Of course you can experience the benefits of Long Deep Breathing without an iPhone or an iPhone App.  Many of you who are patients have already learned the technique and understand some of the benefits of Long Deep Breathing.  

Creating the App is a way to reach out to people far beyond our patient base.   We’re hoping that many people all over the world who  are experiencing stress can learn this simple Long Deep Breathing technique and derive many benefits from it.  Perhaps those who already know the Long Deep Breathing technique will be reminded to practice it more often.  The App does seem to make Long Deep Breathing  more fun, particularly as you work to slow down your breathing….it becomes quite easy to track and challenge yourself. 

We’ve already had sales in 14 countries!  For some reason, it seems to be selling well in Australia. In addition to the iPhone, the App will work on an iPod Touch.

Remember, our clinical experience is that people who practice Long Deep Breathing for 5 minutes, three times daily, will experience major health improvements!

 

To Vaccinate or Not Vaccinate? October 16, 2009

Patients have been asking me lately about whether or not they should get the flu vaccinations, both regular seasonal flu vaccination and the H1N1 swine flu vaccination.

I think the short answer for most of my patients is no.  However, this is not a simple question, so I’m going to take a round about way of answering it, and first discuss vaccinations in general.

Even if every bad thing you have ever heard about the effect of vaccinations on individuals is true: (vaccinations contribute to autism in children, they can cause auto-immune disorders, people often get sick immediately after getting vaccinated, some of the additives in vaccines can contribute to cancer or neurological diseases); even then, from a public health perspective, vaccinations are still often beneficial. The benefits to the general public of not getting epidemics outweigh the individual negatives. Over the course of the 20th century vaccinations have apparently helped reduce the incidence of infectious diseases such as smallpox, whooping cough, and polio. At the same time, for most individuals there seems to be very little immediate negative effects from getting vaccinated.

So what we have to do is find a reasonable balance between the severity of the epidemic threat, the effectiveness of the vaccine against the epidemic threat, and the potential harm to the individual from getting vaccinated.

At this time, for the regular seasonal flu vaccine, there is little or no evidence that the flu shot is even effective at reducing the incidence of flu. You can see a very interesting article in this month’s Atlantic magazine, titled “Does the Vaccine Matter?” (Available online at: http://www.theatlantic.com/doc/200911/brownlee-h1n1 ).  The years that the flu vaccine has been a good match for the seasonal flu have no difference in outcomes from the years in which the flu vaccine has been a poor match. No large scale double blind testing has ever been done. There is a widespread belief that flu shots reduce the incidence of flu, but very little evidence that this is true.

For the H1N1 swine flu vaccination (now just starting to be available) here is the situation: While the virus spreads easily, the sickness itself is so far relatively mild and most people have developed no lasting problems. At the same time, the effectiveness of the vaccine is unknown and the risk of potential harm from a new, relatively untested vaccine is higher than normal.

So it seems that for both seasonal flu and H1N1 swine flu, there is very little benefit from getting the vaccinations and very little risk incurred from not getting the vaccinations.  This is why I have been recommending that patients not get flu shots and that patients instead take other steps to build their immune systems naturally.

Aside from the lack of benefits, there are potential downsides to getting the flu vaccinations. These downsides apply to most other vaccinations as well, and that is why vaccinations should be individually evaluated for benefits and risks.  There is no effective treatment that doesn’t potentially cause some problems.

Here is a partial listing of some of the potential downsides of vaccinations:

Mercury in the form of Thimeresol is used as a preservative in many vaccines. Mercury is a known neurotoxin and can combine with other factors to induce neurological and auto-immune disorders.

If you are already sick, getting a vaccination may throw your immune system further out of balance and cause long lasting problems. Never get a vaccination when you are feeling sick. This is a particular problem with young children since their immune systems are not fully developed. Likewise, receiving multiple vaccinations at once is not a good idea. Children in this country receive far more vaccinations than in other countries with some evidence that their overall health is worse.

Introducing an infectious agent directly into the blood stream means that it is not mediated by the normal immune protections. In addition, some vaccines contain aluminum, formaldehyde and other toxic substances. These substances can cause allergic reactions that can lead to auto immune disorders in those who already have compromised health. Even non-toxic vaccine additives such as squalene or egg whites can induce allergic reactions when introduced directly into the blood.

There are many more potential downsides. Some people will develop either immediate or long term problems after getting vaccinated. Of course, most relatively healthy people will have no problems whatsoever with the vaccines.

In the case of the seasonal flu or H1N1 flu vaccinations, the risks of getting the vaccine are not balanced by the potential rewards.

The answer for other diseases or for future pandemic diseases could be different.

 

Energy Medicine September 7, 2009

Underlying the material structure and physiology of our bodies is an energetic level.  Our sensory perceptions of the material forms of our bodies and our surroundings are somewhat illusory:  to our senses everything seems very solid and distinct, but actually what we are perceiving is mostly empty space with energetic connections.  Our understanding from modern physics and ancient spiritual teachings is that what we term matter is interchangeable with energy and that matter is simply a more dense form of energy.  Clinically we can view the material form of our bodies as a lower frequency version of our energetic nature. 

Disease begins at the energetic level long before it can be detected physically, and healing usually begins at this same energetic level.   When body energy is flowing correctly and in the right quantities, the chemical/structural aspects of the body come into alignment with the body energy and healing proceeds rapidly.   We see this over and over in the clinic. 

Our understanding is that chronic disease or pain states usually occur on an energetic level first; when these imbalanced states persist for periods of time ranging from weeks to years, a physical change occurs that reflects this.  It is at this point that the Western Medicine diagnostic methods can usually identify the problem. 

So many times patients have gone to Western medical doctors with various symptoms and been told that the lab tests do not show any problems.   However, as time passes and the patterns become frozen into physically detectable forms, treatment becomes much more difficult.   If imbalances are treated in their earlier energetic phases, balance is much easier to restore and most physical symptoms can be avoided.  It is these energetic imbalances that we focus on discovering and correcting with our WholeHealth WellnessTM techniques.

Coming soon:  The four predominant historical  systems of Energy Medicine.

 

Preventive measures for H1N1 Swine Flu August 25, 2009

Yesterday the President’s Council of Advisors on Science and Technology issued their estimate of the possible impact of H1N1 swine flu on the American population:  Up to half the population infected and up to 1.8 million hospitalizations required!  This is much more than a normal flu season—we’ll find out in the next few months how accurate their estimate is.  This H1N1 flu variety is relatively new and people have built up less immunity.  Unlike most influenzas, predictions are that older people will have more immunity and that this flu will disproportionately infect younger school age people. 

Here’s a link to the Center For Disease Control’s H1N1 Swine Flu site with lots of good information:  http://www.cdc.gov/H1N1Flu/

I’m certain the mainstream media will be sufficiently alarmist so the real issue becomes what should we do to prepare for the impending flu season.  Disease is always an interaction between the strength of the pathogen and the strength of our immune system.   How can we strengthen our immune systems to better resist these new pathogens?

The vaccine which may help prevent infections won’t be ready until the flu season is well underway.  Vaccines have their own problems as well, and I’ll discuss these in a future blog post.

 The basic recommendations for strengthening the immune system are still primary:     stress reduction,   regular acupuncture,    good diet along with steps to improve digestion,   good hygiene (frequent hand washing, etc…)

I also teach patients various acupressure techniques that are effective for immune building and disease prevention.  In addition, I’ve been dispensing two different supplements to patients to help build their immunity and one supplement to keep in reserve at home in case a cold or flu starts.  We dispense only to current patients since no formula is indicated for everyone.

Two supplements that we often give to patients to boost the immune system:

The first supplement is a Chinese Herbal Formula called Yu Ping Feng Wan, “Jade Wind-Screen Pills”.  This is a very old formula in continuous use at least for the last 700 years in China.  It contains Huang Qi (Astragalus), Fang Feng (Siler), and Bai Zhu (Atractylodes).  The action of this formula is to build up your immunity, hence the name:  create a precious (Jade) Screen around your body to shield you from pathogenic influences (Wind).  Yu Ping Feng San is a good formula for almost everyone to take as we enter cold and flu season. 

We also sometimes give patients another good modern formula that combines enzymes, Chinese Herbs and Western Herbs called ProSol™ Immune.  Here are some of the ingredients of this formula:  PHysioProtease™ is an enzyme blend that activates the immune system to promote healing and seeks out areas of inflammation and tissue damage.  Astragalus root extract – An antioxidant that helps protect the liver, has many known immune stimulating properties.  Goldenseal root – Contains several alkaloids shown to have anti-microbial and antibacterial properties. Echinacea angustifolia root – Has antiviral, anti-fungal and immune-stimulating effects

What do we do when our immune boosting preventive measures are not adequate and we feel ourselves starting to get a cold or flu? 

I’ve been recommending to patients a Chinese Herbal Formula called Gan Mao Ling to keep on hand for just that time.  This formula has antibacterial and antiviral properties and can be very effective at helping the body overcome an initial disease onset.  This formula is not as effective at building the basic protections as Yu Ping Feng Wan or ProSol™ Immune, but is more effective for initial disease onset.  Here are the ingredients of Gan Mao Ling Wan: Ge Gen (Pueraria Root); Da Qing Ye (Baphicacanthus Leaf); Bo He (Mint); Ju Hua (Chrysanthemum); Jie Geng (Platycodon); Xing Ren (Apricot Seed); Lian Qiao (Forsythia) Gan Cao (Licorice).  Gan Mao Ling Wan, if taken at the onset of a cold or flu, can often help your immune system throw the disease off quickly.

Be prepared for flu season!   If you wish to maintain optimal health through this coming flu season, please schedule an appointment.  We dispense only to our patient base, so if you are not already a patient, you will need to make an initial appointment.  Our best wishes for your good health this flu season!

 

Why Do So Many Patients Exhibit Sensitivities to Wheat? August 23, 2009

Filed under: allergies,food sensitivities,stress — Dr. Darshan S. Khalsa @ 2:37 pm
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What is it with wheat?  Why are so many of our patients now testing sensitive to wheat and wheat products?  Wheat is by far the most common food sensitivity we encounter when testing patients.  (Other very common food sensitivities are milk/dairy products, soy products, peanuts, and eggs.)  By simply removing wheat products from the diet, we often see great clinical results, particularly with children.

Wheat probably couldn’t always have been so allergy inducing.  Is it the way wheat is grown and processed in this country?   I’ve had patients who were highly sensitive to wheat here, but who were able to go to Europe and eat the European bread while there with no problems.  Was it just because they were less stressed when on vacation and therefore their digestion performed better?  Or is there a difference in the wheat itself?  When I went to India recently, the wheat there tasted much better than anything I remember having here.  Their wheat was grown locally and probably freshly ground (they were harvesting while I was there); their method of preparation used hot steel and fire and this also probably helped counteract the “damp” producing effects of wheat.  (Damp is a Chinese medical term roughly equivalent to congestion.)

I have read that the type of wheat we are mostly eating today is much higher in gluten than what was historically grown—in other words, the wheat has been bred to be much sticker and starchier than what we historically ate.  The highly refined nature of the wheat and the possible presence of genetically modified wheat are not helpful either.

In addition to the way our USA wheat is grown, stored, and processed, there are probably other environmental stressors that we experience here.  Our country has experienced a vast increase in asthma over the past twenty years.  The same cofactors are probably creating the increase in wheat sensitivities that we see today.  Our overall air quality is much better than in many parts of the world, and yet we are seeing an increase in allergies and asthma.  Why is this?

More on this later….

 

Healthcare Policy from a Practitioner Standpoint August 16, 2009

Healthcare legislation is presently being considered by Congress and the White House and some policy reforms are expected within the next few months.  I expect that the details will be highly complex and the final thousand page proposals will probably contain many surprises.  We are all familiar with the unsustainable growth in the cost of health care and health insurance, so some changes are necessary.  In addition, the present system produces a lot of unnecessary anxiety which drives up overall health care costs.  Our present per capita health care costs are higher than any other country, and our average outcomes put us well behind most other advanced countries.

I am by no means an expert but I’ll give my simple take on the basic problem:  There are no major institutional parties in this country that have a real interest in health.   Treating acute or chronic disease is the focus of our healthcare system.  Indeed it would better be called a sick-care system than a health care system.   Western medicine is wonderful at treating acutely ill cases and trauma, but not particularly effective at preserving and expanding health.

Individual people are of course interested in promoting their own health, but the major institutions involved in health care are not interested in promoting good health.   The private insurance companies pass on all their costs and make extra profits by denying claims and cherry picking only healthy customers; the hospitals make their money doing acute care; individual MD’s generally mean well but are not reimbursed for time spent on educating patients and are themselves focused on acute care; and the pharmaceutical companies main interest is to have people take their drugs for long periods—healthy people are not good pharmaceutical customers.

I am hoping that the final legislation will include a strong “public option” and that this will eventually lead to outcome based standards determining which medical procedures are cost effective.  These outcome based standards could in turn create a motivation to do more preventive medicine:  “ A stitch in time saves nine” and “an ounce of prevention is worth a pound of cure” are two common proverbs for good reason:  with more preventive care, the country could achieve much better health outcomes at a lower cost.  If true outcome based standards are put into place, the utilization of alternative and integrative healthcare will increase, and overall health care costs will decrease.  Right now the institutional incentives are all working the other way.  There was an interesting article in the New Yorker recently discussing local health care differences and some of the institutional pressures driving up health care costs. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande 

Of course, the real change that needs to happen is in the overall consciousness and understanding of people regarding wellness.  For now, there are many individuals interested in health and wellness, but many Americans are still looking for the quick fix, the magic pill that will fix everything.  After a few years, they come in to see us because they are taking six or seven pharmaceutical medications and feeling terrible.  It would be far less costly to change behaviors and avoid the problems in the first place.

On a public policy level, most people want unlimited acute health care for a limited cost, and this is barely being addressed in the current proposals.  It will be interesting to see what comes out of the legislative process with all the competing interest groups contending.  I’m hoping for some improvements, even if the improvements are minor.

We definitely do need to transition from our present sick care system to a true health care system.