35 Burst results for "Dr Howard"
"dr howard" Discussed on Medicine, We're Still Practicing
"Our everyday life pandemic or no pandemic. I do i think. Prior to the pandemic there was a modest amount of telemedicine going on it mostly related to this trend important one to try to create healthcare system. That's more convenient than the patients in for certain kinds of services especially if most of what was going to happen was a conversation between the healthcare professional patients. The concept of having to interrupt someone is doing closed down their computer and go down at elevate on drive across town. Wait for doctor and see them and then going back and doing the same thing possibly twenty minutes conversation when that all they had to do necessarily get on the phone for twenty minutes and not have to waste all time that was getting to be something significant in some patients in particular really valued now became not just an important amount of venus and became a matter of safety way of trying to keep healthy people of possibly a slightly unsafe environment than trying to minimize the spread of a very bad infection. I think as a result of those two things in combination more and more patients and for that matter more and more doctors have become familiar with this technique and may not be a panacea. It's not perfect. But for certain conditions people finding it to be very satisfactory both doctors and patients. And i find it hard to believe that will move away from. Hopefully we're not going to need it for the same reason for the insane intensity because right now we like to keep people out of healthcare facilities as much as possible nice if the only reason delete because this is something that people desire and want as opposed to. They need havoc on because of safety features. So in your estimation are the drug companies cooperating with each other through this process or has this been just a race to the top of the stock market. Well i'd probably a little bit of both. I do think i do want credit. The scientific community. As a whole. Because i think when it came to the actual genetic mapping of the virus sharing that information across countries what was being shared between china and here and the sharing of what was going on research. Labs think there was quite a lot of it continues to be. You know the drug companies. I think on the one hand are very interested and going the right thing because this is such an unprecedented situation that they know they need to come to the rescue. I think they've done most of that. I think they've done quite well and shared some information and learnings and for processes in especially when it came to some of their planning for how they would get the virus manufactured because bossom easy to manufacture one hundred million copies of vaccine on the other hand they are for profit entities and they try to protect their know-how and they have shareholders. And they wanna make sure the profitable and there's an enormous amount of money both from the federal government and from the healthcare system itself that is funding us efforts and so they're obviously trying to maximize of. I'd say probably a little bit of both but in this case the fact that they've got these effective vaccines out so quickly i think they deserve a lot of credit one of the one of the other groups. I can't help it talk about for a minute. Are the people who are the first responders and they drive ambulances and they are the paramedics in ambulances has got to be just a nightmarish situation for them. I'm sure you'd like to say something about what they're doing. But in a place as small as the inside of an ambulance how is it physically possible for a healthcare worker paramedic to protect themselves from the guy who's full of virus. That is lying on that table as they go to the hospital. Well if you're wearing p. p. That's the whole point. I mean because we are very close to our patients in the hospital. And so you can go in and out of a room provided that you're protected and provided you're not breaking that. Pp protection you are going to be safe and secure. I think the thing that a so laudable about the first responders is that by contrast in the hospital we control our environment very well automatically know who's covert positive. Who isn't we isolate them. We don our ahead of time when you are a first responder and i was an ambulance attendant for a short while back in college. You're walking into an environment and you can't control that environment. You try to get control but there are people who can be combated. There are people who yelling screaming who are emotionally distraught. These are high risk situations for an individual be walking into strangers home not knowing what collateral issues were be confronting them. The ambulance itself is the least of the risk. The risk is walking into a strange environment. Where you really cannot control what might be coming at you things that you can't plan for clearly. I'm lucky because i get to sit and talk to you guys. And you're experiencing and steve is intensely experiencing this virus in his icu with all of these patients and the overload patients. And you're sitting here thanking the people who are part of your machine which is noted and appreciated. I know that everybody. Who's listening to this. Wants to thank you guys for your message your process you're forethought and your compassion for people around you because there's no way you're paid enough to do this job. Dr howard freeman. Thank you again for joining us. Thank you bill. And of course. Dr steven taback. We can't even imagine what it was like for you today and yesterday and the day before and the month before that to deal with the surge at the hospital. Thank you for making time for this. And i think the message that you guys are giving is an important one howard. How can people follow you. Oh that's stray kind. So every once in a while put out a tweet and that could be beached at howard foam an md. Thanks to our producer and editor. Aj moseley audio. Mastering is by steve. Ricky berg music for we're still practicing is composed and performed by. Celeste and eric dick. Don't forget the hit. The subscribe button. All that does is let you know what our show is posted. We'll see next time. Stay healthy thanks for joining us on medicine. We're still practicing. Cnx week everybody turco media media for your mind..
Understanding the Virus with Dr. Howard Fullman
"So i are host the quadruple board. Certified doctor of internal medicine. Pulmonary disease critical care in neuro critical. Care my very good friend. Dr steven day back. How are you steve doing. Okay deceive. oh we have one of our favorite experts returning to us today Howard j fomin. He is board certified in internal medicine and gastroenterology and howard served a multi decade tenure at kaiser permanent day as partner ford member president of the executive committee chief of staff and chair of the quality committee. He has supervised over forty three hundred staff and over five hundred doctors. Howard is now seen your operating advisor at atlantic street capital for their medically focused investments. Dr howard foreman nice to have you back thanks to be here high stated it good to see hey steve. What's it like in the icu. With the kobe patients has it gone. It's been very rough at my hospital. The surges hit us really hard. We actually we had a mini surge. Back in may when everybody else seemed to be really struggling at this time it has hit us really hard we have about one hundred and fifty plus cove patients in our hospital and i bought twenty percent of those are in the intensive care unit and those that intensive care unit. They are all on high flow oxygen or intimated. So they're all very very sick. And howard what. Are you hear about kaiser. How are they holding up in all this. I just very proud of everybody. Credible courage by the patients and their families what they're going through doctors nurses respiratory therapist all staff level of dedication i think of the healthcare professionals are just miraculous people. Tired in was there the other day doing data the procedures. And just in what. I do which is way less difficult than being in the icu. For twelve hour shifts just wearing in the ninety five masks in a shield and all the p p being more cautious than ever and trying to make sure that the patients can get in and out so that they're not in the medical center. One minute more than is necessary. Cetera et cetera. Just makes the practice of medicine which is already something that's very challenging even more challenging but my heart goes out to the patients and that that's just a culprit patients Anyone who needs services. The hospital is having more difficult time than usual inside easy being a patient thunder normal circumstances that along under these circumstances. i'm sure they're all kinds of treatments. That have changed since our last conversation. I mean the remdesivir steroids in a number of other treatments that you guys have raised a bad situation. What's working the best these days. Dr steve in actually the one medication that really has shown to decrease mortality everything that we have is decadent on an age old medication. A steroid that's used to decrease swelling decrease inflammation in the body thus far as the only medication that we're using that actually has been proven to diminish with a twenty eight day mortality. We do give them de severe because there has been shown that there's been some benefit in terms of shortening the course of the disease and so it's still part of our protocol and so everybody who's coming in is getting a coverage for we call community acquired pneumonia in case they have bacteria on top of covid. So they're getting the usual medications for that which is usually as for miocene in something called stuff triax zone but the standard therapy provided you have good kidney function that you're not to overwhelmingly sick is the decca drawn remdesivir but it is the decca drawn. That by far has been shown to be very effective. I do believe for those people who are not terribly ill that are just starting to show signs and symptoms of covid that have various co morbidity is considerably overweight have diabetes a monoclonal antibody that has given an infusion. I believe has also been a game changer. Although i've not seen formal data in that way but those are the big three medications that we give. I mean you've got to look at what's going on here in the us and it's gotta frustrate both of you. Knowing how many people are breaking the advice may be needle one column rules because somehow those of us in the us don't like those things called rules. Frankly i've seen a bunch of parties. Go on in my town. There have been a bunch of weekend weddings and dancing. And what have you and it's almost like. What are you supposed to do as a healthcare organization to get the message across. I can't imagine. What would happen. To dr steve here if there was a surge on top of this surge. That's an important point in all of us in healthcare professions of. I wanna start again by saying lots. Lots of people doing their level. Best imply vincent. I feel really badly for people who don't have a luxury to be at home. That essential workers people who were living in very congested areas. Tranquil did very best. They can difficult circumstances. So that's important to make sure we now. The hard work difficult circumstances lots of people living under now everybody's violating these guidelines but there are people who are either inadvertently or something some cases intentionally violence
Doses Of Antibody Drugs Remain Unused As They Present Various Challenges
"The federal government says it has delivered more than 300,000 doses of monoclonal antibody drugs to help facilities nationwide. They're designed to treat patients with mild to moderate covert 19. The ideas keep those patients out of the hospital, but Many of those doses are sitting unused, due in no small part to the challenge of administering those drugs. NPR's science correspondent Richard Harris looks at to healthcare systems that have overcome those hurdles and are seeing hopeful results. Monoclonal antibodies present all sorts of challenges. They're given to people who have active infections, but who aren't hospitalized, so it's important to treat them without exposing other patients to risk. The drugs by Regeneron and Eli Lilly are also given by infusion, and that process takes a couple of hours. So when you add all this up, you know it's really a logistical challenge to deliver this therapy to a lot of people. But Dr Howard Long at Houston Methodist Hospital, says they figured out how to do that. They've opened clinics around Houston and doctors affiliated with the hospital are referring eligible patients. That is people who are over 65 or who have health conditions that put them at high risk. So at this point we're doing about 50 to 70 infusions a day, and patients are usually scheduled within a Relatively short period of time. So from the time they call into being infused, it's usually less than two days. The timing is important because these drugs appear to beam or effective early in the course of the disease. Mostly help people who aren't mounting their own strong immune reactions and, well medication sits unused in many locations around the country. That is not the case at his hospital, Hong says. Right now we're constrained more by the drug supply. They use it as fast as they get it. Any doctors nationwide aren't so enthusiastic about these drugs, though treatment guidelines issued by the National Institutes of Health say there's actually not good evidence to know whether they work. That's because the Food and Drug Administration relied on studies of just a few 100 patients to grant these drugs, emergency authorization. So these are very small numbers that under normal conditions nobody would never publish in the journal like New England Journal of Medicine. Yet this is, you know, kind of headline news. Welcome Toko bit time right. But doctors are gaining experience. Houston Methodist is now treated more than 1100 patients, Hong says. We're seeing results that are comparable to what was reported in the clinical trials by Eli Lilly and Regeneron about six or 7% of patients who are treated end up in the hospital or emergency room. He figures that without treatment about 15% of the most high risk patients could end up in the hospital or ER. Doctors affiliated with the Mayo Clinic or also encouraged by their experience. They've dust more than 2000 patients in Minnesota, Wisconsin, Arizona and Florida. Dr. Raymond reasonably has done a preliminary analysis of the 1st 1000 or so patients and finds low hospitalization rates. More importantly, there is some signal that is also reducing death. But again this our preliminary analysis we have to kind of make sure that this are all vetted by pure review. But this is what we're seeing. That's why we're happy. Unlike a clinical trial, this real world experience doesn't have a careful comparison group so doctors can't say for sure that these patients are faring better. Even so, these encouraging findings may be swaying doctors who weren't sure they wanted to refer their patients for treatment. There's nobody says patients are also becoming less skeptical. Initially, there were more declines than accept. But no, we're actually seeing more except than declines, and even though it takes a lot of person power to provide this treatment reasonably and Hong believe they're actually reducing the overall workload. Keeping patients out of the hospital. Richard Harris NPR
New York investigates whether ParCare health fraudulently obtained COVID-19 vaccines
"State police have launched a criminal investigation into a health care provider in the city for possibly giving the covert vaccine to people who aren't supposed to be getting asked a health commissioner Dr Howard Zucker says authorities are following up on reports would say that the park care Community Health Network May have obtained the vaccines fraudulently, and then administered them to people other than healthcare workers or people living or working in nursing homes. You're great. You're great fingers. Thank you. Park care, even tweeted out of video, showing them vaccinating someone who wouldn't seem to be eligible and older Rabbi and one man and borrow. Park says he applied for a vaccine on a par Ker website. And listed one of the criteria Elderly who Have underlying conditions. But that's not on the approved list. Park areas. Several Brooklyn locations including borrow Park, where this man defends the company. I'm sure they're doing a lot of goods and don't focus focus on the good,
New York health care provider may have fraudulently obtained Covid-19 vaccines, state says
"The New York State Department of Health is investigating Claims of Cupid vaccine fraud, a show Kabbalah has the story Health Commissioner Dr Howard Zucker said on Saturday that his office was given reports of Park Hair Community Health network, fraudulently obtaining doses of the vaccine and illegally transferring it among their facilities. Park hair has locations throughout Brooklyn. The allegations suggests that vaccine intended for frontline health care professionals and long term care residents would be diverted to the Public in a violation of the state's rollout plan. In a press release, Zucker said, We take this very seriously and D O H will be assisting state police in a criminal investigation into this matter. Anyone found to have knowingly participated in this scheme will be held accountable to the fullest extent of the law.
New York health care provider may have fraudulently obtained Covid-19 vaccines, state says
"Have launched a criminal investigation into a health care provider in the city for possibly giving the covert vaccine to people who are not supposed to be getting the shot. State Health Commissioner Dr Howard Zucker says authorities are following up on reports which say that the park care Community Health Network May have obtained the vaccines fraudulently, and then administered them to people other than healthcare workers or people living or working in nursing homes. You're great. You're great fingers. Thank you, Mark care, even tweeted out of video, showing them vaccinating someone who wouldn't seem to be eligible and older Rabbi Yes and one man and borrow, Park says he applied for a vaccine on a par Ker website and listed one of the criteria. Elderly who Have underlying conditions. But that's not on the approved list. Park heiress Several Brooklyn locations, including borrow Park, where this man defends the company. I'm sure they're doing a lot of goods and don't focus focus on the good, Roger, Stir and 10 10 wins in Borrow Park and
NY healthcare provider may have fraudulently obtained vaccine doses
"Health care provider with outposts in Brooklyn and Orange County is now the target of a fraud investigation for a possible scheme involving the new Corona virus vaccine. According to state Health Commissioner Dr Howard Sucker. New York guidelines say the vaccine should go to healthcare workers first, along with the residents and staff at nursing homes. But health officials have gotten reports that Parker Community Health Network might have diverted doses of that vaccine to the general public. State. Police have now launched a criminal investigation and a statement from health Commissioner Zucker says anyone found to have knowingly participated in this scheme will be held accountable to the fullest extent of the law.
Probe underway into claims that health network fraudulently obtained vaccine, diverted it to public
"An an Orange Orange County County is is accused accused of of fraudulently fraudulently obtaining obtaining and and distributing distributing distributing. distributing. The covert 19 vaccine. New York State's Health commissioner, Dr Howard Zucker, said in a statement today that Park Care community health network may have gotten the vaccine and diverted it to members of the public violating state guidelines. The state's plan is to administer the vaccine, first of frontline health care workers and nursing home residents and staff. Dr Zucker says the state Department of Health will be assisting the state police in a criminal investigation. Tension winds reached out to
NY probes ultra-Orthodox clinics for possible vaccine fraud
"County, now being investigated for possible fraud involving the new Corona virus vaccine that word coming today from state Health Commissioner Dr Howard Zucker. A statement from the commissioner says officials received reports that par Ker Community Health Network might have diverted doses of the vaccine to members of the general public and violation of state requirements. Vaccine is supposed to go first to healthcare workers, along with residents and staffers at nursing homes. State police have now launched a criminal investigation and sucker statement goes on to say quote Anyone found to have knowingly participated in this scheme will be held accountable to the fullest extent of the law. 10 10 wins has reached out to
Violent crime keeps rising in Houston. Could COVID be the reason why?
"A streak of violence in houston continued overnight. Ktar k tv reports. Three people were killed and two injured and four separate shootings in the area last night that follows a deadly domestic incident in western. Houston that left. Five people shot and at least two dead houston's murder rate and other types of crimes have been rising in recent months as the pandemic continues to stress. Nearly every part of many people's lives well houston's murder rate is higher than it's been in a decade and here in harris county the murder rate is also a thirty percent since this time last year. Our own brenda boundaries has more on. How much of a role. The pandemic and other factors play into that increase in violent crime logo. Police are reporting sharp rises in violent crime including domestic violence murder and assault. Dr howard henderson is the founding director. Just as research at texas southern university. He's says the pandemic has increased the level of inequality between those who can afford to stay home and those who can't with limited funds limited resources and no positive outlets a win the the day on a break and so the frustration. Vang self out particularly in domestic violence around this country and particularly them henderson matters the pandemic and a reason increasing calls to defend the police make it difficult to predict what is to come. He's as one solution for. Police is to be stationed at high violence hotspots instead of low crime areas which drained resources houston police. Chief recently announced a plan to target crime hotspots with additional officers.
Dr. Howard Fullman: COVID, Probiotics, and the Impact of Coronavirus on the Future of Medicine
"We're honored to have. Dr Howard J foam and join us to catch up on medicine, practice and politics prevention, and of course a bit about our fight against. COVID nineteen so may we suggest that you pull yourself a double. Sit back and join us on medicine. We're still practicing I'm bill, Curtis. I are host. The quadruple board certified doctor of Internal Medicine Pulmonary Disease Critical Care and neuro critical care. My very good friend Dr Steven Taback, however you, Steve Hey bill good to see you. We haven't had dinner together for a while I. Don't remember what it was like. They actually have dinner and enjoy an evening. So you know we have one of our favorite experts rejoining. Rejoining us today Dr, Howard J. Felman he is board certified in internal medicine and gastroenterology will learn more about that. In a minute Howard, served a multi decade tenure at Kaiser Permanente Day as partner board member. President of the Executive Committee Chief of staff and chair of the Quality Committee. He supervised forty three hundred staff over five hundred doctors. Howard is now senior operating advisor. Advisor at the Atlantic. Street capital for their medically focused investments Dr Howard J foam. Welcome back I nice to be here. Stephen nicest to us well Hey Howard. Good to see you so last time we met in our studio in Malibu was only back in February and it seems like a whole lifetime ago in quite a year, and we're only halfway through it and we know. Know there's a lot more to come Howard. I hope you'll forgive me, but I took my nasty pill this morning, so I want to dive into a difficult issue, but as the time of this recording according to Johns Hopkins, Japan although infected early has less than one cova death per hundred thousand population, while the US has thirty nine Cova deaths per one hundred thousand population. Japan more elderly per capita than any other country. They kept their borders open during the Wu Han locked down there, stay home requests by Japanese. Government have been voluntary, as was any of the closing of their non essential businesses. And now for a country with one city that houses more than thirty seven million people. They have less than a thousand deaths countrywide, but the hell is going on I. Don't know that anyone knows exactly all of the differences, but I'll give you. Some and I think that may be different. One is there's probably a genetic component to this disease that we don't quite understand. People were speculating. Why was so much more Italy because Italian get together a lot more than others people wonder with net net might have been some genetic predisposition. She decided kind storms for example, another article morbidity in patient population, so age is one thing you're right. Japanese population is actually older than the US. By other commodities like obesity, which is turning out to be a significant risk factor here is unfortunately. It's still a lot more obesity united. States than there is Japan so just because we've sorted out that the age factor may not explain it, but we have some more chronic illness in the United States spend maybe contributing to it as well and then you know the way we've handled. Handled the public health aspect of this and again I also wanted to be very careful about criticism of even the public health system because I'm sure there's a lot of things we look back and could have done differently, but we also have a lot of public health officers. Some extremely courageous ones and I'll say that I think unfortunately a some of our public does not really believe. Believe in this pandemic, the seriousness that they should, and that may be affecting the outcomes as well. There are certain communities as you know. Where substantial numbers of people were having just seemingly significant disregard, and so that might have been large numbers coming in at a just a bowl of people coming in all the ones that saturated the healthcare system made it hard to take care of. Of someone people possibly people coming in later than they should have because perhaps denial about the significance of the Selma's when it is on severe, and it's not be causing a doctor that I. don't WanNa Fault. The nurses and the doctors and rest of just I've seen what they're doing. My follow it very carefully, and I'm very proud of them, but I think because of the. The differences in population and our public health system is not working well is not resigned the way it should be, and there's not functioning in the way that it has been planned to function the
At least 3 N.Y. youths die from illness possibly linked to COVID-19
"In York is also issuing a new warning urging parents to be vigilant for signs of a new illness believed to be covered nineteen related that is targeting children three children in our area have already died in two more deaths are under investigation CBS is Christina fan has more there is deep concern over growing cases of Kobe nineteen related illnesses in children New York state now investigating eighty five reported cases of pediatric multi system inflammatory syndrome similar to toxic shock and what it does is basically in a child's body triggers intensive almost overwhelming immune system response and that actually causes harm to the body's Dr I'm in L. Mohandas with the CUNY graduate school of public health and health policy says the findings are troubling because up until now kids were considered low risk for the virus already three children a five year old a seven year old and an adolescent in New York have died none had underlying conditions I think this is a a red flag in you important threats lack to parents to treat children dressed as seriously as a treating elderly or each other doctors say they believe the illness is going to be nineteen related even though out of the confirm to patients in New York City only forty seven percent tested positive for corona virus of those who tested negative eighty one percent had antibodies it could either be that the test was false negative possible but the other explanation is that in the cascade of their immune response they have not produced this kind of anybody yes in their system New York state health commissioner Dr Howard Zucker says he has a team of more than thirty people who are working with the CDC to review patient charts to better identify the syndrome that would tell
A Mysterious New Illness Affecting Children
"New York doctors are warning about a mysterious illness affecting children. That may be tied to Cova. Nineteen quoting the New York Times. Fifteen children many of whom had the corona virus have recently been hospitalized in New York City with a mysterious syndrome. The doctors do not yet fully understand but that has also been reported in several year Paean countries. Health officials announced Monday night. Many of the children ages two to fifteen have shown symptoms associated with toxic shock or Kowalski. Disease a rare illness in children that involves inflammation of the blood vessels including coronary arteries. The city's health department said none of the New York City patients with the syndrome have died. According to a bulletin from the health department which described the illness as a multi-system inflammatory syndrome potentially associated with cove in nineteen the disease caused by the virus reached late Monday night. The State Health Commissioner Dr Howard as Zucker said state officials were also investigating the unexplained malady. The Syndrome has received growing attention in recent weeks cases have begun appearing in European countries. Hit hard by the corona virus in
"dr howard" Discussed on Dentistry Uncensored with Howard Farran
"Now I should know what about your mom. Yeah she's on Instagram. She's on facebook. Share US living. Well you have a young hip mother but but what I like but I like the most is is. Here's what I don't like about social media. Let's say that Jasmine Posted something. The Essay was about something that I remember later and I need to go back and find that post well. I don't want to go back to your agents curl back forever. What's beautiful about dental town is? It's a message board index. So I can go onto dental town. There's two hundred seventy five thousand Dennis. They've posted six million post and I go in there and I could. I could type in your name bum pulls it right up or say say. I was having a problem with the help of filter I can go it and I don't remember which one of my facebook friends was talking about a HEP filter lying on the dental town type in hep filter employed every thread. So when I go to the NASA when I go to the Jet Propulsion Laboratory which is at Asu. I WENT TO HAS MASSA LABS. None of them are doing any research on social media which is a five. Oh I in our last. In first out it's all wife. Oh it's more for an inner Teini experience if you to any research in this institution. It's a message board because all of your data is indexed. So when you go to dental town and let's say that you you you were deciding you wanted to buy a microscope and didn't know if you should buy one from global in Saint Louis or if you should buy one from Another company in Korea. You could type in the brand name says you were looking at Global microscopes you could just type in global microscopes and pull up every single thread. That would ever discussed global microscopes. Where I I can't do that on facebook or instagram. I look at facebook and instagram and twitter and Lincoln as as life. Oh last in first out you just get kind of like watching the news you turn on the news. They don't start the news with what happened that there was an accident building the pyramid and five thousand years ago today. Charles fell off Abrek. Now they're talking about the Daily News so you turn on the news you turn on social media. It's fun it's entertaining. It's what's happening today. But it's not for trying to learn how to do a root canal faster easier higher quality lower costs if I cannot find. Mb Too. I WANNA dental town. Where two hundred seventy five thousand dentist for twenty years. I've shared everything not. Nb to type in mb to which searches the whole index insulate and start reading for an hour on finding the embi too. I can't I've never had that experience on social media so maybe I'm old fashioned. Maybe you're looking at me. Think and he's just an old GRANDPA but I prefer dental town. You can download the APP. It's free and and you don't have to worry about all the other problems you have on social media like like I notice on facebook if you make a post they know what you. Yeah but if you've got a really embarrassing question on dental town you might be just smiley too and then you can post the root canal that you did that turned upside down and then everybody can help you and without having you know it was you so again. Thank you for having me on the show today. It was an honor and now I have the extreme honor taking my granddaughter to watch today so the surges hell advantage is beyond optical resolution surgery tells patented ergonomically fitted loops prevent and resolve working pain. Contact your surgical rab at surgical dot com to get your loops and lights evaluated for free..
"dr howard" Discussed on Dentistry Uncensored with Howard Farran
"An article called lawyers law and dentistry showing that dentistry was it was after the After the last collapse there was like a two year delay. Meaning that when you have a big collapse. People are trying to get caught up on their house payment or rent or car payments. You know the two payments that people will not walk away from the most number one is there. Is there either. Phone number TWOS are car. They don't even care about their house when when they lose all the money they just want to take their phone jump in their car and drive back to their mom's house and I get that so that's a priority so it showed that after these economic contractions dentistry is not a mandatory essential item. That's as important as keeping your phone or your car. Even your house. There was a two year delay lag. So we're looking right now. This is April sixteen. Twenty twenty. It's GONNA be at least June of twenty twenty two before there's even a chance that dentistry has resumed. Its Pre pandemic days so right now as you look at the dentistry in. Us dollars of the dental industry is it's it's about four hundred bucks a year per person. That's not a lot of money. You don't need dental insurance to buy your iphone. You don't need dental insurance to buy your gas for your car and you don't need dental insurance for the average American. They have four hundred dollars a year in needs. That means that maybe you spent a thousand this year but won't spend any next year so again not a time. For High Volume. Ppo plans and insurance plans when we look at his average income by dentistry. You can see right. There were general. Dennis income has been drifting down from two thousand five to two thousand till today. It's because the specialist income are going up. There's more demand if you met someone. If you met at all landline me and it turned out. He had prostate cancer. I guarantee he's not GonNa go to his priest. His rabbi or is dentists or his family physician is not even GonNa go to an oncologist. He's GonNa go to a hematologist. That only does oncology and get referred to a on colleges who only does prostate. And that's what everybody's valuing that's where everybody's going everybody's looking for the best human. That could fix their problems. Are there need today So we look at General Denison Com or making one seventy four but look at the ended on us at three twenty five. The oral surgeons at four thirteen. The orthodontist at three zero one of the pediatric dentists at three. Forty seven So right now it's time to learn on zoom on video We have courses. We have four hundred and fifty seven courses on dental town and You know look them up I have done If you go to I tunes or Youtube by a podcast on itunes called mystery uncensored and there's thirteen hundred hour long interviews on that With some of the greatest minds and all of dentistry like Keno or Shah is been grace my presence on their Their just some of the greatest leaders But I also have on. Itunes called Doctor for an thirty day dental MBA. These are all free. And it's thirty one hour videos on the business dentistry when I got my masters in Business Administration when I was done. After two years of postgraduate master's level courses I spent a year summarizing everything I learned in my mba in thirty one hour.
"dr howard" Discussed on Dentistry Uncensored with Howard Farran
"Hot Dogs French fries all day. So we're all different. And that's what makes life exciting. But my Gosh I'm you could just get a job and it was called mentorship it was called an apprenticeship and I think we're going back to those days for two reasons number one the school system. Were you leave your house and you go to grammar school a high school a university. The cost is insane. It's it's the most insanely expensive way to transfer knowledge. We currently see that in the United. Sates all fifty states. Almost half of all their money goes to education and they want more they say the class sizes are too big. We need even more and economists are saying Dude you already cost half the money and then when you come out of dental school. They're coming out of dental school. Four hundred thousand dollars in debt and their best idea is hey if you wanna be a specialist if you WANNA be and ended on US come. Give me another hundred thousand dollars a year for three years. I think they're delirious. I think when you see the rate of cost double or triple the standard rate of inflation which you have seen with the the size of government and the cost of education In real estate when I buy a house and I bite on a thirty year. Loan and the monthly payment would be thousand a month for the next thirty years. That's called the the cost of of this house will. I should be able to rent it out for at least eighty five percent of the rental price so if I buy this house at a thousand a month for thirty years I will. I better be able to rent it out for at least eight hundred fifty. Hopefully nine hundred and the dream would be that. I buy a house for a thousand a month and I rented out for more. I run it out. I say eleven hundred a month and I make one hundred dollar profit will when you see the monthly mortgage on the House. Start going up from a thousand a month to two thousand a month but the rental rate is still the same that he fifty you know prices are overvalued and you know historically I in my lifetime I lived through a couple of real estate crashes and you always knew when they were coming and Gosh darn the greatest investor of all time Warren Buffett from Omaha Nebraska. I actually went to Creighton University in Omaha Nebraska in one thousand nine hundred eighty Warren Buffett came to Creighton and gave us all a lecture. And and you know you talk about the the cost and you keep one eye on the costs and one I on the customer in education costs of grown two or three times the Radovan flation. I think that models dead but you can come out of school now. We're doing this online. I don't need a brick building for this. I'm talking to you and I don't know if you're across the street in. Kansas are Katmandu or live in a canoe. I don't know where you are eight billion people. If you have an iphone you're ready to rock and roll. So I think that mentorships are gonNA come back and if you come out of school right now and there's a ended honest or a pediatric dentist or any specialists. Who Says Yeah you can come be my assistant and worked for me and I'll take everything I know the other thing I would want to look at is online education. Why are you closing down your dental office to go learn about root canals when you could be learning right here on Zoom Online c. e? Yes I'm the founder of Dental Town Dot Com. We have four hundred and forty courses on dental town. They've been viewed over a million times so the the traditional education model is very suspect. But when we look at the specialties. Humans were doctors. Humans are villa bloods whenever I meet. Identity. Says I don't really like blood. I I like bleaching bonding veneers. I'm like dude. You're a doctor. Who who signs up for dental school and says they don't like blood. I mean where did you mean to become an electrical engineer and work on an iphone? Did you did you WANNA learn how to make bottled water? I mean you're a doctor when you tell me you don't like blood. What it tells me is the same thing I think. At any time I ever see a law. That was written down at any his time in history. Every law comes from a trying. It starts out with a deep scar and it was tried to be corrected by passing a law. So there's a lot of pain in every law somebody was harmed. And that's why we have to deal with this law even though it doesn't make sense today or as written a hundred years ago it started out in pain when you tell me you don't like Molar Endo come on. I'm a GRANDPA. I know what happened. You're a child and you did a root canal and beat you up and when it was done you weren't happy you were sad but suck it up. Buttercup you're not you think you think Charles Barkley One is first basketball game you think Mohammed Ali one every fight he ever had. I mean. Of course you start out as an amateur athlete in high school and you do your first soccer game and every time you get the ball it went the wrong way and it was just a miserable time but after you played ten games you're better scale that two hundred games. You're getting pretty good at a thousand games. Oh my gosh. You're the star player at ten thousand Games. You're now a pro soccer player and or a coach or you own a soccer team so when you say you don't like Muller and OBI honest with yourself. I don't care if you lied to me but don't lie to yourself when you say you don't like molar Indo. Have the only done one. Are you a Tan? Are you at one hundred but being old man? I know you haven't done a thousand root canals. No one after a thousand root canal says my Gosh. I eight molar. Endo they go. Oh my God I learned this new trick on Muller Endo I wish I would learn his ten years ago and they're all excited and passionate because you're a dentist and this patient is in pain and I want you to start acting like the hospitals. Do if I break my arm and go to the hospital. The hospital isn't going to say. I'm sorry I'm Uncle Howie but we. We don't do arms. We just do legs dude. I fell right bicycle and broke my arm. And you're the hospital. Yeah I know but you know we. We just don't like arms we. We like lakes and ears. I mean that doesn't make any sense to you and I would remind you. That of all the ten specialties. The one that comes dearest to be is public health because my mom and dad got married when they were very young and had seven kids before they had a dime and the first ten years of my life was a lot of poverty in Wichita. Kansas and it was very nice to live in a country. Where so many people kept one eye on what I wanted and one eye on cost and worked so hard to drive down the cost of this good or service that I had a freedom to fly southwest airlines I remember when I got out of school. Most of the crown and bridge labs charged two hundred dollars a unit but this one called glide well only made one hundred and I had so much respect for Jim Glide well of trying to figure out how to make crown so much faster easier. Higher quality lower cost that people would have the afford the freedom to afford say not so when we look at dentistry you have to be public health. You have to triage these patients so even if you don't WanNa do Perry O or Indo orthodontics. You still have to learn how to triage it. If you don't know the difference in class one class two class reort though if you can't look at this wisdom tooth and decide if.
"dr howard" Discussed on Dentistry Uncensored with Howard Farran
"I'm still a sixteen thirty two and those same thirty stubs would've gone taken me around the world twenty six times that's how this pandemic buyers has been working where you look at the The cases I'm exploding a Lotta people. might compare this to influenza will influence a linear growth. It really comes down to how many people that are sick. How many do they in? Fact if everybody that gets sack infects one. It grows with addition linear but everybody gets infected infects to now our in multiplication and thirty divisions later. We've gone really far. So this pandemic. I have to say that it looks a promising right now. We see that a hundred days after the Wu. Han buyer aside the Chinese are returning back to society. we do see for Global I like to go. You've all got your measurements that you go. Try like the John Hopkins University site by it. Looks like for the globe We've reached a peak But the time it took to go down the peak and all up the peak and all the challenges were still going to have those challenges for a long time but again I'm starting with the children will in one thousand nine hundred. There were no specialties and adopter with Fixture I your eerie knows. Deliver your baby tender. The Second Niamey they did everything by the year. Two thousand when healthcare was fourteen percent of GDP. We had fifty eight. Specialties and dentistry had nine. Now it's twenty twenty healthcare in America seventeen percent of the GDP and And Dentistry added a couple more specialties. So if I was a senior in Donald School and I knew that the world is going to specially like I have friends in Arizona. I have a friend. That's an optician. I who tries on glasses. I have another friend. Who's an ophthalmologist? Who's a medical doctor MD? I have another friend. That only does retinas. I have another friend who only does glaucoma in the eye. So here's a simple able. And there's multiple specialties. So I see a lot of young kids come out and they want to be a jack-of-all-trades I they say they want to learn more Indo They want to learn how to treat filled root canals. They WANNA play. Implants will replace implants. You'RE GONNA have to learn bone grafting and sinus lifts and and how what kind of implants are you GONNA do And then they WANNA do pediatric dentistry and they want to learn silver Diomede floride and they WANNA learn gum disease and tired all disease and they want they want to learn all these all these things and I always look at them and say you're going back in time we're not GONNA go back to nineteen hundred. Were a super doctor walks in your room. She sees her disease and no matter what it is. If it's your eyes ears nose throat your tooth your Muller your tongue. She can master everything that is not where we're going when we look around. Just the United States of America and Canada just this North American market in English Journals there's forty thousand monthly medical healthcare journals. You can't read forty thousand journals. More importantly look at the economics.
Gov. Cuomo Says Federal Stimulus Package Is 'Terrible' for New York
"Governor Cuomo says he doesn't think new Yorkers need to self quarantine if they travel to another state despite what the White House recommended yesterday state health commissioner Dr Howard Zucker says people should comply with the CDC guidelines for social distancing that means everyone should remain six feet apart governor Cuomo also called the Senate's two trillion dollar relief package terrible for New York state he said it only provides three point eight billion dollars for the state one point three billion for New York City he says it is not nearly enough the city will implement a pilot street closing program to to increase social distancing the closed streets will be open to pedestrians the governor also says if people continue to ignore social distancing in the city parks the city will shut down playgrounds he says all contact sports like basketball our
Coronavirus updates: U.S. cases top 1,000 with many clustered in New York
"The number of coronavirus cases continues to grow across New York state the majority of them are in Westchester county just north of New York City correspondent Steve casted bomb tells us some of the steps the state is taking to try to stop the virus from spreading further the largest cluster of coronavirus cases in New York state is in new Rochelle a suburb north of New York City the number of people with covert nineteen connected to synagogues community in the town broke through the one hundred mark and public officials expect that figure to continue growing new Rochelle is a particular problem so yesterday governor Andrew Cuomo announced that a containment area with a one mile radius of the focal point is being set up all schools in other locations in the containment area where people would gather in groups are now closed for at least the next two weeks we're also going to use the National Guard in the containment area to deliver food to homes to help with the cleaning of public spaces satellite lab is being set up inside the containment zone so that people don't have to travel outside of new Rochelle to get tested something that potentially spread the virus New York state health commissioner Dr Howard Zucker said it may seem extreme to some people but it's necessary given everything they know about this cluster we have to remember that that we are sitting with the first point on the curve of first couple points in a curve in and I would be wonderful to be able to go in the future look back and see how this curve is going to evolve but we don't know that and so the most important thing to do is to take all the precautions we can governor Cuomo said it's necessary in order to protect lives this will be a period of disruption for the local community I understand that but for now the community isn't completely locked down meanwhile more schools have been canceling classes were switching to online teaching across the state the governor is urging employers to allow people to work from home and it appears that many already are because the subway has been noticeably less crowded in the city and late yesterday the New York City half marathon was canceled over twenty five thousand people were going to run in the world's premier half marathon on
Containment Area Planned for New York Suburb to Stem Coronavirus Spread
"Well since one hundred and eight of new York's a hundred seventy four confirm coronavirus cases are in Westchester county as of yesterday afternoon governor Cuomo has announced the state is establishing a circular containment area two miles across at the epicenter of the outbreak in new Rochelle health commissioner Dr Howard Zucker says large gathering spots in the circle are going to be closed and cleaned for two weeks starting on Thursday we know where these sort of the center of the activity has it has a kind of from the from the information public health and epidemiology investigation from the beginning of the Westchester nurse shell outbreak and we felt that a mile of a radius of a mile of from that spot would be effective in the governor concedes there will be disruptions it is a dramatic action but it is the largest cluster in the country and this is literally a matter of life and death rich lam WCBS newsradio
NY gov declares 1-mile radius coronavirus 'containment area' in New Rochelle
"Governor Cuomo has announced what he called a containment area in a section of new Rochelle extending in a one mile radius from the epicenter of the Westchester outbreak health commissioner Dr Howard Zucker says large gathering places are being closed for two weeks starting March
With Results for 3 Possible Coronavirus Cases Pending, CDC Allows NYC to Conduct Tests
"But in New York City officials may soon have the ability to test it on their own the state health commissioner Dr Howard Zucker says the biggest risk right now is flow last week alone a thousand eight hundred eighty nine new Yorkers were hospitalized with lab confirmed influenza virus having originated in China doctors doctors urging new Yorkers not the stereo type or single out their Asian neighbors he really should just stick together not attack
"dr howard" Discussed on Medicine, We're Still Practicing
"Do so limit some of the advertising for biologics and some of these incredibly the expensive drugs. There's no reason why though should be television in my opinion. I think it's ridiculous for patients. Come in and say I think I should have the simulator talking to somebody in the media right. I do the one we concur. So you're outnumber so I guess I guess what I what I don't don't understand is Getting political for just a second. I'm not sure how many lobbyists are in Washington related to the subject subject. But it's more than a handful. It's probably I mean strikingly. It's probably thousands of people that are lobbying Being these concepts in Washington and it works because it's whatever the market will bear. Why would the same medication be? Fifty percent is much in Canada and maybe twenty or ten percent as much much in Mexico. So why do we keep hearing silly stuff if you don't mind me saying free healthcare for all free tuition for all. Why aren't we hearing more specific solutions? Like let's stop wasting money by giving so much money into the stock holder to the pharmaceutical companies. I think it's because you you know from my perspective. That solution is very complicated. How are you going to speak to the populace about what you're talking about in terms of talking to the shareholders minimizing? You know their their return so that it reflects something that is more reasonable. We just did it. Pretty quickly. Didn't seem that complicated. Well it's more complicated that it's easier when you're trying to get elected to say free healthcare for everybody because everybody wants to hear about that. Everybody would like to believe that. That's something that can it can be attained. And I think the average person in this country would say okay if somebody says it can be done. I'M GONNA go with that person without thinking realistically is. Is that really something that can take place. So there are platitudes. And then there's reality one of the purposes of this. Show this to talk reality right. I mean that's what we're orders tried to educate the public try to discuss these difficult and complex issues. But this this this you know this Utopian Society were free the healthcare for everybody free tuition for everybody. Maybe there's a way to make that happen. I'm not sure but to just say that in a very blanket statement that this is there's something simple that's not going to require a lot of engineering would be a misrepresentation. So how would I have to ask you. You know I'm as an example title. I'm told that pretty much all men there's a race between our lifespan and the likelihood of our prostate causing a problem right and We're all supposed to deal with that. And now the question is do I get hit by a bus before that or or is that actually going to show up so if the prostate is is going to be a problem if I want free healthcare fine I still want my prostate surgery to be done by Davinci Vinci robot with someone. WHO's trained to do that sitting on the other side of the room and using the absolute cutting edge technology? Isn't that the case. So is that a lot more expensive SUV to conduct that tennis surgery. Well I actually no not that much more somewhat more So I'm very familiar with adventure robot and actually the first Davinci robot in southern in California Kaiser permanent. He was at my medical center. So we actually develop the program For robotic surgery on prostate. Cancer very proud of the record that are surgeons created they're fantastic amazing outcomes with high cure rates and low low side effect rates. How do you do it? You I mean isn't part of outcomes those you want. It's not necessarily the surgery that's better. It's the side effects. So I mean good outcome means high curate. Eight and low side effects and in the case of prostate cancer the use of Davinci robot by a skilled surgeon. WHO's familiar with how to do? The operation does and with proper for case election making sure people who really benefit from it or the ones getting the surgery. The results are extraordinary. And you would want that at should want that and most Americans have access is to that. So that's an area by the way we're we're actually doing quite well and United States cancer care in general would doing quite well. We've actually cut mortality for several cancers in the United States Lung Cancer Answers One and melanoma has been actually cut in less couple. So you know Steve earlier was talking about cancer. Now is often more like a chronic illness. It's not necessarily an acute illness in the way we used to think of it or an episode illness. It's actually something where we can actually suppress. Maybe not always cure cancer but we can keep people alive and relatively healthy for long periods of time until perhaps HAP- something better comes along That perhaps can even cure them of their condition. So I there's no doubt that when it comes to more significant problems like let's say prostate cancer or CARDIOVASC- disease in the United States. We largely do pretty well. And that's an example where investing in the right resources and investing the right training to get people prop the proper people. Doing this in the right equipment has real benefit to patients. Forget there's some insurance companies that will not allow you to have the Davinci if there's something that's more something that's simpler and less expensive and we're there will always be at least a two tier system in this country with those people who have the means that are going to get the best. The brightest the latest technology and will travel the country to doctor shop to technology shop And so to say that everybody is going to be painted with the same brush that everybody is going to be able to receive the same level of care not very realistic. I don't think in probably in any country any industrialized country. But certainly the disparities are always going to be greater in the United States. Yeah I agree I agree with that. That maybe Lancer before there's a little bit Utopian but I do think generally if people have insurance the United States they generally have access to pretty good care. What's more deplorable number? The people we have announced states who don't have access to insurance exactly think about if you're one of those fifty sixty million people who doesn't have access to care what that really means and so there's not one on road to universal care multiple roads but they don't all have to be public they can be private and public and I think the concept that it's all just going to get paid for by a massive asked if expansion of Medicare for the reasons stated I. I don't think that that's very politically tenable and not supported. Probably by the average American I do also want to say you know you're asking about the systems around the world. We've been discussing the healthcare system in isolation as though it exists vacuum and nothing else matters. It's all how fund medicine listen and and medical care but a big part of outcomes and health care. Have a lot to do with would've called social determinants of care which means how much poverty do you have. How much food insecurity security do you have? How much housing insecurity if you look at Los Angeles where we have massive homelessness? What's the effect on the health of those folks so no matter whether they have healthcare coverage and not and presumably many of those folks do not? But if you don't have a house you don't have a home plate. You don't have shelter. You don't have food. That also has a pretty damn big impact on healthcare outcomes and other other countries that are handling that issue better. I think if you look at the data we spend the most on healthcare. We don't necessarily have the best healthcare outcomes we also spend the least on social support. Now that takes different forms in different countries season. I don't consider myself an authority to be able to tell you which system is better but I do believe paying attention to these. Other aspects of people's lives has a major impact on the healthcare outcomes. And it's interesting because I think if you ask the general population the number of people who would say you know what I I think. There should be healthcare for everybody that everybody should have an equal and high level of health care. I think the vast majority of people in this country would say yes. I think that would be a good idea and yet we don't live our lives that way. We don't structure our country and our policies that way and I think in some ways we're kind of stuck because of the history of of Ah of our expectations as we bring this to a close. What grade would you give us now? In America for our outcomes. I'll be generous generous. I'd say overall it gives us a B and Canada. I would give Canada a beyond outcomes and a C. Plus or see on service says like Germany. I'm going to get a higher grade. I'd like the German system a lot one of my favorites. Dr Howard Jay Foreman. We thank you for joining us. And of course Dr Steven Tailback thank you for hosting this And next time if you'd come back and tell us a little about Atlantic street capital and some of the cool investments in the medical industry that you're working on and and how that's going to change the outcomes for the American people happy to bill. Thanks thanks for joining us. Come back and visit medicine. We're still practicing. We'll see you again next time. If you like what you hear please tell your friends and let us know how we're doing by leaving a comment. It really helps. If you give us a five star rating aiding and we really appreciate it. You can also subscribe to the show on Apple podcasts. Stitcher or wherever you listen to your favorite podcast. This episode owed was produced and edited by Mike. Thomas Audio Engineering. By Michael Kennedy. And the theme music was composed and performed by. Celeste and Eric Dick. Thanks thanks for listening. Room Kirk Oh media media for your mind..
"dr howard" Discussed on Medicine, We're Still Practicing
"So we're back with Dr Howard J foaming and of course our host host Dr Steven Tack? Let's go back to the question. I asked before the break comparing outcomes at the. Va to Kaiser and maybe the rest of the country. What do we know about it? Well I I have a tremendous amount of respect. For the Veterans Administration an important mandate and date taking care of a veterans. Nothing could be more important than that you know. We owe so much to our veterans and I will say that I have gotten some of my I training at va hospitals and on the faculty ucla and partly teach at at the Wadsworth the hospital. So I've seen some fantastic medical care and some very devoted did doctors and nurses who try really hard to take care of the patients and do so well. They had made a tremendous investment in electronic medical record before anybody else did they. They had one of the most devolved electricity medical records and did that across the country and that was a big gamble an investment on their part. That actually did pay off quite a lot. But I think To to a significant degree the Va may be under resourced especially given the number of people coming out of the military in recent years and as well as the prevalence of some very important conditions including post traumatic stress disorder which is extremely prevalent amongst our veterans and nobody has a good answer to it and Even even our mental health system outside of the is inadequate the United States with the way insufficient resources. And I think the trying to figure out how to take care of so many people who have so much illness within the budgetary constraints that they have one applaud the Va.. Because I think they're taking very dispassionate. Look at the way. They're providing providing care and trying to re engineer the way they give care and I think they're going to improve over time but it's GonNa take Some work and probably some higher levels of budgets. Get us there so with all the challenges that they've got the reality of course as they are funded with the same type of mechanism that Medicare is funded correct there except except the. It's a little different in the sense that you know Medicare gets funding from payroll taxes. Now has people are working. And that's what they have Whereas the VA gets gets its funding from whatever legislative load is ever legislatively approved by Congress? So Congress could change the level of the funding quarter-by-quarter and and do so at a much higher level where. It's a little more difficult to do that with Medicare which is related to your payroll taxes but any physician. I think that has been trained in the United States has spent a fair amount of time and a VA system And I think everybody has been impressed by the level of service that is being delivered in a very as you sit stated in a very very under-resourced environment. There's only so much money to go around. And so many veterans with such complex care issues From Agent Orange and psychiatric issues relative to post traumatic stress disorder. That I think they do a great job. I would have to echo that but also echo the fact that they are sadly under-resourced and we've always felt that as we were in med school in in doing our rotations through the Va.. Doesn't I also would say about the is that Steve Steve alluded to but stated very very directly that the Veterans Administration does a fantastic job training doctors around the country and has made a huge contribution that way and lot of research is under the VA hospital so I applaud the Va.. I think they do an excellent job. They try very hard. Nothing could be more important than their work. We shall be very grateful and respectful up to the work they do but we also should make sure we're being supportive so that they can do even better. Okay well let's let's talk about. A couple of different specialties. Heart for for example. We've gotten a whole lot less. Invasive in a lot of our heart procedures are outcomes a whole lot better these days than they were even five years ago markedly improved and it's not just our outcomes relative to mortality but our outcomes in terms of trauma both physical and psychological to the patient if you can put a heart valve galvin with minimal invasive procedure as opposed to cracking. Somebody's chest open. That's huge or actually a good friend of mine has recently had valve replacement Because she had terrible case of Andrew Card itis and valve destruction And she lived long enough now with her heart valve to be able to take advantage of the technology that allowed the Cutaneous fouth placement. So there's so much going on that improves. Quality of life that minimizes the invasive procedure. In the pain and suffering. And it's not just outcomes and certainly outcomes mortality have improved but the other side of of Diminishing the trauma. The patients have to undergo for procedures has markedly improved as well and I'd like to add to that that patients who in the past would not have been able to receive any kind of treatment for certain condition because that treatment would have been too invasive into risky for them given their condition can now get a Less invasive approach and not just beat have less trauma but actually survived that maybe when they wouldn't have even been a candidate for the procedures while so that these are huge developments and cardiology is one great example of that doing that In such important ways of strategies in private practice and in practice in medicine in general general is get your patients to live long enough to catch up with so the technology will catch up with your disease. And it's really true. I mean if you can keep somebody alive with today's cancer treatment long enough so that when a cure is now available for their particular type of cancer you've done tremendous service so it's you WanNa you WanNa keep the game going long enough so oh that finally you can get to the to the cure. Hopefully within within our lifetime These careers would become available for a whole host of of medical illnesses. So getting back actually the the outcomes for heart for example where I'm going to tie in your previous subjects where you talked about preventive one of the things that you guys have done? mm-hmm clearly with technology of preventative. Care for heart. Is You're managing people's blood pressure more than ever right in part but part of that is medication vacation so I have to go back to cost for just a second. Because and now this worked for all medication I know but comparing pharmaceuticals related to controlling blood pressure sure look at the cost of those pharmaceuticals here in the US versus just about every other country on the planet. Explain to me why there's such a difference. Well first of all. I think it's important to point half. There's an enormous difference Pharmaceuticals developed in United States manufacturing. United States are often way more expensive offensive here. The United States than those same drugs made an hour factors involved here sold in Europe. But there's a lot of other elements it's not I it's not a functioning market So awesome well. This is not the usual laws of supply and demand we give the pharmaceutical companies long patents. Which means the only supplier even when the drugs go uh-huh too generic this sometimes only one generic manufacturers so it's really almost the same as when they were on brand who becomes a duopoly? We let them have direct to market advertising even for biologic. I A logic medications for complicated illnesses which no other country does and we have insurance. Pay For a good amount of the cost of the so. The individual digital person doesn't see it. They don't necessarily pay it so when you add those factors up. That's a recipe for escalating and very skyrocketing costs which is what we have the United States. And by the way when you talk about where the money's going that's a big part of where the money is going. We now are spending more pharmaceutical costs than we are on physician fees in the United States. And that's true for Medicare and every other insurance and they're going up at a much higher rate part of the answer is start making pharmaceuticals more act like a more mark more like a true market market where the supply and demand and competition. Think you can have the patents be a lot less Long Bill Lot shorter would be one thing. If I were a pharmaceutical company how could I make sense offensive the economics of getting drug past the FDA make plenty of money in with shorter patent cycle. You make it easier for the for the generic manufacturers to get Going into two for multiple wants to make drugs and make it give them incentives to.
"dr howard" Discussed on Medicine, We're Still Practicing
"If we have certain tests that benefit people. We should do a better job of advocating make sure patients get those tests and those tests and do this test so let me talk to you about another create create a poll market for tests rather than the doctor. Saying this is what we expect. Expect from you know that. Just an tests and diet and exercise and vaccinations and all those little things because all of these things have an impact in this is where there is a difference between us and the rest of the world. Because we're we're very much in a drug taking culture you know we get anxiety. We'd take a drug we causing housing's. Id We can't get drug. We eat badly. We take a statin. We need to get into a conversation this country to figure out what we stand for what we want to be in the has to be at the doctor actor level at the patient level the insurance level not just anyone level because we cannot continue on the current course without bankrupting the country and still not getting the outcomes that we deserve their was there a poster child country for the citizens understanding that they have to treat themselves differently. Now I don't think so. I think this is a pervasive problem in the industrialised austrial is world but there are better systems in terms of how they're delivering care than ours certain ways so one of the examples I was going to give the are now using evidence based medicine and to kind of work against and to act as a barrier to care In the private sector where I've been for the past twenty eight years of late in of late meaning in the past probably seven eight years if I wanted to order a cat scan on a patient who I think has a pulmonary process that warrants. A cat scan. Nearly every insurance turns company including Medicare will automatically deny that scan and mandate appear to peer review under the auspices of this is evidence base as we want a test that you are doing this based on some sort of evidence that will allow you to have the scan they then forced me to speak to appear and invariably it'll be a specialist in ob Guy Ni or a specialist in endocrinology. Not that they're not well trained in what they do. But I'm a pulmonary critical care specialist list. I would think maybe not. Maybe they're right but I would think that I have a better handle on what I need based on my at the gestalt of my patient. And hopefully which is evidence-based spaced but under this auspices under the auspices of trying to do things that are evidence based what they have really done to set up a barrier. Because I get on on the phone I'm on hold for fifteen minutes then. I have a peer to peer discussion. Maybe with somebody for another ten minutes fifteen minutes. How many doctors doctors are going to take twenty thirty minutes from their day for every cat scan that they order so there is no peer review structure at Kaiser? No medical necessity acidy within Kaiser. Permanente means whatever the doctor thinks you need you get it. And that's how we operate we trust doctors. We know that they're always trying to do the right thing. and give them Utopian. There's no CFO someplace that walks. The halls and knelt creates nightmares for the doctor's. Now actually the doctors really can give unfettered care and they do what they think is right for the patient. We try to make make sure that they do. Things is evidence based as possible but we don't control the head of quality what. How did you oversee that? If your tenant is the doctor can do what he here she feels is correct. How're you then policing the doctor? That might be deviating from what we'd be spending so we wouldn't call policing but but we certainly share show data so Every doctor would know. Let's say my panel of patients diabetes. This is the average hemoglobin C. And if I'm getting really low and really really impressive Hemoglobin A.. One CS but somebody else is not achieving that there would be peer to peer instruction and comparison. We would share what we're doing so we learn from each other. There's often awful awful lot of healthcare education that goes on to share these best practices and we make put systems in place to make it easy for people to do the thing that benefits. It's the patient the most. So by and large I don't think that the utilization patterns are so much higher necessarily within a system like ours where people can do what they want. But hopefully there's less variation and people are doing things that are much more scientifically evidence based but I I will say that And I think the way Steve that you you describe a little bit ago you know having doctor you know of your stature you know all of the education that a specialist has having to waste their time. That's is not the answer to this. It's not and by the way I remember in the old managed care era. It wasn't peer to peer. Who was actually probably speaking to somebody who didn't have a medical education was reading from a book and you had to just describe with the more that it used to be and I don't think that's the answer? I don't think we should be `gate-keeping. Well this isn't real evidence. Evidence based medicine with this. Setup is a barrier so that most physicians or at least let's say fifty percent of physicians will say I don't have time for this right and so they won't make the call. How how much money is that going to save the insurance entities at the at the end of the day billions of dollars every right? I is that just because Kaiser is kind of existing bubble and they don't have to work with the same parameters as a private hospital. Yeah basically they've created their own bubble now they for better or worse they rise and fall by their decisions economically and medically but they only have themselves to answer to and of course you know every organization has has to be fiscally responsible you as they say no margin no mission so no matter who you are. You can't spend more than you taken because that's not something heckled last forever but but You know we will only scratched the surface on the kinds of things that can be done. We've taught at the moment about prevention. But I'll give you some other examples. The amount of chronic disease that we have the United States is overwhelming at this point diabetes obesity. Hypertension I'm sure Steve can speak to what he sees it. Every day in the intensive care unit people who are now with bad illness because they had these kinds of Mo co morbidity and yet so many folks who have these kinds of problems have not been properly care for before they get desperately ill. They haven't been put on a a proper diet. They haven't been put on a basic medication that is inexpensive and works and helps prevent problems but it takes systems that takes information and takes data data and with the physicians. It's showing them what's working. What's not so that they can get better and better at it and giving them resources around them to help them achieve that? So you mentioned something to me before the show that I'm GonNA throw back at your doctor. You said that The US spends more per capita or per patient than any other country And our outcomes it comes. Don't necessarily show it so I have to ask you. Where's that money going right? Well first of all. That's a very complicated question so to some UM extent we're not spending our money optimally on what works so we're spending disproportionately money on things that in some cases may not happy beneficial may not work was spending a lot of money on people who have very very advanced disease older people people with very severe conditions and so at that point we should start rationing care now. I don't believe in rushing at all but I do think that there are times where we making perhaps different kinds of decisions and not not based on the money but based upon. What's the right care at that time? But at the moment we have lots and placed on. What's care for their for their condition? Revival the for their for their condition at the time. And so we have. I'm sure you know Steve would tell can tell stories. Many many patients intensive care units. Who whose condition is very very profound than some people wind up in the intensive care unit for months at a time and that can be extremely expensive either fishery keeping someone around? Who's WHO's passed their time and I'm not I'm not I don't really believe in that? I I don't I don't believe that I can say when someone is passed their time but I think sometimes doctors can do a better job of of talking to patients and families about how they can what they're conditioners and talking through but it's alternately up to the patient and the family what should be done and only up to them but sometimes doctors are resistant to having those conversations so I think on the one hand I don't believe in rationing and I don't think we should ever ever be the Make our decisions based upon money including including an end of life but on the other hand. I think we need to make sure that we're educating talking to our patients properly. Better conditions at all times when the healthy when they're not healthy but you going back to your question question about. Where's all the money going? So if you look at the Economic Incentives we pay a lot of money to a doctor to do a major operation. But we don't pay them very much money to have to do a physical exam and have a woman's examine a patient so how is a doctor in a primary care. Practice opposed to keep their practice going when doing an extensive history and physical brings them such little money compared to what somebody can make doing a major procedure. That's it's not a good distribution of the way we use money. Are you implying that doctors are being paid more than they should in this country. I well I put it this way. We definitely make a lot more per unit everything per unit time etc than most of the rest of the world. I'm not I'm not even the physicals. Even the doctors make the United States than most other countries per unit time per unit everything. But I but I'm not an apologist for that I I see what it what it takes to become a doctor to be adopted. The stresses of being adopted the value. You would have no. I don't think we're overpaid. I JUST WANNA see people be paid well in American healthcare for all of the work they do not just a procedure work. I'd like to you see Dr be paid well for the cognitive kind of reallocate. How they're paid? I think that would be. I think that would help to degree. Have we reached a certain place in America. Where if reimbursement were to go down any further? Are we going to be able to get the the best and the brightest in field that we think warrants the best and the brightest rightous number. One one thing that should be addressed from public policy standpoint. If you want people to go into any field that they like make make sure that they can afford to do so and try to avoid having to be so much in debt by going to medical school that would be one example by far we have the highest tuition in the world compared to somebody else and that's that's a problem that's something can be dressed as a public policy standpoint and should be you know what I'm GonNa ask us for just a minute. We're GONNA take a quick break but when we come back I want to pick up that subject and then I WanNa talk to you about comparing to bubbles the bubble of Kaiser where they're managing their process. But I'm also GONNA WANNA compare that with the va that's also in a bubble and ask you about their outcomes. We'll be right back. Hi I'm Robert Ross. Host of cars that matter you might be wondering what makes a car matter and I have a feeling you already know the answer. Some cars have changed history. Some you can hear a mile away. Awesome have lines that make your heart skip a beat if a car ever made you look twice then I think you know the ones that matter join me. As I speak with designers collectors Curzon market experts about the nationals drives and passions. We drive cars. That matter. Wherever you get your podcasts.
The Big Dilemma Facing the U.S. Healthcare System
"Are we supposed to juggle the cost of medicine? insurance company limitations and hospital economics. If we'RE GONNA try to enhance patient outcomes that is the big dilemma is that we have tremendous standards in terms of healthcare in our expectations that we were going to provide the the best and the greatest and the newest healthcare available to who are patients. And yet we have this notion that this is GonNa come from vaporware that somehow it will be provided to us and and yet we're really at a crossroads a realizing that our Medicare system is straining relative to the dollars that are available Research Searching Development is taking place in the private sector but then the rest of the consumers are feeling the pain because they're having to pay extreme costs in as as far as their medications are concerned and the entire system sort of feels as if it's a row about ready to collapse how can maintain high quality cutting edge medicine and still manage the economics and those two things are so diametrically opposed and so much of our gross national the product is already being spent relative to healthcare and yet we're drowning Medicare's rationing insurance companies are rationing they're hiding the rationing that's going non but there's rationing going on nevertheless so can i. Can I ask this Howard. Does Kaiser have a unique view of how to manage this problem. I think Especially from the point of view Kaiser Permanente we feel that there are some relatively more simple approaches to health care where it's not all just about spending money on the latest when greatest technology or pharmaceutical For example Prevention we in the United States are much more engineered To have patients get great treatment when they're sick but not really engineered to make sure that they get all the preventive care that they should get and there are literally and insurance wise and everyone who say engineered and every one of those ways we first of all. We don't talk about enough. We don't talk about prevention now. We don't advocate enough for it. And we don't have financial incentives centers that favorite prevention or financial. Incentives favor taking care of people. When they get sick we spend a lot more money per unit time for doctorates CETERA? When someone on a sec then giving them advice on how to prevent them from any sick so if we just could get every single American to do the tests and take the treatments from preventive standpoint that we know work that right there would improve health and that right there would reduce costs and that was certainly something we accuse a permanent? They felt very strongly about and had trump have tremendous data. Show that we've been doing. Those things are very very substantial way making sure that populations of patients get their mammograms. Hypertension screens take basic medications occasions. That work for their condition. But you have to make sure that large numbers of patients in the population do it because of all small population percent do it. You won't get the same benefits so one of many countries around the world and in fact we're starting to do it better in this country. No country does a perfectly however In in fact still that's a problem that that's a problem that is actually international nature but Some countries that are doing better at it include Germany the United Kingdom even the National Health Service where people have their criticisms at times about service and whatnot in the NHL NHL does give care. That's very evidence based But no one country has got a monopoly to give great prevention. That's just a huge opportunity for us and everybody else as well let me give you a negative example from this country. We wish I'm noticing Historically we do screening blood tests on patients every year Complete blood count a comprehensive metabolic panel looking looking at kidney function liver function Your Lipid profile your cholesterol your LDL your HDL etcetera etcetera. And historically this has been paid aid for by insurance companies has been paid for by Medicare currently Medicare and then subsequently other insurance companies have followed that we we will do a blood count if you have a blood disorder. So if you're anemic we will justify doing a blood count if he had kidney failure. We'll just we are justified in running your creatine in your kidney function test if you have thyroid disorder than we will pay for that. But if you don't have that you don't have any of these disorders. We no longer pay for routine screening laboratory data. So does that mean that. The insurance companies have not adopted the principle that preventive care actually ends up costing them less than long run to not pay for the screening blood tests will save millions for private insurance companies as well as for Medicare. So how. You're you're you're focused on how we create better outcomes for patients. Isn't this part of the problem. And what do you suggest do we do about it. Yeah so I can at Kaiser Permanente we didn't control doctors ordering habits. A doctor can do anything That they think is appropriate for a patient and we didn't and tell them not to order tests and whatnot but in particular. We strongly encourage them to do things that are evidence based so. If there's a test to be done that would help detect something early. We actually want doctors to do do that. And and have a very good record of accomplishing that. I mean again. We didn't restrict people from practicing the way they felt was best based upon their view of the clinical evidence in the in the patient's patient's condition however it's similar to what happens in government when governmental When when they're tough times and government budgets challenge they tended slash ask things they took the cup? Because that's the only way they can balance the budget so as we get closer to Medicare insolvency and insurance companies are having problems with costs. They they start getting into to cost savings mode and those those cost-saving modes and not necessarily evidence base. So that you stuck maybe cutting out the baby with the bathwater a little bit and don't intelligently try to to figure out what you should do and what. You should not do. What I'm advocating for is to try to use scientific evidence as much as possible to make thorough assessments of these various technologies analogies are tests and then use the evidence that comes forward and make sure people do get these tests are do get these therapies as opposed to basically you want to use this you want to use this information to convince the healthcare economic controllers the insurance companies to think differently about the pro? I do but I also understand. It's it's it's easy to just blame the insurance companies and I'm not here to be an apologist and then you way for Insurance companies or explain what they do again. I'm very proud of what we did in Kaiser Permanente because because we were not just an insurance company also provider of care and we have a really good record of policy but I do think that the opportunities for improving health certainly exists at the insurance level. The exists at the physician level but they also existed the patient
"dr howard" Discussed on The Finer Points - Aviation Podcast
"It's been such an incredible year and I hope you're all with your family with people that you love. These last two weeks of December are always kind of magical things start to wind down and everybody sort of goes with the people they love and things get quiet it's It's one of my favorite times of the year and it really gets me thinking about people that mean a lot to me and and you know each year we go out and do these adventure flying trips where it's really really a Labor of passion. You know we do three trips. There's so much that goes into getting those trips together and getting them out the door and I've always said you've probably heard me say that one of my biggest joys in all of it is the level of the caliber of instructors that were able to bring to it and that really starts with my partner in the effort. Howard Donner honor? Howard's a medical doctor for those? That don't know he's an expedition physician. He's been featured on Nove. He leads expeditions all over the world sailing. Expeditions conditions He's a river guide. You know what I mean. The list goes on and on and it's amazing to get Howard out there and of course through Howard and his network of friends we get at Peter. Lert people that I know Eric Cope and Ryan Van Heron we just such an amazing caliber of instruction. That's really the value standing around the campfire. Drinking can wine and talking through some of these issues that are sort of live in the back of our mind only now. We've got this company to discuss them in is pretty pretty incredible. I'm so in this podcast. I actually just phoned up Howard. He's up in the mountains. If you're looking for a video version of what you're going to hear it is available to patrons A couple of talking heads but it was a lot of fun onto talk to Howard about some of the ways that he views things like hyperventilation and pulse ox senators and whatnot so I started by asking him about pulse. Ox Senators because I figured that's a piece of equipment. That's in many many pilot fight bags. I think pulse ox. Senators are really important. I carry one of my flight bag. I use one and great tool not Pooh poohing the use of symmetry. But it's really important to know that what a particular pilot will tolerate in terms of oxygen is very different than what might be considered normal in the textbooks and I've seen people get sick with sats in the low ninety S. I've seen people. That are acting very normal with sats in the high seventies. I'm much more interested in how somebody's doing clinically than I am looking at a number. But certainly when you're flying with your friends when people are starting to drop well below ninety percent it's cause for concern but I I would be much happier if I was flying with you and you looked good and felt good and your cognition was normal and that was eighty five. Then your brother other. Do you have a brother. Then your brother who might have sat three points higher than yours. But he's starting to act stupid and his cognition is impaired. So I guess what I'm saying in my normal long winded way as asymmetry is interesting and important but a patient agent or pilots clinical presentation meaning their smartness. Their cognition is more important to me than any particular number. And and I'll also add that. Would I look when I'm flying with people with senators is not just what their absolute number is but what is their baseline at their home. So when I lived in telluride around my house was that almost ten thousand feet and my baseline sat was around ninety percent at home so when I was flying if my sat that drop below ninety I certainly wouldn't make an emergency landing and call an ambulance. It was normal for me to be at ninety so I typically we look and again this is an arbitrary number but I look for people sats to drop more than about ten percent below what their home baseline is. What do you think about Auburn deletion? I look at the questions and it's like okay. Somebody's freaking out. The damage I have in my mind is right and I I am a paper bag. They start breeding knew it presumably even though they're freaking out and then they're fine. Is this a realistic scenario. Does that does a bag fix. It is is a thing for real. Well the good news or the bad news always the bad news. I I gotta end optimistic. Bad News is that I'm not An advocate of paper bag breathing and the reason for that is especially for a non medical person but even for a medical person sometimes in that Situation Association. It's hard to know why. A person is hyperventilating and admittedly in most cases. It's you're probably going to be able to make the diagnosis. Looks like they're having a little bit of a panic attack. Or they're anxious and they're hyperventilating But how do you know. They're not having a pulmonary. Embolism how do you know they're not having an m by a heart attack. You don't know why they're hypotheses and suddenly they're getting short of breath medical term dispe nick and they're breathing like this and you go home. And God they're hyperventilating quote unquote see stick a paper bag over their mouth and they can't get any oxygen the Gen. That's not a good thing so even though it could work and it does work and I have been known to use paper bags so I'm not. Pooh poohing the technique. I I think there are better methods for dealing with hyperventilation in the cockpit and the next thing we got into is actually a question that I got from somebody on instagram. If you're looking for me on instagram grandma learned the finer points. But somebody asked me you know what. Why do the symptoms of carbon monoxide poisoning differ from high poxy if carbon monoxide prevents oxygen from bonding to the blood right? What what's the difference? Why are the symptoms different super? Good question and you know. Sometimes if I don't know control say we don't really understand that but truthfully it this is it is poorly understood. It is known that the mechanism of CO poisoning carbon monoxide poisoning is twofold one are the effects of hypocrisy because of the preferential binding of carbon monoxide on the hemoglobin molecule. And I think that's what most students learn and two hundred three hundred times greater affinity for hemoglobin than oxygen. So it's going to preferentially bind those really important oxygen binding sites on the hemoglobin but there are a number of of non hypotheses mechanisms for carbon monoxide poisoning that are poorly understood but it affects non hemoglobin proteins. And not the least important one of those is Maya Globe which can affect brain function it can affect heart function it can affect neurologic function auctioned in general and there are all sorts of cascades including nitrous oxide prostate gland cascades and on and on and on which ultimately cause oxidative stress and inflammatory mediators. And so the bottom line is that there are a whole bunch of oxidative changes and inflammatory processes that occur in conjunction with the hypocrisy and subsequent hypoglycemia bottom line on on carbon monoxide poisoning. Is that there are hypoplastic issues but there are non hypothetic issues news. And it's now known that carbon monoxide binds to non hemoglobin proteins in the body causing all sorts of oxidative and inflammatory Tori changes in the brain in the heart in the muscle and Jason. It's really important to reiterate and I know you know this and my guess is that your viewers know this as well but that if you're using symmetry and a patient I always say patient it's the doctrine me and a pilot is is exhibiting evidence of carbon monoxide poisoning or hypoglycemia you might measure their symmetry in the airplane and say Oh yeah. They've got us at ninety five. So I'm guessing. They don't have carbon monoxide poisoning because carbon monoxide displaces. The oxygen but that's not true INOX senator will not know the difference between a saturated hemoglobin molecule that has carbon monoxide oxide attached versus oxygen. While that's just absolutely fascinating information Howard's wrong actually didn't know that so I'm glad to know it in the last question question. I asked him also came from instagram. And the question was from somebody that lives at high altitude. The question was already acclimated because I live at high altitude and therefore less susceptible to hypoxia. So the simple answer is yes and no The good news is that if you live at high altitude you definitely we have some degree of acclimatization to high altitude. So generally speaking. Certainly statistically you are going to be doing better than in your sea level cohort But the problem is is there such a high degree of variability in.
"dr howard" Discussed on 710 WOR
"Now, I called you desperately on a weekend. And I said Dr Howard I have the worst flu I've ever had. I've never I've never felt this way. I've never suffered this way you ask some questions about my my nutritional background. I struggled with chronic bronchitis. Growing up. There were regular chest. Congestion issues, and sinuses and allergies and so forth that I was dealing with for a long time. In fact, when I was a kid I would get bronchitis. Nearly every time the weather changed. If it went from real cold to real warm in a fast short period of time. In fact, this spring here in New York, we had one of those days in could tell my body wanted to go. There didn't get there this time. But you you talk to me about the difference in a spark in a flame in the way infection works in the body. And you said what which is easier to put out a big roaring fire or little tiny spark. And of course, the answers to spark. But you did I'm impressed. You remember the oh, man. He made such an impact in you. You basically did say basically your flu a big giant roaring fire right now, you've got you've got to get that doused. But once you do the balance of nature with the nutrition from the fruits and the vegetables can put out those sparks much more quickly, and I found that to be true because in the next year and a half or so since I've been on the product I have not had any serious reoccurrence of bronchitis. And when I when I feel like something's starting to go, I up the dosage take a few more fruits and vegetables for few days under the directions, you gave me and it has worked every single time, including as recently as just a couple of weeks ago, and Dr Howard some some of your best success stories are people that have used it. And and now they tell other people about it. And we've got someone like that who's calling us from coconut creek, Florida. Rachel are you there? Before it's good to have you with us today at bouncing h radio. Rachel, what was your story? What why did you come into contact with balance of nature? I have COPD currently on oxygen twenty four seven. Found my dope. The the the nine. Every day. I.
"dr howard" Discussed on 710 WOR
"Now, I called you desperately on a weekend. And I said Dr Howard I have the worst flu I've ever had. I've never I've never felt this way. I've never suffered this way US. Some questions about my my nutritional background. I struggled with chronic bronchitis. Growing up. There were regular chest. Congestion issues, and sinuses and allergies and so forth that I was dealing with for a long time. In fact, when I was a kid I would get bronchitis. Nearly every time the weather changed. If it went from real cold to real warm in a fast short period of time. In fact, this spring here in New York, we had one of those days in could tell my body wanted to to go. There didn't get there this time. But you you talk to me about the difference in a spark in a flame in the way infection works in the body. And you said what which is easier to put out a big roaring fire or little tiny spark. And then, of course, the answer's the spark. But you did impressed. You remember the oh, man he made such an impact in you. You basically did say basically, your flu is a big giant roaring fire right now, you've got it. You've got to get that doused. But once you do the balance of nature with the nutrition from the fruits and the vegetables can put out those sparks much more quick. And I found that to be true because in the next year and a half or so since I've been on the product I have not had any serious reoccurrence of bronchitis. And when I when I feel like something's starting to go up to dosage take a few more fruits and vegetables for few days under the directions, you gave me and it has worked every single time, including his recently just a couple of weeks ago, and Dr Howard some some of your best success stories are people that have used it. And now they tell other people about it. And we've got someone like that who's calling us from coconut creek, Florida. Rachel are you there? It's good to have you with us today at bouncing h radio. Rachel, what was your story? What why did you come into contact with balance of nature? I have COPD currently on oxygen twenty four seven. Found increase my dope. Nine of the the daddy the nine of. For every day. I found that carried the day that I could take by accident for.
"dr howard" Discussed on 710 WOR
"Bless you. Dr Howard God. Thank you. So so tell me about your experience with it did have you had a health coach. Yes. I did. I had Dr bond for the first time, and then I had Michelle. And I I could various people. Okay. I can't remember all their names. But they're all they all give me such good pointers. And I tried to follow them this way. I can I still have weighed issues, and I have blood pressure issues. And and and and that I'm only on two medications a day, which don't seem to bother me and don't seem to affect the balance of nature. Otherwise, I feel pretty good great. So out of anything that they've talked with you about what would be what point sticks out more than anything else. That they've ever taught you cook you, oh, what points they told me to drink more water? Okay. He told me not to snack. But I I usually snack on. Well. I am at times. I have to admit, I am a junk food junkie. I am a junk food junkie. I don't eat too, much sweets. We miss. We miss out. You don't eat much seats except for what? And special occasions. Okay. Do you eat good vegetables and fruits? Oh, yes. Oh, I love my vegetables and food. I lead you know, anything that. I can that's available that I can get a hold of you know, we tried to buy the frozen. You know, when you live in the city, there's not too much organic around. Right. And if you do go shopping, you have to you know, I mean, I'm on a certain budget. I'm on a fixed income myself. So I have to be careful what I buy. You know, I wanna make sure and we have somebody read the labels for me when I you know, when we do shop. So what was it that ultimately had you call and learn about balance of nature what was going on by hearing just by hearing about the product. That's awesome by hearing about the product itself. And then getting feedback from the listeners who was the people who've tried it. And I said, why don't you? What I talked to my doctor about it. I showed him. He just seemed to say, okay. Well, good. Well, really? Like, you said it's the one product out there. That's one hundred percent safe of what doctor would tell you. No, don't increase your intake of fruits and veggies. That'd be crazy. And there are some actually, but I'm glad yours wasn't one of them. Can you please remind me of what your name is again? My name is JoAnn, JoAnn, JoAnn. I want to ask you a question. So what has been your experience from taking balance of nature? What are some of the things that you have have felt in your body, and you just your overall wellbeing? What are some of the things you've experienced? I experience more like a feeling of alertness, not so much, hyper nece where I'm conserve energy. And when I feel I need to do something I'm able to do with effortlessly. You know being alert. Sometimes the series used to feel like I'm climbing mountains. Now the stairs. Don't see no longer like mountains that get up and go that has gone away for some time has come back because of balance of nature. Yeah. That's wonderful. That's exactly what I love to hear the most simple things that that's what I love to hear. I mean, we have these great big his people come with these great big testimonials and success. And my I I love that too. But my favorites are this. I have more energy have more more. I have more value to life. That's the key balance of nature gives me a reason to live. Wow. That's Dr Howard. Thanks to you. God bless you again. Thank you very much. Thank you so much for calling JoAnne. You've been just wonderful and continue on you have such beautiful energy. And I love your voice, and you have a lot of pep. I think the balance of nature and just you and the way you were made is just continue to take it. I will continue to take that stuff. Beautiful sending them. Part. You do yours. Okay. Thank you. So the best God bless you to have a beautiful day. I hope to meet you one day in Chicago. We'll be doing a lecture there at some point. And I hope to meet you. Well, I'm going to try my best to make it there. Okay. I work. See I go to the senior citizen. I I'm currently involved with the senior citizen lighthouse for the blind here in Chicago. I don't know if you've heard of it. The senior citizens program and really I'm trying to get people to get on the product. You know, the way I know how but just by listening to the radio, you know. See I knew this through relevant radio AM nine fifty. And they're they're they're they're they're all their coast to coast and all over the United States and Hawaii and all that. And they advertise it every once in a while. And I've been waiting to hear my voice. And I haven't heard it yet. So now that I'll be able to hear it. That's great. Great. Thank you. Beautiful day and you as well guys. God bless you to banks. Now in an effort to help more people in getting started..
"dr howard" Discussed on 710 WOR
"You're a doctor of medicine Dr Howard. And yet you really recognize that the spiritual the emotional the mental aspect of life plays a big role in someone's overall health. What it plays a role in is your quality of life. And that's what we're losing in medicine is were fit for forgetting about quality of life. We don't save lives have quality left in it all of those aspects have to be worked with an and you're you're good physician does work with that. And and and you know, if you've been to a physician, and you walk out, I don't care if they save your lights the surgery, but they're rude. And mean, then you don't really feel real great. And you might go home still depressed or whatever. It is depressed. More depressed and more fearful too. That's frequent and more fear. That drives me crazy. When when we're taught in medicine to use fear to get people to do it. We want. No, bounds nature. We use education. Teacher. So so that people can make that choice, not fear. I don't believe in fear factor's, and the health trad is also just magical and. Wonderful thing has a health coach when you're working with people. Sometimes there's a side of the health triad that people can't face, you know, they're just they've been working on it long enough and they're done. They're like I'm giving up on the physical end. I can't lose weight or I can't do whatever I'm done. I'm not going to work on that anymore. And so Dr Howard trains, the health coaches that if you just work on two sides of the triangle, the third one comes up naturally on its own. So we just say, okay, let's set that one aside for now. And let's look at the other two and it improves, and then as things improved than they get more willing to look at that side that so difficult for them. So you have a health coach that takes a customer through the various ways in which the fruits and veggies interact perhaps with other medications or how much you should take. What time you should take them? What are some of the different roles that a health coach fills when they start taking balance of nature. Well, the main role of a health coach is because we are.
"dr howard" Discussed on 710 WOR
"You're a doctor of medicine Dr Howard. And yet you really recognize that the spiritual the emotional the mental aspect of life plays a big role in someone's overall health. What it plays? A role in is your quality of life. And that's what we're losing in medicine is were fit for forgetting about quality of life. We don't save lives. If we don't have quality left in it all of those aspects have to be worked with and you're you're good physician does work with that. And and and you know, if you've been to a physician, and you walk out, I don't care if they save your lights the surgery, but they're rude. And mean, then you don't really feel real great. And you might go home still depressed, or whatever it is more depressed. More depressed and more fearful too. Yeah. That's frequent and more fear. That drives me crazy. When when we're taught in medicine to use fear to get people to do it. We want no at balanceofnature education teacher. So so that people can make that choice, not fear. I don't believe in fear factor's, and the health triad is also just magical and wonderful thing has a health coach when you're working with people. Sometimes there's a side of the health triad that people can't face, you know, they're just they've been working on it long enough and they're done. They're like I'm giving up on the physical, and I can't lose weight or I can't do whatever I'm done. I'm not going to work on that anymore. And so Dr Howard trains, the health coaches that if you just work on two sides of the triangle, the third one comes up naturally on its own. So we just say, okay, let's set that one aside for now. And let's look at the other two and it improves, and then as things improved than they get more willing to look at that side that so difficult for them. So you have a health coach that takes a customer through the various ways in which the fruits and veggies interact perhaps with other medications or how much you should take. What time you should take them? What are some of the different roles that a health coach fills when they start taking balance of nature. Well, the main role of a health. Coach is because we.
"dr howard" Discussed on 710 WOR
"You're a doctor of medicine Dr Howard. And yet you really recognize that the spiritual the emotional the mental aspect of life plays a big role in someone's overall health. What it plays a role in is your quality of life. And that's what we're losing in medicine is we're fit for forgetting about quality of life. We don't save lives. If we don't have quality left in it all of those aspects have to be. Worked with and you're you're good physician does work with that. And and and you know, if you've been to a physician, and you walk out, I don't care if they save your lights the surgery, but they're rude. And mean, then you don't really feel real great. And you might go home still depressed, or whatever it is depressed or more depressed and more fearful too. That's frequent and more fear. That drives me crazy. When when we're taught in medicine to use fear to get people to do what we want. No at balanceofnature, use education. Teacher. So so that people can make that choice, not fear. I don't believe in fear factor's, and the health triad is also just magical and. Wonderful thing has a health coach when you're working with people. Sometimes there's decided they health triad that people can't face. You know, they're just they've been working on it long enough and they're done. They're like I'm giving up on the physical, and I can't lose weight or I can't do whatever I'm done. I'm not going to work on that anymore. And so Dr Howard trains, the health coaches that if you just were two sides of the triangle the third one comes up naturally on its own. So we just say, okay, let's set that one aside for now. And let's look at the other two and it improves, and then as things improved than they get more willing to look at that side that so difficult for them. So you have a health coach that takes a customer through the various ways in which the fruits and veggies interact perhaps with other medications or how much you should take. What time you should take them water some of the different roles that a health coach fails when they start taking balance of nature..
"dr howard" Discussed on 710 WOR
"Dr Howard, the reason you and I are talking is because a number of months ago, maybe a little more than a year ago. Now, I called you. Desperately on a weekend. And I said Dr Howard I have the worst flew overhead. I've never I've never felt this way. I've never suffered this way you ask some questions about my my nutritional background. I struggled with chronic bronchitis. Growing up. There were regular chest. Congestion issues, and sinuses and allergies and so forth. I was dealing with for a long time. In fact, when I was a kid I would get bronchitis. Nearly every time the weather changed. If it went from real cold to real warm in a fast short period of time. In fact, this spring here in New York, we had one of those days in I could tell my body wanted to go. There didn't get there this time. But you you talk to me about the difference in a spark a flame in the way infection works in the body. And you said what which is easier to put out a big roaring fire or little tiny spark. And of course, the answer to spark. But you did I'm impressed. You remember the you? Oh, man, he made such an impact in you. You basically did say basically your flu is a big giant roaring fire right now you've got. You've got to get that doused. But once you do the balance of nature with the nutrition from the fruits and the vegetables can put out those sparks much more quickly, and I found that to be true because in the next year and a half or so since I've been on the product I have not had any serious reoccurrence of bronchitis. And when I when I feel like something's starting to go, I up the dosage take a few more fruits and vegetables for few days under the direction, you gave me and it has worked every single time, including as recently as just a couple of weeks ago, and Dr Howard some some of your best success stories are people that have used it. And and now they tell other people about it. And we've got someone like that who's calling us from coconut creek, Florida. Rachel are you there? Yes..
"dr howard" Discussed on KLIF 570 AM
"Dr howard. How did you discover balance of nature? Well, originally, I was working as Dina foreign student affairs at Pavlov Medical University in Russia while I was there. I started realizing and seeing that many of the diseases that were resurfacing were due to socio economics in other words, as they had less and less money. And they there were people who were living on just black bread and water and their nutrition was dropping out then diseases that we normally would see through bacterial diseases, for example were on the rise wasn't because the bacteria was on the rise. It's because people's immune systems were being depleted. I put that together with why they were being depleted was because of their lack of nutrition when I first returned back to America. My goal was I just to change. Change the diet of my patients just to get them to eat better. My patients were mostly above the age of fifty and I just couldn't get him to change their diets. I mean, I'm not to knock the services Besam had services like meals on wheels. And they would come and I go through a dietary history with them, then they found that they were eating maybe one serving of vegetables in a day, and maybe one serving of fruit and that was on a good week because they do not count iceberg lettuce or potatoes. I just saw that they weren't getting that nutritional base that they needed in their life. So I started trying to get them eat better. They weren't doing that. So then I started trying to get them to juice because I thought well, if I can't get them and get them to juice. Most people liked apple juice, and carrot juice. And that was about it. And then they started actually I had a couple of patients within time and on their own. They started coming in orange, and I started going, oh, I think you're just drinking a little too much, carrot juice. Their actual skin color was their skin color would start. You'll start to turn orange if you drink too much, carrot juice, for example, I realized it wasn't a balance there and at the same time at that time, I was still looking for that magical chemical and fruits and vegetables somewhere. And I I was still in search of a single chemical that was going to cure cancer. And James the world. I knew that that chemistry could be found in fruits and vegetables. What he didn't know which one then with time I learned it's not one it's all of them put together, they have exponential effect on each other. And so when you have tens of thousands of chemicals naturally occurring chemicals in the fruits and vegetables that make up their color, smell and taste. When you put that all together than the more. You can put together the more combinations. The body can make from that juicing wasn't working. So that's when I decided to find a way that I could get enough nutrition my patients, and we found a way that we could preserve the fruits and vegetables. So that we had ninety nine point nine percent of the fresh fruit or vegetable nutrition, that's very important, no heat processes and no air processes, no light processes. And so in other words in a dark cool. Vacuum is how that process can be done, and it's not a cheap process. So we we developed more and more of how we could get that water out without extracting nutrients. He came home. He was like, wow. I think I've I've really I'm really onto something. I if this is real like, this can really be done, then we can create something that's gonna really change people's health was an exciting day. I was interested in wondering, I know that you say often on the program. We don't claim the balance of nature is a cure, all or a cure for cancer. But what doesn't the right proper nutrition help? And then I know that at your company receive literally thousands of letters from people who have been taking balance of nature and different issues. Maladies health problems that have been alleviated and made better because of taking it are you allowed to tell us some of what that is. Sure. I mean, and I do want to stress that we don't claim to be a cure for everything. I in early in my career. I remember a lady calling from Texas, and she was just absolutely furious at me. And she said, how dare you say cancer is preventable. Cancer is preventable. A great percentage of the time. But she was furious at me because she had a son who had passed away. I said, I'm so sorry. If that's what you if you think I'm blaming you for that cancer. I'm not but many times and..