What to do today.

Make a change in your life and make it today. A few days ago I mentioned adding a vegetable. The truth is there is much more to discuss. While there are hundreds of companies touting products for your health, few can deliver in the long term. One company to look at is Eat Right America. The vision is simple: make health something for everyone. The approach includes decreasing animal products, oils, sugars and increasing vegetables, fruits, natural grains and beans.  I realize that it seems this may not be for you.  I get it.  Really.  I have discussed this with many patients some of whom tell me “there is no way I am going to be a vegetarian!”  Let me tell you, they are quite emphatic.  The idea is not to be a vegetarian.  That does not ensure health since you can have oils, fats, fried foods and other items that are not conducive to excellent health.  It is the preparation, quality, and type of foods that you choose.  You can steam saute versus oil pan saute.  This saves 120 calories per tablespoon of oil but also eliminates the possible hydrogenation that can occur to the “good oils” and make them potentially toxic.  Another thing to consider is to eat a combination of raw and cooked vegetables.  It changes the consistency, can enhance absorption of certain vegetables or even remove toxins such as in mushrooms.  The change to make today is eat one portion of cooked veggies with a portion of raw veggies.  Try this today and next time lets add some spices.  Good luck and see ya next time.

Corey

A New You

There is so much information regarding health and body weight that it is impossible not to stop and think: “How can I improve my life?” The problem is that all that information gives you so many choices that it becomes impossible to make a decision. Low fat, high protein diets have dominated the landscape since the 1980′s and have resulted in nothing but a heavier America and poor health costing billions of dollars.

Take charge of your life now. Increasing vegetables in your diet is the first step. Divide your daily plate into two. On one side are vegetables. On the other divide it again into three parts: Fruits, grains, and protein. Try to choose non animal proteins if you can such as black beans. Try pan saute without oil, eat raw or steamed vegetables as well.

On average people consume up to 150 animal products per month. If you begin to decrease this number and add whole foods you can begin to see the changes within just a few weeks.

Your medications will decrease and health will increase. We need to discuss this further tomorrow.

For now, increase your vegetables.

Truth in Diet and Weight Loss: Hunger

I know that many of you are trying to lose weight.  In fact 65% of American Adults are considered overweight or obese.  The problem is that excess body fat causes many health problems making weight loss more than just cosmetic.  I want to address hunger in this blog.  My company Physicians Life Centers (www.physicianslifecenters.com) has its primary focus in evaluating and developing fitness and nutrition programs and educating our clients on these topics.  No fancy medications, no cookies or meals to buy and no, I don’t sell vitamins.  Hunger is a key element that people complain about with regard to weight loss and is often a cause of failure (there are many more that we can discuss at a later date).  Being hungry is not a disease.  It alone will not kill you.  It essentially is a signal to the brain that there are fewer calories around to store into fat and metabolic changes may be coming.  Too much hunger however can be detrimental to the weight reduction process.  Starvation, when the body is denied calories  for extended periods of time, causes physiologic changes that result is fat storage.  That is why eating one or two meals a day can actually lead to increased body fat compared to individuals who spread meals throughout the day or obtain calories around the time they are needed.  The main fuel source for your body is actually fat.  The machine that burns the fat is run by carbohydrates.  This essentially means that no one dietary plan works for all.  The best you can do is blend your foods together (no not in a blender, but have a variety of protein, fats and carbohydrates with each meal) to give you what you need. 

From a hunger standpoint eating foods with lower glycemic index may not be the answer either as some low glycemic foods have a higher glycemic index per portion than others of equal portion.  However, if you eat a small amount of protein, have moderate or lower glycemic index carbs and healthy fats hunger will decrease because you will be supplying what your body needs.

Now, lets say you want to decrease your calories.  Well, sorry to say but you may be a little hungry.  Just try to tell the difference between mild hunger and starvation. 

The bottom line for today:  a little hunger is not so bad, especially if you are trying to decrease body weight and body fat.

Future blogs:  Eating better, exercise, VO2 testing (exercise testing) and even endurance training.

Corey

Seniors be aware, Medicare Does Not Pay For Physicals. Did you know that?

Did you know that Medicare does not cover yearly physical examinations or many diagnostic studies that are considered to be preventive in nature?  Like many Medicare recipients you are not alone.  On this page we will attempt to make it clear what the Medicare rules are and what charges you may incur for non-covered services.

General Screening rules: Medicare

Title XVIII of the Social Security Act, section 1862 (a)(7) excludes routine physical checkups (including tests that are performed in the absence of signs or symptoms) from reimbursement by the Medicare program.  Screening exams/procedures are defined as examinations and/or diagnostic procedures performed in the absence of signs and symptoms.  Screening is often performed based on patient age, and/or family history.  While election to perform such examinations and tests may be considered good medical practice, they are not covered services under the Medicare program.

Welcome To Medicare Visit

The Medicare Modernization Act, section 611, provides Medicare coverage for an initial preventive physical examination for new beneficiaries.   Here is what this visit covers according to Medicare:

• The term “physical exam” is misleading because it is really a “health assessment”.  There is no covered examination covered by the visit except for documentation of your vital signs and a visual acuity test.
• This visit is more like an interview to determine your health risk factors and to expalin what preventive benefits are available (see list below).
• Covered services:
  • Review of your history for risk of depression
  • Electrocardiogram
  • Education, counseling and referral as appropriate based on the results of the history
  • Mammography once per year
  • Colorectal screening/fecal occult blood testing
  • Colonoscopy for high risk individuals
  • Pelvic and breast exams every two years
  • Prostate cancer screening/digital rectal exam yearly
  • Prostate cancer blood testing (PSA) yearly

 Annual Examinations:  The following are considered Non-Covered Services

• Routine examinations (annual examinations) and tests directly related to such exams
• Routine foot and dental care
• Immunizations except for the Flu, pneumonia or Hepatitis B
• Prescription drugs
• Cosmetic surgery

For these services Medicare expects the doctor to bill you directly and you are responsible for the payment. 

Medical necessity means that Medicare only pays if you have signs or symptoms of illness.  Sometimes your visit can be both routine and medically necessary.

Note from Dr. Howard

“I realize this may be different than what you think or how things have been done in the past.  However, these are the guidelines from Medicare and are available online for your review.  I believe that every patient needs to have a comprehensive review of their history, have a a physical exam  performed and have appropriate screening tests ordered even in the absence of disease.  I believe prevention is even more important than just treating disease.  There is a charge for this service and all patients are required to pay their portion after Medicare is billed.”

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