Well, you folks have kept the drumbeat going, improving your health, spreading the word about Fat Head and healthy eating, driving the numbers on Hulu and Netflix, and DVd sales. All of which gets Tom invited to places like the Ancestral Health Symposium at UCLA to present his “Science for Smart People” speech.
So he’s already gone again and I’m already back again. You have no one to blame but yourselves.
First, a quick housekeeping note. It sounds like Tom’s going to be severely out of pocket for the next few days and the comments on the site are already piling up. In the interest of keeping the dialog here moving, I’m going to approve the ones that I don’t think require his attention. If you’ve submitted one and don’t see it, please be patient.
I was going to put up a post about some amazing BLT’s The Wife and I make — including low-carb options — along with some hints on bacon and avocados ( I know, add a couple of eggs to the bacon and avocados and you’ve got the whole paleo food pyramid, right?).
But I had an interesting experience this week and I thought I’d share it. It’s not nutrition or food, but it is about your health, so here goes…
This past Wednesday, being a guy over 50 who generally manages his health by avoiding doctors, I finally went to a new doctor. It took an hour and a half, which was amazing.
Normally, there’s nothing amazing about spending an hour and a half at the doctor’s office. In fact, that would generally fall under “completely normal.”
You know the drill. Get there 15 minutes early so you don’t lose your place, spend 15 minutes refilling out the same paperwork you filled out the last ten times you were there and letting them copy your insurance card again (OMG, you didn’t change insurance companies, did you? Start over!)
Half an hour after your appointment time, the nurse escorts you back to the exam room and spends five minutes asking you some questions, writing your answers, and taking some measurements (height, weight, blood pressure, etc.). The nurse disappears and hopefully after only another fifteen minutes or so your doctor comes in and asks you most of the same questions again. She’ll determine a few tests for the lab to do. If you’ve got a particular ailment, she’ll probably want a few extra tests. Then off she goes.
You get escorted to the lab, wait there for fifteen minutes, a tech spends another ten or fifteen minutes drawing blood or whatever needs doing, then back you go. After another wait — again, fifteen minutes qualifying as a lucky day — your doctor returns, spends up to several minutes reviewing your test results with you, and then tells you that you need to be on statins. Har!
So what’s so different about spending an hour and a half at my new doctor’s? Well for starts, I spent the entire hour and a half — brace yourself — with my doctor! This is him — Dr. Craig Backs
Craig has over 30 years experience as an Internal Medicine Physician, is a past president of the Illinois State Medical Society, and recently returned to private practice after a stint as Chief Medical Officer at Saint John’s Hospital in Springfield. Good person to know.
Almost the entire time was spent with Dr. Backs, except for maybe the first three minutes, which I spent in his reception area, which looks like this…
The seating is comfortable, but this is probably about as crowded as it’s going to get. More on that in a minute.
And when the nurse came to take me back to the exam room? Well, that didn’t happen. He doesn’t have a nurse. Anything that has anything to do with my medical experience, he does.
Also, we spent the first hour of that hour and a half sitting here:
Since this was my first visit, we spent an hour not only going over my medical history, but also any current complaints (coincidentally, I happened to be having a flare-up of sciatica from old injuries) and my goals regarding maintaining and improving my general health. We also spent some time on my conviction of the benefits of, and my personal results from moving to the low-carb lifestyle. With a couple of short detours into politics and economics, of course.
Craig has been a personal friend for years (his son and The Oldest Son went to school with each other from preschool through high school, and remain close friends). As a result, I’d recommended Gary Taube’s Good Calories, Bad Calories in a social conversation before he started his new practice and he read the whole thing. Craig is not a low-carb or paleo (or anything else) physician, but he was comfortable with my decisions about nutrition and health. He’d also support a patient intent on the low-fat approach. Imagine that — a doctor who wants to help his patients work their way towards their health goals on their patients’ own terms.
After building the foundation of our doctor/patient relationship, we moved into a standard exam room for the actual physical, including all of the usual equipment, although most of them were hooked up so they would load results directly into his laptop and my medical records, which are now all electronic. This all took most of the other half hour, including some helpful suggestions on addressing the sciatic flare-up.
[It also unfortunately included the usual test for a guy over fifty, which I was not able to get Dr. Backs to waive for an additional fee. I suppose it’s nice to know your doctor has professional integrity, but it’s even more important that their hands aren’t too big, if you get my drift. Sorry — just had to throw that in as a final shout-out to Kenny M — Tom’s vegetrollian stalker!]
In case I come up with another question or problem, in addition to his office number, I’ve got Dr. Back’s email address. And his cell phone number. Not because he’s a personal friend, but because he’s my doctor. When I called to schedule my first appointment, I asked when I could get in. His office manager asked when would it be most convenient for me?
As I said, none of this occurred because Dr. Backs is a personal friend — it’s all part of his practice that any patient receives. By now you should be wondering how this could all happen. The answer is very simple:
Because I pay him.
I know that may sound strange in a society that’s reached a point where most people think that either their employer or the government is responsible for providing health care for them.
Instead, this is how Craig’s practice operates:
I pay an annual fee for his services. It’s a little more than my cable/internet service bill is for the year, but not enough to be called “concierge health care.” Craig’s term for it is “personal medicine.”
For that fee, I get my annual checkup and his email and phone numbers. There’s a nominal fee for additional office visits (probably a polite way to discourage hypochondria overuse) and I pay for any lab work. I also get a commitment from Craig that he’ll limit the number of clients his practice will accept, probably no more than 500 to start. I won’t be dealing with nurses, physician assistants, or — under normal circumstances — answering and message services. When I have a problem or question, I’ll be talking directly to him. The fee covers kids in the household (up to a certain age), and also any friends or family who are visiting from out of town.
I don’t have to worry that some insurance company is going to tell me I’ve got to pick a new physician because Craig is no longer on the “preferred provider” (low bidder) list. Or that any tests or treatments Craig suggests are dictated by an insurance company policy manual instead of my doctor’s judgement.
Since I’m paying a decent fee up front, Craig doesn’t have to payroll an entire accounting and clerical staff to code, process, submit and follow up on insurance and government reimbursement claims. He doesn’t have to wait until the state scratches enough money together to send him some percentage of money he’s due. He doesn’t have to wonder if the feds are really going to cut his reimbursement rates for seniors by 30 percent next year. He can also respond and help with many patient issues via email or phone. This is something many physicians are understandably hesitant to do, because they’re still using their time and putting themselves on the hook for liability concerns, but reimbursement in the insurance systems all center on an office visit.
That reception area will continue to be lightly populated, as it doesn’t have to be sized and used as a revenue queue/holding pen like under the current medical paradigm, where contracts and reimbursement rates mean if the pipeline isn’t full and the doctors aren’t seeing 30 or more patients a day, they’re losing money. Craig won’t have to order batteries of tests to give him information that he can instead glean with the time he can now spend with each patient.
I believe that this is to health care what the real and local foods movement is to eating and nutrition. That is, this is a modern adaptation to get back to the fundamentals that we lost in the march towards bigger, faster, cheaper. It costs more, but the quality difference is obvious and meaningful.
I’ve always said that although we can all use experts, the bottom line is no one can care about your kids, your money, or your health as much as you can. Personal medicine is a trifecta.
See you in the comments.
Cheers,
The Older Brother
If you enjoy my posts, please consider a small donation to the Fat Head Kids GoFundMe campaign.
Great post, Old Brother! Sounds like a great approach, I hope that this model proves successful so that more Doctors will do it. My experiences with doctors and medical care in general had been so negative that I basically dropped out of that scene completely after my last child was born 17 years ago. (other than my dentist, who is awesome) I just bookmarked the DirectLabs web site.. that may be a reasonable way to ease back into getting some health checks on my own terms.
I think this is the way it used to be.
It’s interesting to me that doctors initially opposed Medicare, calling it socialized medicine, and yet, it turned out to be the door that directed a lot more pts to them.
Now, of course, Medicare payments are being reduced, so it’s bad again.
It’s like the way it used to be and it’s not — it’s a modern interpretation of the way it used to be. It applies all of the new technology, but in the context of “what’s the best way to deliver quality medicine to people who value it.”
Joel Salatin talks about this in regard to farming and real food. They use all kinds of technology that wasn’t available to farmers fifty years ago — modern very low energy electric fencing, for instance, that’s light weight, low cost, and can run on a car battery — that makes it possible for him to farm the way he doe and “deliver the best quality food to people who value it.”
So they both look like the old way, but they’re really modern versions.
Cheers!
@Alexandra
Same here. Other than my ophthalmologist, I have not seen a doctor in years either. The last time I saw my GP, she wanted to run a slew of tests, many of which were not covered by the employer provided insurance that I had at that time. I always wonder why so many tests are called for in the 1st place……
Now that I’m on a fixed income and recently terminated from the job I loved, along with several other co-workers, having a personal physician such as described here is totally out of the question. There is NOTHING about the health care system that invites me back. Unless I am so sick that I need to call an ambulance, I stay away from all doctors’ offices.
I realize that there many tests that I should have done, but I really wonder just how necessary they really are!
Other commenters here had some suggestions on getting good deals on lab tests.
— The Older Brother
As a citizen of Sweden I have experienced socialized medicine first hand for 40 years now and I’m telling you from personal experience. It works great. I have been with the same doctor (you are free to choose) for 15 years now and I pay less then 50% of what you are paying through my taxes. 100% of the population is covered and what medical treatment you need is decided between you and your MD. There are NO bureaucrats involved in making decisions concerning your healthcare, EVER. What’s wrong with that?
The stuff about children born early being left to die in “most” countries sounds like something straight from the big republican book of horror stories. I can truthfully tell you that 70% of babies born between week 22 and 27 are still alive one year later here in Sweden. I expect to find similar statistics for the rest of Europe.
Haiti, Sudan, Afghanistan, most of Africa, Cuba and other underdeveloped countries might have practices as described in this thread, but such a comparison is of course of limited value given the absolute poverty of these countries.
Insurance companies aren’t in it to make you healthy. They are in it for the money. As much of your hard earned money as they can possibly get. This is why it makes perfect sense to cut out the middleman. Everybody wins.
Law enforcement, firefighting, the armed forces, schools and healthcare are best handled by government although very little else in my opinion.
Well, we agree on the law enforcement, firefighting, and armed forces. Throw in a judicial system to address crime and adjudicate contract disputes, and we’re in libertarian world. I’ll continue to make my own arrangements for education and health care, thanks.
Sweden is a fairly homogenous society, which makes socialized anything easier to implement and slower to reach failure.
In the U.S., since over 50% of the population pays zero income taxes, I’m not sure how your deal works out. On infant mortality, the U.S., Canada, and the nordic countries use similar scoring, but as for the rest of the world, here’s an excerpt that cited the OECD:
…The World Health Organization [WHO] defines a country’s infant mortality rate as the number of infants who die between birth and age one, per 1,000 live births. WHO says a live birth is when a baby shows any sign of life, even if, say, a low birth weight baby takes one single breath, or has one heartbeat.
The U.S. uses this definition. But other countries do not — so they don’t count premature or severely ill babies as live births-or deaths. The United States actually counts all births if they show any sign of life, regardless of prematurity, or size, or duration of life, notes Bernardine Healy, former director of the National Institutes of Health and former president and chief executive of the American Red Cross. And that includes stillbirths, which many other countries do not count, much less report.
Also, what counts as a birth varies from country to country. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) before these countries count these infants as live births, Healy notes. In other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless, and are not counted, Healy says. And some countries don’t reliably register babies who die within the first 24 hours of birth, Healy notes.
Norway, which has one of the lowest infant mortality rates, shows no better infant survival than the United States when you factor in Norway’s underweight infants who are not now counted, says Nicholas Eberstadt, a scholar at the American Enterprise Institute.
Moreover, the ranking doesn’t take into account that the US has a diverse, heterogeneous population, Healy adds, unlike, say, in Iceland, which tracks all infant deaths regardless of factor, but has a population under 300,000 that is 94% homogenous.
…
So it may be in the big Republican book of horror stories — I wouldn’t know since I’m not a Republican — but it’s still true.
Cheers!
I think this is the way it used to be.
It’s interesting to me that doctors initially opposed Medicare, calling it socialized medicine, and yet, it turned out to be the door that directed a lot more pts to them.
Now, of course, Medicare payments are being reduced, so it’s bad again.
It’s like the way it used to be and it’s not — it’s a modern interpretation of the way it used to be. It applies all of the new technology, but in the context of “what’s the best way to deliver quality medicine to people who value it.”
Joel Salatin talks about this in regard to farming and real food. They use all kinds of technology that wasn’t available to farmers fifty years ago — modern very low energy electric fencing, for instance, that’s light weight, low cost, and can run on a car battery — that makes it possible for him to farm the way he doe and “deliver the best quality food to people who value it.”
So they both look like the old way, but they’re really modern versions.
Cheers!
@Alexandra
Same here. Other than my ophthalmologist, I have not seen a doctor in years either. The last time I saw my GP, she wanted to run a slew of tests, many of which were not covered by the employer provided insurance that I had at that time. I always wonder why so many tests are called for in the 1st place……
Now that I’m on a fixed income and recently terminated from the job I loved, along with several other co-workers, having a personal physician such as described here is totally out of the question. There is NOTHING about the health care system that invites me back. Unless I am so sick that I need to call an ambulance, I stay away from all doctors’ offices.
I realize that there many tests that I should have done, but I really wonder just how necessary they really are!
Other commenters here had some suggestions on getting good deals on lab tests.
— The Older Brother
I am with Linda and Alexandra. I avoid doctors, and keep my daughter away as well, and she has been very healthy. I always find it strange in reading the different comments on different blogs about peoples’ doctor visits. They invariably mention their doctor doing lab work, wanting to put them on statins, arguing about it, etc. I want to yell at the computer and say “Why – why go at all, why get blood tests, why have to argue?” It is simpler just not to go; after all it is not against the law. I am reminded of what a doctor once told my grandmother, “Mrs. O’Donnell, stay away from doctors, they will kill you.”
I am with Linda and Alexandra. I avoid doctors, and keep my daughter away as well, and she has been very healthy. I always find it strange in reading the different comments on different blogs about peoples’ doctor visits. They invariably mention their doctor doing lab work, wanting to put them on statins, arguing about it, etc. I want to yell at the computer and say “Why – why go at all, why get blood tests, why have to argue?” It is simpler just not to go; after all it is not against the law. I am reminded of what a doctor once told my grandmother, “Mrs. O’Donnell, stay away from doctors, they will kill you.”
@Layla, Dr. Weston Price and Drs. Mellanby had a good deal of success in healing cavities with diet–specifically, diets high in Vitamins A and D and phosphorus. I’m trying such a diet to heal some minor cavities that my dog and I have; John Durant over at hunter-gatherer.com is doing the same thing. I also got a mail-order Vitamin D test and started taking Vitamin D capsules. Result: it’s been less than six months and I haven’t had x-rays, so I don’t know how my cavities are doing. But my TMJ problems from a car wreck a few years ago are nearly gone, which I didn’t expect. There are some posts on the cavity healing diet on my humble blog:
http://relievemypain.blogspot.com/search/label/cavity%20healing%20diet
Ramiel Nagel has a book on this subject and free info on his site:
http://www.curetoothdecay.com/
“Nonvegetarian Seventh-day Adventists were much less likely to prefer whole-grain bread and also consumed alcoholic beverages 20 times more frequently than their vegetarian counterparts.
Thus, when comparing the health experiences of vegetarian and nonvegetarian Seventh-day Adventists, we cannot initially infer that any effects are due to differences in meat consumption”.
It’s interesting & all, but not that meaningful really- just another “apples to oranges” study not comparing any like variables i.e. “animal based nutrient diets to plant based nutrient diets”. Instead really only looking at “high carb, meat consumers, to high carb non-meat consumers”…so, what’s the point? We already know high carb consumers have more health problems.
The study certainly supports the idea that most people who choose vegetarian diets do so because they are more health conscious to begin with than the average American who merely follows the mainstream nutrition propaganda.
Vegetarian SDA’s live pretty cleanly…they’re probably doing lots of stuff right.
Some people just don’t seem to get that this is probably the worst site around to try passing off government/Big Pharma/ Big Food purchased junk science papers written by “Freaking Liars.”
— The Older Brother
This is so awesome to hear. As a nurse I can say I truely believe that this model of Doctor – patient contact should be how medicine is done these days (out side of the hospital anyway). This way your doctor knows you well and if issues come up he should be the consulted Internal Medicine doctor that dictates your care in the hospital….if not then at the very least a Hospitalist (which is just a fancy term for a Internal Medicine doctor that his hired by the hospital to see all the pateints that don’t have a primary physician or their physician doesn’t have privilages at the hospital the patient is at) should be able to contact your doctor and get a concise and accurate account of your prior health.
I think a pay as you go or out of pocket yearly agreement should be how everyone pays for the majority of their care. I wish I could figure out how to use my nursing education to have some sort of nursing practice like this Doctor. Then I could actually help people learn about their wound care, disease process, and medications…the things I’m suppose to be doing now but in acutality spend more time documenting everything to cover the hospitals ass.
The only thing I think tax payer money should go to emergency care (it kinda does already but in a weird and screwed up way) because anyone of us could need emergency care at any time and no one should be given ‘minimal stabilization’ just because they don’t have insurance and so must be shipped off to some other hospital that takes people that don’t have insurance.
I guess insurance might be a good buy against long term/chronic illness, but what I really think is that the government should do more than just let you save money in a taxfree healtcare account. I would like to see people capable of having something more like an IRA for healthcare…no taxes payed when you put in the money and the money can be invested so that it can get bigger on top of contributions.
For the record, I’m a nurse and I don’t hold any insurance but catastrophic insurance. I pay for all my healthcare out of pocket and that is mostly due to the fact that the premiums for my employer provided insurance are higher than me just paying for an MD visit once a year out of pocket….and yes even if I have labs it’s still cheaper. A yearly check up with a pap smear AND CBC, BMP, lipid panel, and A1C (I get the A1C done just because everyone in my family is a type II diabetic that isn’t a normal yearly lab) runs about $700. One year I got every STD test ran too and that still was only around $1500.
When I had insurance I paied $140 a month (my employer paied another $140 a month) and I still had a $20 co-pay and occasionally had to pay a co-pay for my labs, and $100 to go to the ER.
I’m just sick of how medicine is run these days. I wish I had the gumption to go back to school and be a doctor like this gentleman. Kudos to finding a great physician and if your physician has a need for a good nurse or knows how to help a nurse start an honest practice like he did (for patients that need nurses, obviously), please help a sister out. 😀
The whole current medical/insurance model that we’ve ended up with after years of government interference and manipulation is a slow moving train wreck.
The concept of insurance:
A large pool of people who wish to transfer a financial risk that they can’t afford to handle individually. These risks (house fire, car wreck, cancer) are actuarially predictable as to how many times it will happen and how much it will cost. The only thing nobody knows is who exactly it’s going to happen to. So I buy homeowners’ insurance in case my house is the one that burns down this year. I can’t afford to rebuild it from scratch ans also pay the existing mortgage balance. Fair deal. Same for a car wreck or a catastrophic injury or major illness.
Now look at what we have in the health arena — low deductible plans that cover everything. It would be like Congress passing a law that says my homeowners’ policy company also has to pay for my lawn to be mowed, spring cleaning, etc. And I’ve only got to pay $5 each time. How would that turn out, right?
I’ve heard of stand-alone nursing operations in some areas of the country, but it’s highly restricted/illegal in most places depending primarily on state-level laws and regulations.
Cheers
Re: aforementioned cancer study, the first word of the title is significant: “association.” Association isn’t causation. And the study was done by a Seventh-Day Adventist at Loma Linda, a Seventh-Day Adventist university. What are the odds that any study from there would suggest that a Seventh-Day Adventist vegetarian diet doesn’t help you?
At least they admitted that the meat eaters ate more doughnuts than the vegetarians, that “Nonvegetarian Seventh-day Adventists were much less likely to prefer whole-grain bread and also consumed alcoholic beverages 20 times more frequently than their vegetarian counterparts. Thus, when comparing the health experiences of vegetarian and nonvegetarian Seventh-day Adventists, we cannot initially infer that any effects are due to differences in meat consumption” (confounding variables, anyone?), and “Thus, among Seventh-day Adventists, vegetarians are healthier than nonvegetarians but this cannot be ascribed only to the absence of meat.”
I wonder if the booze and doughnuts could have something to do with it. Given that pretty much all the booze and refined grains were consumed by the meat eaters, for practical purposes, it’s likely there were associations between refined grain and alcohol consumption and cancer/heart attack incidence, except that the researchers didn’t seem to bother to find out.
I didn’t even look at the link. I had no doubt that it was bogus, and some Fat Heads would take it apart.
KennyM and his fellow vegetrollians try to “prove” their religious beliefs by what I call “serial obfuscation” — they throw up one of their favorite (discredited) chestnuts; then when the flaws and contradictions are pointed out , a la Science for Smart People, they simply ignore the point and throw the next one over the wall.
Thanks for taking this one.
— The Older Brother
“Nonvegetarian Seventh-day Adventists were much less likely to prefer whole-grain bread and also consumed alcoholic beverages 20 times more frequently than their vegetarian counterparts.
Thus, when comparing the health experiences of vegetarian and nonvegetarian Seventh-day Adventists, we cannot initially infer that any effects are due to differences in meat consumption”.
It’s interesting & all, but not that meaningful really- just another “apples to oranges” study not comparing any like variables i.e. “animal based nutrient diets to plant based nutrient diets”. Instead really only looking at “high carb, meat consumers, to high carb non-meat consumers”…so, what’s the point? We already know high carb consumers have more health problems.
The study certainly supports the idea that most people who choose vegetarian diets do so because they are more health conscious to begin with than the average American who merely follows the mainstream nutrition propaganda.
Vegetarian SDA’s live pretty cleanly…they’re probably doing lots of stuff right.
Some people just don’t seem to get that this is probably the worst site around to try passing off government/Big Pharma/ Big Food purchased junk science papers written by “Freaking Liars.”
— The Older Brother
This is so awesome to hear. As a nurse I can say I truely believe that this model of Doctor – patient contact should be how medicine is done these days (out side of the hospital anyway). This way your doctor knows you well and if issues come up he should be the consulted Internal Medicine doctor that dictates your care in the hospital….if not then at the very least a Hospitalist (which is just a fancy term for a Internal Medicine doctor that his hired by the hospital to see all the pateints that don’t have a primary physician or their physician doesn’t have privilages at the hospital the patient is at) should be able to contact your doctor and get a concise and accurate account of your prior health.
I think a pay as you go or out of pocket yearly agreement should be how everyone pays for the majority of their care. I wish I could figure out how to use my nursing education to have some sort of nursing practice like this Doctor. Then I could actually help people learn about their wound care, disease process, and medications…the things I’m suppose to be doing now but in acutality spend more time documenting everything to cover the hospitals ass.
The only thing I think tax payer money should go to emergency care (it kinda does already but in a weird and screwed up way) because anyone of us could need emergency care at any time and no one should be given ‘minimal stabilization’ just because they don’t have insurance and so must be shipped off to some other hospital that takes people that don’t have insurance.
I guess insurance might be a good buy against long term/chronic illness, but what I really think is that the government should do more than just let you save money in a taxfree healtcare account. I would like to see people capable of having something more like an IRA for healthcare…no taxes payed when you put in the money and the money can be invested so that it can get bigger on top of contributions.
For the record, I’m a nurse and I don’t hold any insurance but catastrophic insurance. I pay for all my healthcare out of pocket and that is mostly due to the fact that the premiums for my employer provided insurance are higher than me just paying for an MD visit once a year out of pocket….and yes even if I have labs it’s still cheaper. A yearly check up with a pap smear AND CBC, BMP, lipid panel, and A1C (I get the A1C done just because everyone in my family is a type II diabetic that isn’t a normal yearly lab) runs about $700. One year I got every STD test ran too and that still was only around $1500.
When I had insurance I paied $140 a month (my employer paied another $140 a month) and I still had a $20 co-pay and occasionally had to pay a co-pay for my labs, and $100 to go to the ER.
I’m just sick of how medicine is run these days. I wish I had the gumption to go back to school and be a doctor like this gentleman. Kudos to finding a great physician and if your physician has a need for a good nurse or knows how to help a nurse start an honest practice like he did (for patients that need nurses, obviously), please help a sister out. 😀
The whole current medical/insurance model that we’ve ended up with after years of government interference and manipulation is a slow moving train wreck.
The concept of insurance:
A large pool of people who wish to transfer a financial risk that they can’t afford to handle individually. These risks (house fire, car wreck, cancer) are actuarially predictable as to how many times it will happen and how much it will cost. The only thing nobody knows is who exactly it’s going to happen to. So I buy homeowners’ insurance in case my house is the one that burns down this year. I can’t afford to rebuild it from scratch ans also pay the existing mortgage balance. Fair deal. Same for a car wreck or a catastrophic injury or major illness.
Now look at what we have in the health arena — low deductible plans that cover everything. It would be like Congress passing a law that says my homeowners’ policy company also has to pay for my lawn to be mowed, spring cleaning, etc. And I’ve only got to pay $5 each time. How would that turn out, right?
I’ve heard of stand-alone nursing operations in some areas of the country, but it’s highly restricted/illegal in most places depending primarily on state-level laws and regulations.
Cheers
Re: aforementioned cancer study, the first word of the title is significant: “association.” Association isn’t causation. And the study was done by a Seventh-Day Adventist at Loma Linda, a Seventh-Day Adventist university. What are the odds that any study from there would suggest that a Seventh-Day Adventist vegetarian diet doesn’t help you?
At least they admitted that the meat eaters ate more doughnuts than the vegetarians, that “Nonvegetarian Seventh-day Adventists were much less likely to prefer whole-grain bread and also consumed alcoholic beverages 20 times more frequently than their vegetarian counterparts. Thus, when comparing the health experiences of vegetarian and nonvegetarian Seventh-day Adventists, we cannot initially infer that any effects are due to differences in meat consumption” (confounding variables, anyone?), and “Thus, among Seventh-day Adventists, vegetarians are healthier than nonvegetarians but this cannot be ascribed only to the absence of meat.”
I wonder if the booze and doughnuts could have something to do with it. Given that pretty much all the booze and refined grains were consumed by the meat eaters, for practical purposes, it’s likely there were associations between refined grain and alcohol consumption and cancer/heart attack incidence, except that the researchers didn’t seem to bother to find out.
I didn’t even look at the link. I had no doubt that it was bogus, and some Fat Heads would take it apart.
KennyM and his fellow vegetrollians try to “prove” their religious beliefs by what I call “serial obfuscation” — they throw up one of their favorite (discredited) chestnuts; then when the flaws and contradictions are pointed out , a la Science for Smart People, they simply ignore the point and throw the next one over the wall.
Thanks for taking this one.
— The Older Brother
Great post and discussion- thanks Older Brother. I believe in putting my money where my mouth is. With limited ‘concierge care’ available to me, I do the next best thing- I buy copies of “Good Calories, Bad Calories” and have given them to my doctor and my doctor-sister and several of my doctor friends, and scientist buddies (I’m a biochemist). I also buy copies of “Fat Head” and give them to everybody I can think of who can’t or won’t read GC,BC. I have gotten several good responses by doing this. I have also decided, in addition to giving books and DVD’s, to no longer give cash and only give of my time. I donate blood too, but I don’t give cash anymore. My husband is a volunteer pilot for ‘Angel Flight’ (they transport medically stable patients to medical services and appointments ,organs sometimes also, because 1/2 of all personal bankruptcies in the US are a result of illness and medical bills) and we as a family volunteer at Camp Sunshine in Maine. It’s a camp for kids who have cancer.
So here’s my question for you. What item(s) on this website does Tom and his family make the most money from selling? I want to continue to support him and his family. So if I buy the ‘Wheat Is Murder’ T-shirts for everybody on my Christmas list will that be more profitable to him than buying something else? Trying to put my money to good use and get all these words out and about. Thank you, Laurie
Good for you on your volunteer work!
I’m not sure what the margins are for his referral sales from the “Fat head Family Store” vs. the t-shirts vs. the DVDs. I’m sure Tom would want you to buy what YOU value the most, and the money part will take care of itself.
Having said that, a couple extra copies of the Fat Head DVD that you can share with friends probably helps spread the word to more people faster than the t-shirts. Of course, I’ve got both.
And just a friendly reminder kids — only 138 shopping days until Christmas!
Cheers
[This is Tom, checking in from L.A. The profit margins on DVDs and the t-shirts are about the same, so like the Older Brother said, it’s whatever you value the most. For the books and other items we recommend through the Amazon portal, it’s a set percentage of whatever you buy, so again it’s whatever you find suits your needs. I appreciate the support very much.]
I also pretty much avoid doctors, except when pregnant. I occasionally get some labwork done using an online site, so I can see and research and interpret my own results. I do take my children to the doctor regularly (mostly paid for by employer-provided insurance), mainly to avoid some sort of social services hoopla if/when I start homeschooling my children.
Awesome Dr!
Great post and discussion- thanks Older Brother. I believe in putting my money where my mouth is. With limited ‘concierge care’ available to me, I do the next best thing- I buy copies of “Good Calories, Bad Calories” and have given them to my doctor and my doctor-sister and several of my doctor friends, and scientist buddies (I’m a biochemist). I also buy copies of “Fat Head” and give them to everybody I can think of who can’t or won’t read GC,BC. I have gotten several good responses by doing this. I have also decided, in addition to giving books and DVD’s, to no longer give cash and only give of my time. I donate blood too, but I don’t give cash anymore. My husband is a volunteer pilot for ‘Angel Flight’ (they transport medically stable patients to medical services and appointments ,organs sometimes also, because 1/2 of all personal bankruptcies in the US are a result of illness and medical bills) and we as a family volunteer at Camp Sunshine in Maine. It’s a camp for kids who have cancer.
So here’s my question for you. What item(s) on this website does Tom and his family make the most money from selling? I want to continue to support him and his family. So if I buy the ‘Wheat Is Murder’ T-shirts for everybody on my Christmas list will that be more profitable to him than buying something else? Trying to put my money to good use and get all these words out and about. Thank you, Laurie
Good for you on your volunteer work!
I’m not sure what the margins are for his referral sales from the “Fat head Family Store” vs. the t-shirts vs. the DVDs. I’m sure Tom would want you to buy what YOU value the most, and the money part will take care of itself.
Having said that, a couple extra copies of the Fat Head DVD that you can share with friends probably helps spread the word to more people faster than the t-shirts. Of course, I’ve got both.
And just a friendly reminder kids — only 138 shopping days until Christmas!
Cheers
[This is Tom, checking in from L.A. The profit margins on DVDs and the t-shirts are about the same, so like the Older Brother said, it’s whatever you value the most. For the books and other items we recommend through the Amazon portal, it’s a set percentage of whatever you buy, so again it’s whatever you find suits your needs. I appreciate the support very much.]
I also pretty much avoid doctors, except when pregnant. I occasionally get some labwork done using an online site, so I can see and research and interpret my own results. I do take my children to the doctor regularly (mostly paid for by employer-provided insurance), mainly to avoid some sort of social services hoopla if/when I start homeschooling my children.
LaurieLM you’re amazing!!!What a great example of using your time and resources to help others.
Awesome Dr!
LaurieLM you’re amazing!!!What a great example of using your time and resources to help others.
We have recently switched to a Medical Savings Account. We pay everything up to $4,000, but if we don’t spend it, it is in the bank – waiting until retirement to an old folks home (probably the only retirement folks our age will see based on the current rate of entitlement spending). I am pissed at myself for paying for traditional insurance for 30 years that I never used – all the while, getting HUGE premium increases.
I wonder if I could use an MSA with this setup. Even if I could I need a Doctor I can trust – wish I knew yours!
GREAT post – great idea! Let’s hope it spreads.
Wanna start an “Opt Out” program? We all opt out and agree to NEVER take money from the government. In exchange we don’t have to pay for Medicare or Social Security. I’ll even keep paying income and sales tax (though such altruism goes against my grain).
Ready for real change yet?
The MSA is the Medical Savings Account associated with a high-deductible insurance policy — sounds like that’s the $4,000 in your case. Originally, the amount you could contribute to the MSA was the amount of the deductible on your policy, but now there’s set annual limits instead. For a family in 2011, it’s $6150 (you can contribute another $1,000 if you’re over 55).
They’ve technically been replaced by Health Savings Accounts, but operate the same. MSA’s were pretty limited when they first started, because Ted Kennedy wanted them to fail. Seriously. They were changed to HSA’s in 2003 and eligibility was greatly expanded, so you probably couldn’t have done much about 22 of those 30 years!
Under current tax law, the portion of the annual payment that is for the checkup is deductible, while the retainer fee portion is not. So for now, it’s a matter of the physician’s invoicing and how aggressive you or your tax accountant are, but some of it should be payable from your HSA. The proposed Family and Retirement Health Investment Act of 2011 introduced by Senator Orin Hatch would remove this ambiguity and specifically allow HSA funds to be used for concierge medical fees.
Here’s hoping.
Cheers
Another simplistic post about a very complicated problem. Probably by a person who has enjoyed relatively good health their entire life.
You solution is a fine one for a primary care physician. However when health problems diverge into other areas, pre-paying and HSAs are basically ridiculous.
Your doctor better be a radiologist to read and MRI’s or CAT scans needed, a Gastroenterologist if stomach problems crop up, A surgeon for that growth you’ve discovered, a Cardiologist for that valve problem, and an Oncologist for that (god forbid) cancer diagnosis.
HSAs can be wiped out by a single by a single cancer diagnosis. Hopefully you don’t have a recurrence, new cancer or heart problem brought on by the chemo they gave you.
Single payer is the only answer, just like the rest of the industrialized world, who BTW have low mortality rates than we do.
Whats next? Big brother visits Syria and finds the actual WMDs? Give my regards to the tea party…
Wow. Amazing how you can make all of that true just by assuming. Or not.
I’ve got insurance in case I get cancer or hit by a bus or need a cardiologist. Maybe you should get out and read a newspaper –the rest of the industrialized world is going broke faster than us, and it’s becoming apparent that governments can’t actually produce scarce resources for their welfare states by fiat. Imagine that.
Nice try on the DNC talking point about our mortality rate. If you take out deaths due to auto wrecks and gun violence, we’re back at the top. Or do you think we’re shooting each other because we can’t get “free” health care?
Cheers!
We have recently switched to a Medical Savings Account. We pay everything up to $4,000, but if we don’t spend it, it is in the bank – waiting until retirement to an old folks home (probably the only retirement folks our age will see based on the current rate of entitlement spending). I am pissed at myself for paying for traditional insurance for 30 years that I never used – all the while, getting HUGE premium increases.
I wonder if I could use an MSA with this setup. Even if I could I need a Doctor I can trust – wish I knew yours!
GREAT post – great idea! Let’s hope it spreads.
Wanna start an “Opt Out” program? We all opt out and agree to NEVER take money from the government. In exchange we don’t have to pay for Medicare or Social Security. I’ll even keep paying income and sales tax (though such altruism goes against my grain).
Ready for real change yet?
The MSA is the Medical Savings Account associated with a high-deductible insurance policy — sounds like that’s the $4,000 in your case. Originally, the amount you could contribute to the MSA was the amount of the deductible on your policy, but now there’s set annual limits instead. For a family in 2011, it’s $6150 (you can contribute another $1,000 if you’re over 55).
They’ve technically been replaced by Health Savings Accounts, but operate the same. MSA’s were pretty limited when they first started, because Ted Kennedy wanted them to fail. Seriously. They were changed to HSA’s in 2003 and eligibility was greatly expanded, so you probably couldn’t have done much about 22 of those 30 years!
Under current tax law, the portion of the annual payment that is for the checkup is deductible, while the retainer fee portion is not. So for now, it’s a matter of the physician’s invoicing and how aggressive you or your tax accountant are, but some of it should be payable from your HSA. The proposed Family and Retirement Health Investment Act of 2011 introduced by Senator Orin Hatch would remove this ambiguity and specifically allow HSA funds to be used for concierge medical fees.
Here’s hoping.
Cheers
Another simplistic post about a very complicated problem. Probably by a person who has enjoyed relatively good health their entire life.
You solution is a fine one for a primary care physician. However when health problems diverge into other areas, pre-paying and HSAs are basically ridiculous.
Your doctor better be a radiologist to read and MRI’s or CAT scans needed, a Gastroenterologist if stomach problems crop up, A surgeon for that growth you’ve discovered, a Cardiologist for that valve problem, and an Oncologist for that (god forbid) cancer diagnosis.
HSAs can be wiped out by a single by a single cancer diagnosis. Hopefully you don’t have a recurrence, new cancer or heart problem brought on by the chemo they gave you.
Single payer is the only answer, just like the rest of the industrialized world, who BTW have low mortality rates than we do.
Whats next? Big brother visits Syria and finds the actual WMDs? Give my regards to the tea party…
Wow. Amazing how you can make all of that true just by assuming. Or not.
I’ve got insurance in case I get cancer or hit by a bus or need a cardiologist. Maybe you should get out and read a newspaper –the rest of the industrialized world is going broke faster than us, and it’s becoming apparent that governments can’t actually produce scarce resources for their welfare states by fiat. Imagine that.
Nice try on the DNC talking point about our mortality rate. If you take out deaths due to auto wrecks and gun violence, we’re back at the top. Or do you think we’re shooting each other because we can’t get “free” health care?
Cheers!
Thank you Guinea Pig and Older Brother and Tom (and to your wife and family who let you spend the time you do on this blog). I have to say I cannot tell you all how fortunate I feel that I discovered Taubes, Naughton and paleo. My life and sanity has literally been saved. Just like volunteering my time, I share gleefully this info with any who will listen. Before I chanced upon all of this wonder, I felt physically and mentally lousy and I wasn’t sure what was wrong- but I knew there had to be something better ‘out there’. I attempt to share some of it by example without being too pushy. I have only recently begun giving blood again. My old, bad grain, bread, vegetable, low-meat diet left me anemic- too anemic to give blood- among many other detrimental things.
About volunteering. I would do it even if it weren’t as much fun, but I often say that I get more out of volunteering than I could ever possibly give. I’m happy to do it and be an example for my children. It is definitely a high-carb, SAD antidote and quite a legal, moral, non-fattening high. It is addicting though- but in a good way.
regarding concierge medicine and the government. I can’t seem to find the doctor in question, but at least one was doing the concierge. The state and federal government decided he was actually providing insurance because he wasn’t charging more money for complex procedures (he was servicing a poor area of Tennessee I believe).
He wasn’t licensed as an insurance provider (bet that costs a bundle) so they tried to shut him down. Last I heard he’s still operating.
I read of cases of that when the concept first started. Those were subsequently clarified in the statutes, ans I don’t believe that’s an issue anywhere now.
— The Older Brother
Now i remember, it was regarding Lodge practice (seems similar to concierge)
http://www.thefreemanonline.org/featured/health-care-and-radical-monopoly/
An excerpt:
One solution to this particular problem is to have a one-to-one relationship between the patient and a general practitioner on retainer. That’s how the old “lodge practice” worked.
…..
But that’s illegal, you know. In New York City, John Muney recently introduced an updated version of lodge practice: the AMG Medical Group, which for a monthly premium of $79 and a flat office fee of $10 per visit provides a wide range of services (limited to what its own practitioners can perform in-house). But because AMG is a fixed-rate plan and doesn’t charge more for “unplanned procedures,” the New York Department of Insurance considers it an unlicensed insurance policy.
I believe that may be what others have brought up in the comments regarding legal problems.
Well, I thought that had been cleared up. No surprise if NYC is still lagging.
Cheers!
Thank you Guinea Pig and Older Brother and Tom (and to your wife and family who let you spend the time you do on this blog). I have to say I cannot tell you all how fortunate I feel that I discovered Taubes, Naughton and paleo. My life and sanity has literally been saved. Just like volunteering my time, I share gleefully this info with any who will listen. Before I chanced upon all of this wonder, I felt physically and mentally lousy and I wasn’t sure what was wrong- but I knew there had to be something better ‘out there’. I attempt to share some of it by example without being too pushy. I have only recently begun giving blood again. My old, bad grain, bread, vegetable, low-meat diet left me anemic- too anemic to give blood- among many other detrimental things.
About volunteering. I would do it even if it weren’t as much fun, but I often say that I get more out of volunteering than I could ever possibly give. I’m happy to do it and be an example for my children. It is definitely a high-carb, SAD antidote and quite a legal, moral, non-fattening high. It is addicting though- but in a good way.
regarding concierge medicine and the government. I can’t seem to find the doctor in question, but at least one was doing the concierge. The state and federal government decided he was actually providing insurance because he wasn’t charging more money for complex procedures (he was servicing a poor area of Tennessee I believe).
He wasn’t licensed as an insurance provider (bet that costs a bundle) so they tried to shut him down. Last I heard he’s still operating.
I read of cases of that when the concept first started. Those were subsequently clarified in the statutes, ans I don’t believe that’s an issue anywhere now.
— The Older Brother
Now i remember, it was regarding Lodge practice (seems similar to concierge)
http://www.thefreemanonline.org/featured/health-care-and-radical-monopoly/
An excerpt:
One solution to this particular problem is to have a one-to-one relationship between the patient and a general practitioner on retainer. That’s how the old “lodge practice” worked.
…..
But that’s illegal, you know. In New York City, John Muney recently introduced an updated version of lodge practice: the AMG Medical Group, which for a monthly premium of $79 and a flat office fee of $10 per visit provides a wide range of services (limited to what its own practitioners can perform in-house). But because AMG is a fixed-rate plan and doesn’t charge more for “unplanned procedures,” the New York Department of Insurance considers it an unlicensed insurance policy.
I believe that may be what others have brought up in the comments regarding legal problems.
Well, I thought that had been cleared up. No surprise if NYC is still lagging.
Cheers!
Boy, I wish I could jump into this kind of a system with both feet. I’ve always felt that “medicine” as it is practiced today in this country was more of a pill-pushing, symptom-chasing exercise than true “medical care.” Gotta meet those goals and do those tests and prescribe that medicine… Baloney!
Unfortunately, at 73, my husband requires multiple meds (or at least he and his doctors seem to think he does) and I couldn’t afford to buy them if it was entirely out of pocket. My employer offers insurance, and we take it just to protect our financial situation. In my case, I take one Rx, for my thyroid, and I avoid seeing the doctor as much as I can. But he will eventually hold my Rx hostage until I have a test or two. Trade off. I can live with it.
I received a related item in my email today. Today’s Medscape (requires registration, but it’s free) included a short talk by a Bioethicist about concierge medicine. (Concierge Practice: Unjust for Patients and Doctors Alike by Arthur L. Caplan, PhD)
Dr Caplan isn’t impressed. His argument boiled down to three points:
1. There aren’t enough primary care docs as it is, and if more of them opt out of the current system to run concierge practices, that just leaves even fewer of them to handle all the patients. (if they weren’t doing so much unnecessary prescribing and testing and requiring their patients to toe the line, maybe we could get a long with fewer.)
2. Patients not in the concierge group will end up being seen by substitutes (PAs and NPs) and might be less than satisfied at paying the same for a less trained provider. (but when you have to see one of these substitutes, they claim you’re getting perfectly good care. Which one is it?)
3. The growth of concierge medicine is more of a symptom of a broken system than a cure. He thinks single payer is a better answer. (yeah, it’s broken, and their cure is Obamacare?? I don’t think so.)
My impression on reading the transcript was that he feels “it’s just not fair!” Boo hoo.
Sorry, Dr. Caplan. As I noted above, I’d do it in a heartbeat if I thought it would work out. Maybe when it’s just me…
Sounds just like the private/parochial schools complaints, doesn’t it?
“Sure, they’re better than us, they cherry pick!” or “We can’t give poor students vouchers — it will kill the public (government) schools.” Of course, every politician who says that has their kids in private school. And I’m sure Dr. Caplan, as an insider, would have no trouble getting quality care for himself and his loved ones in the system he’d inflict on the rest of us.
The bottom line is that they think you should do the decent thing and suffer with the rest of the people who are either trapped or prefer the “free” system, instead of being able to make a free will decision.
My answers to his points would be:
1) Tough crap. That’s why I’m paying for quality.
2) Tough crap. That’s why I’m paying for quality.
3) Tough crap. Assuming earning a degree in medicine (or bioethics) automatically gives doctors insight into the economics of health care delivery is no less ludicrous than assuming an economist who studies health care issues could do your bypass. And long term, just as deadly.
Cheers!
Boy, I wish I could jump into this kind of a system with both feet. I’ve always felt that “medicine” as it is practiced today in this country was more of a pill-pushing, symptom-chasing exercise than true “medical care.” Gotta meet those goals and do those tests and prescribe that medicine… Baloney!
Unfortunately, at 73, my husband requires multiple meds (or at least he and his doctors seem to think he does) and I couldn’t afford to buy them if it was entirely out of pocket. My employer offers insurance, and we take it just to protect our financial situation. In my case, I take one Rx, for my thyroid, and I avoid seeing the doctor as much as I can. But he will eventually hold my Rx hostage until I have a test or two. Trade off. I can live with it.
I received a related item in my email today. Today’s Medscape (requires registration, but it’s free) included a short talk by a Bioethicist about concierge medicine. (Concierge Practice: Unjust for Patients and Doctors Alike by Arthur L. Caplan, PhD)
Dr Caplan isn’t impressed. His argument boiled down to three points:
1. There aren’t enough primary care docs as it is, and if more of them opt out of the current system to run concierge practices, that just leaves even fewer of them to handle all the patients. (if they weren’t doing so much unnecessary prescribing and testing and requiring their patients to toe the line, maybe we could get a long with fewer.)
2. Patients not in the concierge group will end up being seen by substitutes (PAs and NPs) and might be less than satisfied at paying the same for a less trained provider. (but when you have to see one of these substitutes, they claim you’re getting perfectly good care. Which one is it?)
3. The growth of concierge medicine is more of a symptom of a broken system than a cure. He thinks single payer is a better answer. (yeah, it’s broken, and their cure is Obamacare?? I don’t think so.)
My impression on reading the transcript was that he feels “it’s just not fair!” Boo hoo.
Sorry, Dr. Caplan. As I noted above, I’d do it in a heartbeat if I thought it would work out. Maybe when it’s just me…
Sounds just like the private/parochial schools complaints, doesn’t it?
“Sure, they’re better than us, they cherry pick!” or “We can’t give poor students vouchers — it will kill the public (government) schools.” Of course, every politician who says that has their kids in private school. And I’m sure Dr. Caplan, as an insider, would have no trouble getting quality care for himself and his loved ones in the system he’d inflict on the rest of us.
The bottom line is that they think you should do the decent thing and suffer with the rest of the people who are either trapped or prefer the “free” system, instead of being able to make a free will decision.
My answers to his points would be:
1) Tough crap. That’s why I’m paying for quality.
2) Tough crap. That’s why I’m paying for quality.
3) Tough crap. Assuming earning a degree in medicine (or bioethics) automatically gives doctors insight into the economics of health care delivery is no less ludicrous than assuming an economist who studies health care issues could do your bypass. And long term, just as deadly.
Cheers!
My dad was a physician. He quit taking insurance and went to a fixed fee per office visit. He had more patients than when he took insurance. He also made house calls. Aah, the good old days.
It changes the whole dynamic when people are paying for what they get in a direct relationship with their provider, whether it’s their hairdresser, their butcher, or their physician.
The Older Brother
This service is considerably more expensive here in Boston, as I’m sure many things are. Last Dr’s appt. I had I think he may have spent 5 minutes with me but I don’t think it was even that. I felt like I was imposing and left w/o addressing the concerns I had that day. I will not try to force a “professional” to do do his or her job.
If I ever took sick I would do this, well worth the money. In fact the practices I’ve looked at do take insurance but that does not cover the “concierge” charge.
My dad was a physician. He quit taking insurance and went to a fixed fee per office visit. He had more patients than when he took insurance. He also made house calls. Aah, the good old days.
It changes the whole dynamic when people are paying for what they get in a direct relationship with their provider, whether it’s their hairdresser, their butcher, or their physician.
The Older Brother
This service is considerably more expensive here in Boston, as I’m sure many things are. Last Dr’s appt. I had I think he may have spent 5 minutes with me but I don’t think it was even that. I felt like I was imposing and left w/o addressing the concerns I had that day. I will not try to force a “professional” to do do his or her job.
If I ever took sick I would do this, well worth the money. In fact the practices I’ve looked at do take insurance but that does not cover the “concierge” charge.
@Layla, Dr. Weston Price and Drs. Mellanby had a good deal of success in healing cavities with diet–specifically, diets high in Vitamins A and D and phosphorus. I’m trying such a diet to heal some minor cavities that my dog and I have; John Durant over at hunter-gatherer.com is doing the same thing. I also got a mail-order Vitamin D test and started taking Vitamin D capsules. Result: it’s been less than six months and I haven’t had x-rays, so I don’t know how my cavities are doing. But my TMJ problems from a car wreck a few years ago are nearly gone, which I didn’t expect. There are some posts on the cavity healing diet on my humble blog:
http://relievemypain.blogspot.com/search/label/cavity%20healing%20diet
Ramiel Nagel has a book on this subject and free info on his site:
http://www.curetoothdecay.com/