Do you know that most nutrients don’t work alone? They interact—sometimes they join forces, other times they cancel each other out. You have probably heard before that eating vitamin-rich foods is better for you than taking a vitamin supplement…reason is that food contains a mixture of nutrients that interact with one another.

Now look at the list below…it’s by no means complete list but something to start….

Vitamin D and calcium- A partnership

Both calcium and vitamin D are efficacious in protecting the skeleton, particularly when these 2 nutrients are used in combination. Each nutrient is necessary for the full expression of the effect of the other, and where their actions are independent; their effects on skeletal health are complementary. Like most nutrients, calcium is mostly absorbed in the small intestine. Calcium is important because it strengthens bones, but the body often needs vitamin D’s assistance to absorb the nutrient.  Right now, the official nutrition guidelines recommend that adults get 1,000 milligrams (mg) of calcium and 400 international units (IU) of vitamin D daily. For older adults, the recommended daily allowance is a bit higher: 1,200 mg of calcium starting in your 50s, and 600 IU of vitamin D starting in your 70s.

To give you an idea of how much that is, an 8-ounce glass of milk contains 300 mg of calcium and, because of fortification, 100 IU of vitamin D.

Sodium and potassium- A contrasting partnership

Sodium is one essential nutrient, however we consume more of each day than required.  As you might have heard that doctor recommends to control salt intake for patients with high blood pressure as excess sodium interferes with the natural ability of blood vessels to relax and expand, increasing blood pressure—and increasing the chances of having a stroke or heart attack.

But potassium encourages the kidneys to excrete sodium which means high potassium intake might be helpful in lowering the blood pressure. According to the current guidelines, adults are supposed to get 4,700 mg of potassium and 1,200 mg to 1,500 mg of sodium daily. The Simple guideline, to increase potassium intake, load up on fruits and vegetables. To decrease sodium intake, cut back on cookies, salty snacks, fast foods, and ready-made lunches and dinners.

Vitamin B12 and folate- A partnership

Vitamin B12 and folate (also one of the eight B vitamins) form one of nutrition’s best couples. B12 helps the body absorb folate, and the two works together to support cell division and replication, which allow the body to replace cells that die. This process is important during times of growth in childhood, and throughout the body of adults as well. Cells that line the stomach and the cells of the hair follicle, for example, divide and replicate often.

Good food sources of vitamin B12 include meat, eggs and milk.  Natural sources of folate include leafy green, vegetables, beans and other legumes.  Nutrition guidelines recommend 2.4 micrograms of B12 and 400 micrograms of folate daily. This can usually be achieved easily by eating a reasonably well-balanced diet.

However, vegans—people who don’t eat meat and other animal-based products—may have B12 deficiencies. And people who eat poorly or drink too much alcohol may have folate deficiencies.  Folate deficiencies can be corrected with multivitamins or folic acid pills. For a B12 deficiency, ask your doctor.

Deficiency in either or both vitamins may cause a form of anemia, mild tingling sensations and memory loss.

As you look ahead, what do you envision? If you’re like most people, you are probably eager to stay healthy and enjoy your life in the most vibrant, vigorous way possible. No magic pill or secret potion can deliver a long, healthy life. To some extent, your genes are responsible however, abundant research shows that the actions you take today matter the most. Simple lifestyle choices — what you eat, how active you are, whether you smoke — have an enormous impact on your longevity and quality of life.

A 2007 study in the American Journal of Medicine focused on adults who adopted a healthier lifestyle during middle age. The researchers followed ~15,000 adults (ages 45+) for a decade and noted that 970(~9%) of these people embraced a healthier lifestyle by the sixth year of the study. These individuals ate five or more daily servings of fruits and vegetables, worked out at least two and a half hours per week, didn’t smoke, and avoided obesity. Benefits appeared quickly. Just four years later, the group of individuals who made these four changes had a 40% lower rate of death for any reason and 35% fewer cases of heart disease compared with the participants who made fewer of these changes. No matter what your age or stage of life, you have the power to change many of the variables.  Actions you can take to increase your odds of a longer and more satisfying life span are really quite simple:

1. Don’t smoke.
2. Enjoy physical and mental activities every day.
3. Eat a healthy diet rich in whole grains, vegetables, and fruits, and substitute healthier monounsaturated and polyunsaturated fats for unhealthy saturated fats and Trans fats.
4. Take a daily multivitamin, and be sure to get enough calcium and vitamin D.
5. Maintain a healthy weight and body shape.
6. Challenge your mind. Keep learning and trying new activities.
7. Build a strong social network.
8. Follow preventive care and screening guidelines.
9. Floss, brush, and see a dentist regularly.
10. Ask your doctor if medication can help you control the potential long-term side effects of chronic conditions such as high blood pressure, osteoporosis, or high cholesterol.

“Out of the box thinking” by an e-patient.

A patient receives a diagnosis of a close to serious illness; the response is one of fear. How does he will move from a place of fear and uncertainly to a place of empowerment? Isn’t it difficult to get involved in your own care when you don’t feel well?

However, our empowered, engaged, equipped and enabled patient a.k.a “e-patient” digs into pipeline to information.  His approach includes …

• Connect with other e-patient community to learn about others’ experiences, advice…
• Learn about the disease to be knowledgeable about his condition
• Assess treatment options by different providers so as to know what to expect when medical bills knock at the door…would be tough to handle financial/mental stress  with his ongoing illness

But to find the right information, right care is not easy….and on top of that complicated payment   options make things worse. He doesn’t stop there, he thinks out of the box and actually issues Request for Proposal (RFP) to choose the best/most appropriate medical provider to partner with, just like any other purchase, hoping to find a really good fit for his needs i.e. right medical provider who would provide quality care and who is in his budget…

However, doctors don’t like to be called “service providers for consumers”, but this is exactly what they do…isn’t it?  And as a consumer, everybody should evaluate his/her criteria for which/whom he/she wants to get treatment and build the partnership.

We think that, RFP is a great process for patients to define what they want and relative priorities – even though getting clarity about the charges is more challenging than getting quality care…as cost vary depending on the doctor and the condition. But we hope to see future iterations of this as an RFP “checklist” for patients.

Here is the RFP for your reference.  We hope this e-patient gets quality care within his means….

You’ve probably heard a lot of “rules” for losing weight and living a healthy lifestyle: You have to be active for 60 minutes a day. You have to eat five vegetables and fruits a day. You have to get at least 8 1/2 hours of sleep a night. But we believe that in reality, if you try to change too many things at once, the chances are you’re going to fail, and then you’re not going to try at all. So take it slow, you can’t change your whole life at once, but you can surely change 1 small part of it.

You have the power to decide what that first step will be. You can cut out soda for a week, or avoid bagel for a week.  There are many ways that are practical and doable. It’s a matter of being patient with yourself.

If you go on a crash diet such as orange juice/Vegetable juice diet to get into a pair of skinny jeans by a certain date, you won’t be building healthy eating habits, your body stresses out, so you’re likely to give up and gain back the weight. If your goal instead is to get healthier and reach a healthy weight for you, you’re more likely to stick with it.

So be patient, give yourself time and commit to doable short-term goals, such as walking three times a week or cutting out junk food for a week or take up gardening, as it will give you pleasure as well as burn 162 calories per half hr. If you set attainable goals, you’re more likely to achieve them — and that will fuel future successes.

You’ll feel better.

You’ll actually be happier if your goal is to eat healthy and exercise regularly, not to starve yourself. You’ll have more stamina, more strength. Your mood will be better. It’s about feeling good from the inside out, rather than the outside in.  You should do it not for other people, but for yourself.

Few easy exercising tips:

• While cooking, do calf raise stretch while waiting for your pot to boil
• During TV commercials, jog in place
• Put on music and dance as if you are teen again.
• If you’re pressed for time and waiting for something either at work or home, do ab exercises. Contract the muscles around your belly button. Then elevate your upper torso, and release. Finally, contract your buttocks for a few seconds.

You should always consult your doctor before starting any diet or workout plan.

The New Year is a good time to make a fresh start at lifestyle changes, such as eating better, exercising more, or giving up smoking. Like any other goal you set, making a resolution that is (SMART) specific, measurable, attainable, realistic, and timely — can help keep you focused and motivated. For example, instead of saying, “I want to lose weight,” you might say, “I want to lose 10 pounds in six months by eating fewer prepared foods and sweets and adding more servings of vegetables every day.” Or “I want to commit to exercising at the gym for one hour three times a week so that I have more energy to play with my kids.”

After creating your “smart” resolution, based on your unique health status and health risks, follow these tips to further improve your chance of keeping your resolution:

• Go public- Announce your resolution among family and friends and seek their support.  Sometimes creating a resolution pact with a friend helps, even if you don’t have the same resolution, you can touch base with each other every few weeks to check progress and provide encouragement.
• Expect unexpected and be prepared- Even people who are ultimately successful in their resolutions make mistakes along the way. What separates those who succeed in their resolutions from those who break them is how well they recover from mistakes. To be successful, you need to view mistakes as momentary lapses instead of failures and then promptly refocus on your goals.
• Patience…my friend- Remember that change doesn’t happen overnight, so resist the temptation to push yourself too hard. Consider keeping a journal to chart your progress, and congratulate yourself on your steps forward and forgive yourself for any steps backward. Then, if you find yourself doubting your progress, review your journal to recommit to your resolution.  Remember all that starts well will end well may be sooner or later…just keep trying.
• Prevention is better than cure- In addition to your “smart” resolution, routine physical exams and immunizations are important steps you should take to practice prevention. Measures like these can help you and your doctor identify potential health risks so that you can work together to prevent disease, illness, and injury.  The screenings that are appropriate for you may depend on your age and gender. For example:
  • The American Heart Association recommends blood pressure screenings every two years and cholesterol screenings every five years for adults beginning at age 20.
  • The American Diabetes Association recommends that adults have their fasting blood glucose checked every three years, beginning at age 45, to determine their risk for diabetes.
  • The American Cancer Society recommends annual mammograms for women starting at age 40 and colorectal cancer screenings, such as a colonoscopy, every 10 years for both men and women beginning at age 50. The organization also recommends that starting at age 50, men talk to their doctor about the pros and cons of prostate cancer screening, such as a PSA blood test, and whether it’s appropriate for them.

Keep in mind that you might need to be screened earlier or more frequently than these recommendations suggest, depending on individual risk factors such as your family history. Talk to your doctor to learn which screenings might be appropriate for you and when you should schedule them. Similarly, your family’s pediatrician can help you better understand preventive care services for your children.

How many of us actually understand the meaning of “Board Certification” and how many of us actually care whether our doctor is board certified or not.

Board certified officially means that the physician is an exceptional expert in a particular specialty and/or subspecialty of medical practice and has gone through the required training to practice medicine.  It also means that the physician is committed and is consistently achieving superior clinical outcomes in patient-focused setting.

It is believed that for patient like us the board certification is the best measure of a physician’s knowledge, experience and skills to provide quality healthcare within a given specialty. Is it really true?

Does this board certification actually make any difference in patient outcome? May be it does but nobody is sure. We believe that general public never cared where their doctor went for medical school.  People care for quality health outcomes and timeliness. Most of us even don’t know the difference between Doctors of Osteopathic Medicine (DOs) and Doctors of Medicine (MDs). They both go by Primary Care Physician (PCP); the DO is an Osteopathic physician, while MD is Allopathic physicians.  Many don’t even care if they get timely care from a Physician Assistant (PA) or a Nurse practitioner.

So we tried to dig little more into this at American Board of Medical Specialties (ABMS); a nationally recognized organization certifying doctors. After a tedious search process, we got something very interesting

“The physician certification information in the ABMS database is updated periodically with data provided by its Member Boards. Due to the possibility of reporting and processing delays, the accuracy and completeness of records cannot be guaranteed. ABMS shall not be liable to you or others for any decision made or action taken by you in reliance on the information obtained from this service.  It is the user’s responsibility to determine that the physician record obtained is that of the physician whose information is sought”

So… what now…ABMS is telling us that it’s OUR responsibility to determine… so guess we are left with our gut feel while choosing a doctor.

We are not saying that board certification or doctor credential doesn’t mean anything, Doing a background check into your doctor’s credentials is important to be sure they are appropriate and current. But there are other things in addition to credentials that patient needs to think about before choosing the right doctor, such as does the doctor communicate well and believe in building relationship? What is his methodology; prevention or just treatment? Whether he listens to his patient’s concern or just jump on the prescription?  Can doctor relate with the patient?

One’s health is his own and his doctor’s business, nobody wants to disclose health issues to public.  So please take time and research, ask your friends and family when it comes to making right choice for your right doctor…advocate of YOUR health.  We have tried to compile doctor information including reviews from the real patients on DocAsap.com for your convenience, our doctors would love to hear your concerns and they are all Board Certified…J

Eating Right and Staying Active is no rocket science

So here we are in 2012…hopefully you are beginning this New Year with lot of resolutions such as more partying, working hard, letting go, more adventures etc.  Don’t forget that nothing is possible without health.  We believe that staying healthy and fit is the greatest achievement of one’s life.  Frankly speaking, it’s not a rocket science; just eating right and staying active would do the job for you. Don’t need to spend hours in the gym, just dance, jump, go up and down the stairs anything for 15-20 minutes each day will do magic.

As a New Year resolution, some of our friends are doing extremes by quitting sweets (in any form) or grains or dairy. Being committed is good, but healthy eating is not about strict nutrition philosophies, staying unrealistically thin, or depriving yourself of the foods you love. Rather, it’s about feeling great, having more energy, and keeping yourself as healthy as possible– all of which can be achieved by learning some nutrition basics and using them in a way that works for you.

Healthy eating begins with learning how to “eat smart”—it’s not just what you eat, but how you eat. Your food choices can reduce your risk of illnesses such as heart disease, cancer, and diabetes, as well as defend against depression. Additionally, learning the habits of healthy eating can boost your energy, sharpen your memory and stabilize your mood. You can expand your range of healthy food choices and learn how to plan ahead to create and maintain a satisfying, healthy diet.

Trust us…your body deserves the best.  If you have any concerns please visit one of our doctors to find out what is best for your health.

With beginning of 2012, DocAsap proudly announces the launch of fully revamped website at DocAsap.com.  The new website is designed to be more users friendly while continuing to help patients get timely doctor or dentist appointments.

The streamlined site structure and navigation ensures that all information is just one or two clicks away. By enabling patients to quickly research medical practitioners and reserve appointments instantly online, DocAsap seeks to radically expedite and simplify the process of seeing a doctor or dentist.

New components of the website include:

• Differentiated UI experience with enhanced usability and navigation flow
• Enhanced search and filtering capabilities to enable finding the right doctor in the easiest way
• Comprehensive , dedicated web pages for Doctors and Practices to enable easy single point access to all required information

DocAsap.com has always focused on helping patients get timely care. Users can quickly search doctors and dentists, review provider’s bios and validated patient reviews, filter appointments that best match visit reason, insurance, schedule and location requirements and book instantly using a robust and intuitive website. DocAsap.com then manages all email and phone reminders as well.

The average wait time for core specialties in Philadelphia is 25 days surveyed by the firm Merritt Hawkins & Associates. And for some specialties such as dermatologists and obstetrician-gynecologists the wait time is around 45 days.  With DocAsap, patients are able to get timely appointments, majority of DocAsap users’ book appointment within one or two day.

For Medical practices DocAsap’s helps getting new patients. It reduces improves patient experience through 24X7 convenience of appointment scheduling. Additionally, DocAsap greatly reduces manual scheduling work done by the practitioners and their administrative assistants.

Currently, DocAsap is offering timely appointment with primary care physicians, obstetrician-gynecologists, psychiatrist, Pediatrician and dentists in Greater Philadelphia area and provides access to top doctors including University of Pennsylvania Health System.

We are super excited to begin this new year with much hope and success.

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Health care in the United States costs around $2 trillion annually, or 16 percent of GDP. So there’s a lot of concern about what will happen as those costs increase. That has led to three seismic shifts in health care; prevention, transparency and quality care.

We all know that prevention is better than cure, but are we practicing it? We all know that, to reduce health care costs, while still improving quality we need to reduce the burden of disease on the system.  Forty percent of the premature deaths in the United States are caused by obesity, inactivity, and smoking, all of which ought to be preventable. So a natural starting point is to help people stop smoking and help them lose weight.  There are many companies who don’t hire smokers; some good examples are set by Disney CEO Bob Iger who decided that there would no longer be people smoking in films made by Disney. He can easily get other producers to do the same.  As far as inactivity is concerned, people have to understand that they need to get up and move around more or their whole body will start to deteriorate…there is no other option.

Many health systems are taking initiatives to bring in transparency through patient portals as they understand that patient’s information belong to the patient and he has right to have that information. myPennMedicine was launched by Penn Medicine recently to increase patient’s accessibility. In addition to that, Penn Medicine is moving towards open access scheduling, and have already started utilizing online scheduling to offer convenience of online booking and same day appointments to its patients as well as to bring operational efficiency into the system.

Now an informed patient wants same experience from the health care provider as he gets in a restaurant or a spa.  He forms his opinions and talks to people about that experience.  And if patient volume is the concern than we think that it can be solved by addressing the aforementioned seismic shifts.