The Looming Doctor ShortageMarch 2013
By William Faloon
Self-Treating Vascular Risk Factors
A comprehensive blood test can reveal a host of factors that can lead to a heart attack or stroke.
For instance, if fasting glucose is over 85 mg/dL, the rate of heart attack is 40% higher according to a large study of 22,000 people.26 In addition to the use of supplements (like green coffee extract) and lifestyle changes, people should be allowed to purchase glucose-lowering drugs like metformin and acarbose without tying up valuable physician time. Safety data is widely available and doses could be adjusted by empowered patients to achieve optimal glucose control.
Elevated LDL is one of many underlying causes of atherosclerosis. If LDL levels remained stubbornly high despite lifestyle changes and use of supplements, low-dose statins should be available on a non-prescription basis. I mention low-dose because doctors too often prescribe such a high dose of statin drugs that side effects manifest. We long ago described studies showing that far lower doses of statins can produce desired reductions in LDL without creating new health problems.27,28 Empowered patients managing their own LDL/cholesterol levels would eliminate many doctor visits that clog waiting rooms.
Low testosterone is a risk factor for cardiovascular disease in men.29-32 A physician help-line could be established whereby doctors review a person’s blood test results and prescribe testosterone over the phone, thereby enabling more aging men to enjoy youthful testosterone ranges. Follow up blood tests could guard against estrogen overload caused by the excess conversion of testosterone to estrogen, and rule out rare side effects (such as overproduction of red blood cells).
Government regulators today are particularly concerned about people using testosterone without in-person physician visits. The reality is that hurried doctors often don’t prescribe ideal individual testosterone doses, fail to protect against estrogen overload, and neglect long term follow up to ensure optimal free testosterone status. A help-line solely dedicated to providing superior hormone balance in aging men could free up frontline physicians that need to be available to treat patients with serious illnesses.
There is no question that physical examinations by doctors who have adequate time to spend with each patient have clear advantages. But with a looming doctor shortage, this is no longer possible, and aging individuals should be given options that will save them (and the sick-care system) substantial dollars.
Nearly Half of Doctors Already Suffering Burn Out
A national survey of physicians finds the prevalence of burnout is already “alarming.”
The report describes the looming physician shortage as millions of “newly insured” crowd waiting rooms, but the report stated that 45.8% of physicians already suffer a symptom of burnout.33
One doctor describes that being asked to see more patients, while not having enough time to devote to them makes one feel like “being on a hamster wheel.”
Experts were surprised at the high rate of burnout in frontline physicians and stated that this will adversely affect patient outcomes and ultimately drive up costs, as sick people aren’t being efficiently cured.34
When I develop a medical problem, I don’t want my life to depend on a “burnt out” doctor. If adults are given the option of self-medicating for simple and common problems like elevated LDL, hypertension, and urinary tract infections, then the quality of care can increase as the patient load decreases.
Public Needs to Act!
The public is fearful of change, even when circumstances dictate it and the overall result would be huge numbers of human lives spared.
The entrenched establishment dreads any variation that would reduce their profit machines and will not hesitate to disseminate false and misleading propaganda to protect their virtual monopoly.
The appropriate deregulation will eliminate the healthcare cost crisis, yet those who financially benefit from today’s broken system (like pharmaceutical companies) will violently oppose these rationale proposals.
Citizens must act and demand common sense change.
Penalties of Failing to Face Reality
This article only touches on alterations to healthcare regulation that would slash medical expenses, improve patient outcomes, and alleviate physician shortages.
The financial news publishes articles each day describing how sick-care costs are bankrupting governments, businesses, unions, and individuals. I ask when you read these distressing reports that you recall that Life Extension has battled the inefficient regulatory structure behind this cost crisis since the early 1980s.
We predicted with intrepid certainty that failure to tear-down suffocating regulatory barriers would lead to catastrophic economic problems while stagnating the scientific advancement.
The looming shortage of physicians will affect most everyone reading this article. It is just one symptom of a sick-care system plagued by regulatory inefficiency.
The best way to avoid becoming a victim is to take aggressive care of your precious health every single day, as I know most of you do already.
Comprehensive blood tests performed annually, and access to a blood pressure monitor, are two simple steps aging Americans can use to become “empowered patients,” thereby not being 100% reliant on hurried physicians.
For longer life,
- Available at: http://www.ncsl.org/issues-research/health/the-affordable-care-act-a-brief-summary.aspx. Accessed December 11, 2012.
- Available at: http://www.cnn.com/2012/06/29/health/doctor-shortage-affordable-care-act/. Accessed October 16, 2012.
- Available at: http://www.nytimes.com/2012/07/29/health/policy/too-few-doctors-in-many-us-communities.html?_r=0. Accessed December 11, 2012.
- Available at: http://www.usnews.com/education/best-graduate-schools/the-short-list-grad-school/articles/2012/06/19/10-most-popular-medical-schools-2. Accessed December 11, 2012.
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- Willmot M, Leonardi-Bee J, Bath PM. High blood pressure in acute stroke and subsequent outcome: a systematic review. Hypertension. 2004 Jan;43(1):18-24.
- Kario K, Ishikawa J, Pickering TG, Hoshide S, Eguchi K, Morinari M, Hoshide Y, Kuroda T, Shimada K. Morning hypertension: the strongest independent risk factor for stroke in elderly hypertensive patients. Hypertens Res. 2006 Aug;29(8):581-7.
- Lee M, Saver JL, Chang B, Chang KH, Hao Q, Ovbiagele B. Presence of baseline prehypertension and risk of incident stroke: a meta-analysis. Neurology. 2011 Oct 4;77(14):1330-7.
- Qureshi AI, Suri MF, Kirmani JF, Divani AA, Mohammad Y. Is prehypertension a risk factor for cardiovascular diseases? Stroke. 2005 Sep;36(9):1859-63. Epub 2005 Aug 4.
- Lawes CM, Bennett DA, Lewington S, Rodgers A. Blood pressure and coronary heart disease: a review of the evidence. Semin Vasc Med. 2002 Nov;2(4):355-68.
- Shimamatsu K, Onoyama K, Harada A, et al. Effect of blood pressure on the progression rate of renal impairment in chronic glomerulonephritis. J Clin Hypertens. 1985 Sep;1(3):239-44.
- Baldwin DS, Neugarten J. Treatment of hypertension in renal disease. Am J Kidney Dis. 1985 Apr;5(4):A57-70.
- Ridao N, Luño J, García de Vinuesa S, Gómez F, Tejedor A, Valderrábano F. Prevalence of hypertension in renal disease. Nephrol Dial Transplant. 2001 16 Suppl 1:70-3.
- Bergström J, Alvestrand A, Bucht H, Gutierrez A. Progression of chronic renal failure in man is retarded with more frequent clinical follow-ups and better blood pressure control. Clin Nephrol. 1986 Jan;25(1):1-6.
- Basile JN. Rationale for fixed-dose combination therapy to reach lower blood pressure goals. South Med J. 2008 Sep;101(9):918-24.
- Bakris GL. Current perspectives on hypertension and metabolic syndrome. J Manag Care Pharm. 2007 Jun;13(5 Suppl):S3-5.
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- Elliott HL. 24-hour blood pressure control: its relevance to cardiovascular outcomes and the importance of long-acting antihypertensive drugs. J Hum Hypertens. 2004 Aug;18(8):539-43.
- Danaei G, Ding EL, Mozaffarian D, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009 Apr 28;6(4):e1000058.
- Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011 Mar 1;52(5):e103-20.
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- Takahashi S, Hamasuna R, Yasuda M, et al. A randomized clinical trial to evaluate the preventive effect of cranberry juice (UR65) for patients with recurrent urinary tract infection. J Infect Chemother. 2012 Sep 8. [Epub ahead of print]
- Wang CH, Fang CC, Chen NC, et al. Cranberry-containing products for prevention of urinary tract infections in susceptible populations: a systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2012 Jul 9;172(13):988-96.
- Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/utiadult/. Accessed October 18, 2012.
- Bjornholt JV, Erikssen G, Aaser E, et al. Fasting blood glucose: an underestimated risk factor for cardiovascular death. Results from a 22-year follow-up of healthy nondiabetic men. Diabetes Care. 1999 Jan;22(1):45-9.
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- Malkin CJ, Pugh PJ, Morris PD, Asif S, Jones TH, Channer KS. Low serum testosterone and increased mortality in men with coronary heart disease. Heart. 2010 Nov;96(22):1821-5.
- Turhan S, Tulunay C, Gulec S, et al. The association between androgen levels and premature coronary artery disease in men. Coron Artery Dis. 2007 May;18(3):159-62.
- Haring R, John U, Völzke H, et al. Low testosterone concentrations in men contribute to the gender gap in cardiovascular morbidity and mortality. Gend Med. 2012 Dec;9(6):557-68.
- Jankowska EA, Biel B, Majda J, et al. Anabolic deficiency in men with chronic heart failure: prevalence and detrimental impact on survival. Circulation. 2006 Oct 24;114(17):1829-37.
- Available at: http://www.freep.com/article/20120821/FEATURES08/120821013/Doctor-burnout-Nearly-half-of-physicians-report-symptoms. Accessed October 19, 2012.
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