Question: I'm just beginning my pre-med studies. I'm very confused on which way to go. I want to become an N.D. from an accredited college here in the US but I was told that I would only be able to go in to private practice and the State of Texas doesn't even recognize N.D. at all. So, I thought OK I will become a M.D. (PCP) and practice on a more holistic or preventive level and now I'm told if I do that I will jeopardize my license and could even face prosecution. Can you shed some light on this for me. I truly want to go in to preventive health and nutrition, just need the best way to get there. Also, private practice my first year out of school would be most unlikely.
From: Lisa of Texas

Answer: Lisa - congratulations! You have chosen to pursue a career that will be stimulating for you and helpful to others! it sounds like you are doing a good job of analyzing the different options. And, you can certainly proceed with either the ND or the MD option. Both have pros and cons. For example, the ND degree is an excellent option so long as you attend one of the 4 programs in the US that are accredited by the American Association of Naturopathic Medical Colleges (www.aanmc.org). these are in Oregon, Washington, Arizona and Connecticut. You will only need to attend school for 4 years after your bachelors degree. On the downside, you will need to practice in one of the 14 states that currently license NDs. This list can also be found on the AANMC's website as they are constantly lobbying to increase the number of states who license and recognize NDs in practice. In these states, NDs can function as PCPs. In addition, these programs all include detailed coursework in nutrition, one of your goals.

The MD degree is always a good option as well. And, today prominent physicians who take a holistic approach to their practices, like Andrew Weil and Mehmet Oz are allowing all MDs with a holistic approach to become more accepted. All academic medical centers currently have integrative medicine offerings where they employ licensed practitioners like acupuncturists, nutritionists, and even meditation instructors to provide services to patients. The solid schooling you receive at any US Medical school is an excellent foundation for the future. The issue you need to address here is two-fold. First, how long do you want to wait to practice? You will not be eligible for licensure by any state until you have completed 7 years of education after your bachelor's degree (4 years of medical school and 3 years in a primary care residency....3 for family practice and 4 for internal medicine). Second, you will most likely need to obtain additional training in nutrition since most medical schools offer very little in the way of nutrition courses.

Lastly, it sounds like one of your concerns is around the credibility and legality of what you would like to do. As I mentioned above, the ND degree is perfectly legitimate in the 14 states that recognize it, as long as you have graduated from a school accredited by the AANMC. And, as far as holistic MDs go, it appears that the opportunities are wide open at all of the Academic medical centers (hospitals affiliated with medical schools) as well as in many other areas. You just need to decide how much time you want to dedicate to the training......Hope this helps. Ruthann

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As discussed before, there are many natural alternatives to refined sugar or chemical based sweeteners, one such replacement is Carob.

Carob is a member of the legume family, and as such, its roots host bacteria that convert atmospheric nitrogen into nitrates, which can be used by plants to make proteins. Carob beans are grown in pods and then crushed and used as a food substance. It is considered by many a religious food, traditionally eaten on the Jewish holiday of Tu Bishvat. Carob juice drinks are traditionally drunk on the Islamic holiday of Ramadan. Carob pods were the most important source of sugar before sugarcane and sugar beets became widely available. Carob powder and carob chips are sometimes used as an ingredient in cakes and cookies instead of chocolate.

A cup of carob flour (the only version of carob officially titrated in
nutritional data) is 229 calories with 51 grams of sugar. It has only one gram
of fat, which is why it is preferred by some to chocolate. And before raw, vegan
chocolate was available, carob could be used as a vegan chocolate substitute.
It does contain a fair number of minerals including calcium, magnesium,
potassium, and manganese.

For more information about all natural sweenters or incorporating more natural choices into our lifestyle see The Raw Food Diet Myth now available on Amazon.com.

 

Question: Why aren't prescriptions typed instead of handwritten to cut down on errors?
From: Tonya H. of Jacksonville, NC

Answer: Unfortunately, prescription errors account for 1.5 million Americans being sickened, injured, or killed annually according to an article in the Washington Post in 7/06. The errors are in prescribing, dispensing, and taking the medications according to a report by the Institute of Medicine. The additional cost in treating drug-related injuries in hospitals was conservatively estimated at $3.5 billion per year. Although your question is specific to written physician prescriptions, the errors do not rest solely on their shoulders. If you do research on ways to prevent prescription errors, you will find that many experts recommend that the focus be taken off the individual as the problem but rather be placed on the system in place to safeguard against these errors. Individuals are human and humans make errors so the system should expect that errors do occur and so the system must have checks and rechecks along the way. Experts also recommend that there be a system for reporting the errors so that providers, pharmaceutical companies, pharmacists can learn and improve their methods. The experts provide recommendations to all providers, many of them quite simple sounding. For example, physicians need to write clearly and legibly, be specific in their instructions and side effects, use brochures, and consider the use of electronic prescriptions which can check for incorrect doses and dangerous drug interactions. Pharmacists need to check and recheck the prescription and label and keep similar looking and sounding drugs in different areas. When possible, consumers are also urged to read the prescription out loud to the physician and to check the label of the filled prescription with the written prescription. The patient should report all allergies and other medications being taken. The experts also look to the FDA and pharmaceutical companies to evaluate labels, packages, design of products, too many similar sounding medication names. New technology and electronic prescribing are expected to reduce the number of medication errors as well. Also suggested are standardized bar-code systems and “blister packs” that make it easier to identify meds and let consumers know whether they took the day’s dose.

According to a recent survey by the Commonwealth Fund 82% of the over 1000 people surveyed felt that the current US Healthcare system and that major overhauls are needed to improve the quality of care. Additionally over 9 out of 10 respondents felt that proposed healthcare reform is a major factor in the upcoming presidential election. (full report)

Question: Is it more important for an MD to be a member of the AMA or of their specialty association, such as the American College of Obstetricians and Gynecologists?
From: DMG

Answer: There are certainly benefits for a physician to belong to either the AMA or a specialty association. The AMA is involved in advocacy and efforts to effect healthcare policies. The AMA, the largest medical association, includes physicians from many specialties and provides free subscriptions to JAMA, American Medical News, and Morning Rounds. These publications provide new research and treatment findings. Medical students, residents/MDs/DOs may join the AMA. I looked at several specialty association sites and found that each has criteria for membership specific to that specialty. These include CME credits, years of training (dependent on membership level). Here too, members are provided the latest research and treatment findings specific to that area. It is difficult to say that one is more important than the other but I would want my physician to have access to the latest information specific to my problem or diagnosis.

Question: Do pharmaceutical companies assist in covering the cost of medicine?
From: Yvonne P. of San Antonio, TX

Answer: Most pharmaceutical companies, including Merck, AstraZeneca, and Pfizer, offer assistance to those who lack health insurance coverage or whose health plans do not include prescription benefits. Medications may be provided free or at a discount after showing proof of income and physician consent. You can find numerous sites on the web that will direct you to public and private assistance programs. Ask your primary care physician for assistance and/or check www.rxassistance.org, www.rx.hope.com, and www.pparx.org. The latter website is Partnership for Prescription Assistance which brings together America’s pharmaceutical companies, physicians, healthcare providers, patient advocacy organizations, and community groups to assist patients with lower income and who lack prescription coverage. The organization directs patients to public or private programs most likely to meet their needs, including government organizations such as Medicare, Medicaid, or SCHIP. Over 475 programs participate, including 180 programs offered by pharmaceutical companies, and over 2500 medications are available.

Question: Are hospitals inspected regularly?
From: Lisa M.

Answer: If you’ve ever worked in a hospital, you’ve probably lived through an inspection by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and/or that state’s Department of Health. As a hospital patient, you may even be interviewed by a member of an inspection team. JCAHO is a private organization mostly comprised of healthcare professionals. An inspection team includes a physician, a Registered Nurse, and a hospital administrator. JCAHO accredits about 80% of the country’s hospitals as well as home health agencies, hospices, clinical laboratories, and ambulatory surgical centers. Accreditation by JCAHO is voluntary and the facility pays for the survey but it makes the facility automatically eligible for Medicare reimbursement. JCAHO surveys are done every 3 years. In the past, JCAHO announced its regular and follow-up visits months or weeks in advance. This came under much criticism leading the Commission to visit unannounced but still every 3 years. Hospitals are rated on over 500 performance standards.

In addition to JCAHO, all 50 states and U.S. territories contract with the Centers for Medicare and Medicaid Services (CMS) to inspect healthcare facilities.

These inspections are intense but are intended to provide patients with excellent safety and care and provide hospitals with “gold standards.”

RuthannRusso.com now supports Yahoo’s new Buzz service which allows users to share and discover content with other user’s around the globe and create a “buzz”. If there’s a topic you find particularly interesting simply click on the “Buzz up!” located under each post.

“Yahoo! Buzz is an extension of Yahoo! that uncovers the most remarkable and timely content from websites across the Internet. We pull in the hottest stories and videos (and more) from a broad assortment of Web publishers throughout the day, and we give you the chance to be an editor by voting (“buzzing”) content up and down (either on Yahoo! Buzz, or on our publisher partner websites), and by submitting it to Buzz in the first place.

For each piece of content that you see on Yahoo! Buzz, we develop a ranking. That content’s ranking is based on things like the number of votes it receives on Yahoo! Buzz, the popularity of related search terms on Yahoo! Search, and the number of times that content is shared with friends over email. Higher ranked stories are featured more prominently on the homepage of Buzz and within category pages.”

For more information please visit buzz.yahoo.com

Question: Are any hospitals non-profit?
From: Emery L. of Brooklyn Park, MN

Answer: Actually, 70% of hospitals in the U.S. are nonprofit and 30% are for profit. The main difference between the two categories is ownership. Nonprofits are owned by government entities, educational organizations, or religious organizations or they may be community based. Nonprofits are established for charitable, humanitarian, or educational purposes. They are not owned by individuals so individuals do not profit or lose based on the hospital’s financial performance. Nonprofit hospitals are exempt from taxes but, in return, must give back services and care back to the community and patients. Nonprofit hospitals can generate profits but this is used to benefit their communities. To qualify as non-profit, hospitals are required by their state to provide some free care for the indigent. The requirements vary by state and federal rules allow non-profit hospitals to also demonstrate benefit to the community in public service announcements, medical research, and health fairs.

For-profit hospitals are public or private and are owned by an individual, individuals, or a private corporation. A public, for profit is publicly traded and owned by the corporation’s stockholders.

Check the American Hospital Directory website at www.ahd.com to find the status of your hospital.

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