Blog

Pandemic Lockdown Weight Gain & the Medical Reasons for it

by
Could the coronavirus pandemic exacerbate obesity wrbm large

It’s not all your fault, it’s evolution…

Pandemic Lockdown Weight Gain & the Medical Reasons for it. At a time when Americans should have been focused on their health, as a population they were anything but. During the Covid-19 pandemic lockdown the average American gained two pounds a month, according to a study published in the The Journal of the American Medical Association (JAMA Network Open).

But the reasons for this trend were the result of brain chemistry that evolved in humans over the millennia, according to well respected neurologist, Dr. Steven Goldstein, founder of the Houston Healthcare Initiative. He described these on his regular podcast that can be heard on Apple Podcasts, Audacy, Houston Healthcare Initiative, iHeart, Podcast Addict, Podbean, Backtracks, Soundcloud, and just about anywhere podcasts can be heard.

Stress & More Stress

Dr. Goldstein told his audience that the main reason for the weight gain was related to stress. “The main reason is stress, especially given the really bad news about the seriousness of the pandemic and the controversies about different treatments early on,” he told his listeners. “That was stress of a long duration which exacerbated the physiological accompaniments of stress.”

Fight or Flight Responses

As part of the ‘fight or flight’ response, the human brain goes on high alert. To maintain a high state of alertness requires more energy for the brain in the form of calories. “Heightened states of stress and anxiety like this require more calories to keep the brain on high alert, Dr. Goldstein stated. “We eat sugar to get a boost of energy. Sugar gets converted to energy faster but does not last long, requiring more sugar. It is a cycle that is unhealthy short term, but really bad long term.”

Long Term Fear of the Unknown as part of Pandemic Lockdown Weight Gain & the Medical Reasons for it

On top of that stress was the unknown. No one living had ever experienced anything like the Covid-19 pandemic and closure of practically everything. According to Dr. Goldstein, not knowing was a huge problem for the American psyche. Research shows that the unknown makes people more stressed than when they know something is about to happen. “In late March, April, and May of last year we really didn’t know what we were dealing with, in terms of how contagious the Covid-19 virus was or how potentially fatal it might be,” Dr. Goldstein said. “Obviously then, the unknowns of the virus and the dramatic worldwide lock downs were things none of us had any experience with and that is the perfect recipe for stress, anxiety and the overeating that accompanies both.”

To Flee or Not to Flee

Stress like this is in reaction to the ‘fight or flight’ response that is hard-wired into the consciousness of humans. According to the web site Psychology Tools, the fight or flight response is ‘an automatic physiological reaction to an event that is perceived as stressful or frightening. The perception of threat activates the sympathetic nervous system and triggers an acute stress response that prepares the body to fight or flee.’ When the duration of this automatic response is months or even over an entire year, part of the evidence that Americans endured all this stress is registered on the scale.

Brain Chemistry and the Pandemic Lockdown Weight Gain & the Medical Reasons for it

So what in the human psyche links eating with stress? “Humans evolved such that when faced with stress, the body does what it must to keep the brain on high alert,” Dr. Goldstein reported. “It decreases levels of some hormones and brain chemicals to discourage behaviors that won’t help in an urgent situation, and it increases other hormones that will.” Dr. Goldstein added more details, “our ancestors had to outrun predators and other humans or be ready to fight them. Thus, we evolved to release adrenaline in response to the fight or flight response. From an evolutionary perspective, that stress responses are tuned to environmental uncertainty suggests that they gave people a better chance at survival, depending on who or what was chasing you.”

A Gut Feeling

Dr. Goldstein also explained that there was a connection between the brain and the stomach. “The brain is connected to the gut through a two-way communication system called the vagus nerve,” he said. “When you are stressed, your body inhibits the signals that travel through the vagus nerve and slows down the digestive process.”  Eating for comfort can be a natural response to stress, but when combined with the lower motivation to exercise and consumption of low-nutrient, calorie-dense food, people can and did gain weight.

About the Houston Healthcare Initiative

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.

 

The Number of Primary Care Doctors is Shrinking, and That is Really Bad News

by
Primary care shrinking
Access to primary care physicians is a matter of the number of doctors who choose to pursue primary care as a career. Pay for those roles is lower than it is for most specialists and no surprise, fewer are choosing to go into this important part of the healthcare profession.

On the Houston Healthcare Initiative Podcast…

The Number of Primary Care Doctors is Shrinking, and That is Really Bad News

July 20, 2021 – The Number of Primary Care Doctors is Shrinking. An important contributor to the health of Americans is shrinking and the effects on the overall health of people in this country is and will continue to be negatively impacted. This is the subject of the latest edition of the Houston Healthcare Initiative Podcast.

Lower Pay

Fewer medical school graduates are choosing primary care because it pays significantly less than other specialties. Worse still, a lower number of primary care doctors is linked to 85 deaths every day, according to a study published by the National Academy of Sciences. Can primary care doctors make more money? “Under the current system of payment via employer funded health insurance it will be challenging to make that case,” Dr. Goldstein said. “But there may be a chance for new primary care doctors to ignore most of the insurance companies and their accompanying rules and work on a cash basis.”

Cash Only Please

Even patients who have their own health insurance can often save themselves money by paying cash. Doctors will not have to hire staff to process insurance claims, hassle with them over payment or non-payments. Patients save money on premiums and the doctors have fewer expenses. Patients pay less, doctors keep more of the fees because of lower expenses.

Covid Pandemic Bankrupts Many Practices

In addition to a shortage of practicing doctors, primary care visits declined significantly during the COVID-19 pandemic. Add to that a good number of primary care practices were not able to access federal funds and relief and went under. “If these trends continue, it will have a very negative impact,” Dr. Steven Goldstein told his listeners. “Regular visits to the primary care or family doctor allows that physician the chance to know his or her patients better. What are their medical histories, prescribed medication, allergies, or family histories that could affect a diagnosis? These are details that the primary care doctor will know because he or she has a history with patients.”

What Difference Does It Make?

A single visit to a primary care doctor makes a difference for the patient. “When you get sick, that doctor knows how to treat you,” Dr. Goldstein said. Primary care is a health care component where an increased supply is associated with better population health and more equitable outcomes. “For this reason, primary care is a common good, which makes the strength and quality of the country’s primary care services, or its lack, a public concern.”

About the Houston Healthcare Initiative Podcast                                                                   The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To hear the podcast go to: SoundCloud, iHeartRadio, Stitcher, Backtracks, LibSyn, or the website at www.houstonhealthcareinitiative.org. Dr. Goldstein insists that for the health and welfare of the American public, the congress must pass reforms that limit the influence of the pharmaceutical industry and its lobby.

Healthcare Payment Reform is Critical to Improving Primary Care

by
Backs of doctors
Doctors are leaving the primary care practice in numbers that lead to 85 deaths per day. Better pay will retain more for this important healthcare function.

Access to and paying for healthcare is a topic that Dr. Goldstein talks about a lot on the podcast and this one is no exception. But in this case access to primary care is a matter of the number of doctors who choose to pursue primary care as a career. Pay for those roles is lower than it is for most specialists. A lower number of primary care doctors are linked to 85 deaths every day according to a study published by the National Academy of Sciences. In addition to a shortage of practicing doctors, primary care visits declined significantly during the COVID-19 pandemic. Add to that a good number of primary care practices were not able to access federal funds and relief and went under. How can we manage all this? For answers we turn to respected neurologist and the founder of the Houston Healthcare Initiative, Dr. Steven Goldstein.

Listen to the Houston Healthcare Initiative podcast about primary care physicians here. Healthcare Reform is Critical to Retain Primary Care Docotrs

UnitedHealthcare and the non-emergency emergency… Who Decides If You Need To Visit The Emergency Room?

by
UnitedHealthcare
UnitedHealthcare delayed a controversial decision to retroactively declare treatment in an emergency room not an emergency.

UnitedHealthcare and the non-emergency emergency…

Who Decides If You Need To Visit The Emergency Room?

On the latest edition of the Houston Healthcare Initiative podcast, respected neurologist and Houston Healthcare Initiative founder Dr. Steven Goldstein discusses the proposed UnitedHealthcare policy of after the fact review and in some cases possible denial of  some emergency room visits. The Houston Healthcare Initiative podcast can be heard on: SoundCloud, iHeartRadio, Stitcher, Backtracks, LibSyn, Soundcloud, or the website at www.houstonhealthcareinitiative.org.

Declaring the Emergency, a Non-Emergency

UnitedHealthcare is the nation’s largest health care insurer. In early June 2021 UnitedHealthcare announced that it would change how they assess emergency department claims, and thus allow ‘United’ to retroactively deny claims it deemed “non-emergent” or not an emergency. The aim is for the insurance company and their customers to save money, but others say the consequences could be more costly or even deadly. The new policy was originally scheduled to begin on July 1, 2021 but after a wave of criticism from among others, the American College of Emergency Physicians, United backed off and later said they would wait until the pandemic was past to make a decision about this decision.

Bad Policy With Usual Solutions Tried

Like the American College of Emergency Physicians Dr. Goldstein also believes this policy is unwise. “The answer is not to retroactively deny payment for ER care already rendered,” he told his listeners. “What this does is force the hospitals to refuse care for “non-emergency care” as defined by UnitedHealthcare. However, this is not practical because the hospital is more afraid of a potential lawsuit if a patient is refused care and has a poor outcome as a result. The patient then will be stuck with a large bill that cannot be paid.”

Dr. Goldstein states this is another example of an insurance company trying to “manage care.” “They (insurance companies) see a problem, namely they think that Emergency Room services are over-utilized and think they can manage the problem,” Dr. Goldstein said. “They try their usual method of operation and simply deny payment.”

On The Other Hand

UnitedHealthcare claims there are big problems with the misuse of emergency rooms which costs the U.S. healthcare system roughly $32 billion annually. UnitedHealthcare states that misuse typically manifests as patients seek out costly care for minor ailments that could be addressed through other avenues like an urgent care type of clinic. According to the UnitedHealthcare web site, “two-thirds of hospital ED visits annually by privately insured individuals in the U.S. – 18 out of 27 million** – are avoidable.”

Does UnitedHealthcare Have A Point?

Dr. Goldstein stated that United had a point “if the point is that healthcare administered in an emergency room is too expensive.” But he also point out, “UnitedHealthcare negotiated the prices they pay with the hospitals. If it is too expensive, why did they negotiate such a high price?”

About the Houston Healthcare Initiative Podcast

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To hear the podcast go to:

Dr. Goldstein insists that for the health and welfare of the American public, the congress must pass reforms that limit the influence of the pharmaceutical industry and its lobby.

Healthcare and Nanotechnology

by

Nanotechnology concerns the manipulation of materials so small that they are on the molecular or even subatomic level. The new technology, according to SciDev.Net, has enormous implications for the practice of medicine.

Healthcare and Nanotechnology

For example, people who are given drugs to combat cancer do not experience the entire dose at the site of the tumor. This fact is one reason why chemotherapy can be such a stress for the human body, as healthy cells are destroyed along with the tumor.

However, drugs can be carried to the site of a tumor using nanoparticles as carriers, attacking only the cancer cells and leaving the rest of the body alone. Nanotechnology means that people suffering from cancer can see higher remission rates with far less stress on the rest of their bodies. The FDA has approved the first generation of cancer drugs that use nanotechnology.

Nanotechnology has also been used to ensure early detection of diseases such as HIV and cancer. Something called quantum dots has been used successfully to detect a variety of diseases, including tuberculosis and malaria.

Even vaccine development, a matter of great concern in the era of the Covid-19 pandemic, is benefiting from nanotechnology. Aerosol and patch-delivered vaccines are being tested using nanoparticles as a delivery system. Even more conventional injectable vaccines have proven more potent when the inactive virus is delivered by a nanoparticle.

How can this new form of nanotechnology-based medicine be made more widely available, especially in the developing world, where diseases that are rare in the developed world are still common?

In any event, nanotechnology is enabling a new science of precision medicine, in which diseases are diagnosed more quickly and are then dealt with, resulting in more beneficial outcomes, increased lifespans, and quality of life. With proper investments, nanotechnology can decrease the cost of healthcare in the long term by making sick people well more quickly and with greater frequency.

For more information contact us.

How To ‘Hack’ Your Health Savings Account

by

How To ‘Hack’ Your Health Savings Account

On the latest edition of the Houston Healthcare Initiative podcast, respected Houston based neurologist Dr. Steven Goldstein describes how people can best use the often-overlooked benefit known as the Health Savings Account.

The Health Savings Account, or HSA, is a type of savings account that is used for medical expenses. Congress established them in 2003 for those with high deductible health insurance. It is a way to pay cash for routine medical care with pretax dollars. Because the HSA requires a high deductible health insurance account, routine healthcare expenses are not covered, but can be paid for by the HSA. HSA’s are potentially a good value for those who can take advantage.

The High Deductible Health Insurance Plan

A high deductible insurance plan is one where the deductible is higher than with other policies. The ‘deductible’ is the amount the patient has to pay out of pocket before the insurance kicks in. A high deductible is usually between $3,000 – $10,000. “Of course, the higher the deductible; the lower the premium,” Dr. Goldstein told his listeners.

Who Should Consider an HSA?

First, who is this not for? “If you are already sickly and have $5-10,000 in medical expenses every year, the high deductible policy with HSA is probably not for you,” Dr. Goldstein said. “The time to start a high deductible plan with HSA is when you are young and well. Even if you had $10,000 in expenses in one year, it is highly unlikely these expenses would continue every year.”

Tax Free Deposits

The money deposited into the HSA account is not taxed. Many companies contribute to an employee’s HSA to encourage its use. Further, HSAs feature a triple-tax benefit: money the employee contributes to the HSA can be written off on taxes and thus reduce an income tax bill. “Money in your HSA grows tax free, Dr. Goldstein reported. “When you withdraw money for qualified medical expenses, no tax is paid on the withdrawal. However, if you withdraw money for non-medical expenses, you do pay tax as well as a penalty.”

About the Houston Healthcare Initiative Podcast

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To hear the podcast go to: SoundCloud, iHeartRadio, Stitcher, Backtracks, LibSyn, or the website at www.houstonhealthcareinitiative.org. Dr. Goldstein insists that for the health and welfare of the American public, the congress must pass reforms that limit the influence of the pharmaceutical industry and its lobby. Houston Healthcare Initiative seeks to change the way people think about healthcare. Find healthcare pricing and local provider rates!

 

Five Numbers That Could Reform Health Care

by

Five Numbers That Could Reform Healthcare

With over 40 years of health care and management experience, Randy Oostra President and CEO of Promedica presents at TEDxTraverseCity 2020. Randy Oostra, DM, FACHE (63), is the President and Chief Executive Officer of ProMedica, a not-for-profit mission-based, integrated health and well-being organization headquartered in Toledo, Ohio. The $7 billion organization serves communities in 28 states. It offers acute and ambulatory care, an insurance company with a dental plan, and post-acute and academic business lines. The organization has more than 56,000 employees, 13 hospitals, 2,600 physicians and advanced practice providers with privileges, 900+ healthcare providers employed by ProMedica Physicians, a health plan, and more than 400 assisted living facilities, skilled nursing and rehabilitation centers, memory care communities, outpatient rehabilitation clinics, and hospice and home health care agencies.

Randy has 40 years of health care and management expertise, with 22 of those years spent at ProMedica. Randy is regarded as one of the nation’s top leaders in health care and has earned a spot on several prestigious listings, which include Modern Healthcare’s 100 Most Influential People for three consecutive years and Becker’s Healthcare’s 100 Great Leaders to Know in Healthcare This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx

Houston Healthcare Initiative is a group of physicians and health conscious patients that have joined together in a Healthcare cooperative to maintain and improve the physical and mental health of each member of the group.

Healthcare consulting

by

Announcing a new Healthcare Consulting FREE SERVICE offered by the Houston Healthcare Initiative for companies providing health insurance to their employees.

Healthcare consulting

HEALTHCARE CONSULTING

What we will do

1.Listen

Allow the company to explain what are the specific problems they face with the health of their employees and how they are currently addressing them.

2.Learn

What are the details of the current healthcare plan? What data are available concerning current costs and how are these costs broken down. What data are available concerning the health of the employees.

3.Analyze

Use the available data to develop a plan to both improve employee health and lower healthcare cost. We do this from a physician’s perspective.

4.Propose

Steps to accomplish the dual goals of improving employee health and lowering healthcare costs. These steps can be implemented at no cost to the company!

5.Educate

Provide education to employees on how to shop for healthcare services and what they can do to improve their health

To learn more send an email to info@houstonhealthcareinitiative.org

———————————————————————————————–

Most recommendations will include
1.Financial incentives to improve both physical and mental fitness. These incentives could include lowering of employee’s monthly premiums for insurance; sharing the savings on healthcare expenses with employees; employee recognition for improvement in health e.g. awards for weight loss
2.Annual physical exam to identify disease at an early stage, collect data on employee health and use the data to develop the financial incentives for employees to improve their health. Use the data to develop other strategies to improve the overall health of the employee population.

 

Do I Have to Pay for the Covid 19 Vaccine?

by

The short answer to the question as to whether you have to pay for the Covid-19 vaccine is no, according to the CDC website on the vaccine. The federal government, which paid for the development of the vaccines either directly or by promising to pay for their production, is providing shots free of charge. The idea is that the sooner people get the vaccine, the sooner the United States can achieve “herd immunity,” in which transmission of the virus is suppressed because so many people have been rendered immune. Then people can return to normal life without risk of sickness or death, something that the federal government has determined is well worth paying many billions of dollars to achieve.

Do I Have to Pay for the Covid 19 Vaccine?

In other words, you can make an appointment at any pharmacy or designated vaccination site and then walk in and receive your shot without cost. All you will have to do is to fill out some paperwork. You will get your shot regardless of your insurance status. You will not be charged for an office visit or anything else unless you request further healthcare services, which will be billed as appropriate.

The CDC site has some more information that should be transparent to you. You may be asked for your insurance or other healthcare provider information so that the provider of the vaccine can bill them for a portion of the cost. However, you will pay no out-of-pocket costs for the vaccine.

Therefore, the Covid-19 vaccine will be the best healthcare deal you will likely be offered. When you get your shots, either the two required by Pfizer or Moderna or the one by Johnson and Johnson, you may feel some minor side effects. But rest assure any fatigue or fever you might experience will pale in comparison to what might await you if you get Covid-19. In other words, getting the shot costs nothing and will impart peace of mind and protection against the deadliest pandemic in a hundred years.

For more information contact us

8 Questions and Answers… What to Know When Considering a New Doctor

by

8 Questions and Answers…

What to Know When Considering a New Doctor

What to Know When Considering a New Doctor. Eight answers from a practicing physician. 

May 11, 2021 – What should anyone know or ask when considering a new doctor or primary care physician? On his regular podcast, Dr. Steven Goldstein, founder of the Houston Healthcare Initiative tells his listeners what to know and ask when considering a move and why we all even need our own primary care physician. Below is a list of questions and Dr. Goldstein’s answers to them.

Where to Listen

To hear the Houston Healthcare Initiative podcast, visit one of the following: :  Apple Podcasts, LibSyn, Spotify, Radio.Com, Listen Notes, iHeart Radio, Podcast Addict, Podbay, Backtracks, Player FM, Stitcher, and SoundCloud.

Questions and Answers

  1. Why is choosing a regular or primary care doctor such a big deal?

“If you don’t have a regular or primary care doctor, you could be missing out on a very important relationship with someone in a position to help you stay healthy and live the best life possible.  Over time, a regular or primary care doctor learns all about you and your history. So, choosing one is very important and the right time to find one is when you do not need one for any type of immediate care.”

  1. A regular primary care physician knows us, which is good. But what other reasons are there to have one?

“People with primary care doctors are more likely to get preventive services, including cancer screenings, and report significantly better health care access. According to the Journal of American Medicine, Americans with primary care doctors received significantly more high-value care and reported significantly better health care access and experience. Patients in states that spend more on primary care have fewer hospitalizations and emergency room visits. So, there is no doubt that a regular or primary care physician is an important part of anyone’s health and well-being.”

  1. How does one go about finding a primary care doctor?

“Make sure that the doctor you choose or consider, offers easy access – either by phone, email, telemedicine visit, or office visit. You should shop the price and accessibility in advance so that you are not desperate when a health issue arises. An alternative is to identify a doctor hotline to call in an emergency.”

  1. How does the patient know if he/she can afford care and what is the best way to pay?

“When you make an appointment with a new doctor, ask what the cash price for your initial visit will be and ask to compare it to the discounted price your insurance company has negotiated. You may need to speak to the billing office or the office manager to find this out. A common answer is that it depends on the complexity of your problem. When you hear this ask, ‘can you give me a range from a routine to a complex visit? Can you also tell me what my insurance allows?’ If you have the temperament, you can also try to negotiate a cash price. If you are treated poorly or they refuse to give you this information, find another doctor.”

  1. What should a new patient expect on their initial visit?

“When you first arrive, you will be greeted by a receptionist and given multiple forms to complete in the waiting room. Make sure when you come to the ‘consent for treatment’ form you are not agreeing to any test the doctor orders, but you reserve the right to accept or refuse any test in advance. Then you will be escorted to a room where a medical assistant will record your symptoms, take your vital signs and depending on the doctor’s specialty might wish to perform ‘routine’ tests. You can feel free to question the reason for these tests and have a perfect right to refuse them if you do not understand.”

  1. So, some tests are not really needed?

“Precisely. But it is not because anyone is being dishonest. According to a study in the journal Academic Emergency Medicine, the top two reasons doctors ordered tests was fear of missing something that would help them diagnose their patients, and protection against malpractice. The authors of that survey also say that nearly all of the emergency room doctors—97%—admitted to personally ordering unnecessary imaging tests.”

  1. It’s easy for people to be intimidated by their doctor and not be keen to pose questions. So, to help get us started what should we ask?

“You can ask how the doctor arrived at the diagnosis. You can ask if doing any of the tests ordered will affect his treatment plan and are there alternative ways of arriving at the diagnosis. You can ask about the prognosis and what to expect from treatment including possible side effects and what to expect if the condition is untreated. At the end, send yourself another text when the doctor leaves the room. This will document the time the doctor spent with you and this information can be useful to be sure you are not overcharged, your time with the doctor was adequate and a good value.”

  1. I know my primary care doctor has some lab testing capability in his office and others also have x-ray machines. The convenience notwithstanding, are we obligated to do the tests where the doctor sends us?

“No. There is no need to get testing done at the doctor’s office

or at a facility recommended by the doctor. These prices are almost always better at an independent facility and are usually much better than the insurance company discounted price. Your objective is to be as healthy as possible. But no one should have to go broke in the process.”

More Than Just Another Doctor

A primary care physician is more than just a doctor. Over time, he or she learns the nuances of their patients’ medical history, reaction to medications, health goals, lifestyle, treatment preferences and whether or not a caregiver is supporting you in managing the individual’s health. Nothing is more personal. Paying for it is also personal. The time to check prices and ask questions is early in the process of selecting a doctor, not when arriving in an emergency room. Remember too that those who have a regular or primary care physician will be in better shape because of it.

Conclusion

Listen to the over 50 episodes of the Houston Healthcare Initiative podcast on the website, which is www.houstonhealthcareinitiative.org. Plus, there is lots of other information associated with those podcasts and news coverage about Dr. Goldstein and the work he does with the Houston Healthcare Initiative.

 

The Houston Healthcare Initiative podcast with Dr. Steven Goldstein is an information vehicle for people who want to know all medical options for themselves and are interested in reforming the healthcare industry. To learn more about the Houston Healthcare Initiative please visit www.houstonhealthcareinitiative.org.