A 2009 study published by the New England Journal of Medicine analyzed almost 12 million Medicare beneficiaries and found:

• 20% of patients were readmitted within 30 days of discharge
• 34 % of patients were readmitted in 90 days of discharge
• 67.1% of patients percent were readmitted one year after discharge or had died

This revolving door effect cost Medicare $17.4 billion dollars in 2004 and the problem continues to escalate.

Medicare is responding by collecting data on all hospitals and will keep a running three-year average on readmission rates. Those hospitals having high rates will be financially penalized.

According to a Medicare Payment Advisory Commission study, 75 percent of all 30-day hospital readmission are preventable and if they can be avoided, the quality of patient care will improve. Higher rates of hospital readmission are associated with infections and other complications acquired by patients during hospital stays.

In a pilot project in which hospitals were paid bonuses and held accountable for better outcomes and less bounce backs, quality improved and readmission rates fell substantially.

The cause for patients having to readmit patients after a hospital stay seems to fall into one of the following categories:

1. Lack of communication between patient and doctor
2. Complete lists of medications missing from patients
3. Follow-up appointments were never made or communicated
4. Wound care or other instructions were confusing or never received
5. No official hand-off from one physician to another
6. Insufficient monitoring of patients after discharge — especially regarding medications

Medicare does not currently pay hospitals for monitoring or mentoring patients after discharge.

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According to the American Society for Aesthetic Plastic Surgery, more than 90 percent of women had some type of cosmetic procedure and 1.5 million involved surgery. The most popular procedures included breast augmentation, liposuction, eyelid surgery, rhinoplasty, and abdominoplasty.

Psychologist, Vivian Diller, Ph.D., says that women need to ask themselves several questions before undergoing any type of cosmetic procedure:

“I use the acronym S.A.F.E to help women make good choices regarding cosmetic procedures,” says Diller. “I encourage my clients to think about these four issues, safety, affordability, for whom, and expectations, before undergoing any procedure. I tell them that they need to make sure they feel good about themselves on the inside and not use surgery as a magic wand,” adds Diller. “Use the acronym S.A.F.E. to remember to ask the right questions before you have cosmetic work done on your face or body.”

Of course safety should seem like a no-brainer, but many women are hesitant about doing the most basic research on cosmetic procedures or on the doctors they choose to perform the surgery. Women also forget to find out about the anesthesiologist. They can be the most responsible person that makes sure you stay alive during your procedure.

Dr. Jon LaPook, medical correspondent for CBS Evening News says, “Anesthesiologists are more than just the person who controls pain during the procedure. He or she is responsible for keeping your blood pressure, pulse, and oxygen level at the proper levels and for resuscitating you if something goes wrong.” According to LaPook it is up to the anesthesiologist, not the surgeon, to decide if the surgery is medically cleared.

“There are two main reasons why an anesthesiologist should recommend canceling an elective procedure,” says LaPook. “One would be if the patient is medically too sick to undergo surgery and the risks outweigh the benefits (i.e. the person has out of control diabetes and blood sugar levels are too high), and two, the anesthesiologist feels the procedure is not indicated, but that is rarely the case with cosmetic surgeries,” comments LaPook. “When everybody else, surgeon included, are swept up in a decision to do a procedure that’s not in the best interest of the patient, the anesthesiologist represents one last chance for somebody to speak up and say, ‘not on my watch.’ It would be a nice safety net for the patient.”

Most surgeons are extremely open and thoughtful to answering questions their patients may have, but studies show that many procedures would never be done if all the options, including doing nothing at all, were properly explained. “Think carefully about what you hope to accomplish,” advises psychologist Vivian Diller. “Some women are unrealistic about cosmetic surgery. They are shown before and after pictures that look transforming but lack credibility. Plastic surgery can do marvelous things for those who have realistic expectation, but magic it is not,” warns Diller. “It does not make an older woman young, nor does it necessarily transform a woman’s appearance. The most satisfying surgeries are the ones that make small changes that result in a refreshed and healthier looking appearance.”

Women unfortunately rely on magazine ads, friends, or no information at all when deciding to go ahead with cosmetic surgery, a decision that can have permanent ramifications on their lives. Before undergoing any procedure it is important that you ask the surgeon or dermatologist if they are board certified and if the procedure is FDA approved. You should also list personal questions relating to the procedure, and have the doctor relay the pros and cons of it. Questions may include how long will the benefits last? Will there be pain? Do I need anesthesia? How long is my recovery time and can anything be done to avoid bruising or speeding up the recovery? How many years has the procedure been done?

Cosmetic surgery is a personal decision, and only you, not your friends, not your family, not your doctor, have to live with the results. When it comes to your body, your face, and the aging process, treat it like any other important decision in your life.

Take the time to really get the facts and understand what you are doing before going under the knife.

Did you know that the day you were injured, through the negligence of another, you entered a potential red zone? Did you know that your ability to get treatment and compensation may rely on the competence and honesty of insurance company employees?

The insurance industry has spent billions of dollars over the past 30+ years to spread and foster false and misleading information about injury claims.

The insurance industry needs people to believe that the justice system is out of control.

The insurance industry needs the public to believe that people who file lawsuits are getting millions of dollars for minor injuries.

The insurance industry needs you to believe that there are no checks or balances in the judicial system to guard against the flood of “frivolous” law suits.

This is nothing more than propaganda, canards, untruths …in plainer language, lies. The key to propaganda is to make the message simple; give people “someone” to blame; and repeat the message over and over, again and again.

Propagandists will typically select a single isolated event, (such as the McDonald’s case) to represent the idea that insurance companies and corporations are the real victims. Certain facts will be selected to include in the propaganda, but not all the facts; only enough information to paint just the picture they want the public to see. These repeated messages create the false perception among the public that the system needs fixing. Unfortunately, this “misinformation” spread by the insurance industry has had a noticeable and negative influence on juries and their verdicts.

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One of the largest studies to examine the dangers of belly fat suggests that women and men with large waistlines are twice as likely to die younger than their smaller waistline friends. The study, funded by the American Cancer Society, showed that bigger waists carry a greater risk of death even for people whose weight is “normal” on a BMI (body mass index) standard.

The study appeared recently in the Archives of Internal Medicine and is the first of its kind to study waist size and death from too much belly fat. In the three groups of normal, overweight, and obese; waist size was linked to a higher risk of death. The study showed that even four extra inches around the waist increased the risk of dying from between 15 percent to 25 percent. People with bigger waistlines also had a higher risk of death caused by respiratory illness, heart disease, dementia, asthma, and cancer.

“Even if you haven’t had a noticeable weight gain, if you notice your waist size increasing that’s an important sign,” said lead author of the study Eric Jacobs of the American Cancer Society. “It’s time to eat better and start exercising more.”

For years doctors have used BMI indexes to gauge health and body fat and now are finding that BMI isn’t the only indicator of how healthy a person is. They are finding that BMI is only an indication of body fat in general, and it does not take into account where that excessive fat is, which is where the real dangers lie.

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Are 1993 – 2004 model years of Jeep Grand Cherokees killing people?

Is Chrysler’s handling of the potential problem with the Jeep Grand Cherokee eerily reminiscent of Ford’s Pinto?

Did Chrysler also consult the “bean counters” to determine what a recall would cost them as that relates to the total cost of deaths from their product?

Was it cheaper to risk lives than institute a recall?

The National Highway Traffic Safety Administration has instituted an investigation to determine whether the design and positioning of the Grand Cherokee’s fuel tank may be causing unnecessary fires and resulting in deaths by drivers of the 1993 – 2004 Jeep Cherokee.

The Grand Cherokee was on the Car and Driver list of the Ten Best models in 1993 and was Motor Trend’s Truck of the Year for 1993. It also was Peterson’s 4×4 in years 1993, 1996, 1999, and 2001.

In October of 2009, though, the Center for Auto Safety filed a petition with the National Highway Traffic Safety Administration, including a detailed analysis of the design and placement of the gas tank in 1993 – 2004 model Grand Cherokees.

The petition included the following grisly statistics:

• 172 fatal fire crashes involving the Grand Cherokee
• 254 fatalities

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I am asked quite frequently to evaluate supplements cases and thought I would share some information that I have found to be helpful and provide some things to consider.

The following supplements can be very dangerous and I recommend they be avoided. Supplements, which combine these and other ingredients into multi-ingredient supplements, are even worse.

• Aconite
• Bitter Orange
• Chaparral
• Collodial Silver
• Coltsfoot
• Comfrey
• Country Mallow
• Germanium
• Greater Celandine
• Kava
• Lobelia
• Yohmbe

From a litigation perspective, the insurance companies for manufacturers of these compounds are likely to have meticulously excluded cases involving the supplements contained on this list from coverage. Pursuing shell companies without insurance coverage does not, in any way, benefit a client injured by these products.

Being successful in these cases requires very diligent work and insight into these very specialized products is needed. The research is very time consuming when done by even the most knowledgeable people.

The FDA warning to manufacturers relating to misbranding is much like pursuing Al Capone for tax evasion in order to put him in prison for much worse things. A misbranding announcement is the “siren call” for much bigger problems in most cases.

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What do you get when you combine a narrow wheel base, a narrow turning radius, a high center of gravity, and a powerful engine? Add to this combination a vehicle that was marketed to be operated on rough, uneven terrain.

You get vehicle rollovers and severe injuries. Not too terribly difficult to predict, right?

A Yamaha Rhino.

System Engineering and Laboratories tested the Rhino on a “completely flat area” at approximately 13 mph, with devastating results:

The “back story” on vehicles such as the Yamaha Rhino starts with their designation: “UTV” or utility terrain vehicle, as opposed to an “all” terrain vehicle. At the time the Consumer Products Safety Commission had no regulations for this new “utility terrain vehicle”. These vehicles were the first vehicles with side-by-side seating for occupants and designed for off road use. The Rhino design included a high center of gravity and an engine, which propelled occupants at up to 40 mph.

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The Yamaha Rhino UTV litigation continues to progress in federal and state courts. Currently, there are nearly 300 individual lawsuits pending in the federal MDL court in Kentucky as well as approximately 130 cases filed in consolidated state court proceedings in Georgia and 174 cases in California.

All of the cases pending in the federal court system were transferred to Judge Jennifer B. Coffman in February 2009, after the Judicial Panel on Multidistrict Litigation determined that central coordination of the cases would be in the best interest of the court system as well as the parties.

This multi-district litigation (or MDL) process is a common method for dealing with a large number of individual lawsuits pertaining to the same defective product or disaster. Prior to establishment of this MDL (No. 2016), there were 55 individual lawsuits pending before 33 different federal court judges around the country. This diversity of geography and judicial resources proved to be causing significant administrative inefficiencies and permitted the manufacturers multiple opportunities to delay cases and avoid disclosure of critical evidence.

Judge Coffman in Kentucky continues to preside over the federal MDL cases. The first trial in federal court was initially scheduled for October of 2010, but that date has now been postponed to January of 2011. The other 8 federal trials should occur in 2011, after completion of the first trial.

The first trial is part of the MDL “bellwether trial process,” which will allow the judge and the parties to refine a number of generic issues relating to the sufficiency of expert testimony, admissibility of evidence, and resolution of a number of generic legal issues, which will have an impact on all the pending cases. The first cases scheduled for trial were selected from those filed long before 2009. Discovery efforts, including production of documents and the completion of depositions of fact and expert witnesses, continue as well.

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Every day on TV, we are bombarded with advertisements urging us to purchase numerous prescription and over-the-counter drugs that will cure everything that ails us (and even cure diseases and conditions unknown or non-existent prior to drug company marketing efforts).

Do these medications really work?

Do they cause more harm than good to our well-being?

Do the risks outweigh the benefits?

Are there some bothersome conditions that should be tolerated and accepted rather than treated with medications?

The number of medication-related injuries and deaths in the U.S. are estimated at over 1.5 million per year, making medications one of the leading causes of death according to a 2006 report from the Institute of Medicine of the National Academies.

Dr. Leo Galland, M.D., a practicing physician and noted medical author, says that not all medications are created equal and that many have serious side effects that the manufacturers failed to adequately disclose to the FDA prior to approving them for marketing.

Dr. Galland believes that a number of common medications can be hazardous to your health.  For example, nonsteroidal anti-inflammatory drugs (NSAIDs), which include over-the-counter drugs such as aspirin, ibuprofen, and naproxen (also known as Aleve), cause a number of serious injuries and deaths each year.  Dr. Galland’s studies have found that these drugs relieve pain and inflammation by blocking an enzyme called cyclo-oxygenase (COX), but at what cost?

“Although COX activity contributes to pain and inflammation, this enzyme also performs important functions such as protecting the stomach from the corrosive effects of its own acid, regulating circulation of blood to the kidneys, and modulating the activity of the immune system,” says Dr. Galland. “Almost all drugs today are intended to act like biochemical strait jackets which suppress cellular functions that appear to be overactive,” adds Dr. Galland. “They also interfere with the natural and healthy functions of the body. It is like throwing a wrench into a sophisticated machine in an effort to fix it.”

The net result of disturbing this delicate balance in the COX enzymes is that a number of patients suffer life-threatening gastrointestinal bleeding and ulcers as well as renal failure and other significant health problems as a result of ingesting these popular drugs.

The manufacturers of Vioxx sought to build a better mousetrap – a pain killer that was as effective as other popular NSAIDs without blocking Cox-1 enzymes and thereby causing bleeding issues.  In doing so, however, Vioxx caused other disturbances to the COX system that rather than causing ulcers, instead caused pro-thrombotic events that led to heart attacks and strokes.  “What scientists behind the creation of Vioxx failed to recognize is that all forms of the COX enzyme are important for health,” says Dr. Galland.

Many physicians are now recommending proper nutrition, which when used properly, can achieve results that drugs cannot, because nutrients are essential components of the cellular information network in our bodies.

“The regular use of Omega-3 fatty acids in the diet is an excellent example of how the cells of our body use the Omega-3’s to make powerful chemicals that help to maintain normal cell function under conditions of stress,” advises Dr. Galland.

Omega-3 fats provide an alternative to drug therapy for controlling inflammation in the body, a natural process that, when excessive, can lead to cancer and disease.

Patients who change their diets and decrease their consumption of foods that interfere with the anti-inflammatory effects of Omega-3 fats experience less inflammation and therefore have fewer needs for anti-inflammatory drugs.  These dietary changes include reduced intake of red meats and foods that contain certain oils (including corn, sunflower, soybean, safflower or cottonseed oil).  Dr. Galland recommends using olive oil or flax oil as a substitute.

“Making nutrition a cornerstone of everyone’s healthcare has been my longstanding goal and is the first step in real healthcare reform,” adds Dr. Galland. “Moving from a system based on treating symptoms to a system for achieving optimal health will enable healthcare to achieve its true potential.”

One can only hope that our healthcare system takes these maxims to heart, pardon the pun, and seeks to encourage an increase in the healthy foods placed in our grocery cart each week and a decrease in the number of pill bottles placed in our medicine cabinet.

Vitamin water – sounds healthy, huh?

The drink is sweeping the nation, touting claims of being a healthy beverage. However, how much do we really know about these vitamin drinks?

Coca-Cola is being sued by a non-profit public interest group, the Center for Science in the Public Interest, who alleges that vitamin water labels and advertising are filled with ‘deceptive and unsubstantiated claims.’ Coca-Cola is defending itself by agreeing that vitamin water isn’t a healthy product. They are also arguing that people shouldn’t believe their advertising message that vitamin water is a healthy product because no one could possibly believe such a ridiculous claim.  Glaceau is the company who created and marketed the vitamin water and Coca-Cola bought it in 2007 for about $4.1 billion. Coca-Cola reportedly sells over $350 million a year.

So what are the facts about vitamin water? First, the ingredients are listed by Coca-Cola on a “per serving basis” and a serving amounts to less than half a bottle. Since few are going to drink just half the bottle – multiply everything times two plus.

A bottle of Vitaminwater contains 33 grams of sugar, making it more like a soft drink than water. It also means that, in one consumable you are getting the maximum amount of daily sugar recommended in dietary guidelines. With 35 percent of Americans now morbidly obese and 23.6 million with diabetes, health experts will agree that sugars play a key role in health.

Vitamin waters also contain about 122 calories per bottle compared to 140 calories in a regular soda. So if you are watching your calories, you might want to skip the vitamin water and just drink regular water. Plus you don’t get all the sugar.

The name “vitamin water” is simply misleading for consumers looking for weight-loss remedies or for health benefits from vitamins. Whether Coca-Cola likes it or not, the drink is essentially sugar water and a few water soluble vitamins. Do not expect it to replace your multi-vitamin.

Coca-Cola has spent billions of dollars investing in its vitamin water line and has numerous celebrities endorsing the drink such as basketball stars Kobe Bryant and Lebron James. Rap star 50 Cent endorses the water and also owns 10 percent of the product. He even has a product named after him “formula 50.”  These endorsements only serve to confuse and mislead the public about the health benefits of the drink. The products are also strategically placed on grocery store shelves right by regular bottled waters. So with super stars endorsing the product and billions being spent to convince you that it is a healthy drink, it is important that the truth be told about these expensive, enhanced waters.

So, what is the answer? Drink water – just plain ol’ water. 

Why? Because we ARE water and we need to be regularly replenished with it. Look at the facts:

• Our bodies: 60 – 70% water
• Our brains: 80% water
• Our blood: 90% water
• Our livers: 97% water

John Robbins, author of “The New Good Life, Diet for A New America,” writes, “Why do we allow companies like Coca-Cola to tell us that drinking a bottle of sugar water with a few added water-soluble vitamins is a legitimate way to meet our nutritional needs?”

If you need some extra flavor in your water, try adding fruit, or honey to a quart of water.  Green tea is also a great alternative with lots of health benefits. “A plant-strong diet with lots of vegetables and fruits will provide you with what you need far more reliably, far more consistently, and far more honestly,” advises Robbins.