Morning-after pill ‘fails in obese’


MorningA French pharmaceutical company has warned a morning-after contraceptive pill may be ineffective in heavier women, following a Scottish study.

Norlevo, made by HRA Pharma, was less effective in women over 11st 3lb (75kg) and ineffective in women over 12st 8lb (80kg), the study suggested.

The US is reviewing guidance as the active ingredient in Norlevo is used in other brands of morning-after pill.

It is thought the drug is absorbed by fat, lowering the dose in the blood.

The study by the University of Edinburgh in 2011 investigated Norlevo’s active ingredient, levonorgestrel.

It indicated obese women taking the emergency contraceptive were four times more likely to become pregnant than women taking the drug who were a normal weight.

The report’s authors recommended other emergency contraceptives were used in overweight and obese women, such as devices that could be implanted into the womb.

Frederique Welgryn, HRA Pharma’s head of women’s health, said the results were “surprising” and had led to “a lot of discussions” about the effectiveness of levonorgestrel.

The labelling on Norlevo is expected to be changed in 2014.

The development has raised concerns about other morning-after pills.

The US regulator, the Food and Drug Administration, said it was “currently reviewing the available and related scientific information on this issue”.-after pill ‘fails in obese’.

HIV response ‘at turning point’


HIV response ‘at turning point’ .
http://www.bbc.co.uk/news/health-25118975

Sucralose’s Splenda Harms Vastly Underestimated.


A new, in-depth review on the synthetic sweetener sucralose (marketed as Splenda), published in the journal of Toxicology and Environmental Health, is destined to overturn widely held misconceptions about the purported safety of this ubiquitous artificial sweetener.

Found in tens of thousands of products and used by millions of consumers around the world, sucralose’s unique ability to dissolve in alcohol and methanol as well as water, makes it the most versatile and therefore most widely used artificial sweetener in production today. And yet, its popularity is no indication nor guarantee of its safety, as is evidenced by the widespread use of other artificial sweeteners like aspartame, which while being safety approved in 90 nations around the world, has been linked to a wide range of serious health conditions including brain damage.

But the tide may be turning…

Already this year, the Center for the Public Interest in Science downgraded Splenda from “safe” to “caution,” citing their need to evaluate a forthcoming Italian study linking the artificial sweetener to leukemia in mice as a basis for their decision.

Another recent human study linked Splenda to diabetes-associated changes, calling into question its value as a non-calorie sweetener for those suffering with, or wishing to prevent, blood sugar disorders.

The new study, however, may be the most concerning yet to surface in the peer-reviewed literature. Titled, “Sucralose, a synthetic organochlorine sweetener: overview of biological issues,” it reveals an extensive array of hitherto underreported safety concerns, not the least of which is the formation of highly toxic chlorinated compounds, including dioxins, when Splenda is used in baking, an application which its manufacturer, McNeil Nutritionals (a subsidiary of Johnson & Johnson), actively encourages it to be used for. [see: Cooking and Baking: SPLENDA®]

A Dizzying Array of Splenda (Sucralose) Safety Concerns That Have Never Been Adequately Tested

The study argues that, despite its widespread approval and use, further scientific safety research is warranted due the following significant findings:

  • “Sucralose alters metabolic parameters and its chronic effects on body weight are unknown”: both animal and human research indicates sucralose may raise blood sugar and insulin levels, indicating it may have diabetogenic properties.
  • “Sucralose alters P-gp and CYP expression”: While classified as a food additive, sucralose’s organochlorine structure indicates it interferes with a wide range of organochlorine class drugs, and activates detoxification pathways and enzymes, in a manner similar to these xenobiotic chemicals.
  • “The metabolic fate and health profile of sucralose metabolites are currently unknown”: Contrary to statements in the research literature that sucralose passes through the body in the feces ‘unchanged,’ metabolites have been detected in the urine and feces of both animals and humans, the nature and health consequence of which have never been studied
  • “Sucralose alters indigenous bacterial balancein the GIT”: Sucralose (delivered as Splenda) has been found to reduce the number of beneficial bacteria in the gastrointesintal tract (e.g., lactobacilli, bifidobacteria), while  increasing the more detrimental bacteria (e.g., enterobacteria). One study found the adverse effects on flora did not return to normal (baseline) after a 3-month recovery period. Sucralose also altered the pH of the gastrointestinal tract.

Finally, and perhaps most importantly:

  • “Numerous toxicological issues regarding long-term exposure to sucralose are unresolved”: 1) DNA damage (genotoxicity), and possible adverse epigenetic alterations. 2) The generation of toxic compounds during baking, including chloropropanols, 1,6-DCF and dioxins. 3) The bioaccumulation of sucralose and/or its metabolites 4) The interaction between sucralose and/or its metabolites with drugs have not yet been studied or evaluated

Cancer-Causing Dioxins and Dioxin-Like Compounds Formed When Splenda (Sucralose) Is Cooked.

Sucralose's (Splenda) Harms Vastly Underestimated: Baking Releases Dioxin

As the reader can plainly see, the picture is a complex one, and there are more unresolved questions than answers. But perhaps the most concerning issue addressed in the report is the ‘Safety of Sucralose That Has Been Heated.’ According to the paper, historically, sucralose was reported to be heat stable at temperatures used in cooking. But they cite a number of reports from independent laboratories showing that sucralose undergoes thermal degradation when heated. One study showed that the stability of sucralose decreased as the temperature and pH increased, with the breakdown process commencing at 119 degrees Celsius and temperatures of 180 degrees Celsius causing its complete degradation at all pH levels with the release of chloride ions.  Additionally, they refer to research showing that sucralose can break down into the following concerning compounds when heated:

  • Chloropopanols are generated when sucralose was heated in the presence of glycerol. Chloropopanols are a group of contaminants that include known genotoxic, carcinogenic and tumorigenic compounds.
  • Other chlorinated compounds formed when sucralose is heated in the presence of food include dibenzo-p-dioxins, dibenzofurans, dioxin-like polychlorinated bisphenyls and polychlorinated naphthalenes.

Chlorinated compounds like dioxins and DDT are notorious for being both highly toxic and resistant to breaking down once released into the environment, which is why they are classified as ‘persistent organic pollutants.’ Splenda was launched in 2000 with tagline “Made from sugar, so it tastes like sugar,” until it retired this slogan in 2007 after settling with its rival, Merisant Co., the maker of Equal, who accused the makers of Splenda of intentionally confusing consumers into thinking its product was more natural and healthier than other artificial sweeteners. Long gone are the days that this artificial sweetener can be marketed as natural, safe and a healthy alternative to sugar. To the contrary, today’s research clearly indicates that sucralose is a toxic chemical that we should go to great lengths to avoid exposure to rather than something we should intentionally add to our food. You will also find a growing body of research that indicates that sucralose not only does not break down in the environment, but survives water treatment plant purification techniques, with the inevitable consequence that it is accumulating in concentrations in our drinking water and the environment that may adversely impact humans and wildlife alike.

The discovery that thermal breakdown through cooking can lead to the formation of highly toxic and equally persistent chlorinated compounds, including dioxins, should raise a series of red flags for consumers, manufacturers and regulators as the information becomes more widespread. A cursory perusal of the World Health Organization’s description of ‘Dioxins and their effects on human health,’ which lists it as belonging to the “dirty dozen” of the world’s most dangerous pollutants, will see what is at stake here.

The Acceptable Daily Intake of Splenda (Sucralose) May Have Been Set 100’s of Times Too High To Ensure Safety

Lastly, an equally concerning issue addressed by the paper is the problem of the acceptable daily intake (ADI). The FDA approved an ADI for humans of 5 mg/kg/day in 1998 based on toxicity studies in rats by determining a no-observed-effect level (NOEL) of 500 mg/kg/day, and then applying a 100-fold safety factor. Since then, research has emerged showing that the NOEL in the microbiome (‘gut bacteria’) of rats for Splenda is actually as low as 1.1 mg/kg/day – 454 times lower than first determined – and 3.3 mg/kg/day for changes in intestinal P-gp and CYP – 151 times lower than first determined. Therefore, if the biological effects of sucralose in rats and humans are the same, or similar, then significant effects would be expected in humans far below the ADI.

For additional research on sucralose’s adverse health effects, visit our research page that collates peer-reviewed research on its toxicological properties. Also, for research on natural sweeteners not associated with these adverse effects, take a look at the following alternatives:

South Africa’s HIV treatment challenge .


The country with the highest number of HIV/AIDS patients struggles to provide medication to its most remote areas.


Earlier this year, when the Pilani health clinic suffered a shortage of the medication used to treat HIV, patients in the village of Ntshilini had to take an hour-long bus ride on a bumpy, mountainous road to the nearest hospital.

“We ended up paying so the nurse could get someone to go and fetch our drugs,” said Boniwe Gxala, a 36-year-old HIV patient from Ntshilini, who had to go weeks without her supply of the life-prolonging drug.

The shortage reportedly occurred because of delayed deliveries from the provincial department of health in South Africa‘s Eastern Cape region.

People are dying here and we have to say, ‘Sorry, we have no medicine’.

– Selena Arends, assistant nurse at Pilani clinic, Ntshilini village

Improving access to treatment and care is the World Health Organization’s focus for the campaign marking the 2013 World AIDS Day, which takes place on December 1. Nowhere is that message more relevant than in South Africa, a country with the one of the highest rates of HIV/AIDS infection in the world.

More than 5.5 million South Africans are living with the disease, comprising 11 percent of the population. Among women of reproductive age, a staggering 20 percent are HIV-positive.

Public health facilities throughout the Eastern Cape, one of the country’s least developed areas, have experienced severe shortages of essential medicines and medical supplies in the past year. A report published on November 5 by the Eastern Cape Health Crisis Action Coalition details what it calls the “crisis in healthcare” in the region.

According to the report, mismanagement by the municipal health department has resulted in stacks of the antiretroviral (ARV) drugs used to treat HIV infection lying in storage while patients are turned away from clinics. “People are dying here and we have to say, ‘Sorry, we have no medicine’,” said Selena Arends, an assistant nurse at the Pilani clinic.

“The impact on [HIV] patients from not taking their medication is huge,” said Marcus Louw of the Treatment and Action Campaign, an NGO that is part of the Eastern Cape Health Crisis Action Coalition. “If you do not take your ARV pills for weeks, your body develops resistance to the drug and you are also at a high risk of HIV-opportunistic illnesses.”

South Africa’s Department of Health said it is unfair to compare the situation in rural parts of the Eastern Cape to the rest of the country. Minister of Health Aaron Motsoaledi pointed out that South Africa distributes more ARV drugs than any other country, with more than 600,000 people per year registering to receive the medication.

“Our health facilities and supplies systems are exploding,” said Motsoaledi. “The yearly increase [of people registering for ARV] cannot come without any problems, so we will see logistical problems.”

According to South Africa’s National Treasury, the government spent 22.2bn rand ($2.17bn) on HIV in 2012/13. Five billion rand ($491m) came from donors.

Some data show that South Africa’s ARV distribution programme is improving. For instance, according to the National Antenatal Survey, the number of people receiving ARV drugs has increased in the past four years from 923,000 to 2.4 million people, while the number of clinics and hospitals offering the medication has climbed from 490 to 3,540 facilities countrywide.

Yet distributing the drugs has been a challenge. In one case, corrupt health officials at the Esselen Street clinic in Johannesburg stole ARV pills – which are meant to be available to patients at no cost – and sold the medication to them instead.

The HIV medication has also been used as an ingredient in a street drug called “nyaope” or “whoonga”. This cheap, potent mixture of heroin, marijuana and crushed ARV pills has become popular in impoverished townships, according to some accounts. Recently, armed heroin addicts broke into a doctor’s office in Soweto to steal ARVs.

“Two men came in with guns, ordered me to close my eyes, kneel down, emptied my pockets and they said they do not want my car – all they want is the key to the medication cabinet,” said Dr Mngoma Zulu, adding that he is not the only doctor in the area to have such an experience.

However, Cathy Vos of the South African National Council on Alcoholism and Drug Dependence said the story of people getting high on ARVs has been blown out of proportion, and that heroin use is a much bigger problem.

Drug addicts are not the only ones trying to get their hands on ARVs for illicit purposes. Smugglers are on the prowl, too. Cross-border syndicates deal in a variety of medications, including ARVs, selling them in neighbouring countries such as Mozambique, Lesotho and Zimbabwe, according to a spokesman for the premier of Kwazulu Natal province.

The South African government has made major investments to provide ARV pills to the many people who rely on the drug for their survival. Progress has been achieved, but as the international community marks another World AIDS Day, there are still many HIV patients who cannot be sure that next month they will have their medication.

Metabolic acidosis causes cancer, diabetes and premature death.


Cancer, chronic fatigue, diabetes, osteoporosis plus many other degenerative diseases are caused by ‘metabolic acidosis.’ Is your body pH slightly alkaline? If not, this is a serious health condition – that needs to be addressed immediately.

Shocking ‘sick care’ statistics! The top 10 reasons for seeing a doctor include: skin disorders like acne; joint problems; back aches; cholesterol issues; upper respiratory conditions; depression; neurological disorders; hypertension; headaches and diabetes. Do you see a common thread to all these health problems?

Most health-related problems are directly connected to being too acidic. On the next NaturalNews Talk Hour, Jonathan Landsman and Susan Smith Jones, Ph.D. will talk about how to prevent metabolic acidosis and, literally, eliminate the need for (most) doctor appointments.

A wake up call for conventional medicine – most health problems have a simple solution

The typical American diet involves too much animal protein, processed grains – in the form of bread and pasta plus lots of sugar and artificial ingredients. This toxic sludge places stress on the immune system and kidney function. Eventually, as the body becomes more and more acidic, we experience disease and premature death.

It’s such a shame – when you think about it – how easy it would be for doctors to tell people the real cause of their dis-ease. Simply put, eating too many acid forming foods will lower the pH of your bodily fluids and cause a host of serious health problems like de-mineralization of the bones. But I guess that advice would piss off the pharmaceutical industry which profits greatly from the ignorance of the general public – and medical profession.

Tune in to the next NaturalNews Talk Hour and find out how to alkalize your body and prevent disease. Visit: http://www.naturalhealth365.com and enter your email address for show details + FREE gifts!

Does your family physician talk about the value of ‘pH balancing’ and emotional wellbeing?

Ideally, the pH of our blood should be around 7.35 – 7.45 or slightly alkaline. This balance is so delicate – believe it or not – when the pH drops below 7.0, you could slip into a coma and die. If your pH is too high, you could experience a life-threatening seizure. Along with a poor diet, previously mentioned, emotional stress and toxicity issues (i.e. heavy metal poisoning) can cause pH imbalances which decrease cellular energy and increase the risk of disease.

But, when it comes to the ‘right’ diet, it can be a bit confusing for the general public. For example, citrus fruits – which are acid by nature – actually have an ‘alkalizing effect’ on the body. In fact, many ‘acidic’ vegetable juices – like, carrot/apple juice – are quite alkalizing in its effect. Conversely, most animal meats are alkaline – before consumption – yet cause lots of acidic residue in the digestive process. Interestingly, when it comes to emotions and lifestyle habits, meditation, prayer, peaceful thoughts, kindness and love are alkalizing. And, quite the opposite effect, being overworked, angry, feeling fearful, jealous or ‘stressed out’ can make you too acidic.

If you’re suffering with any chronic health problem – find a healthcare provider with experience in balancing pH levels and don’t miss the next NaturalNews Talk Hour.

This week’s guest: Susan Smith Jones, MS, Ph.D., world renowned author and health consultant

Find out how to reverse acidity and stop disease with nutrition and supplements – Sun. Dec. 1

Susan Smith Jones, MS, Ph.D. has certainly made extraordinary contributions in the fields of holistic health, anti-aging, optimum nutrition and balanced living. For starters, she taught students, staff and faculty at UCLA how to be healthy and fit for 30 years! Susan is the founder and president of Health Unlimited, a Los Angeles-based consulting firm dedicated to optimal wellness, health education and human potential.

Susan travels internationally as a frequent radio and TV talk show guest and motivational speaker; she’s also the author of over 25 books, including “Recipes for Health Bliss”, “The Healing Power of NatureFoods” and her latest “Walking on Air: Your 30 Day Inside and Out Rejuvenation Makeover”.

Stop metabolic acidosis! Too much acidity causes weight gain, diabetes, free radical damage, premature aging, poor brain function, heart damage and a lack of oxygen to every cell in our body. Find out how to maintain a healthy pH balance and reverse chronic health problems – naturally.

Comet ISON May Have Survived Encounter With Sun, Scientists Say.


A comet that gained an earthly following because of its bright tail visible from space was initially declared dead after essentially grazing the sun. Now, there is a silver of hope that Comet ISON may have survived.

New images, basically faint smudges on a screen, being analyzed Friday showed a streak of light moving away from the sun that some said could indicate it wasn’t game over just yet.

“It certainly appears as if there is an object there that is emitting material,” said Alan Fitzsimmons, an astronomer at Queens University in Belfast, Northern Ireland.

Basically a dirty snowball from the fringes of the solar system, scientists had pronounced Comet ISON dead when it came within 1 million miles (1.6 million kilometers) of the sun Thursday.

Some sky gazers speculated early on that it might become the comet of the century because of its brightness, although expectations dimmed over time. But it wouldn’t be all bad news if the 4.5-billion-year-old space rock broke up into pieces, because some scientists say they might be able to study them and learn more about comets.

The European Space Agency, which had declared ISON’s death on Twitter late Thursday, was backtracking early Friday, saying the comet “continues to surprise.”

Comet ISON was first spotted by a Russian telescope in September last year, and became something of celestial flash in the pan this week for its vivid tail — visible by the naked eye — and compelling backstory of impending doom.

The comet was two-thirds of a mile wide as it got within 1 million miles (1.6 million kilometers) of the sun, which in space terms basically means grazing it.

NASA solar physicist Alex Young said Thursday the comet had been expected to show up in images from the Solar Dynamics Observatory spacecraft at around noon eastern time (1700 GMT), but almost four hours later there was “no sign of it whatsoever.”

Images from other spacecraft showed a light streak continuing past the sun, but Young said that was most likely a trail of dust continuing in the comet’s trajectory.

comet ison

However, instead of fading, that trail appeared to get brighter Friday, suggesting that “at least some small fraction of ISON has remained in one piece,” U.S. Navy solar researcher Karl Battams wrote on his blog. He cautioned that even if there is a solid nucleus, it may not survive for long.

Two years ago, a smaller comet, Lovejoy, grazed the sun and survived, but fell apart a couple of days later.

“This is what makes science interesting,” said Fitzsimmons, who specializes in comets and asteroids. “If we knew what was going to happen, it wouldn’t be interesting.”

ISON’s slingshot toward the sun left astronomers puzzled and excited at the same time.

Made up of loosely packed ice and dirt, the space rock came from the Oort cloud, an area of comets and debris on the fringes of the solar system.

Baby Dinosaur Skeleton Unearthed in Canada.


The tiny, intact skeleton of a baby rhinoceroslike dinosaur has been unearthed in Canada.

The toddler was just 3 years old and 5 feet (1.5 meters) long when it wandered into a river near Alberta, Canada, and drowned about 70 million years ago. The beast was so well-preserved that some of its skin left impressions in the nearby rock.

The fossil is the smallest intact skeleton ever found from a group of horned, plant-eating dinosaurs known as ceratopsids, a group that includes the iconic Triceratops.

 Rare find

Finding intact baby dinosaurs is incredibly rare.

“The big ones just preserve better: They don’t get eaten, they don’t get destroyed by animals,” said study co-author Philip Currie, a paleobiologist at the University of Alberta. “You always hope you’re going to find something small and that it will turn out to be a dinosaur.”

Paleontologists had unearthed a few individual bones from smaller ceratopsids in the past. But without intact juvenile skeletons, such bones aren’t very useful, as scientists don’t really know how each bone changes during each stage of the animals’ lives, Currie said.

The team was bone-hunting in Dinosaur Provincial Park in Alberta when Currie came upon what looked like a turtle shell sticking out from a hillside. Upon closer inspection, the fossil turned out to be a frill, the bony decorative headgear that surrounds the back of the head in ceratopsids.

When the team excavated, they found the fossilized skeleton of a tiny dinosaur they identified as a Chasmosaurus belli, a species commonly found in the area.

Drowning victim

Amazingly, almost the entire skeleton was intact, although sometime in the past, a sinkhole had opened up below the beast and the forelimbs had fallen away into an abyss. The fossil was so well-preserved that the tiny, rosettelike pattern on its skin was imprinted in the rock below the dinosaur.

Based on its size, the team estimates the dinosaur was about 3 years old — just out of infancy — when it perished. (Like humans, these dinosaurs typically take about 20 years to reach maturity, at which point they have 6.5-foot-long [2 meters] skulls and weigh 3 to 4 tons.)

The fossil was found in sediments associated with watery environments and didn’t have any bite marks or trace of injury, so it’s likely the dino toddler likely drowned.

“I think it may have just gotten trapped out of its league in terms of water current,” Currie told LiveScience.

Soon after, the baby dinosaur was buried by sediments and left untouched for millions of years.

Growth rates

Aside from being cute, the new fossil helps paleontologists understand how these plant-eating dinosaurs grew. Paleontologists can then better identify and age the myriad individual bones from juveniles discovered over the years.

Already, the team has learned that Chasmosaur juvenile frills look different from those on adults, and that limb proportions don’t change much as they grow. Predatory theropods such as Tyrannosaurus rex have disproportionately long limbs as juveniles, presumably to keep up with the adults in the pack.

By contrast, “in Chasmosaurians, the proportions are essentially the same, which probably means the adults were probably never moving that fast,” Currie said. “There was never priority for these animals to run to keep up with the adults.”

Mutant Fukushima Fruit & Vegetable Pictures Go Viral


http://www.naturalcuresnotmedicine.com/2013/11/mutant-fukushima-fruit-vegetable.html?m=1

How Natural Desiccated Thyroid puts T4-only Medications in the


Over 110 years ago, thyroid patients and their doctors knew about and used Natural Desiccated Thyroid (NDT) for their hypothyroidism successfully, whether it was made from pig or sheep glands. And it worked beautifully for the next seven decades because it provided the same hormones one’s thyroid would be making: T4, T3, T2, T1 and calcitonin.

How Natural Desiccated Thyroid puts T4-only Medications in the Garbage Can

The Hoodwink!

Fast forward to 1963 when a so-called large batch of NDT hit the US and UK market, but it wasn’t thyroid at all. It was simply a hoax, as stated in the 1970 4th edition of Pharmacological Basis of Therapeutics. And it caused all sorts of consternation in medical journals, as well as a strong promotion towards the “new and modern”  synthetic T4-only medication, aka Synthroid (http://www.synthroid.com/), then made by Knoll Pharmaceuticals. (http://en.wikipedia.org/wiki/Knoll_Pharmaceuticals)

And the switch began en masse. Doctors were now encouraged to treat their patients with the new-fangled T4-only, whether Synthroid or many other brands which cropped up over the years, such as Levoxyl, Oroxine, Eltroxin and more. T4 is a thyroid storage hormone meant to convert to the life-giving T3, aka Triiodothyronine (http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=5920).

But the poop began hitting the fan, as many patients then and now discovered that the body is not meant to live for conversion alone, i.e. T4-only treatment misses the direct T3 that a healthy thyroid would be giving. All too many T4-treated patients worldwide report a continuation and/or worsening of their hypothyroid symptoms in their own degree and kind, whether from the beginning or the longer they stay on T4.

What happens while on T4?

It’s not a pretty picture. Globally, thyroid patients on T4 report all-too-many symptoms of their hypothyroid state while on T4, either from the beginning or cropping up the longer they stay on it. (http://www.stopthethyroidmadness.com/long-and-pathetic) Those symptoms include, but are not limited to:

  • Depression
  • Anxiety
  • Fatigue
  • Irritability
  • The need to nap
  • Lack of stamina
  • Poor recovery from activity
  • Dry skin or dry hair
  • Joint aches and pains
  • Feeling cold
  • Rising blood pressure
  • Rising cholesterol
  • Heart issues
  • Constipation or hard stools
  • Air hunger
  • Brain fogginess

Even worse, all too many T4-only treated patients end up with the misery of low cortisol (http://www.stopthethyroidmadness.com/adrenal-info), low iron, low Vitamin D, low B12 and more—all due to the inadequacy of the treatment.

 

Six Rules Doctors Have To Know.


Rule 1: They don’t want to be at your office.

It may seem odd to patients, but most doctors forget that going to the doctor is generally unnerving. We work there, and being in a doctor’s office is normal to us. Not so with most patients. The spotlight is on them and their health. They stand on the scale, undress, tell intimate things about their lives, confess errors, are poked, prodded, shot with needles, lectured at, and then billed for the whole thing….There is always an underlying fear and self-consciousness that pervades when a person is sitting on the exam table. The best thing to do in response to that is to show compassion.

Rule 2: They have a reason to be at your office.

They don’t come to the office to waste the doctor’s time. Yet early in my training I was incredulous at the reasons some of my patients were coming to see the doctor. Why come in for a headache? Why come in for a cold?…It took me being in my own practice (and trying to keep my business going) to realize that there is (almost) always an underlying reason for a patient to come in. Sometimes that reason is simple: they have terrible pain that needs to be treated. Other times, however, the reason is more subtle. When a person comes to my office with enlarged lymph nodes, for example, the real reason they are coming in is that they are afraid it is cancer. If a person has chest pains, they are afraid it is their heart. On every visit I try to identify the real reason (or the real fear) that brings them to see me. I don’t end the visit until I have addressed that reason.

Rule 3: They feel what they feel.

Patients will often tell me their symptoms in a very apologetic tone. They seem to think that they have to come to me with the “right” set of symptoms, and not having those symptoms is their fault. Sometimes those symptoms make no sense to me at all, and I am tempted to dismiss or ignore them. But as a physician, you have to trust your patient….Yes, some may exaggerate what they feel out of anxiety or out of fear that you won’t hear them for lesser symptoms, but then your job is to uncover the anxiety, not ignore the complaint. I have heard from many patients that their doctor “did not believe” their complaints because they did not make sense. If you don’t trust them, why should they trust you?

Rule 4: They don’t want to look stupid.

People are often worried that they are over-reacting. They wonder what I must think for a person to come to the office with that symptom. This is especially true of parents bringing their children in. Nobody wants to be “that mother that over-reacts to everything.” In response to this, I try to specifically say, “I am glad you came to the office for this because…” or “Yeah, I can see how that worried you because it could be….”

Rule 5: They pay for a plan.

What do people pay for when they come to the medical office? They pay for opinion, yes. They pay for knowledge as well. But what they really pay for is a plan of action….They want to know what is going to be done to help. I try and give a plan, either verbal or written, to each patient that walks out of the exam room. What medications are given and why? What medications are to be stopped? What tests are ordered and what will the results mean? When is the next appointment? What should they call for if they have problems? The better I can answer these questions, the more confidently the patient will walk out of the exam room. The days of paternalistic medicine are over – no handing a prescription and just saying “take it.” Patients should know why they are putting things in their body.

Rule 6: The visit is about them.

With all of the stresses in a doctor’s office, I get tempted to complain about things. Who better to complain to than someone who feels much the same way? But patients are paying for you to take care of their problems, not the reverse. I keep my personal gripes or frustrations to myself as much as possible.

http://www.doctorshangout.com/m/blogpost?id=2002836%3ABlogPost%3A902726