Bring on the Vitamin D

The much-anticipated report from the Institute of Medicine released in November, 2010 boosted the recommended daily value of vitamin D from 200 IUs (international units) to 600 IUs. Many doctors are surprised that the suggested intake wasn’t set even higher. Over the past year, blood tests for vitamin D have become standard with annual physicals, consumers have begun spending over $400 million per year on vitamin D supplements, and “sunshine vitamin” deficiency has made the headlines time and time again.

What exactly do we need so much vitamin D for? Because of its interaction with calcium, vitamin D is critical to the growth and maintenance of strong bones. Vitamin D deficiencies can also lead to diabetes, heart disease, stroke, and depression. With rising concern over UV exposure, Americans aren’t getting enough vitamin D the natural way – by spending time in the sun. The new standard suggests that we consume 600 IUs daily through the age of 70 and 800 IUs per day after that. If you spend very little time outdoors, or live in a region where the sunlight is rarely intense, you may need to increase your vitamin D intake to as much as 4,000 IUs per day.

Very few foods naturally contain vitamin D. While you can get some vitamin D by eating fish, mushrooms, eggs, and meat, your best bet is to drink extra milk, which is fortified with 40 IUs of vitamin D per cup.

You can expect to see the effects of the new Institute of Medicine recommendations on food labels in the coming months. School lunch menus and any federally sponsored nutrition programs will also be redesigned.

Ultimately, the optimal level of vitamin D has yet to be determined. Some health groups advocate a 30 ng/mL level (as measured by blood tests), while the Institute of Medicine is only recommending 20 ng/mL. Some caution needs to be taken, as there are risks associated with extremely elevated vitamin D levels in the blood. At 50 ng/mL, there is a greater chance of developing pancreatic or prostate cancer, and kidney damage has been observed in those using supplements to reach a 10,000 IUs daily vitamin D level. The available data are simply inconclusive, and the Institute of Medicine is waiting on several long-term studies before they reevaluate their nutritional guidelines.

Let’s Get Healthy!

 

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Sometimes You Just Need a Doctor

The average wait time at doctors' offices in the United States is 24 minutes, according to a report released in 2010 by Press Ganey, a group that researches health care performance. Unfortunately, some wait times can be as much as an hour or more! Yesterday, I read an article featuring patients that are actually starting to bill their doctors for their wasted time! Elaine Farstad, in particular, waited over 2 hrs for her doctor! She said “If you waste my time, you’ve bought my time!”. She billed her doctor....and actually received $100 check from him- the full amount she requested! This trend is catching on as some doctors are actually giving gifts from $5 bills to $50 credits, for causing their patients to wait past their set appointment time...I guess my doctors are behind the trend here…..hopefully they will read this and catch on! All things aside, it’s not fun to waste your time (and prolong your recovery), waiting in your physician’s office, Urgent Care, or the ER.

Here are the grim facts about wait time:

·         The longer an ill patient has to wait to see a doctor, the greater the chance their sickness will worsen.

·         Wait times places patients’ health at risk and costs hospitals, insurers and patients more in resources and dollars.

·         Doctors overbook patients. Overbooking is usually deliberate because doctors are paid by volume under many health insurance reimbursement systems.

·         Increased demand – the number of patients seeking ER care jumped 26 percent to 114 million in the last few years.

·         Doctor shortages especially in rural areas and certain types of specialties.

·         Hospitals closing the Emergency Room – the number of U.S. emergency departments fell about 12 percent in the last few years. Patients will need to make a decision to go to a nearby doctor or travel a long distance to find an available emergency room.

·         Number of Urgent Care Centers in the U.S. - approximately 8,700
Urgent care centers grew by approximately 330 from 2008-2009 and 304 from 2009-2010
(note, approximate number of EDs in the U.S. is 4,600 - source: AHA Trendwatch Sourcebook 2008)

·         Patient Visits: The average number of visits per week increased to 342

Suggestions:

·         Schedule your appointments after your doctor’s lunch break. Usually they are all caught up prior to taking a break, and you have less of a chance to be a backlogged appointment.

·         Ask the doctor’s office to send you any paperwork to complete via email or mail prior to your appointment. When you schedule your time, tell them that you will have the paperwork filled out already for them when you arrive. Often they schedule 30 minutes just for you to handle documents.

·         If it’s just a normal daily health issue you need to resolve (such as allergies, flu, rash, head ache, cold, pink eye, mild aches and pains, etc….) then use technology to interact and interface with doctors. 78% of all Urgent Care, Emergency Room and Physician visits could have been handled over the phone (American Medical Association.) If more people utilized telemedicine, then waiting rooms and doctors would be more available to service clients with more serious needs. Visit. www.Telemed365.com for more information on Telemedicine.