Archive for June, 2012
Access to medical insurance is not the same as access to medical care. ¬†Access to medical insurance was the objective of “Obamacare”. ¬†The second issue, access to medical care,¬†has not been addressed at all.
Here in Iowa, access to medical care is getting tougher to find.¬† Primary Care Physicians are retiring faster than they are being replaced.¬† Nurse Practicioners and Physician Assistants are increasing, but nowhere near fast enough to fill the vacancies.¬† Nearly 40% of the MD and DO docs are over 60.¬† We are slowing down and many will soon retire. ¬† We are decreasing the number of healthcare providers while adding access to insurance to another 40,000,000 people. ¬†How will this help access to medical care?
I see many patients who have failed to improve on osteoporosis medications. ¬†The vast majority of those patients are not getting enough Calcium and Vitamin D to succeed.
Osteoporosis medication alone is not adequate. ¬†A study released last week of patients in France in 2010 brought this home again. ¬†Patients receiving medication AND Enough Calcium in Diet and Supplements Together AND Enough Vitamin D, maintained Bone Mineral Density significantly better than those who did not get all 3.
TV Newsies have reported a story about some Europeans having problems when given Vitamin D supplements. ¬†But they did not report that these patients received 500,000 units of Vitamin D as a single dose.¬† This¬†is¬†ten times the recommended maximum daily¬†dose. ¬†Of course there was a problem!
Their theory was that the national health service would save money and assure compliance by giving Vitamin D just once a year. ¬†Unfortunately there were increased falls in the first week after this HUGE dose. ¬†Falls increase fracture risk.
Use It Or Loose It applies to bone strength. ¬†We all know that muscle must be used to remain strong. ¬†Orthopedic surgeons have known for decades that unused bone disappears. ¬†Put a leg in a cast for 2-3 months, and it is years before bone and muscle size and strength fully return.
Bone strength is much easier to maintain than rebuild. ¬†You cannot put off regular moderate exercise until “next year”. ¬†What is lost, is lost. ¬†Even medications can only partially¬†help to replace it.