The #1 Reason Every Practice Needs Social Media – It’s Likely Not What You Think

Courtesy of Rita Zamora
Founder Social Media Marketing For Dental & Medical Professionals

What is the main reason you got on board with social media? Social media has mainly been seen as a marketing tool – a way to attract new patients. However, social media plays a much more important role for practices.
Erik Qualman, author of Socialnomics, said, “The ROI of social media is that your business will still exist in 5 years.” That statement may have seemed extreme a few years ago, yet new research is beginning to support it. Consider this:
• 70% of Americans now say they look at reviews before making a purchase.
• 90% of customers say buying decisions are influenced by online reviews.
• 92% of respondents said they had more confidence in information they seek out online than anything coming from a salesclerk or other source.
• The average number of resources consumers reference before making a purchase continues to grow; in fact it doubled from 2010 (5.2) to 2011 (10.4).
• Beyond websites, people vet businesses on Facebook, Google, various review sites, YouTube and via their online personal network.
Studies show that people are increasing the amount of research they do before making buying decisions – for all types of products and services, dentistry and healthcare included.
Social media plays a critical role in allowing your practice to appear “believable” during this research process. Does your practice live up to the pristine image your website portrays?
Social media tells the truth. Without a social media presence, you are leaving the door to speculation wide open. Speculation is scary and time consuming for patients – and dangerous for your practice. People want to know everything they possibly can before making an appointment or accepting your treatment plan.
We need to stop questioning the ROI of social media and its ability to bring in new patients. Rather, start embracing the fact that social media is helping your practice to remain a viable (believable) practice that will still be in practice in 5 years.

Great blog post that reinforces what we do… by KevinMD Patients who participate in healthy lifestyle programs increase exercise, chose healthier foods, manage their symptoms better, & report better health, reduced fatigue, and fewer limits on their activities. And they gain these benefits with fewer doctor visits & hospitalizations.


The benefits of successful patient self-management programs

by Mark Novotny, MD | in Physician |

The emerging literature on chronic disease management suggests that successful programs rely on patient self management skills. Having been in the primary care role for 20 years, that initially seemed self evident and a bit “so what?” to me, thinking it meant that we just need to teach our patients a bit more in the primary care office.

However self-management skills refer to specific curricula of skills that can be taught to patients in formal programs, without doctors. Coordinating these activities with what goes on a primary care office, and the community, and other care-giving settings is critical. These specific skills involve patients setting their own goals, and then creating plans to reach those goals with the assistance of their primary care team and others, but not at the direction of their primary care team. This is a real mind shift for the primary care doctor also.


A doctor participating in the Vermont Blueprint (a statewide chronic disease management program) shared with me how difficult a shift in perspective this is. To enter an exam room for a patient with diabetes, and start by asking the patient what goals he or she has set, or how the patient is doing in accomplishing their own goals was a real shift from the doctor’s agenda. There will always be the need to compare the patient’s goals to evidence-based recommendations, but truly putting the patient in charge seems to have dramatic effect on the outcomes. Equipping them with methods for achieving their goals, including support groups, and behavioral health consultation availability in the primary care office are also important.

What are the benefits of successful patient self-management programs? People who participate in them increase exercise, manage their symptoms better, and report better health, reduced fatigue, and fewer limits on their activities. And they gain these benefits with fewer doctor visits and hospitalizations.

The Stanford model and the Coleman model feature these kinds of structured patient self-management skills. Southcentral Foundation, in Alaska, moves this patient-directed concept all the way to the governance of the health system, both centrally and in the communities they serve, by having the goals of the health system and the primary care network driven by Native American tribal leaders and the patients they serve. When chronic disease management becomes a part of the fabric of the community, with connections to prevention, and lifestyle modifications — including walking paths, group outings, school activities, and changes in nutrition — then real sustained change is accomplished. Examples of these successes are already in place.

This is a completely different approach from insurance company-based disease management programs of the last couple decades. Those “1 (800) dial a nurse” programs that were insurance-company specific, and not integrated with the primary care office, have left many primary care physicians with a negative impression of chronic disease management initiatives, because they did not work well.  It is a very different approach to design and implement a program that is applied across an entire population, regardless of payer, and tightly integrate the provider network and across the continuum of care settings.

Mark Novotny is Chief Medical Officer of Cooley Dickinson Hospital in Northampton, MA.

Fat Alone, Not Where It Sits, May Be Key to Heart Problems: Study upends long-held belief that apple-shaped people face highest risk

By Alan Mozes
HealthDay Reporter

Click here to find out more!

THURSDAY, March 10 (HealthDay News) — In a finding that contradicts earlier research, an international study suggests that being obese boosts the likelihood of a heart attack or stroke regardless of where the excess fat is stored in the body.

That challenges the widely adopted notion that not all obesity is alike, with so-called apple-shaped people, who carry fat mainly in their midsections, facing a bigger risk for heart problems than those whose excess fat is carried on the hips or elsewhere.

Not so, say the researchers behind the new study. When it comes to obesity and heart disease, no excess fat is good fat, regardless of where it ends up, their analysis has found.

“Society has accepted the idea that if you carry more weight around the middle, your risk of heart disease is higher,” said Dr. Emanuele Di Angelantonio, the study’s co-author and a lecturer in medical screening at the University of Cambridge in England. “But actually this study shows that it doesn’t matter where your fat is located. If you’re overweight you’re at risk, full stop.”

Complicating matters, however, is the study’s additional finding that the standard diagnostic measurements of fat — such as body mass index (BMI), waist circumference and waist-to-hip ratio — are not the most reliable tools for assessing heart disease risk.

Better indicators, it says, are blood cholesterol measurements and blood pressure readings.

“While excess fat level does remain a very important risk factor, for [doctors] who really want to predict cardiovascular risk in patients, it is enough to look at cholesterol, blood pressure, diabetes and smoking background, regardless of the patient’s obesity status,” Di Angelantonio said.

The study’s findings, developed by a global team of 200 scientists from 17 countries and based at the University of Cambridge in the United Kingdom, are reported online March 11 in The Lancet.

To explore the predictive power of various heart disease risk factors, the researchers examined data from 58 studies that included more than 222,000 men and women from 17 countries.

None of the study participants had a history of heart disease. Data for most people included BMI readings, waist circumference measurements, waist-to-hip ratios, age, gender, smoking history, blood pressure readings, diabetes history and cholesterol measurements. For nearly 64,000 people, fat deposit assessments were conducted periodically for a number of years.

Over about a decade, more than 14,000 participants had a heart attack or a stroke.

The study concluded that being obese certainly raises the overall risk for heart disease, but that those who carry much of their excess fat in the stomach region do not appear to face a particularly higher risk, compared with those whose fat deposits are distributed differently.

They also found that tracking a person’s blood pressure and cholesterol levels, as well as monitoring their history of diabetes, appeared to be best way to assess heart disease risk. When such indicators were readily available, they noted, adding in BMI and waist measurement information did not improve risk diagnosis.

The team was quick to emphasize, however, that being obese should not be deemed any less of a problem when it comes to heart disease. Excess weight, they said, remains a key culprit in the onset of medical conditions that boost the risk for cardiovascular illness.

Because of that, they suggested, calculations of weight, waist circumference and BMI might continue to be of value because the patient portrait they create can help health-care providers promote better diets and lifestyle choices that ultimately reduce risk. An editorial accompanying the study in The Lancet agreed, noting that BMI measurements can still serve as an early warning signal, especially in teens, young adults and middle-aged people without many other obvious signs of heart disease risks.

Dr. Walter Willett, a nutrition professor at Harvard Medical School and chairman of the nutrition department at the Harvard School of Public Health, indicated that the study conclusions make sense.

“It was not surprising that measures of fat distribution, such as waist circumference, did not do substantially better” in predicting heart disease, he noted.

But he said that obesity as a whole remains a key consideration, given that the factors that proved most useful in assessing heart risks — such as high blood pressure and cholesterol — are themselves the product of the “adverse effects of overweight.”

Lona Sandon, a registered dietician and assistant professor of clinical nutrition at the University of Texas Southwestern, agreed that the findings “are reasonable in the grand scheme of things.” But she, too, stressed that the findings should not be interpreted as permission to pack on the pounds.

“First of all, certainly people who are obese, no matter where the obesity is occurring on the body, should not dismiss their risk for heart disease,” she said. “Carrying around excess weight puts you at a higher risk for heart disease than someone of normal weight, period.”

“So while I’m not necessarily surprised that metabolic testing to measure your cholesterol levels, for example, is a better indicator of risk than, say, BMI, people should still be concerned about what’s going on around their waistline,” Sandon said. “In the end, people should think of that extra weight as a risk factor that leads to more risk factors, which lead to heart disease.”

More information

The American Heart Association has more on obesity and heart disease.


SOURCES: Emanuele Di Angelantonio, M.D., Ph.D., lecturer, medical screening, University of Cambridge, England; Lona Sandon, R.D., assistant professor, clinical nutrition, University of Texas Southwestern, Dallas; Walter Willett, M.D., Frederick Stare professor of nutrition, Harvard Medical School, and chairman, Department of Nutrition, Harvard School of Public Health, Boston; March 11, 2011, The Lancet, online

Copyright © 2011 HealthDay. All rights reserved.

Calorie labeling doesn’t change fast-food orders…More Education Needed

By Sophie Terbush, USA TODAY

Calorie labeling in fast-food restaurants has no effect on the food purchases of parents or teens in low-income neighborhoods, according to a new study published in the International Journal of Obesity.

The study, led by Brian Elbel, assistant professor of medicine and health policy at New York University School of Medicine, shows that although calorie labels do increase awareness of calories, they do not necessarily influence food choices or the number of calories consumed.

The study surveyed customers and collected their purchase receipts at four major fast-food chains (Wendy’s, Burger King, McDonald’s and Kentucky Fried Chicken) in July 2008, before New York City’s implementation of a new calorie labeling regulation, and again at the same locations one month after labeling began.

Both sets of samples were taken from low-income areas of the city, including East Harlem, South Bronx and Central Brooklyn; a control group sample was taken from Newark, an area with similar demographics and an urban setting.

Elbel says he assessed low-income neighborhoods because they tend to be of more fragile health and at higher risk for obesity, and they tend to be surrounded by higher concentrations of fast-food restaurants without other, more healthful food options.

“You’d like to see the effects of labeling on these at-risk groups, but it also makes it harder to see an impact on these groups because they’re also choosing based on availability and price of food,” not necessarily nutritional value, he says.

The 349 participants were children and adolescents ages 17 and under who visited the restaurants with their parents (69%) or alone (31%). About three-fourths of participants were from New York City, and 90% were from racial or ethnic minority groups. Adolescents who visited with parents tended to be younger and were not surveyed; instead, the parents completed the interviews.

The study shows that just over half of adolescents and adults noticed the calorie counts after labeling began in New York, but only 9% of adolescents and 16% of adults who saw the information said it mattered to them.

“Both populations are seeing it, but it’s not translating into a change,” Elbel says.

People purchased the same amount of calories before labeling began and after, the study shows; for adolescents, it was about 725 calories, and for adults, about 600 calories. Elbel says adolescents who were alone tended to buy more food than parents bought for their children.

In the choice of food for teens, habit, access, price and location matter some, but “taste is the most important factor,” Elbel says. He also looked at how parents worked with their children to make fast-food choices.

In deciding what the children would eat, 57% of parents chose for their children, 31% let the child choose, and 6% said they chose together. Elbel says parents who chose for their children did not choose fewer calories than when the children were allowed to choose.

A national calorie-posting mandate also was part of the Patient Protection and Affordable Care Act of 2010. The U.S. Food and Drug Administration says it must issue proposed regulations by March 23 for national calorie labeling.

That will include restaurants with 20 or more locations posting calorie counts on menu boards and in retail stores and having nutrient information available in writing upon request. Vending-machine operators with 20 or more machines also would be required to post caloric content for certain items.

For now, Elbel says that while many health researchers, policymakers and restaurant-chain owners are backing the national legislation, there is much more that can be done. “What we’re starting to see is that (labeling) won’t be enough to influence obesity by itself in a large-scale way,” he says. “One of the best things for restaurant owners to do is to reformulate their menus.”

Elbel’s findings in the study are similar to those in a study he published in the October 2009 issue of the Journal of Health Affairs conducted in the same area of New York City, comparing calorie consumption of customers based on receipts gathered outside fast-food restaurants.

He is also analyzing data for a study with the same methodology that he conducted in Philadelphia, before and after calorie labeling took effect there, using Baltimore as a comparison city.

This study will assess a larger sample, looking at higher- and lower-income areas, and may provide more information about the effects of calorie labeling on a more diverse population.

Doctors: Vitamin D levels low in children

FORT MYERS: Even in the Sunshine State, it turns out most kids are not getting enough of the vitamin D. But there is a simple way for your kids to get more of it.

Fort Myers mom Elizabeth Baranowski says she doesn’t want her daughter cooped up inside all day.

“We’re outside enjoying the day, getting some sun and burning off energy,” she said.

Dr. Cayce Jehaimi emphasizes the importance of getting plenty of vitamin D.

“The results are tremendous. Vitamin D has shown to reduce your risk for Type 1 Diabetes, rheumatoid arthritis, multiple sclerosis and reduce your risk of dying from cancer,” Jehaimi explained. “More than 50 percent of children I screen in my clinic have low levels of vitamin D.”

A big problem is that kids are spending too much time indoors. Doctors say shut down the computer, turn off the TV and get outside. A big source of Vitamin D is free. It comes from sunlight.

Dr. Jehaimi recommends children spend some time in the sun without any sunscreen on – about 15 minutes for fair complexions and closer to 30 minutes for darker complections.

He says to do that three times a week so the skin can soak up that vitamin D directly before applying SPF sunscreen.

Baranowski says it’s easy to stay inside, but her daughter’s health is worth the extra jumping around.

“With the beautiful weather we have down here, and there are so many opportunities, you just have to go out and find them sometimes,” she said.

We also learned that vitamin D toxicity, or getting too much vitamin D, is very rare.

You would get it from taking an excessive amount of supplements – not from your diet or too much sun exposure.

By Linh Bui – bio

Pycnogenol and the Multiple Sclerosis Resource Centre

PycnogenolIs Pycnogenol the new wonder nutrient?

What is Pycnogenol?

Pycnogenol (pronounced Pic-Nognol) is the dry extract of the bark from the maritime pine tree (Pinus Maritamia) which grows in profusion in south west France. Although has actually been around for decades, its value is only becoming recognised now in this country.

What makes Pycnogenol so remarkable is that is contains a large number of proanthocyanidins, which are very powerful antioxidants. It also contains bioflavonoids and fruit acids.

The medicinal properties of the bark of the maritime pine were recorded in the thirteenth century, when the native Indians of America brewed up health-giving tea. Indeed, from various trees was used the ancient Chinese and other traditional cultures for its medicinal properties. Together with other ingredients, tree bark was also used to protect ship crews against scurvy.

In modern times, Pycnogenol was first discovered in 1948 by a French doctor, Jaques Masquelier of the University Bordeaux. He read of a substance which had saved members of an expedition from death. This substance turned out to be pine bark.

The biological activities and clinical uses of Pycnogenol have since been the subject of serious scientific research, with more than 30 papers devoted to it.

Realising he was on to a good thing, Dr Masquelier developed the pine bark extract process and was awarded a US patent for the use of Pycnogenol as a free radical scavenger.

You can blame Dr Masquelier for coming up with such an unpronounceable name as Pycnogenol. He coined the word to describe an entire class of bioflavonoids composed of another mouthful – Oligomeric Proanthocyanidin Complexes (OPCs).

Pycnogenol itself comes from the Greek ‘pycno’, which means to thicken or condense; ‘gen’ means to generate, and ‘ol’ comes from their chemical name.

Today, Pycnogenol is big business. It is extracted from trees in specially grown and very scenic plantations of Maritime Pine in the Landes region of Gascony in south west France, where great swathes of these trees back the long, sandy beaches on the Atlantic coast. All of the best products use Pycnogenol supplied from this source.

Pycnogenol and MS

Pycnogenol helps in MS for many reasons:

  • Powerful antioxidant
  • Anti-inflammatory
  • Strengthens blood vessel walls
  • Protects, modulates and boosts the immune system
  • Lowers histamine levels
  • Boosts energy
  • It is rapidly absorbed, and works quickly in the body.

In France and other European countries, Pycnogenol has been used for MS for some time. Pycnogenol helps destroy free radical molecules in the body. These are baddies which accumulate and cause damage to cells and tissues, causing degeneration.

As an antioxidant, Pycnogenol helps prevent lipid peroxidation, which leads to free radical damage. This may help prevent MS attacks and damage to myelin.


  • Anti-inflammatory – Studies have shown that Pycnogenol inhibits inflammation, which is involved in MS attacks. It also inhibits histamine release, which further reduces inflammation.
  • Strengthens Blood Vessel Walls – Pycnogenol promotes the integrity of blood vessel walls. This helps maintain the blood-brain barrier, which can get breached in MS.
  • Skin – Pycnogenol also helps strengthen the collagen bonding, which increases the elasticity and flexibility of the skin. So it’s a beauty treatment from the inside.
  • Energy – There are reported cases in the USA of people with chronic fatigue experiencing a ‘jump start’ in energy when they take Pycnogenol.

How Much Should You Take?

Studies have shown that Pycnogenol’s antioxidant activity works if you take two 20mg capsules a day (total of 40mg). You can take 60mg a day as a therapeutic dose.

Is it Safe?

Yes. It is non-toxic. Decades of laboratory research and clinical studies have confirmed its efficacy and safety. It doesn’t take long to notice the benefits.

Questions about where to find it? Contact Tara Caruana RN, BSN @  727-415-0917

Low vitamin D kids, higher allergy risk

NEW YORK, Feb. 24 (UPI) — Children with low levels of vitamin D have increased risk of developing allergies, New York researchers say.

Senior author Dr. Michal Melamed of the Albert Einstein College of Medicine at Yeshiva University looked at the serum vitamin D levels in blood collected in 2005-2006 from a nationally representative sample of more than 3,100 children and adolescents as well as 3,400 adults.

The researchers used data from the National Health and Nutrition Examination Survey that combines interviews, physical examinations and laboratory studies.

One of the blood tests assessed was sensitivity to 17 different allergens by measuring levels of Immunoglobulin E, a protein made when the immune system responds to allergens.

The research team found no association between vitamin D levels and allergies in adults, but for children and adolescents, low vitamin D levels correlated with sensitivity to 11 of the 17 allergens tested, including both environmental allergens such as ragweed, oak, dog, cockroach and food allergens such as peanuts.

The study, published in the Journal of Allergy and Clinical Immunology, found children who had vitamin D deficiency — defined as less than 15 nanograms of vitamin D per milliliter of blood — were 2.4 times more likely to have a peanut allergy than were children with sufficient levels of vitamin D.

“Many of our young people right now might not outlive their parents because of health-related issues to obesity.”

Changes In The School Lunchroom Could Help Georgia’s Fight Against Childhood Obesity
By Josephine Bennett

MACON, Ga.  —

Lunchroom at Ingram-Pye Elementary School in Macon (photo Josephine Bennett)

When the National School Lunch Act was passed in 1946 the federal government was worried kids weren’t getting enough to eat. Now the government worries kids aren’t getting enough of the right foods. New guidelines will change what’s served in school lunchrooms across Georgia.

Angela Purvis just finished baking over 5-thousand whole grain rolls from scratch. She’s been making lunches for 17 years for Bibb County school kids. But, the way she makes the rolls has changed.

“It was basically what your Mama had and then it started cutting back the fat. We took the butter out. We took the salt out. We took the sugar out and now it’s even more so now. I mean now we’re doing whole grains.”

The finished rolls will be eaten by some of the 21-thousand kids Bibb County feeds every day.

It’s lunch time at Ingram-Pye Elementary.

A line of 5th grade students forms in the lunchroom here. On today’s menu students have a choice of chicken fajitas, whole grain chicken corn dogs, or a salad. Today Theresa Cantrell is one of the servers.

“They love the chef salads. They’re picking up a lot of the fresh fruits that we have out here and of course we’ve changed our French fries and tater tots we’ve changed over to baking them and the children really can’t tell the difference.”

And it’s those subtle changes that allow them to keep the kids lunches to an average of 664 calories. 11-year old Jonathon Sellers is reaching for the fresh options.

“Apples help you learn better. If you eat more healthy foods you can play outside and you will get exercise. My mama’s been telling me that. Don’t eat much junk food.”

In December the federal government unveiled new guidelines for school lunches. The changes are the first major ones in 15 years. Bibb County’s Nutrition Director Cleta Long says it will mean more fruits, vegetables and whole grains on the lunch line, something Bibb County’s already doing.

“Not only are we going to meet caloric requirements for different age groups, but we’re also meeting the fat and keeping the fat lower. We’re also looking at trying to lower the sodium and increase fiber.”

The schools are also making nutrition education part of the curriculum. At Ingram-Pye that includes visits to the classroom by lunchroom manager Janice Williamson where she hands out samples of foods kids might not have tasted.

“Most of the time when we get like the pears, something we don’t normally have…we’ve got them now…we’ll let them taste the pears. So, next time they’ll maybe pick up a pear when they come through the line versus an orange, something they always have.”

This month Bibb County is undergoing a complete review of its nutrition program by the Georgia Department of Education. Once the results are in, the county hopes to qualify for the federal governments Healthier U.S. School Challenge. It rewards schools with extra money if they go the extra mile to provide healthy foods.

But money isn’t the only incentive to change things says nutrition director Cleta Long.

“Many of our young people right now might not outlive their parents because of health-related issues to obesity.”

And with Georgia’s childhood obesity rate over 21-percent, making changes to what kids eat is more important than ever.

“Isotonic delivery is the most efficient way to (orally) deliver nutrients to the body…period”

“Isotonic delivery is the most efficient way to (orally) deliver nutrients to the body…period. When you  start with a specially formulated powder and then mix it with the correct proportion of water it becomes an isotonic solution. You then drink it and within 5-10 minutes it is completely absorbed into the blood stream.  There is no better way to deliver nutrients to the absorption sites within the small intestines.  Pills and capsules only allow for about 15-30% bio-availability due to all of the binders, fillers, hardening agents etc. This isotonic solution is 90-95% bio-available to the body therefore more of the nutrients are absorbed in the system for utilization.  I recommend this to my patients on a regular basis because there are so many health benefits. ” – Jeffrey Caruana, Registered Pharmacist

Interest in vitamin D testing grows: Do you know your Vitamin D level?

Updated: 2011-02-14 13:45:11 CST Category: Vitamin D Deficiency-Diagnosis and Treatment

Interest in vitamin D testing grows   Following the publishing of a review of clinical studies that connected low levels of vitamin D to an increased risk of heart failure, experts say that more doctors than ever are recommending vitamin D testing to their patients.

A team of researchers from the University of California, Los Angeles published a paper in PubMed, a website maintained by the National Institutes of Health. For the study, they reviewed previously published materials on the connection between heart failure and vitamin D deficiency. They found a strong correlation between the two.

Since publishing the article, the researchers say they have received a lot of attention from other medical professionals, and that many are interested to learn more about the benefits of this important hormone.

“The interest on vitamin D deficiency continues to escalate,” said Robert Willix, one of the researchers. “The vitamin D story is now clear to most physicians who are recognizing it as an important pro-hormone that supports the concept that you can achieve a generalized effect and measurable results on health through a simple supplement.”