Surpise at the doc's office

[RLS59]

I don't like this crap at all. This has no place in the practice of medicine. I don't like the fact that doctors are expected to run every aspect of our lives. Some are expected to ask about guns, ammo, smoking, bicycle helmets, seat belts, etc. instead of detecting and treating diseases. I have a friend who needs to lose about 100 pounds. He went to the Mayo for his check up. They told him he had pre-diabetes, pre-heart disease, pre-elevated cholesterol and he left with 4 new prescriptions. Never did they tell him to lose weight. He thinks they are wonderful. It seems that patient satisfaction is becoming more important than outcome.

Big Brother is watching and he will do it through your medical record and doctor.

I wasn't there so I can't say...but being a Mayo pt. for 50 some years I have a hard time believing NOTHING was said about exercise, diet modifications. May have been said but was he "hearing" it.

[Hmac]

And yes, the medical profession has become way too concerned with "patient satisfaction" and it is becoming something that reimbursement is based off of. This is not a good thing.

With the death of private practice, most physicians are employed. Patient satisfaction survey is a common business tool that is widely applied to doctors these days and in many/most cases their jobs depend, at least in some part, on those scores. Most patients know nothing of what constitutes good medical practice, but judge their doctors by whether they were prescribed antibiotics, or pain medication. And patients often don't like it when their doctor disagrees with their own self-diagnosis, especially after they did all that hard work researching their symptoms on the Internet.

[Lumpy]

I don't like this crap at all. This has no place in the practice of medicine. I don't like the fact that doctors are expected to run every aspect of our lives. Some are expected to ask about guns, ammo, smoking, bicycle helmets, seat belts, etc. instead of detecting and treating diseases.

Big Brother is watching and he will do it through your medical record and doctor.

Hence the furor over Obamacare: the price of dependency is obedience.

[yukonjasper]

Obamacare has a component called the "Stars System" which ranks the physician on a number of criteria including treatment effectiveness, patient satisfaction, focus on cost effective treatment. The health insurers and the health care providers are paid from the government commensurate with the number of Stars in their rating. Example would be 100% of contract defined reimbursement for a 4 star provider while a 2 star may only earn 50%. Obviously its designed to reward successful and effective operators and eliminate or discourage the poor operators.

[Hmac]

I donT know what you're talking about. The "Star" system applies only to Medicare Advantage plans. It doesn't penalize, it rewards some primary care specialities if their system rates three or more stars based on several quality measures. I've yet to hear of a primary care doctor whose reimbursement has been affected.

[Ghost]

I don't like this crap at all. This has no place in the practice of medicine. I don't like the fact that doctors are expected to run every aspect of our lives. Some are expected to ask about guns, ammo, smoking, bicycle helmets, seat belts, etc. instead of detecting and treating diseases. I have a friend who needs to lose about 100 pounds. He went to the Mayo for his check up. They told him he had pre-diabetes, pre-heart disease, pre-elevated cholesterol and he left with 4 new prescriptions. Never did they tell him to lose weight. He thinks they are wonderful. It seems that patient satisfaction is becoming more important than outcome.

Big Brother is watching and he will do it through your medical record and doctor.

You should tell your friend to start reading about and doing the ketogenic diet. Most doctors don't understand it and will say it's wrong but the health benefits are significant.

[Hmac]

What's to understand? The ketogenic diet has been around for almost a century. Its benefits are rather narrow in scope and limited to a few neurological disorders. Like all diets, it's not sustainable. Might as well just do the Atkins diet.

[LePetomane]

I don't like this crap at all. This has no place in the practice of medicine. I don't like the fact that doctors are expected to run every aspect of our lives. Some are expected to ask about guns, ammo, smoking, bicycle helmets, seat belts, etc. instead of detecting and treating diseases. I have a friend who needs to lose about 100 pounds. He went to the Mayo for his check up. They told him he had pre-diabetes, pre-heart disease, pre-elevated cholesterol and he left with 4 new prescriptions. Never did they tell him to lose weight. He thinks they are wonderful. It seems that patient satisfaction is becoming more important than outcome.

Big Brother is watching and he will do it through your medical record and doctor.

You should tell your friend to start reading about and doing the ketogenic diet. Most doctors don't understand it and will say it's wrong but the health benefits are significant.

I don't drink alcohol or eat sweets and do not have a weight issue. Having a stress free job doesn't hurt either.

Better yet. I told him to get off his lazy butt and start running with me. And quit the beer and cigarettes and carbs. I'm back and forth between here and my western HQ so it is hard to drag him out but I am trying my best.

[Hmac]

What's to understand? The ketogenic diet has been around for almost a century. Its benefits are rather narrow in scope and limited to a few neurological disorders. Like all diets, it's not sustainable. Might as well just do the Atkins diet.

[LePetomane]

Do you need to be in ketosis to burn fat or does burning fat put you in ketosis?

[Hmac]

Do you need to be in ketosis to burn fat or does burning fat put you in ketosis?

Depleted carbohydrate stores force the body to burn fat, the result of which is ketosis.

[jdege]

Do you need to be in ketosis to burn fat or does burning fat put you in ketosis?

The body is always burning fat, and always burning carbs, and always burning ketones. What differs are the relative rates.

[jdege]

Do you need to be in ketosis to burn fat or does burning fat put you in ketosis?

Depleted carbohydrate stores force the body to burn fat, the result of which is ketosis.

I'd put it the other way - excess carbohydrates forces the body to burn glucose. Dietary carbohydrates raise serum glucose, which raises insulin levels, which signals the body to burn glucose and to stop burning fat, because high glucose levels are toxic.

Burning fat is cleaner - causes less oxidative stress and fewer free radicals, per unit of energy. It's the normal state. Even cultures that eat diets that are primarily carbohydrate spend most of their day burning fat - because that's what a healthy body does, between meals.

You primarily burn glucose, rather than fat, only when your insulin levels are elevated, which in a healthy person is only for an hour or so after eating carbs. After that, your insulin levels normalize and you return to primarily burning fat.

Unless, of course, you're eating carbs every two hours, or you've messed up your metabolism by eating carbs every two hours for so long that you no longer transition into fat burning as easily as you should.

[Hmac]

Do you need to be in ketosis to burn fat or does burning fat put you in ketosis?

Depleted carbohydrate stores force the body to burn fat, the result of which is ketosis.

I'd put it the other way - excess carbohydrates forces the body to burn glucose. Dietary carbohydrates raise serum glucose, which raises insulin levels, which signals the body to burn glucose and to stop burning fat, because high glucose levels are toxic.

No, glucose is the default energy source. The body shifts to fat-burning only after the liver is depleted of glycogen.

[Ghost]

What's to understand? The ketogenic diet has been around for almost a century. Its benefits are rather narrow in scope and limited to a few neurological disorders. Like all diets, it's not sustainable. Might as well just do the Atkins diet.

It's very sustainable, easy and has shown benefits from epilepsy to Alzheimer's to cancer.

It goes against everything you've heard in the last 50 years so most people disagree with it.