Evidence-Based Medicine and the Individualization of Care

When I was in training, I was often advised to individualize care. This admonition was troubling, because it was inevitably the last comment and there were almost never any details on exactly how to...

Read more

Of Apple Watches and Dreams

This week, Apple announced their forthcoming watch. I'm skeptical that this new wearable tool will be the 'next big thing' in health, in part because of the pricetag - $349 and a new iPhone 6 (a minimum of another $200 and a 2-year...

Read more

Exercise is the Antidote

Diabetes is one of America’s biggest lurking health system catastrophes, which concerns us greatly at Sustainable Health Systems.

Here is the CDC (Centers for Disease Control) map of diabetes in 2011, about 95% of which is type 2 diabetes...

Read more

Will We Go Broke Over Health Care?

Americans are getting heavier and more sedentary, with an ever increasing prevalance of pre-diabetes and type 2 diabetes, with subsequent development of vascular and kidney disease.


Read more

Choosing Wisely?

Today I was asked why I recommend that PCPs do Wellness Visits, when the Choosing Wisely initiative of the American Board of Internal Medicine...

Read more

Gait Speed and Dysmobility - a Vital Sign or Sign of Vitality?

This week, I welcome as co-authors three colleagues and dear friends who have worked with me on all 4 editions of the American College of Sports Medicine's textbook - ACSM's Exercise Management for Persons with Chronic Disease and...

Read more

Disparities in Health Care: Accountable Care, Quality Reporting and Engagement

In this week's issue of JAMA, Jha and Zaslavsky discuss the issue on outcome quality reporting on physicians and health care networks, concerning the problem that lower...

Read more
Modifiable Actual Risks for Cause of Death

Health Ecology as the Actual Cause of Chronic Disease and Mortality

A recent headline in the Times of London (England) stated, “One in Three Now at Risk as Diabetes Levels Soar”. One public health official quoted in the article said "If a doctor sits you down and says 'If you carry on they way you are...

Read more

On Paths: Using Group Visits to Improve Health Ecology

In my last blog, we considered a lesson from my college calculus professor, that paths are more interesting than function graphs....

Read more

On Lifestyle and Paths

From time-to-time, our blogs will discuss life’s paths, whether the discussion is about managing a health care practice or mentoring a patient. In today’s era of ‘big data’ it is common to graph associations and relationships that form health...

Read more