Return To Health (Pando Health Groups)

If America is going to provide insurance coverage for millions of more people than we do currently and we already can't handle the current load, then how in the world are we going to be able to do that? It seems so clear to me. The model must change and we must adapt to the reality. I think we could do it with a new model of care where the most common medical interaction is not one to one but one to many. Groups. Medical groups. Medical communities. Clans. That's what I learned in Fiji. Care can be delivered within a different model and one more suitable to caring for chronic issues. We can't continue to deliver care in the model we use; it does not work. People need more -- not more technology or more pharmaceuticals -- just more care and  attention. Attention to their whole being. Thoughts, beliefs, feelings, longings. These all matter. This cannot be done with cramming in more one on one appointments. We will kill the doctors and our society. It is an entire paradigm shi...

A truly great man left our world recently. Lee Lipsenthal was a medical pioneer and one of the warmest, loving people I have had the pleasure of knowing. I met him through my affiliation with the Dean Ornish Program for Reversing Heart Disease. He was their medical director. He also was the President of the American Board of Holistic Medicine (ABHM) of which I am a member. He taught doctors how to find balance and happiness in their lives and careers (a noble and very challenging task). He exuded a warmth, love and kindness that is extremely rare in the medical world. He genuinely wanted to make medicine better and I strongly believe he did. He pioneered movements in patient care in the Ornish program (empowering patients through improving their daily lifestyles and addressing their emotional and spiritual lives) and promoted physician well-being during a time that this was just not valued by the modern medical world. These extremely challenging ventures were bold and strong but always...

I read recently in a business magazine about the goal/concept of "cracking the chronic disease dilemma". The article spoke from a business/IT perspective and the focus was coming up with a technological or system solution to this major challenge (it is estimated that this single issue is largely responsible (maybe 75%) for the out of control efforts to finance our healthcare system). I believe that there is a fundamental error in this approach (technological or shifting the delivery model (i.e. to lower level providers such as nurse practitioners or physician assistants or nurses). Not that these are "bad" options; new technology is great and the above mentioned providers are great. The problem is that these efforts would still be in the same model; attempting to care for "complicated, multifactorial" (chronic) problems with an acute care mentality and perspective. The problem is NOT the providers or the technological support. Fixing these issues could h...

I was just reading about a phenomenon called the Roseto effect. Apparently, the Pennsylvania town of Roseto (named after the Italian town) had a remarkably low rate of death from heart disease in the mid part of the 20th century. It turned out they ate worse, smoked more than other communities but lived long and healthy lives. The causative factor was discovered by the researchers (led by an MD named Stewart Wolf) to be a function of the social nature of the town 's people -- they were remarkably interactive and connected. This effect went away as the immigrant town "Americanized" and became regular in its values and behaviors. This was described in the 1960's. Why can't this be created again? Community is "buildable" even without it being the natural state of being. That is my opinion. It just has to be valued by the community and it happens. Build it and they will come.

In the part of Fiji I visited (rural and removed from the main islands), there were 2 options for medical care: (1) Getting a boat ride to a hospital on the main island (3 hour boat ride -- expensive and rarely done) or (2) Handling things on your own with the aid of your friends and relatives. In America, we have quite different and many more options. We are fortunate but the amazing thing is that they live nearly as long as we do and arguably with as good or better quality of life despite diffuse poverty and minimal resources. What can we learn from these joyous, loving people? How can we be the students as opposed to us being the givers? To me, it is all in their priorities and values. They focus on completely different goals than we do. For them, life is only about connection, community, God, family and giving. For us, it is about money, fame, power, productivity, and competition. The way they care for their people is a reflection of these values and principles. We all want to be...

I would like to proudly announce that I now accept Medicare in my medical practice. I look forward to being able to serve my senior clients with this payment mechanism. I very much like helping this population and feel strongly that I have good things to offer that are not offered in the standard system (time, open discussions about options in managing the challenges of aging and illness and chronic conditions, alternative and complementary approaches, working with emotions and spirituality in relationship to health concerns, and frank conversations about planning a good end of life. Please call my scheduler Tarin @ (858)259-8333 to make an appointment or for any questions. She is available Monday through Friday between 8 and 5. She works for a medical device company so sometimes you get their voicemail.

One of the true highlights of my Fiji trip was sharing my friends Michael Rubano (massage therapist and Feldenkrais practitioner and general body-mind master) and Matt Szymczak (acupuncturist and Tai Chi/Xi Gong master) with the Fijian people. I had noted on my previous trip that the most common complaint was body pain (most notably low back pain) among these hard-working people. I wanted to give them more than just Advil and Tylenol (which they do appreciate) so I invited my good friends who have devoted their lives to studying the body and bringing people relief with "non-medical, non-surgical" means. Matt and Michael were huge successes. They worked incredibly hard and shared their gifts with many, many Fijians as well as members of our team. They worked on some people together double teaming them and the majority individually with needles, touch, body re-integration and their incredible wisdom in concert with their energetic and invigorating personas. They often worked ...