Return To Health (Pando Health Groups)

This a really great website (free) that helps you create new good habits. I am doing it now and find it very easy (as opposed to the usual trying to quit something being painful and frustrating). I highly recommend it! 3TinyHabits.com

There is a relatively new and quite strong movement in the world of neuroscience that is quite exciting. Neuroplasticity is the capacity of the human brain to expand and grow the connections in the brain. It assumes that the brain is able to heal itself all the way to the end of life. This is not what was taught even 20 years ago when I was in medical school. Even more exciting is that this process does not require a new medicine or medical intervention. It is completely in the hands of the individual. In fact, it is the daily lifestyle of an individual which supports this capacity for growth and expansion. The science of this phenomenon is rapidly coming to light. There are many mechanisms for this process -- new synaptic connections, stem cells evolving into new neurons, thickening of myelin which increases the speed of transmission of nerve signals, epigenetic phenomenon (genes being turned on or off). Miraculously, the size and function of various structures in the brain can be v...

I have been noticing in my patients the incredible capacity for fear to "lock in" and perpetuate that which one is afraid of. For example, fear of falling (poor balance) makes balance much worse and makes falling more likely. It is a cruel but very common paradox. A patient has an intense and prolonged fear of not sleeping and indeed, his sleep is disturbed and inadequate for him. My friend has a fear of becoming disabled although she is one of the more capable and "solid" people that I know. Many seniors become overwhelmed with fear of Alzheimer's disease at the slightest sign of normal forgetting. The angst generated by this awareness seems to exacerbate the problem. The old saying, "What you resist, persists" seems particularly applicable and foreshadowing. So, what to do? In my experience, the remedy for this conundrum has 3 parts. First, acknowledging and becoming aware of the fear is a necessity. This is often uncomfortable and difficult to tal...

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.