Prediabetes

Prediabetes

Prediabetes means that your blood sugar level is higher than normal but not yet high enough to be classified as type 2 diabetes. Without intervention, prediabetes is likely to become type 2 diabetes in 10 years or less. If you have prediabetes, the long-term damage of diabetes — especially to your heart and circulatory system — may already be starting.

There's good news, however. Prediabetes can be an opportunity for you to improve your health. Progression from prediabetes to type 2 diabetes isn't inevitable.

With healthy lifestyle changes — such as eating healthy foods, including physical activity in your daily routine and maintaining a healthy weight — you may be able to bring your blood sugar level back to normal.

Symptoms

Often, prediabetes has no signs or symptoms.

One possible sign that you may be at risk of type 2 diabetes is darkened skin on certain parts of the body. This condition is called acanthosis nigricans. Common areas that may be affected include the neck, armpits, elbows, knees and knuckles.

Classic red flags that suggest you've moved from pre diabetes to type 2 diabetes include:

  • Increased thirst
  • Frequent urination
  • Fatigue
  • Blurred vision 

When to see a doctor

Consult your doctor if you're concerned about diabetes or if you notice any type 2 diabetes signs or symptoms — increased thirst and frequent urination, fatigue, and blurred vision.

Ask your doctor about blood glucose screening if you have any risk factors for pre diabetes, such as:

  • You're overweight, with a body mass index above 25
  • You're inactive
  • You're age 45 or older
  • You have a family history of type 2 diabetes
  • You're African-American, Hispanic, American Indian, Asian-American or a Pacific Islander
  • You developed gestational diabetes when you were pregnant or gave birth to a baby who weighed more than 9 pounds (4.1 kilograms)
  • You have polycystic ovary syndrome — a condition characterized by irregular menstrual periods, excess hair growth and obesity
  • You have high blood pressure
  • Your high-density lipoprotein (HDL) cholesterol is below 35 milligrams per deciliter (mg/dL) (0.9 millimoles per liter, or mmol/L) or your triglyceride level is above 250 mg/dL (2.83 mmol/L)

Causes

The exact cause of prediabetes is unknown, although family history and genetics appear to play an important role. Researchers have discovered some genes that are related to insulin resistance. Excess fat — especially abdominal fat — and inactivity also seem to be important factors in the development of prediabetes.

What is clear is that people who have prediabetes aren't quite processing sugar (glucose) properly anymore. This causes sugar to build up in the bloodstream instead of doing its normal job of fueling the cells that make up muscles and other tissues.

Most of the glucose in your body comes from the foods you eat, specifically foods that contain carbohydrates. Any food that contains carbohydrates can affect your blood sugar levels, not just sweet foods.

During digestion, sugar enters your bloodstream, and with the help of insulin, it enters the body's cells where it is utilized as a source of energy.

Insulin is a hormone that comes from a gland located just behind the stomach (pancreas). When you eat, your pancreas secretes insulin into your bloodstream. As insulin circulates, it acts like a key that unlocks microscopic doors that allow sugar to enter your cells.

Insulin lowers the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of insulin from your pancreas.

When you have prediabetes, this process begins to work improperly. Instead of fueling your cells, sugar builds up in your bloodstream. This occurs when your pancreas doesn't make enough insulin or your cells become resistant to the action of insulin or both.

Risk factors

The same factors that increase the risk of developing type 2 diabetes increase the risk of developing prediabetes, including:

  • Weight. Being overweight is a primary risk factor for prediabetes. The more fatty tissue you have — especially inside and between the muscle and skin around your abdomen — the more resistant your cells become to insulin.
  • Waist size. A large waist circumference can indicate insulin resistance. The risk goes up for men with waists larger than 40 inches around and for women with waists larger than 35 inches.
  • Inactivity. The less active you are, the greater your risk of prediabetes. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.
  • Age. Although diabetes can develop at any age, the risk of prediabetes increases as you get older, especially after age 45. This may be because people tend to exercise less, lose muscle mass and gain weight as they age.
  • Family history. The risk of prediabetes increases if a parent or sibling has type 2 diabetes.
  • Race. Although it's unclear why, people of certain races — including African-Americans, Hispanics, American Indians, Asian-Americans and Pacific Islanders — are more likely to develop pre diabetes.
  • Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of later developing diabetes increases. If you gave birth to a baby who weighed more than 9 pounds (4.1 kilograms), you're also at increased risk of diabetes.
  • Polycystic ovary syndrome. For women, having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.
  • Sleep. Research has linked sleep issues, such as obstructive sleep apnea, to an increased risk of insulin resistance. Sleep apnea is a sleep disorder that causes breathing to be interrupted numerous times during sleep, leading to poor sleep quality. People who work changing shifts or night shifts, possibly causing sleep problems, also may have an increased risk of prediabetes or type 2 diabetes.

Other conditions associated with diabetes include:

  • High blood pressure
  • Low levels of HDL, or the "good," cholesterol
  • High levels of triglycerides — a type of fat in your blood

When these conditions — high blood pressure, high blood sugar, and abnormal blood fats and cholesterol — occur together along with obesity, they are associated with resistance to insulin. The combination of three or more of these conditions is often referred to as metabolic syndrome.

Complications

Progression to type 2 diabetes is the most serious consequence of untreated prediabetes because type 2 diabetes can lead to other complications, such as:

  • High blood pressure
  • High cholesterol
  • Heart disease
  • Stroke
  • Kidney disease
  • Blindness
  • Amputations

Source: Mayo Clinic

Choosing The Right Pediatrician For Your Child.


This is the time of year when shopping for school clothes and the latest electronics and accessories is foremost in your child’s mind. But, for parents, back-to-school season brings up back-to-school physicals. No matter what grade your child is about to enter, it is important to schedule a back-to-school physical exam with your child's primary care provider. 

One of the most important branches of medicine is pediatrics and selecting the right pediatrician is very important. A pediatrician is a medical doctor that specializes in the health care of infants, adolescents and children until the age of 21. Most pediatricians offer a variety of services for children and their parents.

Many women begin their search during their second trimester of pregnancy. But if that’s not your case, or you've already chosen one, no worries! It’s never too late to find the right doctor.

Here are some tips to find the right doctor for you and your child.

What you need to know before selecting a doctor: 

  • Pediatric background (Experience)
  • Specialties
  • Locations
  • Hospital privileges (what hospital uses to admit patients)
  • Appropriate training (medical school, residency, etc)
  • Certifications, (if the pediatrician is board certified)
Some parents rely on physician review sites such as Healthgrades or Vitals. Others rely on recommendations from family and friends. But, is that enough? Is that really enough information to trust your child's life to a stranger? 

Luckily, EZDoctor provides everything you need to know about a physician without having to rely on word of mouth or commit to an appointment with a doctor. Here at EZDoctor.com we have comprehensive doctor background checks called EZDoctor Reports. Where you can find all the information mentioned above and more! 

You can research any physician from the comfort of your home and receive a full report directly to your email! 

EZDoctor Reports include: 

  •       Contact Information
  •       Office Locations
  •       License Information
  •       Insurance Accepted
  •       Education
  •       Hospital Affiliations / Privileges
  •       Procedure Pricing Information 
  •       Patient Referral Summary
  •       Prescribing Habits
  •      Publications
  •      Disciplinary Actions
  •      Criminal Offenses
  •      Malpractice Claims
  •      Real Patient Reviews

**Sample of EZDoctor Report***


 Go to ezdoctor.com now and find the right pediatrician for your child today with an EZDoctor Report! 

Psoriasis Awareness Month

Each August, the National Psoriasis Foundation (NPF) sponsors Psoriasis Awareness Month, dedicated to raising awareness, educating the public and dispelling myths about the disease.

What is psoriasis?

Psoriasis is a chronic, noncontagious, genetic autoimmune disease that appears on the skin in red, scaly patches that itch, crack and bleed. It is the most common autoimmune disease in the country, affecting approximately 7.5 million Americans.

Up to 30 percent of people with psoriasis develop psoriatic arthritis, an inflammatory type of arthritis that causes pain and swelling of the joints and tendons. People with mild psoriasis are just as likely to develop psoriatic arthritis as those with moderate to severe psoriasis.

What causes psoriasis?

Genetics and the immune system play a major role in the disease. In people with psoriasis, the immune system sends out faulty signals that speed up the growth of skin cells.

To develop psoriasis, a person must have a combination of the genes that cause psoriasis and be exposed to external “triggers.” Triggers include stress; injury to the skin, such as a tattoo or a scrape; smoking; and certain infections.

There is no cure for psoriasis, but many treatment options are available. Treatment is individualized for each person and depends on the severity of the disease, the type of psoriasis and how the person reacts to certain treatments.

Psoriasis takes an emotional, physical toll

Despite its prevalence, psoriasis is widely misunderstood. People with psoriasis often face discrimination because others incorrectly fear it is contagious. Studies show that people with psoriasis report higher levels of anxiety, embarrassment and depression. In a National Psoriasis Foundation study, more than half the respondents said psoriasis impacts with their ability to enjoy life.

In addition to the psychological and social impact of psoriasis, psoriasis increases risk for other serious health conditions. These include heart diseases, heart attacks, stroke, diabetes, Crohn’s disease, hypertension, obesity and depression.

National Psoriasis Foundation Medical Board urges people with psoriasis to work with their doctors to watch for the potential onset of any health issues related to psoriasis.

Learn more about psoriasis, its associated health risks, treatment options and ways to effectively manage the disease at http://www.psoriasis.org/.

Research to find a cure

National Psoriasis Foundation has grown to be the world’s largest nonprofit patient advocacy organization serving people with psoriasis and psoriatic arthritis and the largest charitable funder of psoriatic disease research worldwide. Finding a cure for psoriatic diseases is the Foundation’s highest priority. In 2012, the Psoriasis Foundation awarded more than $2 million in research grants and medical research fellowships to scientists studying psoriasis and psoriatic arthritis—the most dollars and grants in the organization’s history.

Learn more about the NPF and its investment in cutting-edge research at www.psoriasis.org/research.

Back-to-School Physicals

The most important thing you can do as a parent for your child’s development and overall wellness is to absolutely make sure they have a complete physical and medical history update every single year. And there is no better time of year to do this then before they begin the school year.

The list of what they need continues to grow as they get older. However, the most important thing on this list is the yearly school physical, no matter what their grade or age. Back-to-school physical definitely needs to be the first thing on your list.

Kids from pre-school through high school absolutely need to have annual physicals: everything from visits to the pediatrician or the primary family care physician to the dentist, and for their annual eye exams. There are five main things to know about these back-to-school physicals.

Immunizations

Schools require that kids have certain immunizations before they can attend. Most vaccinations are given before kids turn two but school-aged children can expect booster shots during their annual visit. 

Doctors recommend the following immunizations:

  • Hepatitis B vaccine (HBV)
  • Hepatitis A (HAV)
  • Pneumococcal conjugate vaccine (PCV)
  • DTP (diphtheria, tetanus and pertussis)
  • Haemophilus influenzae type b bacteria (Hib)
  • Inactivated poliovirus vaccine (IPV)
  • MMR (measles, mumps, rubella)
  • Varicella (chickenpox)
  • MCV4 (meningitis)
  • Rotavirus
  • Human papillomavirus (HPV), and influenza and sometimes more.

Some immunizations may cause discomfort, pain or fever so be ready with Acetaminophen or Ibuprofen, with your doctor’s approval, of course.

Behavioral Development

A healthy mind is just as important as a healthy body; therefore doctors take time during a child’s annual back-to-school physical to assess their behavioral and intellectual development. Your physician may ask you and your child questions to evaluate self-esteem, ask about grades and schoolwork, and how your child copes with anger and disappointment. You may be asked if there are any changes at home that may affect your child’s behavior.

Motor and language skills should also be assessed, and teens may be screened for depression, drug abuse and asked about sexual activity. Parents are encouraged to always be comfortable asking for time alone with the doctor for any additional questions or to address other concerns they may have concerning their children.

Preventative Screening

Annual wellness visits give our doctors the opportunity to check kids for illnesses and chronic diseases in early childhood when they may be easier to treat or even be prevented. Physicians can then monitor your child’s overall wellness more easily with routine examinations and tests including blood tests to screen for such problems as high cholesterol levels, diabetes and lead poisoning. They might also do skin tests for things such as tuberculosis.

Preventative screening appointments are also a good time for you and your child to talk to your physician about safety. Depending on your child’s age, that may mean everything from bicycle helmet safety to concerns about alcohol, drugs, cigarettes and sexual activity.

Medical History

Reviewing your child’s and your family’s medical history with our doctors during a back-to-school physical (or any other time for that matter) is important for detecting patterns of disease and chronic illness that run in your family.

During this part of the visit, doctors, patient and parents, (depending on your child’s age) will talk about current medical conditions such as allergies (bee stings to food allergies) and illnesses (such as asthma, diabetes, etc). Parents should make sure to reveal any hospitalizations, surgeries or prior injuries, and what serious illnesses family members have or have had (such as cancer and heart disease).

You should also go to your appointment prepared by having a list of medications your child takes, including prescription medications, over-the-counter medicines, (even baby aspirin) and supplements. Know dosages and include these when completing your paperwork.

Routine Physical

The physical exams will vary from age to age and from doctor to doctor (and sometimes even based on your health insurance plan) but the basics of a back-to-school physical start with the routine exam based on guidelines set by the American Academy of Pediatrics.

Doctors take this opportunity to do a comprehensive check of your child’s body. This usually includes recording height and weight, taking blood pressure and pulse readings, and checking heart and lungs, abdomen, as well as skin, eyes, ears, nose, mouth, teeth and throat.

Additionally, doctors will also screen for scoliosis, hernia and overall level of physical maturity. Reflexes, fine-motor development (such as tying shoes) and gross-motor development (such as jumping) is often checked as well.

Source: Medical Access MD

Fake Plastic Surgeon Performs Procedures On Dozens Of Patients


A court in Germany has sentenced a man to four years and three months in prison for posing as a plastic surgeon and performing procedures on dozens of patients.

The regional court in Regensburg, about 100 kilometers (60 miles) north of Munich, found the defendant guilty of grievous bodily harm and fraud.

German news agency dpa reports that the 31-year-old man, who wasn't named for privacy reasons, had injected Botox and silicone into the cheeks, lips or forehead of more than 50 men and women.

The patients complained of painful swelling and numbness after the procedures.

Prosecutors had asked the court to hand the man a five-year sentence, but judges considered the defendant's confession and mental illness as a mitigating circumstance.


Source: Huffington Post

Court upholds Florida law restricting doctor-patient speech about guns.

For the second time in little more than a year, a federal appeals court Tuesday upheld a controversial Florida law that restricts doctors from asking questions and recording information about patients' gun ownership.

The 2-1 decision by a panel of the 11th U.S. Circuit Court of Appeals was a victory for the National Rifle Association and other gun-rights advocates and a defeat for medical groups that argued, at least in part, that the law infringed on doctors' First Amendment rights.

The appeals court last July also upheld the 2011 law but issued a revised ruling Tuesday. After last year's decision, medical groups continued challenging the law, including asking for a rehearing before the entire Atlanta-based appeals court.

Dubbed the "docs vs. glocks" law, the measure includes a series of restrictions on doctors and other health providers. As an example, it seeks to prevent physicians from entering information about gun ownership into medical records if the physicians know the information is not "relevant" to patients' medical care or safety or to the safety of other people.

As another example, the law says doctors should refrain from asking about gun ownership by patients or family members unless the doctors believe in "good faith" that the information is relevant to medical care or safety. Also, the law seeks to prevent doctors from discriminating against patients or "harassing" them because of owning firearms.

A federal district judge in 2012 sided with opponents of the law and issued an injunction against it. But the appeals court last July and again Tuesday overturned the injunction.

"The purpose of the act, as we read it, is not to protect patient privacy by shielding patients from any and all discussion about firearms with their physicians; the act merely requires physicians to refrain from broaching a concededly sensitive topic when they lack any good-faith belief that such information is relevant to the medical care or safety of their patients or others,'' said the majority opinion, written by Judge Gerald Tjoflat and joined by Judge L. Scott Coogler.

But Judge Charles Wilson wrote a lengthy dissent arguing that the law violates the First Amendment rights of physicians.

"Simply put, the act is a gag order that prevents doctors from even asking the first question in a conversation about firearms,'' Wilson wrote. "The act prohibits or significantly chills doctors from expressing their views and providing information to patients about one topic and one topic only, firearms."

The Republican-dominated Legislature and Gov. Rick Scott approved the law after hearing accounts of doctors unnecessarily asking questions about gun ownership or even refusing to continue providing care if such questions were not answered.

In Tuesday's majority opinion, Tjoflat repeatedly pointed to instances in which doctors can continue justify asking about firearms, such as in the case of a patient considered at risk of suicide.

"Thus, a physician may make inquiries as to the firearms-ownership status of any or all patients, so long as he or she does so with the good-faith belief --- based on the specifics of the patient's case --- that the inquiry is relevant to the patient's medical care or safety, or the safety of others,'' the majority opinion said. "If, for example, the physician seeks firearm information to suit a personal agenda unrelated to medical care or safety, he or she would not be making a 'good-faith' inquiry, and so the act plainly directs him to refrain from inquiring."

But Wilson's dissent raised questions about whether the law stemmed from anecdotal incidents. He also argued that doctors should have the right to ask questions about guns in addressing the well-being of patients.

"There is nothing to suggest that the doctors' inquiries or messages regarding firearms were not genuinely believed to be in the patients' best medical interest when given,'' Wilson wrote. "But there is evidence in the legislative history to suggest that the harassment provision (of the law) is designed to prevent these conversations from taking place in the future. That is certainly the result it will achieve. Doctors will largely cease inquiring into and counseling on the topic of firearms, lest they be accused of crossing the line between providing life-saving preventive medical information and promoting an anti-firearm political agenda.

Source: Ocala.com

OB/GYN TOLD HE CAN'T DELIVER BABIES ANYMORE

The Texas Medical Board has temporarily restricted an Angleton doctor from delivering babies citing a "continuing threat to the public and welfare" and three fetal deaths.

Dr. Gregory Cooke, 50, is an obstetrician and a gynecologist licensed since 1996. He had privileges at UTMB-Angleton campus, which have been suspended, per the Board's order.

According to the order dated June 26, the Board examined the treatment of six patients dating back to 2010. One was cleared, but five had tragic outcomes, including three fetal deaths, and there seems to be pattern.

In four cases, the Board found Dr. Cooke did not respond in a timely manner, despite calls and text messages from nurses.

For instance, in one case where the baby's heart was slowing down, it took him almost two hours to arrive at the hospital and to perform an emergency C-section. The woman's uterus had ruptured and the baby died.

In another case, he was delayed to "get through my office." The baby was stillborn.

A nurse had to deliver another baby and in yet another case it took him 90 minutes to show up after he had ordered a patient to be prepped for a C-section.

Ultimately the Board panel found Dr. Cooke "engaged in a pattern of mismanagement of labor and delivery, resulting in adverse outcomes including fetal demise."

"It doesn't mean he has to quit practicing. They (the Board) just don't want him delivering babies while they investigate further," said Brian Tew, both a doctor and a lawyer who often represents doctors in front of the Texas Medical Board.

Courtney Newton, Cooke's attorney said, "although the temporary suspension hearing was held by the medical board, the board did not suspend Dr. Cooke's medical license. Instead they took temporary action, which he is appealing and we anticipate will be resolved at an expedited hearing."

Cooke did not respond to a call requesting comment.

UTMB- Angleton Campus released this statement:

"Our patients' safety is always our main concern. We take this action very seriously and we are looking into the situation."

Cooke's labor and delivery restriction stands until the Board takes further action. An appeal hearing has not yet been scheduled.

F.D.A. Wants Food Labels to Quantify Added Sugars

The Food and Drug Administration proposed on Friday that nutrition labels on packaged foods cite the amount of added sugars they contain as a percentage of the recommended daily calorie intake.

The proposal brought immediate criticism from manufacturers of foods and beverages, which claimed that the labels would confuse customers and that dietary limits on added sugars were not scientifically justified.

Added sugars are those not found in foods before they are produced and packaged. Federal officials recommend that Americans limit added sugars to just 10 percent of their daily calories.

Last year, for the first time, the F.D.A. proposed that companies list added sugars on nutrition labels, but consumers would have had to do the math themselves to determine the percentage of calories. Under the new proposal, nutritional labels would lay out that figure.

Agency officials determined that 50 grams of added sugars should be the upper dietary limit, or daily value, for adults and children aged 4 and older.

That means “one 16-ounce soda, and that’s it for added sugars for the day,” said Marion Nestle, a professor of nutrition, food studies and public health at New York University.

Professor Nestle predicted that the label change would not only “affect the choices of the subset of people who read labels” but also, more important, “encourage food manufacturers to look harder for ways to cut down on added sugar in their products.”

Officials at the Grocery Manufacturers Association, a trade group, criticized as inadequate the standards the agency used to establish a dietary value for added sugars.

“Before F.D.A. requires that a percent dietary value be declared for any nutrient, it must assure that the dietary value is based on intake levels evaluated through an independent, rigorous scientific process,” the organization said in a statement.

Last year, the International Food Information Council Foundation, a research organization financed by the food and beverage industry, conducted a survey in which consumers were asked to interpret food labels with information on added sugars.

The survey, published last month in the Journal of the Academy of Nutrition and Dietetics, found that the new language confused a majority of the 1,088 respondents, who mistakenly thought that products with labels listing added sugars contained more sugar than they actually did. People seemed to think “added sugars” were in addition to the total sugar listed.

The survey also found that consumers would be less likely to buy a product if its nutrition panel listed added sugars.

Source: New York Times

Anthem announces definitive agreement to acquire Cigna Corporation.

Anthem, the nation's second largest health insurer by revenue, will acquire Cigna, the nation's fifth largest, the companies announced Friday, creating a health insurance behemoth that raises fresh questions about competition in the industry.

The $54.2 billion deal will create the largest private health insurer as measured by the number of members. It values Cigna at $188 per share, a 38 percent premium from its closing price of $154 a share on Thursday. Cigna shareholders will receive a combination of stock and cash in the transaction.

A merged company would serve 53 million people and is part of a dramatic, long-predicted reshaping of the health insurance landscape from five big players to threet. The new company is projected to generate $115 billion in annual revenues.

UnitedHealth Group has more than 45 million members, and Aetna and Humana announced they would merge in July, creating a company serving 33 million people.

While the major trend of consolidation is the same in these big health care deals, analysts said there are key differences between them. Aetna's deal to buy Humana greatly expanded its presence in the Medicare Advantage marketplace, whereas the Cigna and Anthem merger will have the biggest ripple effects for the commercial insurance market, where both companies are already major players.

"The consolidation of the largest insurers will certainly reduce competition, leaving employers with fewer options for finding a low-priced plan for employees," Paula Wade, analyst at Decision Resources Group wrote in an e-mail.

The deal is a ripple effect of the Affordable Care Act, which changed how insurance companies make money. Analysts say that because of new caps on the profit that insurers can make on their plans, the companies have been looking to cut administrative costs by increasing their scale. They will be able to cut redundant departments and also may be able to make investments in new technology more efficiently. The larger companies will also have increased clout in negotiating rates with hospitals and doctors groups.

“We believe that this transaction will allow us to enhance our competitive position and be better positioned to apply the insights and access of a broad network and dedicated local presence to the health care challenges of the increasingly diverse markets, membership, and communities we serve,” said Joseph Swedish, president and chief executive officer of Anthem, in a statement. He will remain chief executive of the new firm.

"Going forward our new company will deliver an acceleration of innovative and affordable health and protection benefits solutions that help address our health system's challenges and provide supplemental insurance protection, and health care security to consumers, their families, and the communities we share with them," said David M. Cordani, president and chief executive officer of Cigna.

Anthem is parent to the well-known Blue Cross and Blue Shield plans in 14 states and a Medicaid plan called Amerigroup in 19 states. Cigna, meanwhile, has well-known insurance plans in the United States and globally. The combined firm will serve individuals, employees and governments. It will close in late 2016, pending regulatory approvals.

Federal and state regulators are likely to scrutinize both of the deals closely, although the companies have argued that the mergers will benefit consumers. The effect on competition will likely vary by geographical market, and possible anti-trust concerns could arise in some areas where the combined companies might control too large a share of the market.

Wade cited the example of Connecticut, where Anthem already holds 35 percent of the commercial market share. Adding Cigna brings their market share to just over half.

"Where an employer might have had his choice of Anthem, Cigna, UnitedHealth and Aetna, after these mergers he’s only got three companies from which to choose," Wade said.

Some analysts say that the growth of insurance premiums will slow because the industry is regulated and the new companies will be more efficient. For example, Anthem and Cigna are expected to save $2 billion a year from the much larger company within two years, Swedish said Friday morning. Whether those savings trickle down to consumers remains to be seen.

"The premise of the merger for both of these transactions is that they can achieve cost savings and economies of scale, and they of course maintain that will lead to their ability to price even more competitively," said Richard Zall, chair of the health care department at Proskauer, a law firm. "It will take some time to see. ... Is there still sufficient competition in the various markets that it won’t lead to price increases?"

2012 study of the 1999 merger between two large insurers, Aetna and Prudential, found that premiums rose by seven percentage points. Another study in the American Journal of Health Economics found that having more insurers in the marketplaces set up by the Affordable Care Act brought the cost of premiums down.

“The lack of a competitive health insurance market allows the few remaining companies to exploit their market power, dictate premium increases and pursue corporate policies that are contrary to patient interests," Steven J. Stack, president of the American Medical Association said in a statement.

Source:  Washington Post

Image Source: Washington Post. The Anthem logo hangs at the health insurer's corporate headquarters in Indianapolis. (AP Photo/Michael Conroy)

Why is Online Reputation Management Important for Doctors?

Online Reputation Management is the influencing and/or control of an individual's or business's online reputation.

Originally a public relations term, the advancement of internet and social media use, along with reputation management companies, have made it primarily an issue of search results. Parts of reputation management are often associated with ethical grey areas, such as review sites, censoring negative complaints or using SEO tactics to game the system and influence results. There are also ethical forms of reputation management, which are frequently used, such as responding to customer complaints, asking sites to take down incorrect information and using online feedback to influence product development.

Why is an online reputation important for doctors and medical practices?

More patients than ever are going online to research their doctor. According to a study from Pew Internet, 44 percent of patients online do so. And about one in five use physician-rating sites. Physicians don't want to be defined by a negative news story, or a bad review from an online physician-rating site. That's why it's important that they take control of their online reputation before someone else does. The number of patients who consider physician-rating sites to be important is much higher than it was just a few years ago. 

Physicians should see online reviews as an opportunity for growth, and encourage patients to leave positive reviews. A new patient that understands your strengths and flaws and chooses you with awareness of these factors is likely to be a patient you'll enjoy working with. 

Doctors can encourage online reviews and take a few simple steps to developing a good online reputation:

  • Sign up for physician review sites. Don't wait for the reviews to come to you. Create a profile on major review sites. You'll be able to provide the websites with accurate, up to date information, including your practice address, specialties, education, and awards.
  • Respond to reviews. Show patients that you truly care what they think of your service as a medical professional by responding to their reviews, both positive and negative.
  • Consider negative feedback a gift. Hearing the truth hurts, especially if a review is not entirely fair or based on factors outside of your control. Still, negative reviews can help you shed light on missteps in your practice. Patients who complain about long wait times or trouble with filling prescriptions may help you better direct your office staff. 
  • Ask patients to review you. Let patients know that you are proud of your work as a physician, and that you appreciate recommendations, both through word of mouth and online. Place links to physician review sites on your website and newsletters, allowing patients to see and contribute to your reviews online 
It's important for doctors to Google themselves at least once a week and see what comes up, because that's what patients are doing

Source: Reputationmanagement.com, HuffingtonPost.com