Are You Getting Too Much Medical Care?

Some tests and procedures lead to worse—rather than better—health

With all the high-tech—and expensive—medical care available in the US, you may assume that Americans are among the healthiest people in the world. But that’s not true.

Troubling fact: The US spends more than any other country (about 17% of its gross domestic product) on health care but ranks 12th (among 13 industrialized nations) in measures of overall health, such as life expectancy.

For an insider’s perspective on what’s wrong with our medical system—and advice on how we can protect ourselves—Bottom Line/Health spoke with Dennis Gottfried, MD, who has extensively researched this subject and worked as a general practice physician for more than 25 years. Click here to read full article on Bottom Line/ Health

Critique of AHA/ACC BP Guidelines

The Flawed ANA/ACC Blood Pressure Guidelines:Making More People Sick
by Dennis Gottfried MD on the Huffington Post.

12/19/2017 09:56 am ET

It is well accepted that high blood pressure increases the risk for strokes, heart disease, and kidney failure and that lowering that pressure decreases the risk. Sometimes the treatment for high blood pressure consists solely of life style changes such as regular exercise, diet, and weight control but, more often, medications are also required. These blood pressure medications, although generally not very expensive, still come with a price tag and more importantly, introduce potentially serious Click here to read more



FOMO ( Fear of Missing Out)

Americans are spending increasingly more time online on social networks and among those networks, Facebook is the most popular. This is especially true in the millennial age group, those born between 1980 and the early 2000s. Although one might expect that spending time on social networking would enhance human connection and communication, research actually suggests quite the opposite. Primarily as a result of the widespread use of social networking, the acronym, FOMO, has been added to the Oxford dictionary. FOMO, or fear of missing out, typically arises from posts seen on social media networks. It is defined as anxiety that an interesting or exciting event might currently be happening elsewhere and that the person with FOMO might be missing out on that possibly exciting occurrence. To avoid these feelings, people with FOMO are constantly connecting to social media and checking posts from their various acquaintances. As they view the activities described in other posts, these people feel unworthy, and unfulfilled. They have the fear that other people are having a better time than they are and that they are missing out.
These dissatisfied people with FOMO can also have physical complaints including headache, chest pain, and impaired thinking. The more that they feel like they are left out, the greater the impulse to check social media and it becomes a vicious, time consuming cycle. The higher the FOMO score as measured by a questionnaire (, the lower are the individual’s feeling of autonomy, connectivity, and competence. The greater the use of smartphones and social media, the lower the length and quality of sleep. When separated from their phones in experimental studies, the participants exhibited classical symptoms of addiction withdrawal including rapid heart rate, elevated blood pressure, and anxiety.
With increasing public awareness of these challenges, online apps have been developed to control social media time. Mindfulness training and cognitive behavior therapy, psychological tools, have been successfully employed to limit social media exposure. The attempt is to limit social media contact to one or two specific time windows each day. With this becoming a more common problem, approaches to its control will undoubtedly be aimed at preventing it in the first place through psychological, electronic, or pharmacological means.

Chronic Cough

According to the Center for Disease Control and Prevention, a cough is the most common presenting symptom for a patient to a primary care doctor’s office. Coughs, though, can have a variety of etiologies. The most usual cause of a cough is a viral illness such as the common cold.These coughs typically are associated with runny noses or sore throats and last only a few days although they can linger up to two or three weeks.

A more bothersome cough is the chronic cough which, in adults, is defined as a cough that lasts longer than eight weeks. Although a chronic cough is only rarely serious or life-threatening, it can cause fatigue, loss of sleep, muscle pain, and even depression. A chronic cough has many possible origins, but most are uncommon and only a few conditions cause the vast majority of cases.

Associated symptoms are important in evaluating each person to determine the cause. Is there a history of cigarette smoking, weight loss, excessive shortness of breath, environmental exposures, fevers, or asthma? Occasionally, a chest x-ray might be helpful in finding the etiology.

Overall, the most common cause of a chronic cough is the “upper airway cough syndrome”, more commonly known as post nasal drip. Usually, patients with this problem will complain of nasal congestion or of drainage in the back of their throats. Its treatment may include anti-histamines, decongestants, saline nose rinses, steroid nose spray, and occasionally antibiotics. Improvement with treatment usually occurs within a few days.

About one quarter of chronic coughs are produced by asthma even when wheezes are absent. Treating asthma with inhalers or oral steroids relieves the cough. A condition called non-asthmatic eosinophilic bronchitis is an allergic condition in the airways which is also a frequent cause for a chronic cough. Like asthma, this type of cough improves with inhaled or oral steroids. GERD, or acid reflux, causes heartburn, hoarseness, sour taste, and occasionally, a chronic cough. Weight loss, raising the head of the bed, and medications to decrease gastric acid production can relieve the cough associated with GERD. Other, less common causes of chronic cough, include medications like Lisinopril or Enalapril, chronic lung disease, environmental triggers, and aspiration. The causes for a chronic cough are varied and are only uncommonly related to an infection. Through a careful evaluation, effective treatment can almost always be recommended.