Genetics and Disease Prevention: Complementary or Contradictory?

Clinicians may feel that nothing can be done to change genes, so prevention in a genetic context seems ridiculous. The reality is that genetic preventive healthcare has been a part of clinical practice for years and that future applications are almost limitless. It will soon be possible to sequence an individual's genome, scan it for important gene variations, and create an individualized health plan to modify the effects of these variations, optimizing that individual's health over a lifetime. This article presents an overview of selected clinical disorders, describes ways in which genetics is already being used to improve clinical outcomes, and offers a glimpse into the future of personalized medicine.     

Alcohol recovery and spirituality: strangers, friends, or partners?

Alcoholics Anonymous, with its steady but nonspecific promotion of belief in a higher power and its emphasis on the group process, long held a near-monopoly in the outpatient alcohol recovery field, but its hegemony has now been challenged by two very different perspectives. The first is a nonspiritual approach that emphasizes the individual's capability to find a personal pathway to sobriety, exemplified by Rational Recovery. The second is a faith-based method, built on a religious understanding of alcoholism, of which Celebrate Recovery is a prominent example, based upon Christianity. Most communities offer a variety of approaches, so clinicians who are aware of these differences are in a good position to help patients make intelligent choices among the competing recovery philosophies.     

Herbal or complementary medicine: fact or fiction?

Although herbal medications have been used in medical therapy since the dawn of civilization, they have not undergone careful scientific assessment. Some herbal derivations are exceptional and have become standard therapy in cardiovascular disease; eg, digitalis, reserpine, and aspirin. The high prevalence of herbal use around the world and in the United States today may have a negative impact on patient care when herbal preparations are used in combination with medications ordered by healthcare providers who are not advised of the patient's use of herbs. Healthcare providers need to be familiar with all herbal medications in order to prevent potentially serious reactions between conventional and herbal medications. They should be asking patients about herbal use when first obtaining a medical history. Patients who use alternative therapies do not tell their healthcare providers about such use.     

Qi Gong: medicine or enlightenment?

According to Dr. Yang Jwing-Ming, the translation for Qi Gong would be "Whatever practice or study related with Qi which requires a lot of time and effort". Qi Gong is a practice which combines posture exercises, gestures, breathing and a mental attitude destined to make Qi circulate in order to preserve one's health, cure diseases and prolong life.     

MCOs: cost centers or profit partners for employers?

Although health insurance has traditionally been a cost center for employers, and they are ever striving to reduce such costs, MCOs have the opportunity to become a means for employers to save costs rather then suffer more. By focusing on the total health-related costs affecting businesses' bottom lines, MCOs can become "account managers, " where the "account" reflects all the costs that they can positively affect through their own initiatives, and thereby become true solutions rather than costs. This method will enable them to differentiate themselves from competitors and generate "solution pricing"-based new revenue focusing on outcomes versus coverage. This article covers the rationale for and basics of such a strategy.