Salmonella: Facts and New Guidelines 

Red meat is not bad for you.  Now blue-green meat, that's bad for you!   

~Tommy Smothers

FACTS:   Salmonella is a very common bacteria found worldwide both in and on animals and in the environment.  It causes a disease in humans called Salmonellosis, which is one of the most frequently reported forms of food-poisoning in the United States.  The CDC reports more than 40,000 cases every year, but estimates that 30-40 times that many infections go unreported.  Symptoms include diarrhea, fever, and abdominal cramps 12 to 72 hours after infection and generally last 4-7 days.  Most cases require no treatment.  In some people, however, especially children, the elderly, and those with compromised immune systems, the severity of the diarrhea requires hospitalization.  These same patients are also at risk of blood infections from the bacteria and death.  Around 400 people die every year in the US from Salmonellosis.

Like the dreaded E. coli, Salmonella bacteria are spread by feces contaminated objects and food.  But unlike E. coli infections, cases of Salmonellosis are on the rise and actually increased 10% last year in the United States.  To help turn the tide of infection, the US Department of Agriculture revised many of its cooking and food handling recommendations last month.  Though infections caused by processed foods like peanut butter are difficult, if not impossible, to avoid on the home front, there are many steps that we can all take in the kitchen to reduce the possibility of the disease.

NEW GUIDELINES:  

• Cook whole cuts of meat (even pork) to 145 degrees Fahrenheit using a food thermometer at its thickest point.  Allow the meat to rest for 3 minutes.
• Cook ground meats to 160 degrees.
• Cook poultry to 165 degrees.
• Wash your hands (including underneath your fingernails) for at least 30 seconds with warm water and soap after handling food or using the bathroom.
• Wash cutting surfaces and countertops with ¾ teaspoon of bleach per quart of water.
• Wash fruits and vegetables in clean water before cutting or peeling.
• Refrigerate or freeze foods quickly after grocery shopping or meals.

The Partnership for Food Safety Education, whose members include food-industry associations and food-science professionals, offers many other food safety tips for consumers on its website.

Martin Bucknavage, a food-safety expert at Penn Sate University says "When we have a lapse in good practices, salmonella is an organism that can really take advantage of that."

Opposition grows to Healthcare Act Advisory Panel

The Independent Payment Advisory Board (IPAB), created by the Affordable Care Act (ACA) to set fees and control Medicare costs, is facing unexpected opposition from some ACA supporters, including seven House Democrats who are cosponsoring a Republican-authored IPAB repeal bill and the National Committee to Preserve Social Security and Medicare.

Opponents contend that the IPAB allows Congress to abdicate its responsibility for Medicare costs and services, leaving potentially substantial program cuts in the hands of an unelected panel of bureaucrats which has little Congressional oversight. Proponents contend that healthcare decisions should be evidence-based and that taking them out of the hands of ideological elected officials (liberal or conservative) is just what the system needs.  In any case, some healthcare provider groups, including the American Hospital Association, have expressed concerns about the IPAB, and the GOP Doctors Caucus, made up of Republican physician lawmakers, has asked the White House to reconsider the board.

Your Meds! They can save your life! 

Does your medicine cabinet contain half a dozen partially  

consumed antibiotic prescriptions?

Do you frequently forget to take your meds or even get your prescriptions filled because you can't afford them?

Taking your physician prescribed medication and taking it as prescribed is one of the most important things that you can do to benefit your health.

Sandra Fryhoffer, MD in Medicine Matters recently recounted some sobering American Medical Association (AMA) statistics:

• 75% of Americans don't always take the meds they are prescribed.
• 33% of prescriptions go unfilled.
• Only 1 in 2 people take their prescriptions as prescribed.

In doctor lingo this kind of behavior is called noncompliance.  Noncompliance is expensive both for your health and your pocketbook.  Quite simply, noncompliant patients are much more likely to be hospitalized and even die.  Your annual healthcare costs are twice as much as those who carefully follow their doctor's advice and it's estimated that medication noncompliant patients account for $300 billion in healthcare costs every year!!

It's not about shame and blame.  Patients have a lot on their plates (especially sick ones) and it's easy to forget.  Prescriptions can also have uncomfortable side effects, which definitely influence whether or not people take them.  And meds can be expensive!  Once purchased, the information that accompanies the prescription is often confusing, not helpful, or remains unread.  The AMA and the Food & Drug Administration are working to streamline consumer medication information and there is hope that the healthcare overhaul will improve affordability in the long term. But . . .  

Things you can do now to become more compliant:

• Listen carefully to your doctor, ask questions, take notes during your appointment, and don't hesitate to call us with concerns!
• Take the time to read the medical information inserts that accompany your prescription.
• Use a pill box.
• Keep a list of your current meds - good to have in you wallet, too, in case of an emergency.
• Keep medicine in an easily visible place (out of reach of children).
• Create a positive ritual around taking your medicine.  Perhaps take them with a satisfying cup of your favorite morning drink or create an evening ceremony in which a loved one or cherished caregiver brings them to you - on a platter, with a fresh-picked flower - you get the idea.
• Put refill dates on your calendar and ask your pharmacy to call you with a refill reminder.
• Listen to your body.  Are you feeling under-medicated?  Over-medicated?  Are the side effects really bothering you?  Bring your questions and concerns to your DMHC team.

Concern over ACA and employer-sponsored health insurance

Alan Kronhaus, M.D., CEO

Doctors Making Housecalls