Report: Doctors' Personal Beliefs Can Dictate Your Medical Care
Where patients live and which doctors they see strongly influences the procedures they get, and patients may not be playing a large-enough role in making medical decisions. A new report by researchers with the Dartmouth Atlas Project, a group that analyzes how medicine is practiced across the country, found wide differences in rates of elective surgery among Medicare patients nationally. An elderly woman in Victoria, Texas, who has early breast cancer, for example, is seven times more likely to have a mastectomy than her counterpart in Muncie, Ind. (Women with early breast cancer can typically choose between a mastectomy, which removes the entire breast, and breast-conserving surgery, which removes only the tumor and some surrounding tissue.) Patients with chest pain because of heart disease are 10 times more likely to have a blocked artery stented if they live in Elyria, Ohio, than those in Honolulu, who more often rely on medication to manage their condition. And Medicare patients in Casper, Wyo., are nearly six times more likely to have elective back surgery than are New Yorkers in the Bronx, who are more likely to choose to live with the pain or to treat it with nonsurgical options like physical therapy. Differences in doctors' personal beliefs may be behind the findings, the researchers say, and patients' preferences are not always given sufficient weight. "Physicians differ very strongly in their opinions about the value of these procedures," David Goodman, coleader of the Dartmouth Atlas Project, told Reuters. "There are regional differences, or differences in cultures of care, that develop, partly related to how physicians are trained or the history of the place." Since undergoing surgery is an important life event, the researchers say, patients need to make sure they're fully informed, while doctors focus on shared decision-making.
10 Signs You're Exercising Too Much
Regular workouts are supposed to increase your muscle mass and decrease your body fat, right? Well, yes, with a caveat. Some folks ramp it up too much especially when they start a new training regimen to prepare themselves for, say, a grueling marathon or triathlon, fitness blogger Chelsea Bush writes for U.S. News. Overdoing your workouts can actually lead to diminished strength and increased body fat—your body's way of begging for a break. While your body can handle a particularly tough workout, it also needs time to recover from the stress overload, says Corey Stenstrup, performance development trainer at IMG Academies.
The best way to recover from that particularly tough workout? A day or two of rest followed by a light bout of exercise, recommends Stenstrup. Also make a point to get at least eight hours of sleep a night which your body will need to repair those tiny muscle tears that occur during workouts and enable your body to build new muscle. Good nutrition is also key: Think lean protein (fish, skinless chicken breast, tofu), whole grains and plenty of fruits and vegetables. Here are the 10 ways your body will let you know if you're headed for exercise burnout.
1. Decreased performance. A drop in your workout performance is one of the earliest signs of overload, according to Jini Cicero, a conditioning specialist based in Los Angeles, Calif. Altered performance levels are often more apparent in endurance activities such as running, swimming and cycling, she says. [Read more: 10 Signs You're Exercising Too Much.]
Your Strength Routine: 7 Tips to Shake It Up
If you've never done resistance training or a strength routine before, simply learning the exercises is plenty. But once you've mastered the basic moves, you'll need to shake things up in order to progress, U.S. News reports. Here are seven tips for doing that from Rachel Cosgrove, a personal fitness coach and owner (with her husband) of Results Fitness in Santa Clarita, Calif. Her first book, The Fit Chick Body, was published by Rodale in 2009.
Accept that you can't just go on autopilot. It would be nice to be able to memorize one strength routine and simply repeat it with the same set of dumbbells, three times a week, for the rest of your life. But the key to getting stronger, says Cosgrove, is to vary and change things on a regular basis.
Keep a program for four to six weeks. "You don't want to change too often, because then your body can't conquer things," says Cosgrove. Take the first week to master the workout. In the second week, add a second set of each exercise. By the third week, maybe add some more weight or add a third set. By the fourth week, add enough weight to make it really challenging. "We usually say to change one variable at a time," says Cosgrove.
Your program doesn't have to be totally new every time. If you can only do a pushup against a wall, try that for four to six weeks. The next time, you can do the move on your knees, and in your next four- to six-week period, try a regular pushup. [Read more: Your Strength Routine: 7 Tips to Shake It Up.]
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