Australian Humor

Today's post is just for fun, we hope you enjoy it and have a great weekend!

Two traffic patrol officers in Newcastle Australia were clocking motorists with a hand-held radar device. As a suspect car topped the hill, the radar recorded a speed of 800 km/h (500 mph). The officers' confusion was short-lived as the thurdering roar of a low-flying RAAF Boeing F-18 Hornet soared over their heads. Back at the station, the furious Area Commander fired off an email to his counterpart at the nearby Williamtown air base.

The reply:

"Thank you for your message, which allows us to complete the file on this incident. You may be interested to know that the tactical computer on the Hornet had detected the presence of, and subsequently locked onto, your hostile radar equipment and automatically sent a jamming signal back to it.

Furthermore, an air-to-ground missle aboard the fully armed aircraft had automatically locked onto your equipment.

Fortunately, the pilot flying the Hornet recognized the situation for what it was, and was able to override the automated defence system before the missle was launched and you hostile radar installation was destroyed.

Thank you for your enquiry."

Posted by: Scott W. Yates, MD, MBA, MS, FACP

Concierge Doctors: Real Deal Behind Hit Drama 'Royal Pains'

NEW YORK - The premise of the latest hit medical drama sounds improbable even for television: A doctor who makes house calls. In the Hamptons. Dashing among the hedgerows, dropping in on the rich and sick at one eye-popping estate after another.

But come on. Who makes house calls these days, even on TV? The last such doc who did was Marcus Welby, M.D., and he has been off the air for more than 30 years. So Hank Lawson, the young "concierge doctor" on USA Network's Royal Pains, is just another Hollywood fantasy, right?

Not exactly.

Meet Ronald Primas, a middle-aged concierge doctor in Manhattan, where the rich and famous dwell and where parking is usually impossible unless you happen to be a "doctor on call" with the official dashboard sign and license plates to prove it.

Primas, 49, tools around town in a luxury Range Rover with a portable EKG machine in the back and a doctor's bag in the front seat, visiting patients - some of them rich and famous, some of them not - who have figured out that you really can get anything delivered to your door in New York. As long as you're willing to pay - as little as $200 a house call or more than $600 for routine primary care. Cash on the barrel or credit card.

Primas is convinced Royal Pains (Thursdays, 10 p.m.) is based at least in part on him and his practice. Brad Bernstein, a spokesman for NBC (which owns USA), says the show is based on a story that one of the series's creators heard about a doctor in the Hamptons.

On Royal Pains, Hank Lawson (Mark Feuerstein) lives free in a billionaire's fabulous guesthouse. From there, he might be called to a beachfront palace to take care of a senator's son felled by a mysterious ailment. He's accompanied by his beautiful and efficient Anglo-Indian physician's assistant, Divya, and a fully stocked mobile medical van. (Need a portable MRI? No problem!).

Hank gets paid a lot - big, fat checks, although we never see how much. HankMed, as his endearingly schemey brother/CFO Evan has named the business, is soon a hit in the Hamptons.

Discretion is vital.

In Manhattan, Primas lives on the Upper East Side and has a small office on Fifth Avenue in the 70s across from Central Park. When he's not seeing patients there, he might be called to apartment buildings overlooking the park (the kind of pre-war buildings where the apartments are so big they take up the entire floor and the views are staggering). There he will check a CEO's blood pressure or examine a little girl for signs of strep throat while reassuring her worried Wall Streeter parents.

"My fees range, depending on the complexity of the visit, time of face-to-face contact (with the patient), waiting time (because the patient is on a production shoot or it's a visiting head-of-state), the time of day (nights and holidays are more) and ancillary testing," he says.

Despite liberties taken for dramatic effect and despite the fact that Hank Lawson is not only a doctor-on-demand but a sort of a medical MacGyver, too, Primas says Royal Pains is not that far off the mark. Hank's patients crave the same things as Primas'.

"Availability, personalized attention, convenience, discretion," (especially discretion), says Primas, as he heads for Park Avenue on his way to another call, juggling a cellphone and dodging the crowds gawking at the film crew shooting a movie with Jennifer Lopez on the sidewalk across the street from his office.

It will be another long day of seeing patients and taking calls, lasting late into the night. "My life is very hectic," he sighs. "The biggest drawback is the randomness of (a typical day of calls). The problem with celebrities is that if they're paying, they expect you to come RIGHT NOW.

"One of my patients (not a celebrity) lives a few blocks away but just doesn't want to leave the apartment. So I go there," he says. "Some of these people have become my friends, not just patients. After 17 years, I've built up a level of trust and comfort with them."

What he has built is a practice specializing in travel medicine (he makes house calls to luxury hotels to tend to ailing tourists) and the health care of wealthy people and celebrities in Manhattan. Not that he'll talk very much about the latter - discretion, after all. But he has trademarked the title "doctor to the stars," some of whom (Britney, Beyoncé, Kelly Osbourne, Ludacris, Kimora Lee Simmons) have been spotted slipping into his office.

A huge rap fan, he also has music-industry bigwigs as patients. This after starting out his career taking care of poor and homeless people at inner-city clinics in East Harlem and Brooklyn.

"He's great - he makes you feel like family, it's as simple as that," says rapper/actor Ludacris (real name Chris Bridges) by phone, who was referred to Primas five years ago by his record company. "With my strenuous schedule, I need someone on call and I need to be sure of privacy."

Across the country in Southern California, Cheryl BryantBruce is a concierge doctor with a small practice of about two dozen families, most of them celebrity athletes, executives or entertainers (she believes Royal Pains is based on her practice, too). She says many famous people are plagued by stalkers or the media.

"They all want to be sure that no one can access their medical information, because their jobs depend on it," says BryantBruce, who makes house calls and frequently travels with her patients all over the world. "Concierge doctors can offer them that. "

Hotel concierge referrals

But you don't have to be famous or even very rich to get Primas to come to you: About half of his patients are strangers in town staying in hotels; they've fallen ill and have been referred to Primas by the hotel concierge.

On a recent midtown hotel call, Primas took care of Matias Pavan, 15, visiting New York with his family, Argentines who live in Italy. They were afraid Matias had swine flu. Speaking good Spanish, Primas takes a patient history, checks Matias' temperature, swabs the inside of his nose and tests him for flu. It's negative. Matias' parents, Alex Pavan and Laura Sanchez, are relieved.

Later, Primas heads downtown to visit Kelly Klosterman, 38, a marketing consultant from St. Petersburg, Fla., who was in town on business when she started feeling sick. Was it swine flu?

"I went on the Internet and found him," she said, coughing as Primas examined her in the loft overlooking the art gallery where she had been working. "I prefer someone come to me rather than go sit in an office with a lot of other sick people. I figured in New York City, you can find anything," including a doctor who makes house calls. She didn't have swine flu but she did have a sinus infection that migrated to her chest; Primas wrote her a prescription for an antibiotic.

There are an estimated 5,000 concierge, or "boutique," doctors in the country, depending on how you define the term. It's a term much in the news lately for a confluence of reasons, the most obvious being Royal Pains, a surprise summer hit and the top-rated new cable series. Medical dramas are old hat on TV, but this series has enough new twists on the tired formula to attract growing numbers of viewers - more than 7 million at last count.

Another reason for the attention: the death of Michael Jackson, who was taken ill suddenly in his Los Angeles home on June 25 while under the care of what his family called his "personal physician," a cardiologist named Conrad Murray. State and federal authorities are investigating Murray's role in Jackson's death.

There is some question whether Murray was actually a concierge doctor; for one thing, he had only one patient - Jackson - and concierge doctors typically have at least several dozen patients and often several hundred. But in the extensive press coverage of Jackson's death, the term concierge doctor has been applied to Murray.

The third reason for the attention is the ongoing debate over the nation's insurance-based health care system, which concierge doctors have escaped. They provide routine primary care only, don't take insurance, and can charge from as little as $1,500 a year to as much as $25,000 or more charged by elite practices catering to the wealthy. This is on top of the catastrophic health insurance the patient buys to cover serious illness. If a patient has a serious illness, his concierge doctor refers him to specialists and coordinates his care.

Thomas LaGrelius, a concierge doctor in Torrance, Calif., and president of the board of the Society for Innovative Medical Practice Design, a group of concierge doctors, says that 30 years ago almost all doctors were concierge or direct-practice doctors like Marcus Welby. He likes Royal Pains, even though he says Hank Lawson's practice is not typical of most concierge practices today. Even so, LaGrelius says, "any publicity is good."

Concierge medicine may be a niche market now, BryantBruce says, but "people are hearing about it, they're seeing it on TV and they want that, they wish they could afford that," she says. "They're looking back to the days of Marcus Welby, when we all had personal attention from our doctors."

As for Hank Lawson, Royal Pains has just been renewed for a second season.

By Maria Puente, USA TODAY
Posted by: Scott W. Yates, MD, MBA, MS, FACP

The president's Trojan horse

Yes, Obama will push you out of private health care

During his recent speech to the American Medical Association, President
Obama addressed what he called the "illegitimate concern" that "a public
option is somehow a Trojan horse for a single-payer system." Referring
to such concerns, he added that "when you hear the naysayers claim that
I'm trying to bring about government-run health care, know this: They're
not telling the truth."

As the authors of "A Trojan Horse Plan" (Opinion, June 1), we are
perhaps uniquely situated to respond. For our part, we're prepared to
believe that the president honestly thinks his "public option" isn't a
Trojan horse; that he honestly believes it won't lead to government
control of our health care system. What we don't know is why he believes
that.

The Lewin Group, a prominent consulting firm, estimates that, under a
widespread, Medicare-like "public option," 118 million Americans would
lose their private health insurance and be switched onto government-run
care. To the best of our knowledge, the president hasn't cited any
studies to the contrary. When you combine those 118 million with the 80
million people already covered by government health care, there wouldn't
be much room left in which private insurance could operate.

Because he doesn't support a "single-payer" system, the president
implies he doesn't support "government-run health care." But if, through
payment policies, the government decides what doctors we use, what drugs
we can take, and how much is charged, the system is government-run. So
we can agree that Mr. Obama technically isn't supporting a single-payer
system. But he is supporting a government-run system that may well lead
to a single payer.

Mr. Obama says that the "public option" would merely provide Americans
with a new choice for health insurance: "If you like what you're
getting, keep it. Nobody is forcing you to shift." In truth, however,
millions of employers would choose the "public option" - for their
employees.

Given a choice between accepting the cost, risk and burden of continuing
to provide insurance, or having the government take over that
responsibility, millions of employers would bolt. And anyone who
believes a public option plan wouldn't become a tax-subsidized plan
hasn't been watching very closely for the past 50 years.

The president says his proposal will be "deficit-neutral in the next
decade." Given its projected cost of $1.5 trillion over that decade - an
amount greater than the annual gross domestic product (GDP) of Canada -
this is quite a claim.

Keep in mind that we're already running higher deficits - even as a
percentage of GDP - than during the Great Depression. Only 55 percent of
2009 federal spending ($2.2 of $4.0 trillion) comes from tax revenue;
the rest is borrowed money. Yet the creation of a massive new
Medicare-like program won't increase deficits?

The president says this unlikely result will be made possible through
miscellaneous tax increases and Medicare spending reductions, but he
never specifies the cuts. As secretary of health and human services, I
took a budget to Capitol Hill containing half the reductions the
president says Congress must make, and I was politically stoned by those
in his party and many in mine. With all due respect, Mr. President, name
the cuts. Show us the money.

Most of Mr. Obama's claims would be impossible to believe even if there
weren't such a clear track record to support disbelief. In the 1960s,
President Johnson and the Democratic Congress both projected that
Medicare would cost $12 billion in 1990. Its actual cost was $111
billion - 9 times the original estimate. The Medicare Hospital Trust
Fund is now projected to become insolvent in 2016, three years earlier
than last year's estimate.

So, we're prepared to believe, as Mr. Obama watches Congress begin to
build the "public option" Trojan horse, following the blueprint he has
provided, that he honestly thinks this is merely a fine-looking gift for
the American people, and not the vehicle through which government-run
health care will pierce the gates, capture their wallets, and ration
their health care. We're just not prepared to believe he's right.

By: Michael O. Leavitt, secretary of the U.S. Department of Health and
Human Services from 2005-09, is a former director of the Environmental
Protection Agency, and a three-term governor of Utah. Jeffrey H.
Anderson is a senior fellow at the Pacific Research Institute. Published
in The Washington Times.

Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

Small businesses queasy from health care proposal

Worries of cost, limitations rampant among small companies

Like the freon in the air conditioners Stan Johnson's company installs,
his support for health care reform that's been proposed has evaporated.
Johnson made that clear when he testified before Congress' Small
Business Committee about the stimulus package as a representative of the
Air Conditioning Contractors of America; the last question posed to him
was about health care.

"In February, we supported what [President] Obama was floating out as
possible reform of health care. Today, what's on the table our industry
no longer supports," said Johnson, owner of Stan's Heating and Air
Conditioning Inc. in Austin. "The support has evaporated because it is
over-reaching and it is no longer reform, it is a take over."

Johnson's thoughts echo sentiments held by many small business owners
and the associations that represent them, many of which have long sought
health care reform, but are concerned about many of the components in
the America's Affordable Health Choices Act, H.R. 3200, which was
introduced July 15 by Rep. John Dingell, D-Mich.

The main criticisms include:

* The bill's employer mandates and penalties would be too costly for
cash-strapped small business.
* It would limit employers' health care options.
* The legislation does not appropriately address health insurance
reform.

Keeping track of bills

Perhaps compounding fears within the small business community is that
there are multiple versions of the bill on the table.

As of July, there were three versions of H.R. 3200 circulating in the
House, one in the Senate and another is expected from the Senate Finance
Committee, which has jurisdiction over Medicare. Lawmakers expect to
have a bill to present to the entire Fiance Committee on or about Sept.
15. While no one is certain how that bill will end up, small business
proponents have widely criticized H.R. 3200 in its current form.

At the end of July, the National Federation of Independent Businesses
said it opposed the bill "because it threatens the viability of our
nation's job creators ... and fails to address the core challenge facing
small business - cost."

NFIB is also concerned that a public health insurance option, which
Obama has said is an essential part of reform, could hurt the private
insurance industry. Instead, some business and physician organizations
are pushing for greater reform of the private insurance market so that
insurers can provide more health care options. But others, including
U.S. Rep. Lloyd Doggett, D-Texas, say a public option will help small
businesses in the long run.

"For many small businesses, the new Health Insurance Exchange will offer
lower-cost, higher-quality coverage," Doggett said. "Under the current
failed system, too many small businesses cannot secure coverage for
their employees or must pay substantially more than a large business,
while getting less coverage." A spokeswoman for NFIB's Austin chapter,
which opposes much of the proposed bill, said small businesses pay an
average of 18 percent more for health care coverage than their
big-business counterparts.

Today, 62 percent of small businesses with three to 99 employees offer
health benefits, according to the Texas Association of Business.

Pay for coverage or pay a tax?

NFIB's Austin chapter and the Texas Association of Business staunchly
oppose the bill's use of employer mandates to provide health insurance.
Under H.R. 3200, a company with more than $250,000 in payroll will have
to provide insurance or face a payroll tax, starting at 2 percent for
those with payrolls of $250,000 and rising to 8 percent for companies
with payrolls exceeding $400,000. But a different version of the bill
raises the exemption threshold, requiring employers with $500,000 in
payroll or more to provide health insurance. The House will vote next
month on which exemption to include in the bill.

Bill Hammond, president of the Texas Association of Business, said a
payroll tax will be crushing to small businesses already struggling in
the down economy. "It will definitely limit new hires. Businesses large
or small can't afford these taxes," Hammond said. Laura Stromberg,
communications director for NFIB Austin, agreed, saying employer
mandates would have a "devastating ripple effect" for small business.
National NFIB analysts estimate that an employer mandate and the costs
associated with it could cost 1.6 million jobs with more than 1 million
of those jobs lost in the small business sector.

Doggett and others, however, dispute the argument that the proposed bill
would cost jobs.

Access to affordable insurance will make small employers more
competitive in the labor market, and an accessible health care system
should decrease absenteeism and increase productivity, Doggett said.

Jonathan Gruber, an economics professor at the Massachusetts Institute
of Technology, agreed that health care reform is an automatic win for
small businesses. The proposed insurance exchange would reduce premiums,
and tax credits would help many small businesses afford coverage, Gruber
said.

Also, Gruber argued, would-be entrepreneurs who feel locked into their
current jobs because they need employer-provided health insurance would
form new businesses.

Meanwhile, a study commissioned by the Small Business Majority estimated
that if health care reform is enacted, businesses with fewer than 100
employees could collectively save up to $855 billion during the next 10
years compared with what they would otherwise pay for health insurance.
The Small Business Majority is a nonprofit organization that believes
employers should provide health insurance for their workers.

Medical community unsure

Dr. Thomas McHorse, a health care provider and small business owner,
said he believes that employers should be responsible for employees'
health insurance, but that the proposed legislation is still too much of
a moving target to take a stance on the bill. "Any reasonable
businessperson would ask, 'What is the cost of this and how is it going
to get paid for?'" McHorse said. "You can't talk about increasing the
number of people who are covered and talk about reducing costs. That
doesn't follow."

The Texas Medical Association has said the proposed legislation is
troublesome. The bill falls short in areas such as Medicare financing,
health insurance reform and medical liability reform, the association
said.

Austin Business Journal - by Sandra Zaragoza ABJ Staff
Kent Hoover contributed to this report.

Reviewed / Posted by: Scott W. Yates, MD, MBA, MS, FACP

Life expectancy lagging in the United States

Consider the following and then ask yourself why the United States has the same life expectancy as Cuba and Slovenia.

Best, Worst Countries for Life Expectancy

Japan has the world’s greatest life expectancy, and it’s more than twice the life expectancy in Sierra Leone.

That’s according to a new report, World Health Statistics 2009, issued by the World Health Organization.

The report shows that children younger than 5 account for nearly 20% of the world’s deaths, and that child mortality is a major reason for the wide range in life expectancy amount countries.

The World Health Organization’s new report is based on data from 2007, the most recent year for which global life expectancy statistics are available.

The report shows that 14 countries had life expectancies of at least 81 years. Here are those countries, along with their life expectancy for babies born in 2007:

Japan: 83

Australia, Iceland, Italy, San Marino: 82

Andorra, France, Israel, Monaco, New Zealand, Norway, Singapore, Spain, Sweden: 81

At the other end of the life expectancy spectrum, 15 countries had life expectancy below age 50. Here are those countries and their life expectancy for babies born in 2007:

Sierra Leone: 41

Afghanistan: 42

Lesotho, Zimbabwe: 45

Chad, Zambia: 46

Central African Republic, Guinea-Bissau, Mozambique, Swaziland, Uganda: 48

Burkina Faso, Burundi, Mali, Nigeria: 49

In the U.S., life expectancy for a baby born in 2007 is 78 year. Chile, Cuba, Denmark, Kuwait, Slovenia, and the United Arab Emirates share that same life expectancy.

Think you’re healthy?

Don’t answer too quickly. Even though we’re bombarded with health and fitness information, on average American adults still don’t get it.

Researchers at the Medical University of South Carolina compared two large-scale studies covering the period 1988 to 2006 and found the percentage of adults with a body mass index (BMI) greater than 30 rose from 28 percent to 36 percent.

The number of people exercising three times a week or more fell from 53 percent to 43 percent, while the number of people eating five portions of fruit and vegetables a day fell by nearly 40 percent.

The Bottom Line: As Americans, our sedentary, overfed, and indulgent lifestyle trumps our world-class health care system.

From WebMD and World Health Organization: “World Health Statistics, 2009.”
Comments / Posted by M. Keith Schrader, MD

U.S. Adults Dying of Preventable Diseases

Vaccine-Preventable Diseases Kill More Americans Than Car Wrecks

Diseases easily preventable by adult vaccines kill more Americans each year than car wrecks, breast cancer, or AIDS.

Yet relatively few in the U.S. know much about these diseases -- and far too few adults get vaccinated, find surveys by the CDC and the National Foundation for Infectious Diseases (NFID).

"It may surprise you to learn that over 50,000 adults die each year of diseases that are potentially vaccine preventable," NFID president-elect William Schaffner, MD, said at a news conference held to announce the survey results.

"We have a chronic disease epidemic in the U.S. It is taxing our families and taxing our economy," the CDC's Anne Schuchat, MD, said at the news conference. "We have a need for culture change in America. We worry about things when they are really bad rather than focusing on prevention, which can keep us out of the hospital and keep our families thriving."

What are these diseases? Don't be surprised if you don't know. The surveys show that fewer than half of Americans are familiar with this list:

· Flu. Most Americans don't know that flu is the biggest killer of all vaccine-preventable diseases.

· Hepatitis B. Only 40% of Americans say they know about this major cause of liver cancer and liver disease.

· Pneumococcal disease kills 4,500 U.S. adults each year -- yet only 20% of Americans know much about it.

· Meningitis. It's a killer, but only 36% of Americans know this.

· Shingles. Fewer than half of young adults know that chickenpox virus hangs around to cause shingles later in life.

· Human papillomavirus (HPV) causes cervical cancer and genital warts. There are more than 6 million new infections each year, yet only 30% of Americans say they're very aware of the problem.

· Tetanus. Fewer than half of young Americans know tetanus causes lockjaw.

· Pertussis or whooping cough. Only 37% of young people, and only 67% of older people, know that there's a vaccine to prevent this disease, which can be serious in adults but life threatening when adults transmit the disease to young children.

A big problem with getting adults vaccinated is that universal coverage for the cost of vaccines ends when a person turns 19. Many adults think vaccines are just for kids.

As a result, vaccination rates are low. According to the CDC survey:

· Pneumococcal vaccine is used by 25% of Americans at high risk of severe illness and by 60% of Americans aged 65 and older.

· Hepatitis B vaccinations were completed by 32% of high-risk U.S. adults under age 50 and for 34% of non-high-risk adults under age 50.

· HPV vaccinations have been given to only 10.5% of American women 19-26 -- and only 6% got all three shots.

· Tetanus shots are current for only 60% of U.S. adults under age 65 and only 52% for older adults.

· Flu shots are taken by fewer than two-thirds of adults at high risk of severe flu complications.

· Shingles vaccines are taken by only 7% of U.S. adults 60 and older.

"These findings show poor insight and possible complacency about adult immunization among the adult population -- and lack of knowledge about vaccine-preventable diseases in general," Susan J. Rehm, MD, medical director for the NFID, said at the news conference.

By Daniel J. DeNoon, WebMD Health News
Posted by Scott W. Yates, MD, MBA, MS, FACP

Adult ADHD

10 Symptoms of Adult ADHD

Many people think of rowdy kids who can't sit still when they think of attention deficit hyperactivity disorder, or ADHD. But the fact is, symptoms of ADHD can linger into adulthood. In fact, many adults with ADHD aren't aware they have it and don't realize that many of the problems they face, including staying organized or being on time, are symptoms of adult ADHD.

What Causes Adult ADHD?

While experts don't know for sure what causes ADHD, they believe genes may play an important part in who develops attention deficit hyperactivity disorder. Environmental issues, such as exposure to cigarettes or alcohol while in the womb, may also play a role.

Unlike other psychiatric disorders, including anxiety and depression, ADHD can't develop in the adult years. So symptoms must have been present since childhood for a diagnosis of adult ADHD to be made.

10 Adult ADHD Symptoms

The conventionally used diagnostic criteria for ADHD, including the most common symptoms, were developed based on how the condition shows itself in children.

These symptoms include forgetfulness and excessive daydreaming, as well as an inability to sit still, or constant fidgeting with objects.

Yet many experts think adult attention deficit hyperactivity disorder symptoms manifest themselves differently and more subtly. This can make it difficult to recognize and diagnose adult ADHD.

Adult ADHD Symptom No. 1: Problems Getting Organized

For people with ADHD, the increased responsibilities of adulthood -- bills, jobs, and children, to name a few -- can make problems with organization more obvious and more harmful than in childhood. While some ADHD symptoms are more annoying to other people than to the person with the condition, disorganization is often identified by adults struggling with ADHD as a major detractor from quality of life.

Adult ADHD Symptom No. 2: Reckless Driving and Traffic Accidents

Attention deficit hyperactivity disorder makes it hard to keep your attention on a task, so spending time behind the wheel of a car can be difficult. Because of this, ADHD can make some people more likely to speed, have traffic accidents, and lose their driver's licenses.

Adult ADHD Symptom No. 3: Marital Problems

Many people without ADHD have marital problems, of course, so a troubled marriage shouldn't be seen as a red flag for adult ADHD. But there are some marriage problems that are particularly likely to affect the relationships of those with ADHD. Often, the partners of people with undiagnosed ADHD take poor listening skills and an inability to honor commitments as a sign that their partner doesn't care. If you're the person suffering from ADHD, you may not understand why you're partner is upset, and you may feel you're being nagged or blamed for something that's not your fault.

Adult ADHD Symptom No. 4: Extreme Distractibility

Attention deficit hyperactivity disorder is a problem with attention regulation, so adult ADHD can make it difficult to succeed in today's fast-paced, hustle-bustle world. Many people find that distractibility can lead to a history of career underperformance, especially in noisy or busy offices. If you have adult ADHD, you might find that phone calls or email derail your attention, making it hard for you to finish tasks.

Adult ADHD Symptom No. 5: Poor Listening Skills

Do you zone out during long business meetings? Did your husband forget to pick up little Jimmy at baseball practice, even though you called to remind him on his way home? Problems with attention result in poor listening skills in many adults with ADHD, leading to a lot of missed appointments and misunderstandings.

Adult ADHD Symptom No. 6: Restlessness, Problems Relaxing

While many children with ADHD are "hyperactive," this ADHD symptom often appears differently in adults. Rather than bouncing off the walls, adults with ADHD are more likely to exhibit restlessness or find they can't relax. If you have adult ADHD, others might describe you as edgy or tense.

Adult ADHD Symptom No. 7: Problems Starting a Task

Just as children with ADHD often put off doing homework, people with adult ADHD often drag their feet when starting tasks that require a lot of attention. This procrastination often adds to existing problems, including marital disagreements, workplace issues, and problems with friends.

Adult ADHD Symptom No. 8: Chronic Lateness

There are many reasons adults with attention deficit hyperactivity disorder are usually late. First, they're often distracted on the way to an event, maybe realizing the car needs to be washed, and then noticing they're low on gas, and before they know it an hour has gone by. People with adult ADHD also tend to underestimate how much time it takes to finish a task, whether it's a major assignment at work or a simple home repair.

Adult ADHD Symptom No. 9: Angry Outbursts

Attention deficit hyperactivity disorder often leads to problems controlling emotions. Many people with adult ADHD are quick to explode over minor issues. Often, the person with ADHD feels as if they have absolutely no control over their emotions. Many times, their anger fades as quickly as it flared, long before the people who dealt with the outburst have gotten over the incident.

Adult ADHD Symptom No. 10: Prioritizing Issues

Attention deficit hyperactivity disorder can wreak havoc on planning, too. Often, people with adult ADHD mis-prioritize, failing to meet big obligations, like a deadline at work, while spending countless hours on something insignificant, such as getting a higher score on a video game.

Do You Have Adult ADHD?

Only a qualified health professional can make an accurate adult ADHD diagnosis, but there are some self-screening tests that may help you decide whether to consult a medical professional about your adult ADHD symptoms.

Since many different conditions can cause adult ADHD-like symptoms, these tests alone can't diagnose adult ADHD.

If, after talking with a qualified health professional, you or your loved one is diagnosed with adult attention deficit hyperactivity disorder, you'll need to work together with your doctor to design the best treatment plan. Often, adult ADHD is treated with a combination of ADHD medications, such as Adderall, Concerta, Ritalin, or Strattera, and therapy.


From WebMD News
Posted by Scott W. Yates, MD, MBA, MS, FACP

Crazy Talk: Oprah, Wacky Cures & You - Newsweek Takes on Oprah (again)

Live Your Best Life Ever! Wish Away Cancer! Get A Lunchtime Face-Lift! Eradicate Autism! Turn Back The Clock! Thin Your Thighs! Cure Menopause! Harness Positive Energy! Erase Wrinkles! Banish Obesity! Live Your Best Life Ever!

In January, Oprah Winfrey invited Suzanne Somers on her show to share her unusual secrets to staying young. Each morning, the 62-year-old actress and self-help author rubs a potent estrogen cream into the skin on her arm. She smears progesterone on her other arm two weeks a month. And once a day, she uses a syringe to inject estrogen directly into her vagina. The idea is to use these unregulated "bio-identical" hormones to restore her levels back to what they were when she was in her 30s, thus fooling her body into thinking she's a younger woman. According to Somers, the hormones, which are synthesized from plants instead of the usual mare's urine (disgusting but true), are all natural and, unlike conventional hormones, virtually risk-free (not even close to true, but we'll get to that in a minute).

Next come the pills. She swallows 60 vitamins and other preparations every day. "I take about 40 supplements in the morning," she told Oprah, "and then, before I go to bed, I try to remember … to start taking the last 20." She didn't go into it on the show, but in her books she says that she also starts each day by giving herself injections of human growth hormone, vitamin B12 and vitamin B complex. In addition, she wears "nanotechnology patches" to help her sleep, lose weight and promote "overall detoxification." If she drinks wine, she goes to her doctor to rejuvenate her liver with an intravenous drip of vitamin C. If she's exposed to cigarette smoke, she has her blood chemically cleaned with chelation therapy. In the time that's left over, she eats right and exercises, and relieves stress by standing on her head. Somers makes astounding claims about the ability of hormones to treat almost anything that ails the female body. She believes they block disease and will double her life span. "I know I look like some kind of freak and fanatic," she said. "But I want to be there until I'm 110, and I'm going to do what I have to do to get there."

That was apparently good enough for Oprah. "Many people write Suzanne off as a quackadoo," she said. "But she just might be a pioneer." Oprah acknowledged that Somers's claims "have been met with relentless criticism" from doctors. Several times during the show she gave physicians an opportunity to dispute what Somers was saying. But it wasn't quite a fair fight. The doctors who raised these concerns were seated down in the audience and had to wait to be called on. Somers sat onstage next to Oprah, who defended her from attack. "Suzanne swears by bioidenticals and refuses to keep quiet. She'll take on anyone, including any doctor who questions her."

That would be a lot of doctors. Outside Oprah's world, there isn't a raging debate about replacing hormones. Somers "is simply repackaging the old, discredited idea that menopause is some kind of hormone-deficiency disease, and that restoring them will bring back youth," says Dr. Nanette Santoro, director of reproductive endocrinology at Albert Einstein College of Medicine and head of the Reproductive Medicine Clinic at Montefiore Medical Center. They just don't need as much once they get past their childbearing years. Unless a woman has significant discomfort from hot flashes—and most women don't—there is little reason to prescribe them. Most women never use them. Hormone therapy can increase a woman's risk of heart attacks, strokes, blood clots and cancer. And despite Somers's claim that her specially made, non-FDA-approved bioidenticals are "natural" and safer, they are actually synthetic, just like conventional hormones and FDA-approved bioidenticals from pharmacies—and there are no conclusive clinical studies showing they are less risky. That's why endocrinologists advise that women take the smallest dose that alleviates symptoms, and use them only as long as they're needed.

"It completely blew me away that Oprah would go to her for advice on this topic," says Cynthia Pearson, the executive director of the nonprofit National Women's Health Network and an authority on hormone therapy. "I have to say, it diminished my respect."

Somers says it's mainstream doctors who need to get their facts straight. "The problem is that our medical schools do not teach this," she said in a February interview with NEWSWEEK. She believes doctors, scientists and the media are all in the pocket of the pharmaceutical industry. "Billions are spent on marketing drugs, and these companies also support academic research." Free from these entanglements, Somers can see things clearly. "I have spent thousands of hours on this. I've written 18 books on health. I know my stuff."

On Oprah's show, there is one opinion more equal than others; and by the end of the program there was no doubt where Oprah herself stood on the issue. She told her audience that she found Somers's bestselling books on bioidentical hormones "fascinating" and said "every woman should read" what she has to say. She didn't stop there. Oprah said that although she has never had a hot flash, after reading Somers she decided to go on bioidenticals herself. "After one day on bioidentical estrogen, I felt the veil lift," she wrote in O, The Oprah Magazine. "After three days, the sky was bluer, my brain was no longer fuzzy, my memory was sharper. I was literally singing and had a skip in my step." On the show, Oprah had her own word of warning for the medical establishment: "We have the right to demand a better quality of life for ourselves," she said. "And that's what doctors have got to learn to start respecting."

All in all, it was a perfect hour of tabloid television. Who could look away from Suzanne Somers's sad but captivating efforts to turn back time? And if there was a stab of guilt in the pleasure we took in the spectacle, Oprah was close by to ease our minds, to reassure us, with the straightest face, that it was all in the name of science and self-improvement. Oprah routinely grabs viewers with the sort of tales of the strange and absurd that might be found a few clicks over on Maury Povich or Jerry Springer: women who leave their husbands for other women (another recent Oprah episode); a 900-pound mom (ditto). But there is a difference. Oprah makes her audience feel virtuous for gaping at the misfortunes of others. What would be sniffed at as seamy on Maury is somehow praised as anthropology on Oprah. This is Oprah's special brilliance. She is a gifted entertainer, but she makes it seem as though that is beside the point. Oprah is not here to amuse you, she is here to help you. To help you understand your feelings; drop those unwanted pounds; look and feel younger; get your thyroid under control; to smooth your thighs, nip and tuck your wrinkles, awaken your senses and achieve spiritual tranquillity so that you can at last be free to "Live Your Best Life."

Oprah takes these things very seriously. They are, after all, the answers she hopes to find for herself. If Oprah has an exquisite ear for the cravings and anxieties of her audience, it is because she shares them. Her own lifelong quest for love, meaning and fulfillment plays out on her stage each day. In an age of information overload, she offers herself as a guide through the confusion.

Her audience cannot get enough. After more than two decades on the air, the Oprah franchise continues to expand. Forty million people tune in to watch her television show each week. O magazine, which features her picture on every cover, sells more than 2 million copies each month. She has her own satellite radio channel and a very popular Web site. Forbes puts Oprah's personal fortune at $2.7 billion. Her empire is about to get bigger. Oprah has made a deal to launch her own cable television channel that will reach 70 million homes. It will be called, of course, the Oprah Winfrey Network and will include Oprah-approved programming on health and living well. In announcing the deal, Oprah said, "I will now have the opportunity to do this 24 hours a day on a platform that goes on forever."

Oprah says things like this without irony. But really, how could it not go to her head, even a little? Her most ardent fans regard her as an oracle. If she mentions the title of a book, it goes to No. 1. If she says she uses a particular wrinkle cream, it sells out. At Oprah's retail store in Chicago, women can purchase used shoes and outfits that she wore on the show. Her viewers follow her guidance because they like and admire her, sure. But also because they believe that Oprah, with her billions and her Rolodex of experts, doesn't have to settle for second best. If she says something is good, it must be.

This is where things get tricky. Because the truth is, some of what Oprah promotes isn't good, and a lot of the advice her guests dispense on the show is just bad. The Suzanne Somers episode wasn't an oddball occurrence. This kind of thing happens again and again on Oprah. Some of the many experts who cross her stage offer interesting and useful information (props to you, Dr. Oz). Others gush nonsense. Oprah, who holds up her guests as prophets, can't seem to tell the difference. She has the power to summon the most learned authorities on any subject; who would refuse her? Instead, all too often Oprah winds up putting herself and her trusting audience in the hands of celebrity authors and pop-science artists pitching wonder cures and miracle treatments that are questionable or flat-out wrong, and sometimes dangerous.

Oprah would probably not agree with this assessment. She declined to be interviewed for this article, but in a statement she said, "The guests we feature often share their first-person stories in an effort to inform the audience and put a human face on topics relevant to them. I've been saying for years that people are responsible for their actions and their own well-being. I believe my viewers understand the medical information presented on the show is just that—information—not an endorsement or prescription. Rather, my intention is for our viewers to take the information and engage in a dialogue with their medical practitioners about what may be right for them."

The first-person story that, as Oprah says, puts "a human face on topics" is an important part of the show's success. Perhaps Oprah's most attractive quality, and one that sets her apart from other daytime hosts, is that she abhors the celebration of victimhood. She succeeded despite a childhood of abuse, and her own experience left her with very little tolerance for people who indulge in self-pity or blame cruel fate for their troubles. She often features regular people or, even better, celebrities, who have met challenges in their lives.

In 2007, Oprah invited Jenny McCarthy, the Playboy model and actress, to describe her struggle to find help for her young son. When he was 2½, Evan suffered a series of seizures. A neurologist told McCarthy he was autistic. "So what do you think triggered the autism?" Oprah asked McCarthy. "I know you have a theory."

McCarthy is certain that her son contracted autism from the measles, mumps and rubella (MMR) vaccination he received as a baby. She told Oprah that the morning he went in for his checkup, her instincts told her not to allow the doctor to give him the vaccine. "I said to the doctor, I have a very bad feeling about this shot. This is the autism shot, isn't it? And he said no, that is ridiculous; it is a mother's desperate attempt to blame something on autism. And he swore at me." The nurse gave Evan the shot. "And not soon thereafter," McCarthy said, "boom, soul gone from his eyes."

McCarthy is now the most prominent voice in a small but vocal movement of parents with autistic children who are demanding action from the government. They believe that chemicals once used to preserve vaccines, combined with the increase in the number of shots kids get today, have created an epidemic of autism; and that doctors, the government, the media and drug companies are hiding or ignoring the truth. McCarthy declined an interview, but in a statement she said, "I understand that vaccines are an important part of keeping us alive today. My problem is with the ingredients in some vaccines that can become toxic when introduced to children with vulnerable immune systems. I want those children to be able to delay vaccines that could cause them harm."

It is easy to see why parents like McCarthy have latched onto vaccines as the culprit. They want answers, and sadly there are few. Studies have found some genetic and environmental links that may increase the risk of autism, but its causes are still unknown. The baffling rise in the number of autism cases has loosely coincided with an increase in the number of childhood immunizations. Yet researchers have not found a link between the vaccines and autism. Here is what we do know: before vaccinations, thousands of children died or got sick each year from measles, mumps and rubella.

But back on the Oprah show, McCarthy's charges went virtually unchallenged. Oprah praised McCarthy's bravery and plugged her book, but did not invite a physician or scientist to explain to her audience the many studies that contradict the vaccines-autism link. Instead, Oprah read a brief statement from the Centers for Disease Control saying there was no science to prove a connection and that the government was continuing to study the problem. But McCarthy got the last word. "My science is named Evan, and he's at home. That's my science." Oprah might say that McCarthy was just sharing her first-person story and that Oprah wasn't endorsing her point of view. But by the end of the show, the take-away message for any mother with young kids was pretty clear: be afraid.

Oprah told viewers that McCarthy would be available to answer questions and give guidance later that day on Oprah.com. One viewer went online to ask McCarthy what she would do if she could do it all over again. "If I had another child," McCarthy answered, "I would not vaccinate." A mother wrote in to say that she had decided not to give her child the MMR vaccine because of fears of autism. McCarthy was delighted. "I'm so proud you followed your mommy instinct," she wrote. A year later, McCarthy was back on the show for an episode about "Warrior Moms," which gave her another opportunity to expand on her claims about vaccines and autism. Oprah must have liked what she heard. McCarthy became a semiregular guest on the show, and in May, Oprah announced that her production company had signed McCarthy for a talk show of her own.

McCarthy is not the only guest who has warned Oprah's viewers off vaccines. Last summer Dr. Christiane Northrup, a physician and one of Oprah's regular experts, took questions from the audience. One woman asked about the HPV vaccine, which protects women against a sexually transmitted virus that can cause cervical cancer. Northrup advised against getting the shot. "I'm a little against my own profession," she said. "My own profession feels that everyone should be vaccinated." But Northrup cautioned, "There have been some deaths from the vaccine." She suggested a different approach. "Where I'd put my money is getting everybody on a dietary program that would enhance their immunity, and then they would be able to resist that sort of thing. All right?"

It is true that of the millions of women who have received the vaccine, 32 have died in the days or weeks afterward. But in each case, the Centers for Disease Control and the Food and Drug Administration investigated the deaths and found that they were coincidental and were not related to the shot. "This is a very safe vaccine," says Susan Wood, a research professor in the School of Public Health at George Washington University and the former head of the FDA's Office of Women's Health. "Because of the power and influence that Oprah's show has, she should make an extra effort to be clear." Neither did Oprah question Northrup's assertion that women can stop the spread of a cancer-causing sexually transmitted disease by eating healthy foods. There is, Wood says dryly, "no evidence that money spent on general health promotion" will do that. Reached by phone, Northrup herself now concedes she isn't certain that anyone has died from the vaccine. And she didn't mean to leave the impression that women should avoid it. "I would say that there is a chance that they could be injured from it, but I wouldn't say not to take it."

Northrup holds a special place in Oprah's constellation of regular guests. A Dartmouth-educated ob-gyn, she stresses alternative therapies and unseen connections between the soul and the body that she believes conventional doctors overlook, but that she can see. She has written about how she has used Tarot cards to help diagnose her own illnesses. (On her Web site, she sells her own "Women's Wisdom Healing Cards.") In other words, she gets right to the center of Oprah's search for hidden mystical meanings. Oprah says she reads Northrup's menopause book "just like it's the Bible. It's the book next to my bed. I read the Bible. I read that book." (Disclosure: NEWSWEEK correspondent Pat Wingert, who worked on this article, and contributor Barbara Kantrowitz are coauthors of a book on menopause.)

Oprah turned to Northrup for advice in 2007, when, as she put it, she "blew out" her thyroid after a stressful season of work and travel. She felt sick and drained and she gained weight. She asked the doctor to come on the show to explain what was going on. "When I called her to talk about this whole thyroid issue," Oprah told the audience, "she always connects the mind, the body and the spirit."

Thyroid dysfunction, which affects millions of Americans (mostly women), occurs when the thyroid gland located in the neck produces too much or too little thyroid hormone. Too much (hyperthyroidism) and the metabolism races, sometimes causing anxiety and weight loss. Too little (hypothyroidism) and it slows, which, if severe, can lead to depression and weight gain. Many things can trigger the disease, especially autoimmune disorders.

But Northrup believes thyroid problems can also be the result of something else. As she explains in her book, "in many women, thyroid dysfunction develops because of an energy blockage in the throat region, the result of a lifetime of 'swallowing' words one is aching to say."

On the show, she told Oprah that "your body gives you signals: 'Hey, you've been putting too much stuff under the carpet ...' "

Oprah : So your body ... is only manifesting what's really going on with your spirit?

Northrup: But your intellect doesn't know it. This is the important part. It's not—you're not causing this deliberately ... It's your soul bringing it to your attention.

Oprah: Right. It's your soul trying to speak to you.

An interesting theory—but is there anyone who believes that what Oprah suffers from is an inability to express herself? She didn't make it clear on the show what form of the disease she had, or what her doctors believed brought it on. She shared with her audience that she took thyroid medication and spent a month relaxing in Hawaii, where she ate fresh foods and drank soy milk. Northrup advises that in addition to conventional thyroid medication, women should consider taking iodine supplements.

That is just what they shouldn't do, says Dr. David Cooper, a professor of endocrinology at Johns Hopkins medical school who specializes in thyroid disease. "She is mixing truth with fantasy here," he says. First, "thyroid disease has nothing to do with women being downtrodden. She makes it sound like these women brought it on themselves." Cooper agrees that thyroid patients should seek thyroid hormone treatment to bring the symptoms under control. But, he says, Oprah should have stayed clear of soy milk. "If you're hypothyroid and you're taking thyroid medication, you do not want to be taking soy. It will block your body's ability to absorb the medication."

Iodine, he says, can be even riskier. "[Northrup] says iodine deficiency is more common in women, when in reality it's not very common in women at all. This is a myth." The thyroid gland, he says, is extremely sensitive to iodine. "If you have mild hypothyroidism, taking iodine will make it worse."

"The problem is that this all has the aura of being scientific when a lot of it is wrong, or not proven or just utter hogwash," Cooper says. "No wonder it sounds very credible to the patients, and in my opinion, that's even worse. If it was all complete rubbish, people would be more likely to see it for what it really is."

All this dreary talk of measles and cancer and thyroids. Wouldn't you rather "Stop the Clock on Aging!" Hear about "The Latest Age-Defying Breakthroughs!" Get the skinny on the miracle "Lunchtime Face-Lift Which Means No Cutting and No Down Time!" These are all teaser lines Oprah has recited on her show. Oprah hasn't had plastic surgery herself, and she has aired the cautionary tales of desperate, youth-obsessed women who ruined their faces with too many procedures. Yet she seems fascinated with the subject and has been among the first to promote the newest treatments. In 2004, Oprah debuted a new "groundbreaking" procedure on the show called a thread lift. Her guest, dermatologist Karyn Grossman, called it "pretty much as close as you can get to a face-lift without actually cutting."

Oprah liked the sound of that. "Well, let's see what this is, y'all!" she told the audience. She played a video of Grossman performing the procedure on a 61-year-old woman named Sandy. Grossman poked multiple holes on each side of Sandy's face near her ears, eyes and cheekbones, then pulled through thin threads under the skin. The threads caught in her flesh, hoisting her tissue up and back. "Threads are tied off," Oprah enthused, "and a one-hour lunch-break lift."

Sandy was in the audience to show off the results. Oprah flashed the "before" picture, what appeared to be a no-makeup shot under harsh lighting. She looked like a 61-year-old woman with no makeup. Then, the big reveal. Sandy emerged under the warm studio bulbs, her face heavily pancaked with makeup. She looked like a 61-year-old woman heavily pancaked with makeup. It was difficult to tell if there was any difference. But Sandy pronounced herself pleased with the results, and the audience burst into applause.

Oprah said almost nothing about possible risks. "It is a relatively painless procedure, I'm told," she said. "Scarring is minimal, and recovery time is measured in days instead of weeks." Yet according to Plastic Surgery Practice, an industry magazine, some doctors reported that "over time, the suture tends to act like a 'cheese wire'," cutting through delicate facial tissue. Some patients who underwent another version of the procedure, which used barbed threads, experienced bunching of the skin, dimples and scars. Others complained the left and right sides of their faces no longer matched up due to "migration of the sutures." One of the most common complaints, though, was that they couldn't see any improvement at all.

The thread-lift craze, such as it was, did not last long. "You never hear anything about them now," says Dr. Alan Gold of the American Society for Aesthetic Plastic Surgery. "That procedure turned out to have major downsides and rapidly fell into disrepute."

You would not know this from watching Oprah. The New York Times noted problems with the treatment in a 2006 article specifically about the Oprah show's tendency to hype plastic surgery without mentioning the risks. But Oprah never circled back to warn her viewers that they just might want to cross it off their to-do list. Grossman says Oprah never gave her an opening to talk about the downsides, and in the moment it didn't occur to her to raise them herself. If she went on the show again, she says, she'd do things differently. "We should have said, 'This is a new procedure. It looks interesting and exciting, but we don't know everything about it yet and there may be risks that haven't come up yet'."

Oprah was also one of the first to feature a procedure called Thermage. It smooths wrinkles by using radio waves to tighten skin. The Times article noted that Oprah was one of the first to call attention to the $30,000 Thermage machines after they were released in 2003. "The show drove so much interest that our sales reps were selling machines over the phone," the president of the company told the paper. In the years since, Oprah has featured the product numerous times on her TV show and Web site and in her magazine.

In February 2004, dermatologist Brandith Irwin appeared on an episode called "Look Younger! Live Longer!" The show aired again twice over the next two years. Irwin came on the program to promote a book and to talk about cosmetic procedures. She had nothing but praise for Thermage, which was then still a relatively new treatment. "I tell my patients they'll lose about half a day, and then you go back to your normal activities the next day." Neither Oprah nor Irwin said anything about a significant downside to the procedure: it hurt, a lot. And it didn't always work. On her own Web site, Irwin acknowledges that in those early days of Thermage, "the treatments were painful without sedation (we sedated everyone in our office), and the results were inconsistent." O magazine recently ranked Thermage as a four on a pain scale of one to five. Five was "agony." There was also no mention on the show about the potential risks, which included burns and scars.

The makers of Thermage say the latest generation of machines are more effective and far less painful. And the risk of complications is very low. Stephen Fanning, the company's CEO, says Oprah certainly helped drive sales and interest. But he is uncomfortable when his product is promoted without giving people the whole picture. "I think any time you're dealing with a cosmetic device, you always have to present a balanced approach. Oprah didn't." Fanning believes Oprah should have made it clear that Thermage isn't for everyone. "Who isn't a good candidate? Someone who smokes a lot, someone who consumes a lot of alcohol, is not going to get the kind of results they want. The same can be said for someone who has spent a lot of time in the sun."

Yet Irwin says there was no time on the Oprah show to go into these kinds of details. "It was meant to stimulate interest, and then people could go find out about it from their doctor and decide what's appropriate for them. That's what the Web site and the book and office visits are for," Irwin says. "I am in sympathy with the idea of doing better medical segments," she says. "We can't do that in 15 seconds."

Right about now is when you might be asking, is there anything Oprah gets right? In fact, there is. For one, she gives excellent diet and fitness tips. Two of her longest-serving resident experts, Dr. Mehmet Oz and trainer Bob Greene, routinely offer sound, high-quality advice to Oprah and her audience on how to lose weight and improve overall health. For the most part, it is free of the usual diet-industry hype, perhaps because so many of her viewers are on to those scams by now. Oz's and Greene's philosophy amounts to: eat nutritious foods, and exercise.

Oz, fit and handsome, is particularly good at connecting with Oprah's audience. He is a cardiac surgeon at Columbia University and generally sticks to the facts. He is also a natural showman who comes onstage in surgical scrubs, as if he might be asked to perform an emergency heart transplant at any moment. He sometimes arrives carrying preserved body parts as visual aids. On one show, "Everybody Poops," Oz conducted a genuinely fascinating seminar on what comes out the other end. (It should be shaped like an S and "hit the water like a diver from Acapulco." Who knew?)

Oz isn't without his faults. He sometimes keeps quiet on the show when Oprah's out-there experts are spouting their questionable theories. There seems to be an unwritten rule that one Oprah expert may not criticize or correct another, and Oz has an interest in keeping Oprah happy. She has turned his books into mega-bestsellers, and features him on her Web site and in her magazine. Her production company is also bankrolling his own syndicated TV show, Dr. Oz, which debuts in the fall. "My role on The Oprah Winfrey Show was never to assume editorial control or in any way to debate the position that other guests might take," Oz said in a statement. "My participation on the program, much like that of any physician on television, was never intended to replace the discussion necessary between patients and their personal health-care provider."

Oprah, of course, is notoriously bad at sticking with the advice Oz and Greene dispense, especially when it comes to her weight. She laments her inability to keep off the pounds. In January she embarked on yet another attempt to trim down, which means all of Oprah's viewers are now—actually or vicariously—on a diet too. She will lose the weight, and there will be much remarking upon it. But then, in a year, or two, or three, experience teaches us that the fat will likely come back. And she will lament. And then she will do it all over again, with a whole new set of experts armed with the latest breakthrough theories on how to live our next best life and all-new, must-have books and gadgets and ointments to ease the way.

At some point, it would seem, people will stop looking to Oprah for this kind of guidance. This will never happen. Oprah's audience admires her as much for her failings as her successes. In real life, she has almost nothing in common with most of her viewers. She is an unapproachable billionaire with a private jet and homes around the country who hangs out with movie stars. She is not married and has no children. But television Oprah is a different person. She somehow manages to make herself believable as a down-to-earth everywoman. She is your girlfriend who struggles to control her weight and balance her work and personal life, just like you. When she recently related the story of how humiliated she felt when she arrived for a photo shoot to find that she couldn't fit into the clothes she was supposed to wear, she knew she had every member of the audience in her hand. Oprah's show is all about second and third and fourth chances to fix your life, and the promise that the next new thing to come along will be the one that finally works.

This perpetual search for The Answer reached its apex a couple of years ago, when Oprah led the frenzy over The Secret. The video and accompanying book were a rehash of one of the oldest of self-help truisms—"think positive"—refreshed with a dusting of "science." The secret of The Secret was something called the Law of Attraction. As Oprah put it on the show, "It says that the energy, that the thoughts and feelings that you put out into the world, both good and bad, are exactly what is always coming back to you, so you have the life that you have created." Oprah and the teachers of The Secret, as they call themselves, did not mean this metaphorically. They explained that the universe and everything in it are made of vibrating energy, and by thinking positively we can actually "attract" the positive vibrations of the universe and bend them to our will. "You're a field of energy in a larger field of energy," one of The Secret's teachers said. "And like attracts like, and that's very, very scientific."

By harnessing this powerful science, they said, we can have anything we want—happiness, love, fabulous wealth. This was so inspiring to Oprah that she devoted three shows to the product and appeared on Larry King to talk it up more. She said it encapsulated everything she believes. "I've been talking about this for years on my show," she said. "I just never called it The Secret."

On one of the Secret shows, Oprah gave an example of the scientific power of the concept. She said that once, while she was hosting an episode about a man who could blow really big soap bubbles, she was thinking to herself, "Gee, that looks fun. I would like to blow some bubbles." When she returned to her office after the show, there, on her desk, was a silver Tiffany bubble blower. "So I call my assistant," Oprah told the audience. "I say, 'Did you just run out and get me some bubbles? 'Cause I got bubbles by my desk.' And she says, 'No, the bubbles were always there. I bought you bubbles for your birthday and you didn't notice them until today'."

There are many lessons that might be drawn from this anecdote. One is that if you give Oprah a thoughtful gift, she may not bother to notice it or thank you for it. This is not the lesson Oprah took away from her story. Because the way she sees it, her assistant hadn't really given her the gift at all. She gave it to herself. Using the power of The Secret, she said, "I had called in some bubbles."

According to The Secret, however, the Law of Attraction can use the vibrations of the universe to deliver more than just bubbles. The book that Oprah urges everyone to live by teaches that all diseases can be cured with the power of thought alone: "The question frequently asked is, 'When a person has manifested a disease in the body temple … can it be turned around through the power of "right thinking"?' And the answer is absolutely, yes." The book then offers the testimonial of a woman identified as Cathy Goodman. "I was diagnosed with breast cancer. I truly believed in my heart, with my strong faith, that I was already healed. Each day I would say, 'Thank you for my healing'." Goodman watched "very funny movies" to make herself laugh. "From the time I was diagnosed to the time I healed was approximately three months. And that's without any radiation or chemotherapy."

The message got through. In March 2007, the month after the first two shows on The Secret, Oprah invited a woman named Kim Tinkham on the program. She had been diagnosed with breast cancer, and her doctors were urging surgery and chemotherapy. But Tinkham wrote Oprah to say that she had decided to forgo this treatment and instead use The Secret to cure herself. On the show, Oprah seemed genuinely alarmed that Tinkham had taken her endorsement of The Secret so seriously. "When my staff brought this letter to me, I wanted to talk to her," Oprah told the audience. "I said, get her in here, OK?" On air, Oprah urged the woman to listen to her doctors. "I don't think that you should ignore all of the advantages of medical science and try to, through your own mind now because you saw a Secret tape, heal yourself," she said. A few weeks earlier, Oprah could not say enough in praise of The Secret as the guiding philosophy of her life. Now she said that people had somehow gotten the wrong idea. "I think that part of the mistake in translation of The Secret is that it's used to now answer every question in the world. It is not the answer to all questions," she instructed. "I just wanted to say it's a tool. It is not the answer to everything." The Law of Attraction was just one law of many that guide the universe. "Although I live my life that way," Oprah said, "I think it has its flaws."

There were limits to The Secret's healing powers even for Oprah. For there she was, in the months that followed, worrying over her thyroid, ingesting bioidentical hormones and putting on pounds. The Secret warns that all illness and misfortune is caused by attracting the negative power of the universe. "You cannot 'catch' anything unless you think you can," it says. "You are also inviting illness if you are listening to people talking about their illness."

It is possible that this is what happened to Oprah. Listening to so many guests talk about their troubles dampened her energy fields. Yet it may be for the best that things didn't quite work out. What if Oprah had managed to solve all of her problems, to end her search for meaning and fulfillment and spiritual calm and a flatter, firmer stomach by summoning the very power of the universe itself? It might have been hard for her to take Suzanne Somers seriously after that.

Find this article at
http://www.newsweek.com/id/200025

By Weston Kosova and Pat Wingert NEWSWEEK
Published May 30, 2009 From the magazine issue dated Jun 8, 2009

Posted by Scott W. Yates, MD, MBA, MS, FACP