Medical Malpractice

The contemporary health care industry is making substantial efforts to deliver quality care and increasing credentials driven by competition among the organizations. The main objective is to deliver effective health care service proposes to build the management and leadership capacity of health care managers and practitioners. There are many criteria taken into consideration for managing health care organization, such as:

Legislative role: The political & social factors influence on the productivity & accessibility of the health services. Higher medical costs reduces the utilization of services. Private insurance companies restraints from providing more benefits,& also increase premium rates. Non-insurers find difficulty to meet the expenses, & would be deprived of tertiary health care services. Private stake -holders expect profits from their investments, find hard to pay salaries to doctors & nurses, & ultimately derogate to invest in health industry. In such situations, managers or hospital administrators organise for public awareness camps, free consultation programs, special discount offers on investigative procedures, etc to attract customers/ patients.

Science & Technology: Involvement of technology & varied branches of science,such as, toxicology,bio-medical research bio-instrumentation, bio-materials, genetics, rehabilitation engineering, nutrition & diet, & others have accelerated the procedure of the diagnosis & treatment providing quality to life. Medical informatics provide services in various areas, such as, knowledge management, guidance on best practices, education of professionals, & the public,& the use of new communication & computer technologies. Electronic medical record services helps for easy creation, storage, retrieval & research of medical data. It proves remarkable advantage for telemedicine & medical tourism industry. Therefore analysis of outcome measures in comparison to knowledge & technology should prove cost-effective & efficient.

Organization structure: Operating standard equipments, sanitation, hygiene, availability of emergency & safety measures are essential components of hospital. The emerging science of quality management, such as, registered national hospital accreditation certificate, & international accreditation certification (JCAHO, JCI) has occupied the place of pride in hospitals. Six sigma approach for improving methodology, reducing variability & waste, giving greater patient satisfaction rates are highlighted for success.

Managing organization: Hospital administrator have to manage the hospital staff with varied behavioural & educational status.The dangers outcomes of strikes, facing contradictions of union leaders are the major risks involved. Relationship (transformational) leadership motivates & inspires the staff members to see the importance & rate value to the task. Participative leadership works best in circumstances of disasters, outbreaks of epidemics, etc.

Internet & social media: The easy availability of information & knowledge from various intelligent resources has rationally mandated issues, in case of medical negligence, malpractices, illegal procedures,& given power to redress the grievances of our citizens. Therefore, customer feedback reports helps gain goodwill & increase credentials of an organization.

The challenging role of hospital administrator deliberately attempts to make strategies,that principally devotes benefits of health care service to everyone.

As we are all aware, over the last few decades expanding theories of liability and the proliferation of litigation has given increased emphasis to Asset Protection Planning to the extent that it is now a well recognized area of practice. However, traditional Estate Planning has always encompassed the concepts of asset preservation and protection. Accordingly, all of us who have business owners, physicians and other professionals as clients need to be able to integrate our Estate and Business Planning with Asset Protection Planning in order to properly serve the needs of our clients. Certainly the area of Asset Protection Planning is a concern for all of these types of clients.

Why has there been such an increase liability exposure over the past thirty years? There are several reasons, the principal ones of which are as follows:

1.Plaintiffs' lawyers have made huge contingency fees on malpractice and other kinds of claims and class action lawsuits. Obviously, the financial reward drives this kind of legal action.

2.The deep pocket theory where those who are "have nots" want a piece of the assets of those "who have".

3.We live in a victim-oriented society where everyone tries to place blame with financial remuneration attached to it on someone who has the financial resources to pay.

4.The increase media and society awareness of claims results in high notoriety for these types of lawsuits and creates a ready and willing audience of plaintiffs.

Business owners, physicians and other professionals are especially high profile targets because of the public perception of wealth of these types of individuals. The job of the lawyer is to assist these types of clients in setting up and arranging their assets and affairs in a manner that will successfully transfer their legacy to their heirs in the most orderly and tax saving manner while at the same time preserving and protecting their property during lifetime.

I like to talk about implementing the three "Ps":

*Preserve assets for their heirs and family by structuring the proper Estate Plan and by reducing death taxes.

*Protect assets during their lifetime by creating liability shielded entities and lowering financial profiles

*Process the plan by properly designing and implementing strategies in the most practical and skillful manner.

I have devised a significant and fundamental approach to addressing all the legal and tax concerns of business owners, physicians and other professionals by implementing the three "Ps" in a systemic tiered approach which I call "The Ladder of Success". Each step on the ladder or level of strategy provides immediate asset protection and estate planning benefits. Some or all levels of the complete ladder will be applicable to every business owner, physician and professional depending on the individual state of their career development and net worth. The steps on the ladder and the levels of strategy are as follows:

Level One: The Business Entity Itself: This is the entity that must shield and protect the business owner or professional from direct claims against the operating business. There are also several tax and management issues that have to be addressed at this level dealing with the operation of the client's business.

Level Two: Basic Estate Planning: This is the fundamentals of Estate Planning involving the Revocable Trust, Pour Over Wills, Durable Powers of Attorney, Healthcare Directives and Medical Record Release Forms. This level has to be integrated with all the other levels so that the entire plan is cohesive and well coordinated.

Level Three: Exemptions and Marital Planning: At this level, we examine and review exemptions such as ERISA Plans, homesteads, insurance and annuities. Many of these exemptions are state law driven and have to be analyzed on the state of residence basis. Marital planning can be very important with respect to the division of assets between the working and non-working spouse and in some states it is critical as to the manner of how property title is held with respect to the married couple.

Level Four: Liability Protected Entities for Investment Assets: It is especially critical that real estate be protected from claims that may well be either beyond the limits or outside the coverage of insurance and the limited liability company seems to be the best vehicle for this purpose. Other types of investments can also be placed in LLCs for additional protection.

Level Five: Domestic Modular Planning with Asset Protection Trusts: As we are all aware, many states have now adopted favorable Asset Protection Trust legislation such as Nevada, Delaware and Alaska. This means that the Domestic Asset Protection Trust can be utilized to hold title to the member interests of LLCs that hold the underlying investment assets.

Level Six: Offshore Modular Planning with Foreign Asset Protection Trusts: For those clients who have sufficient liquidity and preferably some international connections or attributes, the Offshore Asset Protection Trust can be utilized as the owner of offshore LLCs into which investments and capital can be placed. Because of the jurisdictional limitations involved, this approach maximizes the Asset Protection potential for the client.

Level Seven: Advance Estate Planning Techniques: This level examines more advanced Estate and Asset Protection Planning techniques such as GRATS, Private Annuities and QPRTS as well as certain types of insurance vehicles. In conclusion, by addressing the concerns of professional and business owner clients in this tiered analysis program, the Preservation, Protection and Processing of Estate and Asset Protection Planning can all be accomplished.

Each day children in the United States are hurt in a range of accidents that result in different types of severe injuries. To make matters worse, many of these injuries could have been prevented if a responsible adult had been adequately monitoring the children to ensure proper safety was being used.

The number one cause of death in children over the age of one year is trauma. More than six thousand children die annually from various accidental injuries. In addition to this number, another fourteen million children are injured by a form of careless act.

Children are regularly injured by playground equipment that is not installed correctly, swimming pools that are unsafe, car accidents, animal bites, school bus accidents, falls, poisoning, molestation, as well as from defective products such as cribs, clothing, car seats, strollers, and toys. Furthermore, children may also suffer from being misdiagnosed by a physician or by being negligently treated for an illness.

Anytime a child is injured, there is a great deal of physical, emotional, and financial trauma that results. This can be quite serious and overwhelming to both the child and the parents. In the event that a child is injured so severely he or she loses their life, these feelings are only compounded.

Here are some examples of cases involving child injuries that resulted in large settlements:

Brain Damage Case from Malpractice/Negligence

A delayed diagnosis of appendicitis resulted in permanent brain damage of a two year old boy. In this case, the medical team did not act quickly and did not notice his perforated appendix for a prolonged period of time, which led to a condition known as peritonitis. This then led to metabolic acidosis, which triggered cardiac arrest, causing the boy to have his brain deprived of oxygenated blood for a several minutes.

The boy's father actually brought his son into an outpatient treatment facility a week prior to this episode, and then again three more times. Each time he was released without treatment. It was not until two days before the cardiac arrest took place that he was finally hospitalized. Following the cardiac arrest, the boy was able to be resuscitated, and was hospitalize for nearly five months. The extent of the damage that occurred was severe, and left the boy with spastic quadriplegia, blindness, and a lack of cognitive function. The child now requires 24/7 medical care, for the rest of his life.

Automotive Accident

A fourteen year old boy was riding in the backseat of a motor vehicle that was involved in a head on collision. The driver of the car entered an intersection that was flooded, with no warning signs as to the danger. Even though it was raining earlier in the day, it was not raining at the time of the accident. When the driver entered the flooded road, the car lost traction, spun, crossed into oncoming traffic, and struck another vehicle head on. The child suffered a severe head injury, which caused him to slip into a coma. He also suffered right arm, and left leg fractures. The medical bills alone for the child's care totaled more than half a million dollars. Since the boy suffered brain damage as well, doctors do not believe he will be able to live a normal life, hold a job, and be self-sufficient. In this case, medical expenses, pain and suffering, future medical care expenses, and loss of future earnings were all awarded.

High School Sport Injury

In this case, a thirteen year old boy suffered permanent paralysis as a result of rough housing that took place, without the adults supervising the children noticing. The boys began to wrestle and rough house before football practice, and during this event, another boy jumped on the first boy and injured his spine, severing it. Even though the school maintained the boys were the ones at fault, a settlement found the school district liable and a cash payment was made. The reason the school district could be held liable was because there is a certain amount of supervision that is assumed when children are left in the custody of teachers or coaches. When this is not carried out, negligence occurs. In this case, the settlement was large enough to cover medical expenses, past, present, and future, as well as for assistance for the rest of the child's life.

Negligence by Public Transportation

The severe injuries that were sustained by a sixteen year old girl struck by a train warranted a substantial settlement. The girl's injuries were so severe, that her left lower leg had to be amputated below the knee. When the accident occurred, the girl was crossing the street with a walk signal. Since it was proven that the girl was crossing at the right time, the municipality and the railway were found to be negligent in this case.

Amusement Park Injuries

Every year, thousands of children enjoy the activities found at amusement parks, yet many children suffer injuries in these locations. In one case, a high school student was harmed when a waterslide collapsed. The girl was taking part in her senior class trip, when the slide unexpectedly broke. It was proven that the manager of the amusement park had understaffed the business, which caused a lack of personnel to monitor the rides, and too many children were allowed onto the slide. The girl suffered permanent medical injuries that not only caused a lengthy recovery time; they also caused her to be limited in her future activities.

Abuse at School

One nine year old boy was awarded a hefty settlement after he suffered abuse at school from a teacher. This teacher physically and verbally abused the boy for a period of six months. The end result of this abuse was the teacher throwing the boy across the room, causing him to collide violently with a wall. When it was proven that the school had received many complaints about this teacher from other parents regarding their children being mistreated as well, the district was found liable and was forced to pay damages.

These are just a few cases of child injuries. Any time your child has suffered any type of injury due to someone else's carelessness it is extremely important that you contact a personal injury attorney right away. While the injury cannot be undone, damages can be awarded to help restore some sort of normalcy and to protect your, and your child's, future.

Resource-based relative value scale (RBRVS) is a method used to determine how much money medical providers should be paid by Medicare and health plans. Medicare, under the Reagan administration, initiated in 1985 the development of a new, fair and a more transparent fee schedule. This led to a large study, jointly conducted by researchers at Harvard University and at the American Medical Association, to estimate the relative amounts of "work" physicians contribute to the services they render. The definition of "physician's work" took into account the physician's time, mental effort, judgment, technical skill, physical effort and psychological stress.

The results of the Harvard-AMA study, published in 1988, laid the groundwork for what is now known as the resource-based relative value scale (RBRVS).

Medicare implemented the RBRVS payment system on January 1, 1992.

How Physician Fees Are Determined
The RBRVS breaks down the total cost of providing a particular physician service into 3 components expressed in relative value units, commonly known as RVU's:

1. Physician's work RVU (wRVU) ~ [accounts for 52% of the cost] - Costs include the relative time, effort, and skill for each service.
2. The physician's practice expense RVU (peRVU) ~ [accounts for 44% of the cost] - Costs associated with maintaining a practice, such as rent, equipment, supplies, and non-physician labor.
3. Malpractice expense RVU (mRVU) ~ [accounts for 4% of the cost] - Accounts for the professional liability insurance of the physician.

Each of the three cost components is adjusted by geographic region that accounts for variations across market areas in the cost of living. So a procedure performed in Los Angeles is worth more than a procedure performed in Dallas.

The sum of these geographically adjusted RVU's for a particular service then constitutes the total RVU of that service.

Finally, to convert this schedule into a fee schedule expressed in dollars, the total RVU of a given service is multiplied by a "conversion factor" - a dollar amount per RVU applied to all services in the relative value schedule.

The formula for calculating physician fee schedule payment amount is as follows:

Non-Facility Pricing Amount =

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) + (MP RVU x MP GPCI)] x Conversion Factor (CF)

The conversion factor for CY 2011 was $33.9764 (CF in 2012 is $34.0376).

For example, the 2011 approved amount for CPT 99213 for Los Angeles, CA is calculated as:

Non-Facility Pricing Amount =

[(0.97 x 1.039) + (0.99 x 1.220) + (0.07 x 0.722)] x 33.9764

1.00783 + 1.2078 + 0.05054 = 2.26617 x 33.9764 = $77.00

The Pros and Cons of RVUs
Benefits of using RVUs:

• Useful tool to compare the relative difficulty associated with the different procedures
• Ability to benchmark data
• Associate physician's work to his/her relative time, effort, and skill needed
• Accounts for cost of living variations - higher standard of living equates to higher RVUs

Criticisms against RVUs:

• Payment is based on effort and does not include adjustments for outcomes, quality of service, severity, or demand. This system leads to overuse.


• One effect attributed to the current RBRVS system is incentivizing specialists at the expense of primary care physicians (PCPs) -- because specialist services require more effort and specialized training, they are paid at a higher rate. This leads to fewer people selecting to stay in the field of primary care.


• The Specialty Society Relative Value Scale Update Committee (RUC) is largely privately run. RUC is secretive, with the meetings being closed to the public and uninvited observers.


• The data are effectively copyrighted by the AMA, but its use is required by statute.


• Although the RBRVS system is mandated by the Centers for Medicare and Medicaid Services (CMS) and the data for it appears in the Federal Register, the American Medical Association (AMA) maintains that their copyright of the CPT allows them to charge a license fee to anyone who wishes to associate RVU values with CPT codes. The AMA receives approximately $70 million annually from these fees, making them reluctant to allow the free distribution of tools and data that might help physicians calculate their fees accurately and fairly.

Committees With Influence
The following is a brief explanation of how codes for physician services are developed and priced. Our current payment system is based on procedure codes which are developed by a 17-member committee known as the CPT Editorial Panel. The AMA nominates 11 of 17-member group while the remaining seats are nominated by the Blue Cross and Blue Shield Association, the Health Insurance Association of America, CMS, and the American Hospital Association. The CPT Committee issues new codes twice each year.

Another committee, the Specialty Society Relative Value Scale Update Committee (RUC), meets 3 times a year to set new values, determines the Relative Value Units (RVUs) for each new code, and revalues all existing codes at least once every 5 years. The RUC has 29 members, 23 of whom are appointed by major national medical societies. The six remaining seats are held by the Chair (an AMA appointee) and a representative from the following areas:

• AMA;
• CPT Editorial Panel;
• American Osteopathic Association;
• Health Care Professions Advisory Committee; and
• Practice Expense Review Committee.

Anyone who attends its meetings must sign a confidentiality agreement.

The influence of this secretive panel is enormous. The CMS, which oversees Medicare, typically follows at least 90% of its recommendations in figuring out how much to pay doctors for their work. Medicare spends over $60 billion a year on doctors and other practitioners. Furthermore, many private insurers and Medicaid programs also use the federal system in creating their own fee schedules.

So... what's at the core of our healthcare mess? The doctors and hospitals overcharging? Insurance companies stealing from everyone? Pharmaceutical companies paying-off Senators to allow the continuance of obscene pricing? Medical device manufacturers creating margins of a million percent? The government's ineptitude at administering the Medicare program? Well, yes. And no. These are all contributors (and there are many, many more), but as Curly said to Billy Crystal in City Slickers, it comes down to "One Thing."

Now, it took Billy 1:45 of cinema run time to figure out what that One Thing is. But for the rest of us 300+ million Americans, this healthcare movie is like watching "Lost" - there's no real answer and there's no end in sight. So I'm here to give you the answers to the SATs.

The "One Thing" is entitlement. Every American feels entitled to receive healthcare services for free. It's why we constantly complain about $20 copayments and deductibles. We think that's unfair. The doctors and hospitals make enough money. Why should we have to shell out hard-earned cash because we were unlucky enough to get sick or hurt? I mean, how much did it really cost the doctor to look in my kid's ear for 5 seconds and write a stupid prescription? Is the cost of the ink that much?

Most people deny this is the way they feel. They'll tell you that doctors should get paid well. But the truth is, that is EXACTLY how we all feel. We just don't want to pay for this stuff. So where does this feeling of entitlement come from?

Well, it starts with the insurance companies. There is always going to be a problem when you have a third party paying the bills. Think of it this way... if your father is filthy rich and he happily pays all of your bills, how much attention are you going to pay to prices or the amount of stuff that you buy? Well guess what... when it comes to healthcare, most of us have that rich father. Let me 'splain.

A couple of generations ago, insurance companies recognized a new way to make money by wedging their way in between the doctors and the patients. The result of this was, and is, a system where patients see their doctors, and their insurance company mails their doctor a check. Free healthcare. In point of fact, the original "indemnity" plans paid 80% of the doctor's charges, but the doctors never bothered to collect the other 20% from the patient because the reimbursement was so good, and because they didn't want to upset their "customer". But then came the '80s Wall Street boom. The doctors saw how much money their investment banker friends were making, and wanted to even the playing field. So they started charging more for their services, unbundling their bills and performing more money-generating services and tests.

The same greed entered the hospital, pharmaceutical, medical device, and other healthcare sectors resulting in an explosive increase in costs to the insurers. The insurers (never ones to lose money) responded by developing managed care plans (HMOs & PPOs) to control costs, cutting back on benefits, instituting lifetime caps and exemptions for pre-existing conditions, requiring referrals and preauthorizations, establishing co-pay requirements, increasing deductibles and raising premiums. Doctors got paid less and responded by billing more aggressively and performing extra tests to protect themselves from the rapacious malpractice attorneys. Ultimately, the result is less service for a higher cost.

Now, most Americans get health insurance through their employers (or the government), who pick up most, if not all of the premium payments. In recent years, as the cost of insurance has escalated, the employers have passed more of the costs on to the employees. So an employee might be paying $50, for example, out of each bi-weekly paycheck for health insurance ($1,200/year) plus a $20 co-pay when they see their doctor. But their employer is likely paying $20,000/year to their insurance company (or self-insured administrator) on their behalf. A nice perk, but very few employees recognize or appreciate this. They see the health benefit as a "given right" instead of viewing it as additional compensation. I have a friend who just lost his senior-level Wall Street job, and his primary complaint is that, in addition to not earning income, he now has to pay $25,000/yr for health insurance for his family. In the words of Bruce Willis, "welcome to the party, pal." He has been incessantly whining because this is a new expense for him that is unfair. Of course, the fact that he earned a million dollars a year for umpteen years and got health coverage for free didn't seem to soften the blow for him. Entitlement!

And then there's the "pass the bill" attitude. Since insurance is paying the majority of our healthcare bills, we want to get the most for our money. It's like going out to a fine restaurant with a large group. Everyone subscribes to the Nash Equilibrium concept and orders the most expensive dish and multiple drinks, figuring that when the bill is split equally among the throng, they'll pay less than their fair share because those that have consumed less will make-up the difference. The only problem is, in healthcare everyone is gaming the system.

So we all go to the doctor and allow him/her to take unnecessary x-rays, perform extra blood tests, do unnecessary vascular doppler studies, hearing tests, physical therapy - whatever - because the insurance company is paying. What do we care??

Well, here's what happens. The bills get passed to the insurance company and they respond by raising the price of coverage, which you and I pay directly, or indirectly in the form of a smaller paycheck from our employer. And we thought we were getting away with something - that someone else would pick-up the tab. In reality, when you litter in healthcare, you will, at some point, have to clean-up your own mess. The penalty is guaranteed... it's just delayed.

Now, in the case where Medicare (the government) is the insurer, eventually the system runs out of money. And they can't pass the loss on to employers, so they pass it on to the tax payer - YOU and ME! So along comes Obama who says we have to fix this. Well... there are 3 components of healthcare delivery, and to fix the system, all 3 have to lose money. And we all know, nobody likes to lose money. Those 3 components are 1) Providers [i.e. doctors and hospitals]; 2) Insurance companies; and 3) Businesses that feed off healthcare like pharma companies, blood labs, imaging centers, medical device manufacturers, etc. And all three lobby heavily to both sides of the aisle to block this new legislation that will blow-up the runaway, money-generating healthcare gravy train.

The Republicans argue that reform will be bad for business, generate unrecoverable debt, and result in poorer healthcare services because of government mismanagement. The Democrats argue that everyone is entitled to healthcare access at any cost. But there is one thing we all agree on - SOMETHING has to be done. We just don't want to pay for it. A complicated issue, to be sure. Let's just hope we're moving in the right direction. That we're entitled to.

Many men are a bit hesitant to get moving immediately right towards doing hand exercises and so they do substantial research before they begin to gather as much information as possible. But, one of the first things that they need to know right after they realize that these are 100% real is if they will experience any pain doing them.

A lot of guys want to know what sort of agony should they be expecting with these routines. The answer is that If you maintain your reason and do not go insane, but maintain a normal exercise schedule then you need to experience no absolutely zero discomfort. It is now known that the pressure you are applying to yourself with these motions is about equivalent to that of masturbation techniques. But, unlike masturbatory methods you are not applying stress to the head of your manhood so in that respect these are less risky than anything else.

If you begin to feel sore, or if you are feeling any pain or you try and do too much in a short period of time then you are going to need to stop. There is nothing else on the face of the earth that will get you larger besides these and a medical procedure. And the medical option will get you nowhere near as big as these, the most they claim to add is about 1 inch. Addi tonally, that is thousands of dollars and involved cutting your most prized possession with the risk of infection, impotence, or malpractice.

Personal Injury is one of the broadest subjects of civil law. It can include anybody from individuals to big companies. An injury in the law's point of view is not similar to what a medical doctor might think. Personal injury lawsuits can be divided into cases of negligence and intentional acts.

Negligence is the term used when the individual who is the source of harm did not mean to cause the injury yet was not careful with the wellbeing of other individuals. Examples for such case are a driver in a vehicular accident or a doctor of a patient who dies pointlessly. In order to get the upper hand in a negligence suit, the plaintiff must explain that the defendant has a responsibility to exercise sensible care, that the defendant ignored that duty, that the injury was caused by this violation of his duty, and that the injury could have been prevented had the duty not been breached.

In the situation of a vehicular accident, the driver of the car has a duty to passengers, pedestrians, and other motorists to drive safely. It can be foreseen that errors made while operating a vehicle, if not careful, can have the consequence of accidents which may harm others. As a result, a person that was harmed in this accident has a right to accuse the driver of negligence and coerce him to pay for the damages caused.

Some common examples of negligence consist of vehicular accidents, slip-and-fall mishaps due to faulty design or improper maintenance, and medical/dental malpractice suits.

Intentional tort is the term used for cases where the individual intended to commit a wrongful act and, thus, caused harm to another. Most commonly, it will not matter if the harm was intended, or if the harm done is far more serious than originally intended.

The legal point of view, it is close to impossible to get compensation from the individual who made the assault because insurance doesn't cover those. Nevertheless, some injuries are the effects of the actions of multiple parties or more than one cause of action may come from the same act. Take the case of a child day care services, they have a duty to afford sufficient supervision of its surroundings to ensure that the kids are out of harm's way, which includes keeping them away from the likely wrongful acts of outsiders. Thus, if child molestation occurs, the act itself is considered an intentional tort. Nonetheless, if the daycare center allowed the outsider to enter the site or did not thoroughly screen their employees and a child happened to be molested, they are guilty of negligence.

The complex U.S. legal system requires attorneys to work exclusively in specific aspects of the law. Lawyers, who specialize in trying cases, are the most financially successful. This group has an unsavory reputation for good reason. The tort lawyer lobby is powerful in Washington, DC because it donates more money than any other campaign contributor and enjoys the empathy of the many elected legislators, who are, in many cases, lawyers. Laws are on the books to expose individuals, professions, and industries to expensive, often unnecessary, liability suits because of their lobby's effectiveness with Congress. Trial lawyers' lobby prevents any legislation that would cap damage awards.

As a result, the health services have been seriously impacted. Hospitals and physicians are the victims of lawsuits, many unfounded, and the unrealistic awards are meted out by unsophisticated juries. Hospitals and health-care professionals have been forced to cut or discontinue their services because of rising insurance premiums (due in part to the numerous liability lawsuits). Certain medical specialties such as surgery, cardiology, and obstetrics have become shorthanded because of the high cost of malpractice insurance.

The liability laws have been cleverly crafted so that tort lawyers can claim responsibility for harm against anyone or any entity even remotely involved. Consequently, lawsuits routinely name a multitude of defendants. Many of the named defendants end up settling, even if they could prevail, because of the prohibitive cost of lawsuits. The person or company with the most money is the main litigant - what's known as going after "the deep pockets." Trial lawyers cause and have caused serious damage to industries, while earning huge fees for this disservice.

Lawyers earn the largest fees through class-action lawsuits, and tort lawyers are the instigators of today's favorable class-action regulations. This one-sided piece of legislation allows attorneys to sue on behalf of individuals without getting the written permission of the majority of the class affected. Successful class-action suits result in millions of dollars for the barristers and far less for the people for whom the suit was filed. Many of these cases are based on technicalities and pseudo science.

As noted previously, trial lawyers, one of the most effective special interest groups, have and continue to cause considerable damage to this country. Their influence with the legislature has distorted the laws to their advantage resulting in an abuse of the principles of justice. These aggressive lawyers take advantage of inexperienced juries to gain outrageous sums of money for themselves and their clients. The most abused case type is the class action suit. Currently, trial lawyers can apply for class action status with a just a few of the injured parties as their clients. They get huge fees that are way out of proportion to the amount of money their clients receive in these lawsuits. There have been attempts to pass legislature to cap awards or move these cases to Federal courts with no success because of the power of the trial lawyer's lobby.

There are several reforms that would be effective in correcting the tort abuse in America, require: experts, in the discipline of the case, to set the monetary awards; written permission from a majority of the harmed individuals in the class to represent them; that the lawyers earn a fixed percentage of the amount of money each client receives.

Wouldn't it be good if you could just massage in wrinkle cream as they do on those wonderful commercials we all see and all your lines and wrinkles start to fade away? Well unfortunately it just isn't as simple as that and even those products that do seem to achieve a positive outcome can really only have a limited amount of success

You are just not going to get the same encouraging results that you would with a Botox treatment but never the less using good quality anti wrinkle cream on a regular basis will help to keep your skin in a much better condition. That alone will help you to remain looking younger for longer. Most of the best anti wrinkle products on the market will have ingredients in them that will help to stimulate the production of collagen.

Collagen is the support structure that helps the skin to retain a youthful appearance and remain plump and firm looking. The more collagen the better the tone and condition of the skin and does play a huge part in helping to slow down and sometimes even reverse the ageing process.

These skin care products sometimes not as good as medical invasive procedures but they do have their benefits in low costs and the convenience of use.

There are many of us who are reluctant to use any form of invasive procedures they are often very expensive and there are stories of malpractice that can have devastating effects. Certainly there are many anti ageing skin care products that can help to make considerable improvements if the right one is carefully chosen for your individual skin type.

No doubt you will read the many glowing testimonials that are available to help sell almost any product on the market but there have been many tests done that have shown that there is no correlation between the benefits that these anti wrinkle/anti ageing products deliver and the prices that you have to pay. Just because you are paying a high price doesn't mean the product is any better and of course products normally in the lower price range are not always beneficial either.

Before any such product comes to market it must undergo a vast amount of research and vigorous testing and this comes at a cost to the manufacturer. This is of course reflected in the product price so if it is at a very low cost then perhaps you do really only get what you pay for, better perhaps to concentrate your search in the medium price range of available solutions to the problem.

Try small samples of products that you believe will help you and look at the results with an open mind to see whether they are worthwhile or not. There are creams that can certainly help to get you looking and feeling better but remember that they have different effects for different people and no two people will get the same results.

As families begin to confront the decisions involved in how to best care for a loved one who no longer is able to live alone, who requires assistance with daily living, or requires medical care, family relationships are becoming increasingly strained. According to Susan Butterwick, Esq, Directing Attorney for caregiver mediation projects for the Center for Social Gerontology, Ann Arbor, MI.; mediator and mediation trainer, "this is one of the most difficult dilemmas our society, families, caregivers and elders face. Families often find themselves on opposing sides in a courtroom involved in contested litigation over how best to care for a loved one."

Indeed, today family conflict is not uncommon - especially when care needs are great. This is the first in a two-part series on mediation. What mediation means, how the parties in the mediation process resolve conflict, the value of mediation will be presented along with helpful websites to access. A follow-up sequel (Spring 2003 Guide) will explore the specialization family caregiver mediation and explain how this process helps to salvage precious family ties while coping with caregiving issues for a parent or another significant other.

Mediation has been recognized in Ohio for over twenty years. It is an informal, confidential process held in a private setting in which a neutral third party (mediator) helps people to better understand their individual interests and needs then to develop and agree on a workable solution to their problem(s).

Mediation is different than other alternative dispute resolution processes in the following ways. Usually, a negotiation involves the opposing parties and there is not a neutral third party. Arbitration uses a neutral third party who actually makes the decision on how to resolve the conflict. Litigation is far more expensive and time consuming than mediation and involves a judge who makes the final decisions. According to Butterwick, in litigation and arbitration, there is usually a "WINNER" and a "LOSER." In mediation, however, the goal is for opposing parties to work toward a "win-win" solution; the mediator has no decision-making role in the mediation process. Mediation may be voluntary or court ordered. Butterwick adds, "if it is court ordered, the parties are ordered only to show up for the mediation and the rest of the process is voluntary". It is confidential in either case.

The mediation process has several advantages. A main advantage is that the parties retain control over the decision(s) they choose to agree to in writing. Also, results are generally win-win because outcomes fit the needs and interests of the opposing individuals. Because the outcomes also reflect the party's choices and priorities, in turn, there is a higher level of compliance (80-85%) with the written agreement than with court judgments which according to Butterwick is much lower.

The beauty of mediation is that individuals are validated and empowered by the process. The way one sees a deeply felt problem is deemed as equally important as the other's view. The same is true for the options offered for resolving the problem. Anxiety can lessen as the opposing parties are treated and communicated with in a compassionate, courteous, respectful manner. Another plus is that the groundwork is laid for improving the overall relationship as the parties work out their differences with the help of a neutral third party.

A mediators can be court staff, volunteers at mediation centers, attorneys and private practice mediators Fees can vary widely (see http://www.mediate.com.) For a Consumer Guide on selecting a mediator see http://www.state.oh.us / Useful Resources. Topics of disputes are numerous. Some include business, contract, landlord/tenant, property damage, neighbor issues, domestic violence, discrimination and other workplace issues, intellectual property, real estate, personal injury, malpractice, victim- offender, civil rights, special education, divorce, child protection, family issues, and adult guardianship.

According to Butterwick, family caregiver mediation is a relatively new outgrowth of adult guardianship mediation being explored and implemented by The Center For Social Gerontology who has found the need for mediating effective solutions to address problems that arise in family caregiver situations is significant.

As a cardiac surgeon, along with other prominent physicians labeled "opinion makers," we insisted heart disease resulted from the simple fact of elevated blood cholesterol.

The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter, of course, we physicians insisted would lower cholesterol and heart disease.

Deviations from these recommendations were considered heresy and could quite possibly result in malpractice. Despite the fact that 25% of the population takes expensive statin medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.

Let Me Say Emphatically, It Is Not Working!

Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.

The cholesterol theory led to no-fat, low-fat dietary recommendations that in turn created the very foods now causing an epidemic of inflammation. These recommendations are no longer scientifically or morally defensible.

The epidemics of obesity, heart disease and diabetes, consequences of which dwarf any historical plague in terms of mortality, human suffering and economic consequences, are the result of those dietary recommendations.

We followed the recommended mainstream diet not knowing we were causing repeated injury to our blood vessels. We now know this repeated injury creates chronic inflammation leading to those diseases.

Simply stated, without inflammation being present in the body, cholesterol would not become trapped in the artery wall; instead, it would move freely throughout as nature intended.

Inflammation

Inflammation is simply your body's natural defense to a foreign invader such as a bacteria, toxin or virus. The cycle of inflammation is perfect in how it protects your body from bacterial and viral invaders. However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process, a condition results called chronic inflammation.

Chronic inflammation is just as harmful as acute inflammation is beneficial. The biggest culprits of inflammation are overloads of simple, highly processed carbohydrates (sugar, flour and all the products made from them) and the excess consumption of Omega-6 vegetable oils like soybean, corn and sunflower that are found in many processed foods.

Sugar And Simple Carbohydrates

When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works. When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat.

Omega-6 Oils

Processed foods are manufactured with Omega-6 oils for longer shelf life; chips and fries are soaked in soybean oil. While Omega-6's are essential being part of every cell membrane controlling what goes in and out of the cell - they must be in correct balance with Omega-3's. When the balance shifts to excessive Omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation.

Today's main stream diet has produced an imbalance ratio from 15:1 to as high as 30:1 in favor of Omega-6. That's a tremendous amount of cytokines causing inflammation. In today's food environment, a 3:1 ratio would be optimal and healthy.

Animal Fat

Animal fats contain less than 20% Omega-6 and are much less likely to cause inflammation than the supposedly healthy oils labeled polyunsaturated. The science that saturated fat alone causes heart disease is non-existent.

The science that saturated fat raises blood cholesterol is also very weak. Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today.

Fat Cells -- Pro-Inflammatory Chemicals

Excess weight creates overloaded fat cells that emit large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar. In time this vicious cycle creates heart disease, high blood pressure, diabetes and finally, Alzheimer's disease, as the inflammatory process continues unabated.

I have peered inside thousands upon thousands of arteries. Arterial inflammation looks as if someone took a brush and scrubbed repeatedly against its wall. Several times a day, every day, the foods we eat create small injuries compounding into more injuries, causing the body to respond continuously and appropriately with inflammation.

How To Quiet Inflammation

To quiet inflammation, return to foods closer to their natural state. To build muscle, eat more protein. Choose carbohydrates that are very complex such as colorful fruits and vegetables. Cut down on or eliminate inflammation-causing Omega-6 fats like corn and soybean oil and processed foods made from them. One tablespoon of corn oil contains 7,280 mg of Omega-6; soybean contains 6,940 mg. Instead, use olive oil or butter from grass-fed beef.

Choose whole foods your grandmother served and not those your mom turned to as grocery store aisles filled with manufactured foods. By eliminating inflammatory foods and adding essential nutrients, you will reverse years of damage in your arteries and throughout your body from consuming the typical American diet.

Today's nurse is not yesterday's nurse. We are still caregivers, but through the years we have evolved into leaders, not followers. We still take orders, but today we have the ability to question these orders and the professional responsibility to assess and evaluate them. We no longer receive an assignment and spend the next eight hours doing tasks.

In nursing whether you are an RN Registered Nurse or an LVN Licensed Vocational Nurse or an LPN Licensed Practical Nurse we are responsible for safe practice. What does this mean? It means assessment (monitoring and observing); it means to plan and implement nursing care; it means to implement specific actions (such as teaching and supervision); it means evaluating nursing care (observing, monitoring and communicating); it means maintaining adequate documentation; it means working within our scope of practice.

When a patient asks for pain medication, it's not enough to give it and walk away. Nurses must follow the steps of safe practice: Where is the pain? What is the level of pain on a scale of 0 -10? What makes it better and what makes it worse? When was the patient last medicated for pain? What was the medication, how much medication and did the patient receive any relief? Now it may be time to administer the pain medication, document this, reassess in one hour, and then document the effect.

Each licensed nurse whether practicing RN nursing, LVN nursing or LPN nursing is responsible for knowing the Nurse Practice Act in their state. This is the law that controls the practice of nursing. The nurse must also know and understand the Standard of Care for the facility in which they are working. Procedures and polices can differ from facility to facility. A nurse also needs to know the difference between negligence and malpractice.

What are the qualities of an effective leader? One that is supportive and creates a positive environment; one who is assertive and makes needs and desires known; one who is sensitive and objective; one who uses active listening skills; one who is responsible and dependable; one who facilitates: one who provides resources and motivates others.

Each nurse needs to take responsibility for their professionalism. We need to remember that we not only represent ourselves but each other. Be proud of being a nurse, take it seriously. Continuing education in RN courses, LVN courses or LPN courses is a necessary and important part of our profession. Medicine changes rapidly and nurses need to be aware of new technology. We are lucky to have so many different specialties to work in. Whatever you are doing, remember you are a professional!

This article is one of a series, collectively titled "The Dirty Dozen: Mistakes That Could Ruin Your Business." Making these mistakes can be very costly in both time and money, but all of these possible mistakes can be easily avoided by some advance knowledge and planning ahead. Although I think the information in this series of articles can be very valuable to home business operators, it is very important for you to know that I am writing this series of articles solely from a "lessons learned" perspective. I am not a legal, tax, or accounting professional. You should consult an appropriate professional for detailed advice that is specifically relevant for you and your business.

In this article, I am going to discuss the potential problem areas of setting up your home computer business identity and not carrying adequate insurance.

Let's start with properly setting up your home computer business identity. No clue what this means? Welcome to the club! It was all pretty much a mystery to me when I got started running my own business.

The situation is basically this: your business must have its own "self," just like you do. But here's the difference. You didn't get to choose who you would be, select your own name, etc. You can (and must) make all those choices for your business.

To begin with, you must decide what kind of legal and tax identity your business will have. There are two big possibilities: a sole proprietorship, or a corporation (Inc. or LLC). Each of these possibilities has advantages and disadvantages, which may vary a lot based on your own tax situation, your expected business income, and even the state in which you live (in the United States).

Many, perhaps most, small businesses are operated as a "sole proprietorship." This essentially means that you are the "only owner" of your business. It is usually the easiest type of business to set up, and it generally requires no "set up" costs other than perhaps a business license if your local government (city, county, etc.) requires you to have one. Under a sole proprietorship, you and your business are seen as being one single entity. All business records will include your name, your Social Security number, etc. Your personal income (say, from your existing job) and your business income will be counted together when you do your taxes, which minimizes number of IRS forms you need to fill out.

However, one of the big reasons that some business owners invest the time and money to set up a different type of business ownership is precisely because, in a sole proprietorship, you and your business are regarded as a single "being."

Here's one potential problem with that type of business identity. Let's say you own a little ice cream shop, and you operate it as a sole proprietorship. You're not making a huge amount of money after expenses, but it's working, and it's getting better week by week, and you have actually set aside $10,000 in profits.

Then, one awful day, little Joey comes in, slips on melted ice cream you haven't wiped up yet, gets a complicated break in his right arm, and the fall gives him a concussion. You could be responsible for the costs of all of that -- Joey's hours in the emergency room, the consultation with pediatric neurosurgeons, the orthopedic surgeon who specializes in setting really bad bone fractures, Joey's X-rays, his MRI and CAT scans, his two days in the pediatric intensive care unit - I think you can probably add even more. And that is all hoping that Joey's mother doesn't sue you for negligence (being careless or irresponsible) in addition to paying for all of his medical bills!

Those costs could burn through your $10,000 in profits in a couple of days - and that's not even the worst of it. Because you and your business are seen as one entity in a sole proprietorship, you and your business share both income and liabilities. That could mean that after you have spent your $10,000 in business profits, you could be required to start paying the rest of Joey's medical costs with your "own" money. In effect, all of your personal income and assets could become vulnerable to being used to cover your business costs.

It doesn't even have to be a big dramatic situation like little Joey to create big problems for you. What if you ordered a gigantic amount of ice cream for the summer, and it rains most of the time from June until September? Your business income will probably go way down below what you expected, and your profits may not be enough to cover the cost of all that ice cream that is still in your freezer - not to mention that you're having trouble covering your store rent and utilities with only a few people buying ice cream in a rainy summer. Same problem. After you've used up your saved $10,000 in profits, you could be required to use your own savings etc. to pay those bills.

Pretty scary, huh? Now, admittedly, those are pretty extreme made-up examples. But the point remains. In a sole proprietorship, your personal assets can be taken to cover your business expenses.

Enter corporations. A huge difference between designating your business as some type of corporation vs. a sole proprietorship is that your incorporated business is seen as being a separate entity from you and your personal income and assets. To make this seem more real, consider again little Joey and his accident in your ice cream store. If your ice cream business was set up as a corporation, Joey's medical bills would belong to your corporation - not you personally. Then when you used up your $10,000 in corporate assets to pay his bills, your personal assets could be protected from being taken to cover any of Joey's remaining bills. Same thing with all the ice cream from the rainy summer. Even if your corporation owes money to your ice cream supplier etc., those people cannot take your personal assets to pay your corporation's bills.

As an internet entrepreneur, you are probably way less vulnerable to physical injury and unsold merchandise problems than "real business" owners are. So it may make perfectly good sense to start your home business as a "paperwork-simple" sole proprietorship. The important thing here is to be aware of alternatives and get good professional advice about the best choices for you. And do it before your business is already well underway - playing catch-up is no fun - especially when it involves tax and legal issues.

Get help here:

www.score.org

SCORE (Service Corps of Retired Executives) is group of (guess what?) retired executives who will share their years of experience and expertise with you, for free!!

One more time, please remember that what I am giving you here is only my personal understanding of these topics. I advise you to get professional assistance.

Not Carrying Adequate Insurance

Back to little Joey and his ice cream disaster. If you had bought liability insurance for your ice cream shop, probably your insurance company would have paid a good part of little Joey's medical bills - and helped defend you against a negligence lawsuit if Joey's mother decided to sue you.

Again, you will not likely have a "Joey" experience as an internet business owner, but you still could find yourself in a situation where someone is claiming that something you did cost them time, money, inconvenience, pain, etc., and they want you to pay them for it. Just think about all you hear about malpractice suits against physicians.

To help protect themselves against similar lawsuits, many professionals who sell their ideas, advice, or expertise (think accountants, attorneys, business advisers, etc.) carry a specialized type of insurance called "Errors and Omissions" (E&O). Discuss this with your insurance agent.

If you expect to have business clients visiting you (either in an office away from your home, or in a home office), you should think about liability insurance. Your basic homeowner's insurance may or may not cover people who come to your house as clients of your business.

Guess what I'm going to say now? Yep! Be sure to consult with an insurance professional to find out exactly what you need to protect yourself and your business.

Most people with health insurance, especially employer paid health insurance, really don't know what their health care costs are. Furthermore, in many cases, they are limited in which health providers (doctors, hospitals, pharmacies etc) they can use.

Most people are locked into a network of doctors. They know what the co-pay is, but have no idea what the doctor actually charges.

When insured consumers are hospitalized, they rarely see the bill. They don't know if the insurance company was overcharged or not. There are firms that audit hospital bills for insurers and self insured companies. They get paid a percentage of what they save on the bill payer by finding overcharges, duplicate charges and the like. The last I heard these firms were still making lots of money.

Overcharging, whether deliberate or not, by doctors and hospitals drive up health care costs for all. (So do malpractice suits, but that's another story.)

In order to give consumers more direct control not only over their health costs, but in the choice of which doctor they can see or which hospital they can enter, Congress enacted the Health Savings Account Availability Act. As of the beginning of 2004, individuals who are not otherwise insured can have Health Savings Accounts (HSA) , which carry with them some very attractive tax benefits.

An individual can set up an HSA for himself or his family. An employer can add an HSA option to the so-called cafeteria benefit plan it may already offer.

The money put into the plan is before taxes, including Social Security, if part of an employer plan. Otherwise it is a above-the-line deduction, meaning you don't have to itemize your deductions to get the tax break and that the deduction is not subject to the phase-out rules that make many itemized deductions unavailable to high wage earners.

The plan is set up like an IRA. A trustee approved by the IRS must be used. Money put in the plan grows tax free and funds withdrawn for qualified medical expenses are also tax free. Unlike the older Flexible Savings Accounts offered in employer cafeteria plans, you don't have to spend the money put into the account by year end or otherwise lose whatever's left. Money can be rolled over from year to year. This can allow for a nice chunk of money to accumulate that can be withdraw tax free at age 65.

In order to qualify, the individual or family must purchase a high deducible health insurance policy. These are special policies that have a minimum deductible of $1000 to a maximum of $5000 for an individual and $2000 to $10,000 for a family. The higher the deductible, the lower the premium.

Individuals can deduct the lesser of $2250 or the deductible on the policy: for married couples or families it is double that. If over 55, the deduction is $600 higher for individual and $1200 higher for couples and will continue to rise at $100 a year until 2009, where it will be capped at $1000 for individuals and $2000 for families.

The money in the HSA cannot be used to pay the premiums for this policy except in certain circumstances (basically when you're unemployed). It is meant to meet the deductible, co-pays, drug costs, eyeglasses or any other medical expense that could be itemized on an individual tax return as a medical expense.

Money withdrawn in excess of qualified medical expenses is taxed as income and subject to a 10% penalty, unless the owner is disabled or over 65. Any money in the account at death is added to the taxable estate.

There are no income limits on this plan. If started early, when you are still young and healthy a substantial amount of money could accumulate to either meet higher medical costs as you get older or to use to supplement your income.

It pays to compare the costs of this plan with whatever your insurance you have now. It might turn out that your employer's plan is still cheaper and you might want to keep it. Or you might want to consider HSA's for their portability (you carry it from job to job without cost or loss of any contributions) and the tax benefit of having another vehicle to shelter income and capital growth, while giving you more control over the cost and quality of your health care.

In any given year, more than 10 million people, most aged 65 or older, are in the long-term care of assisted living or nursing home facilities in the United States. For their families, that means considerable 'out of pocket' expenses must be dedicated to the cost of assisted living. In fact, some estimates suggest that over 75% of those expenses are borne directly by the patient themselves or their immediate and extended families.

If you and your loved one are considering making the move toward senior living or a nursing home environment, you'll certainly want to know as much about the costs that are involved as you can. The cost of assisted living will no doubt make a significant impact on family finances, but one of the many advantages the concept offers is that it's typically much less than the cost of a nursing home.

Comprehensive care nursing facilities can cost up to 50% more than their counterparts in assisted living. The reasons are fairly obvious; the patients in the care of nursing homes typically have magnified medical and domestic needs compared to those in senior living. As such, everything from medical staffing to liability and malpractice insurance must be dealt with in larger numbers than required for partial senior living. At the end of the day, nursing homes are really just smaller versions of hospitals, while senior living can take any of several different approaches, all of which are generally considered to be closer to a home environment than the classic nursing home model.

So what is the cost of senior living? The answer, of course, is that it depends on a broad range of factors, such as the amount of care needed or the patient's location.

Depending on whether the patient will need intermittent care in his own home or a full-time staff at a senior living building, the difference in cost can range from a few hundred dollars per month for in-home care, to several thousand dollars for an upscale apartment in a room and board facility.

As for location, the same cost of living factors that affect those without senior living needs will have an impact on those who do. Estimates suggest that depending upon which state the patient will reside within, the cost can vary by more than 150%. For example, 2007 estimates point to an annual cost of assisted living in North Dakota at just over $23,000.00 per year. Washington DC, however, would have cost over $60,000.00 in the same year!

The cost of assisted living will always be dependent on a variety of elements. The decision to place a loved one in the care of strangers, professional though they may be, is hard enough without the financial aspects to consider. But with a small investment in time to research your options, you may find that the financial sting of the experience can be minimized without compromising on the quality of care.

In today's fast paced society, people are always looking for fast, easy solutions to their problems. The medical field has become the center of quick fix solutions. Everybody is searching for a magic pill to cure their ailment.

Weight loss is no exception to that rule. People are looking for a pill they can take at bedtime and wake up a "super model" body. They want the fat on their body to disappear instantly even though it took months (sometimes even years) to accumulate. Is there even such a thing? If there is, please tell me about it.

After trying every diet, exercise plan, and "over the counter" diet pill there is, people turn to their doctors. There are a few diet drugs that are commonly prescribed by physicians, but the cold hard truth still remains. There is no miracle pill. Despite the huge profits made from diet products, the medical industry has realized miracle pills do not exist. So they have turned to more drastic measures such as weight loss surgery.

Weight loss surgery can get you fast results. As a matter of fact it can get you extremely fast results, but they come at much risk. That is why it cost so much. They have to be able to cover all those malpractice suits. It's better and healthier to stick to the good old fashioned way of weight loss.

Weight loss pills can be a great aid to losing weight but they should not be solely relied upon. It takes more than that. With lifestyle changes, exercise, and only the best diet pills [http://bestpills4dieting.com/] - one can realize their goals. But you must be patient. It does not happen overnight. To lose weight and keep it off, the key is perseverance along with determination.

Surgery isn't the first or even the last thing that comes to mind when you think tourism and vice versa. As misnomered as it may sound, surgical tourism is what is happening in the health care industry today. Surgical tourism, also known as medical tourism, medical travel, health travel and health tourism, is traveling abroad for surgery.

So why would someone choose to go overseas for surgery?

The number one reason is because they can get huge discounts when compared to the price tags on surgeries at home. Surgical tourists claim to have saved from 50% to over 90%. Another reason revolves around the long wait-lists in countries like Canada and UK with public health care system. Some go for elective surgeries not covered by insurance.

Does low cost mean poor quality?

Check out pictures of some of the international hospitals catering to foreign patients and you will notice how immaculate their 5-star hotel type facilities are. Their accreditations include those like JCI, JCAHO and ISO. Patients vouch for the personalized service they get. It's not uncommon to see world-renowned surgeons at these international hospitals playing finger-magic behind the latest billion-dollar robotic machines.

So exactly how is such a miracle possible?

Well, that's because in some countries like India, Thailand, Singapore, Turkey, Mexico, Costa Rica, Panama and others, the cost of labor when compared to the US, UK or Canada is lower. Plus, administrative costs and malpractice costs are also lower. These are the countries that are hot surgical tourism destinations.

Some of the surgeries that patients go overseas for...

Range from breast augmentation to Birmingham hip resurfacing surgery, and from lap band to triple cardiac bypass surgery. And it's not just surgeries that people seek. Some go for therapeutic treatments and others for cancer treatments. Restorative and reparative treatments like LASIK are common and so are preventive check-ups and simple dental fix-ups.

Where is tourism in the picture?

While the primary motivation for most surgical tourists is affordable surgery, the opportunity to visit exotic destinations is an additional draw for some. You can plan to have a holiday during your visit to the foreign country before the surgery if your health permits or after the surgery if your surgeon permits.

How do I go about arranging my surgery abroad?

Getting surgery overseas is not even closely related to getting surgery at your local hospital but it can save you a ton of money. However, it involves careful research and planning. Begin by collecting more information about the trend of surgical tourism. Read what others are saying about it. Educate yourself about the surgery desired. Do your due diligence in researching the various international hospitals and surgeons at the surgical destination you are interested in. Compare quotes from various providers and finalize one.

Many people find it useful to work with a surgical tourism provider that helps them with all the logistics of surgical tourism. Surgical tourism providers connect you with the hospital of your choice while providing many other related valuable services like detailed information about various procedures, detailed hospital profiles and surgeon profiles, medical records transfer, free surgery quote, pre- and post-consultation with the overseas hospital, feedback and testimonials from previous patients, medical and dental loan financing, passport and visa, airport pick-up and drop-off, hospital escort, tickets, travel insurance, hotel booking, tourism services in the destination country, etc.

If you are considering LASIK eye surgery it is vital that you find a well qualified surgeon that you are comfortable working with. You need to be confident that they have the skills necessary to do a good job. You don't want to take unnecessary risk with your eyes. Make sure you do your own research as well when it comes to a LASIK surgeon.

Look for proof of their education as well as any complaints others have filed against them. You should feel comfortable to ask the surgeon how many procedures they have performed and any other questions you have. You can check with the American College of Surgeons for various facts about anyone you may be consulting with. The American Academy of Ophthalmology is another great place to find information.

There are plenty of options for finding a LASIK surgeon - you can ask other people who have had it done, look in the phone book, find information online, or come across ads in the newspaper. Make sure you take the time to schedule a free consultation with them before you pay for anything or commit to anything. If you aren't comfortable with the surgeon or you feel rushed to make a decision then go somewhere else for your services. You should get a minimum of two consultations before you make a decision.

Yet you need to know a great deal about them before you commit to working with them. Your eyes are simply too valuable to trust to just anyone. Make sure you know how many years the surgeon has been in the LASIK profession, not just a surgeon. You want to find out how skilled they are with the new equipment they have as well. Find out the statistics on the results of their patients. How many of them walk away with 20/40 vision or better? You want the answer to that to be around 90%. You should also ask how many walk away with 20/20 vision or better. This statistic should be around 50%.

Many surgeons understand why consumers are looking into this information. They are also willing to provide the names and contact information of very happy patients for you to visit with. You have to be careful though as they aren't going to refer you to anyone who has anything negative to say. If you find the surgeon has been sued for malpractice, has had their license suspended, or they have pending charges you may want to seek LASIK eye surgery elsewhere.

These questions may seem a bit tough, even rude, yet bear in mind that this line of questioning is par for the course in the medical field, even if rarely done. As well, it is categorically your RIGHT to ask such questions. Best of luck.

Not every plastic surgeon is responsible, which may be surprising considering that even though their trade is mostly cosmetic there are the same medical risks that would be associated with any procedure. Irresponsibility seems all the more rampant when large amounts of money are involved. Just take a look at any of the tabloids and you'll witness a sea of over inflated duck lips, hardened and bolted on breasts, and skin stretched so tightly it looks as if it might tear like moist tissue. It is important for a surgeon to know their limitations as well as their clients'.

So what are the traits of a responsible plastic surgeon and his practice? There are many signs that are indicative of a true professional, unwilling to compromise his ethos for a quick paycheck. Any professional worth his salt will require a thorough consultation or even two before agreeing to perform any procedure on a patient. Consults are often offered free of charge or have prices that are deductible from the cost of any procedures that are booked. A consultation is not only about discussing possibilities, but should include an assessment of a client's overall health, candidacy for the procedures desired, as well as their emotional state. A person under noticeable duress, who is demanding, has unrealistic expectations, or seems otherwise unstable, should not be operated on. Not only is the plastic surgeon taking a great risk with a potential unreasonable malpractice suit or other legal issues, but often times the procedure does not benefit the patient in any way.

The physical health of a person is also key to determining if they are suitable candidates to undergo a particular procedure. A good plastic surgeon will strictly enforce certain standards, such as requiring patients to quit smoking well in advanced of any booked procedure, or carefully checking their medical history to ensure that they are not at a great risk if they undergo anesthesia. They may even require patients to lose weight or improve their health before having a second consultation to reassess the possibility of a cosmetic procedure. If you find that the specialist you have chosen seems to be demanding too much from you, odds are good that he has your best interests in mind.

Some people are under the impression that you can never have enough of a good thing. A skilled plastic surgeon knows all too well that if a client wasn't satisfied with his first four nose jobs, the fifth isn't going to make that much of a difference. People who constantly seek physical improvement without having a noticeable need are big risks. Going under anesthesia and being operated on should never be taken lightly, so someone who is constantly in and out of different medical offices might have a serious mental problem that cannot be cured through any procedure. While there are plenty of patients who have legitimate reasons for several or even revision procedures, once a person begins to look unrecognizable from their former self a line has been crossed.

A study has shown that nearly 70% of the people do not bother to fight for compensation cases for personal injuries, even if they are entitled to it. Many times, individuals find themselves victims to any of the following circumstances. A person can be involved in physical injuries such as automobile accidents, or be a victim of discrimination, wrongful termination or having to face the brunt of medical or legal malpractice.

Usually, the people finding themselves in such circumstances do not take recourse to the law, because they do not have adequate funds to fight their cases. It is here that lawsuit financing by companies comes into the picture.

These companies provide non-recourse loans to the injured persons or the plaintiffs. People can contact these companies and discuss their cases. These companies then contact the lawyer of the plaintiff and get their feedback. Based on the anticipated settlement expected, these companies advance a loan to the plaintiff who then has to pay either a flat fee or a recurring fee.

Most companies will settle for about ten to fifteen percent of the settlement value. Also, if the plaintiff loses the case, then he or she does not have to pay anything. Simply stated the plaintiff has to pay back the loan only on winning the case and not otherwise.

There are many companies in the market who provide lawsuit funding. Re member that because of the high risk involved, these companies will do a thorough check to decide upon the merit of the case. Before taking a loan, it is always better to consult multiple financing companies to get the best possible offers. You can always ask a company to revise the rate based on the rates given by another company. Much will depend upon your negotiating skills.

Also, you should ask the companies of the various loan options that are open. For example, if you are sure that your case is not going to be a protracted one, you might find it cheaper to obtain lawsuit funding, even if it involves a significant fee.

We spend 2-3 times as much on our healthcare as most of the countries that now have "socialized medicine". Yet, every country with socialized medicine has much better overall health statistics. As a matter fact, we are hovering around 32nd in the world. Even some "third world" countries are ahead of us.

How can this be? The richest country in the world, spending more than any other country, yet the health is one of the worst! What's wrong? How have we come to this state of affairs?

There are a variety of reasons. Let's look at some of these, and look at the alternate answer:

1. There's a lot of talk about 40-50 million "uninsured" people in the US. "Uninsured" doesn't mean that they aren't taken care of. No Emergency Room can turn down anyone who comes for "treatment". (Although many hospitals try to shift "poor" people to county or state facilities for profits sake.)

There's also Medicaid for the very poor. But, that still leaves the great majority of "uninsured" swinging in the wind. They make just a little too much money to qualify for Medicaid, or the state they live in has run out of money and facilities. (Under the Bush Administration, the cuts in Medicaid have limited this coverage in virtually every state.) A severe medical problem bankrupts many of these families every year.

Who pays for Medicare and Emergency visits? The usual - US taxpayers! So, like it or not, we already have a "sort of" socialized medicine.

By the way, when did the phrase "socialized medicine" become a bad phrase? (Was it another "spin" fostered by "vested interests"?) How often have you heard "just ask a Canadian about their socialized medicine"?

Ask 100 persons from any country(s) that has socialized medicine two questions: "How do you like it?" and "Would you like to get rid of it".

The answers to the first question are often a lot of individual complaining. Yet, the answer to the second question is an overwhelming "Never". Could this dichotomy be the reason that so many people in the US "think" that socialized medicine is bad - those "bitching" (and very human) answers. Most people ask only the first question, NOT the second. I've asked both, and have yet to find a Canadian or a Brit who answers "yes" to the second question, but many, or most, will find something to complain about.

Isn't it interesting that all the "civilized industrial nations" in Europe and elsewhere have some version of socialized medicine? Even in almost bankrupt Russia and Georgia, healthcare is free to all. And, even their health statistics are better than ours. (FYI, they also subsidize any "bright" student all the way to a "doctorate" if they are smart enough. College tuition in the US is prohibitively high for mid and low income families - are we wasting a major resource? You bet!)

2. Why is our health care costing so much? Simple - the insurance companies are running it. They make huge profits for this "service". Cut out the middleman - the insurance companies, and cut the costs by an impartial estimate between a third and a half!

What other benefits would this have? Doctors would have more time to talk to patients, and spend less time, and office staff filling out forms to get paid. When was the last time your MD spent more than 2 minutes with you?

Let's not overlook the fact that prevention is always better than catastrophe! All too often, when a poor person winds up in an Emergency Room, the cost of their problem is much more than it would be if that person had had insurance that allowed doctor visits to head off catastrophe with some prevention. This is a major factor favoring socialized medicine.

There's still another factor in this equation. Malpractice insurance (more profits to insurance companies)! We do need to limit this. Some formulas have to be developed for how much any doctor can be sued for. And, medical boards need to oversee MD's (and their mistakes) much closer. Doctors do make mistakes! And, the injured have a right to be compensated for such! What do the other countries do about this problem? Has anyone made any study of this?

3. There is another often overlooked problem. We, as a nation, have a terrible diet! We eat "fast foods" way too often. We eat too few "healthy foods", and too many "high carbohydrate" foods. The statistics show clearly that a poor diet on the part of a mother results in a baby that is not nearly as healthy as it should be.

Take a look at some "poor" natives of African countries in photographs. Look especially at the wide mouths full of very strong, very even, teeth. Compare this to the US "standard" of two very prominent front teeth, a high narrow arch to the roof of the mouth, and crowding of the rest of the teeth. Dr Von Hilsheimer of Maitland Florida wrote a book years ago detailing the various "abnormalities" and "anomalies" of children of poor diet mothers. There is a definite correlation between these children and increasing allergy and sensitivity in our children

Recently I read a very interesting article about a school that changed the diets of the attending students, and by this simple change only, the entire attitude and moral outlook of the students was changed. It was very simple! They took out all the soda machines, and replaced them with water fountains. They eliminated hamburgers and fries, and similar poor diet foods, and emphasized fruits and veggies. Lo, and behold, the school which had previously been shunned by teachers because of unruly students was completely changed! Students were calm, quiet, and learned more and better than other schools in the area. Acts of violence or vandalism were eliminated. There are several other similar studies which school boards do not pay enough attention to.

As a result of our overall "poor" diet, we, as a nation, get sick more often than other countries. This adds to the cost of healthcare tremendously in this country.

4. The American Medical Assn, one of the strongest unions in the world, backed up by the huge drug industry (Big Pharma), and the insurance industry have the power and the money to "buy" enough politicians to prevent any "reasonable" health plan. Bill and Hilary Clinton found this out in his first year in office. There's so much money involved, it may be impossible to even get anything done except a "Band-Aid" on the cancer.

What can we, as individuals, do? Start asking the politicians we elect what their previous votes have been, and what their future votes will be on these questions. Vote for those who will vote for at least a form of socialized medicine. And throw out the other rascals. Our votes are powerful, and we need to use them wisely.

There are specific types of claims for personal injury where it is essential that you are assisted by Sacramento personal injury attorneys. Claims involving severe and serious injuries, toxic chemical or substance exposure and malpractice are best handled by a professional Sacramento personal injury attorney. You are in a better position if you hire the services of a competent lawyer to handle your personal injury claims as his mere representation of your claim is enough motivating factor for insurance companies to act favorably and swiftly.

Nonetheless, when you are pursuing personal claims as complicated as a claim for serious and severe injuries, you will definitely need the assistance of a competent lawyer who specializes in these kinds of claims. There are complex rules that must be followed and critical documentary requirements that must be prepared when making a personal injury claim. In instances where the personal injuries are severe, the amount of claim will definitely be higher than normal and you will definitely need the assistance of a lawyer in order to justify such amount of claim for serious and severe injuries. Finally, you will need to hire a good lawyer in cases where the insurance companies decide not to settle and contest the claim that you are making.

There are serious accidents that lead to injuries that significantly impair one's physical capabilities or causes major damage to one's appearance. It would be a very complex and tedious process of determining the amount that can be attached to such debilitating injuries whose effects are long term and in worst cases, permanent. In this particular instance, you will definitely need the help of a competent personal injury attorney. An experienced lawyer will be able to help you get the highest possible claims for serious injuries that result to permanent disability and damage.

The amount of compensation is largely determined by the severity of the injury suffered by the claimant. There are several factors that are considered in determining the value of the injury suffered. The factors include the medical bills, the kind of injuries and the length of time needed for your recovery. As soon as you make for higher claims for injuries you have suffered, the discrepancy between the amount being asked for and the norm will also become wider. You then would have to put up a strong argument to support your claim for higher compensation. A personal injury lawyer shall be the proper person who can help you make a strong case with the insurance company.

You will also need to seek the help of a competent lawyer if your injuries are caused by negligent and irresponsible action by a doctor, medical nurse, clinic, hospital or laboratory. Aside the complicated medical issues involved, the legal procedures is also complicated.

Claims for injuries caused by exposure to certain toxic and harmful substances are generally made against specific companies or industries. These claims are the most complicated and difficult to handle. These large industries have practically built a wall of legal cover for such adverse claims. An extremely competent lawyer is what you need if you want to make a go with your claims for compensation for personal injuries suffered because of your exposure to toxic and harmful chemicals.

Over the last good many years as the industrial medical complex has been blowing up its bubble, I've been observing people complaining about their pains, ailments, and worries about their healthcare. Really all this negative talk is making things much worse for them psychologically. It's as if half our population has turned into a bunch of hypochondriacs.

As far as I am concerned our healthcare sector has a growing problem and our citizens have a going problem - that is to say they are going to the doctor's offices far too often, and all this is costing us 100s of billions of dollars in unneeded treatments, pharmaceuticals, and visits. Let's discuss all this shall we?

You cannot watch TV for more than 30-minutes without seeing an advertisement for pharmaceuticals, unless it is prime time election season and in that case the political ads are busy talking about your health, the failures of the system, or using scare tactics as to what "might" happen to you and your family if you don't elect them. Wouldn't it be nice if they just stopped reminding us of all the doom and gloom scenarios? I'm getting sick - of it myself.

Everyone is running around worried about their health, as if nothing else matters, and yes, it is a huge industry and it accounts for a huge percentage of our GDP, and millions of jobs, but our population has become a mass mob of hypochondriacs. All of these folks have joined together in their negative talk, it's as if misery is loving the company and the companies running the healthcare sector are soaking in a massive flow of money from the government.

Meanwhile, the companies in the medical healthcare industrial complex are coaxing and patients to come and more often, and doctors are practicing defensive medicine due to the lawyers which are making a ton of money suing the doctors for malpractice, some of which may be deserved from time to time, and the insurance companies are raising rates and making a ton of money also. About the only people that aren't making money on this, is all of the citizens who are paying incredible premiums for their healthcare insurance. They didn't go down like we were promised with ObamaCare, all they've been doing is going skyward.

To top it all off, just about everyone is involved in a feeding frenzy trying to get all the services they can for fear that those services may disappear one day. Most of these folks are talking themselves into illnesses that they don't actually have, and now they are taking drugs and requesting drugs, demanding the doctors give them those drugs because they saw an ad on TV. Maybe everyone just needs to take a chill pill, hopefully made of sugar, and then they can think everything will be all better, because we can't afford this anymore. Please consider all this and think on it.

In today's high technology environment, organizations are becoming increasingly dependent upon their information systems. Information is widely regarded as the life blood of the modern enterprise. And, consequently, the security controls surrounding these systems are becoming the differentiating factor in customer choice. With data being held on many of the most sensitive aspects of the business, including key third party stakeholders, information security integrity has become a focal point of all business initiative. The protection of information assets - information security - is therefore overtaking physical asset protection as a fundamental corporate governance responsibility.

Organizations are facing a flood of threats to their information, with new challenges emerging almost daily. Any breach to security can have a severe effect on the operational running, reputation, or legal compliance of the organization. Damage to any one of these areas can be measured by its impact on the bottom line, in both the short and long term. It is self-evident that organizations should, therefore, take appropriate steps to secure and protect their information assets. This is now particularly relevant with the web of legislation and regulation to conform too, making firms criminally liable, and in some instances making directors personally accountable for implementing and maintaining appropriate risk control and information security measures. No longer is it enough to find and fix vulnerabilities on an ad-hoc basis. Only a comprehensive, systematic approach will deliver the level of security that any organization really needs.

Today, security processes need to be well documented and substantiated. So it's no longer good enough to be secure; organizations have to be able to prove they are secure. If done correctly, this additional layer of regulatory scrutiny and reporting can help enterprises combine their security and compliance programs better to streamline efforts, control costs and keep networks secure and compliant.

With the key corporate governance objective being to ensure that the organization has an appropriate balance of risk and reward in its business operations, information security requirements should be identified by a methodical assessment of security risks, with expenditure on risk controls needing to be balanced against the business harm likely to result from security failures.

The most practical and effective way for policy makers to handle their information security risks and obligations, is to adopt and implement an information security policy and information security management system (ISMS) that is capable of being independently certified as complying with ISO/IEC 27001:2005. The standard provides the only independently developed framework for the management of information security. While compliance with the standard does not of itself confer immunity from legal obligations, it does point clearly to management's implementation of best practice, of effective IT governance. Security risks managed in this systematic and comprehensive manner help to garner competitive advantage in the organization through the adherence to an international best practice standard. Certification to ISO27001 can also aid in forming part of any potential legal defense required after a security breach.

ISO27001 compliance ensures a company will meet the regulatory guidelines and standards such as the following:

o Sarbanes Oxley (SOX) requires companies to disclose information regarding finances and accounting. SOX helps prevent financial malpractice and accounting disclosures. All US-listed companies must adhere to SOX regulations.

o Gramm-Leach Bliley Act (GLBA) requires financial institutions to protect customer data and provide privacy notices. Banks and financial institutions must follow GLBA.

o Health Insurance Portability and Accountability Act (HIPAA) requires health care organizations to ensure the privacy of personal health information. Hospitals, medical centers and any business dealing with patient medical records must comply with HIPAA.

o Payment Card Industry (PCI) specifies how to secure information systems and media containing cardholder account information to prevent access by or disclosure to any unauthorized party. PCI also covers effective deletion of unnecessary data. Companies that store, process or transmit credit card holder data must follow PCI.

o COBIT is an IT governance framework and supporting toolset that allows managers to bridge the gap between control requirements, technical issues and business risks. COBIT enables clear policy development and good practice for IT control throughout organizations. COBIT emphasizes regulatory compliance, helps organizations to increase the value attained from IT, enables alignment and simplifies implementation of the COBIT framework.

ISO27001 provides a single coherent and over-arching framework for compliance with all the regulations and standards laid out above, while also actually providing a risk assessment-based approach to information security. Nonetheless, in order to achieve a risk assessment that is completed methodically, systematically and comprehensively an appropriate software tool is a must. It is practically impossible to carry out and maintain a useful risk assessment for an organization that has more than about four workstations without using such a tool that contains fit-for-purpose databases of risk threats and vulnerabilities. This is because the risk assessment is a complex and data-rich process. And for an organization of any size, the only practical way to effectively undertake the project is to create a database that contains details of all assets within the scope of the ISMS, and then to link, to each asset, the details of its (multiple) threats and (multiple) vulnerabilities, and their likelihood and resulting impacts, together with details of the asset ownership and its confidentiality classification.

The risk assessment process is made enormously simpler if ready-made databases of threats and vulnerabilities are used. The database should also contain details of the control decisions made as a result of the risk assessment, so at a glance, it easy to see what controls are in place for each asset within the ISMS. To one extent or another, the software tool chosen to perform the ISMS should automate the risk assessment process and generate a Statement of Applicability. It should also encourage the user to perform a thorough and comprehensive security audit on the organization's information system, while not generating too much paperwork. The chosen software should produce risk assessment results that are easily comparable and reproducible.

One such tool on the market developed to help organizations quickly and easily carry out an ISO27001-compliant risk assessment is the ISMS tool vsRisk(TM)- the Definitive ISO27001: 2005-Compliant Information Security Risk Assessment Tool. Equipped with a wizard-based approach to simplify and accelerate the process for undertaking risk assessments; asset by asset identification of threats and vulnerabilities; the tool easily imports additional controls to deal with risks, and an integrated threats and vulnerability databases, which are continually updated to ensure that they are the most up-to-date available. vsRisk(TM), in terms of functionality, ease of use and value for money, and alignment with the requirements of ISO27001 is the most complete ISMS software tool on the market.

Effective risk management is a continuous Plan-Do-Check-Act-Cycle which means that the risk assessment must be regularly revisited at planned intervals and take into account changes in the business environment, regulatory bodies, and a review of the residual risks. However, following the initial resource intensive phase of the ISMS implementation the organization should find subsequent reviews of the ISMS are much less labour intensive and relatively easily maintained with the aid of the right software tool.

* vsRisk(TM) can also be found as part the No 3 Comprehensive ISO 27001 ISMS Toolkit, a necessity for organizations looking to accelerate their ISO27001 project and develop an ISO27001-compliant Information Security Management System (ISMS).