The Microbiome: How to Talk to Your 2 Million Genes

By Deepak Chopra, MD and Naveen Jain

The term “microbiome” has become popular in the last decade, and most people now realize that their bodies are populated by an enormous quantity of microbes. Taking every location from the skin to the mouth to the intestinal tract into consideration, the microbiome weighs around 3 lbs., roughly the same as the human brain.

 

The radical importance of keeping your microbiome balanced and healthy is just beginning to dawn on medical science and biology. If you took a snapshot of a tiny portion of your digestive tract, it would be teeming with an array of life forms almost beyond comprehension (including bacteria, viruses, bacteriophages, archaea, fungi, yeast, etc. Since it has long been known that we can’t digest food without the aid of the so-called “flora” in our intestines, the microbiome didn’t spring out of nowhere. What wasn’t realized until recently, however, is its staggering extent.

 

A human being possesses roughly 23,000 to 25,000 genes, and there is enough capacity for juggling DNA into new combination that these genes create 7 billion unique individuals on Earth, with no end in sight for creating billions more unique people.  Your trillions of cells, however, are estimated to be outnumbered around 3 to 1 by the collected microbiota (as the collective microbial colonies are called) that co-exist with us. In terms of genes, however, it is estimated that all of these small creatures and plants contribute 2 million genes to our existence.

 

Now we realize that the human body is an ecosystem, and to be healthy requires “talking” to your microbiome in all kinds of ways—you have a whole planet to manage at the microbial level. The digestive functions they perform is barely the tip of the iceberg. As intestinal microbes feed, they excrete chemicals that are essential to wellness. Besides producing well-known chemicals like vitamin B, the microbiome sends neurotransmitters like serotonin and dopamine into the bloodstream. Hormonal levels are influenced, and so is your immunity from disease.

 

What we are realizing is that none of the microbial life inside us is a free rider. Those 2 million genes evolved with us. Some are actually woven into our own DNA. As in the Earth’s ecosystem, survival demands that every microbe performs a useful function. But where there is balance the possibility for imbalance occurs. When this happens, the body and the microbiome are off kilter, with the result that disease processes may start to form, and natural functions like staying at a proper healthy weight are impaired—or even become impossible.

 

The cutting edge of microbiome research involves mapping out thousands of microbes and identifying their functions—an overwhelming task now made possible by high-speed computers and data analysis. But even at this early stage, we can jump to some practical conclusions.

 

Companies are beginning to offer a service that analyzes your personal microbiome. With a small stool sample, it is possible to profile your unique digestive process, which foods you metabolize well or not so well, which chemicals (known as metabolites) your microbiome is secreting in terms of harmful and helpful ones—and this is just the beginning.

 

The most challenging epidemics in modern society are connected to lifestyle, and lifestyle is how we “talk” to our microbiome. The next bite of food you eat sends a message to your microbiome, and in reply it will send a chemical message back.  Unhealthy chemical responses that originate in the microbiome are thought to be strongly linked to heart disease and overweight, for example. No two people are chemically alike at any given moment. The body is like an information superhighway, and although traditionally the brain was the hub for all incoming and outgoing information, the true hub is the gene. Therefore, with its huge preponderance of genes, the microbiome is thought now to dominate the information superhighway.

 

Pursuing gene therapies for the past fifteen years, ever since the Human Genome Project provided a complete map of human DNA, has proved frustrating and enormously expensive. But influencing your ecosystem of genes happens naturally every day. The information superhighway is populated by the messages sent from gene to gene, and these come from thoughts, emotions, stress levels, relationships, and the quality of food, air, and water you ingest.

 

The future of wellness is at stake here. By attending to the ecosystem that is you, the entire system of mind and body is affected.  For the first time, in practical terms relating to eating, being active, sleeping, and managing stress and inflammation, the old model of preventing risks can be replaced by a positive model. The positive model is about optimizing the personal well-being of each person. If we learn from an early age how to “talk” to our microbiome, that conversation turns into feedback loops that maintain balance and wholeness everywhere.

Deepak Chopra MD, FACP, founder of The Chopra Foundation and co-founder of The Chopra Center for Wellbeing, is a world-renowned pioneer in integrative medicine and personal transformation, and is Board Certified in Internal Medicine, Endocrinology and Metabolism.  He is a Fellow of the American College of Physicians and a member of the American Association of Clinical Endocrinologists. Chopra is the author of more than 85 books translated into over 43 languages, including numerous New York Times bestsellers. His latest books are The Healing Self co-authored with Rudy Tanzi, Ph.D. and Quantum Healing (Revised and Updated): Exploring the Frontiers of Mind/Body Medicine.  www.deepakchopra.com

 

Naveen Jain is an entrepreneur driven to solve the world’s biggest challenges through innovation. He is the founder of several successful companies including Moon Express, Viome, Bluedot, TalentWise, Intelius and InfoSpace. Moon Express is the only company to have permission from the US government to leave earth orbit and land on the moon. Viome is focused on disrupting healthcare with the goal of “making illness elective” by identifying biomarkers that are predictive of chronic diseases and preventing them through personalized diet & nutrition. Naveen is a director of the board at the X PRIZE Foundation and Singularity University. Naveen Jain has been awarded many honors including “Ernst & Young Entrepreneur of the Year”, “Albert Einstein Technology Medal” for pioneers in technology, Recipient of “Ellis Island Medal of Honor”, Most creative person” by Fast Company,  “Top 50 philanthropists of 2018” by Town & Country magazine and “Humanitarian Innovation Award” at the United Nations.

The Best Strategy to Combat Aging

By Deepak Chopra, MD and Rudolph E. Tanzi, PhD

When people think about growing old, they blame the passage of time—the years roll by, and the body stops looking younger year by year. But the latest science disputes this view. A person ages because the cells in their body age, and cells live only in the present. This is one reason memory remains such a mystery. Brain cells function through electrochemical activity that occurs the instant a chemical reaction or electrical impulse is able to occur. There are no pauses to think about reacting; if the potential is there, the action must follow.

 

Whatever a brain cell does, it can’t go back to the past. So how do we seem to go back into the past when we remember a childhood birthday party or our first kiss? No one knows, but when the answer is found, it won’t involve time travel, either forward or backward. If you expand this to every cell in the body, they too must function instantly in the present moment when any two molecules interact. So the problem of aging can be stated as the gap between how a cell lives and how a person lives. As people, we repeat the past, get stuck in old habits, cling to stubborn beliefs, fear the future, and in general occupy mental states that are not in the now.

 

If you can return to the now, you close the gap between your life and the life of your cells, and by doing this, you can prevent aging or even reverse it. Aging isn’t one thing but a complex of possibilities. Which possibilities get triggered is infinitely complicated, but no one has ever shown that any symptoms of aging must occur.

 

Even though we can all tick off the disagreeable signs of growing old—creaky joints, wrinkled skin, loss of energy, erratic sleep, declining memory, and so on—there is someone who has actually improved as they aged in each of these areas, except perhaps for wrinkles. However unusual, there are individuals who retain limberness, energy, good sleep, mobility, and memory.

 

In fact, once we abandon the notion that aging is normal, it dawns that aging might actually be the sum of disease processes, and without these disease processes, cells can function at a high level of efficiency for a very long time. (In laboratory experiments it has been shown that a cell can only divide a limited number of times, around 50, which would place a physical limit on lifespan, and this may indicate a genetic barrier that cannot be crossed. However, in real life people live to be 100 already, and the goal is to remain well up to an advanced age, not to aim for immortality.)

 

In our latest book, The Healing Self, we deal in depth with the prospects of anti-aging and the reversal of the aging process. We also outline an anti-aging regimen, which lists things each person can either do or undo.

 

DO

  • Meditate
  • Join a social support group
  • Strengthen emotional bonds with family and close friends.
  • Take a multivitamin and mineral supplement (if you are age sixty-five and older).
  • Maintain a balance of rest and activity.
  • Explore a new interest.
  • Take up a challenging mental activity.

 

  • UNDO
  • Don’t be sedentary—stand up and move throughout the day.
  • Examine your negative emotions.
  • Heal injured relationships that are meaningful to you.
  • Be mindful of lapses and imbalances in your diet.
  • Address negative stereotypes about aging and ageism.
  • Consider how to heal the fear of death.

 

Each of these choices is correlated with maintaining a state of wellness throughout one’s lifetime. In our program, we advise doing or undoing one thing on the list, then not moving on to the next thing until the first choice is well established in your daily life.

 

Of everything on this list, meditating is critical because it brings the mind into the present moment, where the body always lives. There is much more to be said about “the power of now,” but the key here is how aging is affected. Finding a way to live in the present moment can be looked upon as a spiritual aspiration, but as far as your cells are concerned, the present moment is where every decision to survive and thrive is made. That should be our attitude also.

 

Deepak Chopra MD, FACP, founder of The Chopra Foundation and co-founder of The Chopra Center for Wellbeing, is a world-renowned pioneer in integrative medicine and personal transformation, and is Board Certified in Internal Medicine, Endocrinology and Metabolism.  He is a Fellow of the American College of Physicians and a member of the American Association of Clinical Endocrinologists. Chopra is the author of more than 80 books translated into over 43 languages, including numerous New York Times bestsellers. His latest books are The Healing Self co-authored with Rudy Tanzi, Ph.D. and Quantum Healing (Revised and Updated): Exploring the Frontiers of Mind/Body Medicine.  www.deepakchopra.com

 

Rudolph E. Tanzi, Ph.D. is the Joseph P. and Rose F. Kennedy Professor of Neurology at Harvard University and Vice Chair of Neurology at Mass. General Hospital. Dr. Tanzi is the co-author with Deepak Chopra of the New York Times bestsellers, Super Brain, and Super Genes. His latest book is The Healing Self co-authored with Deepak Chopra. He is also an internationally acclaimed expert on Alzheimer’s disease and brain health with over 500 research publications. He was included in TIME Magazine’s “TIME 100 Most Influential People in the World.”

How to Be Your Own Medical Advocate

By Deepak Chopra, MD and Rudolph E. Tanzi, PhD

When the average person goes to the doctor, shows up at the ER, or enters the hospital, the possibility of controlling what happens next is minimal. We put ourselves in the hands of the medical machine, which in reality rests upon individual people—doctors, nurses, physician’s assistants, and so on. Human behavior involves lapses and mistakes, and these get magnified in medical care, where misreading a patient’s chart or failing to notice a specific symptom can be a matter of life and death. The riskiness of high-tech medicine like gene therapy and toxic cancer treatments is dramatically increased because there is a wider range of mistakes the more complex any treatment is. To be fair, doctors do their utmost to save patients who would have been left to die a generation ago, but they are successful only a percentage of the time.

Risk and mistakes go together, but the general public has limited knowledge of the disturbing facts:

  • Medical errors are estimated to cause up to 440,000 deaths per year in U.S. hospitals alone. It is widely believed that this figure could be grossly inaccurate, because countless mistakes go unreported—death reports offer only the immediate cause, and many doctors band together to protect the reputation of their profession.
  • The total direct expense of “adverse events,” as medical mistakes are known, is estimated at hundreds of billions of dollars annually.
  • Indirect expenses such as lost economic productivity from premature death and unnecessary illness exceeds $1 trillion per year.

Statistics barely touch upon the fear involved when any patient thinks about being at the wrong end of a medical mistake. What the patient is all too aware of is the doctor visit that goes by in the blink of an eye. A 2007 analysis of optimal primary-care visits found that they last 16 minutes on average. From 1 to 5 minutes is spent discussing each topic that’s raised. This figure is at the high end of estimates, given that according to other studies, the actual face-to-face time spent with a doctor or other health-care provider comes down to 7 minutes on average. Doctors place the primary blame on increasing de

mands for them to fill out medical reports and detailed insurance claims. Patients tend to believe that doctors want to cram in as many paying customers as they can, or simply that the patient as a person doesn’t matter very much.

 

As a result there’s a new movement afoot to provide a personal advocate who stays in the doctor’s office with the patient. The advocate is basically someone who represents the patient’s best interests in any medical situation. The person might be a well-meaning relative who helps an older patient understand what’s going on, or who steps in to do attendant tasks like picking up prescriptions and organizing medical bills. But more and more one sees the need for an advocate who is professionally trained to buffer the mounting risks in a health-care system in which less and less time is spent between doctor and patient.

It would be up to an advocate to find out, and needless to say, this has created hostility from some doctors. Used to ruling their domain with absolute authority, few doctors want an overseer in the room asking questions, inserting their own opinions, and potentially finding fault. At worst, the specter of a malpractice suit looms. The movement for professional advocates, which is quite young, insists that looking out for a patient’s best interests is benign. The medical profession has its doubts.

The upshot, for now at least, is that patients who want an advocate must play the role themselves. At the heart of the problem is passivity. When we surrender to medical care, whether at the doctor’s office, the ER, or the hospital, we shouldn’t surrender everything. Poking and prodding is intrusive. Undergoing various tests can be stressful. The minute we walk in the door, we become largely anonymous—a walking set of symptoms replaces the person. There are doctors and nurses who take these negative effects seriously and who go out of their way to offer a personal touch. They should be saluted for their humane compassion in a system that focuses more on impersonal efficiency.

You may like your doctor and feel that he cares, but this doesn’t rule out being your own advocate. Quite the opposite—the inherent stress in medical treatment is what you want to counter. First comes the stress of worry and anticipation, what is commonly known as white-coat syndrome. We all remember how afraid we became as children thinking about getting a shot from the school nurse or how scary it was sitting in the dentist’s chair even before the drill was turned on. Studies have verified that anticipating a stressful situation can cause as great a stress response as actually undergoing the stress. In one study subjects were divided into two groups, one of which gave a public speech while the other was told that they were going to give a speech but actually didn’t. Both groups became stressed out, but the researchers wanted to measure how well they recovered from the stress

Knowing that you are going to be in a stressful situation, there are a number of ways to feel more in control:

  • Be informed about your illness. Don’t relinquish your opportunity to find out exactly what is wrong with you. This doesn’t mean you should challenge your doctor. If you feel the need to inform your doctor about something you saw online, you aren’t being confrontational, and most doctors are now used to well-informed patients.
  • If the illness isn’t temporary and minor, contact someone else who is going through the same diagnosis and treatment as you. This may involve a support group, of which many exist online, or simply talking to another patient in the waiting room or hospital.
  • If you are facing a protracted illness, become part of a support group, either locally or online.
  • Keep a journal of your health challenge and the progress you are making toward being healed.
  • Seek emotional support from a friend or confidant who is empathic and who wants to help (in other words, don’t lean upon someone who is merely putting up with you).
  • Establish a personal bond with someone who is part of your care—nurses and physician’s assistants are typically more accessible and have more time than doctors. Ideally, this bond should be based on something the two of you share—family children, hobbies, outside interests—not simply your illness.
  • Resist the temptation to suffer in silence and to go it alone. Isolation brings a false sense of control. What actually works is to maintain a normal life and social contacts as much as possible.

Following these steps will go a long way to achieving the goal of patient advocacy, which is to serve the patient’s best interests at all times. But there remains a difficult unknown, the possibility of a medical error.
 

Seeing the doctor involves personal interaction, and it’s important to reduce any possible friction. Here are a few pointers:

Do

  •             Be involved in your own care.
  •             Inform the doctor and nurses that you like to be involved.
  •             Ask for extra information when you need it.
  •             Ask for a questionable event, like a pill you aren’t sure is the right one, to be checked with the doctor.
  •             Tell somebody if you have gone out of your comfort zone.
  •             Remain polite in all of the above.
  •             Praise the doctor and nurses when it’s called for. A show of gratitude doesn’t go amiss

            Don’t

  •             Don’t act hostile, suspicious, or demanding.
  •             Don’t challenge the competency of doctors and nurses.
  •             Don’t nag or whine, no matter how anxious you are. Reserve these feelings for someone in your family, a friend, or a member of a support group.
  •             Don’t pretend you know as much (or more) than the people who are treating you.
  •             Don’t, when hospitalized, repeatedly press the call button or run to the nurses’ station. Trust their routine. Realize that the main reason patients call a nurse is more out of anxiety than out of real need.
  •             Don’t play the part of a victim. Show your caregivers that you are maintaining a normal sense of security, control, and good cheer even under trying circumstances.

Probably the most important finding about medical mistakes is that they are frequently caused by lack of communication.
In our new book The Healing Self we delve into patient advocacy in more detail as well as covering the expanding role of self-healing, which is going to only become more important in the coming decades.

 

Deepak Chopra MD, FACP, founder of The Chopra Foundation and co-founder of The Chopra Center for Wellbeing, is a world-renowned pioneer in integrative medicine and personal transformation, and is Board Certified in Internal Medicine, Endocrinology and Metabolism.  He is a Fellow of the American College of Physicians and a member of the American Association of Clinical Endocrinologists. Chopra is the author of more than 80 books translated into over 43 languages, including numerous New York Times bestsellers. His latest books are Super Genes co-authored with Rudy Tanzi, Ph.D. and Quantum Healing (Revised and Updated): Exploring the Frontiers of Mind/Body Medicine.  www.deepakchopra.com

 

Rudolph E. Tanzi, Ph.D. is the Joseph P. and Rose F. Kennedy Professor of Neurology at Harvard University and Vice Chair of Neurology at Mass. General Hospital. Dr. Tanzi is the co-author with Deepak Chopra of the New York Times bestseller, Super Brain, and an internationally acclaimed expert on Alzheimer disease. He was included in TIME Magazine’s “TIME 100 Most Influential People in the World.”

 

References:
Brennan TA, Leape LL, Laird NM, et al. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med 1991;324:370–6.

 

Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington DC: National Academy Press, 2000.

 

Department of Health and Human Services. Adverse events in hospitals: national incidence among Medicare beneficiaries. 2010. http://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf.

 

A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care James, John T. PhD Journal of Patient Safety: September 2013 – Volume 9 – Issue 3 – p 122–128

doi: 10.1097/PTS.0b013e3182948a69

 

Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ 2016;353:i2139. doi:10.1136/bmj.i2139

 

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review. Mirelle Hanskamp-SebregtsMarieke ZegersCharles VincentPetra J van GurpHenrica C W de VetHub WollersheimPublished 22 August, 2016 http://bmjopen.bmj.com/content/6/8/e011078.full

 

Weismann JS, Schneider EC, Weingart SN, et al. Comparing patient-reported hospital adverse events with medical records reviews: Do patients know something that hospitals do not? Ann Intern Med. 2008; 149: 100–108.

 

Overview of medical errors and adverse events. Maité Garrouste-Orgeas François Philippart, Cédric BruelAdeline MaxNicolas Lau and B Misset Annals of Intensive Care 20122:2

 

DOI: 10.1186/2110-5820-2-2 Published 16 February 2012

 

Valentin A, Capuzzo M, Guidet B, Moreno R, Metnitz B, Bauer P, Metnitz P: Errors in administration of parenteral drugs in intensive care units: multinational prospective study. BMJ 2009, 338: b814. 10.1136/bmj.b814

 

Ridley SA, Booth SA, Thompson CM: Prescription errors in UK critical care units. Anaesthesia 2004, 59: 1193–1200. 10.1111/j.1365-2044.2004.03969.x

 

Garrouste-Orgeas M, Timsit JF, Vesin A, Schwebel C, Arnodo P, Lefrant JY, Souweine B, Tabah A, Charpentier J, Gontier O, et al.: Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II on behalf of the Outcomerea study group. Am J Respir Crit Care Med 2010, 181: 134–142. 10.1164/rccm.200812-1820OC

 

Garrouste-Orgeas M, Soufir L, Tabah A, Schwebel C, Vesin A, Adrie C, Thuong M, Timsit JF: A multifaceted program for improving quality of care in ICUs (IATROREF STUDY) on behalf of the Outcomerea study group. Critical Care Med, in press.

 

Overview of medical errors and adverse events. Maité Garrouste-Orgeas, François Philippart, Cédric Bruel, Adeline Max, Nicolas Lau and B Misset Annals of Intensive Care20122:2

 

DOI: 10.1186/2110-5820-2-2 Published 16 February 2012

 

Kennerly DA, Kudyakov R, da Graca B, et al. Characterization of adverse events detected in a large health care delivery system using an enhanced Global Trigger Tool over a five-year interval. Health Serv Res 2014;49:1407–25. doi:10.1111/1475-6773.12163 Google Scholar

 

Rutberg H, Borgstedt Risberg M, Sjodahl R, et al. Characterisations of adverse events detected in a university hospital: a 4-year study using the Global Trigger Tool method. BMJ Open 2014;4:e004879. doi:10.1136/bmjopen-2014-004879

 

Christiaans-Dingelhoff I, Smits M, Zwaan L, et al. To what extent are adverse events found in patient records reported by patients and healthcare professionals via complaints, claims and incident reports? BMC Health Serv Res 2011;11:49. doi:10.1186/1472-6963-11-49 [CrossRef][Medline]Google Scholar

 

Classen DC, Resar R, Griffin F, et al. ‘Global Trigger Tool’ shows that adverse events in hospitals may be ten times greater than previously measured. Health Aff (Millwood) 2011;30:581–9. doi:10.1377/hlthaff.2011.0190

Sari AB, Sheldon TA, Cracknell A, et al. Extent, nature and consequences of adverse events: results of a retrospective casenote review in a large NHS hospital. Qual Saf

J Health Care Finance. 2012 Fall;39(1):39-50.

 

The economics of health care quality and medical errors. Andel C1, Davidow SLHollander MMoreno DAhttps://www.ncbi.nlm.nih.gov/pubmed/23155743

 

How Patient Advocates Can Help with Doctor’s Visits

By Deepak Chopra MD, Lizabeth Weiss, BA, Nancy S. Cetel, MD, Danielle Weiss, MD, Joseph B. Weiss, MD,

 

When the average American goes to the doctor, shows up at the ER, or enters the hospital, the risks and complexities of our healthcare system strike home vividly. Besides the expense of care and the intricate tests and procedures a patient faces, there is a widely under-reported risk of medical mistakes and “adverse events,” as they care called, which can range from minor to disastrous.

 

The new idea whose time has come is the patient advocate, someone who represents the patient’s best interest in any medical situation. An advocate might be a well-meaning relative who helps an older patient understand what’s going on, stepping in to do attendant tasks like picking up prescriptions and organizing medical bills. But more and more we see the need for an advocate who is professionally trained to buffer the mounting risks in a healthcare system where less and less time is spent between doctor and patient, raising the possibility of a wide range of bad outcomes.

The public has limited knowledge of the relevant facts:

  • Medical errors are estimated to cause 440,000 deaths per year in U.S. hospitals alone.
  • The total direct expense of adverse events is estimated at hundreds of billions of dollars annually.
  • Indirect expenses such as lost economic productivity from premature death and unnecessary illness exceeds one trillion dollars per year.

 
untitled-design102What the patient is all too aware of is the doctor visit that goes by in the blink of an eye. A 2007 analysis of optimal primary-care visits found that they last in total 16 minutes on average. From 1 to 5 minutes is spent per topic discussed. Although a visit to a primary-care physician or specialist has increased to 20 minutes, a shift in a doctor’s workload in recent years, some of it mandated by law, finds more time being allocated to computer and desk work, such as entering data in the Electronic Health Record (EHR).

 

The actual face-to-face time with a doctor or other health care provider actually comes down to 7 minutes on average. Therefore, a patient advocate clearly has a huge gap to fill. The advocate can begin by simply observing the visit or procedure to make sure that simple mistakes and errors in communication don’t occur. Many of these are unavoidable byproducts of nurses changing shifts, hospital doctors on rotation, etc.

 

But in an aging population, the advocate’s efforts become even more critical. An advocate can take time to take a detailed patient history, something often lacking in our rushed system. They can translate information into the patient’s first language as needed, calm nerves in the stressful and unfamiliar surroundings of a hospital or clinic, and thereby bring to the fore the questions and answers that need to be transmitted. In the stress of a medical event, it’s very common for patients, particularly the elderly, to be so flustered and anxious that they forget to ask important questions or give important information.

 

Not everything is potentially positive if patient advocates become a standard part of health care. If they have their own agenda because their employer is a hospital or insurance company, the patient’s best interests may not be uppermost. One anticipates antagonism between the advocate and the doctor, who isn’t used to third-party input and values his autonomy. And if the advocate isn’t calm, professional, and common-sensical, adding another anxious person in the examining room would be a detriment.

 

Still, we feel that the benefits far outweigh the potential downside. The key is for advocates to be accepted as a positive extension of the existing system, not an opposition party. A concerted effort to standardize a curriculum and certification for advocates is now being developed. It needs all the support it can get. The creation of an educated, licensed workforce of professional advocates can and should be an integral part of improving the safety and efficacy of our national health care. With your eyes now opened, you’ll see how great the need is the next time you need to see the doctor.

 

 

 

 

Deepak Chopra MD, FACP, Clinical Professor of Medicine, University of California, San Diego, Chairman and Founder, The Chopra Foundation, Co-Founder, The Chopra Center for Wellbeing

 

Lizabeth Weiss BA, Research Associate, The Chopra Center for Wellbeing, Assistant Director, Rancho Santa Fe Senior Center

 

Nancy S. Cetel, MD, President and Founder, Speaking of Health and specialist in women’s health and reproductive endocrinology.

 

Danielle Weiss, MD, FACP Clinical Assistant Professor of Medicine, University of California, San Diego, Medical Director & Founder, Center for Hormonal Health & Well-Being

 

Joseph B. Weiss, MD, FACP, Clinical Professor of Medicine, University of California San Diego.

 

References: Brennan TA, Leape LL, Laird NM, et al. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl J Med 1991;324:370–6.

 

Kohn LT, Corrigan J, Donaldson MS. To err is human: building a safer health system. Washington DC: National Academy Press, 2000.

 

Department of Health and Human Services. Adverse events in hospitals: national incidence among Medicare beneficiaries. 2010. http://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf.

 

A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care James, John T. PhD Journal of Patient Safety: September 2013 – Volume 9 – Issue 3 – p 122–128 doi: 10.1097/PTS.0b013e3182948a69

 

Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ 2016;353:i2139. doi:10.1136/bmj.i2139

 

Measurement of patient safety: a systematic review of the reliability and validity of adverse event detection with record review. Mirelle Hanskamp-Sebregts, Marieke Zegers, Charles Vincent, Petra J van Gurp, Henrica C W de Vet, Hub WollersheimPublished 22 August, 2016 http://bmjopen.bmj.com/content/6/8/e011078.full

 

Weismann JS, Schneider EC, Weingart SN, et al. Comparing patient-reported hospital adverse events with medical records reviews: Do patients know something that hospitals do not? Ann Intern Med. 2008; 149: 100–108.

 

Overview of medical errors and adverse events. Maité Garrouste-Orgeas François Philippart, Cédric Bruel, Adeline Max, Nicolas Lau and B Misset Annals of Intensive Care 20122:2

DOI: 10.1186/2110-5820-2-2 Published 16 February 2012

 

Valentin A, Capuzzo M, Guidet B, Moreno R, Metnitz B, Bauer P, Metnitz P: Errors in administration of parenteral drugs in intensive care units: multinational prospective study. BMJ 2009, 338: b814. 10.1136/bmj.b814

Ridley SA, Booth SA, Thompson CM: Prescription errors in UK critical care units. Anaesthesia 2004, 59: 1193–1200. 10.1111/j.1365-2044.2004.03969.x

 

Garrouste-Orgeas M, Timsit JF, Vesin A, Schwebel C, Arnodo P, Lefrant JY, Souweine B, Tabah A, Charpentier J, Gontier O, et al.: Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II on behalf of the Outcomerea study group. Am J Respir Crit Care Med 2010, 181: 134–142. 10.1164/rccm.200812-1820OC

 

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Top Stories in Medicine in the Last Century

 

Description: Dr. Sanjiv Chopra will cover the greatest discoveries and scientific advances in the last 100 years. All scientific breakthroughs come in fits and starts. The stories behind the discovery of drugs like penicillin and statins; of vaccines for polio and Hepatitis B; the control of HIV, the greatest of all plagues, with HAART therapy; the cure of diseases such as Hepatitis C; the history of how the birth control pill came about; and advances in cardiology such as the development of the pacemaker for complete heart block have not only changed medicine forever but make for fascinating tales that combine serendipity with brilliant science.
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