The future's so bright, I gotta wear shades.

I feel a bit like Janus today. He was the Roman god of transitions; usually depicted with two faces, one looking forward and one looking back, Janus stands at the crossroads of our lives, guiding our passages from where we are to where we shall be. Today, I look back on what, in 2015, becomes two decades of private practice, and where I will be going in the future. So for a moment or two, Janus I shall be. 2014 was a year full of new beginnings for me, both personally and professionally. I’ve made a great many new friends, and enjoyed a renewal of both intellect and spirit. It was also the year I rediscovered my voice, as my writing -- once my career -- has again begun to flourish, not only publishing on my blog, but also at other sites such as the Good Men Project. My book has been resurrected, and is finally making steady progress.

The Center for Alternative Medicine, my practice in Litchfield, also saw an incredible amount of expansion in 2014. I introduced my private line of supplements for general health, assisting people with chronic diseases, and to support mental health issues such as anxiety and depression. This, along with my ability to create custom herbal formulas for patients, has fulfilled a life-long dream of mine; the ability to incorporate my knowledge, not only into the recommendation or use of herbs and nutrition, but in their creation. This is a wonderful capability that will benefit all of my patients, regardless of whether they are seeing me for physical injuries or internal disorders.

I am the only doctor in Connecticut, to my knowledge, that has ability to offer both of these services. It has taken years of education and experience to reach this point, and my heartfelt thanks goes to all of those people who have helped me get here.

Growth occurred internally, as well. Over the course of this past year, I went from having a single employee to three employees. Though most of my patients don’t see anyone except the person at the front desk, behind the scenes I now have people handling the medical billing as well as bookkeeping and accounts receivable. This rapid growth also had me working hard on administrative issues, developing the policies and procedures that never had to exist before.

The front desk is now in the capable hands of Giselle, whose laughter is infectious and whose efficiency is becoming legendary. The steely-eyed Joanne is facing off with the insurance companies, making sure that they live up to the promises they made to you, my patients. And Thanhien, who has managed million-dollar payrolls in her sleep, is making sure that our cash flow runs evenly. I could not ask for more capable hands to assist me.

As if those weren’t changes enough, I have an ambitious program outlined for the next year, with some entirely new services.

In December, I passed the examination to become a federally certified Medical Examiner, and am now one of only a handful of doctors in Connecticut who offer the medical examinations required every two years for everyone who carries a commercial drivers license. I really enjoy doing these exams, as I get to explore with drivers the wide range of health issues that effect them. I have already uncovered a few serious illnesses during the course of my exam, and helped drivers find appropriate care for them.

I also now have a CLIA-certified laboratory on site, and in partnership with a couple of other laboratories, we can now provide a comprehensive suite of employment and forensic testing services.

I now have the ability to provide breath, urine and hair analysis for drugs of abuse, for everything from alcohol to opiates. When these test results are required for evidence in court, I have the ability to provide what is called “chain of custody” handling, which means that the sample is overseen from collection to analysis, virtually eliminating the possibility of intentional or accidental tampering.

I can also provide a full range of relational DNA testing, including gestational paternal testing. This means that, with a couple of blood samples, I can determine the father of a child even before it has been born, with 99% accuracy. I can also perform non-invasive parental DNA tests, as well as testing for multiple siblings.

My DNA testing, like the drug testing, can be done with chain-of-custody handling for the court or other agencies, or even to support immigration and citizenship claims.

The best thing is that I am making all of these services as affordable as possible for the average person.

Anyone who has picked up a paper in the past few years knows that medical services and products are incredibly expensive and have a huge markup. This is, in part, due to the inefficiencies of the medical system, with huge amounts of overhead.

I, on the other hand, have been a sole practitioner for decades. I know how to keep my overhead low, and as a result, I can offer these services more conveniently and at less cost than anyone else.

Ok, so is that the crop? Let me think...private line nutrition, custom herbs, new staff, DOT exams, drug testing, DNA...yep, I think I covered all the bases.

Oh, yes, except for one thing:

I want to thank every single one of you who helped make 2014 the incredible year it was. My patients, my friends new and old, and my family have given me so much for which I am grateful. I can only hope that I have given back in equal measure. I wish for all of you the most wonderful year to come.

The Doctor of the Future

Watching the news, it is difficult to escape the conclusion that humanity is fast approaching a turning point of great impact. I'm not speaking of ISIS or the Gaza-Israeli conflagration; conflicts such as this are older than history. Rather, I'm referring to the ever-growing polarity of our possible futures. On the one hand, you have a rapidly growing income disparity and a civilization utterly dependent on cheap energy which is about to lose its primary source of that energy; a world that is already so overflowing with people that in even rich, technologically advanced countries, such basic things as readily-available water cannot be counted upon; a food supply that is so trucked-up in technology that it now causes the diseases that proper nutrition once prevented; and a worldwide ecology already in the midst of chaotic change.

On the other hand, you have technology so advanced that robots will soon be able to replace men in dangerous, life-threatening jobs, saving countless lives; the possibility, albeit remote, of extending mankind's territory to other planets; genomic manipulation to the degree that natural selection can be replaced with social selection, and entirely  new species can be created; and artificial environments designed to replace the one that our overpopulation has begun to destroy.

The latter scenario is highly unlikely, except, perhaps, as a time-limited state in the longer progress of the former. We have already passed several points of no return in the alteration of our worldwide ecology, as CO2 levels have passed the 400 ppm mark, global temperature has reached the highest peak of this geologic period and shows no signs of stopping, and we are in the midst of a mass extinction of species. Our technology is nowhere near the point of replicating on any large scale, the vast diversity of the once-living earth, and that is critical to our survival at anywhere near our current population. Anyone who places their faith in unlimited technological progress in a reality circumscribed by limited natural resources is bound to be disappointed.

This shouldn't come as a surprise. From the beginning of history, civilizations have outgrown their habitats and outlived their creative energy, leading to periods of turmoil before another another order arises.

But the cry arises: "It will be different this time!"

Perhaps, perhaps. But not in the way the hopefuls imagine. The laws of physics and biology make it inescapable that we are headed for a post-industrial society of some sort. The only real question that remains is what that society will look like.

Certainly, the cheap transfer of goods and materials will cease. The days of raising chickens in the U.S., sending them to China for processing, and then shipping them back here to be sold will be long gone. With the disappearance of cheap energy, we will primarily be able only to move knowledge, not products, over long distances. Computational devices may remain, as they are less material- and energy-intensive, and can be supported by low-powered, decentralized power grids. Though they require exotic materials, they require them in small amounts, making their continued manufacture a possibility. Large-scale, centralized manufacturing will disappear, and if we manage our affairs right, we can arrive at a safe landing with local economies intact, using local resources for small-scale creation of goods. The post-industrial society, it turns out, will have quite a different flavor than the one first imagined by Daniel Bell, instead being closer to the future predicted by neo-Malthusians.

My interest, of course, is primarily in how this will affect health and health care delivery. A lot will change under this scenario, not all of it bad.

First of all, the changes in the transportation system will yield many positive results. With people walking and cycling more, obesity and many related sedentary lifestyle co-morbidities will greatly decrease. The incidence of diabetes, heart disease and cancers will drop significantly.

With energy-intensive factory farming techniques all but obliterated, a return to local production and harvesting of foods will further enable improved health through better nutrition. Indeed, a cultural shift in this direction has already begun, despite regulatory and economic  roadblocks that have been put into place to protect the Monsanto-dominated paradigm.

A return to a more pastoral and village-centered lifestyle will also be accompanied by a decrease in the anomie of life that is a direct outcome of our currently disconnected, disembodied and overly-embroidered lives. Less depression and anxiety almost always accompanies stronger social networks.

Of course, all of this is predicated on the maintenance of a society relatively protective of both individual liberties and cognizant of the need of our strong social obligations to one another. And it's not all sun-dappled rides on two wheelers through abundant fields of grain, either.

Drug production and distribution will be inhibited, putting those dependent on such drugs, such as insulin-dependent diabetics, at risk. Essential vaccines, such as pertussis and measles, would become scarce. And antibiotics, which are already on the wane would be hard to come by, though as I have previously mentioned, that's not necessarily much of a calamity. Certainly "advanced" medicine, with its exotic potions and technology-dependent surgical techniques, will go by the wayside.

I'll make the argument that, in fact, much of that medicine and technology is largely superfluous. The advanced medicine of the latter half of the 20th century and the first decade of this one has made no impact on human longevity, measured in productive years. Many of the surgeries and medicines that are employed today are only necessary because of the society in which we live. Change the parameters of that society, and these disorders would largely cease to flourish.

What does that leave us with, health-wise? It leaves us with a health-care delivery system which is supported by locally-available resources, and which utilizes low-technology manual interventions. It would also leave us with a health care system supported by a truly interdisciplinary population of healers, unrestricted by practice laws and insurances aimed more at preserving the power and income of a protected class of professionals.

In this health care milieu, there would be more shamans and crones and fewer psychiatric wards, more midwives and fewer cesareans. There would be doctors who know the properties of herbs, where they could be found, and how they could be prepared. Who know the use of food and nutrition to turn on the genes of health. Who know foodstuffs and how to use them to cure disease, and who know the human body and its anatomy, and who can alleviate pain with their hands. Doctors who can continue to work when the lights go out.

The fact of the matter is, the doctor of the future looks very familiar. And as I more frequently walk upon the Old Paths in search of the knowledge that can help my patients, I am increasingly cognizant that the wisdom I gather is not only for the benefit of my patients today, but also for the doctors of the future.

Why You Are Sick

Today, more than ever, we live in a disease-ridden society. But that's not because we lack sanitation, hygiene, abundant foods or opportunities for exercise.

We live in a disease-ridden society because we are creating diseases. Or, more accurately, we are having diseases created for us, and through careful manipulation of our fears, we have come to accept these manufactured diseases as real.

Anyone who watches television or reads a magazine has seen (albeit largely unconsciously) how cleverly marketing first creates a disease, ensures that lots of people come down with it, and then offers a "cure" to get rid of it.

As an example: Until Viagra came along, impotence was either an occasional mishap resulting from emotional causes or secondary to other disorders, such as circulatory problems, nutritional deficiencies, and diseases or trauma interfering with nerve function.

Then Pfizer came along, developed a drug that increases blood flow to the male penis, and needed a market to sell it to. Nevermind that Viagra's ability to improve function is limited to a single mechanism that really only works for a few men (those that are producing insufficient amounts of nitric oxide). That market was too small. What Pfizer needed to do was to create a larger market.

First, they created the need, and that was easy: What man doesn't want to be better in bed? Second, they created the disease, i.e., the reason you're not better in bed. They took the old name -- impotence -- and scotched it, because of its negative connotations. The word "impotence" conjures up images of a skinny-armed teen getting sand kicked in his face by the guy with the rock-hard biceps and bosomy blonde in tow. Or the cuckolded husband coming home from his 9-to-5 only to discover his randy wife in bed with the next door neighbor.

No, those are not images with which any man would associate himself. So Pfizer created a new disease -- Erectile Dysfunction -- with an entirely neutral connotation -- and craftily expanded the boundaries of this  created disease. The really, really important thing to note here is that Pfizer took a symptom of several diseases and made it into a disease by itself so that they could sell a drug to "treat" the disease.

It still hasn't reached the point where a man is going to sit down on the bar stool, look over at his neighbor and say, "Damn, dude, I just got diagnosed with ED. Pass the peanuts, wouldya?"

But the reformation of impotence (the symptom), into ED (the value-neutral disease), mainstreamed the concept to the point where healthy young men are now taking the drug for a perceived extra performance edge.

And Pfizer is putting lots of money in the bank.

---------------------------

Another excellent example of a manufactured disease is osteopenia.

There was a time when osteopenia was an incidental finding on an x-ray, a way you would describe a bone which had gotten more transparent than others. It was an indicator of the loss of mineral in that bone, and a sign that, as a doctor, you might want to be on the lookout for osteoporosis further on down the line.

Or maybe not. Plenty of people experience temporary osteopenia, which reverses on its own. A number of pharmaceuticals cause osteopenia as a side effect, and as soon as the drug is no longer taken, normal bone is restored.  People living sedentary lifestyles, either due to other health problems or simple neglect,  often develop osteopenia which disappears with a return to activity.

But for several years, I had many a middle-aged woman come to my office with the "diagnosis" of osteopenia, for which they had been prescribed Fosamax or one of the other bisphosphonates.

Again, here we have a symptom, or exam finding, that has been carefully recrafted into a disease.

The rebranding of osteopenia came with the development by Merck of a new drug that could increase the mineralization of bone. But this new drug -- Fosamax -- like, Viagra, had a very limited audience. People with osteoporosis, a true weakening of the bone.

But in 1997, Merck hooked up with the developer of a cheap and easy x-ray machine which purported to measure bone density in a way that would predict risk of fracture.  The DEXA scan immediately multiplied Merck's market by creating a new class of disease sufferers, this time people who had the new disease of "osteopenia."

And the market took off. With the addition of standards manufactured by the drug companies themselves, medical doctors started prescribing Fosamax to a huge number of middle-aged women.

The wheels have since come off that cart, at least a little bit. No so much because subsequent research shows that Fosamax does not create healthier bone, nor because Fosamax has also been shown to actually cause bone death and increase fracture risk in certain bones (true). Nor has the fad decreased because research has also shown that the DEXA scan does not adequately -- or even remotely -- predict bone fracture (true).

No, the fad has passed because the patent on Fosamax ended in 2008, and the horde of no-name drugs has reduced the value of Fosamax considerably. With competition, Fosamax is no longer the money maker that it once was.

But the lesson that Merck learned was a valuable one. No, not the lesson about the consequences of releasing a dangerous and poorly-tested drug onto the market.

The real lesson here was that coupling tests which purport to objectively demonstrate the presence of a "disease" with a drug that cures that "disease" is an extremely potent form of marketing.

Today, consultants of pharmaceutical companies are offering week-long seminars on how to couple drug development with tests that will increase the demand for that drug, and then market them to medical doctors and consumers alike.

This development has gone largely unnoticed, and unreported, and the vast (and unwarranted) trust that Americans have in their medical physicians makes such sales easy to make.

Medical doctors, on their side, are seeing pharmaceutical company payouts, in the form of "consulting fees," as a lucrative sideline to offset the continuing pressure on their income. Medical doctors are also paid ludicrous sums for enrolling patients into research programs, to the extent that some practices have hired specialists to sift through the studies available and determine which will be the most profitable to participate in.

And patients, on their side, are manipulated by the fear spread by pharmaceutical companies that previously unheard-of diseases will dramatically affect their quality of life.

But you know what? Most people aren't sick, and most people don't need prescription drugs -- although 50% of the U.S. population are taking them.

In fact, most of the people taking drugs today are not the victims of disease, they are victims of a lucrative marketing scam no more ethical than an email from a banker in Kenya.

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

There is a better way to manage your depression and anxiety. Find out how.

Paralysis. Suicide. Fatigue. Heart Attack. Birth Defects. Liver Disease. Weight Gain.

Is This Any Way To Treat Depression and Anxiety?

These are just some of the side effects of antidepressants. At the same time, research has shown that these drugs are not much better than placebo at treating depression and anxiety.

Please join me on Nov. 9 for an exploration of the dangers of medical treatment for depression and anxiety, and a look at alternative management strategies.

At this seminar, you will learn:

• What are the long-term effects of using drugs for mood disorders?
• What really causes depression and anxiety?
• Can acupuncture help people with depression?
• Which herbs are most effective for people with depression? Can herbs really reduce anxiety?
• What is the research behind alternative management strategies?

If you or someone you know suffers from anxiety or depression, call today to reserve your seat.

Wednesday,  Nov. 9, 2011 Litchfield Community Center 7 p.m.

Call 860-567-5727 and ask for Teresa, or email to depression@averyjenkins.com

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at alj@docaltmed.com or by calling 860-567-5727.

The Economics of Pharmaceutical Research

I'm starting to get a little worried that, with this post, two out of the last three posts involve comics. I really do read other things than the comics section of the local newspaper. Honest.

March Podcast — Brittle Bones and Bad Drugs

The March edition of the Alternative Healthpod is now available. If you are not a subscriber, you can listen to it here, or as always subscribe to it by clicking on this feed. You can also subscribe via iTunes. Show Notes:

Two new studies published last week show that long-term use of oral drugs prescribed to prevent osteoporosis may be associated with unusual fractures of the thigh bone -- in other words, they are weakening the bone they are supposed to strengthen.

The research is not the first to link the drugs, known as bisphosphonates, with fractures. Other research has found that these drugs also increasing the risk bone death in the jaw.

Dr. Melvin Rosenwasser, a professor of orthopedic surgery at Columbia University College of Physicians and Surgeons in New York City, and co-author of the study, said that when bisphosponates are "used beyond a certain point...they may actually be bad."

A second study looked at bone biopsies taken from the thigh bones of 21 women, all past menopause, who had suffered fractures at the site. Nine had not taken the drugs, while 12 had, for an average of 8.5 years.

The women on the bisphosphonates, researchers found, had 90% "old" bone, meaning that new bone was not being created in the women taking the osteoporosis drugs.

Source: American Academy of Orthopedic Surgeons Annual Meeting, 2010.

If you are taking osteoporosis drugs, or are concerned about your risk of fracture, please contact me immediately at 860-567-5727, or email me at alj@docaltmed.com.