Skip navigation


Below is an excerpt from a letter my patient, KP received from The Trustees of the Plumbers’ Welfare Fund in September 2010:

Elimination of Mental Health Benefits

Effective October 1, 2010, no amount is payable under the Welfare Plan for claims connected with the treatment of a Mental Health Condition. A Mental Health Condition is generally defined as a condition or illness that affects an individual’s emotional or psychological well-being. Mental Health Conditions include, but are not limited to, dementia, delirium, anxiety disorder, schizophrenia, depression, bipolar disorder, delusions, obsessive-compulsive behavior, Anorexia, Bulimia, attention deficit disorder, mental retardation and autism.”

Below is KP’s Résumé:

  • Current Position: (held for the past 18 months): Field Superintendent/ Project Manager with a 35 man Plumbing Company. He began as an entry-level plumber and within 3 months was promoted to his current position; second in command only to the company’s owner. A company with $3M annual revenues at the time of his promotion it has since grown to revenues of $15M the year following KP’s promotion. Every member of the company, including its owner, would attribute this explosive growth in the face of a down economy to KP’s performance as their Superintendent. They would tell you about his innate leadership abilities, his ability to command respect while being perceived as a genuinely nice guy who cares about the people he works with. This quality, combined with the treasure-trove of plumbing wisdom KP absorbed in his quarter century in the field, has made this explosion in his company’s growth seem effortless. Not being one for accolades, I do know that KP takes pride in the fact that he is the first one there in the morning and the last to leave; this is just who he is and this is just the way he does things.
  • October 2006 to Present: With his sheer willpower and the support of his family and his physician (yours truly), KP became a Recovering Cocaine Addict.
  • October 2006KP in another failed suicide attempt took an overdose of medicine which I prescribed to treat his Mood Disorder.
  • From 1967 to October 2006: KP, like 25% of the American population, was functionally impaired due to  a Mental Health Disorder and, as is the case for two-thirds of the members of this population, KP went unrecognized and untreated in spite of his frequent use of the healthcare system. (1)
  • Career PathAs are nearly 10% of persons in this country, KP was born with Attention Deficit Hyperactivity Disorder (ADHD). (2) By the age of 14, KP went on to acquire Bipolar Disorder when he effortlessly met the stringent requirements for achieving his first full-blown Major Depressive Episode.  It was at about this time PK began dabbling in something in which he fortunately never became very proficient; suicide. A novice in the skill of snorting cocaine at 17, he rapidly ascended to become a full fledged functional Cocaine Addict by the age of 21. No surprise really, since most 17 year olds with PK’s diagnoses that do not receive treatment become substance abusers and addicts by the time they turn 21, with cocaine being the usual drug of choice. (3) Until 2005, KP continued to self medicate with an addictive, deadly and illegal substance in his futile attempt to treat the agonizing symptoms of mental illness. Miraculously, due to his strong faith, his will to live and his having family and friends that loved and believed in him, he is now the 12 Million Dollar Man; twice as good as any TV superhero.

While KP is, indeed, a rare person his diagnoses are all too common. He came to me in 2005 to find out why he was experiencing severe pain from a relatively minor back injury, he had gained about 60 pounds and was having digestive problems. Had I not done 2 minutes worth of screenings for Depression, Bipolar Disorder and ADHD, as I do on every new patient to my practice, these symptoms never would have come out from KP’s spontaneously elicited complaints. (4) (5) (6) Fortunately, when I reviewed the Mental Health Screeners with KP he was open, honest and quite frankly, relived to share with me the details of the symptoms from which he suffered  silently for the previous quarter century; and his silence was not due to his fear of being stigmatized. KP, as intelligent a person as he is, simply never even considered that these symptoms were relevant to any physician.  You can imagine his surprise when I told him that he was suffering from a medical condition as treatable as Congestive Heart Failure but, more common and with a far better prognosis. He trusted me enough to commit to taking 4 medications per day for the rest of his life.

I am recounting the case of KP the Plumber, not to show my readers what a great physician I am. What I accomplished with KP does not require the skills of a great physician, just a good one. The treatment of mental illness is as straight forward as the treatment of Asthma, Hypertension or any other common disorder physicians treat on a daily basis. Yet, two-thirds of persons suffering with mental illness are simply not recognized; and this is not due to their not accessing the healthcare system. (7) Persons with undiagnosed mental illness use the healthcare system more than those persons without mental illness. (7)They most commonly do so for the evaluation of the physical symptoms that are actually a common component of mental illness. (7) Recognizing mental illness is as simple as asking every patient if they have it or not; this is simply not being done and until it is there will continue to be needless human suffering and an excessive waste of healthcare dollars.

In the 18 months during which KP increased his company’s annual revenues by $12M, the total expenditure on his health care, including my treatment and his medications, was a grand total of $13,500.  Stated another way, for every $1 invested in KP’s mental health his company realized a return of nearly $900. Any venture capitalist would gladly have purchased as many shares as possible of KP Inc. Unfortunately for KP he is not a publicly traded company on the NASDAQ and unfortunately for The Trustees of the Plumbers’ Union Welfare Fund they only consider cost and not return on investment when they make healthcare decisions. This gives me cause to seriously question their sanity.

END

Mitchell R. Weisberg, MD. MP

Advertisements


  • Employers’ indirect costs resulting from Employee Mental Illness is 4 fold greater than their direct costs for Employee healthcare. (1)
  • In spite of the fact that people with mental illness use the healthcare system much more often than does the general population, most (2/3) of Mental Illness is never recognized (diagnosed) or treated. (2)
  • Once diagnosed, Mental Illness is highly treatable with between 70 and 90 percent of people having significant reduction of symptoms and improved quality of life with a combination of medication, talk therapy and other supports. (2)
  • A major obstacle to recognizing mental health disorders is their lack of symptoms in the traditional sense of the word. (3)
  • Recognizing mental illness depends on an awareness of an individual’s functional status such as their social functioning or work performance.
  • Since there is evidence that even workers with mild or “sub-threshold” problems begin to show productivity problems early on – perhaps long before they experience other health consequences – employers are in a unique position to effect significant change in the way services are delivered. (1)
  • Over the past two decades The Balanced Scorecard has been widely employed as the Business Management tool of choice by most major employers worldwide. (4)
  • The Balanced Score Card aligns the goals of an Organization with the personal goals of its Employees for the purpose of achieving optimal performance at the Organizational level.  (5)
  • Systematic  measurements of performance against the Organization’s stated goals is an essential part of an effective Balanced Scorecard. (5)
  • Information contained within employee performance data, if viewed from a clinical perspective, will facilitate the early recognition and treatment of mental illness in a workforce. (1)
  • The early recognition and treatment of mental illness in a workforce yields a significant Return on Investment for Employers. (6)
  • Since there is evidence that even workers with mild or “sub-threshold” problems begin to show productivity problems early on – perhaps long before they experience other health consequences – employers are in a unique position to effect significant change in the way services are delivered.
  • With more than 2 decades of clinical experience as both a Primary Care Physician and a Mental Health Care Provider and a career commitment to optimizing the health and performance of his patients, this physician is in a unique position to help employers effect this change. (1)
  • This physician can show the stakeholders of any Organization how to realize the value of adding a clinical perspective to their Balanced Scorecard.
End Post

It should come as no surprise that when the term human capital first appeared in the annals of economic theory some 60 years ago it was a fungible resource similar to the machinery of what was, at that time, a manufacturing based economy. (1) This characterization literally changed at the speed of light with the United States response to the Soviet’s launching of Sputnik in 1957 and the advent of  what is now commonly called the World Wide Web(2) As a direct result of this development, there has been a continual servicization of the US economy ever since with 77% of US GDP in 2010 being derived from the service sector. (3) In this same 60 year time span, the US labor market had to transition from one based almost entirely on its brawn to one that is now based almost entirely on its brains. The implications of this transition we are only now beginning to collectively witness. For instance, it is the cognitive evolution of our nations economy that resolves the seemingly paradoxical coexistence of Depression level unemployment with the critical low mass in attraction and retention of talent and successorship in Corporate America(4) When viewed from this cognitive” perspective it also should come as no surprise that absencedisability and unrealized productivity related to issues of employee mental health cost employers more than four times the cost of current employer-based medical treatment. (5) Leadership, both public and private, continues to fixate on spiraling health care costs while perilously neglecting the value of the most important asset in our national portfolio; our Human Capital.

Mental illness is the single largest contributor to disability on the globe accounting for 33% of the total and the single largest cause of impaired work performance in the United States. (6) While 70 to 90% of people with a mental illness improve appreciably with treatment only 1 in 3 workers with mental illness are ever even diagnosed much less effectively treated. (7) What is more is that always preceding a person’s first or repeated episode of a full-blown mental illness, there is a sub-threshold form of the illness where functional impairment is the only harbinger of the malady that is to follow. (8) Organizations that effectively watch and appraise their employees work performance and align this with their Balanced Scorecard are in a unique position to leverage these performance metrics in a way that will have an order of magnitude impact on both the health of their workforce and their bottom lines.

Organizational Health in the 21st Century:

Work Performance; a New Vital Sign for a New Economy

Providers of a cognitively complex service with a global reach need only experience an episode of jet lag to understand how functioning at anything less than their optimal mental state can negatively impact their work performance, much less should they experience a full-blown mental illness. One in four members of the American workforce is impaired by a treatable mental illness; arguably, those employees providing the most cognitively complex services will be most susceptible to performance impairment. While Cognitive Behavioral Therapy (CBT), psychotropic medication or both is effective in 70 to 90% of people with mental illness, only one in three workers with mental illness actually seeks the attention that they need and only one in ten actually receives adequate treatment. (8) In addition to the burden of human suffering, there is the unrealized value of the most critical asset in an Enterprises portfolio, its human capital.

If we are to fix this problem, we first must understand why we are failing to recognize mental illness. The perceived stigma of being diagnosed with a mental illness continues to play a significant role in the under-recognition of mental illness. However, the fact that persons with non-diagnosed mental illness, on a per capita basis, utilize significantly more non-psychiatric healthcare services including non-psychiatric hospitalizations, Emergency Department visits as well as visits to Primary Care Physician that the general population points to the main culprit, and that is the  failure to recognize mental illness.

Two factors contribute to the invisibility of  mental illness.  First is lack of recognition on the part of patients that their flailing work performance may be due to a mental health condition, and thus they don’t seek the care of a professional for diagnosis and treatment.  The second is the medical school and post-graduate training physicians receive, which focuses on diagnosing and treating illnesses that are three-dimensional; that have a color, a texture or a mass that can be pointed at with a finger. In contrast, mental illness is invisible to every clinical tool that the modern healthcare provider has at their disposal.  Two clinical vignettes can best demonstrate this contrast:

–      In the first post season playoff game on the opening pitch all 50,000 fans in the stadium hear the loud popping noise that comes from the pitcher’s mound and witness him fall to the ground grabbing his right shoulder in utter agony. Neither the team’s trainer nor a single spectator need to see him throw a second pitch to diagnose the fact that something terrible has happened to the shoulder of their beloved star’s pitching arm.

–      Another pitcher has a 10 year career ERA of 1.8 until this season, in which his ERA has fallen to 4.1.  Needless to say his team did not reach the post-season. Neither his trainer nor a single fan in the stadium ever considered that this once high achieving superstar had recently begun to have depressive episodes due to an undiagnosed mental condition known as Attention Deficit Disorder. In spite of the fact that his performance on the mound is meticulously and accurately measured, none of these metrics gave any sign that his decline in performance was a direct manifestation of his underlying mental illness.  Failing to receive treatment widely recognized as highly effective in restoring function and performance, this pitcher was sent back to the Minor Leagues and was never seen in the Majors again.

In the case of the first pitcher the definitive diagnostic tool for recognizing a torn rotator cuff is the MRI.  But what most organizations, including baseball teams and companies of all types don’t realize is there is an equivalent to the MRI for detecting a range of mental health conditions.  Inherent in the Human Resource organization’s rigorous employee processes and performance tracking resides the essential information to assure that a workforce’s health is maintained at an optimal level, and to detect instances where a treatable mental health condition is  likely present.

The Human Resources professional of the 21st century, wittingly or not, is at the front line in this nation’s battle to break with its myopic cost oriented health care system and lead us to one that is value based  with a return on investment; and who better qualified for this position than an person who actually has the term human capital in mind with every action she executes. Like a principle of an elementary school, she spends 90% of her professional life with 10% of the human capital whose professional lives are within her charge; but this is not where the similarity ends. The 21st century Enterprise comes equipped with performance metrics or, highly advanced versions of report cards that, when executed well, hold invaluable information germane to the future continual success of the employee, manager or executive to whom it is applied.

End Post

Please stay tuned for the following posts coming soon:

  • Performance-Health: The missing link in the evolution of Employee and Organizational Wellness
  • What the quality of an Employee’s performance saying about the quality of their health and why it is important to know?
  • Anticipating the unintended consequences of Performance as a Vital Sign
Thank you for sharing your comments and insights!

It should come as no surprise that when the term human capital first appeared in the annals of economic theory some 60 years ago it was characterized as a fungible resource similar to the machinery of what was, after all, a manufacturing based economy. (1) This characterization of human capital changed at the speed of light in the aftermath of the Soviet’s launching of Sputnik in 1957 and President Eisenhower’s determination that the United States to never again lose to another nation in the race for information, and the  Advanced Research Projects Agency (ARPA) and soon thereafter, the internet was born. (2) Prior to Sputnik, approximately 40% of the US GDP was derived from the manufacturing sector. (3)  From the dawn of the Information Age however, a virtual servicization of the US economy has occurred with 80% of US GDP in 2011 being derived from the service sector. (3) With this transition from a manufacturing to a service economy, the US workforce evolved from one dependent on its brawn to one that is based almost entirely dependent on its brains; consequently the employee health issues that are most likely to impair their work performance hav  (5) Mental illness is the single largest contributor to disability on the globe accounting for 33% of the total and the single largest cause of impaired work performance in the United States. (6) While 70 to 90% of people with a mental illness improve significantly with treatment only 1 in 3 workers with mental illness are ever even diagnosed much less effectively treated. (7) What is more is that always preceding a persons first or repeated episode of a full blown mental illness, there is a sub-threshold form of the illness in which functional impairment is the only harbinger of the malady that will soon follow. (8) Organizations that effectively monitor and appraise the performance of their employees as a component of their Balanced Scorecard are in a unique position to leverage these performance metrics in a way that will have an order of magnitude impact on both the health of their workforce and their bottom lines.

Please stay tuned for my upcoming post,

Organizational Health in the 21st Century:

Employee Performance; the New Vital Sign in the New Economy

Until then remain healthy and remain effective.

End

Mitchell R. Weisberg, MD, MP


What would your computer guy say to you if you had 6 programs running simultaneously and you shut off your computer? He would say thank you because you would be doing damage to your computer which means more work for him and orthodontia for his daughter. Every one that has ever used a PC knows that we need to shut down each open program, one at a time before saying good night to our beloved PCs. Have you ever noticed the similarities between the human brain and the personal computer; no coincidence since the PC is a creation of the human mind.

Our efficiency and accuracy in performing tasks runs parallel to our sense of wakefulness which peaks soon after awakening and gradually degrades as the day progresses until evening time when we become sleepy and the cycle starts anew. While feeling sleepy is something with which everyone can identify, diminished executive functioning (our ability to identify and fulfill tasks) is not as obvious. Never the less our executive functioning diminishes as the day progresses being the first brain function to decline when we are sleep deprived or drowsy. To prove this point, a major review conducted in 1996 suggested that the oil spill of the Exxon Valdez, the space shuttle Challenger disaster, the nuclear accident at Chernobyl (costing over 4,000 lives) and the near nuclear accidents at the Three Mile Island and Peach Bottom reactors were all associated with sleep deprivation of the people involved. Sleepy driving causes as many car crashes as driving under the influence.

During the course of our hectic days we too have a whole host of open programs in our brains, which is as it should be when we need to execute tasks and move our agendas forward. Just like our personal computers, our brains cannot go from having 6 open programs to off without some adverse consequences when we go to re-open these same programs tomorrow. In order for sleep to fulfill its restorative function we must get both the proper quantity and quality of sleep. People that work right up until the time that they fall asleep are deluded if  they think this increases their productivity; however this habit actually decreases productivity due to their inefficiency and error of performing tasks while drowsy.  Just like with our computers, we need to start shutting down our open programs, one at a time, starting well before sleep time. Time management, as it relates to human performance and productivity is not a zero sum game. The 90 minutes we spend “chilling” before we sleep is not 90 minutes of work lost; it is actually a pre-requisite for restoring our ability to function “executively” the next day.

My message is, shut down your open programs and chill out for a while before trying to go to sleep tonight; it may just prevent a disaster from happening tomorrow.

Mitchell R. Weisberg, MD, MP


The current Prognosis for U.S. Business:

Footing for at least 1/3 of this nation’s healthcare expenditures, the continually rising costs in this sector is a cancer that threatens the life of U.S. Business. In the past 2 decades healthcare expenditures have increased 300%; a rate that is 5 times that of inflation for this same time period.  This represents 16.2 % of GDP (gross domestic product), giving our nation the unflattering distinction as the leader of the industrialized world in this category.(1)  Based on the current spending trajectory, by this nation’s tricentennial nearly one half of its collective productivity will be consumed by healthcare expenditures. (2) Characterizing this issue as a terminal illness is not simply a convenient medical metaphor; absent an unprecedented fundamental change in how healthcare is provided in the near future, the long-term prognosis for U.S. Business is certainly a grim one.  

The Diagnosis: US Business became so fixated on cost they have completely forgot about value

For the past 3 decades Corporate Americas’ prevailing healthcare strategy has been to outsource to third-party payers. While initially cost-effective, based upon the statistics just cited, this is clearly no longer the case. In its effort to survive spiraling health care costs, US Business has adjusted its strategy to cost shifting to its employees.This has only served to deepen the crisis by disenfranchising the workforce during an economic climate in which US business can ill afford to do this. While US unemployment is at its highest post Depression rates, recruitment and retention of talent and successorship are also at a critical mass in our nation; at the same time, global competition has never been more intense. Most importantly, cost shifting is only postponing the inevitable need to grapple with what, after all, is the elephant sitting on the sofa; an overvalued healthcare system. By conservative estimates 1 dollar of every $3 spent on healthcare in this country is wasted outright.(3)

This physician’s proposed course of Treatment

Sound business principles dictate that curing the malignant growth in health care spending be derived from novel combinations of proven remedies already in existence. In house strategies, such as on site wellness programs is one such proven remedy. Such programs have consistently demonstrated healthy returns on investment of $3 to $6 return on every $1 invested. While still an emerging trend, on site health services have higher employee participation and employer satisfaction rates than most other health programs. (4) In contrast to the negative PR generated by cost shifting, companies offer on site programs to stay competitive in the marketplace and use such programs as a recruitment and retention benefit. While clearly a breath of fresh air, in-house strategies have inherent limitations that keep them from making any more than a small dent in our current healthcare crisis. However, with some creativity these limitations may be easily overcome. When organizations have  invested in on site wellness programs they typically realized returns quickly. Unfortunately, due to the inherent selection bias of such programs, these returns seem to plateau just as quickly. Selection bias would predict that those employees most likely to participate  in an on site wellness program will be those already wellness minded. As a result if this phenomenon, these programs will tend to help those employees that least need it while leaving those employees that have the most to gain, behind. Overcoming this limitation would require a method to easily identify those employees that would derive the greatest benefit from an on site wellness program and provide them with the incentives to take part in it. Such methods of employee selection will appropriately raise the ethical and legal concerns regarding an employees privacy and a multitude of other such issues. However, with what this physician has in mind, such issues will be of no concern. Before addressing this issue, it is necessary to provide the clinical background information upon whicn this authors solution for healthcare is founded. Please stay tuned for my next post, The Neuroscience of a Service Based Economy

 

End

Mitchell R. Weisberg, MP, MD

(1) http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358 http://www.measuringworth.com/ppowerus/.

(2)  http://www.cbo.gov/ftpdocs/89xx/doc8947/01-31-TechHealth.pdf

(3) http://thomsonreuters.com/content/press_room/tsh/waste_US_healthcare_system

(4)  http://www.hewittassociates.com/_MetaBasicCMAssetCache_/Assets/Articles/2010/Hewitt_Survey_Findings_TheRoadAhead_2010.pdf


As we embark upon the 5th decade of the Information Age, our health and our performance has never been so intertwined. In the first decade of the new millennium 80 cents of every dollar in the United States came from the Service Sector. To me, an Internist and Psychopharmacologist, Service means Cognitive Functioning. In other words, as compared to just a generation or two ago, we derive our livelihood in this nation primarily by using our brains a lot more than our brawn. Consequently, the meaning of health has changed dramatically. The primary impairment to our work performance is no longer just our backs, our wrists or our shoulders; it’s our Cerebral Cortices.

When we think about this from an Evolutionary perspective, this makes perfect sense. 100 % of the 1 or 2% difference between Chimpanzee and Human DNA went into the design of the Human Cerebral Cortex; the seat of our superior ability to reason, speak, discover, create and deceive. For better or for worse, it follows, that the part of us that makes us distinctly human,  our Cortex needs to be in command of the rest our beings; when it’s not,  our health and our performance is rendered suboptimal.

From this vantage point, one will see just how arbitrary the border separating the mind from the body is. For example, 9% of Americans suffer from a major depressive episode each year. Amongst people with Type 2 Diabetes, 25% have a major depressive episode annually. A single chronic health condition is associated with a nearly three-fold increased risk of Depression! What’s more, in people that have both Type 2 Diabetes and Depression, those that have their depression treated have much improved control and reduced complication rate of their diabetes than in those that do not have their depression treated. The implication of this for me as a physician is that for me to optimally treat Type 2 Diabetes, the most common chronic condition in the United States, I must also be able to optimally treat depression.

I use Diabetes and Depression simply as a graphic example of the folly and the danger of the prevailing view of the separation of Mind and Body that continues to persist in our society in general and in our healthcare system in particular. With our ability to perform in our world being such a cerebral experience, anything from a bad night’s sleep, to skipping meals to chronic pain or having multiple chronic health disorders will have an effect on a persons’ ability to learn, work or interact socially with family members friends and co-workers. The time has come where we must completely reject this concept of the separation of  mind and body or physical and mental; our lives and our livelihoods depend on it!

Welcome to the Evolution.

References

http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml 

http://www.nimh.nih.gov/science-news/2010/diabetes-and-depression-associated-with-higher-risk-for-major-complications.shtml 

End

Mitchell R. Weisberg, MD. MP


Cereals with > 5 grams or more of fiber: the entire line of Kashi cereals (with a few exceptions); there are hundreds of cereals on the market now that meet these criteria. However, Cheerios, Rice Krispies, Kellogg’s Corn Flakes are all 2 grams of fiber or less. Kellogg’s Special K only has 2 grams but now they have come out with a Special K that has 5 grams of fiber. (they heard I was complaining)

Breads in general should contain 2 grams or more of fiber per slice.

Crackers: > 3 grams per serving (Kashi brand)

Fruits and Vegetables in general are good sources of fiber

Soy,  is a vegetable that is high in fiber as well as protein: Edamame; try Melissa’s brand; Boca Brand of burgers and sausages (it’s all soy and actually tastes great); Morning Star is another brand of the faux meat products (and I am not a vegetarian)

Trail Mixes: these are extremely practical because of how portable they are. Trail mixes can vary in their content quite a bit; some are more candy than anything else. Just check the nutrient content for the 5 grams of fiber and go for it. This is something you can keep in the car at your desk in backpacks, purses, brief cases, etc.

Energy Bars: Look for > 5 grams of fiber per serving:  Cliff Bars and Kashi GoLean are both excellent choices in this category. 

Here is a plug for Starbucks; they seem to get it. They have prepackaged trays such as their protein breakfast with apple; peanut butter; whole wheat bagel; hardboiled egg; some cubes of cheese and grapes. They have a fruit and cheese tray. Most of their sandwiches are on high fiber breads. They sell individual small packages of trail mixes. Granted they are pricey, but I do have to give them credit for offering this type of food.

OK; you got it? Good, then go and have something to eat before you get hungry.

End

Mitchell R. Weisberg, MD. MP


Eat before you are hungry

When you eat in response to feeling hungry  you will consume more calories than when you eat before feeling hungry. Hunger is a late phase in the metabolic process occurring some time after our function is sub-optimal. Eating the exact same diet but spreading the calorie intake into smaller, more frequent meals will result in weight loss and an improvement in your overall functioning.  Due to the physical laws which govern the process of  cellular metabolism, 2,000 calories consumed in 5 meals of 400 calories will have a much different effect on body weight and available energy than the same 2,000 calories consumed as a single meal. In the smaller, more  frequent scenario as little as 200 calories (10%) is stored as fat, while in the single meal scenario as much as 1.000 calories (1/2 of the total calories consumed) is stored as fat. If you were to do nothing other than redistribute the same calories you are now consuming into smaller and more frequent meals, you would have more energy and you would lose weight!

Eat 4 to 6 grams of fiber 4 to 6 times per day

Fiber, while classified as a carbohydrate,  is not actually a nutrient in the usual sense in that the human digestive tract does not have the enzyme required for absorbing fiber into the blood stream; it is  not used as a source of energy for life processes.   By remaining in your digestive tract, fiber enhances allows you to feel satisfied for longer. More importantly, due to its unique chemical and physical properties, fiber slows the rate of absorption from your digestive tract of the other nutrients that you consume with the fiber. As a result of this slower rate of absorption, the nutrients you consume will be delivered to your 40 trillion cells at a rate which allows them to handle these nutrients most efficiently; thus, capturing the greatest possible amount of energy for living and the least possible amount for storing these calories as fat.  If you were to do nothing other than add fiber to your diet, you would immediately have more energy and lose weight.

End

Mitchell R. Weisberg, MD, MP


Overview of my My Clinical Method and Services

Albert Einstein said if he had just 60 minutes to save the world he would spend 55 minutes defining the problem and 5 minutes deriving the solution. Similarly, when optimizing an individuals’ health, I spend most of my time illuminating their symptoms, which I define as anything they perceive as impeding their ability to function, be it physical, mental or emotional. My 21 years of clinical experience as an Internist and Psychopharmacologist has allowed me to develop a unique clinical method in which I pinpoint the region(s) of the Central Nervous System (Brain and Spinal Cord) from which their symptoms originated. Next, I match these symptoms with the functional impairments they are experiencing. This  is referred to as “deconstructing the syndrome” and serves as the key to my transcending the imaginary boundary separating physical and mental health (mind and body). This process requires I spend about 2 hours, face to face, with an individual; once completed navigating a path to achieving Optimal Health and Performance, just as Einstein would have predicted, is the relatively simple leg of the journey.

While honoring the uniqueness of every person, my general management strategy never varies. In my lineup optimal levels of NutritionPhysical Activity and Sleep bat first, second and third; with my prescription pad, when needed, batting cleanup.

With this as my own personal healthcare system, I offer comprehensive individualized Health and Performance Optimization Programs for Adolescents and Adults impaired by:

  • Addictions
  • Anxiety Disorders
  • Attention Deficit Hyperactivity Disorder
  • Chronic Pain Syndromes
  • Eating Disorders
  • Menopausal Management
  • Menstrual Disorders
  • Mood Disorders
  • Overweight/Obesity

By Medicalizing Mental Health I resolve my patients’ symptoms; removing the stumbling blocks obstructing the path leading to their Optimal Health and Performance.

End

Mitchell R. Weisberg, MD, MP