3 Easy Steps to Fast and Lasting Weight Loss

3 Steps To Lose Weight That Will Last

When it comes to losing weight there are no magic pills or secret diets that can help you reach your weight loss goals. But you can achieve your goals with these 3 steps to help lose weight.

Like most things in life losing weight (a lot of weight) boils down to conscious effort, discipline, determination and perseverance.

Losing 10, 20, 50 or 100 pounds or more all comes back to what you do on a daily basis. If you do what you’re supposed to do (eat right + exercise) day in a day out you will eventually lose all the weight you want.

However, if you throw caution to the wind and don’t do what you’re supposed to do then you may never see your weight loss dreams come true. This my friend is the saddest scenario there is.

If you’re bored of being fat, if your tired of being overweight, if your ready to start your new life today then hold on because I am about to give you the simple yet extremely effective weight loss plan you’ve been waiting for.

Are you ready? I am going to tell you in no uncertain terms what you have to do to lose all the weight you want in 3 easy to do steps. However, in order for this to work you must maintain your focus and discipline everyday to keep doing the steps until you reach your desired results.

Even if you falter and veer off your weight loss track, it’s OK. If you are able to quickly get back on track you will overtime, reap the benefits of dramatic weight loss and improved health.

And now, without further adieu here are your 3 basic steps to weight loss…

1. EAT LESS

2. EAT BETTER

3. EXERCISE

There they are. What do you think? A little anti-climatic, huh? Maybe you were expecting more… Well, let me tell you if you are able to grasp and implement this powerfully safe and effective weight loss plan is you will never again have to spend another unnecessary dime on weight loss products that don’t work.

You see, your body is a fine tuned weight loss management machine. If you follow the right plan and give your body only what it needs to survive it will do all the hard work for you.

Given enough time and following the 3 steps above you can lose tens and even hundreds of pounds without starving yourself or resorting to bogus weight loss pills or dangerous body sculpting surgeries.

Now, this is not to say that the road to significant weight loss will be easy or that you will not have to suffer a bit to reach your desired results. There will be days when you feel like throwing in the towel and giving up.

On those days you might just cave into your undeniable cravings and go crazy at your local all you can eat artery clogging buffet. But hey,that’s OK. You’re human. Sometimes you have to go a little nuts to get back on track.

However, if you are truly committed to reaching even your most seemingly unattainable weight loss goals you can and will do it by following the plan above. Now, for your benefit let’s go a little deeper into each step of the plan.

1. EAT LESS

There is really no doubt about it. If you want to lose weight you have to start eating less. You have to create a calorie deficiency in order for you body to start shedding pounds.

If you do not begin to limit how much food you take in no amount of exercise will help you reach your goals. Eating less of your favorite greasy, fat filled foods will be the quickest way to dramatic weight loss.

It really doesn’t matter how much weight you have to lose. Unless you take control of both your conscious and unconscious eating habits you’ll be hard pressed to lose even one pound.

No, you have to start cutting back on the amount of food you are used to eating. I’ve heard of stories where people would go to Mc Donald’s and pack away two Super Sized Big Mac Meals.

Obviously, this is way too much. In this situation even cutting down to one Super Size meal would be an improvement. But, as we will see in our next step, a better plan would be to do away with the Super Size meal all-together and start eating better.

2. EAT BETTER

As the saying goes, “We are what we eat.” If we eat crap, guess what? However, if we learn to eat well then not only will our waistline thank us for it but we’ll also feel better about ourselves to boot.

One of the quickest changes you can make to your diet when trying to lose weight is to ditch all the junk food you may be used to eating (chips, sodas, pizzas, donuts, cookies, etc) and start eating more vegetables.

Now, I know what you might be thinking. You may still be traumatized by your mother not letting you get up from the dinner table until you finished all your broccoli but let me tell you, your mother was right.

If you can fill half your plate at every meal with high fiber and nutrient packed vegetables you are well on your way to significant and long lasting weight loss. This is probably one of the simplest things you can do to really kickstart your weight loss journey.

While it might not be easy to start eating vegetables at every meal the sooner you begin the better off you’ll be and the quicker the weight will start to melt off your body.

3. EXERCISE

In order to kick your weight loss adventure into high gear you have to get your body moving. I don’t care if you call it working out, exercising, aerobics or whatever the point is you have to do something to get your heart rate up and your sweat glands working overtime.

Exercise is the key to sustainable, long lasting and real weight loss. For every pound you lose by eating right and exercising that is one more pound that will never come back to haunt you.

Why? Because you now know the “secret” to safe and effective weight loss. If you ever feel yourself creeping back up on the dreaded scale o’ fat all you have to do is put these 3 steps into action and watch as you stabilize and contradict any unwanted weight gain.

By exercising on a regular basis you are giving your body the energy boost it needs to ramp up your metabolism rate to start efficiently and effectively losing weight on a daily basis. I don’t about you but that sounds pretty darn good to me.

The more you push yourself physically the faster you will see change in your body occur. You may not have to work out with a personal trainer everyday but you do need to do something.

Be it going for a walk, running, swimming, biking, hiking, or any other physical activity you like to do start doing it now. Don’t spend another night on the couch watching the latest re-runs. Get your body moving and start losing weight today.

CONCLUSION

Losing weight (even a lot of weight) is not rocket science. So rest assured that anyone can do it, even you. However, it will require all the patience, discipline, determination and perseverance you can muster.

Start slow. Take it one day at a time. You may not reach your ideal weight in one week, one month or even one year but stick with it and reach it you will. By following the 3 steps above you too can become a success story like so many other before you.

So go forth and start losing all that unwanted weight that years of undisciplined living have left behind. Take control of your life starting today. Soon you’ll be glad you did. When that day comes there will be no looking back.

How Effective Is Weight Loss Surgery?

For severely overweight individuals that have failed to see results from diet and exercise alone, weight-loss surgery has become the safest and most effective means of achieving significant weight loss. In fact, studies have shown that with diet and exercise alone, nearly 95% of obese patients will gain all the lost weight back within 5 years. On the other hand, long-term success rates for weight-loss surgery – including the LAP-BAND procedure – are remarkably high, allowing patients to maintain a loss of between 50-70% of their excess body weight. Though there are many factors that can impact an individual patient’s weight-loss success, weight-loss surgery is simply the most effective long-term weight loss and healthy lifestyle solution for severely obese patients.

Studies show that most patients that undergo weight-loss surgery will lose between 50-70% of their excess body weight within the first three years following their procedure. Those that undergo gastric bypass surgery will lose excess body weight more rapidly in the first 12 months than those that choose LAP-BAND surgery. However, gastric bypass patients typically experience a greater number of complications and side effects than LAP-BAND patients, as the LAP-BAND procedure allows for more gradual and natural long-term weight loss.

From a clinical perspective, a weight-loss surgery is considered successful when the patient loses at least 50% of their excess body weight and keeps the weight off for at least five years. While important lifestyle changes need to be made to ensure that the weight loss is maintained in the long term, studies have shown that most weight loss surgery patients are able to maintain a 50-60% loss of excess body weight 10 years after the surgical procedure. However, it is important to note that a weight loss of just 10% of total body weight can begin to have positive health effects in resolution of obesity-related condition like asthma, gastric reflux (GERD), and diabetes. As weight-loss surgery is usually performed on patients that are at least 75-100 pounds overweight or have a Body Mass Index (BMI) of at least 35 with a health condition, overall weight loss can range anywhere from 40 pounds to over 100 pounds. But the patient is really the leader behind achieving these results.

While patients will certainly look and feel better after weight-loss surgery, there are also numerous health benefits associated with successful weight loss. In most cases, health conditions that develop as a result of excessive body weight or are worsened by obesity can be improved upon or, in some cases, remedied by weight-loss surgery.

But there are other ways to measuring success with weight-loss surgery, like the LAP-BAND System. For instance, many weight loss surgery patients take great pride in being able to perform certain activities that may not have been possible for a number of years, like crossing their legs, bending over to tie a show, walking up stairs without being easily winded or sitting comfortably in an airplane seat.

While most patients that undergo weight-loss surgery experience incredibly positive results, there are many factors that can impact the overall success of an individual patient’s procedure and follow-up treatment. Here are some important factors to consider as you try to determine whether weight loss surgery is right for you.

Pre-surgery Weight

Generally speaking, the higher a patient’s pre-surgery weight or BMI, the more excess weight the patient can lose after surgery. However, recipients of weight-loss surgery with less excess body weight will eventually come closer to their ideal weight when committed to long-term diet and exercise. Also, resolution or improvement in obesity-related diseases can occur with even moderate amounts of weight. Often many diseases can become closer to cured than improved with earlier intervention at a lower weight.

Overall Health

While pre-existing health conditions can impact the overall success of weight-loss surgery (for instance, patients with type 2 Diabetes typically lose less excess body weight after surgery), studies have shown that many ailments linked to obesity are either improved upon or fall into remission after a successful procedure. For instance, a 2000 study performed on 500 weight loss surgery patients showed that nearly 96% of health conditions associated with obesity – such as high blood pressure, depression, sleep apnea, back pain and diabetes – improved greatly following loss of excess weight and long-term commitment to diet and exercise.

Surgical Procedure

As there are potential risks and complications associated with any surgical procedure, potential patients should always seek to have their weight-loss surgery performed by a trusted medical staff. Prospective patients should inquire about their surgeon’s success rates with weight-loss surgery and listen to the experiences of former patients. Additionally, a patient’s weight-loss success may also be impacted by the quality of post-surgery care and counseling provided by their bariatric outpatient facility.

Diet and Exercise

As diet and exercise are two of the most important factors in any weight loss plan, patients with the physical ability to exercise after weight-loss surgery have increased chances of meeting their goals. To maintain the weight loss achieved by surgery, both exercise and healthy eating habits must become integral parts of a patient’s lifestyle.

Commitment

The ability to remain committed to suggested dietary guidelines, exercise regimens and any follow-up care recommended by the bariatric outpatient facility is important for both short-term weight loss and long-term weight management.

Motivation

Patients that are motivated to lose weight and willing to follow through with diet and exercise prior to receiving weight loss surgery may experience greater levels of success immediately following the procedure and in the long term. Most people did not find themselves severely obese overnight. It took years to reach that weight and therefore patients should be patient with the weight-loss process, which will also not occur overnight. Successful patients find small victories along the way to celebrate and stay motivated.

Support

As weight-loss surgery will require some time away from everyday activities, it is important to have the support of family, friends and coworkers before undergoing any surgical procedure. Furthermore, as the ongoing weight-loss process following bariatric surgery may require a certain level of emotional support, prospective patients may want to establish a support network – including friends and family members that can join in on exercise and healthy eating.

Fast Weight Loss Is More Water Than Fat

A lot of people want to lose weight in the quickest way possible and are often fascinated when they use a weight loss product or service that produces a rapid weight loss in the first few days or weeks. While it might be appealing to think that they are at last on the right track and that they will finally be able to stick to it and lose unwanted body weight, there is however a flip-side to this rapid weight loss experienced.

After experiencing the initial rapid weight loss, it is too often the case that a lot of dieters who make use of such quick fat reduction products find that they simply start losing hope as their fat loss rate almost always grinds to a snail pace. And while it might be great if all the bodyweight reduction experienced during the initial phase of the diet program was actually from body fat, the fact is that this is not the case.

The truth of the matter is this – losing body weight is actually easy, but losing body fat is not as easy as it might seem. It would also not be an exaggeration to say that a lot of diet promoters are pretty much aware of this fact but somehow intentionally fail or refuse to enlighten dieters about this weight loss phenomenon.

This is what is actually happening. A great percentage of the weight lost during the early phase of virtually any weight loss program is mostly due to water loss from body tissues because water forms part of every single cell in the human body. In fact, fat-free mass is 70-75% water, and body fat is just about 10-40% water.

Due to the reduction of calorie intake during the early periods of using any weight loss product and in particular those especially designed to “supposedly” facilitate quick fat reduction, the body is forced to release and burn its stored glycogen for energy fuel. Glycogen is essentially made up of 75% water and 25% glucose and therefore when glucose is metabolized, water is largely produced as a by-product.

Consequently, about 75% of the weight lost during this initial rapid bodyweight reduction is mostly from lean body mass (muscle and water) and 25% from unwanted body fat. Normally, for every gram of glycogen that is burned, the body loses about 4 or 5 grams of weight. When body water is lost in this way, and due to the fact that water is heavy, the drop in pounds is easily noticed on the scale.

It is only when the body’s glycogen stores become significantly depleted that the body begins to burn fat for energy. However, each gram of fat has about twice the calorie content of 1 gram of glycogen and therefore it would require burning double the amount of calories needed to lose 1 gram of glycogen to lose 1 gram of fat.

Therefore, since fat contains only about 10-40% water, when the body moves into the fat burning phase of a weight loss program, the bathroom scale tends to be much slower than when glycogen was being burnt for energy at the beginning of the diet.

Taking into account the aforementioned points, it is unfortunate to note that there are actually some weight loss programs that in an attempt to show prompt results incorporate the use of diuretics to give the illusion of weight loss. Diuretics, both drugs and diuretic herbs, promote body water loss through the kidneys. Apart from these diet programs leading to body water loss which easily shows up on the bathroom, the dieter risks getting dehydrated.

Equally, be it a conventional diet, a fad diet, or a diet pill, the early rapid bodyweight reduction effect mostly likely to be experienced is virtually the same – body water loss. However, diets that employ have severe caloric restrictions or that are high in protein can significantly increase this effect.

Actually, the natural course of weight loss is to experience a quick loss of weight resulting from the loss of water from body tissues which is then subsequently followed by a significant slowdown in fat loss as the body now switches to burning its fat stores to meet it energy needs. After the initial rapid bodyweight reduction phase of a weight loss program, the rate of further healthy fat loss should be somewhere around 1-2 pounds per week, or slightly more depending on the individual’s make-up.

Therefore when a diet plan or some other fat reduction program claims to have the ability to help you lose as much as 10-30 pounds of body weight within a questionable period of time, say 1 week, you now have an idea of what you are up against. You simply can’t burn fat that easily, instead you will be losing your body water.

When dieters have a proper understanding of the body weight they are more likely to shed during the early days of a diet program, their focus and expectations will not be unnecessarily raised as they now understand just where they are and what to expect.

Understanding the little intricacies involved in losing weight such as the body water loss concept above, helps dieters to be far better poised to set realistic fat reduction goals. This allows for a design of a fat reduction plan that anticipates how to handle situations and other inevitable minor setbacks that test the dieter’s resolve without him or her feeling unnecessarily discouraged.

A sensible and long-term focused weight loss program should therefore target body fat loss instead of concentrating solely on scale weight loss. For successful and long-term weight loss, there is the need for an individual to make some positive and permanent changes in his or her lifestyle such as the incorporation of a calorie-controlled diet with regular physical exercise.

Online Pharmacies and Telemedicine

Not a day goes by when our email inboxes do not fill with advertisements for prescription drugs. Many of these emails promise to deliver drugs of all classes by overnight courier without a prescription. While there are legitimate online pharmacies, and the practice of telemedicine or cyber-medicine is gaining acceptance, this change in the way medicine is being practiced is rocking the foundations of the medical establishment. Being able to consult a doctor online, and obtain prescription drugs delivered to your doorstep by UPS has broad social and legal implications. The Internet facilitates making drugs available to those who may not be able to afford to pay US prices, are embarrassed to see a doctor face-to-face, or are suffering from pain, the treatment of which puts most doctors in direct conflict with the ‘war on drugs’ but on the other hand there is the question whether these pharmacies make drugs available to recreational drug users without the oversight of a licensed medical practitioner.

The Need for Alternatives

Medical care in the US has reached a point where it is expensive and impersonal which has caused the consumer to become generally unsatisfied with the medical establishment as a whole. Examples include the huge differences between the cost of drugs in the US and Canada, long wait times in US pharmacies, and poor service in general. Perhaps realizing this, US customs appears to tolerate the millions of Americans that visit Canada every year to buy their medications, as for the most part, these ‘drug buyers’ are elderly American’s that can’t afford the high cost of filling their prescriptions in the US.

Rather than to travel to Canada or Mexico millions of Americans are now turning to the Internet for both their medical needs. Telemedicine (or cyber medicine) provides consumers with the ability to both consult with a doctor online and order drugs over the Internet at discounted prices. This has resulted in consumers turning to online pharmacies for their medical needs, and in particular pharmacies with a relationships with a physician, which allow the consumer to completely bypass the traditional brick and mortar pharmacies, with the added benefit of having their physician act as an intermediary between the consumer and the pharmacy. According to Johnson (2005) this is as a result of consumers becoming very dissatisfied when it comes to dealing with both brick and mortar pharmacies and medical practitioners. As Johnson, notes, “Consumers are more likely to know the name of their hairdresser than their pharmacist.” When Johnson (2005) rated the various professions within the health care system, he found that pharmacists had the lowest interaction with their patients than did any other group. Today, as a result of this “consumers are buying 25.5 percent of their prescriptions online, opposed to 13.5 percent of which are picked up at a brick and mortar pharmacy” (Johnson 2005).

Drugs and Society

What has brought so much attention to online pharmacies is that it is possible to obtain just about any drug without a prescription online. Many of these prescriptions are for legitimate purposes purchased through an online pharmacy because the buyer is too embarrassed to visit the doctor or for other reasons including the unavailability of FDA approved drugs to the consumer. These drugs may include steroids that due to their misuse and being classed as a classed a category three drugs, are seldom prescribed by physicians. These drugs have a useful purpose to those suffering from any wasting disease such as AIDS, they also play a role in ant-aging (FDA, 2004).

The Doctor Patient Relationship

Today a visit to a doctor is generally brief, much of the triage it is done by a nurse or a nurse practitioner with the doctor only dropping in for a few minutes, if at all. In many cases the patient is seen by a nurse practitioner. One of the arguments against telemedicine or perhaps a better term is cyber-medicine, is that the doctor does not have a physical relationship with the patients and thus is in no position to make a diagnosis, and thus can not legally prescribe drugs.

Ironically when one compares the work up that one has to go through to consult with an online physicians and compares this to a face-to-face visit with a brick and mortar doctor, one finds that the online physician, in many cases, has a better understanding of the patient’s medical condition than does the doctor who meets face-to-face with the patient. In most cases before an on-line a doctor prescribes any type of medication they insist on a full blood workup they may also require that one has additional tests performed, for example.

The AMA, the federal government, and various states claim, however, that it is illegal for a doctor to prescribe drugs without a valid doctor-patient relationship. While there are no laws at present that outlaw online pharmacies, various states have enacted legislation, or are in the process of enacting legislation to prohibit a doctor from prescribing drugs to a patient that they have not seen face to face. Some states also require that the doctor that prescribes the drugs be licensed in their state. This alone could hamper the development of cyber-medicine. According to William Hubbard (2004), FDA associate commissioner “The Food and Drug Administration says it is giving states first crack at legal action, though it will step in when states do not act” (FDA, 2004).

Internet Pharmacies

The reason that email boxes around the country fill up with offers to supply drugs of all kinds, at reduced prices, without prescriptions, and more is because people buy them as the billions of dollars the drug companies are making each year attest to. The Internet has become the drug store of choice for many.

Categories of Internet Pharmacies

Internet pharmacies are generally acknowledged to be comprised of the following five categories:

Internet pharmacies can be divided up into five different categories, as follows:

Licensed online pharmacies with a no medical affiliation.

Licensed online pharmacies with a medical affiliation

No record online pharmacies (NRP)

International online pharmacies (IOP)

Licensed compounding pharmacies

The licensed online pharmacies with a no medical affiliation are of course Drugstore.com, CVV, and others. They all require a prescription from a licensed doctor that the patient has a doctor patient relationship with. The prescription can be called in by the doctor.

The licensed online pharmacies with a medical affiliation often depend on a broker. The broker collects your medical information, and then assigns your case to one of their networked physicians. Many of these networked physicians are willing to prescribe pain killers as they believe that it is only through the use of these drugs that some people can live a harmonious life.

A Government Accountability Office (GAO) Committee on aging held in June 2004 found that “Unlicensed international pharmacies do not require a prescription, and are generally located off shore.” No prescription pharmacies can be found all over the world. Many of these sites have come under controversy as in some cases all it takes to have that prescription delivered to you by next day air, is to fill out a questionnaire online.

A study conducted by Henkle in 2002 to ascertain how easy it would be to obtain drugs over the Internet found that “37 of the 46″ pharmacy required a prescription from a licensed doctor. The emphasis was on the prescription and not on the doctor. Henkle (2002) in fact notes that some sites offered to recommend a doctor.” Henkle (2002) was able to obtain prescription drugs from nine sites outside the US during the study, without a prescription.

Online pharmacies with a doctor affiliation

There are a number of online pharmacies, with a medical affiliation is that take great pain to differentiate themselves form unlicensed overseas pharmacies. These pharmacies, stress that they are “American based companies that provides consumer’s easy access to FDA approved online prescriptions over the Internet and are quick to point out that “An online consultation can be just as relevant as an in-person consultation.” It is interesting to note that many of these online pharmacies also point out that “While they are committed to making access to online prescriptions easier, they believe that the Internet can not replace the importance of regular doctor visits to fully evaluate your health and any medical conditions.” Many of these online pharmacy sites also makes a wealth of drug information available on its web site that enables the consumer to educate themselves on drugs that may have been prescribed. The Internet has for all intensive purposes is quickly replacing the brick and mortar base physician as a patient’s primary health care provider.

A sales pitch, of course, or is it? Most of the legitimate online pharmacies ensure that they comply with state and federal regulation. The doctors are licensed in all 50 states and their pharmacies are too. These legitimate Internet pharmacies cater to those that are looking for a better price; for some it comes down to making the choice of eating cat food on crackers in order to afford their medications because of the high US drug prices. In other cases patients resort to cyber-medicine to avoid the embarrassment of having to deal with a physician or pharmacy that may be judgmental. Many of these online pharmacies will arrange a consult with a licensed, medical doctor over the phone and will then fill the prescription accordingly.

According to Henkel (2000) “More and more consumers are using the Internet for health reasons” and references a study carried out by a market research firm Cyber Dialogue Inc., “that found that “health concerns are the sixth most common reason people go online” (Henkel 2000).

For many people a trip to the pharmacy is an ordeal. In some cases the local pharmacy may also be located in the closest town which may mean a long drive if one lives in a rural community. Online pharmacies provide a means through which their prescriptions can be delivered conveniently and quickly. Being online also allows the consumer to shop for the best prices, an important factor if one is living on a pension.

The Internet has also created a more aware user. It is not unusual for a consumer to research drugs on the Internet. A consumer may have seen a TV or magazine advertisement advertising a new drug. Ultimately, the Internet also provides the consumer the opportunity to enter into a doctor patient relationship that may in fact be more legitimate than the doctor who makes a physical appearance. Further information on doctors that practice telemedicine can be found at: http://www.becomeone.com

It is interesting to note, as discussed previously, that consumers are becoming dissatisfied with the care and treatment they receive from both brick and mortar physicians and pharmacies. Zanf (2001), references a study by Lang and Fullerton that “Identified four factors related to outpatient pharmacy services: professional communication, physical and emotional comfort, demographics, and location and convenience.” All of which are contributing factors as to why more and more consumers are resorting to cyber-medicine.

The Dark Side

There is also a dark side to the Internet pharmacy, as previously discussed, spam email touting the availability of any prescription drug one could want, without a prescription, is something everyone is familiar with has reached epidemic proportions.

From Ambien, and of course Viagra to more powerful drugs such as Oxycontin, you can have it all. Over night shipping is available in most case, or so these emails proclaim.
In some instances this pharmacy spam originates from unscrupulous individuals who have no intention of delivering the drugs, realizing that very few people, if any, will complain about the non delivery of an illegal drug through the mail.

In other cases the drugs are sent without a prescription from countries where that particular drug may legally be sold without a prescription, or at least the laws are more relaxed. Valium, for example, is sold over-the-counter in Taiwan.

According to Crawford (2004) “Consumers who purchase drugs online thinking that they are they are getting the same drugs as they would from their local brick-and-mortar pharmacy are being misled, and as a result are putting their health, and eventually their lives at risk” Crawford cites examples of Internet pharmacies supplying drugs that were under strength, contaminated and mislabeled (Crawford 2004).

According to Won (2005) Drug-industry executives think the Internet and mail-order operations will be the biggest source of counterfeit drugs over the next five years, according to a report released today by Ernst & Young. According to James G Dickinson (2005):

The federal government in July shut down an alleged illegal Internet pharmacy for selling counterfeit drugs and issued a warning on other counterfeits found to have been sold in Mexican border pharmacies to individual patients from the U.S. The Internet pharmacy had sold more than $7 million in counterfeit Viagra and other prescription drugs over the past five years, according to the San Diego Union-Tribune. The San Diego-based operation required individuals to complete a $35 “doctor consultation” survey before receiving the prescriptions, but the survey was never shown to a health professional to evaluate whether a safety risk existed, the paper says (Dickson, 2005).

In a separate action, the FDA warned Americans about counterfeit versions of Merck’s cholesterol drug Zocor and generic Carisoprodol – used for treating musculoskeletal conditions – that had been imported from Mexico by individual Americans (FDA, 2005).

Over the last year patients suffering from pain, and other conditions that they are reluctant to see a doctor face-to-face, have had the option of consulting a doctor online. The ability to consult with a doctor online, and then to receive drugs as a result has come under much controversy. This has for the most part been as a result of not adequately screening patient’s records, or ordering from unregulated overseas pharmacies.

The Internet – a new way of marketing

Not all Internet pharmacies are illegitimate, however, and there are many pharmacies that provide the consumer with a legitimate prescription by overnight service. My last prescription came by mail. The whole transaction was completed over the Internet. It was a prescription that my doctor had given to me personally, however. As discussed, what constitutes a doctor patient relationship is at the crux of the online pharmacy debate. This of course has implications as to what constitutes a legitimate prescription. What constitutes a legitimate prescription is a hotly debated topic.

The Future

As noted, being able to consult a doctor over the phone, and then have one’s prescription filled by an Internet pharmacy is convenient for many people. As the American population ages, more and more people will have trouble getting to the doctors office, not to mention driving to the pharmacy. Clearly safeguards are needed if cyber-medicine is to raise the quality of medical care available to Americans. The online pharmaceutical industry has taken a number of steps to ensure that consumers are protected against unscrupulous online pharmacy operators including the certification of online pharmacies.

According to Henkel (2000) “One way consumers can ensure the quality of an online pharmacy is to look for the Verified Internet Pharmacy Practice Sites (VIPPS) seal.” According to Henkel (2000) any site bearing this seal has gone through a rigorous series of quality checks which are part of the Verified Internet Pharmacy Practice Sites program. Unfortunately as Henkel (2000) notes, “Because VIPPS certification is fairly new and voluntary, only a few sites have been certified so far.” Recognizing the problem of ‘rouge’ pharmacies, SquareTrade, has also implemented a program to protect consumers from ‘rouge’ pharmacies. According to SquareTrade, “The Licensed Pharmacy program verifies that your business is a pharmacy in good standing. Verified pharmacies can display the Licensed Pharmacy Seal on their websites – distinguishing themselves from unverified and rogue pharmacies.”

If these safe guards are not put in place, and legislation is enacted that makes it illegal to obtain a prescription from an online pharmacy based on an online consult, the black market for drugs will continue to thrive. Customs by its own admission only catches approximately 2% of all illicit prescription drugs that enter the US.

Negating the fact that through technology, one could enter into a doctor patient relationship that may be affordable. Security, as some have suggested could be accomplished through the use of video cameras and biometric scanners which would cut down on the number of fraudulent prescriptions written. Measures like these would put the convenience of using an online pharmacy out of the reach of those without the technology. One could also not prevent consumers from using off shore online pharmacies. While the FDA is presently trying very hard to get the Canadian government to enact legislation that would prohibit the export of drugs from Canada by mail it appears that the profit that results from the sale of drugs is causing the legislation to stall. As one Canadian pharmacy owner noted, however “We will just move to the UK.”

Ironically, the Canadian’s are offering to crack down, not because of any concerns relating to the sale of drugs online, but because Canada controls drug prices, making them far cheaper than the same drug in the US. The Canadian authorities are planning on cracking down “arguing that the system was created to help Canadians, not Americans.” The drug industry itself has gone so far as to black list Canadian pharmacies that sell to American customers over the Internet. With all the paranoia relating to terrorism there is a concern that any drug coming in from another country may be contaminated. There are no instances on record of a consumer having received a contaminated drug from Canada (Matthews, 2003).

Even more ironically with all the talk about the dangers of drugs purchased from overseas, some legitimate companies are now being forced to buy from other than US sources because they have been black listed by US drug manufactures (Matthews, 2003). Mathews (2003) goes on to illustrate this by pointing out that “Canadian suppliers, in particular, that have been blacklisted, are now turning to sources in Europe.” Mathews (2003) notes that while for the most part these European sources are legitimate and make a high quality drug. In some cases, however Mathews et al. (2003) note that the pharmacies are having to go ‘farther a field’ to find product.

Conclusion

While there need for controls to be put in place to regulate the practice of both medicine online and Internet pharmacies, we also need to acknowledge that science and technology has furthered the practice of medicine, and that the Internet will further it yet.

The Internet has the potential of expanding medical care to those that may not routinely seek it, or are too infirm to travel to the doctor’s office. While the present trend appears to be to make it illegal for a doctor to prescribe drugs without seeing the patient face-to-face there is also a move to establish rules and regulations that ensure that patients receive quality care over the Internet. Unfortunately medicine and politics have become so intertwined and doctors have inadvertently become unwilling agents in the war against drugs.

Move With the Times – New Fitness Trends

Bored with the same fitness routines? Are you a fitness freak who gets bored doing the same exercises day in and day out? Or are you someone who finds working out in the gym not exciting enough? Well, here are some new fun fitness trends that might catch your fancy:

Piloxing: A unique mix of Pilates and boxing that promises to burn the fat as well as tone up the muscles. Using heavy gloves, it blends the flexibility, coordination and the graceful moves of Pilates with the speed and power of boxing. No wonder this new trend has the who’s who of Hollywood sweating it out to promising results.

Wii Fitness: A fitness video game created by Hiroshi Matsunaga, it takes working out at home to a new level. In this the player stands on a special balance board (which uses Bluetooth technology and pressure sensors that measures the persons center of balance) and can choose to do yoga, aerobics or strength training. The difference between Wii Fitness and regular workout DVD’s is that it provides an on-screen personal trainer who is able to direct and evaluate the user.

Cardio Tennis: Love tennis but can’t find someone to play with every day? Try Cardio Tennis. This non-stop group fitness class is based on tennis moves while also combining other endurance building exercises, so the whole group gets a workout while improving their strokes. It promises a total body workout which is more than what you get with just tennis. Like circuit training or boot camp, it includes activities like running, cycling, and squats while trying to hit tons of tennis balls and unlike traditional tennis the emphasis is on movement rather than technique.

Zumba: Hate to exercise but love to dance? Then Zumba is tailor made for you. The craze was accidentally started by Alberto Perez, an aerobics instructor in Columbia. He apparently forgot to get his traditional aerobics music one day and had to play the salsa and meringue tapes that he had. This resulted in a class that not only had an electrifying workout but also learnt to burn the fat while dancing. Zumba now also incorporates disco, samba, mambo, belly dancing and even some Bollywood moves.

Water Aerobics: Also called ‘Waterobics’, ‘AquaFit’ or ‘Aqua Aerobics’, this involves doing aerobic exercises in shallow water. The benefit of exercising in water is that it makes you feel lighter and hence running, jumping or moving in water does not have the same impact on the body and joints as when the same is done on land. Hence, it has lesser risks and can be done by people who have back problems, arthritis or knee problems. It also strengthens muscles as exercising in water is supposed to provide about 12 times more resistance than air.

Dancing: You can burn calories with almost any kind of dance. Search your neighborhood for some dance classes – the more exotic the name, the better. If the traditional Bharatanatyam or Kathak is not your cup of tea, you could try things like bollywood dancing, disco Yoga, masala bhangra or even African rhythms!

New Fitness Trends – How to Stay Fit

There is an increased interest in fitness, diet, health, and exercise in today’s world. It seems that everybody is looking for new ways to get in shape, lose weight, or eat healthier. In keeping with this, many exercise enthusiasts are looking into new fitness trends. There seem to be many fitness trends to choose from, and people need to examine them closely before choosing one that will work for them.

Fitness Trend- Exercising Outside

The first fitness trend that is really catching on quickly with lots of people is exercising outside. Traditionally, exercise has taken place indoors in a gym setting. However, more and more people are deciding to exercise outside instead. This option is a really good choice for people who like to be out of doors and enjoy fresh air. Examples of exercising outside are running in the park, jogging around the neighborhood, walking around the local high school track, or playing outside sports such as tennis or football. Individuals who don’t want to be confined indoors on beautiful days can really get many benefits from exercising outside.

Fitness Trend- Gender Specific Gyms

Another of the new fitness trends is gender specific gyms. These gyms cater to either a female or male clientele. Female specific gyms are on the rise in neighborhoods across the United States right now. These gyms serve female customers only and customize the workouts for the female body. The workers and trainers in these gyms are female as well. These gyms offer special help for women who want to tone their bodies, lose weight, or find healthier eating habits. Women seem to feel more comfortable working out with other women instead of with men. Some women even join in groups with their friends, so they can all work out together without feeling self conscious in front of male gym users.

Fitness Trend- Personal Trainers

Even though many new fitness trends exist, one is certainly catching on quickly. This trend is using a personal trainer. This option usually costs a little more than joining a traditional gym or working out on one’s own. However, the results from using a personal trainer are often very, very good. People can choose to have a personal trainer come to them in their own homes or can choose to use a personal trainer at a traditional gym. Either way, the personal trainer will customize routines and exercises to meet a specific client’s individual needs. The personal trainer is knowledgeable about dieting, toning, and exercising. The trainer will sit down with the client one-on-one to find out what the client’s specific needs are whether it is related to toning muscles, losing weight, or endurance training. The exercise regiment will be custom for the client, which often allows for excellent results.

Beauty and Fragrance to Fit Your Personality

Many of us must have heard the phrase, “Beauty is only skin deep”, but is it really only skin deep? Everyday you may be applying make up on your face not realizing that it blocks your skin pores. To bring out the real beauty of your facial skin, you must take time each day to cleanse and moisturize your skin. For women especially, wearing perfume helps give us presence and can make us seem more appealing. There are many kinds of perfumes available in today’s market.

When choosing perfume, hair care and skin care products, make sure to select those that fit your personality best. We are all unique and different to one another. So are our skin tone and body fragrance. What suits your friend or even family member may not work well for you. Your individuality comes to life when choosing beauty products. You must find that perfect scent that suits your mind and body. It should work well for all occasions like work and social events. Only use one fragrance at a time. Using several will totally change the scent of the other and have a negative effect. As the saying goes, “too many cooks spoil the broth”.

Choose a fragrance that is subtle and pleasant. You just need to dab or spray a little on various areas of your body. You also need to keep in mind that factors such as skin type, clothing detergent and other fragrant cosmetics will affect the scent of your perfume. Beauty products are available everywhere. More recently many online stores have opened, which makes it all the easier for you to make your purchase. Of course the drawback would be you can’t try the perfume. Make sure you’ve done your research before making a purchase. Often you can find all the products you need online, even at a discount. Many men’s fragrance products are available like cologne, body spray, deodorant, and hair care products. Keep in mind never to rub a fragrance on the skin as this will break down its various compounds. You should not spray fragrance into the hair as many fragrances contain alcohol, they could dry out and damage your hair.

To ensure that your scent remains on you throughout the day, layer the fragrance instead of reapplying over and over again. Layering refers to the use of other body products that contain the same scents like shower gels, body mists, and skin lotions. Many brands offer layering options with just the right scent dosage. Fragrances come in a variety of concentrations, which include oils, perfumes, eau de toilettes, and colognes.

I would like to give you some ideas on how to buy the right fragrance. The first step to locate the right fragrance is to find out what you want from your scent. If you want a strong smell that can hold its fragrance throughout the day, then you should choose oil. Next, never purchase a fragrance without first trying it out. If possible try to obtain free trial samples of the fragrance you are considering and try it out. If you can’t get trial samples, visit the stores that have the scent you want and use a tester. Remember to test the scent in the middle of the day because according to fragrance experts, it is the time of day when the sense of smell is most active.

The Trends in the Beauty and Cosmetic Industry

Beauty PR plays an important role in promoting beauty through healthy eating and popular beauty products. Indeed, the right PR program plays an important role in advising people on how they can go about looking better. Beauty is a quality which offers great pleasure to an individual’s mind as well as her spirit. This and the cosmetic industry have continued to thrive as a result of many people being attracted and absorbed by beauty. What has been fueling the cosmetic industry?

· A lot of money is being generated by companies in the industry

When you consider the industry, there is a new product being introduced in the market. Many of these products promise glamour for the younger women and youth for the older women. Most of the magazines are willing to set aside sections for glossy advertisements about lipstick or eye shadow and the latest designer clothing and shoes. They generate good money from these advertisements. Beauty has become big business: although it does not cost much to manufacture a small-sized tube of body cream, many of the beauty conscious women are willing to part with a substantial amount of money to achieve the desirable results promised by the product.

· The anti-aging industry has been growing at a rapid rate

Some ten years ago, there were only just a few products promising to get rid of wrinkles and fine lines. Today, the market is flooding with many products purporting to erase wrinkles and fine lines. There are many microdermabrasion products, peels, retinoids and antioxidants. In addition, there is a wide range of minor cosmetic procedures being tried by many women, even as early as the age of 25 years. These fillers provide women with a simple and less expensive option to look young. Today, facelifts have become common place with many women getting the desired look at competitive rates.

· The celebrity factor plays an important role in advertising

In the last couple of years, celebrities have become beauty PR ambassadors for many products. They have become spokes models for leading brands, unseating ‘supermodels’ who were often used particularly in the 80’s and early 90’s. This is a reflection of the general trend in advertising beauty products. Many of these celebrities do not wear makeup when they are going about their daily activities; however in advertising, they seek to convey the message that they are ardent users of a particular brand.

Bringing Lean Healthcare to Life

Starting Blocks

Without a doubt, Lean is set to make a big impact on the Healthcare sector over the next few years and many Healthcare organisations in both the public and private sector are already exploring how they could apply it to their patient pathways and administrative processes.

Whilst many of the tools of Lean are familiar to the people in the Healthcare sector, particularly aspects of Process Analysis, the real difference that Lean will bring is a change in the way that improvements activities are implemented rather than the use of the tools themselves.

Many people in the Healthcare sector are looking to people with Lean skills gained in manufacturing to help guide them through the maze of implementing Lean, including helping the organisation to prepare for Lean as well as undertake the specific improvement activities, including Value Stream Events, Rapid Improvement Events etc. Running alongside this is the need to develop the internal capacity of organisations to lead improvements themselves, which is achieved by developing internal Lean facilitators (or Change Agents).

However, as we already know, not every problem in Healthcare can be related to a problem encountered in Manufacturing and there are some significant differences in approach required to make for a successful improvement programme for people more familiar with leading Lean improvements in Manufacturing.

In this article we review some of the key differences that we have found in pioneering Lean transformation in Healthcare and share the structure to Lean activities that we have been developing to ensure that the organisations make sustained improvements rather than isolated Lean ‘ram raids’.

Interestingly, our work to date is also providing some useful learning that can be applied in reverse – from Healthcare back into Manufacturing!

The Same, But Different

As we have already said, Lean will make a big difference to Healthcare and will help them achieve their operational and financial targets but it needs to be applied sensitively within organisations that have been ‘pummelled’ by initiatives and legislation and have a not unreasonable cynicism towards ‘this new initiative called Lean’.

Like in many manufacturing businesses first embarking on an improvement journey, Healthcare employees are concerned about Lean being a vehicle to cut jobs. This feeling has not been helped by the recent NHS guide issued about Lean Healthcare which has chosen to use a Chainsaw as their main logo and was referred to by a Service Improvement Lead within an SHA (Strategic Health Authority) as the ‘Slash & Burn’ guide to Healthcare.

Issues such as this, along with the use of manufacturing focused terminology, photos and case studies when working with employees in Healthcare, has the effect of building up internal resistance and leads to comments such as “My patients are not cars” made by a Renal Consultant we encountered recently.

Additional differences can be seen in the attitude towards risk in Healthcare. In Manufacturing, if you make a mistake with Lean you may increase the risk of accidents but it is more likely it will just reduce productivity or profits. In Healthcare, similar mistakes can impact on Patient Safety (including increasing Morbidity or even Mortality) and can attract significant media attention.

Making this scenario even more complex is the fact that the ‘care pathways’ that patients experience often interact and overlap in a way that Manufacturing value streams do not, with patients switching between pathways and specialities dependent on their specific needs and treatment plans.

Management of these processes and pathways is complicated by the need to balance clinical concerns (such as patient safety and medical best practice) with ‘business’ concerns (availability of resources and finance), and the often uneasy balance that has to be struck between senior clinicians and organisational managers on these issues.

Whilst this sort of complexity is not alien to manufacturing, where there is a constant need to balance cashflow against sales (for example), the fact that this balancing and the resulting management of risk in Healthcare is so prevalent leads to a very different style of management – being more consultative and inclusive than Manufacturing, which slows decision making and involves a lot more analysis than many Manufacturing decisions, and the need to prove things first to sceptical clinicians.

This constant need for balance between clinical and operational concerns leads to one of the biggest differences we encounter, namely the difficulty in engaging the right people for the right amount time to make the improvements sustainable. This is not a new problem in Healthcare with many improvement initiatives having fallen foul of changing priorities, the allocation of insufficient people to an improvement process or simply having failed to move from discussion into action quickly enough.

One final difference between Manufacturing and Healthcare that we thought useful to highlight is simply the differences between what ‘customers’ think of as Value Adding in the two sectors. Giving comfort and advice to a patient is highly valued (for example, a nurse accompanying a patient being taken to theatre) but does not translate easily into a manufacturing equivalent activity.

A Holistic Approach
To counter these issues, introducing Lean into Healthcare requires a holistic approach that takes into account the following points:

1. Understanding Customer Value

Whilst the patient is the obvious (and most important) customer in a process, they may not be the only customer in a Healthcare environment; with others including (say) a Primary Care Trust that has commissioned a Hospital to undertake some activity on a patient and which will be invoiced for the activity.

However, in exploring what customer think of as value adding we do find some customers (patients) in Healthcare have become conditioned by their experiences to date. In one example we were speaking to a patient who attended clinics weekly as part of their treatment plan and was required to wait at every appointment for up to two hours. When we discussed what they valued and whether a reduced waiting time would be beneficial, they said they had come to expect the wait and would place more value on access to free coffee and better magazines to read!

2. Scoping Effectively

Identifying a compelling need for the improvement process is absolutely essential. The need to improve productivity or finances are often driving improvement initiatives in Healthcare but a compelling need based on saving money will rarely engage people from across the pathway.

Often a successful compelling need will focus on improving patient outcomes and achieving the statutory targets within public Healthcare (such as achieving an 18 Week maximum lead-time from referral by a GP to the start of treatment) as well as the need to achieve best practice rates for activity. Because of the importance of this step in the process, we have shown what we believe are the key elements required to successfully scope an improvement project in the text box opposite. It is worth stating that to be truly successful, the scoping of Lean improvements relies on having representation from across the pathway – even if, as is so often the case, that means including people who have never considered themselves as co-workers before, such as the GP and the Hospital Porter we had sitting next to each other at a recent Scoping session.

3. Effective Sponsorship

Leading a Lean project that spans such broad patient pathways requires a high degree of influencing skills. Even seeking to improve a simple administrative process like a Patient Discharge for example, could require the Project Sponsor to liaise, cajole and drive change across several stakeholder groups including GPs, consultants (the real custodians of the NHS), ward staff, medical secretaries, pharmacy staff, IT, social services and porters!

The Sponsor’s belief in Lean will be tested daily by such a large group of interested parties and so their capacity to maintain enthusiasm and motivate the Change Agents is vital. The secret weapon at their disposal, once the Scoping session has been completed is that an agreed Compelling Need will create “clarity of purpose”. Ultimately, if they engage enough people with the same message enough times, the followers will start to assemble.

4. Building Awareness & Capacity

Given the concerns of many in Healthcare that Lean is going to be used to shed jobs, it is essential that there is thought given to the communication of the ‘Compelling Need’ – what Lean is, what it is not and what will happen. Running alongside the raising of awareness will be the need to focus on developing the capacity of individuals within the organisation to enable them to lead Lean improvements.

In addition to initial awareness activities, there is also a need to build on-going communication activities to report on progress, involve others in the design of new processes and ensure that the organisation embeds the improvements achieved before (or alongside) moving onto the next challenge.

Our experience of this shows that at the start of the process a lot of people think of Lean as being just about ‘Process Mapping’ and there is a certain cynicism about it in many areas. This is quickly overcome but can be quite demoralising when first encountered and this confusion about Lean underpins the need to develop broad awareness within the organisation of what Lean truly can deliver.

In terms of capacity, many Healthcare bodies are keen to build internal capability to develop themselves as Lean organisations. Performance Improvement Teams are popping up all over the place and we have found that a large part of our work has been focused on helping these teams of change agents develop the facilitation skills and leadership attributes that will enable them to not only deliver change but make it sustainable.

5. End 2 End Understanding

We mentioned earlier that one of the ways that Lean in Healthcare is different to Lean in Manufacturing is that the pathways (value streams) interact in a different way. Another problem is often encountered through isolated events in one area having an unexpected (and often negative) impact either upstream or downstream in the pathway. Given the risk associated with making changes in different parts of Healthcare, we believe it is essential to develop an understanding of how the pathway operates from End 2 End and to review its critical constraints, current operating performance and the impact that likely changes might have elsewhere before seeking to create a suitable ‘Future State’ and implementation plan.

6. Embedding the Change

Much like Manufacturing, a large percentage of Lean projects in Healthcare are going to fail to deliver the results that organisations hoped for and many of these problems are related to the challenge of embedding the changes. So, having gathered support for an improvement programme and achieved the changes (through Focused Improvement Teams, Rapid Improvement Events etc), it is critical to also conduct the activities that will assist the embedding of the changes including:

 Publicity and communication of how the new systems/processes work
 Celebration of the improvements achieved
 Reviews of achievements (Progress Gates) which look back at what has already been done
 Auditing to ensure the changes don’t slip back to ‘the old way’
 Further events and activities (as one success often breeds further successes)
 On-going Change Agent Development
 On-going, visible Sponsorship.

No Magic Bullet
When we opened this short article, we mentioned that Lean is set to have a big impact on Healthcare as it can address the needs for improved effectiveness as well as reduced lead-times and costs, but that its application is different to the way that improvement activities are led in Manufacturing and has different risks and threats to success than in other sectors.

We do not claim to have a monopoly on good ideas about how to address these points and have written this article from the basis of real experience of delivering improvements to a variety of Healthcare organisations. We would welcome feedback on your experiences.

As a closing thought to Lean practitioners everywhere who are looking to be (or are already) involved in Healthcare – whatever the operational benefits that are possible, no-one wants to achieve these at the expense of patient safety – as it is only by addressing both operational and clinical needs that Lean Healthcare will truly come to life.

Mark Eaton MSC MBA CEng MIET FIOM
Mark is a Fellow of the IOM and Chairs the Operations Development Panel. He is a frequent speaker on the topic of making improvement sustainable and has worked with the Armed Forces, NHS, Local Authorities and Manufacturers for over 10 years on improvement programmes.

Simon Phillips MA FRSA
Simon is a Fellow of the Royal Society of Arts and Manufacturing and has spent many years helping industry leaders and their organisations to embrace new ways of working. He was recently awarded a National Training Award and has worked across all sectors in the UK, Europe, South Africa and the US.

Evolving Healthcare Trends

The model trends in the healthcare system have been changing over the period of time. The old trend gave importance to the individual patients and the emphasis was on treating illness. The goal of the hospitals was to do inpatient admissions, fill up the beds and more emphasis was given to acute inpatient care. The role of managers in the old paradigm was to run the organization and coordinate services. In the old system, all providers were essentially the same. The hospitals, physicians and health plans were separate and not integrated.

The newer trends that evolved gave importance to the population as a whole. It not only treated illness, but emphasized on promoting the wellness of the people. The goals of the healthcare system after being transformed over the years is to provide care at all levels which is continued. The role of managers in the new paradigm is more broad. They see the market and help in quality and continued improvement. They not only run the organization, but also go beyond the organizational boundaries. In the evolving system, the providers are differentiated according to their ability. The hospitals, physicians and health plans have formed an integrated delivery system.

One of the current trend in the healthcare delivery model is that continued care is emphasized. The key professionals are not only treating patients for their illness, but they are promoting and managing quality of health. For example, a patient with high cholesterol visits a doctor. He is not only given one-on-one medical treatment, but he is also offered to attend a group session where information is provided on how lifestyle and behavioral change can help. The patients learn from the clinicians and also from each other. Another current trend is to take care of the health of the defined population and not only individual patients. All the health needs of the population as a whole are identified and served. It is emphasized that the community uses the health and social services provided. Healthcare has become more population-based. Another trend that has evolved is that the hospitals, physicians and health plans have got connected and have formed an integrated delivery system. More investments are being made with a goal of providing services to the customers and retaining them.

There is a beneficial impact in the transformation of healthcare towards emphasizing continued health. The way healthcare has been viewed in the past has been changing. The shifting of care from treating acute illnesses to providing continued care is resulting in enhancement of the health of the people. The only appropriate and feasible model is to provide a continuum of care with the emphasis firmly on the family and community. The health of the population and community is considered as a whole. This is advantageous as it creates value in the healthcare delivery system. The healthcare providers work with the community as a whole and consider to improve the health of the general population. Even though this requires new kinds of ways of organizing and managing healthcare services, it helps in understanding the health needs of the target population. By studying their needs, the right health and social services could be provided to them. Examples of promoting wellness of the whole community are organizing health campaigns and providing preventive education to the people in general. Another example is providing awareness about flu vaccines and encouraging people to get the vaccination.

Integrating the healthcare delivery system has led to certain advantages to the patients. For example, they can be offered alternative sites of care depending on their convenience. It helps in meeting the needs of the customers and their preferences which is taken into account. The number of providers are expanded and the patients get to have a choice. The relationship between providers and health plans are organized in the current trend and this ensures that the right care is provided in a convenient way to the customers.

There are defined budgets and expenditure targets for the populations which implies that there is a need to be efficient and productive. The formation of strategic alliances, networks, systems and physician groups can also add value. There are capitated payments and budgets allotted to the healthcare organizations. These are used to provide care to the defined population. The organization might like to improve on the payments and budgets as the expenditures of the companies increase. This results in the management to make decisions like forming strategic alliances with other organizations and increase the total resources. The growth of such networks will help in providing better care to the customers. Financial resources greatly influence the efficiency and productivity of the organization.

The aging population is influencing the healthcare delivery. There is increased demand for primary care of people over 65 years and for chronic care of people over 75. The ethnic and cultural diversity is also influencing the healthcare delivery. This provides a challenge in meeting patient expectations on one hand and diverse workforce on the other. Biological and clinical sciences have met with technological advances and have led to new treatment modalities. This has led to open new treatment sites and manage across the organization. External forces change the supply of certain areas of health professionals like physical therapy and some areas of nursing. The management needs to compensate for such shortages and they need to develop different teams of caregivers at different work sites. Changes in education of health professionals implies that the management be more creative in offering healthcare services. With an increase in diseases like AIDS and morbidity from drugs and violence, there is more and more need to work with community agencies, form social support systems and there is a need for more chronic care management. Advances in information technology is another area where there is a need to train the healthcare employees in new advances. They also need to manage issues of confidentiality and rapid information transfer. Increasing expansion of world economy has led to more competitive management of strategic alliances, care of patients across the nations and of different cultures.

Current environmental trends impact the healthcare delivery model. Organization’s success depends on its external and internal environment. The complex environments made up of uncertainties and heterogeneity of components leads to different organizational designs. The current environmental trends influence managerial and organizational decision making. The unique challenges facing the healthcare delivery organizations should be analyzed in order to develop and implement new and effective operational processes and strategies. As an impact of current environmental trends, the healthcare delivery system needs to improve individual, team, and organizational accountability and performance. The impact of advances in medical knowledge and information technology on the process of healthcare delivery should also be examined, and it should be leveraged to improve quality of care, process and cost controls, and revenue. New strategies would need to be identified and implemented for learning and performance improvement to create a culture that supports accountability, safety, and high-quality care. Innovative models in healthcare delivery would also be required in order to develop and implement strategies that promote organizational success and competitiveness.

Due to the current environmental trends, more emphasis is given to the customers and there is more of a patient-focused care. The healthcare delivery model has been shifting to the community based care. There has been an increased modification in care processes. The traditional ways are being challenged and more experiments are being performed to fulfill the demands to improve the quality of care. Due to the shift in the environmental trends in the healthcare delivery model, more emphasis is given to quality improvement. This will help improve the performance levels of key processes in the organization. The performance levels are being measured, the defects are eliminated and new features are being added to meet the customer’s need efficiently.

There is a new emerging contemporary trend in the U.S. healthcare system. Presently, the management research and assessment have been offered increased recognition. The emerging trend seen is that this is slowly forming an integral part of managerial and organizational effectiveness. With the emerging efforts in information management, it is leading towards clinical and financial networking. The trend seen among the physicians and nurses is that they are being increasingly involved in managerial activities. The managerial trends are also changing with respect to role performance and changing values. The managers role is getting more and more recognized in managing finance and human resources. Management training, lifelong and distance learning is being offered in preparing future managers.

The healthcare executives and managers will be faced with the major responsibility and challenge in the years ahead. They will be working with other healthcare providers and will be creating a competitive future for their organizations. They will not only be managing organizations but also a network of markets, services and joint ventures. Formation of more and more strategic alliances and partnerships will lead the management to manage across boundaries. The management will change from managing a department to managing the continuum of care. The management will be following a community-based approach. Trend in management is also shifting from just coordinating services to providing improvements in quality.

As the demands in healthcare are increasing, the management is responsible for forming performance standards. The management is also challenged to maximize the productivity and quality to serve the health needs of the community. The management is looking after the demands of the external environment as well as attending to the performance of the internal environment. The management is responsible for the performance of the organization.

Healthcare organization leadership will be responding to new trends and competitive forces. It will respond to continuum of care, overall health status of the population and more complex organizational structures. These emerging trends in the healthcare system will effect the organization’s leadership. The future managers would need leadership skills and vision to integrate the organizations and help in providing the best care. The managers will have to be committed to leadership and work on giving their organizations the best place and help their organizations adapt to the changing circumstances. More value will be given to leaders who will be able to lead the change process. As changes are inevitable for the betterment of the organization, the leaders should be able to identify how the change is to be received and how it is to be communicated at all levels of the organization without damaging the implementation process. The leaders might have to deal with increased pressures due to organizational complexity.

The leader in the organization provides strategic direction to the organization, manages diverse stakeholders, becomes mentors for management, is willing to take risks, helps the organization interact with the external environment and attends to the internal needs as well. Where required the leader will involve physicians in governance process and align physician and organizational interests. There will be a need for formation of learning organizations. Transformational leadership will create the required vision for the organization. Leaders will have a greater role complexity and they themselves will have to adjust rapidly to new situations. The healthcare organization leadership will have to live up to the values of the organization and will help in fulfilling the mission of the organization.

Individuals and groups within the healthcare organizations require more and more competencies. An enhanced lifelong learning is required due to the fast, changing environment. The individuals and groups within the healthcare organizations will be benefitted as there will be rapidly developing medical technologies which will result in increased services. More sophisticated health services will be provided to the consumers. The range and quality of services provided will be regulated for the benefit of people requiring home care, long term care and ambulatory care. The anticipated future development will also result in the increased competition among the health services organization. The individuals and groups will be involved more and more with the community for issues like drug abuse, teenage pregnancy and violence.

Individuals and groups will be faced with increased strategic planning and management in the healthcare organizations as there will be ever increasing involvement by the trustees and physicians. As the future environment in the organizations will be more complex, the individuals and groups in the healthcare organizations might feel more pressurized. They will need to serve the changing demands of the community as the population of elderly patients will increase. These individuals will require more professional training, increased levels of education and should be taking part in continuing education programs.