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Archive for March, 2011

The diversity success team Shaklee is not a new name. Shaklee was started by Doctor Forest Shaklee in the year 1956 and is one of the first companies in the nutrition and health business and one of the first to enter the multi level marketing industry. The company has spend years creating a strong public awareness about the MLM channel and offers a diverse range of products to its team to ensure their success. Today, there are thousands of MLM networks in the country and it is a huge industry that is known to almost everyone. Shaklee had been a part of the few pioneers who introduced this new way of marketing products and services to the world.

What Products Does the Company Offer?

Diversity success team Shaklee enjoy the benefit of a wide range of products that can be chosen from. Anyone who joins the MLM business opportunity of Shaklee would be able to choose from the products and niches given below:

Health care: the Get Clean home care products are natural and non-toxic cleaning materials that are smart, green, powerful and safe. The products are earth safe and are very effective when it comes to keeping the house clean.
Weight management: Cinch is a weight management products line from Shaklee. It is a system that helps people build muscle, lose inches and fat. The product had been designed by doctors that understand the concept of weight management programs and what they should include.
Skin Care: Shaklee’s line of skin care products offer vitamin based products for the health of the skin.
Nutrition: the company also has a wide range of nutrition and health products that have been designed to promote the vitality and health of people in all age groups.

MLM Business Opportunity

The diversity success team Shaklee offers a unique MLM business opportunity to those who are interested in starting a business of their own. The concept is that of MLM and in order to make money, the members will have to recruit other people, promote and attend hotel meetings, product parties, presentations and seminars that are sponsored by the company. This business program has been around for years and quite a lot of people might consider it to be a little outdated for the world of MLM today. However, one of the biggest benefits of working with Shaklee is that the products that are offered by the company are very high quality and need no promotion at all.

The brand is very well known and speaks for itself and for this reason alone, selling products and promoting them may not be a big problem. Diversity success team Shaklee offers great products in a diverse range and a good home  based business opportunity.

Next, continue reading on about how you can leverage the power of the internet to help you grow your Diversity Success Team Shaklee more effectively online!

Every day, people by the millions pour food from a package into their pet’s bowl. Day in and day out, meal after meal, pets get the same fare. This strange phenomenon is widely practiced by loving pet owners who believe they are doing the right thing.

Why? Certainly because it is convenient, but also because the labels state that such foods are “complete and balanced,” “100% complete,” or that they have passed various analytical and feeding test standards. Furthermore, manufacturers, and even veterinarians, counsel pet owners about not feeding other foods, such as table scraps, because of the danger of unbalancing these modern processed nutritional marvels. The power of the message is so great that pet owners en masse do every day to their pets what they would never do to themselves or their children – force-feed the same processed food at every meal.

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Think about it. Our world is complex beyond comprehension. It is not only largely unknown, it is unknowable in the “complete” sense. In order for nutritionists and manufacturers to produce a “100% complete and balanced” pet food, they must first know 100% about nutrition. However, nutrition is not a completed science. It is, in fact, an aggregate science, which is based upon other sciences, such as chemistry, physics, and biology. But since no scientist would argue that everything is known in chemistry, or physics, or biology, how can nutritionists claim to know everything there is to know about nutrition, which is based upon these sciences? This is the logical absurdity of the “100% complete and balanced” diet claim. It is the reason a similar venture to feed babies a “100% complete” formula turned out to be a health disaster.

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In that instance, after sufficient disease and death resulted from attempting to retire the human breast to a mere appendage of adornment, government stepped in and controlled the commercial hype. Now doctors, nurses and purveyors of baby formulas cannot say these products are complete or that they are equal to or superior to breast-feeding. Good for the regulators. (Although they should have been proactive and prevented the disaster before it ever took root, not have merely stepped in after enough deaths accrued.)

Even with that lesson as a dire warning, pet food regulators turn a blind eye. Instead of preventing pet food producers from claiming a processed food concoction is 100% complete, they in effect promote the death and disease-dealing specious claim by setting bogus standards that supposedly justify and authenticate the claim. They legitimize sloppy science in order to win consumer confidence. All a manufacturer has to do is guarantee that their percentage of protein, fat and the like meets National Research Council standards. In the alternative, manufacturers can do feeding trials on caged laboratory animals for a few weeks, measure cursory blood parameters, and monitor growth and weight – as if survival after a few weeks on a food has anything to do with achieving optimal health and long life!

Down the primrose path millions of trusting pet owners go while at the same time unknowingly condemning their pets to terrible degenerative diseases. Pet food regulators then spend the majority of their time harassing pet food companies with picayune requirements about terminology on packaging and where certain words must be placed on labels. In this regard manufacturers must contend with the USDA (United States Department of Agriculture), FDA (Food and Drug Administration), AAFCO (American Association of Feed Control Officials), and 50 State feed regulatory agencies. All for naught. It’s like the entire police force busying themselves ticketing people for jaywalking while turning a blind eye to the murder and rape going on in the alleys.

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Claiming that anything is 100% is like claiming perfection, total knowledge, and absolute truth. Has pet nutrition really advanced that far? Does a chemist make such a claim? A physicist? Doctor? Professor? Did Einstein, Bohr, Pasteur, Aristotle, Plato, or any of the greatest minds in human history make such claims? No. Has the science of pet nutrition advanced to the point where everything is known about the physiology, digestion and biochemistry of animals, or that everything is known about their food? Certainly not.

The fact of the matter is that the “100% complete” claim is actually “100% complete” guesswork. At best, one could say that such a claim is the firm possibility of a definite maybe.

Each time regulatory agencies convene to decide how much of which nutrients comprise “100% completeness,” debate always ensues and standards usually change. This not only proves that what they claimed before was not “100% complete,” but this should also make us highly suspicious about what they now claim to be “100% complete.”

Moreover, consider that in order to determine the minimum requirement for a certain nutrient – say protein – all other nutrients used in the feeding trials must be adequate and standardized. Otherwise, if vitamin E, for example, is in excess or is deficient in the basal diet, how would one know if the results of the study were because of the effects of protein or due to something amiss with the level of vitamin E?

If the minimum requirements for all 26+ essential nutrients were all set and absolutely etched in stone, that would be one thing. But they aren’t. They are constantly changing. This means each time any nutrient requirement is changed, all test results for all other nutrients using the wrong minimum for this nutrient would then be invalid. Most nutritionists simply ignore this conundrum, feeling like cowboys trying to lasso an octopus – there are just too many loose ends. But they continue to perpetuate the “100% complete” myth, and excuse themselves by saying they make adjustments when necessary. An apology of “I’m sorry,” when the false premise of “100% completeness” is still retained, deserves no forgiveness.

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Also consider that virtually all so-called complete pet foods are vigorously heat processed to gelatinize the unnatural starch components (making them “digestible” – meaning more easily converted to glucose) and to extend shelf-life by sterilization. Dry foods are extruded at hundreds of degrees and hundreds of pounds of pressure. Canned foods are retorted. Commercial pet foods also contain a mix of ingredients including meats, fats, starches (a variety of label dressing “natural” ingredient buzzwords) and vitamin/mineral “fortifiers.” Although the ingredient label is evocative and beguiling, what is in the final product is another matter. Essential fatty acids are oxidized and isomerized. Cytotoxic, mutagenic and carcinogenic cholesterol oxidation products (COP) are formed, including C-7 derivatives, 5,6-epoxides, triols, 25-OHs and 3,5-dienes – the real culprits in human atherogenesis, incidently. The cooked meats form heterocyclic amines, proteins are degraded and amino acids destroyed or racemized. Carbohydrates are glycated, acrylamides are formed, vitamins destroyed, oxidized and racemized and minerals are complexed into unavailable matrices. The end result is a potpourri of imbalance, unavailability and toxicity – not “100% completeness.”

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Yes, pets can survive for a time on such fare, but that is simply a testament to their physiological capacity to adapt. They seek equilibrium at higher and higher levels of toxicity until adaptive reserve is exhausted. Chronic degenerative diseases and immune failure is the end result.

The point is, don’t believe the claim on any commercially prepared pet (or human) food that it is “100% complete and balanced.” It is a spurious unsupported boast, intended to build consumer trust and dependence on commercial products – not create optimal health.

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Unfortunately, most people think animal feeding is a mystery. It is not. Animal nutrition is not a special nutritional science to which common sense human nutrition principles cannot be applied. Use the same reasoning in feeding your pets that you use for feeding your family. Nutrition is also not about some special ingredient, the absence of some boogeyman ingredient, or claims such as “natural,” “organic,” or the like.

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If you feed processed foods, use discernment since just about anyone can create a commercial pet food. The pet food industry has hundreds of brands. Business profiteers and the occasional movie star are the most common forces behind the labels. All one needs is a little money and they can go to any number of toll manufacturers and have them slightly modify a shelf formula. Then all that is needed is to dress it all up with a fancy package, a clever brochure, and some advertising. Voila! Another brand is added to the 20-billion-dollar pet food industry heyday.

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Nutrition is a serious health business, not a mere opportunity to turn dollars. Check the credentials of the decision maker at the head of the company you are entrusting your pet’s health to and examine closely its operating philosophy. Health

If you’re forever looking for healthy foods for you and your family, and are tired of scouring the grocery store aisles in search of meaningful nutrition which is non-existent, you might want to try going to a health food store instead. You will find that all the nutritious foods you were looking for are to be found there.

And depending on the size of your health food store, you might also find that it carries such things as raw organic foods as well as processed organic foods. Health food stores are also a great place to pick all sorts of things to help you round out your life and make it healthier.

Here, depending not only the literal size of the store, but also in its growth potential as well as the type of health food store it is, you might also be able to find herbs and herbal remedies right alongside your other natural remedies.

With the growing interest in staying healthy and living healthier lifestyles, health food stores are popping up all over the world. This means that the price tags they carried while still being somewhat ridiculously high, are not as wallet-damaging as they used to be. In fact, more and more people can now afford to shop at a health food store without thinking twice about it, and more and more people are turning to this resource to help them get their lives in order.

Over fifty years ago people were still mostly living a healthy lifestyle which included a good rounded diet as well as regular exercise. Healthy, fresh foods were available from just about every corner store and people didn’t have to go out of their way to eat in a healthy manner.

Nowadays if you want to live a healthy lifestyle and still live in the real world, you need to make an extra effort to do so. So you join a gym and scout out the best health food store in your area. Not only that, if you really want to go healthy, you have to not only look for fresh fruits, vegetables and animal products, but you also need to look for these products in their organic form.

This said having a good health food store is so much easier than having to find everything that you need at your local grocery store. For one thing, the range and choice of health foods that you find in normal everyday grocery stores just isn’t the same as what you would find in a health food store.

And for another thing, in a health food store you also have the assurance that there will always be health foods in stock for you to buy. Do you always have that guarantee from your normal grocery store?

Health food supplements are one of the hottest selling products in the market these days. Their total consumption values billions of dollars in the U.S. alone. Recent surveys show that more than half of the adults in the U.S. consume health food supplements in different forms, such as tablets, capsules, powders, soft gels, gel caps and liquids.

The increased consumption of health food supplements can be attributed to public awareness of health issues and improved standard of living in our society. Many studies have shown that there is a close correlation between health and nutrition. Insufficient supply of nutrients can weaken our body defense mechanism, causing medical problems from common ailments to more severe illnesses in the long term.

There are different types of health food supplements, including macronutrients (amino acids, proteins, essential fatty acids), micronutrients (vitamins and minerals), enzymes (digestive enzymes and antioxidant enzymes), probiotics (beneficial bacteria in the gut), and herbal supplements. These supplements have unique functions in our body. They are either essential for life and good health, modulate our immune system or help with liver detoxification, digestion, mental clarity, etc.

Many people argue that there is no need to consume health food supplements as long as you have a healthy lifestyle and eat a balanced diet. While this may be true, the fact is maintaining a healthy lifestyle and proper diet is difficult to achieve by many people.

Over the past few decades, the green revolution has changed the farming practices over the world. We use more chemical fertilizers, more pesticides to grow the food produce in order to increase harvest and shorten the growth period. As a result, soil nutrients and the population of beneficial soil bacteria are depleted rapidly, and the produce we grow today contain less micronutrient than before.

A stressful lifestyle, improper eating habits, imbalanced diet and increased exposure to chemicals such as environmental pollutants (air, water) and pesticides, drugs, hormones, heavy metals in foods also weaken our body gradually.

Although health food supplements can be beneficial to our health, consumers should still choose the products carefully. Currently, there is little regulation on the quality of health food supplements. Composition of some health food products may not match the label claims and the quality of raw materials and finished products is not guaranteed. Therefore, consumers should only buy from reputable health food manufacturers, read the labels carefully and read more related literatures.

Here are some general rules for buying health food supplements:

1) Supplements made from whole foods, natural sources are better than the synthetic ones. They are more bioactive, can be absorbed readily, and less likely to be contaminated by chemicals such as coal tars used in chemical synthesis.

2) Protein-bonded vitamins and minerals (vitamins and minerals in organic form, binding to amino acids) are more bioactive than the inorganic forms.

3) Buy supplements using safe extraction methods, such as cold pressed extraction or supercritical extraction. This can avoid the harmful residue from chemical extraction.

4) Herbal concentrate and extract are usually more effective than the raw herbs.

5) Organically grown or wild crafted herbs are less likely to be contaminated by heavy metals, pesticides and other chemicals.

6) Read the labels, do not consume more than the recommended dose.

7) Be careful when consuming certain herbal supplements, such as Ma Huang / ephedra, Kava Kava, comfrey, etc. Some studies have shown that these herbs may cause severe side effects to some people. Stop use if unusual signs appear after consumption.

Some health food supplements may interact with drugs, either by decreasing or increasing their effects. Consult your doctor if you are currently taking medications.

9) Pregnant and nursing women, people with specific medical conditions such consult the doctors when consuming health food supplements.

10) If in doubt, contact the supplement manufacturers or distributors for more information of their products.

11) Health food supplements are available in many places, such as grocery stores, health food stores, drug stores, pharmacies, supermarkets, department stores, online stores, etc. Be a smart consumer, compare the price and service before purchase.

To learn more about health food supplements, please visit http://vitaminstores.4reviews.net.

According to Maslow’s hierarchy of need, care is an essential need of human. After fulfilling basic and safety needs, next strong desire is having social relations. Care lies in both, safety and social needs. On average, long term care is considered as physical care when someone is in poor health. But fact is long term care in more ethically, mentally and spiritually than physically. Psychologically peaceful person can be cure easily than a mentally disturbed personality. Before describing benefits, core issues, and types of long term care insurance policy, let us take an overview about different types of care, which a human is needed usually.

Home Care:

It in most basic care service available in home. Everyone deserves this natural care through blood relations and spouse. Strong intangible relation among family members tempts to develop and sustain long term care for each other. This basic type of care is more intense when one of family member is suffering from bad health. Home care service grants strong moral support to someone so that he can perform complicated and hard tasks of daily life.

Community Base Care:

community base care means, someone needs more than natural homecare. This is social and ethical responsibility of his community to provide him moral and physical support. Government agencies and private social communities provide adult day care and hospice services to adult ones in community.
Hospice care services provide healthcare facilities to most senior citizens of community. These services can be provided in hospital but usually this service is granted at the place, where needy person lives.
Another form of community base care services is adult day care services. These are best alternate of home care. This service provides daily basic needs like meal, health consultancy, transportation and many other required services. Normally these are paid services and private agencies provide such services at contract base. Other distributers of these services are government and insurance companies.

Facility Care:

Nursing homes and assisted living facilities are two major types of facility care services. Very frankly, nursing homes are becoming essential parts of someone’s daily life. Especially in USA, ratio of getting health and long term care services is above than average. Nursing home does not only means, availing health care services in sickness but also a place of care where people need normal care. These are also called rest homes. Such facilities are also commercialized and payable.

Long Term Care Insurance Coverage:

Long term care insurance in most broad type of insurance. A big mistake of understanding long term care insurance considering, it is a type of health insurance. Actually this myth is not true. Long term care insurance policy is taken by health people while health care insurance relates with sick and ill people. Long term care insurance emphasizes at care rather than cure. It does not only cover the cost of sickness but assist in daily life activities. Most common activities of daily living (ADL)are taking bath, cooking meal, dressing, transpiration etc. other long term care insurance coverage includes community based programs, described in the start of article. Visiting nursing homes and hospice services are also major coverage of this type of insurance.

Why People Hesitate to Get Long Term Care Insurance:

According to my research and analysis, many of myths are behind the psyche that people don’t feel the need of long term care. Common human behavior is, he does not think about getting care unless he suffers in mental or physical trouble. Once he is sick, health insurance covers him better than long term care. Mostly people think about their care in the age of 60, the age of retirement. Before it people don’t want to waste money by getting care insurance. Actually right time of getting this insurance policy is middle age. Premium cost is very low at this time, and person is just entering in the age where he will need long term care soon. Getting policy before its need it a wise decision. It is wrong concept that this insurance plan is established for old age people.
Another wrong concept, I never needed long term care insurance coverage. But the fact is, when he needs it suddenly, I mean when he suffers from unexpected bad situation, long term care policy is not available then. Research data shows that 44% of USA citizens are expected to enter in a nursing home before the age of 65.

Common Types of Long Term Care Insurance Policy:

With respect to taxation, there are two major types of long term insurance plans in USA. First is tax qualified and other is non tax qualified. Tax qualified policy is commonly offered by most of insurance companies. Policy holder cannot perform routine activities and he intensely needs an associate to help him in routine activities. Non tax qualified long term care insurance plans are very the minority. In this case, doctor advice a policy holder for medical care and insurance company will pay the patient against claim. Regarding with long term health insurance policy, three different coverage of nursing home are available. Intensive long term care includes complete treatment plan, healing from injury, medical consultancy with absolute care of patient. Insurance company pays all bills for curing and caring the patient.
Standard long term care includes caring of policy holder in routing activities. Insurance company pays for an assistant, who help him in bathing, cooking, transporting and other routing activities. Before asking for free online long term care insurance quotes, it is necessary to evaluate company’s goodwill and price after comparison among different local companies. Another key issue is terms and conditions decided among policy holder and company. Don’t take any decision without evaluation of all factors otherwise you will suffer in long term trouble rather than long term care.

The existence of dentist helps us solve so many problems occur inside our mouth. Dentist is the specialist who always ready to help us, including modify our appearance. People in West Virginia sometimes are asking about the best dentist. They confuse because all clinics and hospitals there offer and promise satisfying services. If they want to have the right one, the key is inside their heart.

Choosing West Virginia dentist is not about taste but it is also about comfort. Fresh graduate dentists come in the industry each year. Some of them are reliable but some other is not good enough. All of us will always choose the reliable ones; unfortunately, sometimes it spends more expensive expense than the amateurs do. If we want to find the right West Virginia dentist, at least we must know what problems we face.

The first key is comfort; as long as we feel comfortable with him or her, it means, we have found the right West Virginia dentist. Do not ever consider about price; even it is expensive but if the dentist gives comfort to you, you can trust him or her. You can go to Westvirginiadentistry.net for further info about dentist in West Virginia.

When one thinks about the people who have significantly contributed in utilizing science for the betterment of life, then the works of Robert Lanza come to ones mind instantaneously. When he was young boy, no one thought he could ever become a well-known and successful scientist in times to come. He has conducted numerous researches and performed several experiments throughout his career. He has also been a significant member of various successful teams.

Robert Lanza was born in Boston, grew up in Stoughton and now lives in Clinton. His career in science started from Stoughton when he was a teenager. He performed an experiment on chickens in the basement of his home. In this experiment, he was attempting to modify the genetic nature of the chickens. The great thing is that he succeeded in doing so. After this, he went to Harvard Medical School to show the results of his research to scientists there.

Christian Barnard, Jonas Salk and B.F. Skinner examined the results of his experiment at Harvard. They were astounded to observe the findings of this young lad. They asked him to stay there with them so that they can supervise his works. Robert Lanza agreed and worked with them for the next 10 years. After that, he went to University of Pennsylvania to seek higher education. He got his BA and MD degrees and became a University Scholar there. After doing several experiments, he started working with teams of scientific experts. He was conducted many different experiments with various teams and most of them have been successful.

When you become aware of all the toxins in our food chain, it is refreshing to know that certain health drinks can help you eliminate some of those toxins. The secret of daily detox is to consume safe, gently cleansing health drinks consistently enough to gain the benefits.

Maybe you’ve tried one of the popular detox diets that lasts a few, painful days. Unfortunately, as soon as you’re done cleansing, the toxins start going right back in immediately. That seems like taking out the garbage once in a while, but watching it pile up again. Daily detox with gently cleansing health drinks makes more sense. It allows the body to stay clean and healthy on a consistent basis.

To understand more about toxins in our food chain read, “Lake Effect” by Nancy Nichols. Speaking about this topic on National Public Radio, September 30th, 2008, she described a personal quest for the cause of her sister’s death from ovarian cancer. While working on the book, Nichols received her own diagnosis of a rare form of cancer, which requires aggressive treatment. “My story was my sister’s once over,” she writes. It is this sort of life altering event that motivates people to seek out natural health drinks or other alternative resources for detoxifying the body.

Nichols documented evidence of the many different forms of pollution that may have contributed to the cancers. She came to the conclusion that it was the fish she ate which created the direct pathway delivering toxins from the polluted waters to her body. The fish she consumed came primarily from the Great Lakes region, specifically near where she grew up in Waukegen, Illinois, on the shores of Lake Michigan.

An abundance of evidence points to proof that there are high levels of mercury and other toxic chemicals in fish from all over the world. Swordfish and tuna have long been known to carry dangerous levels of mercury, and experts suggest you eat them sparingly. In addition to decreasing your consumption of these toxins, you may wish to protect yourself further with health drinks that provide a daily detox of the liver and tissues where these pollutants often settle in the human body.

When searching for specific health drinks for daily detox it is important to be sure that they are gentle and that they taste good. You have to be able to drink them regularly, instead of just plain water. You want something so gentle and effective that you can drink it on a daily basis without major lifestyle changes. Granted, you’ll probably urinate more often, but that means the health drinks are working. When your urine has a strong odor or a dark color then you probably have some toxins in your blood stream that need to be eliminated. When you see the color changing from bright yellow to clear then you know the health drinks are working to cleanse those toxins. One note- it is not unusual for most people to have more color in their urine first thing in the morning as they eliminate the toxins from the day before.

The health drinks I have found to be most effective for daily detox taste good and are made entirely from whole food, plant based ingredients. They work perfectly with the body’s natural processes of elimination and they boost your drinking water with powerful antioxidants for even more anti-aging benefits. I’ve never seen drinks that fit this description in any retail stores, just on the net. I suggest you search the Internet for all natural health drinks that allow for safe, gentle, daily detox.

The developing and the increasing number of the internet users in the world nowadays means that there are millions of domains names have been taken by people worldwide. This fact could make people who are just starting to create a domain will have a fewer options to choose when it comes to the domains names that they want to create.

If you are willing to get a domain in the internet and wonder if the domain name that you have in mind is still available or not, you can actually use the help offered by the PCNames.com to search in the whole internet about the domain that you wish to have is available for you or not. They provide the search in many types of websites and hosts as you can see there are .com, .us, .net, and many more. The website will go through all websites and make the precise result for you. You should perform the domain name search before you get over excited with the name that you’ve been thinking of and get huge disappointment when you find out that the domain is already taken. The name of the domain really is important for people to actually consider since people will try to remember the name and it is easier to remember an interesting yet simple name for the domain.

Domain search will be beneficial for you when you are going to create the domain for your business. When you get a domain that available for you, you can make a certification through the website to make sure that the name is yours and you have the right to protect it when you found someone stole your domain names. Make sure that everything is available and well protected for you and you will get the benefit of having the domain names that you wanted.

Ten years ago, four hospitals in Bucks and Eastern Montgomery counties had cardiac catheterization or electrophysiology labs. Fewer had advanced cancer diagnosis and care. And robotic surgery was science fiction.

Today most local hospitals have at least two cardiac cath labs. Most have opened comprehensive cancer, cardiac care, orthopedic and diagnostic imaging centers. And at least two have robotic surgery programs.

In less than a decade, at least six radiation oncology centers have opened within a 20-mile radius of Bucks and Eastern Montgomery suburbs; a seventh is expected to open next year in Doylestown.

Same-day surgeries are routine. Next month a second Bucks County hospital will open a hyperbaric oxygen chamber used in wound treatment.

Some hospitals participate in clinical trials testing new drugs or medical devices for major pharmaceutical companies.

The advanced specialty medical care that Philadelphia suburbanites once found only in large urban and academic hospitals is as close as their well-manicured backyards.

“A ton of primary care is being done by specialists – that is why health care is so expensive, said Tom Getzen, a professor in the risk, insurance and health care management at Temple University’s Fox School of Business. “If you don’t have specialty stuff, you can’t get by anymore.”

As a result, suburban hospitals face pressure to expand and add profitable services and the latest advanced technology as a way to attract the best medical professionals, meet higher patient quality standards, and underwrite the less profitable, but necessary, community services and unpaid care.

They also have encountered unforeseen competition for shrinking health insurance dollars: private doctors with the expertise and financial ability to provide identical services.

To meet the growing specialty care demands, some suburban and urban hospitals are forging alliances.

The new radiation oncology center planned at Doylestown Hospital is a joint venture with Hospital of the University of Pennsylvania; last year Philadelphia’s Moss Rehab opened a 12-bed inpatient rehab unit inside Aria Health’s Bucks County campus in Falls.

Other Philadelphia-based health care providers are migrating north in pursuit of privately insured patients seeking lucrative elective procedures.

Fox Chase Cancer Center last year opened a million radiation treatment center – its first suburban satellite – in Chalfont about 20 miles outside its main Philadelphia campus.

The Rothman Institute, the region’s largest private orthopedic practice, recently opened its first specialty hospital in Bensalem.

The medical building it occupies is the former Comprehensive Breast Care Institute of DSI Bucks County, another specialty hospital that closed less than two years after its 2007 opening because of insufficient patient volumes and financial issues.

Deregulation to proliferation

Industry analysts trace Pennsylvania’s suburban specialty explosion with the end of the Certificate of Need (CON) program in December 1996, which removed the requirement that hospitals gain state approval before adding or expanding most medical services and technologies. Some business experts say CON programs contain health care costs.

Before deregulation Philadelphia and its four suburbs had 15 open heart surgery programs – all but three located in Philadelphia. By 2004, 24 hospitals had open-heart surgery- only half located in Philadelphia hospitals.

Between 1997 and 2004, Bucks County hospitals more than quadrupled the number of open- and closed-heart operations from 190 to 853. During the same time period, Philadelphia hospitals experienced a 41 percent drop in cardiac surgeries, from 8,758 to 5,143.

Today, many suburban hospitals offer every type of cardiac and cancer diagnosis and treatment procedure, except the most high-end specialty care such as organ transplants.

“It was almost as if there was a dam holding back a lot of these developments and the dam broke in 1996,” said Craig Holm, senior vice president of Health Strategies and Solutions, a Philadelphia health care strategy company.

Two significant events fueled the suburban market for advanced specialty care, health analysts say. The population explosion created a large enough patient base and greater demand for nearby medical care, and nationally health care dollars began shifting away from expensive inpatient to cheaper outpatient care, a trend that hospitals were eager to pursue.

A decade ago, Pennsylvania had 61 freestanding outpatient diagnostic or surgical centers, most wholly or partially hospital-owned. They included one center in Bucks and nine in Montgomery County.

But as technology improved and prices dropped, private doctors found they also could perform the same profitable medical procedures outside hospitals. As of last year, the number of Pennsylvania outpatient centers was 261 including 15 in Bucks County and 29 in Montgomery County. Most are privately owned.

Outpatient diagnostic and specialty centers are far less expensive to operate since they are less regulated than full-service hospitals, don’t provide a broad range of services, take patients at low-risk for medical complications, and they don’t have to treat the uninsured.

The proliferation of suburban specialty care, while more convenient for patients, doesn’t guarantee better quality, health business experts point out. Many studies show that hospitals that perform the most medical procedures have the best patient outcomes.

A good example is cardiology, said Holm, of Health Strategies and Solutions. Heart centers that don’t perform enough procedures tend to have lower quality levels – it’s the old practice-makes-perfect adage, he said.

As hospitals upgrade medical technology, the older equipment is typically sold to primary doctors and private outpatient centers. But those providers likely have less highly skilled and experienced staff interpreting data and images, said Guy David, an assistant professor of health care management at the Wharton School of Business.

“For me that is the big worry,” he added.

Higher standards

Health experts also worry the specialization trend could force full-service hospitals to reduce or eliminate less profitable services that communities depend on, forcing patients to travel farther and placing greater burdens on hospitals that continue the services.

Last year Grand View Hospital closed its 18-bed behavior health unit, citing underuse and a shift towards outpatient treatment. Grand View and Penn Foundation, which jointly ran the unit, combined lost about 0,000 annually operating the behavior health unit, hospital officials said.

Since 2007 alone, short-term psych beds in Bucks County hospitals have dropped from 113 to 59.

Also last year Abington Memorial Hospital eliminated the maternity unit at Lansdale Hospital, which it purchased in 2008 with officials also cited under use as the reason.

Since 2000, the Philadelphia region has seen 12 maternity units close.

Local hospital administrators, though, insist community need, not profit margins, drive financial and service decisions.

“OB is the perfect example and the perfect example why we are continuing it,” said Dr. Scott Levy, Doylestown Hospital’s chief medical officer. We just don’t feel we could possibly give up OB because of the community need.”

Hospitals also face greater standards of patient care, specifically the speed and level at which they are expected to administer care, which requires better equipment and more highly trained staff, said Eleanor Wilson, vice president of patient services at Doylestown Hospital.

“The bar has been raised everywhere,” she added.

Ten years ago, hospitals were not expected to have a heart attack patient in the catheterization lab for angioplasty in under 90 minutes. Now the standard is moving toward 60 minutes or less. Ten years ago, suspected stroke patients were observed for hours before diagnosis; now clot-busting drug treatment should be administered within four hours of symptom onset.

“You can’t get them downtown fast enough,” Wilson said. “It’s not going to work.”