A sailor without a destination cannot hope for a

                        favorable wind.  Leon Tec, M.D.

This last weekend I started work on a 3 season porch (we actually have 4 seasons in Minnesota). The planning phase took quite a while but will be well worth it. I read (I think it was Demming) that teams and individuals save about 10 minute in execution for every minute they spend in planning. I know from past experience that the "Ready! Fire Aim!" approach leaves a lot to be desired. First thing this morning spend 15 minutes planning your day or week. See if you save the planning time and then some. This approach should work for small plans as well as large ones. Lay a good foundation for your work so it stands the test of time. Speaking of which… I dug three holes in hard clay 30inches by 30 inches and 42 inches deep over the last two days. I haven't used many of those muscles for a while so I'm off to take a little ibuprofen (yes OTC generic) and turn in. I'll plan tomorrow…tomorrow!

1) ZeeZee is the name they should have used…

Combination of Zetia and Zocor could have bee fronted by the spokes-band ZZ Top. Instead, the new cholesterol lowering combo is being called Vytorin as the FDA gave its final approval.   Name and concept is boring! The combination pill is being priced to compete with Lipitor and Crestor and I predict it will do so successfully. It will, however prolong the Zocor franchise that is due to lose patent in 2006 as a single drug entity.

http://biz.yahoo.com/rb/040723/health_cholesterol_5.html

2) Medicare recipients to get a free physical as they enter the program.

I expect this will uncover some underlying disease that, if treated, would reduce the overall drug spend. Things like diabetes, asthma, obesity and heart disease would be the prime targets. I hope that "they" compare the costs of care between those who opt for the exam vs those who put it off. My bet would be that those who opt for the testing will be cheaper to maintain. (from NYT- free registration required). Note: That "mean old president Bush" championed this while the "darling Dems" have tried to block it….its crazy out there people! Why can’t we all just get along?

http://www.nytimes.com/2004/07/28/politics/28medicare.html?th

3) And then there is the one about "What do you have when you find 250 trial lawyers at the bottom of the ocean?"…

When people say the cost of health care is too high they often do so without thinking of where the money goes. Health care dollars go to doctors (how many will take lower salaries?), nurses and pharmacists (ditto), hospitals (they are already on subsistence reimbursement), drug companies (maybe 17% of the whole health care pie)…and then there is LITIGATION which raises everyone's costs while the lawyers get more. Glaxo reacts to some legal headaches…. and finds that 2% of the GDP is diverted to such lawsuits.

The punch line is "a good start!"

http://biz.yahoo.com/rc/040727/health_glaxo_legal_1.html

4) Tee many martoonies?

Not if alcoholics take this "new" drug. Used for many years in Europe and elsewhere in the world, it now comes to the USA.  The FDA approved the first "new" drug to help alcoholics (recovering kind) stay off "the sauce."  Side effects include nausea, vomiting, and abdominal cramps…this  sounds like a hangover without the headache. With roughly 1 in 10 people adversely affected by alcohol abuse…. (the 17 million drinkers have families too) …this might help nearly everyone!

http://news.moneycentral.msn.com/ticker/article.asp?Feed=RTR&Date=20040729&ID=3939042&Symbol=US:FRX

5)"Dem bones…dem bones…dem dry bones"

Bone are likely more porous than you like. Osteoporosis problems are up as more hips are snapping. Docs who replace the joints don't refer for treatment of the osteoporosis. Maybe some prevention is in order?

http://www.usatoday.com/news/health/2004-07-26-osteoporosis-study_x.htm

6) CMS site improves the talk line

…of the Medicare Prescription Drug benefit (coming in 2006).. It still reads like the Dewy Decimal System … but better. This version has access to the rules.

http://www.cms.hhs.gov/medicarereform/

7) Watson, come here, I need you!

This time not the words of Alexander Graham Bell.  Francis Crick died of colon cancer this week at age 88. He worked with James Watson. The "boys" were awarded the Nobel Prize for their work on the Double Helix structure of DNA. The remaining strand of the dynamic duo, Dr. Watson, is slightly younger and still scientifically active.

http://www.usatoday.com/news/science/2004-07-29-crick-dna_x.htm