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What Is Homeopathy?
In the opinion of most US medical professionals, homeopathy is nothing but quackery. While herbs and supplements have remained largely outside of mainstream medicine, physicians have no problem accepting in principle that these could have effects in the body. In contrast, homeopathy is an approach to healing that sounds quasi-magical: homeopathic remedies are so phenomenally diluted that they contain no material substance in them except pure sugar (see below). Proponents of homeopathy claim that these so-called "high-potency" remedies possess some sort of healing energy field—a concept that does not sit well with medical professionals accustomed to seeing the world from a scientific perspective.
Nonetheless, homeopathy is used widely even today, especially in the United Kingdom, but also in the US and other countries. Some studies seem to provide evidence that homeopathic remedies can be effective.
The term homeopathy is formed from the combination of two Greek words: omio meaning "same" and pathos meaning suffering.1 This etymology reflects the homeopathic belief that a substance that causes certain symptoms in a healthy person can cure an ailing person of similar symptoms. Although this theory sounds superficially similar to the principle behind vaccines, homeopathy actually functions in a distinctly different manner. The homeopathic theory has some relationship to ancient healing traditions, but in many ways stands uniquely on its own ground, unrelated to other approaches.
The Origin of Homeopathy
Homeopathy is the invention of Samuel Christian Hahnemann, born in 1755 in Dresden, Germany, and educated as a physician.
The medical practices of the 18th century were remarkably unhelpful and invasive. A good example is bloodletting. Doctors commonly bled their patients of a pint of blood or more per treatment, in the belief that it would accelerate healing. More likely, however, bloodletting impaired the patients' ability to recover, rather than strengthened it, and the practice is undoubtedly responsible for many deaths.
Physicians also used strong laxatives to "cleanse" the body. These purgatives included very toxic drugs containing mercury or arsenic, and they too contributed to the great danger attendant on being visited by a doctor.
Samuel Hahnemann quickly became disillusioned by the standard medical procedures of his time; he gave up his medical practice and supported his family in part by translating old scientific and medical texts into German. In 1790, while translating William Cullen's Materia Medica, he was struck by the lack of experimental basis for Cullen's suggested uses for drugs. Hahnemann wondered how doctors could justify prescribing toxic substances without even knowing their effects on healthy people. He came to believe there was a correlation between the resulting symptoms of toxic doses of a given substance and the symptoms that the substance was being used to cure.
To explore his new theory, Hahnemann began collecting reports of accidental poisonings. Later, he tested various substances on himself and documented his reactions to them.
For example, he had read that Cinchona officinalis, or Peruvian bark, was used by South American Indians to treat malaria. Hahnemann took a high dose of Cinchona officinalis and his body reacted by breaking out in fever. Since malaria is characterized by fever, he perceived his own fever as evidence that a substance used to treat an ailment produced similar symptoms in a healthy individual.
Hahnemann then set out to experiment systematically with this hypothesis, ingesting other substances and carefully noting his reactions to them. He also gave substances to other healthy people. Hahnemann took detailed notes of the reactions. He recorded not only major physical symptoms, such as fever, but practically any sensation experienced by the person, including such details as a desire to lie down on one's left side and restlessness that is worse in the early evening.
These "provings", as he called them, were recorded in homeopathic medical texts (such as the Homeopathic Materia Medica) and became the basis for homeopathic treatment.
Currently, provings are done in a different manner, using homeopathic dilutions of substances rather than the substances themselves. Currently, provings are more often done using high dilutions of substances; in other words, the homeopathic remedy is tested, not the underlying substance. This method is safer, even if not entirely consistent with the original theory.
The Three Laws
Based on his observations, Hahnemann postulated three major laws of homeopathy: the first two proposed early in his practice, the third after 20 years of practicing. (There are at least six other relatively minor laws as well.)
The first law is known as the Law of Similars, or "like cures like." This law states that "a substance that produces a certain set of symptoms in a healthy person has the power to cure a sick person manifesting those same symptoms." The second law, or Law of Infinitesimals, states that diluting a remedy makes it more powerful.
These two laws in combination define the method of creating homeopathic remedies. The following is an example: the substance ipecac (today, an over-the-counter household remedy for poisoning) causes vomiting. According to the first and second laws of homeopathy, diluted ipecac would potentially treat vomiting, and the more it were diluted, the more effective it would be.
Hahnemann's third law, the Law of Chronic Disease, states that "when disease persists despite treatment, it is the result of one or more conditions that affect many people and have been driven deep inside the body by earlier allopathic therapy."2
The word allopathic, which is sometimes today used to describe conventional medicine, was also a creation of Hahnemann and was used as the opposite of "homeopathic." Allopathic means "other than the disease," while homeopathic means "same as the disease." In other words, homeopathy uses remedies that, when taken in high doses by healthy people (according to the first law), cause symptoms similar to those of the disease it is intended to treat. However, the allopathic remedies used by conventional physicians, such as prednisone for asthma, do not have the same relationship. They simply relieve the symptoms, and for that reason (according to homeopathic theory), don't get to the heart of the problem.
Hahnemann felt that allopathic treatments were actually harmful. A person with a skin rash provides an example. To Hahnemann, such a condition represents the body's attempt to "release" a deeper illness. Homeopathic treatment would seek to facilitate such a release. In contrast, allopathic remedies, like cortisone cream, "suppress" the rash and thereby drive the illness back into the body.
Note that herbal remedies are also allopathic, according to this principle. Taking St. John's wort for depression, according to homeopathy, is just as likely to worsen the underlying problem as using Prozac. Furthermore, herbs, like drugs, are said to interfere with the effectiveness of homeopathic remedies. Thus, contrary to popular opinion, homeopathy and herbal medicine are not compatible.
In further work developing the third law, Hahnemann elaborated on the various types of deeply buried diseases that could be the roots of many illnesses. He focused ultimately on psoriasis and syphilis as the primary underlying "miasms" beneath many health problems. However, this feature of his theory is less popular with today's practitioners of homeopathy.
The Practice of Homeopathy: Constitutional Homeopathy vs. Disease-Oriented Homeopathy
Hahnemann's theory of homeopathy is now known as constitutional (or classical) homeopathy. This holistic art looks at the symptom picture of a person, including psychological, emotional, physical, and hereditary information, and tries to choose an appropriate remedy. Recently, however, a simplified form of homeopathy has developed, disease-oriented (or symptomatic) homeopathy, in which remedies are given based solely on specific diseases.
Both types of homeopathy have been studied scientifically, although disease-oriented homeopathy has received more attention for the simple reason that it is easier to study.
The Practice of Homeopathy: Constitutional Homeopathy vs. Disease-Oriented Homeopathy Hahnemann's theory of homeopathy is now known as constitutional (or classical) homeopathy. This holistic art looks at the symptom picture of a person, including psychological, emotional, physical, and hereditary information, and tries to choose an appropriate remedy. Recently, however, a simplified form of homeopathy has developed, disease-oriented (or symptomatic) homeopathy, in which remedies are given based solely on specific diseases.
Both types of homeopathy have been studied scientifically, although disease-oriented homeopathy has received more attention for the simple reason that it is easier to study.
Homeopathy Today
Homeopathy is highly respected in Britain, where it is part of the national health care system. It is also widely used in India and, to a lesser extent, France, Germany, the Netherlands, Greece, South Africa, and South America. In the United States, homeopathy is becoming more widespread again after a period of decline.
In the US, over-the-counter homeopathic remedies are available in pharmacies and healthfood stores. Unlike herbs and supplements, manufacturers of homeopathic products are allowed to make strong healing claims on the labels, in part because one of the founders of the organization that became the Food and Drug Administration, Senator Royal Copeland, was a homeopathic physician. He made sure that homeopathic medicines were given a specially protected status.
How It Works
Homeopathic Dilutions
The second law of homeopathy requires that a homeopathic treatment be diluted for maximum effect. Hahnemann developed techniques to control the concentration, or dilution, of substances to create homeopathic remedies. First, he took the substance and preserved it in a solvent, usually alcohol. The substances he used were plants and minerals. After letting the substance stand for a month, he poured off the liquid, which became the "mother tincture." Next, he took one drop of tincture and added it to 99 drops of pure alcohol. He then mixed the liquid by banging the container on a hard surface, a process called "succussion." Homeopathic practitioners believe that succussion is essential to creating an effective remedy.
This first step creates a remedy with a dilution of one part in 10 2, or 100. This dilution would be noted by "c," for centesimal (indicating a dilution of two factors of 10), or by the terms 2x or D2 (x and D each indicate one factor of 10). The dilution is then continued, always adding one part of tincture to 99 parts alcohol, and succussing at each step. Such a process carried out six times leads to a 6c remedy (or 12x or D12), and so forth.
Sometimes homeopathic remedies are made with substances that are insoluble. In this case, they are ground up, mixed with lactose, and then made into remedies. At times, people make homeopathic remedies by diluting one part of tincture to nine drops of alcohol at each step, to make a 1x or D1 dilution.
The complete process of creating homeopathic remedies is called "potentization," based on the theory that each successive dilution makes the remedy more potent. Today, you can buy homeopathic remedies that consist of small white milk sugar pills into which the potentized solution has been absorbed. Other remedies are in the form of liquids to ingest or creams to use externally.
Special Forms of Homeopathic Remedies
In addition to standard homeopathic remedies that use unrelated substances that happen to produce a similar symptom, there are two special forms of homeopathic remedies that use substances specifically related to the condition.
Isopathic remedies are made from the actual substance that causes the condition. For example, homeopathically prepared cat dander (containing zero molecules of cat dander) might be used to treat cat allergy.
Nosodes are made from infected animal tissues or bodily secretions. For example, tuberculosis-infected glands from a cow could be homeopathically diluted to create a remedy for human tuberculosis.
A Note About Safety
Although serious objections remain regarding the possible efficacy of homeopathy, there is little doubt that in one respect, at least, Samuel Hahnemann achieved his aim when he invented the treatment: even if it doesn't work, it cannot possibly cause direct harm.
As described earlier, homeopathy came into being during a period in history when conventional medicine was very often more harmful than helpful. It was the age of "heroic medicine," during which treatments were chosen more for the drama of their effects than any evidence of efficacy. The most dramatic effects, however, were frequently the most dangerous. Bleeding sick patients or inducing vomiting or diarrhea were more likely to kill people than help them.
Today, conventional medicine is far safer (not to mention more effective). Nonetheless, most pharmaceutical medications present at least some risk. Not so with homeopathic treatments. On a chemical basis, there is nothing in them (or, for low potency formulations, next to nothing); for this reason, it is as difficult to conceive of any manner in which homeopathic remedies could cause harm as it is to believe that they can cure. Homeopathic tablets are, by nature, completely nontoxic.
However, according to the principles of classical (or constitutional) homeopathy, versus disease-oriented (or symptomatic) homeopathy, these remedies can cause problems. On the way toward a cure, temporary exacerbation of symptoms are said to occur frequently. Such "homeopathic aggravations" are supposed to indicate a "release" of underlying problems, and are therefore seen as ultimately helpful, if temporarily unpleasant. However, there is no meaningful scientific evidence that such aggravations take place at any higher rate than could be accounted for by chance (and patient's expectation).9
Evidence on How It Works
Despite its widespread acceptance in some countries, most modern scientific authorities do not take homeopathy seriously, putting it in the same category as perpetual motion machines, ghosts, and ESP. There are several reasons for this intense skepticism, but the most important focuses on a basic fact of chemistry. Simply put, there's absolutely nothing material in a "high-potency" homeopathic remedy; some force of nature unknown to modern science would have to be involved if homeopathy is effective.
Here's why. In the process of making a 30x homeopathic remedy, the original substance is diluted by a factor of one part in 1030. This is such an enormous dilution that not even one single molecule is likely to remain. Such a remedy is merely pure sugar (if the form is a sugar pill) or pure water (if the form is a tincture). Even higher dilutions are in use, some so vast that you could use the entire earth as the starting material, and still not end up with a single molecule of the original material in the resulting remedy.
Because of this chemical reality, the comparison of homeopathy to vaccinations, as advanced by many homeopathic practitioners, falls short. Vaccinations contain a great deal of substance, an amount that can be measured and weighed, and which stimulates the immune system. High potency homeopathic remedies, by contrast, contain nothing at all. (Low potency remedies do contain a measurable amount of substance, but they are supposedly less effective than the high potency forms, which are physically content-free.)
Some researchers have speculated that homeopathic remedies produce subtle alterations in the structure of the water in which they are dissolved.3 However, studies with highly sensitive equipment have failed to find any evidence of such structural changes,10,13 and chemistry, as it has been understood both before and after the development of quantum mechanics, makes it highly implausible that liquid water could retain any changes of the type hypothesized.
There are other problems with homeopathy as well. For one, it is hard to understand why a substance that produces certain symptoms when taken in overdose should cure a disease that just coincidentally happens to possess the same symptoms. This hypothesis appears too pat, too tidy and perfect, to reflect the messy world of human illness.
Furthermore, the detailed symptom pictures upon which constitutional homeopathy are based seem to be far too specific and personal to offer any likelihood of universal truth. For example, the homeopathic remedy sulphur is said to be useful for people who have red lips, stooped posture, and a tendency toward untidiness in personal affairs. A small selection of other supposed characteristics of this remedy include mid-morning hunger and a tendency for increased discomfort of whatever physical symptoms they may be experiencing between 10:00 and 11:00 a.m. and after exposure to cold air or motion.
As noted above, these symptoms were assembled through multiple experiences of overdose (homeopathic provings). However, from a scientific perspective, it is difficult to believe that the majority of people who overdose on sulphur experience symptoms largely similar to these (as well as to the several pages of other symptoms commonly associated with the remedy). In any case, modern knowledge of the difficulties involved in evaluating the effects of medical treatments indicates that provings must be conducted in a double-blind and placebo-controlled manner to be valid. Otherwise, participants are likely to experience symptoms simply because they expect to, and observers will tend to observe the expected symptom picture as well. Unfortunately, few of the provings used to define the treatments chosen by homeopaths were performed in a scientifically reliable way.4 Large, rigorous studies have failed to find any difference in symptoms or biochemical measures between healthy people given homeopathic treatments or placebo.5,11,12,14
Thus, on the face of it, homeopathy seems to be a method that shouldn't have a ghost of a chance of being true. However, some studies have found evidence that homeopathic remedies do, in fact, relieve symptoms of illness. Many of these were double-blind, placebo-controlled studies, the most meaningful kind of study. This presents a conundrum to impartial scientists.
How can this contradiction be resolved?
One possibility is that homeopathy operates via some mysterious new force that science has yet failed to discover. Another, less optimistic interpretation, is that the positive trials may be too flawed to mean anything—even though they were double-blind.
In 1997, scientists Klaus Linde, Nicola Clausius, and others published a groundbreaking review of all placebo-controlled trials of homeopathic remedies. This article appeared in a prestigious British journal, The Lancet.6 The authors wanted to determine whether there was enough evidence in total to say that homeopathy has benefits beyond the placebo effect. The results of this meta-analysis were positive and have been widely quoted by advocates of homeopathy to conclude that the method has been proven effective.
However, not all double-blind, placebo-controlled trials are created equal. Fairly subtle design flaws can invalidate the results of a study that, on first glance, seems rigorous. In 1999 the authors re-analyzed the data and noticed a direct relationship between the quality of the study and the amount of benefit seen: the higher the quality, the less the benefit.7,8 Based on this, Linde et al. concluded that their original meta-analysis overestimated the extent to which homeopathy has been proven more effective than placebo. A 2005 evaluation of all the evidence regarding homeopathy also failed to find convincing evidence that homeopathy is more effective than placebo.15
Since then, however, further positive studies have been reported, some of which appear to be quite well designed. So does homeopathy actually work?
Maybe. But when a method seems, on the face of it, scientifically impossible, it properly requires a high level of evidence before it can be accepted as true. Homeopathy has certainly not yet achieved this level of evidence, and therefore must be regarded at present as unproven therapy.
What to Expect From a Session With a Homeopathic Physician
To understand how a visit to a homeopathic physician works, consider the following imaginary scenario: Sam has felt tense and nervous for months. His workload has increased dramatically since he started a new job last year. He has not been sleeping well, and he's lost weight. His conventional physician recommends a stress-reduction program consisting of gentle exercise and regular relaxation, but he decides to try classical homeopathy instead.
His initial homeopathic consultation consists of a lengthy interview. The homeopath makes note of small nuances that would not be considered important by a conventional physician. Aside from his nervousness, Sam has been suffering from frequent nosebleeds, easy bruising, dry cough, hoarseness of voice at times, and occasional diarrhea and stomach aches.
The doctor asks whether cold drinks relieve his stomach pain, and Sam nods. Next, the homeopath asks him several questions about his family history, personality, and psychological tendencies. Sam says that he is outgoing and friendly and likes company. "You wouldn't happen to be afraid of thunderstorms," she asks, and Sam answers that, in fact, he is. The interview continues for an hour.
Based on her analysis of Sam's "constitution" as revealed by close questioning, the homeopath carefully selects a homeopathic remedy that matches, based on the classic description in the Homeopathic Materia Medica. This text reports the symptoms to be expected when taking an overdose of various substances. These descriptions are complex and elaborate, covering physical and psychological symptoms that developed in the people who undertook the experiment; taken together, they represent the "symptom picture" of the remedy.
Sam's homeopath chooses the remedy Phosphorus, because its symptom picture matches him closely. He is told to take the remedy for 3 months. During the period of treatment, he is advised to avoid the use of any pharmaceutical drugs, medicinal herbs (such as St. John's wort), or foods with drug-like properties (eg, coffee) because they have properties that might "antidote" (counteract) the effect of treatment. At the end of 3 months, he is advised to call for a follow-up visit, at which point he may be given a new remedy to treat "deeper" problems that may emerge.
Note: This description applies to practitioners using classical or constitutional homeopathy. Many alternative practitioners use homeopathic remedies to treat particular diseases and use herbs and supplements in conjunction with them.
Homeopathic Remedies
Acetic Acid: Surgery Support
Aconite: Sports Injuries, Surgery Support
Aconitum: The Common Cold
Aconitum Napellus: Ear Infections, Surgery Support
Aesculus: Hemorrhoids
Ambra Grisea: Vertigo
Antimonium Crudum: Warts
Apis Mellifica: Rheumatoid Arthritis
Arnica: Bruises, the Common Cold, Head Injury, Sports Injuries, Stroke, Surgery Support, Venous Insufficiency
Arnica Montana: Childbirth Support, Fibromyalgia, Sports Injuries
Arsenicum: Diarrhea
Arsenicum Album: Cancer Chemotherapy Support
Artemisia Cina: the Common Cold
Asafoetida: Irritable Bowel Syndrome
Asclepias Vincetoxicum and Sulphur: Asthma
Aurum: High Blood Pressure
Baryta Carbonica: High Blood Pressure
Belladonna: Bladder Infections, Breast Engorgement, Childbirth Support, the Common Cold, Ear Infections, Migraines, Radiation Therapy Support, Sports Injuries, Stroke
Bellis Perennis: Sports Injuries, Surgery Support
Berberis Vulgaris: Bladder Infections, Rheumatoid Arthritis
Bryonia: Breast Engorgement, Rheumatoid Arthritis, Fibromyalgia
Bryonia Cretica: Rheumatoid Arthritis
Calcarea Carbonica: Osteoarthritis, Premenstrual Syndrome (PMS), Rheumatoid Arthritis, Venous Insufficiency, Warts
Calcarea Fluorica: Osteoarthritis, Rheumatoid Arthritis
Calendula: Minor Burns, Sports Injuries, Surgery Support
Cantharis: Bladder Infections, Minor Burns
Carbo Vegetabilis: Surgery Support, Tinnitus
Caulophyllum: Childbirth Support
Causticum: Rheumatoid Arthritis, Warts
Chamomilla: Diarrhea, Premenstrual Syndrome (PMS), Sports Injuries
China Regia: Surgery Support
Chininum Sulphuricum: Tinnitus
Cimicifuga: Childbirth Support
Cocculus: Vertigo
Collinsonia: Hemorrhoids
Colocynthis: Irritable Bowel Syndrome
Conium: Vertigo
Cuprum: the Common Cold
Cyclamen: Migraines
Drosera: the Common Cold
Echinacea: Insect Bites and Stings
Echinacea Angustifolia: Sports Injuries
Echinacea Purperea: Sports Injuries
Equisetum: Bladder Infections
Eupatorium Perfoliatum: the Common Cold
Euphorbium: Hay Fever
Euphrasia: the Common Cold
Ferrosi Phosphas: the Common Cold
Ferrum Phosphoricum: Ear Infections
Galphimia Glauca: Hay Fever
Gelsemium: Migraines, Stroke
Graphites: Tinnitus
Hamamelis: Hemorrhoids, Sports Injuries, Venous Insufficiency
Hepar Sulphuris Calcareum: Sports Injuries
Homeopathic Cough Syrup: the Common Cold
Homeopathic Mouthwash: Cancer Chemotherapy Support
Human Growth Hormone: General Health and Well-being
Hypericum: Sports Injuries, Surgery Support
Ignatia: Migraines
Isopathic Remedies: Hay Fever, Insect Bites and Stings
Kali Carbonicum: Osteoarthritis
L52: the Flu
Lachesis: the Common Cold, High Blood Pressure, Migraines
Ledum: Insect Bites and Stings, Surgery Support
Ledum Palustre: Osteoarthritis, Radiation Therapy Support, Rheumatoid Arthritis
Lycopodium: Gastritis, Irritable Bowel Syndrome
Mercurius Solubilis: Cancer Chemotherapy Support, Sports Injuries
Millefolium: Sports Injuries
Natrum Muriaticum: Migraines, Warts
Natrum Sulph: Head Injury
Nitricum Acidum: Hemorrhoids, Warts
Nux Vomica: Gastritis
Opium: Surgery Support
Oscillococcinum: the Flu
Petroleumm: Vertigo
Phosphorous: the Common Cold, Surgery Support
Phytolacca: the Common Cold
Plantago: Surgery Support
Podophyllum: Diarrhea
Pulsatilla: Ear Infections, Gastritis, Premenstrual Syndrome (PMS)
Raphanus: Surgery Support
Raphanus Sativus Niger: Surgery Support
Rhus Tox: Fibromyalgia, Osteoarthritis, Sports Injuries
Rhus Toxicodendron: Osteoarthritis, Rheumatoid Arthritis, Sports Injuries
Sarcolactic Acid: Sports Injuries
Sepia: Warts
Silicea: Migraines
Solidago: the Common Cold
Staphysagria: Bladder Infections, Surgery Support, Warts
Strychnos Nux Vomica: Rheumatoid Arthritis
Sulphur: Cancer Chemotherapy Support, Migraines, Radiation Therapy Support, Warts
Symphytum: Sports Injuries
Symphytum Officinale: Osteoarthritis
Thuja occidentalis: Warts
Uragoga Ipecacuanha: the Common Cold
Urtica: Insect Bites and Stings
- Lockie A. The Family Guide to Homeopathy. Simon and Schuster; 1989.
- Weil A. Health and Healing. Houghton Mifflin Company; 1995.
- Gray B. Homeopathy: Science or Myth. Berkeley, CA: North Atlantic Books; 2000:51-99.
- Dantas F, Fisher P. A systematic review of homeopathic pathogenetic trials ("provings") published in the United Kingdom from 1945 to 1995. In: Ernst E, ed. Homeopathy: A Critical Appraisal. London: Butterworth Heinemann; 1998:69-97.
- Fisher P, Dantas F. Homeopathic pathogenetic trials of Acidum malicum and Acidum ascorbicum. Br Homeopath J. 2001;90:118-125.
- Linde K, Clausius N, Ramirez G, et al. Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. Lancet. 1997;350:834-843.
- Linde K, Scholz M, Ramirez G, et al. Impact of study quality on outcome in placebo-controlled trials of homeopathy. J Clin Epidemiol. 1999;52:631-636.
- Ernst E, Pittler MH. Re-analysis of previous meta-analysis of clinical trials of homeopathy [letter]. J Clin Epidemiol. 2000;53:1188.
- Grabia S, Ernst E. Homeopathic aggravations: a systematic review of randomised, placebo-controlled clinical trials. Homeopathy. 2003;92:92-98.
- Anick DJ. High sensitivity 1H-NMR spectroscopy of homeopathic remedies made in water. BMC Complement Altern Med. 2004 Nov 1. [Epub ahead of print]
- Brien S, Lewith G, Bryant T. Ultramolecular homeopathy has no observable clinical effects. A randomized, double-blind, placebo-controlled proving trial of Belladonna 30C. Br J Clin Pharmacol. 2003;56:562-568.
- Vickers AJ, van Haselen R, Heger M. Can homeopathically prepared mercury cause symptoms in healthy volunteers? A randomized, double-blind placebo-controlled trial. J Altern Complement Med. 2001;7:141-148.
- Walach H, Jonas WB, Ives J, et al. Research on homeopathy: state of the art. J Altern Complement Med. 2005;11:813-829.
- Witt CM, Bluth M, Hinderlich S, et al. Does Potentized HgCl(2) (Mercurius corrosivus) Affect the Activity of Diastase and alpha-Amylase? J Altern Complement Med. 2006;12:359-365.
- Ernst E. Is homeopathy a clinically valuable approach? Trends Pharmacol Sci. 2005 Sept 12. [Epub ahead of print].


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Aaron Hernandez denied bail in murder case
A judge on Thursday denied bail for former New England Patriots tight end Aaron Hernandez, who is charged with first-degree murder in the shooting death of a friend.
Hernandez's lawyer argued that Hernandez is not a risk to flee and the case against him is circumstantial.
But a prosecutor said the evidence is "overwhelming." A search of a Hummer belonging to Hernandez turned up an ammunition clip matching the caliber of casings found at the scene of the killing of Odin Lloyd, the prosecutor said.
Lloyd's body was discovered by a jogger in a remote area of an industrial park not far from Hernandez's home 10 days ago. He has pleaded not guilty.
Prosecutors called Lloyd's killing an execution-style shooting orchestrated by Hernandez because his friend talked to the wrong people at a nightclub. Hernandez could face life in prison, if convicted.
Hernandez was cut from the NFL team less than two hours after he was arrested and led from his North Attleborough home in handcuffs, and nine days after Lloyd's body was discovered. The 2011 Pro Bowl selection had signed a five-year contract last summer with the Patriots worth $40 million.
Another man, Carlos Ortiz, 27, was arrested Wednesday in Hernandez's hometown of Bristol, Conn., as part of the murder investigation, New Britain State's Attorney Brian Preleski said Thursday. Ortiz was charged as a fugitive from justice and waived extradition to Massachusetts. Prison records show he is being held on $1.5 million bail at a Hartford jail.
Ortiz's public defender, Alfonzo Sirica, declined to comment about the case.
In the meantime, police have been searching a third-floor unit in a condo complex in Franklin, Mass., that Hernandez had visited in recent weeks, according to the unit's next-door neighbor.
Condo resident Carol Bailey said that starting Wednesday and continuing Thursday, police removed items from the modest, two-bedroom rental unit and asked her questions about its occupants. She said a new tenant told her in May that he was moving in with his cousin, and she realized later that the second man he had referred to that way was the Patriots player.
"I thought, 'This is Aaron Hernandez. He's renting a place here so he can have some peace and quiet,'" the retiree said Thursday.
The Ledgewood Condominiums resident said she didn't see the two men often, but Hernandez always had a hoodie pulled up when she saw him.
"I think all of us who recognized who it was didn't want to invade his privacy," she said of neighbors.
Bailey said she believed a black Hummer with expired, temporary Ohio tags that was parked at the complex was driven by someone in the condo. She said police towed away the Hummer on Wednesday.
Lloyd, 27, a semi-pro football player with the Boston Bandits, had known Hernandez for about a year and was dating the sister of Hernandez's fiancee, the mother of Hernandez's 8-month-old baby, Bristol County Assistant District Attorney Bill McCauley said.
On June 14, Lloyd went with Hernandez to the Boston nightclub Rumor. McCauley said Hernandez was upset Lloyd had talked to people there with whom Hernandez had trouble. He did not elaborate.
Two days later, McCauley said, Hernandez texted two unidentified friends and asked them to hurry to Massachusetts from Connecticut. At 9:05 p.m., a few minutes after the first message to his friends, Hernandez texted Lloyd to tell him he wanted to get together, McCauley said.
Later, surveillance footage from Hernandez's home showed his friends arrive and go inside. Hernandez, holding a gun, then told someone in the house he was upset and couldn't trust anyone anymore, the prosecutor said.
At 1:12 a.m. June 17, the three left in Hernandez's rented silver Nissan Altima, McCauley said. Cell towers tracked their movements to a gas station off the highway. There, he said, Hernandez bought blue Bubblicious gum.
At 2:32 a.m., they arrived outside Lloyd's home in Boston and texted him that they were there. McCauley said Lloyd's sister saw him get into Hernandez's car.
From there, surveillance cameras captured images of what the prosecutor said was Hernandez driving the silver Altima through Boston. As they drove back toward North Attleborough, Hernandez told Lloyd he was upset about what happened at the club and didn't trust him, McCauley said. That was when Lloyd began sending texts to his sister.
Surveillance video showed the car entering the industrial park and at 3:23 a.m. driving down a gravel road near where Lloyd's body was found. Four minutes later, McCauley said, the car emerged. During that period, employees working an overnight shift nearby heard several gunshots, McCauley said.
McCauley said Lloyd was shot multiple times, including twice from above as he was lying on the ground. He said five .45-caliber casings were found at the scene.
Authorities did not say who fired the shots or identify the two others with Hernandez.
At 3:29 a.m., surveillance at Hernandez's house showed him arriving and walking through the house with a gun in his hand, McCauley said.
His friend is also seen holding a gun, and neither weapon has been found, McCauley said.
Then, the surveillance system stopped recording, and footage was missing from the six to eight hours after the slaying, he said.
The afternoon of June 17, the prosecutor said, Hernandez returned the rental car, offering the attendant a piece of blue Bubblicious gum when he dropped it off. While cleaning the car, the attendant found a piece of blue Bubblicious gum and a shell casing, which he threw away. Police later searched the trash bin and found the gum and the casing. The prosecutor said it was tested and matched the casings found where Lloyd was killed.


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1956-62 Corvette Buyer's Guide
What a difference a year makes. In 1955, the Corvette was on the ropes struggling to stay alive. The new small-block V-8 engine and competition from Ford's sporty two-seater Thunderbird helped Corvette answer the bell for 1956. The substantially revised body styling, along with even more potent V-8 engines, made Corvette more than just a contender–these changes started Corvettes on the way to being champions of the sports car world.
All 1953-62 Corvettes are considered C1 (first-generation) cars, but the 1953-55 cars are really their own subset. The major 1956 restyling set a new course for Corvette style. Even though 1956-62 Corvettes are lumped together, restyling can separate them into three subgroups: 1956-57, 1958-60, and 1961-62.
Revved Up For Success
Greatly improved performance, styling, handling, and comfort were all part of the restyled 1956 Corvette. The dashboard was about the only vestige of the 1955 Vette. The Corvette was now a true convertible with roll-up windows. The auxiliary hardtop was a factory option. The 265 cid V-8 was available in 210- and a dual-quad 225-horsepower version. When the RPO 449 high-lift camshaft was ordered, horsepower hit a reputed 240. The new styling featured coves in the front fenders and doors. The coves could be painted either beige or silver. This two-tone look was very popular.
The Magic Year: 1957
1957 was a "highlight reel" year for the auto industry. A huge number of iconic/cult cars were produced. It was a time when performance was coming on very strong, but before excessive styling gimmicks took hold. Virtually everything Chevrolet produced was a winner in 1957, and the still-freshly restyled Corvette was the leader of the pack.
Engine displacement was increased to 283 cubic inches. GM's Rochester carburetor division introduced a mechanical fuel injection system cleverly called Ramjet. The new "fuelie" Corvettes came in 250- and 283-hp versions. The latter put the Corvette at the sensational one horsepower per cubic inch zenith.
Corvettes were increasingly successful at racing venues, and the expanding option list made it possible to order a car with either all-out performance, or comfortable cruising in mind. 1957 was the end of rival Thunderbird two-seaters, but Corvettes were just getting started on their way to being America's sports car.
1958 And Onward
Styling veered slightly in 1958, but not to a detrimental level. Quad headlights were in vogue, and Corvettes did as handsome a job as anyone with them. Performance continued to improve, with the 283 peaking at 315 hp in 1961. The enlarged-for-1962 327 small-block hit even greater heights with a 360-horse fuelie motor. Sales climbed every year to close out the C1 era, with 14,531 units sold in 1962.
What To Look For
Originality, completeness, and documentation are key things to look for in a 1956-62 Corvette. The more highly optioned or rare a particular car is, the more important those elements are.
In the case of mildly modified cars, the above factors are important along with the ability to return the car to its stock condition. For cars that have been modified beyond full restoration and cars without their original drivetrains, the current condition of the car is what counts. The quality and functionality of the mods–along with the car's aesthetics–are paramount. It helps if the modifications are tasteful and on the conservative side, because the wildest cars are the quickest to become outdated and lose value.
Rust is always a Corvette problem, because only the bodies were fiberglass. Not all early Corvettes were sold in California and Arizona. A car that sat in the weeds for decades could have frame damage, but this is easier to fix than undetected body problems.
Poor repairs are another big problem. Many (if not most) Corvettes were driven hard after they hit the used car market. These early Corvettes were popular theft targets, whether for parts or joy rides. As a result, many were crashed and/or stripped of their running gear. Those unlucky Corvettes were likely destroyed after their most salvageable parts were recycled, but some of these rolling wrecks survived.
Rolling C1 wrecks are relatively common offerings at big swap meets. The problem with these cars is that they can cost more to restore than buying a good car in the first place. The best reason for buying a basket case is if it is a verifiably rare Corvette such as a 1957, fuel-injected, four-speed car.
Where To Find Them
Unlike the more rare 1953-55 Corvettes, the later C1 cars from 1956 through 1962 are easy to find. There's much interest in these cars and a good supply, so they tend to change hands fairly often. Prices have been strong for many years, and strong prices have the effect of bringing out "hidden" cars.
This era of Corvettes is a favorite among the baby boomer collectors, but that group's advancing age may have divergent influences on 1956-62 Corvettes. On one hand, the still financially confident boomers are likely to be out buying their dream cars while they're young enough to enjoy them. College expenses are likely behind this group, so there can be extra discretionary income.
On the other hand, boomers who didn't fare well in the housing/stock/job markets may be ready to consolidate their holdings and downsize. This part of the group could be ready to make the hard decisions to let some of their toys go. Translation: now is a good time to talk to baby boomer owners of Corvettes you admire. Even if a car isn't actively for sale, this could be an excellent time to open a low-pressure dialog about contacting you if/when the owner decides to sell.
This era of Corvette can be found at almost any outdoor car show bigger than a local drive-in gathering. There are also lots of regional and national Corvette meets. The major meets such as Bloomington Gold, Corvettes At Carlisle, and the Corvette Fun Fest put on by Mid America Motorworks are guaranteed to be swarming with C1 Corvettes.
Major auctions attract lots of high-caliber cars (usually with corresponding high prices). The Internet and specialty Corvette publications are good sources. Specialty Corvette dealers are another fine source. Their prices may seem high, but remember that everything is negotiable. And, unlike indecisive private sellers, dealers usually finance their inventory so rapid turnover is essential to their financial success.
Options And Colors
The quality of the car is the most important factor in determining value, but color and options are also very influential. The most valuable 1957-62 option is fuel injection. This is especially true of 1957 Corvettes equipped with the four-speed manual. The irony of fuel injection is that when these cars were relatively new to the used-car market, many owners discarded the fuel injection systems in favor of easier-to-tune, smoother-idling, single four-barrel carburetor setups. There was a time in the late Sixties when Rochester fuel injection units and manifolds could be bought in the hundred-dollar range. Now prices start at $5,000 and go up from there. Completeness is very important–buying fuelie parts a la carte is extra expensive.
Many people naturally assume that all Corvettes had four-speed manual transmissions. A four-speed fits the Corvette image. The truth is, lots of them came with three-speed manual transmissions and two-speed Powerglide automatics. The three-speed was the only manual transmission in 1956 and at the start of the 1957 model year. The vaunted four-speed wasn't introduced until April 1957. As a result of the late availability, only 664 units were sold. In 1958, the first full year of four-speed availability, production rose to 3,764 units. Four-speed popularity continued to rise throughout the C1 era, peaking at 11,318 units in 1962–out of a total production of 14,531 cars!
Any of the high performance or racing-related options such as metallic brakes, heavy-duty suspension, and extra-capacity gas tanks are highly desirable. Power windows, the power folding convertible top, and the auxiliary hardtop are all value-enhancing options.
The various shades of red (1956-57 Venetian Red appears almost orange) and black are the color chart popularity leaders. Only 65 cars were painted Inca Silver in 1957–with 193 in 1958–and Cascade Green appeared on a mere 140 Corvettes in 1960, making them the most rare colors. Approximately 15,000 1956-62 Corvettes were white.
Best Buys
The best buys are those offered by motivated sellers. This is a very diverse market segment, so it's hard to pinpoint particular years or drivetrain combos as best. It depends largely on your expectations. If future appreciation/salability is number one, then a fairly priced 1957 fuelie four-speed should be your goal. There are no giveaways on these cars.
If you want the great looks of a 1957 without the premium price, seek a nice 1956 Corvette. These two years are outwardly identical. A Powerglide-equipped car could work well here, both from a price standpoint and for easy cruising.
Among the 1958-60 body style the 1958s used to be the bargain cars, but their extra chrome has caught on, making them generally more expensive than the 1959-60 cars. This group as a whole used to be the "blue light specials," but not anymore. Base engine cars can still be affordable. When searching for modified 1958-60 Corvettes, be aware of the aftermarket bodies that originally came from Mexico. These cars aren't exact replicas, and who knows about their paperwork?
Of the 1961-62 Corvettes, the 1962s have a slight edge as being the last of the solid-axle cars. That makes 1961s a potentially better bargain. People tend to associate 1962 Corvettes with the cult TV show Route 66, but the heroes, Tod and Buz, started out in a 1961 Corvette when the show debuted in the fall of 1960.
Mildly modified cars with non-matching-numbers running gear can be good values, but they don't have nearly as much room for appreciation as totally original, fully documented cars. Restomod Corvettes are great drivers, and they typically sell for less than it costs to build one.
Regardless of which 1956-62 Corvette you choose, they're all knockouts.
The Gold Standard for 1956-62 Corvettes is the fuel injected 1957 with a four-speed transmission. Any color is good, but Venetian Red is great.
These are the magic words for first-generation Corvettes. When you see Fuel Injection on the side of a 1957-62 Corvette, the value spikes regardless of the car's overall condition.
The addition of the Rochester fuel injection unit on 1957 Corvettes made it possible to obtain one horsepower per cubic inch on the 283-horse engine. There was also a 250-horse version.
If you want to find the largest assortment of the highest-caliber early Corvettes, attend a National Corvette Restorers Society judged event such as Bloomington Gold. The cars vying for awards are thoroughly inspected by leading Corvette restoration authorities.
Interiors of 1956-57 Corvettes have a distinctive "waffle" pattern on the seat centers and on the door panels. This same pattern was used on the 1955 Chevy Nomad. The two color choices were beige and red. Seat belts weren't a factory option, but mounting points were provided for dealer installations.
Fuel injection engines hogged the limelight, but over three times as many 1957 Corvettes were equipped with dual four-barrel carburetors. This is the powerful 270-horse version. There was also a dual-quad, 245-horse option.
Modified or restomod early Corvettes are a popular subgroup. Many of these cars were hot rodded early on, but the most popular current trend is to upgrade a classic body with modern Corvette running gear. This Cascade Green 1957 has an LS3 engine backed by a T-56 six-speed trans.
Any number of late-model Corvette engines are popular choices for restomod cars, but it's hard to go wrong with a mighty 7.0-liter LS7. Putting modern Corvette running gear in a lightweight early body makes for some awesome performance.
Chrome was king in 1958 at General Motors, so even the restyled Corvette received an extra dose. The unique trunk spears disappeared for 1959. Another 1958-only styling touch was the faux hood louvers.
The quad headlights first appeared in 1958 (it was the year of extra headlights for all GM products). The chrome headlight bezels led to fender top spears. This unrestored original 1960 Corvette is the very rare Cascade Green (140 cars painted this color), which is quite different from the more turquoise Cascade Green of 1956-57.
Corvettes were restyled for 1961. The most noticeable change was the rear quarter panels and taillight panel. The upswept look was a hint at 1963 rear styling. 1961 was the last year that a contrasting cove color could be ordered. Adding period-correct custom wheels like these Halibrand mags is a nice way to modify a car without sacrificing its originality.
This very nice 1962 Corvette sold quickly two years ago with an asking price of $34,500, even though it had a later 350 engine. Roman Red is one of the most popular 1959-62 colors.
Dashboards/instrument panels received a major restyling in 1958. The tachometer was now located just above the steering column, where it was much easier to read than the central dash location in 1957. The seats and door panels were now pleated, as seen in this 1962 Vette.
Horsepower zoomed past one per cubic inch in 1962, when the RPO 582, fuel-injected engine delivered 360 ponies from only 327 cubic inches. This 360-horse example is backed by a T-10 four-speed and a 4.11:1 Positraction rearend.
A thorough underside inspection should be performed before buying any classic Corvette. Besides looking for any rust problems, you can also get a better look at the backside of body panels. This 1959 Corvette was flawless from top to bottom.
Just because Corvettes have fiberglass bodies, that doesn't mean they can't have rust issues. This barn-find 1961 had lots of rust in the engine compartment and on the chassis. All the chrome was bad, and even the steering column hub was rusty.
The older and more valuable C1 Corvettes become, the more willing people are to restore marginal cars. This remnant of a 1961 Corvette was offered for $6,000 at the most recent Corvette & High Performance Meet in Puyallup, WA. There was no running gear, and the car only had a bill of sale (and no title).
Published Dec 7th, 2015


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According to numerous surveys, more than half of business owners intend to transition ownership of their business during the next 10 years. Yet most business owners do not have a formal strategic or financial plan, and many are unaware of the possible tax and estate implications. As a result, there is a real need for business exit planning, and it should be initiated a year or more in advance of a potential sale. A robust exit plan will help chart a course toward extracting maximum value from the company to reach the seller's goals, and should include the following: Understand your objectives. An exit plan will look different than a succession plan. An exit plan is typically geared toward an outside third-party buyer, whereas a succession plan addresses ownership transition to family members or other insiders. The business transfer option you choose will impact taxes, timing and cash considerations. Assemble a team. Before you initiate the sale process, assemble a team of experts that will help steer your sale to a positive end. Your deal team should include attorneys, accountants and an investment banker or business broker, all of whom can help you navigate the 2013 tax and deal landscape. You also should build a team to help with your post-transaction estate and retirement needs (such as an estate attorney, insurance planner and/or wealth manager). A good team will allow you to continue to focus on growing the business throughout the sale process, thereby maximizing the sale price and minimizing business disruption. Understand your business' worth. Before you go through the effort of preparing your business for sale, you will want to know how much your business is worth. One option would be to get a formal valuation, which would give you a realistic idea of what your business is worth and help you assess your financial and non-financial status, including current industry dynamics and market position. Your investment banker also will be able to provide feedback on valuation metrics for your business. Make the business look desirable to buyers. Just like selling a car or house, in order to maximize value, you need to make your business look desirable. In addition to making sure the physical assets of the business are clean and attractive, you should objectively look at the financial opportunity you present to buyers. For example, a better time to sell is when the business is growing with remaining upside runway. Additionally, your chances of selling at a high price are greater with more formally prepared financial records. However, your reported financials may provide an incomplete picture of how profitable your business will be after a sale and your accountant or investment banker will work on restating the profits/losses and justifying these adjustments. Finally, get your paperwork and records in order, including contracts, permits, titles, corporate charters and leases. Starting early to round up this information will not only help smooth the sale process, but it also may identify any business risks, such as environmental issues or expiring contracts/leases. Improve business operations and profitability. It is key to focus on the business' core operations and underlying profitability. There are many things you can do to legitimately make your business more profitable/valuable/less risky to a new owner, including diversifying the customer base, filling management holes, upgrading systems/processes, closing down less profitable business lines, culling unprofitable customers and keeping your work force lean. These are likely items you have thought about many times, but the process of planning to sell can provide the impetus to execute on improvement.
Have a question for Northeast Ohio's M&A professionals? Email us and look for your question and an answer in an upcoming Dealmaker Alert.


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This dish is one of our most beloved dinners. Chicken and broccoli covered with a creamy sauce, and then topped off with gooey melted cheese and buttery breadcrumbs. It is a delight and it's even got all your four food groups covered.
Granted, it is a bit time consuming since the chicken needs to be boiled, the broccoli needs to be cooked, cheese grated, etc. When we make it, it practically takes half a day and it's all hands on deck with each person being given a task to do to lessen the work.
If you're in more of a rush, I have learned some shortcuts that take a lot of the effort out of this dish. My tips to you would be to buy a roasted chicken (so all you have to do is debone it), use frozen broccoli (which requires less time to boil), and buy your cheese already grated. It'll go a lot quicker this way, believe me.
But, whether you make it completely from scratch or cheat a little, the divan will come out divine every time. My family absolutely loves it and I know yours will too.
I am pleased to announce that I will be starting a new linky party this week called, "Sweets for a Saturday." Why this theme, you ask? Well, see, Saturday is usually when we would invite my grandparents over for dinner. Naturally, dessert is always served and I want to have a collection of desserts at my fingertips for just such an occasion. Besides that, it's also the weekend and what better way to celebrate the end of the week than with a sweet treat. The linky will be up on my blog starting Friday night, so be sure to come by to link up all your delicious desserts and sweet treats. I can't wait!
Chicken Divan
4-5 lbs. chicken thighs, boiled and deboned
1 1/2 lbs. broccoli florets, parboiled (or more if you're broccoli lovers like we are)
2 smaller cans cream of chicken soup (low fat or lower sodium is fine)
3/4 c. mayonnaise
1 tsp. lemon juice
grated cheddar cheese (about 1 1/2 cups)
5 slices bread, broken into small pieces
1 stick butter
Boil and debone the chicken thighs. Parboil the broccoli until tender. Combine the cream of chicken soup, mayonnaise, and lemon juice. Melt 1 stick butter over medium-medium high heat. Remove from heat and add the pieces of bread. Stir well until all the bread pieces are coated with butter.
Form a layer of chicken in the bottom of a 9x13 pan. Layer the broccoli over the chicken. Pour the cream of chicken sauce over the broccoli. Top with grated cheese and then sprinkle with the buttered breadcrumbs. Bake at 350F for 40 min. until everything is heated through and the cheese is melted.
Note: It can be made ahead of time and refrigerated until ready to bake.
This recipe is linked to:
Mouthwatering Monday
Hearth n' Soul Blog Hop
Tempt my Tummy Tuesdays
Tuesdays at the Table
Dr. Laura's Tasty Tuesdays
3 Shades of Green Tasty Tuesdays
Beauty and Bedlam's Tasty Tuesdays
Tuesday Night Supper Club
Delectable Tuesday
Recipes I Can't Wait to Try
Prairie Story Recipe Swap
Miz Helen's Full Plate Thursday
Fun w/ Food Friday
What's Cookin' in the Kitchen
Friday Potluck


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Measurement has long been a cornerstone of quality improvement, whether it's on the factory floor or the hospital ward.
And making the quality scores of doctors and hospitals publicly available is central to the idea that health care can become a service that patients shop for intelligently. The results can also ratchet up professional peer pressure for improvement.
But does public reporting lead doctors and hospitals to game the system by withholding care from the sickest patients?
Some researchers turned to Medicare data to compare treatment of acute heart attack patients using angioplasty and stents. They looked at three states that have led the way on public reporting with other states that don't report the results.
The upshot: New York, Pennsylvania and Massachusetts had lower rates of angioplasty — about 20 percent lower — than other nearby states that didn't publicly report the findings. Overall, the death rates at a month after treatment were no different, however, and the rates of bypass surgery for heart attack treatment were comparable.
Outcome scores typically include factors to account for the condition of patients, but some doctors have questioned whether those adjustments for sicker people are adequate.
But the biggest drop in treatment was seen for some of the very sickest patients, those with a so-called STEMI heart attacks, cardiac arrest and cardiogenic shock in the reporting states.
The results appear in JAMA, the Journal of the American Medical Association.
Now there are a couple of possible explanations for the findings, but the study, which looked backward at patients treated between 2002 and 2010, can't prove exactly what's happening.
One possibility is that doctors, patients and their families chose to forgo futile treatment or treatment that wasn't necessary. It's also possible that doctors skipped appropriate treatment of patients who were at the highest risk of dying to avoid the possibility of a lower quality score.
Adjustments to the measures are supposed to take care of that problem, but the formulas have their limitations.
"The concern has been that if you don't give people credit for how sick their patients are, you might be penalizing hospitals of last resort," cardiologist Karen Joynt, lead author of the study tells Shots.
She accepts that measurement and public disclosure are here to stay. "We can't improve without measuring our quality," says Joynt, who works at Brigham and Women's Hospital in Boston and the Veterans Administration Medical Center in West Roxbury.
But public reporting could have unintended consequences. "We need to understand just how this policy is playing out — not just in policy world — but in clinical world," she says in a video accompanying the study. Something that looks good on paper may not be so great in the hospital.
Copyright 2020 NPR. To see more, visit https://www.npr.org.


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Honda enjoys an excellent reputation for reliability and quality, with the Accord becoming America's most popular car in 1989. Today, the brand continues to be one of the most respected in the industry, offering everything from fuel-sipping hybrids to full-size SUVs, and almost everything in between. At SPACE25 Automotive Care, we work on them all, including:
Our mission is to earn your business and trust by providing superior service for your Honda vehicle. We're a family-owned and operated auto repair shop, so you can feel good about bringing your business our way AND our experienced, well-trained mechanics save you money with accurate diagnosis and precise repairs. Some auto repair shops replace entire parts instead of simply fixing the component that needs to be fixed. Not at SPACE25 Automotive Care. We'll troubleshoot exactly what your Honda needs, and clearly explain our prognosis.
The purpose of SPACE25 Automotive Care is to HELP you. We want to solve your auto repair and maintenance concerns, ensure your safety, give you trouble-free driving, and maximize your investment in a Honda vehicle—and we want to do so in the most enjoyable manner possible. Whether you know how to rebuild an engine or pumping gas is the limit of your automotive knowledge, we treat every customer the same way—the way we like to be treated, with respect and courtesy.
Let's face it, nobody is ever happy to spend money on auto repairs, but if getting your Honda serviced is a pleasant experience then it tends not to be such a big deal. For high quality, value-minded repairs delivered in a timely manner, bring your vehicle to SPACE25 Automotive Care!


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MusConv easily imports your playlists and favorites from Google Play Music to Musixmatch
Start now!With MusConv you can easily transfer all your music from Google Play Music to Musixmatch!
How to import Google Play Music to Musixmatch?
Transferring between Google Play Music and Musixmatch was never so easy! Try it out!
You need to perform 4 easy steps to migrate between two services:
1 Select Google Play Music as source service
2 Select playlists you want to transfer
3 Select Musixmatch as destination service
4 Take a tea and wait till we move songs for you 😉
Once finished, your playlists and songs will be available on Musixmatch.
Move From Google Play Music to Musixmatch – Video Tutorial
Alternative method to transfer playlists and songs from Google Play Music to Musixmatch
- Select source service as Google Play Music
- Select playlists you want to export
- Choose CSV file as destination
- Select source as just saved CSV file
- Select destination service as Musixmatch
This method allows to backup all your music data to CSV file and use it anytime to import to Musixmatch.
By the way, you can also transfer music from youtube to play music.


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Trust Garage Door - Garage Door Hardware Repair 10022 - 212-918-5404
Trust Garage Door is a well-known garage door service company that has been servicing the people living in and around New York, NY 10022 for the past several years. Over the years, our professionalism and high quality services have made us the best agency in the region. Today, we are the go-to service providers of the community members. What distinguishes us from our competitors is our premium services made available at affordable costs.
A malfunctioning garage door is a source of inconvenience to the owners and is best repaired as soon as possible. If you have a garage door, it is important that you be in touch with reliable services like ours.
The team behind it all
All our professionals are well trained and have plenty of experience in installing, maintaining, replacing, repairing and upgrading garage doors. They have worked with hundreds of garage doors of all kinds and are well versed with all kinds of issues that may happen with a door. When you hire us, you can rest assured of expert services. Our technicians have an in-depth understanding of the trade and are highly adept at what they do. No matter what kind of issue you may be facing with your garage door, you can rest assured that we can take care of it.
Mobile solutions:
With us around, you would never need to visit a workshop to fix your garage door concerns. We have a fleet of mobile vans at our disposal. As soon as you call us, we dispatch our technicians in our well stocked vans. They arrive at the site in less than 30 minutes and offer a quick resolution of your issue. Whether it's a repair or a replacement job that needs to be done, we have everything in our mobile vans to help us offer speedy and accurate service.
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Our extensive array of services has benefitted hundreds of people living in and around zip code 10022. If you are looking for reliable garage door services, just call us at 212-918-5404 to know more.


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Physical Therapist Jobs, Athletic Trainer Jobs, Occupational Therapist Jobs, Social Worker Jobs, Mental Health Counselor Jobs, Radiologist Jobs, And Respiratory Therapist Jobs In Florida, United States
Here is a list of specialties for healthcare jobs in Florida, United States that match your requirements. Please select the specialty below that most closely matches your skillset.
If you do not see a specialty that you think should be listed, please let us know!


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The FBI is offering a $1 million reward for information leading directly to the safe return of one of its retired agents.
Robert Levinson disappeared five years ago this week on Kish Island, Iran. He worked at the FBI for 22 years before he retired, taking as a private detective. It was that job that sent him to Iran in March 2007, where he went missing.
U.S. government officials believe he may be a hostage, held by a group in Afghanistan or Pakistan. So they're launching a new reward campaign, and putting out leaflets, radio spots and billboard messages across Southwest Asia.
At a news conference in Washington, with a wall of current and former law enforcement agents standing behind him, FBI director Robert Mueller told Levinson's wife Christine that agents "share in your heartache."
"We are working every day to bring your husband, your father, your grandfather home to you," Mueller said.
Christine Levinson told reporters, "there are no words to describe the nightmare my family and I have been living every day."
Authorities released a video of a thin and haggard-looking Levinson in 2010. They say he has diabetes and hypertension, but likely little access to medical care.
Since then, James McJunkin, who leads the FBI field office in Washington, says there have been no public hints about his well being and no demands for a ransom.
Levinson will turn 64 years old on March 10th, McJunkin says.
"We're trying to underline the importance this case has to the FBI," he says. "We're hoping for a break here."
Update at 3:01 p.m. ET. Family Launches Twitter Feed:
Bob Levinson's family has launched a twitter feed to keep people up to date on the latest.
Copyright 2023 NPR. To see more, visit https://www.npr.org.


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Prostate Cancer Staging
When prostate cancer spreads, it's often found in nearby lymph nodes. If cancer has reached these nodes, it also may have spread to other lymph nodes, the bones, or other organs.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if prostate cancer spreads to bones, the cancer cells in the bones are actually prostate cancer cells. The disease is metastatic prostate cancer, not bone cancer. For that reason, it's treated as prostate cancer, not bone cancer. Doctors call the new tumor "distant" or metastatic disease.
These are the stages of prostate cancer:
- Stage I: The cancer can't be felt during a digital rectal exam, and it can't be seen on a sonogram. It's found by chance when surgery is done for another reason, usually for BPH. The cancer is only in the prostate. The grade is G1, or the Gleason score is no higher than 4.
- Stage II: The tumor is more advanced or a higher grade than Stage I, but the tumor doesn't extend beyond the prostate. It may be felt during a digital rectal exam, or it may be seen on a sonogram.
- Stage III: The tumor extends beyond the prostate. The tumor may have invaded the seminal vesicles, but cancer cells haven't spread to the lymph nodes.
- Stage IV: The tumor may have invaded the bladder, rectum, or nearby structures (beyond the seminal vesicles). It may have spread to the lymph nodes, bones, or to other parts of the body.


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Good morning, I'm David Greene.
In England, a man went to the store and bought a package of six eggs. He cracked the first one open and found a double yolk. Then he cracked open the second, two yolks in that one as well. It turns out all six eggs were like that. The chances of that happening: about one in a trillion. As unlikely as winning the lottery, the man said, before adding the lottery would be better, obviously. Still, what a way to beat the odds with eggs?
Fry 'em up while listening to MORNING EDITION. Transcript provided by NPR, Copyright NPR.


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This is SCIENCE FRIDAY, I'm Ira Flatow. Earlier this week, the New York Times reported new CDC data on diagnosis of attention deficit hyperactivity disorder, ADHD, in kids. And the numbers are startling, with 11 percent of the parents surveyed reporting a diagnosis of ADHD for their school-age kids, higher numbers for some sub-groups of age and gender. That's a big jump. Estimates before that had been that ADHD affected somewhere from three to seven percent of children.
So what's behind the surge in numbers? Is the spike real, or is it just a reporting error? And what does that increase in diagnoses mean? Joining us now to talk about it is William Graf, he's a professor of pediatrics and neurology at Yale School of Medicine in New Haven. Welcome to SCIENCE FRIDAY.
WILLIAM GRAF: Hi Ira, thanks for inviting me.
FLATOW: Were you surprised by these numbers?
GRAF: Yeah, these numbers are pretty high, and it is surprising, and I think that on one hand they're sort of real because we've seen this change over the last two decades as the rates have slowly gone up, and on the other hand they're inflated a little bit, probably because of the way they were obtained.
These are - the CDC did a study, which is like polling data. They - it's called the National Representative randomized Cross-sectional Survey. And it's - this particular trial supposedly was done with land line and cell phone telephone surveys of all households who have children.
There was a similar study just published a couple weeks ago that was on autism, which showed the rate of autism was two percent of the population, which is also very high and was discussed just in the same way. But these are epidemiological survey data, and they're worth something. We have other data to show that the numbers are indeed going up.
FLATOW: Give us an idea again what actually ADHD is, real ADHD.
GRAF: Yeah, I think that's one of the points of the discussion. Probably ADHD is three to seven percent of the population, and we're talking about a rise now, but it has an interesting history. It probably dates back 40 or 50 years. It was called, you know, minimal brain damage a long time ago in the '70s.
The Diagnostic and Statistical Manual III, DSM-III, called it ADD with or without hyperactivity. And then the name sort of changed. DSM-IV called it ADHD. DSM-V will change it slightly differently. You have to remember that ADHD overlaps with other minor neurological - relatively minor. They can cause impairment.
And the three classic symptoms are inattentiveness, impulsiveness, hyperactivity, and we can talk about what that is. And that has to lead to impairment. And there's a couple of reasons why this diagnosis would be controversial, and that is because there's no biological marker for it, because the diagnostic criteria are somewhat subjective and because different people will interpret the impairments and the symptoms differently even in the same child.
FLATOW: Could this not be one of the reasons for over-diagnosis, that these are vague ways of diagnosing some of the symptoms.
GRAF: There's probably a lot of social reasons why and environmental reasons why it could be over-diagnosed. There are also these co-morbidities with ADHD. Probably half of the kids have - who really have ADHD have some form of a learning disability. There are different names that are out there like auditory processing disorder, and the latest is something called executive function disorder. That's the most popular right now.
And I can well see that there'll be a shift in ADHD diagnosis to something else, just like the terms for autism have changed in the last 10 years to spectrum disorders and things like that. So you have changes in the names we give, the labels that we give for these conditions.
FLATOW: Is the diagnoses coming from the parents, the doctors, the teachers? Where are we seeing this increase coming from?
GRAF: So I can list a couple of possible explanations for why the numbers are going up. First of all, it could be that kids are actually changing, and there is actually more ADHD out there. But most people probably don't believe that. Kids are spending more time in front of their computers, and they might be exercising less than in the past. Those are probably true. But whether or not that translates to a diagnosis of ADHD is less clear.
I think some of the reasons, that there's a lot of surveillance for this, so people are looking for it. There's greater awareness and acceptance of the disorder and in part because the pharma industry has direct-to-consumer advertising, and they've succeeded in selling this.
And then adolescents are way up, and that's an interesting sub-group here because the boys in high school, their numbers have jumped, and there's got to be an explanation for why the diagnosis is being made so late. And then lastly we just recently published a position paper through the American Academy of Neurology on pediatric neural enhancement, which is a sub-group that might be taking stimulants and might be coded as ADHD, but actually it's healthy children who are using stimulant medications as study drugs. And that probably explains some of the jump.
FLATOW: You know, there is - if you just think about it, it seems like the jump is occurring at the same time we hear about the epidemic of obesity in children, of type 2 diabetes, of sugar consumption. Have these things been controlled for or thought about as perhaps having some connection?
GRAF: I don't know if the data is so clear on the connection there. But kids are definitely getting heavier. Looking at movement and physical activity and then human activity, the need to move, and this thing called hyperactivity, most studies actually don't show that children with ADHD are moving that much more. They're just fidgeting more. So that's sort of an interesting part of this disorder.
Most kids that I see who have ADHD are actually quite thin. And I don't know if that's a national trend or not.
FLATOW: How about the link to medication? Do we see more kids with the disorder and more medication of those kids?
GRAF: That's where the data comes through beyond the survey science, there are more doctor visits coded for ADHD management. There's more stimulants being prescribed. There's more drug being manufactured, and there's more drug being consumed. And actually last year there was a national shortage of methylphenidate for a while, which means it's actually being consumed.
Another question that comes up periodically is whether people might be motivated to have the ADHD label because of privileges or rights that they might get to take longer for tests. So it would be a diagnostic label which would have some sort of benefit to them, even if they're not taking stimulant medication.
FLATOW: Is there any federal funding for parents or schools or people like that for children who have ADHD? And if so, might that be a motivation?
GRAF: Oh, whether - I think to get Social Security income for a child would depend on the parents' income, and I've heard of that as a possibility, but I don't think it's very common. Certainly the services for children that are publicly funded through public schools are there, the ability to have children be assessed in school.
And that's usually where the assessment takes place. It's not in the doctor's office. It's - these are kids that are not doing well in school, and then the teachers and the school psychologists gather data on that child and bring it back to the physician.
FLATOW: So they're - yeah, are they capable, are they trained enough to be able to actually bring that data to assess, to make the assessment?
GRAF: Again there's - this is a complicated disorder. It's a brain-based disorder when it's real. And then the real question here is, like you say, these numbers are rising, so are these just milder cases. What are the other explanations for that? I think by definition of ADHD, the problem is bad enough that it's causing functional impairment, and that means the child has to be struggling in school. And usually the data is there.
With the milder cases of the kids that are actually normal who are accounting for part of the increase by getting a label of ADHD and then potentially getting stimulants as study drugs, we don't have any data on that because it's not legal, and it's - we believe as the American Academy of Neurology that it's also not ethical to give children medications who are healthy.
FLATOW: So you look at this study, and what's your takeaway message on this?
GRAF: It's sort of the same as the autism that came out a few weeks ago. I don't believe that two percent of children with autism - two percent of children have autism. And I don't think one in five boys in high school has ADHD. But this is a wonderful opportunity to talk about these changes over the course of the last two decades.
This is a national discussion we should be having. Why has this happened, and where are we going with the next two decades? Is this the new normal, that everybody's going to have a label and a medicine in school? This is sort of a sociopolitical discussion that one might have in terms of the competition that kids are forced to have, the school pressures, the No Child Left Behind and the other measures that would put schools under pressure to have better test scores and things like that.
FLATOW: Dr. Graf, thank you for taking time to be with us today. We'll be following this issue with you.
GRAF: Thank you, Ira.
FLATOW: William Graf is a professor of pediatrics and neurology at Yale School of Medicine in New Haven. Transcript provided by NPR, Copyright NPR.


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I must be going crazy. Or senile.
Valentina posted a cookie recipe on her blog in Portuguese especially for my sister. They looked super tasty and Jessica and I baked them in one of the days she spent at my house.
I was completely surprised to realize, more than a month later, when I was about to post the cookies, that I had already baked them…
I didn't notice it. Not even for a moment. They looked a bit different, too – and I'm not trying to justify myself here. :)
These cookies are so delicious they are worth being posted again – it was a good thing that Jessica had the idea of using white chocolate chips, too, so they (sort of) have a new look. :)
Super chocolate cookies with dark and white chocolate chips
125g dark chocolate, minimum 70% cocoa – I used 60%
150g flour
30g cocoa powder
1 generous teaspoon baking soda
½ teaspoon salt
125g unsalted butter, room temperature
75g brown sugar
50g caster (superfine) sugar
1 teaspoon vanilla extract
1 large cold egg
100g semisweet chocolate chips
100g white chocolate chips
Position a rack in the middle of the oven. Preheat the oven to 165ºC/325ºF.
Line 2 baking sheets with parchment paper.
Put the dark chocolate in a heatproof container or the top of a double boiler and place it over, but not touching, a saucepan of barely simmering water (or the bottom of the double boiler). Stir the chocolate until melted and smooth. Remove from the water and set aside.
Sift the flour, cocoa powder, baking soda and salt into a medium bowl and set aside. In a large bowl, using an electric mixer on medium speed beat the butter, brown sugar and sugar until smoothly blended, about 1 minute.
Stop the mixer and scrape the sides of the bowl as needed during mixing. On low speed, mix in the melted chocolate until blended. Add the egg and vanilla, mixing until blended, about 1 minute. Add the flour mixture, mixing just until it is incorporated. Mix in the chocolate chips (both semisweet and white).
Using an ice cream scoop or measuring cup with a ¼-cup capacity*, scoop mounds of dough onto the prepared baking sheets, spacing the cookies 3 inches apart.
Bake the cookies one sheet at a time until they crack slightly on top and a toothpick inserted in the center of a cookie comes out with moist crumbs, not wet batter, about 18 minutes (if the toothpick penetrates a chocolate chip, test another spot).
Cool the cookies on the baking sheet for 5 minutes, then use a wide metal spatula to transfer them to a wire rack to cool completely. The outsides of the cookies will become crisp as the cookies cool.
The cookies can be stored in a tightly covered container at room temperature for up to 4 days.
* We used 1 ½ tablespoon of dough for each cookie and got 24


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Alaska Airlines To Stop Handing Out Prayer Cards
"After more than 30 years of handing prayer cards to customers aboard its planes, Alaska Airlines has decided the practice is outdated and will stop doing it on Feb. 1," The Seattle Times reports.
A few things struck us about this news.
-- An airline handing out prayer cards? We haven't flown Alaska Airlines, so this was a surprise. And at first it seemed like a bit of misplaced marketing. Sure, many nervous fliers say a prayer or two. But why play into any fears?
Well, it turns out that the cards come with meals — and that the airline once saw them as a way to "fancy up the meal service since many folks like to give thanks before a meal," as one of its executives once said. So it was the food they were supposed to be praying about, not the flight. And since it was airline food, perhaps that makes some sense.
The cards have a rotating series of psalms from the Old Testament.
-- This is another sign of how times change. In an email to frequent fliers, the Times reports, Alaska Air Group CEO Bill Ayer and Alaska Airlines President Brad Tilden said the airline had been receiving a growing number of complaints from fliers who were offended. Just eight years ago, the airline said the number of thanks it got far exceeded the complaints.
-- It was a bit odd to also read that for the past six years, only first-class fliers were getting the cards. We can see why, of course, since all airlines have been cutting back on meal and drink service in coach class. No meals, no cards. But as the Anchorage Daily News writes: "Insert joke here about first-class passengers being more valuable to the airline."


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Pleasanton Flower Shop
3120 Ste C Santa Rita Rd, Pleasanton, CA 94566
Local: 925-463-9595
3120 Ste C Santa Rita Rd, Pleasanton, CA 94566
Local: 925-463-9595
The FTD® Red and Lavender Rose Bouquet
B23-4386The FTD® Red and Lavender Rose Bouquet beautifully expresses your love with its gorgeous combination of color and elegance. Rich red roses mingle with lavender roses accented with vibrant greens, all arranged in a clear glass vase to make a lasting impression on your sweetheart this Valentine's Day.
- For U.S. and Canada deliveries only
- Delivery Information
All items featured on this site represent the types of arrangements we offer and may vary depending upon availability in certain regions. Substitution Policy


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UNIVERSAL CITY, Calif. (AP) — Soulful rocker Josh Kaufman has the winning voice.
The 38-year-old from team Usher was crowned the season six winner of NBC's "The Voice" Tuesday.
"It was a lot of nerves and heart-racing and it felt like forever," Kaufman said during a post-show press conference.
This is the first win for Usher, who also coached during season four.
Usher relished his triumph over previous winners Adam Levine and Blake Shelton.
He joked that the Maroon 5 frontman was likely "behind the stage counting votes."
Shelton's country crooner Jake Worthington came in second place, and singer-songwriter Christina Grimmie from team Levine took third.
Coldplay, Ed Sheeran, OneRepublic, Tim McGraw and Robin Thicke performed during the finale.
Gwen Stefani and Pharrell Williams will join Levine and Shelton for the sing-off's seventh season.
Follow Nicole Evatt at https://twitter.com/NicoleEvatt


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Newly insured to deepen primary care doctor gap
The Associated Press
| Sunday, June 23, 2013, 10:05 a.m.
COLUMBUS, Ohio — Getting face time with the family doctor could soon become even harder.
A shortage of primary care physicians in some parts of the country is expected to worsen as millions of newly insured Americans gain coverage under the federal health care law next year. Doctors could face a backlog, and patients could find it difficult to get quick appointments.
Attempts to address the provider gap have taken on increased urgency ahead of the law's full implementation Jan. 1, but many of the potential solutions face a backlash from influential groups or will take years to bear fruit.
Lobbying groups representing doctors have questioned the safety of some of the proposed changes, argued they would encourage less collaboration among health professionals and suggested they could create a two-tiered health system offering unequal treatment.
Bills seeking to expand the scope of practice of dentists, dental therapists, optometrists, psychologists, nurse practitioners and others have been killed or watered down in numerous states. Other states have proposed expanding student loan reimbursements, but money for doing so is tight.
As fixes remain elusive, the shortfall of primary care physicians is expected to grow.
Nearly one in five Americans already lives in a region designated as having a shortage of primary care physicians, and the number of doctors entering the field isn't expected keep pace with demand. About a quarter million primary care doctors work in America now, and the Association of American Medical Colleges projects the shortage will reach almost 30,000 in two years and will grow to about 66,000 in little more than a decade. In some cases, nurses and physician assistants help fill in the gap.
The national shortfall can be attributed to a number of factors: The population has both aged and become more chronically ill, while doctors and clinicians have migrated to specialty fields such as dermatology or cardiology for higher pay and better hours.
The shortage is especially acute in impoverished inner cities and rural areas, where it already takes many months, years in some cases, to hire doctors, health professionals say.
"I'm thinking about putting our human resources manager on the street in one of those costumes with a 'We will hire you' sign," said Doni Miller, chief executive of the Neighborhood Health Association in Toledo, Ohio. One of her clinics has had a physician opening for two years.
In southern Illinois, the 5,500 residents of Gallatin County have no hospital, dentist or full-time doctor. Some pay $50 a year for an air ambulance service that can fly them to a hospital in emergencies. Women deliver babies at hospitals an hour away.
The lack of primary care is both a fact of life and a detriment to health, said retired teacher and community volunteer Kappy Scates of Shawneetown, whose doctor is 20 miles away in a neighboring county.
"People without insurance or a medical card put off going to the doctor," she said. "They try to take care of their kids first."
In some areas of rural Nevada, patients typically wait seven to 10 days to see a doctor.
"Many, many people are not taking new patients," said Kerry Ann Aguirre, director of business development at Northeastern Nevada Regional Hospital, a 45-bed facility in Elko, a town of about 18,500 that is a four-hour drive from Reno, the nearest sizable city.
Nevada is one of the states with the lowest rate per capita of active primary care physicians, along with Mississippi, Utah, Texas and Idaho, according to the Association of American Medical Colleges.
The problem will become more acute nationally when about 30 million uninsured people eventually gain coverage under the Affordable Care Act, which takes full effect next year.
"There's going to be lines for the newly insured, because many physicians and nurses who trained in primary care would rather practice in specialty roles," says Dr. David Goodman of the Dartmouth Institute for Health Policy and Clinical Practice.
Roughly half of those who will gain coverage under the Affordable Care Act are expected to go into Medicaid, the federal-state program for the poor and disabled. States can opt to expand Medicaid, and at least 24 and the District of Columbia plan to.
In Ohio, which is weighing the Medicaid expansion, about one in 10 residents already lives in an area underserved for primary care.
Mark Bridenbaugh runs rural health centers in six southeastern Ohio counties, including the only primary care provider in Vinton County. The six counties could see some of the state's largest enrollments of new Medicaid patients per capita under the expansion.
As he plans for potential vacancies and an influx of patients, Bridenbaugh tries to identify potential hires when they start their residencies — several years before they can work for him.
"It's not like we have people falling out of the sky, waiting to come work for us," he said.
State legislatures working to address the shortfall are finding that fixes are not easy.
Bills to expand the roles of nurse practitioners, optometrists and pharmacists have been met with pushback in California. Under the proposals, optometrists could check for high blood pressure and cholesterol while pharmacists could order diabetes testing. But critics, including physician associations, have said such changes would lead to inequalities in the health care system— one for people who have access to doctors and another for people who don't.
In New Mexico, a group representing dentists helped defeat a bill that would have allowed so-called dental therapists to practice medicine. And in Illinois, the state medical society succeeded in killing or gutting bills this year that would have given more medical decision-making authority to psychologists, dentists and advanced practice nurses.
Other states are experimenting with ways to fill the gap.
Texas has approved two public medical schools in the last three years to increase the supply of family doctors and other needed physicians. New York is devoting millions of dollars to programs aimed at putting more doctors in underserved areas. Florida allowed optometrists to prescribe oral medications — including pills — to treat eye diseases.
The federal health care law attempts to address the anticipated shortage by including incentives to bolster the primary care workforce and boost training opportunities for physicians' assistants and nurse practitioners. It offers financial assistance to support doctors in underserved areas and increases the level of Medicaid reimbursements for those practicing primary care.
Providers are recruiting young doctors as they gear up for the expansion.
Stephanie Place, 28, a primary care resident at Northwestern University's medical school in Chicago, received hundreds of emails and phone calls from recruiters and health clinics before she accepted a job this spring.
The heavy recruitment meant she had no trouble fulfilling her dream of staying in Chicago and working in an underserved area with a largely Hispanic population. She'll also be able to pay off $160,000 in student loans through a federal program aimed at encouraging doctors to work in areas with physician shortages.
Place said the federal law turned needed attention to primary care as a specialty among medical students.
"Medical students see it as a vibrant, evolving, critical area of health care," she said.
Even so, many experts say the gap between doctors and those gaining care under the health reforms in many parts of the country will not close quickly. Access to care could get worse for some people before it gets better, said Dr. Andrew Morris-Singer, president and co-founder of Primary Care Progress, a nonprofit in Cambridge, Mass.
"If you don't have a primary care provider," he said, "you should find one soon."