Monday, June 28, 2010
Wednesday, June 23, 2010
The Cost Effectiveness of Physical Treatment for Back Pain for long term Wellness
Cost Effectiveness of Physical Treatments
for Back Pain in Primary Care
FROM: British Medical Journal 2004 (Dec 11); 329 (7479): 1381 ~ FULL TEXT
Findings from the:
“United Kingdom Back Pain Exercise and Manipulation (UK BEAM) Randomised Trial”
DISCUSSION:
We believe that this is the first study of physical therapy for low back pain to show convincingly that both manipulation alone and manipulation followed by exercise provide cost effective additions to care in general practice. Indeed, as we trained practice teams in the best care of back pain, we may have underestimated the benefit of physical therapy (spinal manipulation) when compared with "usual care" in general practice. The detailed clinical outcomes reported in the accompanying paper reinforce these findings by showing that the improvements in health status reported here reflect statistically significant improvements in function, pain, disability, physical and mental aspects of quality of life, and beliefs about back pain. [1]
Effects of a Managed Chiropractic Benefit on the Use
of Specific Diagnostic and Therapeutic Procedures
in the Treatment of Low Back and Neck Pain
FROM: J Manipulative Physiol Ther 2005 (Oct); 28 (8): 564–569
Nelson CF, Metz RD, LaBrot T
Health Services Research, American Specialty Health, San Diego, CA 92101, USA. craign@ashn.com
OBJECTIVE: The aim of this study was to measure the effects of a managed chiropractic benefit on the rates of specific diagnostic and therapeutic procedures for the treatment of back pain and neck pain.
DESIGN: This study is a retrospective analysis of claims data from a managed-care health plan over a 4-year period. The use rates of advanced imaging, surgery, inpatient care, and plain-film radiographs were compared between employer groups with and without a chiropractic benefit.
RESULTS: For patients with low back pain, the use rates of all 4 studied procedures were lower in the group with chiropractic coverage. On a per-episode basis, the rates in the group with coverage were reduced by the following: surgery (-32.1%); computed tomography (CT)/magnetic resonance imaging (MRI) (-37.2%); plain-film radiography (-23.1%); and inpatient care (-40.1%). On a per-patient basis, the rates were reduced by the following: surgery (-13.7%); CT/MRI (-20.3%); plain-film radiography (-2.2%); and inpatient care (-24.8%). For patients with neck pain, the use rates were reduced per episode in the group with chiropractic coverage as follows: surgery (-49.4%); CT/MRI (-45.6%); plain-film radiography (-36.0%); and inpatient care (-49.5%). Per patient, the rates were surgery (-31.1%); CT/MRI (-25.7%); plain-film radiography (-12.5%); and inpatient care (31.1%). All group differences were statistically significant.
CONCLUSIONS: For the treatment of low back and neck pain, the inclusion of a chiropractic benefit resulted in a reduction in the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs. This effect was greater on a per-episode basis than on a per-patient basis.
Clinical Utilization and Cost Outcomes from an Integrative Medicine Independent Physician Association:
An Additional 3-year Update
FROM: J Manipulative Physiol Ther 2007 (May); 30 (4): 263–269
Richard L. Sarnat, MD, James Winterstein, DC, Jerrilyn A. Cambron, DC, PhD
Alternative Medicine Integration Group, LP, Highland Park, Ill 60035, USA. rsarnat@amibestmed.com
OBJECTIVE: Our initial report analyzed clinical and cost utilization data from the years 1999 to 2002 for an integrative medicine independent physician association (IPA) whose primary care physicians (PCPs) were exclusively doctors of chiropractic. This report updates the subsequent utilization data from the IPA for the years 2003 to 2005 and includes first-time comparisons in data points among PCPs of different licensures who were oriented toward complementary and alternative medicine (CAM).
METHODS: Independent physician association-incurred claims and stratified random patient surveys were descriptively analyzed for clinical utilization, cost offsets, and member satisfaction compared with conventional medical IPA normative values. Comparisons to our original publication's comparative blinded data, using nonrandom matched comparison groups, were descriptively analyzed for differences in age/sex demographics and disease profiles to examine sample bias.
RESULTS: Clinical and cost utilization based on 70,274 member-months over a 7-year period demonstrated decreases of 60.2% in-hospital admissions, 59.0% less hospital days, 62.0% less outpatient surgeries and procedures, and 85% less pharmaceutical costs when compared with conventional medicine IPA performance for the same health maintenance organization product in the same geography and time frame.
CONCLUSIONS: During the past 7 years, and with a larger population than originally reported, the CAM-oriented PCPs using a nonsurgical/nonpharmaceutical approach demonstrated reductions in both clinical and cost utilization when compared with PCPs using conventional medicine alone. Decreased utilization was uniformly achieved by all CAM-oriented PCPs, regardless of their licensure. The validity and generalizability of this observation are guarded given the lack of randomization, lack of statistical analysis possible, and potentially biased data in this population.
From the Full-Text Article:
Discussion:
Although it is not valid to make the assumption that the predictive vs actual utilization of medical expenditures is an accurate generalized measure of treatment efficacy, it is interesting to note that the utilization data are substantially lower during both eras of 1999 to 2002 and 2003 to 2005. This gives credence to the argument that the power to achieve reduced utilization is due to the underlying philosophy of medical management and not due to differences in PCP education or licensure. It would be interesting to know the normative ratio of predicted vs actual utilization of these relative cost value units for the HMO network as a whole, but this information is unavailable.
The escalation of medical expenditures remains an urgent problem. Conventional medical strategies for clinical improvement and cost containment are failing to achieve their target goals. [8-13] Many patients, looking for improved outcomes, commonly use CAM therapies mixed with conventional medical care without the oversight of a physician specializing in integrative medicine. The safety, efficacy, and cost effectiveness of this unsupervised concomitant use are unknown at this time. However, this study makes the observation that over a 7-year period, the cost outcomes of the integrative medicine IPA are below those of the conventional medical IPAs contracted with the HMO and that, concomitantly, the member satisfaction scores are higher than the conventional medical IPA's.
Along with the single targeted question on patient satisfaction, the HMO's independent quality control division analyzed approximately 50 other questions on the annual member survey to determine if a given IPA achieves “blue ribbon status.” The AMI's IPA has achieved blue ribbon status every year since its inception. In the AMI model, the annual onsite audit scores measuring IPA compliance with the HMO utilization management policies and procedures continue to be above the HMO network normative values. The AMI's annual audit scores in the years 2002-2005 for medical administration and medical management were between 97% and 100% in each category. The HMO minimum required score for IPA performance is 90%. This observation may demonstrate that it is possible to deliver CAM-oriented primary care in a highly regulated environment without compromising either quality or safety.
There are several limitations within this study. First, it is a limitation of the methodology that the data available to us did not allow for a regression analysis. Our analysis of utilization data was unfortunately limited to descriptive comparisons between the identified populations as subsets of the entire HMO population. As the necessary data for traditional statistical methods were unavailable to us, we attempted to assess possible population bias via other strategies. We acknowledge that the lack of statistical analysis may have led to a serious bias. However, even without the ability to complete a statistical analysis and with the potential for bias, these preliminary data are important to present within the medical community. Likewise, attempted statistical analysis might have implied results beyond the methodological capacity of this study. Second, this article is an observational report and does not claim to report causal outcomes but rather the continued long-term observational correlation in decreased utilization seen by enrolled members of an integrative medical model. It is one of the few medical models where concomitant use of both conventional and CAM-oriented treatments is supervised by a licensed health care professional with expertise in both arenas. Third, based on the methods of this study, there is some question about scientific reproducibility. A randomized clinical trial would be necessary to determine if the alternative medicine IPA had a different utilization rate and cost outcome than the conventional IPA. Finally, we were not able to control for differences in baseline characteristics between the integrative medicine group and the conventional IPA. If the baseline demographic or clinical factors differed between the groups, the data may be seriously biased in either direction.
In its effort to improve outcomes, the lay public continues to increase its CAM-oriented utilization; and CAM providers of all licensures continue to slowly gain acceptance within the conventional medical arena. It is clear, however, that not all CAM therapies are efficacious for all disease states. [14-16] Although a blinded, randomized controlled trial isolating individual CAM therapies targeting individual disease states is beyond the scope of this endeavor, it is of great interest that the correlation of decreased utilization of standard managed care benchmarks is seen across the board for the variety of medical conditions reported in the IPA's enrolled population.
Early results from AMI's Integrated Therapies Demonstration Project, a utilization and cost analysis study for the treatment of chronic pain produced for the Florida Agency of Health Care Administration, suggest that the integrative medical strategies, which are the core component of AMI's medical management, seem to be generalizable to other populations, such as Medicaid/Medipass and targeted disease states in a more classic disease management model.
Conclusion:
Although the generalizability of such observations is always in question, the IPA model presented here is correlated with a decrease in clinical utilization and cost outcomes, compared with conventional medical strategies, over an extended period and in a safe and highly regulated environment. The consistent decrease in cost and care utilization achieved by AMI's integrative medical management strategy over a 7-year time frame warrants larger independent third-party funding for multicenter, randomized controlled trials.
for Back Pain in Primary Care
FROM: British Medical Journal 2004 (Dec 11); 329 (7479): 1381 ~ FULL TEXT
Findings from the:
“United Kingdom Back Pain Exercise and Manipulation (UK BEAM) Randomised Trial”
DISCUSSION:
We believe that this is the first study of physical therapy for low back pain to show convincingly that both manipulation alone and manipulation followed by exercise provide cost effective additions to care in general practice. Indeed, as we trained practice teams in the best care of back pain, we may have underestimated the benefit of physical therapy (spinal manipulation) when compared with "usual care" in general practice. The detailed clinical outcomes reported in the accompanying paper reinforce these findings by showing that the improvements in health status reported here reflect statistically significant improvements in function, pain, disability, physical and mental aspects of quality of life, and beliefs about back pain. [1]
Effects of a Managed Chiropractic Benefit on the Use
of Specific Diagnostic and Therapeutic Procedures
in the Treatment of Low Back and Neck Pain
FROM: J Manipulative Physiol Ther 2005 (Oct); 28 (8): 564–569
Nelson CF, Metz RD, LaBrot T
Health Services Research, American Specialty Health, San Diego, CA 92101, USA. craign@ashn.com
OBJECTIVE: The aim of this study was to measure the effects of a managed chiropractic benefit on the rates of specific diagnostic and therapeutic procedures for the treatment of back pain and neck pain.
DESIGN: This study is a retrospective analysis of claims data from a managed-care health plan over a 4-year period. The use rates of advanced imaging, surgery, inpatient care, and plain-film radiographs were compared between employer groups with and without a chiropractic benefit.
RESULTS: For patients with low back pain, the use rates of all 4 studied procedures were lower in the group with chiropractic coverage. On a per-episode basis, the rates in the group with coverage were reduced by the following: surgery (-32.1%); computed tomography (CT)/magnetic resonance imaging (MRI) (-37.2%); plain-film radiography (-23.1%); and inpatient care (-40.1%). On a per-patient basis, the rates were reduced by the following: surgery (-13.7%); CT/MRI (-20.3%); plain-film radiography (-2.2%); and inpatient care (-24.8%). For patients with neck pain, the use rates were reduced per episode in the group with chiropractic coverage as follows: surgery (-49.4%); CT/MRI (-45.6%); plain-film radiography (-36.0%); and inpatient care (-49.5%). Per patient, the rates were surgery (-31.1%); CT/MRI (-25.7%); plain-film radiography (-12.5%); and inpatient care (31.1%). All group differences were statistically significant.
CONCLUSIONS: For the treatment of low back and neck pain, the inclusion of a chiropractic benefit resulted in a reduction in the rates of surgery, advanced imaging, inpatient care, and plain-film radiographs. This effect was greater on a per-episode basis than on a per-patient basis.
Clinical Utilization and Cost Outcomes from an Integrative Medicine Independent Physician Association:
An Additional 3-year Update
FROM: J Manipulative Physiol Ther 2007 (May); 30 (4): 263–269
Richard L. Sarnat, MD, James Winterstein, DC, Jerrilyn A. Cambron, DC, PhD
Alternative Medicine Integration Group, LP, Highland Park, Ill 60035, USA. rsarnat@amibestmed.com
OBJECTIVE: Our initial report analyzed clinical and cost utilization data from the years 1999 to 2002 for an integrative medicine independent physician association (IPA) whose primary care physicians (PCPs) were exclusively doctors of chiropractic. This report updates the subsequent utilization data from the IPA for the years 2003 to 2005 and includes first-time comparisons in data points among PCPs of different licensures who were oriented toward complementary and alternative medicine (CAM).
METHODS: Independent physician association-incurred claims and stratified random patient surveys were descriptively analyzed for clinical utilization, cost offsets, and member satisfaction compared with conventional medical IPA normative values. Comparisons to our original publication's comparative blinded data, using nonrandom matched comparison groups, were descriptively analyzed for differences in age/sex demographics and disease profiles to examine sample bias.
RESULTS: Clinical and cost utilization based on 70,274 member-months over a 7-year period demonstrated decreases of 60.2% in-hospital admissions, 59.0% less hospital days, 62.0% less outpatient surgeries and procedures, and 85% less pharmaceutical costs when compared with conventional medicine IPA performance for the same health maintenance organization product in the same geography and time frame.
CONCLUSIONS: During the past 7 years, and with a larger population than originally reported, the CAM-oriented PCPs using a nonsurgical/nonpharmaceutical approach demonstrated reductions in both clinical and cost utilization when compared with PCPs using conventional medicine alone. Decreased utilization was uniformly achieved by all CAM-oriented PCPs, regardless of their licensure. The validity and generalizability of this observation are guarded given the lack of randomization, lack of statistical analysis possible, and potentially biased data in this population.
From the Full-Text Article:
Discussion:
Although it is not valid to make the assumption that the predictive vs actual utilization of medical expenditures is an accurate generalized measure of treatment efficacy, it is interesting to note that the utilization data are substantially lower during both eras of 1999 to 2002 and 2003 to 2005. This gives credence to the argument that the power to achieve reduced utilization is due to the underlying philosophy of medical management and not due to differences in PCP education or licensure. It would be interesting to know the normative ratio of predicted vs actual utilization of these relative cost value units for the HMO network as a whole, but this information is unavailable.
The escalation of medical expenditures remains an urgent problem. Conventional medical strategies for clinical improvement and cost containment are failing to achieve their target goals. [8-13] Many patients, looking for improved outcomes, commonly use CAM therapies mixed with conventional medical care without the oversight of a physician specializing in integrative medicine. The safety, efficacy, and cost effectiveness of this unsupervised concomitant use are unknown at this time. However, this study makes the observation that over a 7-year period, the cost outcomes of the integrative medicine IPA are below those of the conventional medical IPAs contracted with the HMO and that, concomitantly, the member satisfaction scores are higher than the conventional medical IPA's.
Along with the single targeted question on patient satisfaction, the HMO's independent quality control division analyzed approximately 50 other questions on the annual member survey to determine if a given IPA achieves “blue ribbon status.” The AMI's IPA has achieved blue ribbon status every year since its inception. In the AMI model, the annual onsite audit scores measuring IPA compliance with the HMO utilization management policies and procedures continue to be above the HMO network normative values. The AMI's annual audit scores in the years 2002-2005 for medical administration and medical management were between 97% and 100% in each category. The HMO minimum required score for IPA performance is 90%. This observation may demonstrate that it is possible to deliver CAM-oriented primary care in a highly regulated environment without compromising either quality or safety.
There are several limitations within this study. First, it is a limitation of the methodology that the data available to us did not allow for a regression analysis. Our analysis of utilization data was unfortunately limited to descriptive comparisons between the identified populations as subsets of the entire HMO population. As the necessary data for traditional statistical methods were unavailable to us, we attempted to assess possible population bias via other strategies. We acknowledge that the lack of statistical analysis may have led to a serious bias. However, even without the ability to complete a statistical analysis and with the potential for bias, these preliminary data are important to present within the medical community. Likewise, attempted statistical analysis might have implied results beyond the methodological capacity of this study. Second, this article is an observational report and does not claim to report causal outcomes but rather the continued long-term observational correlation in decreased utilization seen by enrolled members of an integrative medical model. It is one of the few medical models where concomitant use of both conventional and CAM-oriented treatments is supervised by a licensed health care professional with expertise in both arenas. Third, based on the methods of this study, there is some question about scientific reproducibility. A randomized clinical trial would be necessary to determine if the alternative medicine IPA had a different utilization rate and cost outcome than the conventional IPA. Finally, we were not able to control for differences in baseline characteristics between the integrative medicine group and the conventional IPA. If the baseline demographic or clinical factors differed between the groups, the data may be seriously biased in either direction.
In its effort to improve outcomes, the lay public continues to increase its CAM-oriented utilization; and CAM providers of all licensures continue to slowly gain acceptance within the conventional medical arena. It is clear, however, that not all CAM therapies are efficacious for all disease states. [14-16] Although a blinded, randomized controlled trial isolating individual CAM therapies targeting individual disease states is beyond the scope of this endeavor, it is of great interest that the correlation of decreased utilization of standard managed care benchmarks is seen across the board for the variety of medical conditions reported in the IPA's enrolled population.
Early results from AMI's Integrated Therapies Demonstration Project, a utilization and cost analysis study for the treatment of chronic pain produced for the Florida Agency of Health Care Administration, suggest that the integrative medical strategies, which are the core component of AMI's medical management, seem to be generalizable to other populations, such as Medicaid/Medipass and targeted disease states in a more classic disease management model.
Conclusion:
Although the generalizability of such observations is always in question, the IPA model presented here is correlated with a decrease in clinical utilization and cost outcomes, compared with conventional medical strategies, over an extended period and in a safe and highly regulated environment. The consistent decrease in cost and care utilization achieved by AMI's integrative medical management strategy over a 7-year time frame warrants larger independent third-party funding for multicenter, randomized controlled trials.
Friday, June 18, 2010
Onions and Flu Remedy - Old Wives Tale ?
ONION
In 1919 when the flu killed 40 million people there was this Doctor that visited the many
farmers to see if he could help them combat the flu.
Many of the farmers and their family had contracted it and many died.
The doctor came upon this one farmer and to his surprise, everyone was very healthy.
When the doctor asked what the farmer was doing that was different the wife replied
that she had placed an unpeeled onion in a dish in the rooms of the home,
(probably only two rooms back then). The doctor couldn't believe it and asked if
he could have one of the onions and place it under the microscope. She gave him one
and when he did this, he did find the flu virus in the onion. It obviously absorbed the bacteria,
therefore, keeping the family healthy.
Now, I heard this story from my hairdresser in AZ. She said that several years ago
many of her employees were coming down with the flu and so were many of her customers.
The next year she placed several bowls with onions around in her shop. To her surprise,
none of her staff got sick. It must work.. (And no, she is not in the onion business.)
The moral of the story is, buy some onions and place them in bowls around your home.
If you work at a desk, place one or two in your office or under your desk or even
on top somewhere. Try it and see what happens. We did it last year and we never
got the flu.
If this helps you and your loved ones from getting sick, all the better.
If you do get the flu, it just might be a mild case..
Whatever, what have you to lose? Just a few bucks on onions!!!!!!!!!!!!!!
Now there is a P. S. to this for I sent it to a friend in Oregon who regularly contributes
material to me on health issues. She replied with this most interesting experience about onions:
Weldon,
Thanks for the reminder. I don't know about the farmers story...but, I do know that
I contacted pneumonia and needless to say I was very ill...I came across an article
that said to cut both ends off an onion put one end on a fork and then place the forked
end into an empty jar...placing the jar next to the sick patient at night. It said the onion
would be black in the morning from the germs...sure enough it happened just like that...
the onion was a mess and I began to feel better.
Another thing I read in the article was that onions and garlic placed around the room
saved many from the black plague years ago. They have powerful antibacterial,
antiseptic properties.
This is the other note.
LEFT OVER ONIONS ARE POISONOUS
I have used an onion which has been left in the fridge, and sometimes I don't use a whole one at one time,
so save the other half for later.
Now with this info, I have changed my mind....will buy smaller onions in the future.
I had the wonderful privilege of touring Mullins Food Products, Makers of mayonnaise. Mullins is huge,
and is owned by 11 brothers and sisters in the Mullins family. My friend, Jeanne, is the CEO.
Questions about food poisoning came up, and I wanted to share what I learned from a chemist.
The guy who gave us our tour is named Ed.. He's one of the brothers Ed is a chemistry expert and is involved
in developing most of the sauce formula. He's even developed sauce formula for McDonald's.
Keep in mind that Ed is a food chemistry whiz. During the tour, someone asked if we really needed to worry
about mayonnaise. People are always
worried that mayonnaise will spoil. Ed's answer will surprise you. Ed said that all commercially-
made Mayo is completely safe.
"It doesn't even have to be refrigerated. No harm in refrigerating it, but it's not really necessary."
He explained that the pH in mayonnaise is set
at a point that bacteria could not survive in that environment. He then talked about the quaint essential picnic,
with the bowl of potato salad
sitting on the table and how everyone blames the mayonnaise when someone gets sick.
Ed says that when food poisoning is reported, the first thing the officials look for is when the 'victim'
last ate ONIONS and where those onions came from (in the potato salad?). Ed says it's not the mayonnaise
(as long as it's not homemade Mayo) that spoils in the outdoors. It's probably the
onions, and if not the onions, it's the POTATOES.
He explained, onions are a huge magnet for bacteria, especially uncooked onions. You should never plan to
keep a portion of a sliced onion.. He says it's not even safe if you put it in a zip-lock bag and put it in your refrigerator.
It's already contaminated enough just by being cut open and out for a bit, that it can be a danger to you
(and doubly watch out for those onions you put in your hotdogs at the baseball park!)
Ed says if you take the leftover onion and cook it like crazy you'll probably be okay, but if you slice that
leftover onion and put on your sandwich, you're asking for trouble. Both the onions and the moist potato
in a potato salad, will attract and grow bacteria faster than any
commercial mayonnaise will even begin to break down.
So, how's that for news? Take it for what you will. I (the author) am going to be very careful about my
onions from now on. For some reason, I see a lot of credibility coming from a chemist and a company that
produces millions of pounds of mayonnaise every year.'
Also, dogs should never eat onions. Their stomachs cannot metabolize onions .Please remember it is
dangerous to cut onions and try to use it to cook the next day ,it becomes highly poisonous for even a
single night and creates Toxic bacteria which may cause Adverse Stomach infections because of
excess Bile secretions and even Food poisoning.
Please pass it on to all you love and care for.
In 1919 when the flu killed 40 million people there was this Doctor that visited the many
farmers to see if he could help them combat the flu.
Many of the farmers and their family had contracted it and many died.
The doctor came upon this one farmer and to his surprise, everyone was very healthy.
When the doctor asked what the farmer was doing that was different the wife replied
that she had placed an unpeeled onion in a dish in the rooms of the home,
(probably only two rooms back then). The doctor couldn't believe it and asked if
he could have one of the onions and place it under the microscope. She gave him one
and when he did this, he did find the flu virus in the onion. It obviously absorbed the bacteria,
therefore, keeping the family healthy.
Now, I heard this story from my hairdresser in AZ. She said that several years ago
many of her employees were coming down with the flu and so were many of her customers.
The next year she placed several bowls with onions around in her shop. To her surprise,
none of her staff got sick. It must work.. (And no, she is not in the onion business.)
The moral of the story is, buy some onions and place them in bowls around your home.
If you work at a desk, place one or two in your office or under your desk or even
on top somewhere. Try it and see what happens. We did it last year and we never
got the flu.
If this helps you and your loved ones from getting sick, all the better.
If you do get the flu, it just might be a mild case..
Whatever, what have you to lose? Just a few bucks on onions!!!!!!!!!!!!!!
Now there is a P. S. to this for I sent it to a friend in Oregon who regularly contributes
material to me on health issues. She replied with this most interesting experience about onions:
Weldon,
Thanks for the reminder. I don't know about the farmers story...but, I do know that
I contacted pneumonia and needless to say I was very ill...I came across an article
that said to cut both ends off an onion put one end on a fork and then place the forked
end into an empty jar...placing the jar next to the sick patient at night. It said the onion
would be black in the morning from the germs...sure enough it happened just like that...
the onion was a mess and I began to feel better.
Another thing I read in the article was that onions and garlic placed around the room
saved many from the black plague years ago. They have powerful antibacterial,
antiseptic properties.
This is the other note.
LEFT OVER ONIONS ARE POISONOUS
I have used an onion which has been left in the fridge, and sometimes I don't use a whole one at one time,
so save the other half for later.
Now with this info, I have changed my mind....will buy smaller onions in the future.
I had the wonderful privilege of touring Mullins Food Products, Makers of mayonnaise. Mullins is huge,
and is owned by 11 brothers and sisters in the Mullins family. My friend, Jeanne, is the CEO.
Questions about food poisoning came up, and I wanted to share what I learned from a chemist.
The guy who gave us our tour is named Ed.. He's one of the brothers Ed is a chemistry expert and is involved
in developing most of the sauce formula. He's even developed sauce formula for McDonald's.
Keep in mind that Ed is a food chemistry whiz. During the tour, someone asked if we really needed to worry
about mayonnaise. People are always
worried that mayonnaise will spoil. Ed's answer will surprise you. Ed said that all commercially-
made Mayo is completely safe.
"It doesn't even have to be refrigerated. No harm in refrigerating it, but it's not really necessary."
He explained that the pH in mayonnaise is set
at a point that bacteria could not survive in that environment. He then talked about the quaint essential picnic,
with the bowl of potato salad
sitting on the table and how everyone blames the mayonnaise when someone gets sick.
Ed says that when food poisoning is reported, the first thing the officials look for is when the 'victim'
last ate ONIONS and where those onions came from (in the potato salad?). Ed says it's not the mayonnaise
(as long as it's not homemade Mayo) that spoils in the outdoors. It's probably the
onions, and if not the onions, it's the POTATOES.
He explained, onions are a huge magnet for bacteria, especially uncooked onions. You should never plan to
keep a portion of a sliced onion.. He says it's not even safe if you put it in a zip-lock bag and put it in your refrigerator.
It's already contaminated enough just by being cut open and out for a bit, that it can be a danger to you
(and doubly watch out for those onions you put in your hotdogs at the baseball park!)
Ed says if you take the leftover onion and cook it like crazy you'll probably be okay, but if you slice that
leftover onion and put on your sandwich, you're asking for trouble. Both the onions and the moist potato
in a potato salad, will attract and grow bacteria faster than any
commercial mayonnaise will even begin to break down.
So, how's that for news? Take it for what you will. I (the author) am going to be very careful about my
onions from now on. For some reason, I see a lot of credibility coming from a chemist and a company that
produces millions of pounds of mayonnaise every year.'
Also, dogs should never eat onions. Their stomachs cannot metabolize onions .Please remember it is
dangerous to cut onions and try to use it to cook the next day ,it becomes highly poisonous for even a
single night and creates Toxic bacteria which may cause Adverse Stomach infections because of
excess Bile secretions and even Food poisoning.
Please pass it on to all you love and care for.
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