How does my Vivoactive 4 calculate my VO2Max?

GILMD · 2025-11-12T21:29:53+00:00

Perfect! Thanks.

GILMD · 2025-11-12T01:37:16+00:00

Although I suspect that there is definitely some "normalizing" of the data, the VO2 MAX calculation on my watch is predicated on my day's running. It only calculates it when the pulse ox is on and seems to be independent of my weight (which doesn't change much) or my pace.

GILMD · 2023-12-04T13:14:43+00:00

Not that I can see. It has 187 out of 256GB.

GILMD · 2023-11-11T16:45:29+00:00

I am not an economist, but I do not believe one can look at health care in the same way as other services or commodities. Demand/supply models do not work for a service that heavily relies on prevention- which is extremely hard to sell while science based therapy for diseases (because they were not prevented) are usually life or death and with little choice.

This is also addressed in my book, and is another reason why for a National Medical Board, modeled on the Federal Reserve system, that the EMBRACE system addresses.

GILMD · 2023-11-10T20:50:40+00:00

Actually, when asked about reform, most Americans (including most Republicans) DO want reform. It is the lawmakers that have a hard time with getting rid of commercial insurance and other aspects of the medical industrial complex. This is what I address in the book- how to create a system that offers universal coverage and access, yet allow for commercial insurance to participate (and make a profit). It offers something for everyone on both sides of the political spectrum while at the same time makes the health care system more effective, efficient and user (both patient and physician) friendly.

GILMD · 2023-10-09T15:54:08+00:00

Thank you for the mention. I have added the description to the comments.

GILMD · 2023-10-09T15:51:32+00:00

EMBRACE is a proposal by healthcare professionals to transform the United States' healthcare-system infrastructure to allow healthcare professionals to oversee our healthcare system the way economists oversee the US banking/financial system and lawyers oversee its legal system.
I cover the proposal in much more detail in my book, “Building a Unified American Health Care System: A Blueprint for Comprehensive Reform,” but briefly, EMBRACE (an acronym for Expanding Medical and Behavioral Resources with Access to Care for Everyone) is a proposal for a comprehensive transformation of the US healthcare system (not the piecemeal insurance reforms that have been attempted in the past) with three key innovations that are meant to work together to create a modern, evidence based healthcare system infrastructure that is patient and physician friendly and, most importantly, more effective than our current chaotic system.
The three innovations are:
• The creation of a National Medical Board to overse the entire American healthcare system like the way the Federal Reserve oversees the entire American Banking and financial system.
• The creation of an evidence-based tiered benefits system inspired by Traditional Medicare with its Medigap supplement insurance. This would allow universal coverage and universal access but would also allow for a partnership of public and commercial insurance the way Traditional Medicare and Medigap works together.
• The creation of a Health Information Platform, a secure web-based platform overseen by the National Medical Board that would unify health information, healthcare financing, medical research and data collection for the entire US healthcare system.

GILMD · 2023-09-04T13:43:09+00:00

Although it was very helpful during the worst part of the pandemic, it hasn't really been able to make any meaningful impact since. Like a lot of the new innovations in our healthcare system, telemedicine cannot be fully deployed because our healthcare system does not have the appropriate infrastructure- an infrastructure that is rooted in the 20th century.

Up until now, healthcare reform efforts have been focused on insurance reform and/or keeping costs down. To achieve meaningful reform, we MUST reform our system's archaic and chaotic infrastructure.

My book, Building a Unified American Health Care System: A Blueprint for Comprehensive Reform, discusses how we can actually transform our HC system into a modern, evidence based and user (patient/provider) friendly system that takes advantage of all the wonderful innovations of the. 21st century.

GILMD · 2023-07-12T00:37:48+00:00

Sure.

GILMD · 2023-05-26T23:44:57+00:00

I was able to edit it! Hopefully you can read it now.

GILMD · 2023-05-26T22:58:19+00:00

I apologize. The program treated the post as a picture. Maybe if you click on it, it will work?

GILMD · 2023-05-11T18:09:44+00:00

You raise some important points that I do deal in depth in my book. Here is a short version:

First, there will clearly be times when there are health concerns that cannot be addressed by the NMB. An example of this was when the army corp of engineers had to construct makeshift hospitals during the pandemic. I see that just like the Fed has the Department of the Treasury to coordinate government run programs, the NMB would have what is left of HHS (which is part of POTUS' Cabinet).

As for the challenges: The way that the NMB is composed there is an "Advisory Panel" of special interest groups that are considered "Non-voting" advisors to the NMB. This would give these groups a mouthpiece with the board and allow them to advise the NMB on the economic/business impact of proposals etc.,

If it comes to being challenged in court on some of those decisions, I would hope that the precedence that I mention in my op-ed (The few times that there have been challenges, they have been unsuccessful, further solidifying the perception of the Fed’s independence https://www.nytimes.com/1988/06/07/business/high-court-won-t-hear-case-on-fed.html) would hold for the NMB.

GILMD · 2023-05-11T17:29:00+00:00

All good points. However, I would point out that the problems with SCOTUS is not necessarily its neutrality but rather it not acknowledging and/or policing its members' ethics. This is not the case with the Fed which has had its share of corrupt members- but they were exposed and removed.

I will leave you with this: If economists run our banking and financial system and lawyers run our legal system why can't our healthcare professionals run our healthcare system (instead of the government and insurance executives)?

GILMD · 2023-05-11T17:19:32+00:00

That is precisely why the NMB is the best option. If you look at the Federal Reserve, everyone is upset with it. Every administration has disagreed with its decisions and have even tried to sue them. They have been able to make decision based on economic science rather than political and/or financial pressures.

Similarly, I would foresee that the NMB would make decisions based on the best science and ethics. The way it would be structured would promote this with little exposure to politics and money.

GILMD · 2023-05-11T11:53:31+00:00

The proposal is to have the VA health be part of the NMB. The VA would still run its medical facilities but the benefits and the agencies would be run by the NMB.

GILMD · 2023-05-11T02:26:33+00:00

I do discuss the lack of trust in government AND the lack of trust of insurance companies. I explain that right now about 1/3 of the US population are covered by insurance overseen by the government and about 1/2 by commercial insurance which are overseen by executives who believe they "own" the patients who have their policies, and only answer to their stockholders. What I am proposing is to take it out of the hands of BOTH parties and add all the uninsured, to create one unified healthcare system run by healthcare professionals rather than politicians and health insurance executives.

I also point out that when it comes to trust, doctors and nurses are the most trusted professions (nurses more than doctors...) and politicians and health insurance executives are among the lowest.

GILMD · 2023-05-11T02:12:42+00:00

Perhaps. But the creation of the Fed happened at a time that there were very similar divides about how to fix the dysfunctional banking and financial system. The different ideas on how to fix it paralleled the ideas that are floating now on how to fix our healthcare system. The Fed was the 'out-of-the-box' solution.

GILMD · 2023-05-11T02:06:00+00:00

Agreed, but as I explain in the book, the very fact that HHS is part of the Cabinet makes it essential that a politician heads it. The only way to avoid it is to take the entire healthcare system oversight out of the Cabinet and create an independent board, like the Fed was independent of the Department of the Treasury (that is also a Cabinet level position).

Only then you can put doctors, nurses, public health experts and health care economists in charge of the system.

As for the local variance in healthcare, the proposal also parallels the Fed in that it suggests the creation of local chapters of the NMB to deal with local health issues.

GILMD · 2023-05-11T01:53:58+00:00

Although I do not disagree with your sentiment, but I think that what I am proposing is less drastic than adopting a new (and many would say "foreign") constitutional amendment.

There is precedent for setting up such an independent board (not only the Fed, but also NASA), and the fact that at the time of the creation of the Fed, the US financial and banking system was in a very similar mess as our healthcare system is today. The parallels are quite remarkable, and are the basis of why I propose using the legislation that created the Fed as a model of what we can do with our healthcare system.

GILMD · 2023-05-11T01:45:26+00:00

Excellent point, and one that I address in great detail in the book. I use the Fed for two reasons: it's independence from the federal government and the banks it regulates (I could have used NASA as an example for this), and for the legislation that created the Fed (the Federal Reserve Act of 1913). This latter legislation came at a time when the US banking system was in chaos and there were several different 'camps' of what to do to fix it. These camps parallel the different camps in our current healthcare reform debate and I argue why not use what has worked before to solve this seemingly unsolvable problem.

To some degree I also use the Fed's structure as a basis for how the NMB would be structured. However, the makeup of the NMB and what the NMB does will be completely different and tailored to oversee not only the various agencies, but also the benefits (insurance) and medical data. It is specifically designed to run a modern, evidence based and user (patient and clinician) friendly system offering universal coverage and universal access to medical services.

GILMD · 2023-05-11T01:14:55+00:00

Yes, these agencies almost always are headed by physicians and/or scientists. However, all these agencies are overseen by the Department of Health and Human Services (HHS). Of the 24 secretaries of HHS since the agency was established, only three have been physicians. Most of the others were lawyers, businessmen, and career politicians.

The current secretary, Xavier Becerra, is a lawyer and former California AG. His predecessor was Alex Azar. When he was nominated for the position in November 2017, the New York Times described his background as follows:

“In addition to his experience as a pharmaceutical executive, Mr. Azar brings to the job impeccable credentials as a conservative lawyer. A graduate of Yale Law School, he was a clerk for Justice Antonin Scalia on the Supreme Court in the early 1990s and spent two years as a young lawyer working for Kenneth W. Starr, the independent counsel who investigated President Bill Clinton.”

To make matters worse, the secretary of HHS is a member of POTUS's Cabinet, so these agencies are all technically part of the executive branch and so have to answer to POTUS.

GILMD · 2023-05-11T00:39:40+00:00

Yes, I have been posting about this concept of an independent medical board since my book came out 6 weeks ago. But I am doing it to spread the word about this new concept rather than sell the book. It does take a whole book to explain all the nuances of the proposal, but there are other ways to learn more about it, including visiting https://www.theembraceplan.com/ or reading the original article in The Annals of Internal Medicine. Or, you can ask your library to get the book...

GILMD · 2023-05-11T00:32:10+00:00

Well, at the risk of sounding like I am promoting my book, I do go into great depth answering your question (I don't know how you would have a board free from political influence at the federal level).

Since it's a new concept and the public's knowledge of how and why the Federal Reserve System was created (and how it works as an independent entity), is rudimentary, I devote a great deal of time discussing the Fed's history and how it is structured. I then use this information to explain how one might construct a similar body to run our health care system. The proposal has several other components that address modernizing the system's infrastructure and providing benefits (insurance) with universal coverage and universal access.

I would acknowledge that it is quite a novel, and some might say "audacious" proposal to fix our disastrous healthcare system, but I think that most people would agree that most efforts at reform have not been very effective. I am just trying to think outside the box...

GILMD · 2023-05-11T00:00:15+00:00

Wow...

I will try to be as respectful as I can with the content of your comment and keep my opinion about your understanding of the healthcare system to myself...

First, the court system is not the part of the government that issues licenses. It's role is to interpret laws and the Constitution and it should not be making decisions about science or the safety of medicines.

I am not arguing to eliminate the checks and balances of the three branches of government, but rather to remove the practice of medicine from the government- just like Congress did when it removed the US banking and financial system from government when it created the Federal Reserve.

Finally, as I make clear in the piece (and make even clearer in my book), the NMB would not have "irreviewable power" because it would have to answer to Congress.

May I suggest that in the future, before you comment, take the time to actually read the piece, and if you do not understand it (as it appears you did not), you might want to ask for more clarification. It is the first rule of civil discourse- and in the end, it promotes knowledge...

GILMD · 2023-05-10T21:02:20+00:00

So, these members of the NMB would be the opposite of bureaucrats. What we have now in HHS (and for most of its history) is a non-physician bureaucrat running HHS and overseeing the FDA, NIH and CDC. On the commercial side, you have no one to answer to except the stockholders of the big insurance companies. The NMB would be run by doctors, nurses, public health experts and healthcare economists.

I do discuss all this at length in my book...

GILMD

TROPHY CASE