Online health sites | Salon Life
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: "The medical establishment, in fact, has taken way too much time to understand that the Internet is a disruptive innovation that has overturned the status quo. It has leveled the playing field between expert and novice -- in this case, doctor and patient. While some doctors like Haig may find that challenge threatening to their status as an expert, the Web is now providing the kind of information doctors need to be aware of if we want to continue to be good at our job, and the kind of trends that can help patients be smarter and healthier."
Source: The Patient's Doctor - May 17, 2008
e-patients: The Plausible Promise of Participatory Medicine
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: "Participatory medicine is what Eric Raymond calls a “plausible promise”: something big enough to inspire interest yet achievable enough to inspire confidence.Reforming health care is too big for most people to grasp; creating spaces for participatory medicine is not. E-patients are already finding, sharing, and mashing up health information online. If you want to take advantage of the internet’s capabilities, find ways to make it easier for people to find and share information that you and your organization hold."
Source: The Patient's Doctor - May 17, 2008
Health Management Rx
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: "If we use web-evolutionary terms to define the current position, then we can predict where Health 2.0, consumer-centric care - enabled by HIT but also ‘brick and mortar’ integration of wellness tech- will go…*Health 1.0 (1C) = content*Health 2.0 (2Cs) = content + community*Health 3.0 (3Cs) = content + community + commerce (transactions that create value for both company and consumer)*Health 4.0 (4Cs) = content + community + commerce + what we’re currently missing - coherence"
Source: The Patient's Doctor - May 17, 2008
Musings of a Medical Dinosaur
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: " * First Law: The Art of Medicine consists of amusing the patient while nature takes its course. * Second Law: It is impossible to make an asymptomatic patient feel better. * Third Law: The urgency of the test is inversely proportional to the IQ of the insurance company preauthorization clerk. * Fourth Law: There is no cure for stupid. * Fifth Law: A patient's acceptance of a screening test is inversely proportional to its necessity for that particular patient. * Sixth Law: Trauma survival is inversely related to the patient's value to society. * Seventh Law: Fertility is inversely proportional to intelligence. *...
Source: The Patient's Doctor - May 17, 2008
Concierge Medicine For the Masses
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Concierge Medicine For the Masses " Dr. Alan Dappen is available to his patients 24 hours a day, 7 days a week, by phone, email and in person. Visits may be scheduled on the same day if needed, prescriptions may be refilled any time without an office visit, he makes house calls, and all records are kept private and digital on a hard drive in his office.How much would it cost to have the luxury of a personal physician on-call for your every whim?Would you believe only about $300/year?What's Dr. Dappen's secret to success? He accepts no insurance, keeps his overhead low, offers full price transparency, has physician extender...
Source: The Patient's Doctor - May 17, 2008
Improving Patient Outcomes
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: "Physicians’ Records has designed a comprehensive service for the patient as well as physicians. The one tool that can provide a real difference for patients needing not only emergency healthcare, but also in their everyday follow-up care with Primary Care Providers and specialists.Our Registered Nurses provide direct support for patients that encompass archival and secure access to healthcare information, so they can be an integral participant in their healthcare outcome. The most important information that physicians in both emergent and non-emergent settings need to make decisions about patients is the ACTUAL record...
Source: The Patient's Doctor - May 17, 2008
Consumer-focused healthcare: Interview with Evan Falchuk of Best Doctors: Giving consumers the opportunity to double check diagnosis and treatment dec
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isions: "Well, first thing for a consumer is to make sure you’ve got that right diagnosis and treatment. Don’t assume, no matter how good your doctor is, and there are a lot of great doctors out there that you’ve got the right answer. So if you have a benefit like Best Doctors, call and ask for help. If not, perhaps you want to ask your employer, do we have this program? But ask questions. Become an informed patient, and make decisions based on the best information you can.VG: Right, so this kind of reinforces the point and it’s been a continuing theme—many doctors need to do things quickly and they’re forced b...
Source: The Patient's Doctor - May 17, 2008
Consumer-focused healthcare
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: "An interesting statistic is that about 75% of people will have a symptom of a health problem or a health problem within a 30-day period. And it’s also true that about 8 out of 10 of those people don’t ever enter the health care system. They figure out that they’ve got a cold and they’re just going to drink a lot of fluids and get better. Or that their child does not really have an ear infection—they make these decisions—this cut does not need stitches, and all those kinds of things. And so people already do a bunch of this stuff, and from a health plan side, there’s no claim, there’s no nothing, so peopl...
Source: The Patient's Doctor - May 17, 2008
Patient Records Need Reviews - WSJ.com
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: "With health-care costs rising fast and insurers more closely scrutinizing potential clients, consumers need to pay closer attention to what is in their medical records.Not only can incorrect medical information lead to ineffective or harmful treatment -- the Institute of Medicine estimates that as many as 98,000 patients die each year in hospitals from medical errors -- it can also affect your insurability.'You need to make sure you know what's in your medical records and correct any errors before you apply for insurance,' says Carolyn McClanahan, a certified financial planner in Jacksonville, Fla., and a former medical...
Source: The Patient's Doctor - May 17, 2008
Another Reason Patients Should Review Their Health Records
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: "This is another reason for routinely reviewing your health records. In an era of covert rationing, you can protect yourself by not exposing your doctors to the ever-present temptation to “spin” the records. (Some doctors are regular DJs.) If your doctor knows you are going to read whatever he puts down, he’s a lot less likely to color the story to your disadvantage.Indeed, for this very reason, DrRich would be especially suspicious of doctors who refuse to give you copies of your own health records."
Source: The Patient's Doctor - May 17, 2008
Why Americans Are Going Abroad for Health Care
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: "For someone such as Toral, the hypertrophied medical-industrial complex is just begging for a dose of disruptive innovation. He calls his vision the 'Toyota-ization of health care,' a metaphor so vast that it contains multiple readings, some fit for industry conferences and others he'll cop to only in confidence. In Toral's view, medical tourism as we know it is already giving way to 'globalized health care.' Hospital chains at home will buy, partner with, or even sell out to foreign rivals like Bumrungrad, creating worldwide networks of patients who will hopscotch across continents chasing the best care and costs. Insu...
Source: The Patient's Doctor - May 16, 2008
medinnovationblog: 25 Things I've Leaned about the Physician Culture
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: "25 Things I've Leaned about the Physician Culture .1. People become doctors to serve patients, not hospitals or business corporations.2. Patients are not “customers,” they’re individuals who need your help, even when that help may be expensive and experimental.3. Physicians are “the patient’s advocate,” a protector and guide through a world fraught with obstacles to care.4. Filling outforms frustrates doctors because paperwork takes time away from seeing patients: some doctors take hospital jobs because they can practice medicine rather than processing paper."
Source: The Patient's Doctor - May 16, 2008
Could that symptom be from your meds?
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: "4,000 Americans Die From Adverse Drug Effects Every Week . Protect Yourself and Your Loved Ones. Ask the First Question First: Could that symptom be from your meds? PharmaSURVEYOR is the fast online way to find out!Simply enter your current medications and review the risks. Search for your symptoms to see how your medications may be contributing to them. PharmaSURVEYOR identifies the compound risks associated with additive toxicities in addition to drug interactions, providing more complete risk assessment across your entire drug regimen."
Source: The Patient's Doctor - May 16, 2008
The Trillion Dollar Challenge
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: "My MD and Me spokesman said, 'If the patient does not pay the doctor a barrier is placed between them and costs are inflated. Think about it like a grocery store. You get coupons, great service. You know who offers the best value by shopping around, word of mouth from friends and reputations in the community. This changes if the customer stops paying the bill. What is the incentive to know the cost if you do not pay the bill? What is the stores' incentive to give good service? How does the consumer know who offers the best value?' he continued, 'Service naturally declines because the ?customer' is not the person getting...
Source: The Patient's Doctor - May 15, 2008
Successful Medical Practise Management
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Source: The Patient's Doctor - May 15, 2008
How Information Therapy can heal a sick healthcare system
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Source: The Patient's Doctor - May 15, 2008
Information Therapy and the Empowered Patient
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Source: The Patient's Doctor - May 15, 2008
Indian healthcare success story - Emergency Management and Research Institute
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: "EMRI (Emergency Management and Research Institute) is a pioneer in Emergency Management Services in India. It is a not - for - profit professional organization founded, funded and nurtured by Mr.B.Ramalinga Raju, founder and Chairman, Satyam Computers and his brothers. Operating in the Private Public Patrnership (PPP) mode, EMRI is the only professional Emergency Service Provider in India today.EMRI handles medical, police and fire emergencies through the ' 108 Emergency service'. This is a free service delivered through state- of -art emergency call response centres and over 610 ambulances accross Andhra Pradesh and Gu...
Source: The Patient's Doctor - May 15, 2008
Nagging via text messages to help teens remember meds
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: "4gt yr meds? Getting kids to remember their medicine may be a text message away. Cincinnati doctors are experimenting with texting to tackle a big problem: Tweens and teens too often do a lousy job of controlling chronic illnesses like asthma, diabetes or kidney disease.It's a problem long recognized in adults, particularly for illnesses that can simmer without obvious symptoms until it's too late. But only now are doctors realizing how tricky a time adolescence is for skipping meds, too.Of necessity, parents start turning over more health responsibilities to their children at this age. It's also an age of angst, someti...
Source: The Patient's Doctor - May 15, 2008
Could I Be Any Less Productive?
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Yesterday was a gorgeous day in America's 3rd world country. The sun was shining, it was not cold outside, the birds were singing, so after 2 attendings told me that I should take some time to enjoy it, I left. I wasn't getting much done anyway.Then, today, I've been trying to do some data analysis. One is from some genetic stuff, and it involves more than 2 million data points, and I did some of it by hand before and now the analysis is automated, and I'm trying to make sure I got different results because I made a mistake with the manual analysis (not a big stretch there).But mostly, I've spent the day reading blogs and ...
Source: Midwife with a Knife - May 14, 2008 Tags: research job search
Suture for a Living: Words to Live By
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: "'Although we may remember David Cheever as a surgical innovator, his character is more aptly revealed in the following passage from a lecture, delivered before the Harvard Medical School class of 1871, entitled “How to Study Medicine”: If you seek for wealth you have mistaken your avocation. There must be something more, and something higher. That something is a love of your profession; a passion for science for its own sake; a broad humanity, which covers all the sick with a mantle of charity. Never lose sight of that motive, for if it once takes flight, your profession is reduced to a trade, and there is absolute...
Source: The Patient's Doctor - May 14, 2008
Baltimore Health Examiner - Medical Information: tainted or pure? - Examiner.com
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: "Here’s a secret: the medical information that you hear, whether on the radio, on TV or straight from your doctor’s mouth, may not be as pure as you think. You might imagine that those medical experts on the morning news or big-shot specialists at Johns Hopkins are simply sharing straight-up facts. Think again.As much as we, physicians, like to imagine that we are unbiased, there are many forces influencing us. Drug companies dangling generous consulting fees, the desire to please media sponsors, and the need to recruit patients for our research studies just to name a few."
Source: The Patient's Doctor - May 14, 2008
Being an IVF specialist helps me to be a patient advocate !
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Source: The Patient's Doctor - May 14, 2008
Free ebook - How to Have a Baby - free download
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You can now download the book ( both as a pdf file and as an ebook) free at http://drop.io/howtohaveababy.
Source: The Patient's Doctor - May 14, 2008
allAfrica.com: Africa: Toll-Free Mobile Service to Give Rural Africa Access to Medics (Page 1 of 1)
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: "A toll-free mobile service being launched in selected remote areas in Africa promises to save lives by connecting people with emergency medical cases to health personnel.Under the initiative launched in Nairobi on Wednesday, health workers will also be trained through mobile phone sessions on day to day skills like collecting and sharing basic household health information.Telecommunication equipment provider Ericsson and mobile phone service provider Zain have adopted the new approach in a bid to stimulate the demand of mobile solutions in areas they consider commercially challenging."
Source: The Patient's Doctor - May 13, 2008
Do I Lie To You?
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So... my job search is progressing well. As it turns out, most people need MFMs as badly as I need a job. I didn't anticipate this little side effect of subspecialty training.... but it's good to be me, that way. 7 years of torture...erm, I mean training (as much as many neurosurgeons) ought to pay off some how.So here's the thing.... A lot of places are having me fill out these "I'm not a serial killer nor am I a convicted pedophile" forms for their credentialing committees before they even see me. For the most part, it's not a problem. I am, after all, not a serial killer, nor am I a pedophile.However, some of the forms...
Source: Midwife with a Knife - May 12, 2008 Tags: Society physician as patient personal stuff you don't want to read job search
Using Information Therapy to heal a sick healthcare system
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Patients and doctors both feel the healthcare system today is sick . One reason for this is because it is so doctor-centric. Healthcare is fragmented and disorganized and there are too many specialists , most of whom have tunnel vision. Often your cardiologist has no idea what your gastroenterologist is doing – and they are so focused on treating the heart or the liver, that they sometimes forget that these belong to a human being ! To reform the healthcare ecosystem we need to put patients at the center ! Patients ( or their relatives and friends) are intelligent and capable; and because they have a lot at stake , they...
Source: The Patient's Doctor - May 12, 2008
Happy Mother's Day
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to all of you Mothers, would-be-mothers, and glad-you-aren't-mothers, We had a great active weekend here. CindyLou had her 4th birthday party (dinosaur theme, of course, every girl's dream), and the Bean was baptized this weekend. I also was on call, but so far the call gods have been kind to us! May has been a crazy month, with lots of travel, and busy-ness in general. I am hopeful for the summer. I am looking to interview with other practices in the coming weeks. I am also going to meet "the other woman" this weekend at a mutual friend's wedding. Give me the strength to be civil and polite to this person with whom I reg...
Source: Ob/Gyn Kenobi - May 11, 2008 Tags: CindyLou Bean
What I'm Going to Do on My Summer Vacations
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That's right. Summer vacations. Our "vacation year" (is that a real term?) runs from July through June (like the academic year). I haven't taken real vacation in over a year, and I don't believe in letting vacation time go unused. So, I'm taking 3 weeks off, starting in 8 days. During that time, I will clean my house and go to visit my family. I'm hoping it will be relaxing, although there's always that family stuff. The fact that my mom always resents my visiting other people other than her (although, really, that shouldn't be my problem. I've taken to telling her my plans and expecting her to deal with it, which isn't a ...
Source: Midwife with a Knife - May 11, 2008 Tags: medical students rest Conferences family Sleep job search
In Other Words...Abbreviations, Acronyms, and Other Healthcare Shorthand - Health Literacy
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: "Frank Federico, RPh, is concerned about abbreviations and acronyms from a patient safety point of view. Federico is content director for the Institute for Healthcare Improvement in Cambridge, Massachusetts. One area that particularly concerns him is the use of abbreviations for medications.Federico says one of the more serious safety concerns is the fact that the meaning of an abbreviation may differ from one hospital to another. For example, depending on where you work, “MTX” could stand for either “methotrexate” or “mitoxantrone” (different drugs that are both used to treat certain kinds of cancer).Another...
Source: The Patient's Doctor - May 7, 2008
In Other Words...Helping Patients Separate True Health Information From False - Health Literacy
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: "Use external aids to improve accurate recall. To aid recall, Skurnik recommends the use of memory aids such as note taking, supplemental reading material, or using another person as a “second set of ears.” Memory aids can help to offset the fact that people may remember just bits and pieces of claims, especially when the situation — or context — is rushed, harried, or otherwise distracting, as is often the case in a clinical setting."
Source: The Patient's Doctor - May 7, 2008
medical travelers market - Mapping the market for medical travel - Health Care - Strategy & Analysis - The McKinsey Quarterly
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medical travelers market - Mapping the market for medical travel - Health Care - Strategy & Analysis - The McKinsey Quarterly: "Mapping the market for medical travel * Medical travel has captured the world’s attention and imagination, but a new McKinsey study suggests that the market isn’t as large as reported and that most medical travelers seek high quality and faster service instead of lower costs. * McKinsey places the current market at 60,000 to 85,000 inpatients a year, but these numbers could grow substantially if certain barriers, such as noncoverage from payers, were removed. Payers and providers looking...
Source: The Patient's Doctor - May 6, 2008
Challenging patients make our work interesting !
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Source: The Patient's Doctor - May 6, 2008
The Enquirer - Text messages help teens with asthma
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: " Tylor Thomas, 16, has never counted how many text messages he gets in a day, but it’s a lot.Tucked in among all those shout-outs from friends, one potentially lifesaving message arrives every morning around 9 for the Winton Hills teen.“They just text me and tell me, ‘Hi. Don’t forget to take your asthma meds,’” Tylor said.He’s one of a handful of teens participating in a Cincinnati Children’s Hospital Medical Center pilot project to determine how well text-message reminders work to help teens manage their asthma.If text messages are an effective solution for asthma management, there’s no reason the...
Source: The Patient's Doctor - May 6, 2008
Pleio Health Support Systems
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: "For millions of patients, new medications are often misunderstood or misused. Everyone has a parent, friend, brother or sister who fails to get the advice, encouragement or support they need when they need it. Most patients quickly abandon drug therapy; many times for the wrong reasons—and with serious consequences. Pleio brings people together to improve patients' experiences with new medications, for the benefit of patients, their families and the entire healthcare industry.Pleio GoodStart™ is a practical adherence support system for patients in the early adoption stage of a new medicine—the first 100 days. It...
Source: The Patient's Doctor - May 6, 2008
Personal Health Profiler: Part 1 | Trusted.MD Network
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: "I’m going to delve into the details of a truly next-generation personal health record (PHR). As I discussed in my last post, this paradigm-busting software technology is a radical departure from current day applications. It addresses this question: How can a computer help an individual and his/her healthcare professionals understand how the person’s health, wellbeing and quality of life are affected by his/her: * Thinking processes (one’s beliefs, attitudes, perceptions, etc.); * Emotional processes (how one feels in different situations and why); * Behavioral tendencies (including how and a person act in self-...
Source: The Patient's Doctor - May 6, 2008
HiFi's and Healthcare | Trusted.MD Network
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: "Specialty facilities can offer more expert care more quickly, and (perhaps) more cost-efficiently than traditional hospitals. They lack, of course, extended stay options; when my mother was recently hospitalized, she was taken first to the same facility as I had been, but had to be transported later that day to a 'regular' hospital. Still, we couldn't have known that at the time, and it seemed a reasonable choice.It seems to me that 'distributed healthcare' may be on the horizon. By unbundling services, providers can specialize more efficiently, which may lead to a reduction in the cost of health care (and hence, of hea...
Source: The Patient's Doctor - May 6, 2008
All you wanted to know about adoption in India !
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NAAF, the National Association for Adoptive Families in India, has published an excellent guide for prospective parents who want to adopt a baby. Unfortunately, this is now out of print, so we've uploaded this to the web ! It's a free download - and is packed with useful information !
Source: The Patient's Doctor - May 6, 2008
How Information Therapy can help to improve healthcare
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Traditionally, most of us think of Information Therapy as information which is prescribed by the doctor and administered to the patient. Actually, it can be much more than this !For one, Information Therapy can be dispensed by other healthcare professionals , such as pharmacists and X-ray technicians . At present, they are often underutilised. By getting them to teach patients, we can make more effective use of their skills. They much more likely to be experts in their area of interest ( for example, most pharmacists would know much more about drug interactions than the average doctor); and because they are much less intim...
Source: The Patient's Doctor - May 5, 2008
Costs of overtreating patients - Los Angeles Times
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DOCTORS ARE frequently criticized for the things they fail to do. In general, they don't spend enough time on patient education, don't provide adequate preventive care and don't treat many chronic disorders aggressively enough.These shortcomings are well-documented. An equally important problem that attracts less attention, however, is doctors who do too much. Whether it's ordering an unnecessary test or advocating an aggressive form of treatment over one that's more measured, the result is the same. Patients wind up getting more than they need.
Source: The Patient's Doctor - May 5, 2008
Self Indulgance and Exercise
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I have many posts I've been meaning to do.... home births, non-compliance, the rising c-section rate, teaching residents, the fact that nobody ever listens to me (heh!), but instead of blogging about something important, today I'm blogging about me...So, I've been on prednisone for the colitis for most of the past year, with doses averaging at about 20mg, but on 10 mg for the past couple of months (ever since I saw New GI Doc). I'm not symptom-free on 10mg, but my symptoms are manageable and tolerable on that dose. It's not a very high dose, but there's still a difference (for me) in side effects in being on 10mg vs 0 mg o...
Source: Midwife with a Knife - May 4, 2008 Tags: jogging kicking Exercise Culture of Medicine
The Democratization of Health Knowledge by Steve Denning, Guest Contributor « Lisa Neal
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: "Steve Denning wrote previously about The democratization of knowledge: anyone can know anything.“This phenomenon is particularly notable in the spontaneous formation of global communities of interest in the field of medical problems. Patients who were once at the mercy of doctors who had unique access to esoteric medical knowledge now find themselves able to contact other doctors and patients and explore their particular subject, gather new data, discover new leads for treatment, and learn how to cope with side effects. The emerging communities are global in nature. A patient in the US may be able to learn from a doct...
Source: The Patient's Doctor - May 4, 2008
Health 2.0 - Modern Healthcare Online
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: "The first principle, O’Reilly says, is the software of a Web 2.0 company has to be Web-based, has to provide a service and that service has to be structured so that the more people use it, the better it becomes. He described it as 'an architecture of participation.' An exemplar is eBay; as more and more buyers and sellers participate, the broader the eBay market becomes, which creates more value to the customer.O'Reilly calls the second key principle 'harnessing collective intelligence,' which also is referred to by others as 'the wisdom of crowds.' To avail themselves of this wisdom, Web 2.0 developers must create ap...
Source: The Patient's Doctor - May 4, 2008
The open-access medical office - Seeing patients when they want to be seen helps you respond to their needs and stay competi
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tive. - Medical Economics: "How important is open access? It's one of the seven core components of the medical office of the future as envisioned by TransforMED, a practice redesign initiative of the American Academy of Family Physicians. If you want more proof, witness the burgeoning growth of retail clinics and urgent care centers that patients can visit at the drop of a hat. For medical practices to compete, they'll need to be just as convenient.Beyond delighting patients with quick service, open-access scheduling produces a cascade of other benefits. Chief among them are a steep reduction in no-shows and cancellations ...
Source: The Patient's Doctor - May 3, 2008
Six Word Meme
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A long time ago, I was tagged by TBTAM for the six word memior meme. The instructions? Write a 6 word memior and tag 6 others. Catch a baby, watch the floor.I'll tag all three shrinks at shrink rap, someonetc, RLBates, and Mark's Tails.
Source: Midwife with a Knife - May 2, 2008 Tags: Memes
Literacy Partners of Manitoba - Plain Language Service
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: "Literacy and Health Manual. This workshop manual introduces health providers to the links between literacy and health and offers strategies for reaching clients with low literacy skills. Another cool tool is the ClearDoc Index which is a handy plain language checklist."
Source: The Patient's Doctor - May 1, 2008
Dispensing patient information
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If we all agree that information therapy needs to be prescribed, how do we ensure that it is efficiently dispensed ? One solution would be to have a patient education resource Center at every point of clinical care. This would include the doctor's clinic ; the pathology laboratory ; the diagnostic center; the pharmacy ; and the hospital. When someone falls sick, these are their contact points with the healthcare system. Each of these represents an opportunity to educate the patient. We all know that in order for an information prescription to be effective , this information should be provided at the point at which the pati...
Source: The Patient's Doctor - April 30, 2008
The doctor is part of the patient's tool-box of dealing with illness
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One of the problems with modern healthcare is the excessive importance given to doctors. When patients fall sick , they are very happy to dump their problems on the doctors's lap and they expect him to provide a quickfix. Unfortunately , this is an unrealistic expectation; and gives rise to a lot of unhappiness and stress both for patients and for doctors.An illness is just an episode in the patient's life; and that while the doctor usually sees only a disease which needs to be treated and is fixated on fixing the medical problem, the patient has a life which is much more than just his illness.One way of putting the patien...
Source: The Patient's Doctor - April 30, 2008
Learning health from the scriptures:
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" It is often said that Indians are fatalists who leave everything to fate or to God. The excuse patients usually quote is: "Our religion tells us that bodily sufferings are a result of sins incurred in our past life". This excuse is used to avoid taking medicines or insulin, and to explain inertia on part of the patient. "My sugar levels are always 400: they will never come down." What do our scriptures actually teach us? Lord Krishna exhorted Arjuna to fight the Mahabharata, not to bow before his enemies. Lord Ram and Hanumanji fought Ravana and his army of demons. Hindu scriptures talk of Gods fighting 'asuras'( demons...
Source: The Patient's Doctor - April 29, 2008
Patient Education in Ancient India
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" The treatise Sutrasthana mentions four essential parts of a successful treatment regime, known as The Quadruple of Atreya. The four components necessary to treat diabetes, or any other disease, are1.The Physician.2.Drugs.3.The Patient.4.Attendants. [ = Family = nurses]Just as successful cooking requires utensils, fuel /fire, food items and a cook, successful medicine requires all the above four. Similarly, the potter has to coordinate earth/clay, water and his wheel to create good pottery.And just as a strong table needs four equally stable legs to stand, all four components of the quadruple of Atreya have to be equall...
Source: The Patient's Doctor - April 29, 2008
