A city is an urban area with a large population and a particular administrative, legal, or historical status. Large industrialized cities generally have advanced systems for sanitation, utilities, land usage, housing, and transportation and more. This close proximity greatly facilitates interaction between people and firms, benefiting both parties in the process. However, there is debate now whether the age of technology and instantaneous communication with the use of the Internet are making cities obsolete. A big city, or metropolis, may have suburbs. Such cities are usually associated with metropolitan areas and urban sprawl, creating large numbers of business commuters. Once a city sprawls far enough to reach another city, this region can be deemed a conurbation or megalopolis.

Executive Health

Executive Health Practitioner Associations are coming together to customize health programs for groups of executives and independent businesses with an objective of reducing the lost productivity time. At the core of many Executive Healthcare packages is an Executive Physical. In many instances, the doctor will travel to company facilities in order to perform a basic physical for all executive members. In others, as in the case of Elite IPA (Independent Practitioner Association), the office visit is an option, but executives are given the benefit of in-depth diagnostic treatment, which allows for an even more in-depth analysis of their health than what is typical. This level of the physical exam, given at a time that is convenient for the executive, is to have a positive impact on the bottom line. The average wait to see a physician is 68 minutes. There is no wait with the IPA Health associates for executives. IPA works around the schedule. Nor does IPA rush the visit. The visit is complete only when all of the concerns and questions answered. For those who prefer to communicate in writing, IPA is only an e-mail away. IPA physicians travel with hand-held e-mail devices for quick responses. Furthermore, IPA does not rush the visit. The visit is complete only when all of the concerns and questions are answered. Of course, there are times when one just wants to speak directly with the doctor on the telephone. One of the first things given to a new IPA patient is the doctor’s personal cell phone number. Wherever business or pleasure takes you, IPA is just a phone call away. Turn to IPA’s Executive Health for a complete executive physical that looks at health from all angles. True health and wellness is only achieved when there is a good understanding of the family history and personal medical history. IPA offers the latest in both non-invasive and blood-based cardiovascular screening testing. For early cancer detection, there may be reason to consider modern scanning approaches, including the PET technology. The integration of state-of-the-art cancer detection approach is a major feature of the program, as is ready access to leading specialists for preventive consultations.

Adjustable Gastric Band

A laparoscopic adjustable gastric band, commonly referred to as a lap band, is an inflatable silicone device that a surgeon places around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. Adjustable gastric band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 40 or greater, or between 35 to 40 in cases of patients with certain co-morbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, high blood pressure or metabolic syndrome, among others. Gastric banding is the least invasive surgery of all bariatric surgeries. Gastric banding using laparoscopic surgery usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures. The patient can continue to absorb nutrients from food normally. Gastric bands are made entirely of biocompatible materials, so they can stay in the body without causing harm. However, not all patients are eligible for laparoscopy. Patients who are extremely obese, who have had previous abdominal surgery or have complicating medical problems may require a more open surgery approach. The surgeon creates a small incision near the belly button and pumps carbon dioxide into the abdomen to create a workspace. Then the surgeon inserts a small laparoscopic camera through the incision into the abdomen. The camera sends a picture of the stomach and abdominal cavity to a video monitor. It gives the surgeon a good view of the key structures in the abdominal cavity. The surgeon makes more small incisions in the abdomen. The surgeon watches the video monitor and works through these small incisions using instruments with long handles to complete the procedure. The surgeon creates a small, circular tunnel behind the stomach, inserts the gastric band through the tunnel and locks the band around the stomach. Clinical studies of laparoscopic bariatric surgery patients found that they felt better, spent more time doing recreational and physical activities, benefited from enhanced productivity and economic opportunities and had more self-confidence than they did before surgery. The placement of the band creates a small pouch, or stoma, at the top of the stomach. This pouch holds approximately one half cup of food. A typical stomach holds about six cups of food. The pouch fills with food quickly, and the band slows the passage of food from the pouch to the lower part of the stomach, causing the sensation of being full. As the upper part of the stomach registers as full, the message to the brain is that the entire stomach is full, and this sensation helps a person to be hungry less often, feel full more quickly and for a longer period, eat smaller portions, and lose weight over time. As patients lose weight, their bands will need adjustments, or "fills," to ensure comfort and effectiveness. The surgeon can adjust the gastric band by introducing a saline solution into a small access port just under the skin. There are many port designs and a surgeon may place them in varying positions, but they always connect to the muscle wall in and around the diaphragm via sutures or staples.

Overloaded Physicians

All of the professionals in our healthcare system struggle under the crushing weight of cost control measures imposed by insurers and medical institutions, which force doctors to minimize the time they spend assessing, treating, and discussing options with patients and their families. Protecting a family in an overtaxed healthcare system requires expertise. The statistics on medical errors, while often quoted, are still disturbing. In the United States, over 70,000 people die every year because of preventable medical errors that occur in hospitals. That means these avoidable mistakes kill more people than breast cancer or traffic accidents, making medical errors the eighth leading cause of death in the country. The report found that these errors were not the result of individual recklessness on the part of caregivers, but basic flaws in the organization of the American healthcare system. The treatment of over 50% of patients with diabetes, hypertension, tobacco addiction, hyperlipidemia, congestive heart failure, asthma, depression, and other chronic illness is inadequate. Due to cost constraints and resource limitations, doctors are not able to spend adequate time with their patients and do not necessarily have access to information on all available forms of treatment. In addition, when patients see more than one doctor, their care, medical records, and medications are rarely effectively coordinated. The burden of managing treatment most often falls on the shoulders of the patient and family who are already overwhelmed by having to deal with a serious illness. The average office visit is 10 minutes and physicians may be seeing as many as 40 patients a day. In addition, there are long waits for rushed appointments, the confusion about what types of care are available and best suit the needs, and the stress of navigating the U.S. healthcare system. When dealing with a serious medical situation, it is only natural to be overwhelmed. People tend to be confused about their options and too distracted or upset to ask the important questions. IPA Health provides private health management services.

Minimal Scar

Minimal scar surgery uses modern techniques to reduce scars and avoid visible scarring. Minimal-incision or endoscopic surgery is performed using a tiny fiber optic lens inserted through half-inch incisions placed inconspicuously in your skin. The camera lens is connected to a video screen, allowing for visualization of the surgery. The surgeon makes small incisions for the insertion of tiny scalpels, scissors and retractors. The surgeon performs the procedure while viewing the television monitor and manipulating the tiny instruments externally. Minimal-incision surgery is particularly useful with younger patients, where the removal of excess skin is not required. A minimal-incision facial surgery for patients in our region to make the face look as young as they feel. A forehead lift or brow lift can smooth out your wrinkles and correct drooping brows and heavy lids to provide a younger, friendlier appearance. A mid-facelift or cheek lift can remove facial wrinkles and lift sagging cheeks, while a neck lift can tighten loose, sagging skin under your chin. Benelli made a major contribution to the reduction of breast lift scars. He eliminated the anchor and lollipop scar patterns used for breast lift and breast reduction. At first he developed a new skin procedure, he called the "round block," that he followed with two glandular techniques which were quite innovative. His technique leaves a scar around the areola only, coined the "doughnut pattern."