Human connector
To my contacts and readers,
I am reaching out to connect. Some of you are in my gmail address list since 2011 and 4 years have past and a lot of changes happened to us all as we keep on finding new ways to work or succeed better, we are open to change.
We thank God that we are still healthy or aging well and pray for those who left us. We work and add love to what we do for love alone gives worth to all things. And so as St Teresa of Avila have said “Accustom yourself continually to make many acts of love, for they enkindle and melt the soul.”
In the past our paths have crossed. We are connected at work or play (dance or art). I would like to hear any update from you. Work, business, personal triumphs, projects and goals. I am your human connector, if you need to link to someone at Linkedin or post as guest blogger at my blog www.clubalthea.com or if you have a personal finance or holistic health related question, I will help you find the right resource. Please update Plaxo.com so I can be reminded of your birthday.
You may email me if you need referrals or connection as I will ask the same, for a referral in the bay area or USA to anyone who needs a financial strategy to save on income taxes as business owners or protect their cash flow as employees.
Regards,
Connie DelloBuono
motherhealth@gmail.com
www.clubalthea.com now 1450 posts
San Jose CA 408-854-1883
Understand tax implications medical practice buy-ins,buy outs by Steven R. Antico, JD
Understand tax implications medical practice buy-ins,buy outs by Steven R. Antico, JD
Structure agreements carefully to maximize benefits when an owner or partner leaves or is brought on board.
Your practice can’t avoid the tax implications related to buy-ins and buy-outs of partners if it wants to survive and expand in a competitive environment. When offering a new equity position or buying out a retiring partner, considerations vary depending on the structure of the practice, so it is important to note the differences when dealing with a partnership, as distinguished from a corporation. The appropriate structure of a practice depends on the needs and desires of the practice owners.
TAX CONSIDERATIONS ARISING FROM A BUY-IN
The price of an ownership interest in a practice usually depends on a variety of factors. It always should include, at a minimum, the value of the practice’s furniture, fixtures, and equipment (FFE) allocable to the equity interest being purchased by the new owner—for example, 20% of the FFE if the new equity owner is purchasing a 20% interest in the practice.
Next, the price should account for the new owner’s pro rata interest in the practice’s accounts receivables. The practice can either require the new equity owner to purchase the value of the accounts receivable allocable to the equity interest it is purchasing or allocate the existing collectible accounts receivable directly to the existing owners, payable to them over a period of, say, 12 to 24 months.
Goodwill. The purchase price also may account for goodwill payments, which are designed to compensate the existing owners for their work in developing the practice and the referral sources that generate income for the practice. Any payments greater than the allocable portion of the FFE and collectible accounts receivable constitute goodwill payments.
Some practices lessen the financial burden of a buy-in by using salary differentials for a period of years to “charge” the new owner for the existing benefits. For example, the new owner might receive a smaller percentage of his or her normal entitlement (60% in the first year, 70% in the second year, etc.). The income differential approach works well when the practice intends to distribute available cash flow on a pro rata basis. It does not entirely address the needs of the existing owners if the practice’ compensation methodology is based on productivity or allocation of overhead.
Property contributions by the purchasing partner/shareholder. In some buy-ins, the buyer will contribute property to the practice in exchange for his or her ownership interest. A property contribution will have varying tax implications, depending on the structure of the practice. If the practice is a partnership, a contributing partner is not required to recognize gain or loss upon contribution of property. In most circumstances, the contributed property has built-in gain or loss or is otherwise encumbered by certain liabilities. The pre-contribution gain or loss is allocated directly to the contributing partner to the extent realized by the partnership on the property’s disposition. This action ensures that the partner contributing the property receives the financial benefits or disadvantages associated with the property.
If the contributing partner’s contribution increases the practice’s liabilities, then each existing owner’s basis will increase accordingly as if the contribution were a cash contribution the partner had made to the practice. Each partner’s share of interest in the resulting partnership debt increases his or her basis in his or her partnership interest. This arrangement is beneficial to the partners because basis is necessary for each partner to take advantage of the partnership losses for tax purposes. Each partner can deduct his or her share of partnership losses to the extent of his or her basis in the partnership. In other words, any increase in a partner’s basis enables the partner to deduct more losses.
If the practice is a corporation, the contributing shareholders are not required to recognize a gain or loss from contribution of property in exchange for an equity interest, provided that immediately after the contribution of the property, the shareholders have control of the corporation. “Control,” in this case, means the contributing shareholders collectively own at least 80% of the combined voting power of all classes of voting stock and at least 80% of each class of nonvoting stock. If the control requirement is not satisfied, the contributing shareholders will be liable for the tax on the amount by which the value of the property received for the contribution exceeds his or her adjusted basis in the property.
The tax implications following contributions of property with built-in gain or loss are not nearly as great for corporations as they are for partnerships. The gain or loss inherent in the property being contributed by a shareholder will not be allocated to the contributing shareholders, as is the case in a partnership. Instead, the pre-contribution gain or loss usually will be allocated to all shareholders in proportion to their stock interests. Therefore, a shareholder contributing appreciated or depreciated property may, in effect, shift a portion of his or her pre-contribution gain or loss to the corporation’s other shareholders.
PARTNER/SHAREHOLDER OUTSIDE BASIS
Outside basis will depend on how the practice is organzied.
Practices organized as a partnership. A partner’s basis in his or her practice interest is referred to as outside basis. A partner’s outside basis is equal to the cash and/or adjusted basis of the property he or she contributed to the practice partnership, plus the amount of gain recognized by the member upon such contribution. If the contributed property is subject to indebtedness or if the practice assumes the partner’s liabilities, then the basis in the contributing partner’s interest is reduced by the amount assumed by or allocated to the other partners. Any increase in the practice’s liabilities is treated as if it were a cash contribution made by each partner to the practice, thereby increasing the outside basis.
Practices organized as a corporation. Conversely, the outside basis of a shareholder is not affected by the debt obtained by an S corporation. This fact presents a disadvantage for shareholders. Shareholders can minimize this basis disadvantage by borrowing personally and contributing the loan amounts to the corporation to increase their basis. This course is not always possible, however, because lenders often prefer to lend to the practice rather than to the individual partners attempting to obtain loans with the property to be purchased with the loan proceeds.
If property is transferred in exchange for stock in a C corporation and the transaction qualifies as a nontaxable transaction, then the transferring partner’s basis in the stock he or she receives will equal his or her basis in the transferred property immediately prior to the exchange, increased by any gain recognized and decreased by liabilities assumed by the corporation.
PARTNER/SHAREHOLDER INSIDE BASIS
Inside basis also will depend on how a practice is organized.
Practices organized as partnerships. A practice’s basis in its assets is referred to as inside basis. The practice’s inside basis in its property is equal to the basis that the contributing partner had in the contributed property. A disparity may exist between the inside basis and outside basis due to, for example, the contribution of property with built-in gain or loss. This disparity may be remedied by what is known as an Internal Revenue Code (IRC) 754 election.
An IRC 754 election
Increases the adjusted basis of the partnership property by the excess of the basis of the transferee partner of his or her interest in the partnership over his or her proportionate share of the adjusted basis of the partnership property, or decreases the adjusted basis of the partnership property by the excess of the transferee partner’s proportionate share of the adjusted basis of the partnership property over the basis of his interest in the partnership.
Also consider this election when negotiating the purchase price, because it will affect the calculation of the purchasing partner’s basis in his or her partnership interest, and thus affect the amount of gain and loss recognized.
Consider the example presented in the accompanying tables, which illustrates the benefits of such an election. D purchases C’s one-third interest in the capital and profits of the ABC practice for $35,000 at a time when the practice’s balance sheet is as follows:
Assume that D is admitted as a partner in the practice, and that the partnership has not made an IRC 754 election at the time of the purchase. D’s purchase price for his or her interest is $35,000; thus, his or her outside basis is $35,000. No adjustment is made to the basis of the practice’s property, however, so when the practice sells its assets for $30,000, it will recognize $15,000 of ordinary income.
Because A, B, and D share equally in the profits and losses of the practice, D must report one-third of the partnership’s income on the sale, or $5,000, even though the $35,000 purchase price that D paid for C’s interest considered the value of C’s one-third interest in the practice’s inventory and even though C recognized $5,000 of ordinary income that was attributable to the appreciation in the inventory at the time of the sale of C’s interest. The election, in effect, prevents D from being taxed twice on his or her proceeds from the sale.
Similarly, one-third of the $30,000 capital gain that the practice recognizes on a later sale of its capital assets will flow through to D, even though the amount that D paid for the interest included the value of C’s one-third interest in the practice’s capital asset.
Any gain on the practice’s sale of its assets that flows through to D increases D’s outside basis. On a later sale of D’s interest in the practice, D may recognize a loss equal to the $15,000 gain that D was required to recognize on the practice’s sale of the capital asset. The offsetting loss, however, may not compensate D for the gain that he or she was able to recognize.
In most cases, D’s loss on the sale of the interest will be a capital loss, whereas the gain that D recognized from the practice’s sale of the asset is ordinary income. If D holds the interest until death, no loss will be permitted on a later sale of the interest, because D’s estate or D’s heirs will take the interest with a stepped-down basis, equal to the fair market value of the interest at the time of D’s death or at the time the interest is valued for estate tax purposes.
An IRC 754 election would have resulted in an adjustment to the basis of the practice’s assets when D purchased C’s interest. Because of the adjustment, the practice’s basis in the asset would have increased to $20,000. The $5,000 increase would apply only with respect to D to prevent D from recognizing the gain that accrued before D purchased the interest in the practice. On a later sale of assets for $30,000, the practice would recognize $10,000 of ordinary income which would be shared equally by A and B.
Similarly, an IRC 754 election would cause the practice’s basis in its capital asset to increase to $25,000. On a later sale of the capital assets for $45,000, the practice would recognize $20,000 of capital gain, which would be shared equally by A and B.
In cases where an IRC 754 election is in effect, an adjustment is required under IRC 734(b) for distributions that involve gain or loss to the distributing partner and distributions in which the basis of the property distributed is different for the distributing partner than it is for the partnership.
Here’s an example: Member X has a basis of $10,000 for his one-third interest in practice XYZ. The practice has no liabilities and has assets consisting of cash of $11,000 and property with a partnership basis of $19,000 and a value of $22,000. X receives $11,000 in cash in liquidation of his entire interest in the practice. He has a gain of $1,000. If an election under IRC 754 is in effect, the partnership basis for the property becomes $20,000 ($19,000 plus $1,000).
BUY-OUT TAX CONSIDERATIONS
Buy-out considerations depend on the particulars of the buy-out, such as how shareholder stock is treated as well as the practice arrangement involved.
Cross purchase/redemption. If a corporation acquires the departing owner’s stock, the basis of the remaining owners’ interests stays the same. Alternatively, if the remaining owners purchase the departed shareholder’s stock, the surviving owners will receive a step-up in basis to the extent of the price paid for the acquired stock. This method reduces the gain on the liquidation or sale of the business (or increases a deductible loss, if applicable). The latter method is called a cross purchase arrangement and is the recommended structure in a corporate setting.
In most cases, payments made to a shareholder for the shareholder’s equity in the corporation are considered payments for a capital asset. Capital assets held for more than 1 year before the exchange are subject to long-term capital gain treatment.
Partnerships. A significant difference between the sale and redemption of an exiting partner’s partnership interest is that any gain or loss realized from the sale or exchange of the interest is characterized as capital gain or loss, except to the extent that the Internal Revenue Service treats any amount received by the exiting partner in exchange for the partner’s interest in unrealized receivables or inventory items of the partnership as an amount realized from the sale or exchange of property other than a capital asset. Ordinary income is recognized on the sale or exchange of the interest to the extent of the exiting partner’s interest in the partnership’s unrealized receivables and inventory allocable to the transferred partnership interest.
A partnership redemption, by contrast, generally occurs through a distribution or series of distributions by the partnership to the exiting partner. The tax consequences of these payments depend on whether they are characterized as distributive shares of the partnership’s income or as guaranteed payments. A distributive share entitlement is the partner’s share of the partnership income and is taxed as ordinary income and deductible to the partnership. IRC 736(a) payments are deductible by the partnership, even if such payments may properly be considered attributable to unstated goodwill or similar intangibles.
As noted previously, a medical practice constitutes a business in which capital is not a material income producing factor, because all of the income derives from professional services. Accordingly, payments of unrealized receivables and goodwill by a physician are treated as 736(a) payments, and the partnership may take a deduction for the payments.
The tax issues stemming from medical practice buy-ins and buy-outs are complex and are best approached using professional guidance. But putting in the time and effort to structure a buy-in or buy-out properly will help ensure that all parties to the deal come away satisfied.
This example was adpated from Susan Kalinka, “Sale or Exchange of a Member’s Interest: Tax Cnsequences to the Purchaser or Heir of an Interest in a Limited Liabilty Company and the 754 Election,” in Limited Liability Companies and Partnershps: A Guide to Buisness and Tax Planning. 3rd Ed. (Vol.s. 9-9A Louisiana Civil Tax Treatise). Used with permission of Thomson Reuters.
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I worked with a team of experts for doctors selling and buying a medical practice. Contact Connie Dello Buono 408-854-1883 motherhealth@gmail.com Buyers save about 40% in taxes while sellers save about 20% in taxes.
Medical doctors: 2014 tax law changes , impact and financial strategies
Medical doctors: 2014 tax law changes , impact and financial strategies
How will 2014 tax law changes impact your finances this year and beyond?
Although the top marginal tax bracket was increased to 39.6%, most physicians will have their marginal rate (their last dollar of income) taxed at 28% or 33%, depending on your taxable income.
Understanding tax brackets
Contrary to popular belief, when you earn an additional dollar and cross into the next tax bracket, only that dollar and any additional dollars are taxed in the higher bracket, not income below the threshold. Some people reduce their income for fear of moving into a higher bracket, but only additional dollars are taxed at the higher rate.
Taxes are calculated in two ways, the traditional way and what’s known as the “alternative minimum tax” (AMT). The AMT was established for taxpayers who itemize their deductions and take significant write-offs. It can add as much as $5,000 to $10,000 per year to a tax bill. All taxpayers are obligated to calculate their taxes using both methods and to pay the higher amount.
For taxpayers in higher brackets, most long-term capital gains (a category that includes most assets held for more than one year) and qualified dividends are taxed at either 15% or 20% for federal purposes, plus any state or local tax. The tax rate you pay depends on your level of taxable income. The highest tax rate on long-term capital gains and qualified dividends is 20%.
The Affordable Care Act, however, added a 3.8% Medicare tax for taxpayers with adjusted gross incomes over $250,000 if married or $200,000 if single, in addition to the 20% rate mentioned previously. The tax also applies to rental income and other forms of unearned and passive income. Therefore, your capital gains and qualified dividend tax bracket could be as high as 23.8%.
Itemized deduction phase out
The government also reinstituted the phase out of itemized deductions and personal exemptions if you are married and your adjusted gross income exceeds $300,000 or if you are unmarried and your adjusted gross income exceeds $250,000.
Essentially, this means that you lose some deductions, such as mortgage interest and charitable donations, and exemptions if your income is higher, effectively raising your taxes further. You lose 3% of the amount by which your adjusted gross income exceeds the stated thresholds. Although this provision had been in effect previously, it had not applied since 2009 and has now been implemented again.
Estate and gift taxes
Any person can gift up to $14,000 per calendar year to any other person without paying gift taxes and without reporting the transaction on a gift tax return.
For example, a married couple can each give $14,000 to each child and grandchild. Larger gifts can also be given by filing a Federal Gift Tax Return. Such gifts would offset one’s lifetime exemption, and usually not result in taxes.
The exemption during an individual’s lifetime or upon the person’s demise is currently $5.34 million per donor. To the extent that a taxable estate at death exceeds this threshold, there is a federal 40% tax on the excess.
Subject to certain exemptions, there is also a generation-skipping tax that often applies when passing assets to grandchildren, a technique often used to keep them out of the estates of children, where they would be taxed at a higher rate. This should be considered when doing estate planning.
Even if you do not exceed the new high estate tax thresholds, it is important to update your wills and trusts to ensure that your assets are passing to the intended parties whether they be your children, grandchildren, charities or others.
Payroll taxes have also increased, because the Social Security wage base increased to $117,000 this year. Taxes paid on this level of income fund Social Security and Medicare. Although the employer and employee pay both Medicare and Social Security up to the aforementioned wage base, Medicare taxes apply even to wages, exceeding the wage base, and are in addition to the 0.9% surtax that became law as part of the ACA.
Save about $70k in income taxes through a business structure, contact Connie Dello Buono 408-854-1883 motherhealth@gmail.com who teamed up with financial advisors for financial strategies.
For doctors who do not own their medical practice (in C corp plus another entity) but works with an institution, what type of income do you receive? W2 or 1099?
a. If W2, can you have your payroll dept switch a portion of your income to 1099? For instance, take the base salary as W2, then any overtime or bonuses to 1099?
b. Do you have a corporation set up? If so, what is the structure (LLC, S Corp or C Corp?)
c. If you are stuck with W2 income from the hospital, not much we can do with taxes
on the front end, but we can definitely do financial planning to avoid taxes on the back end.
Note that 401k savings and other investments are taxed later on
(around 40-50% including penalties)
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Free 30min phone chat with a sr financial advisor at Harding Financial to help you reduce income taxes using a business structure and financial strategies, connie.dellobuono@hardingfinancial.com or conniedbuono@gmail.com 408-854-1883
Make 2014 and 2015 be the year to protect your wealth and secure your retirement.
Dr. Mercola’s top 5 tips that will help you beat the flu
Here are Dr. Mercola’s top 5 tips that will help you beat the flu:
- Get enough vitamin D – Dr. Mercola believes that lack of vitamin D is the likely cause of seasonal flu viruses. A recent large-scale study showed that people with low vitamin D levels were more prone to colds and bouts with the flu.
- Take a probiotic supplement and eat plenty of probiotic-rich fermented foods– Protect your gastrointestinal system because eighty percent of your immune system, your body’s natural defense against disease, is located in your gut.
- Eliminate or drastically reduce your sugar intake – Sugar is a natural enemy of your immune system.
- Get enough sleep and rest – Listen to your body. Take a break when you need to because your body will easily succumb to the flu virus if you’re always fatigued.
- Manage your stress levels – A stressful lifestyle rarely leads to a healthy body. You can’t separate wellness from emotions. How you deal with stress directly affects your state of health.
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Add ginger, garlic, onions, turmeric and some essential oils such as eucalyptus, tea tree, clove, rosemary and peppermint. Connie
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Wanted Sports Nutrition independent reps or Ambassador at USA, Sweden and Australia at http://gogyv.com/cdellobuono/
Have your own site for free before end of August and invest in your health monthly for a favorite anti-aging supplements of athlete powered by Biogenesis. Email Connie -> motherhealth@gmail.com or text 408-854-1883 for more info for your sports nutrition business online
Energy Drinks Can Take Teeth On An Irreversible Acid Trip by Eliza Barclay
In a study published in the May/June issue of General Dentistry, researchers have looked for the first time at the effects of energy drinks on teeth. It turns out there’s often a lot of citric acid in the drinks.
Why? It’s a preservative that enhances flavor and shelf life. But it also happens to be very good at stripping enamel from teeth.
Dentists are especially worried about teens — 30 to 50 percent of whom are estimated to be gulping down energy drinks — losing enamel because once it’s gone teeth are more prone to cavities, and more likely to decay.
“We are well aware of the damage that sugar does in the mouth and in the whole body — the role it can play in obesity, diabetes, etc,” says Poonam Jain, an associate professor in the School of Dental Medicine at Southern Illinois University, Edwardsville, and the lead author of the study. “But the average consumer is not very well aware that acid does all kinds of damage, too.”
To measure just how energy and sports drinks affect teeth, the researchers looked at the fluoride levels, pH, and something called “titratable acidity” of 13 sports drinks and nine energy drinks, including Gatorade and Red Bull. That last data point, by the way, is all about how long it takes for saliva to neutralize acid in the mouth.
The researchers then measured how much enamel the drinks took off teeth, dousing sliced-up molars in a petri dish with the beverages for 15 minutes, followed by artificial saliva for two hours. The was repeated four times a day for five days.
The researchers found that teeth lost enamel with exposure to both kinds of drinks, but energy drinks took off a lot more enamel than sports drinks.
The precise amount of citric acid in a drink isn’t something beverage companies have to declare on the label. And the American Beverage Association says drinks can’t be blamed for damage to teeth.
“It is irresponsible to blame foods, beverages or any other single factor for enamel loss and tooth decay (dental caries or cavities),” the ABA said in a statement responding to Jain’s paper. “Science tells us that individual susceptibility to both dental cavities and tooth erosion varies depending on a person’s dental hygiene behavior, lifestyle, total diet and genetic make-up.”
And, it should be said, previous research in the same journal showed that acids in citrus fruit juices (particularly lemon juice) can also erode the enamel on teeth.
Jain, the dental researcher, is concerned about health effects beyond cavities . She says consuming a lot of citric acid can lead to loss of bone mass and kidney stones. “This has become a big concern because people are drinking more of these drinks and less milk,” she says.
This dust-up over acid isn’t the first time, of course, that energy drinks have come under fire from health experts.
Last year, as we reported, the American Academy of Pediatrics said children should never drink caffeinated energy drinks out of concern about what high doses of caffeine can do to a young growing body that’s not fully mature.
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From Dr Mercola:
side from their chronic use during athletic training, sports drinks are also a popular beverage choice during summer months.
Many believe they are necessary to restore your electrolyte balance duringexercise or other outdoor activities, but while the theory is sound, commercial sports drinks are anything but healthy.
Sports drinks (Gatorade, Powerade, and others) basically “work” because they contain high amounts of sodium (processed salt), and other electrolytes, which are meant to replenish the electrolytes you lose while sweating. However, this processed salt is by no means ideal. (Below I’ll discuss healthier alternatives.)
One of the primary problems with sports drinks is related to the high amounts of sugar these drinks contain. The leading brands of sports drinks typically contain as much as two-thirds the amount of sugar found in sodas and many contain far more. They also contain processed high-fructose corn syrup (HFCS) and/orartificial sweeteners.
Sugar, as you probably know, is the enemy when it comes to maintaining optimal dental health. It’s very difficult to maintain caries-free teeth if you’re consuming high amounts of sugar, as sugar feeds bacteria that produce tooth decay and gum disease.
Previous research has also shown that sports drinks are up to 30 times more erosive to your teeth than water, courtesy of the corrosive activity of phosphoric or citric acid. Brushing your teeth won’t help because the citric acid in the sports drink will soften your tooth enamel so much it could be damaged by brushing.
Latino Families to Gather at Google Campus Friday for Fun-Filled Family Event
The Latino Community Foundation (LCF) has partnered with Google to host the 3rd Annual Health + Tech Day.

A Film screening of “Underwater Dreams” will follow the event.
Health + Tech @Google is a community event focused on improving the lives of low-income Latinos from the South Bay. LCF has partnered with a diverse group of community leaders, corporate sponsors, and various Latino-based nonprofit organizations to offer a fun-filled day of tech and wellness for the whole family.
A fitness circuit (yoga, sit-ups, hula-hoops) will be led by bi-lingual Google staff and more than 50 LCF volunteers. Coding Dojo will offer coding lessons and LCF will have an RV TECH BUS to teach basic computer skills to youth and parents.
The San Jose Earthquakes and San Jose Sabercats will host fun filled activities for youth, including a soccer clinic. Telemundo will host a community Zumba party for all attendees, Milagros de Mexico will offer testing for high blood pressure, and Community Health Promotores will be engaging parents about health and wellness resources.
Chromebooks, Nexus tablets, and bikes will be raffled.
In its mission to build a better future for California, LCF believes a healthy community starts with a healthy family. With recent polling showing that only 52% of Latino families are connected to the Internet at home, a technology component has been added to the annual event.
LCF has launched a “Get Latinos Connected” campaign with several established nonprofit, philanthropic, and corporate partners, including the California Emerging Technology Fund and Chicana Latina Foundation, to connect 1,200 low-income, primarily monolingual Latino households to the Internet by 2015.
–Image and information courtesy of the Latino Community Foundation.
Antiobiotic-resistant infections caused more deaths than AIDS
Antiobiotic-resistant infections caused more deaths than AIDS
Just as incurable viruses gain new footholds around the world, a growing number of bacterial infections that were once easily treatable are now withstanding modern medicine’s arsenal of antibiotics. Twenty-three thousand Americans die from antibiotic-resistant pathogens every year. Methicillin-resistant Staphylococcus aureus, or MRSA, is among the most notorious. The number of adults hospitalized due to another culprit, a resistant strain of Clostridium difficile has nearly doubled over the last decade, according to a study published last week.
A case in point: The first person diagnosed with the Ebola virus in the U.S. was initially sent home with antibiotics. The drugs, of course, wield no power against viruses.
But it’s their use in animals that has sparked the loudest debate. Despite warnings going back to penicillin-discoverer in the 1940s and the U.S. Food and Drug Administration in the 1970s, as well as successful efforts over the last decade in Denmark, the Netherlands and other European countries to curb the practice, livestock producers across the U.S. continue to routinely feed healthy animals small doses of antibiotics.
“The overwhelming proportion of antibiotics are used in animal feed in a very uncontrolled fashion,” said Ellen Silbergeld, a professor at Johns Hopkins School of Public Health. “It is the perfect recipe for creating antibiotic resistance.”
Overall, cattle, swine, chickens and other livestock receive about 80 percent of the nation’s antibiotics — with most of those drugs administered in low concentrations to prevent the spread of disease or simply to promote growth. Just as an incomplete course of antibiotics can result in the rise of a more virulent infection in a person, this sublethal use in animals means bacteria that can withstand the drugs will survive, reproduce and pass on their resistance to the next generation of bugs on the farm. In the end, animal antibiotics are thought to affect human health via multiple pathways: direct or indirect contact with food, water, air or anywhere urine or manure goes.
A study published on Tuesday builds on evidence that antibiotic residue in the environment spurs the growth of resistant bacteria — at even lower concentrations than previously thought.
At the turn of the century, he told HuffPost, animals were receiving approximately 95 percent of the country’s antibiotics. And as in the U.S., most of that medicine was not given to sick livestock. So in 2006, the government banned the use of antibiotics as growth promoters and began requiring veterinarian oversight for other uses.
“But that didn’t result in any reduction in use of antibiotics in animals,” Kluytmans said. Rather, use of the drugs as therapy increased dramatically.
It wasn’t until the country faced two subsequent outbreaks of antibiotic-resistant infections, whose sources were traced to animals, that the numbers began to fall. “There was a lot of public awareness and media attention,” said Kluytmans. “Farmers and others involved realized that they could not continue in the same way.”
Since 2009, use of antibiotics on Dutch farms has dropped by about 60 percent. An independent authority now tracks antibiotic usage on each farm. What’s more, Kluytmans said, there have been no “measurable negative effects” on the animals or on productivity.
Juli Putnam, a spokeswoman with the FDA, said the agency is working with other federal officials to “enhance current data collection efforts,” and “intends to seek public input on such approaches.”
In 1970, the U.S. Surgeon General declared that the war against infectious disease had been won. Today, Ebola and antibiotic-resistant superbugs warn us otherwise. While Kluytmans is confident Ebola won’t pose a serious problem in developed nations, antibiotic resistance is another story. He and other infectious disease experts are particularly fearful of emerging resistance to carbapenem, one of today’s last-resort antibiotics.
Spellberg, the Los Angeles doctor who treated the young woman who died from an infection, recalled looking at a printout on the computer screen showing all the antibiotics the implicated bacteria could resist. “Resistant. Resistant. Resistant. Resistant. Resistant. It was resistant to everything,” he said in the new documentary, which is currently screening around the U.S. and will be available to the public in the spring.
“Since penicillin,” he added, “we’ve expected that we’re going to have relatively inexpensive, safe, tremendously effective drugs to treat infections, and this woman had returned to 1935.”
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Please read info on probiotics for chicken.
It is not too late to save for when you live too long
http://www.msn.com/en-us/money/tools/retirementplanner
Contact Connie Dello Buono , retirement planner, 408-854-1883 motherhealth@gmail.com to save before the year ends. CA Life Lic 0G60621
More die from antibiotic-resistant infections than AIDS as transmitted from animals to humans
Just as incurable viruses gain new footholds around the world, a growing number of bacterial infections that were once easily treatable are now withstanding modern medicine’s arsenal of antibiotics. Twenty-three thousand Americans die from antibiotic-resistant pathogens every year. Methicillin-resistant Staphylococcus aureus, or MRSA, is among the most notorious. The number of adults hospitalized due to another culprit, a resistant strain of Clostridium difficile has nearly doubled over the last decade, according to a study published last week.
Largely to blame for this public health predicament, experts say, is the continued misuse and overuse of antibiotics in both humans and animals. A case in point: The first person diagnosed with the Ebola virus in the U.S. was initially sent home with antibiotics. The drugs, of course, wield no power against viruses.
But it’s their use in animals that has sparked the loudest debate. Despite warnings going back to penicillin-discoverer Alexander Fleming in the 1940s and the U.S. Food and Drug Administration in the 1970s, as well as successful efforts over the last decade in Denmark, the Netherlands and other European countries to curb the practice, livestock producers across the U.S. continue to routinely feed healthy animals small doses of antibiotics. Some of the antibiotics belong to the same classes of drugs used to treat people — including key weapons in fighting urinary tract infections and infections after surgeries. Even use of antibiotics not considered important in human medicine, experts now warn, can promote cross-resistance to the more critical drugs.
“The overwhelming proportion of antibiotics are used in animal feed in a very uncontrolled fashion,” said Ellen Silbergeld, a professor at Johns Hopkins School of Public Health. “It is the perfect recipe for creating antibiotic resistance.”
Overall, cattle, swine, chickens and other livestock receive about 80 percent of the nation’s antibiotics — with most of those drugs administered in low concentrations to prevent the spread of disease or simply to promote growth. Just as an incomplete course of antibiotics can result in the rise of a more virulent infection in a person, this sublethal use in animals means bacteria that can withstand the drugs will survive, reproduce and pass on their resistance to the next generation of bugs on the farm. In the end, animal antibiotics are thought to affect human health via multiple pathways: direct or indirect contact with food, water, air or anywhere urine or manure goes.
A study published on Tuesday builds on evidence that antibiotic residue in the environment spurs the growth of resistant bacteria — at even lower concentrations than previously thought.
Last week the FDA released some relevant new data: It reported that the total quantity of antibiotics that are known to be important in human medicine and are sold or distributed for use in food-producing animals jumped by 16 percent between 2009 and 2012. In total, 61 percent of the antibiotics sold to the meat industry are considered medically important.
The Animal Health Institute, which represents pharmaceutical companies, suggested the new data tell a “small part of the story.” Recent reports, the industry group told The Huffington Post in a statement, support their position: Just because food animals consume the bulk of antibiotics, responsibility for the majority of the human health problem doesn’t necessarily rest on the industry.
A report published in September by the President’s Council of Advisors on Science and Technology also puts a greater emphasis on human health contributions — although it does raise concerns over a role for animal agriculture, and touts the FDA’s new voluntary guidance on the use of the drugs in animals. The agency has asked drug companies to voluntarily change their labels by December 2016 to exclude uses for growth promotion. If a label changes, then farmers or feed mills would need to obtain a prescription from a veterinarian to treat a sick animal or to prevent disease. Before, they could simply buy the drugs over the counter and administer them without any involvement of a veterinarian.
Silbergeld criticized the PCAST report for not putting the animal agriculture issue “front and center,” and argued that the FDA’s voluntary policy doesn’t go far enough. She is also among critics who point to a potential loophole in the strategy, as illustrated by experiences in Europe.
Dr. Jan Kluytmans, a professor of microbiology and infection control at University Medical Center Utrecht in the Netherlands, recalled the initial difficulty when his country began trimming use of antibiotics in their livestock.
At the turn of the century, he told HuffPost, animals were receiving approximately 95 percent of the country’s antibiotics. And as in the U.S., most of that medicine was not given to sick livestock. So in 2006, the government banned the use of antibiotics as growth promoters and began requiring veterinarian oversight for other uses.
“But that didn’t result in any reduction in use of antibiotics in animals,” Kluytmans said. Rather, use of the drugs as therapy increased dramatically.
“When the last few drugs were banned for growth-promoting purposes, they did what we fear is going to happen in the U.S.,” said Laura Rogers, project director for the Pew Campaign on Human Health and Industrial Farming. “They called everything else a therapeutic use. They used tetracycline like it was candy.”
It wasn’t until the country faced two subsequent outbreaks of antibiotic-resistant infections, whose sources were traced to animals, that the numbers began to fall. “There was a lot of public awareness and media attention,” said Kluytmans. “Farmers and others involved realized that they could not continue in the same way.”
Since 2009, use of antibiotics on Dutch farms has dropped by about 60 percent. An independent authority now tracks antibiotic usage on each farm. What’s more, Kluytmans said, there have been no “measurable negative effects” on the animals or on productivity.
Obtaining such detailed information — which is critical for setting and enforcing regulation — is not yet possible in the U.S., as regulators don’t monitor how the drugs are administered on farms. In fact, much of the information on animal antibiotic use is currently considered confidential business information. Juli Putnam, a spokeswoman with the FDA, said the agency is working with other federal officials to “enhance current data collection efforts,” and “intends to seek public input on such approaches.”
Whether or not the progress in the Netherlands has actually resulted in benefits for public health is not clear. Kluytmans could only state that a previously steady rise in resistant infections in the 2000s had appeared to level off after 2009.
A Harvard paper published in August cautions that more research is needed to fully understand the effect of animal antibiotics on resistant infections. But the review, which was among the documents quoted by the industry group as evidence of animal agriculture’s minimal role in the human health threat, also underscores the limited available data and the need for the U.S. agricultural industry to be more “forthcoming.” It further notes that once antibiotic-resistant strains have emerged, “it might be only a matter of time before they cross the species barrier and adapt to living in humans, at which time there is very little regulation of agriculture can do to prevent their persistence in the clinical setting.”
“The greatest value of reducing agricultural antibiotic use now may be in maintaining a status quo that, while far from ideal,” the researchers write, “is greatly preferable to the alternative.”
In 1970, the U.S. Surgeon General declared that the war against infectious disease had been won. Today, Ebola and antibiotic-resistant superbugs warn us otherwise. While Kluytmans is confident Ebola won’t pose a serious problem in developed nations, antibiotic resistance is another story. He and other infectious disease experts are particularly fearful of emerging resistance to carbapenem, one of today’s last-resort antibiotics.
Spellberg, the Los Angeles doctor who treated the young woman who died from an infection, recalled looking at a printout on the computer screen showing all the antibiotics the implicated bacteria could resist. “Resistant. Resistant. Resistant. Resistant. Resistant. It was resistant to everything,” he said in the new documentary, which is currently screening around the U.S. and will be available to the public in the spring.
“Since penicillin,” he added, “we’ve expected that we’re going to have relatively inexpensive, safe, tremendously effective drugs to treat infections, and this woman had returned to 1935.”



