An agenda to dissolve general Internal Medicine as a unique specialty? Say it isn’t so!
An agenda to dissolve general Internal online pharmacy viagra as a unique specialty? Say it isn’t so!

In several previous posts I’ve mentioned the external forces and unintended consequences that threaten Internal Medicine as a specialty. Well now it appears their’s a deliberate agenda afoot to eliminate the specialty of IM. That agenda is stated in an article from a recent issue of the journal Academic Medicine. (You can read the full text here if you’re registered with Medscape). The author has an obvious conflict of interest: He’s a professor and chair of Family Medicine.

Simply stated, the proposal is to “merge” the specialties of Family Practice, Pediatrics and Internal Medicine, a euphemism for the dissolution of Peds and IM as unique, stand alone specialties.

For example:

Because the new discipline would provide continuous, comprehensive health care for an individual through his or her entire lifetime, it would naturally incorporate models and processes of care that integrate the known effects of genetic factors, health risks, lifestyle choices, prenatal and natal factors, and disease processes over a person's complete lifespan. From a professional perspective, additional efficiency and cost saving would also be gained by creating a single set of standards and mechanisms for initial board certification and continued maintenance of certification

So what’s this “new discipline” he’s describing? It’s Family Practice!

How will medical students making career choices react to this? They’ll think long and hard before entering a specialty that’s under consideration for dissolution in 20 years!

I issue this challenge to the American College of Physicians and the Society of General Internal Medicine: Tell us in no uncertain terms that you intend to support general Internal Medicine as a unique specialty for the long haul. If you can’t do that it’s time for us to form a new organization that will represent the highest traditions and professional interests of our specialty.

Viagra for Men

What Is cheap viagra?

cheap cialis is a pill used to treat erectile dysfunction (impotence) in men. It can help many men who have erectile dysfunction get and keep an erection when they become sexually excited (stimulated).

You will not get an erection just by taking this medicine. VIAGRA helps a man with erectile dysfunction get an erection only when he is sexually excited.


In many men with erectile dysfunction, VIAGRA helps the body's natural erection process. When a man is sexually excited, the penis will fill with enough blood to cause an erection. After sex is over, the erection goes away.


VIAGRA is only for patients with erectile dysfunction. VIAGRA is not for newborns, children, or women. Research is underway into the possible effectiveness of Viagra for Women, however until the results are known, we do not recommend the use of VIAGRA by women. Do not let anyone else take your VIAGRA. VIAGRA must be used only under a doctor's supervision.

VIAGRA must never be used by men who are taking any medicines that contain nitrates. Nitrates are found in many prescription medicines that are used to treat angina (chest pain due to heart disease) such as:

nitroglycerin (sprays, ointments, skin patches or pastes, and tablets that are swallowed or dissolved in the mouth) isosorbide mononitrate and isosorbide dinitrate (tablets that are swallowed, chewed, or dissolved in the mouth)

Nitrates are also found in illicit drugs such as amyl nitrate or nitrite ("poppers"). If you are not sure if any of your medicines contain nitrates, or if you do not understand what nitrates are, ask your doctor or pharmacist. If you take VIAGRA with any nitrate medicine or illicit drug containing nitrates, your blood pressure could suddenly drop to an unsafe level. You could get dizzy, faint, or even have a heart attack or stroke.


VIAGRA does not cure erectile dysfunction. It is a treatment for erectile dysfunction. VIAGRA does not protect you or your partner from getting sexually transmitted diseases, including HIV-the virus that causes AIDS. VIAGRA is not a hormone or an aphrodisiac.

Possible Side Effects

Like all medicines, VIAGRA can cause some side effects. These effects are usually mild and do not last long. Some of these side effects are more likely to occur with higher doses.

VIAGRA is generally well tolerated. Side effects are rare, but if experienced they are usually mild and temporary.

The following is a list of the most common side effects:



Upset Stomach,

Stuffy Nose,

Steps to Longer Lasting Erection in Your Penis - Happy Sex
I don’t know any man who would say no to a longer cialis. And although there is nothing wrong with wanting to improve certain parts of your body, the reasons beneath it could be wrong. It is a wide-spread myth that if you have a longer penis it is easier for you to satisfy a woman sexually. Absolutely not true. You could be less than average and still be the best sex she’s ever had.

So what is the secret to satisfying a woman? We all know about the G spot and that stimulating it is the way to guarantee a female orgasm. Supposedly the G spot is deep in the female vagina and this is where the myth about longer penis being the key to reach it comes into play. In reality the exact location of the G spot varies from woman to woman, but usually it is no more than 2-3 inches deep. The key to stimulating the G spot is to apply firm and constant pressure. It takes a woman longer to climax therefore if you can last long enough your woman is guaranteed to experience a deep and unforgettable orgasm. In other words, the secret to pleasure your woman every time is to keep your penis up longer. There are certain techniques you can use to assure that.

First step is watching your diet. A long lasting erection takes up a lot of nutrients, therefore you need to make sure your body receives enough of them. The crucial source of energy is carbohydrates, so include such foods as pasta, brown rice, potatoes, and bread in your diet. Another important element is zinc, which is essential for production of sperm. Zinc can be found in seafood, beef liver, raw cashews and pecans. Eating lots of fruits and vegetables, and getting a sufficient amount of oils in your diet helps lower your cholesterol and keep your blood vessels in good condition. Blood vessels are responsible for delivering blood to the penis, which is the key element of an erection, and nitric oxide, which causes the penile tissue to relax and accept the blood. Avoid eating a lot right before having sex, allow at least an hour so that all the consumed food is properly digested.

Another way to prolong erection is to limit your sensitivity. The easiest and most obvious way of doing it is wearing a condom. You can also try focusing on something other than sex. Whenever you feel like you are about to lose control take your mind off the activity at hand for just long enough to avoid ejaculation but not lose your erection.

There are certain exercises you can do to help strengthen and control your PC muscle and other abdominal muscles that hold your erection. These exercises are very easy, you could even do them at work without anyone knowing, and don’t require much time, 15-20 minutes a day. For these exercises to be effective, you have to perform them on a consistent basis. Not only will these exercises help you gain harder and longer erections on demand but also improve your overall penis health and increase your sex drive and stamina. You can find a detailed description of how to perform these exercises by searching for "Kegel exercises" in any search engine.

If you are smoking or drinking in excess, you might want to cut back or quit altogether. Smoking constricts blood vessels and leads to bad blood circulation, which could even lead to erectile dysfunction. Drinking too much alcohol makes your penis lose sensitivity and can inflate your prostate.

The last step is trying a penis ring. Penis rings are used to make penis firmer and harder for a longer period of time and to delay and intensify the orgasm by constricting the blood flow and keeping it at the shaft of the penis. Penis rings are made of different materials such as rubber, leather, metal or plastic. There are also different styles of penis rings, varying based on where they are worn, whether they are just one size or adjustable, some have extra straps to go around the testicles and so on. All these differences in design will not affect the erection, the only difference it will make is how your genitals feel. Penis rings are very safe as long as they are being used properly. Do not keep a penis ring on for longer than 30 minutes. If you feel any pain or discomfort, be sure to remove it immediately.

These are the steps to follow to have long lasting erections that will always leave your partner satisfied. But most important of all don’t stress out about it too much, feel confident about yourself and enjoy your sex life!


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