Reflexology Trial", Simon Singh states that if indeed the hands and feet "reflect" the internal organs, reflexology might be expected to explain how such "reflection" was derived from the process of Darwinian natural selection; but Singh says that no argument or evidence has been adduced. In the United Kingdom, reflexology is coordinated on a voluntary basis by the Complementary and Natural Healthcare Council (CNHC). Registrants are required to meet Standards of Proficiency outlined by Profession Specific Boards, but since CNHC is voluntary anyone practicing can describe themselves as a reflexologist. When the CNHC began admitting reflexologists, a skeptic searched for, and
Step therapy availability to the patient. The use of generic drugs when possible allows health care plans to pursue both of these goals effectively. Physicians and managed care providers may disagree on the proper step therapy and patients are encouraged to become knowledgeable in managing their own care. Opponents of step therapy, such as Fail First Hurts, have detailed the pitfalls of step therapy. "Fail First is used by health insurers to control costs. It is time-consuming from a physician and patient standpoint, is more expensive from a direct and indirect out-of-pocket cost perspective, denies patients the drugs they need when they