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in good Meet Your Doctor

November 2016 •

Issue 203

Private Doctor

Cataract Surgery

Interested in having your own private physician, one who can come to your home and is available 24/7 by phone, text or in person? Now it’s possible and costs less than you might think

Surgeries are quicker, precise and allow many patients to discard their reading glasses

This amount is what a family is expected to pay for an average funeral ceremony nowadays.

See Savvy Senior column inside

CNY’s Healthcare Newspaper

Hire Your Own

New chief medical officer at Excellus BlueCross BlueShield, Richard Lockwood, M.D., talks about the fine balance between providing quality care and holding down cost of care

$11,000

cnyhealth.com

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When Will the Flu Peak This Season?

‘Doc, This Election’s Killing Me!’ page 2

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MVP’s New Medical Chief: Background in Engineering

Nut Butter

November is National Peanut Butter Lovers’ Month! What better time to celebrate all that’s wonderful about this healthy plant-based protein? page 13

Flushing Unused Medications?

Experts talk about how to dispose of medication properly. Flush them?

Nope! Put them in the garbage? That won’t do. See what they say page 11

‘Doc, This Election’s Killing Me!’ More than half of Americans report stress as Clinton, Trump battle for the White House

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s Donald and Hillary duke it out on the campaign trail, Americans are feeling pummeled, too, a new poll finds.

The 24/7 coverage of the acrimonious U.S. presidential election has caused stress for more than half of American adults, regardless of party

affiliation, according to a survey conducted by the American Psychological Association (APA).

“We’re seeing that it doesn’t matter whether you’re registered as a Democrat or Republican — U.S. adults say they are experiencing significant stress from the current

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A Journey to HOPE

Friday, November 4, 2016 Nicholas J. Pirro OnCenter Ballroom Honoring Donald M. Mawhinney, Esq. For tickets or more information, call HOPE for Bereaved at 475-9675 Page 2

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

election,” said Lynn Bufka, APA’s associate executive director for practice research and policy.

“Election stress becomes exacerbated by arguments, stories, images and video on social media that can heighten concern and frustration, particularly with thousands of comments that can range from factual to hostile or even inflammatory,” she added in an association news release.

Overall, 52 percent of Americans aged 18 and older said the election is a somewhat or very significant source of stress. That included 55 percent who align with Democrats and 59 percent with Republicans.

The survey also found that 38 percent of respondents said political and cultural discussions on social media causes them stress. More than half who use social media said the election is a very or somewhat significant source of stress, compared with 45 percent of those who don’t use social media.

Men and women were equally likely to feel stressed by the Trump-Clinton battle, but there were differences between generations.

Only 45 percent of Generation Xers — those born from 1965 to 1980 — reported election stress, while nearly six out of 10 “matures” did so, according to the online survey conducted in August. Matures were born pre-1946.

In addition, 56 percent of millennials and half of baby boomers said the election is a very or somewhat significant source of stress.

Number of Americans With Severe Joint Pain Keeps Rising Close to 15 million people live with the problem

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evere joint pain plagues an increasing number of aging, often arthritic Americans, a new report finds.

In 2002, about 10.5 million people in the United States said they battled severe joint pain, but by 2014 that number had jumped to 14.6 million, said researchers from the U.S. Centers for Disease Control and Prevention.

The CDC team defined “severe” joint pain as discomfort measuring 7 or more on a 1-to-10 score on a questionnaire, with 1 being no pain and 10 being “pain and aching as bad as it can be.”

The problem may only get worse, the researchers said, since much of this joint pain is linked to arthritis. One in every four people with arthritis in the new study rated his or her pain as “severe,” and arthritis cases among Americans are expected to rise.

In the United States, “arthritis affected an estimated 52.5 million [22.7 percent] adults in 2010-2012 and has been projected to affect 78.4 million adults by 2040,” wrote the team led

by CDC researcher Kamil Barbour.

HOPE for Bereaved’s 38th Anniversary of Helping Grieving Children and Adults

November 2016 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

Nov. 5

Nov. 7

Senior Moments Resource Conference targets human Fair in Auburn trafficking, exploitation

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

The Senior Moments Resource Fair, a free event for aging individuals and their families, is scheduled for 10 a.m. to 2 p.m., Saturday, Nov. 5, at the Fingerlakes Mall, 1579 Clark Road, Auburn.

This event will feature keynote speaker Yvonne Conte, of Humor Advantage, Inc., who will make a presentation titled “Senior Moments and Serious Laughter.” Other presentation will focus on estate planning and falls prevention. There will be an aging simulation activity, Medicare insurance individual consultations and exhibits from a wide variety of organizations, which provide services, information and assistance to older individuals, their caregivers and family members.

The goal is to educate the community about the importance of planning for the care of aging individuals by providing the necessary information and resources at a convenient, one-stop-shop event, organizers said.

The SCAT Van will be available to provide rides from designated locations. To arrange a ride, call 315253-0996.

The event is presented by the Human Services Coalition of Cayuga County, Cayuga County Office for the Aging, Cayuga County NYConnects Long Term Care with support from Home Instead, Fidelis Care, Auburn Rotary, Chobani, and Wegmans.

For more information, call the Office for Aging at 315-253-1226.

A Safe Harbour Conference focusing on the issues of human trafficking and exploitation is scheduled from 8 a.m. to 4 p.m., Nov. 7, at Lake Ontario Conference Center, 26 E. First St., Oswego. The event is intended for school personnel, law enforcement, child protective/child welfare, mental health professionals, medical providers, clergy, hotel management and other professionals working with children. It’s sponsored

by Oswego County Opportunities, Catholic Charities of Oswego County, the Child Advocacy Center of Oswego County, and the Department of Social Services.

The keynote speaker will be Jasmine Sudarkasa whose presentation is titled: ‘Learning to Work with Commercially Sexually Exploited and Domestically Trafficked Youth.’

Sudarkasa is the senior training and technical assistance coordinator at Girls Educational and Mentoring Services (GEMS) in New York City.

She conducts trainings and provides technical assistance for legal professionals, law enforcement and social service professionals on the issues of commercial sexual exploitation of children and domestic trafficking.

Workshop session presenters are Captain Mark Lincoln, New York State Police; Rev. Daniel LeClair; Michael Dubois, FBI; Sudarkasa; and Todd Bunnenberg, Homeland Security.”

To register, go to http://tinyurl. com/hhjt5vl.

Nov. 5

Nov. 12

Ready. Set. Run for Babies!

Veterans Parade and Expo at NYS Fairgrounds

March of Dimes will sponsor its March for Babies Nov. 5 in the SRC Arena at Onondaga Community College. As part of the event, organizers will kick off the first Run for Babies, designed to help raise funds for premature birth.

Registration for the Syracuse Run for Babies begins at 8:30 a.m. with the certified 5K run kicking off at 9:30 a.m. Immediately following the run will be the March for Babies. To register for the Run for Babies, visit www.runforbabies.org/Syracuse. For questions, call the March of Dimes office at 315-463-0700.

Funds raised by Run for Babies in New York help support prenatal wellness programs, research grants, newborn intensive care unit (NICU) family support programs and advocacy efforts for stronger, healthier babies.

Premature birth is the most urgent infant health problem in the U.S. today. It affects nearly half a million babies each year, including 28,000 in New York, according to the organization. For more information, visit marchforbabies.org.

The public is invited to visit the 2016 CNY Veterans Parade and Expo from 9 a.m. to 3 p.m. Nov. 12 at the Center of Progress Building, NYS Fairgrounds. The parade itself will start a noon at Chevy Court. This year’s theme will honor Vietnam veterans. Five grand marshals, one Vietnamera veteran from each branch will be featured. The event will also hold a National Archives exhibit of photographs from. According to organizations, the purpose of the CNY Veterans Parade and Expo is to thank veterans for their military service and to recognize their importance in the communities.

For more information, visit CNYVeteransParade.org, email cnyveteransparadeandexpo@ yahoo. com or call 428-9651.

Deadline for Calendar of Health Events: Nov. 11 for December edition editor@cnyhealth.com

Americans Are Changing Their Supplements of Choice Vitamin D, fish oil are in, multivitamins less so, study finds

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raditional multivitamins are falling out of favor among Americans, while supplements such as vitamin D, fish oil and probiotics are gaining ground, a new study finds.

Researchers found that between 1999 and 2012, Americans’ overall use of supplements remained stable.

Slightly more than half of adults said they took vitamins, minerals or some other type of dietary supplement.

What’s changed are the products of choice.

Multivitamins and many individual vitamins and minerals are less popular, as are botanicals such as echinacea, ginseng and garlic extracts, the investigators found.

On the other hand, more people are using vitamin D, omega-3 fatty acids and probiotics — “good” bacteria said to benefit the digestive system.

Researchers said the findings make sense.

“I did expect to see that vitamin D use would go up, and that fish oil would go up,” said lead researcher Elizabeth Kantor, an epidemiologist at Memorial Sloan Kettering Cancer Center in New York City.

That’s because both have been

the focus of a lot of research and media attention in recent years, Kantor pointed out.

Some studies, but not all, have suggested fish oil pills can curb the risk of heart attack and other cardiovascular trouble. And studies have hinted that vitamin D could be protective against a range of ills, from cancer to diabetes to multiple sclerosis — though clinical trials testing those ideas have yet to be finished.

The drop in multivitamin use was less expected, Kantor said. But it also makes sense, she added.

During the study period, a number of studies questioned the value of multivitamins when it comes to preventing major health conditions.

Similarly, antioxidants — such as vitamins C and E, and beta-carotene — were once a hot topic. Early studies suggested they might battle ills like heart disease and cancer.

But clinical trials later found either no benefit, or even potential harm, from antioxidants, Kantor’s team pointed out in the new report.

The current findings are based on almost 38,000 U.S. adults who took part in a nationally representative government health survey between 1999 and 2012.

IN GOOD HEALTH Central New York’s Healthcare Newspaper.

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ONONDAGA, OSWEGO, CAYUGA AND MADISON COUNTIES in good A monthly newspaper published by

Health CNY’s Healthcare Newspaper

Local News, Inc. 5,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.

In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776.

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Matthew Liptak, Anne Palumbo, Melissa Stefanec, Chris Motola, Ernst Lamothe Jr. Eva Briggs (M.D.), Paul Rice • Advertising: Amy Gagliano, Cassandra Lawson • Design: Eric Stevens, Jeff Adkins • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider.

Consult your physician before making major changes in your lifestyle or health care regimen.

November 2016 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

Meet

Your Doctor

By Chris Motola

Richard Lockwood, M.D. New chief medical officer at Excellus BlueCross BlueShield talks about the fine balance between providing quality care and holding down cost of care Q: You became Excellus BlueCross BlueShield’s chief medical officer in February. What was your interest in assuming the position?

A: I had been in private practice for almost 30 years. I was very involved with the hospital in terms of quality management and utilization management. I became very interested in trying to provide cost-effective care. When I joined Excellus BlueCross BlueShield, I was able to become more involved in trying to make the best use of premium dollars.

Q: Were you practicing in the CNY region prior to your role with Excellus BCBS? A: I practiced for 28 and a half years at Community General Hospital. I still work in one of the area nursing homes and see patients there every day.

Q: What is it like to be viewing healthcare from a more resource-based perspective?

A: I’ve been on both sides now, but even at the hospital we were always looking at costs and resources. So it’s always been high on my agenda to hold down the cost of care.

But in my position here at Excellus BCBS, I’m able to go further in-depth and look at the issue more broadly.

Q: What do you think the low-hanging fruit is with regards to costs, post-Affordable Care Act? A: I don’t know that there’s low-hanging fruit anymore. I think it’s already been harvested. I think that we could look more at the medical necessity of using certain drugs and at getting care and procedures done in the most cost-effective arena.

So it might be moving things from a hospital setting to an outpatient setting or even a home setting.

Q: To what degree can insurance shape policy to the benefit of patients?

A: In an environment of rising copays and deductibles, what insurance can do is try to make sure our members get their care in the most appropriate and cost-effective setting. So we want them to get the right care, in the right place, at the right time. There may be less expensive options. It might not need to be done in the hospital.

based on objective information as much as possible. We have physicians from the community look at our policies to make sure they are consistent with their goals of providing high-quality care. That’s how we go about it.

Q: So you still have a lot of contact with medical personnel?

A: I interact with the other medical directors throughout the company, as well as our management nurses. There’s also the business side, because the decisions we make affect businesses and vice versa. We try to get the two to mesh. Quality is what drives us, so even when it’s not necessarily the most cost-efficient route, we’ll drive it by the quality.

Q: What are some of the local challenges to delivering cost-effective, quality health care?

A: For Central New York, there are two issues. A lot of our population hasn’t had access to coverage, so that’s where the exchange products are coming in.

We also have a large rural population, so delivering health care to those populations becomes more of a challenge. Those are the two big items.

Q: How do you address the latter one?

A: We’ve done a couple things. One of the ways is the use of telemedicine, which allows out-ofarea patients to interact with Upstate University Hospital specialists without having to drive long distances.

Q: What would you say to a young physician who was interested in moving into your position?

A: The most important thing is that they should spend a good deal of time in private practice taking care of patients so they understand the

Q: How do you go about making the decision to green light a procedure or deny coverage of it?

A: For hospital care, we use nationally recognized guidelines such as InterQual. For something like cancer treatment, we use something called NCCN criteria. We use published literature, medical society recommendations. We create policies Page 6

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

system and what it’s like. If possible, they should be involved in the administration of their practice, or be on a committee at the hospital. They might want to also look at certification or getting an MBA. Q: How long does it usually take to figure out whether or not a procedure is approved?

A: That is regulated by the state. It varies depending on whether you’re dealing with Medicare, Medicaid, or a commercial product.

Generally a couple of weeks if it’s non-emergent, 48 hours if it is. We even speed up the process in cases where, say, the surgery is tomorrow.

Q: Has there been a move toward making that process more automated?

A: Very good question. We have a process called Clear Coverage that physicians can access online and fill in a number of questions and be approved automatically with no wait at all. We’re trying to automate more of our processes.

Q: What misconceptions do you think the public has about private insurance?

A: I think the biggest one is the idea that we have a pot of gold in the basement. It goes hand-in-hand with the misconception that all care is good care. Care that isn’t needed is not good care, because any care can

have unforeseen complications. Our goal is to offer access to high-quality, cost-effective care.

Q: How does the push toward outcome-based reimbursement affect you?

A: The effect it’s had on us is that we’re forming partnerships with groups, typically hospital groups, and establishing quality measures.

It’s still in the early stages, but that’s going to be the direction in the future.

Lifelines Name: Richard Lockwood, M.D. Position: Vice president and chief medical officer of Excellus BlueCross BlueShield, CNY region Hometown: Queens, NY Education and training: State University of New York Downstate Medical Center College of Medicine. Completed his internship and residency in internal medicine at the Medical College of Pennsylvania in Philadelphia.

Affiliations: SUNY Upstate Community General campus Career: Has been in private practice with Onondaga Hill Internists, FamilyCare Medical Group, Van Duyn Home and Hospital, Loretto, and Hill Haven Nursing Home, all in Syracuse. He has held the position of medical director at Iroquois Nursing Home, Jamesville, since 2005. Joined Excellus BlueCross BlueShield as a part-time associate medical director in 1999 and was named medical director for the company’s Central New York region in 2011. In July 2015 became Excellus BCBS vice president and chief medical officer of utilization management.

Served as president of the medical staff at Community General Hospital before it merged with Upstate Medical University. He is a fellow of the American College of Physicians Organizations: American College of Physicians; Medical Society of the State of New York; Onondaga County Medical Society Family: Married, two daughters, two grandchildren Hobbies: Running, skiing, biking

Healthcare in a Minute

By George W. Chapman

Hospital Ratings

The recent five-star ratings of hospitals by Medicare raised the issue of whether large teaching hospitals got a fair shake because the survey upon which the ratings were based (Hospital Consumer Assessment of Healthcare Providers and Systems) did not account for patient acuity. Large teaching hospitals treat more trauma and often care for difficult patients transferred to them by surrounding rural and suburban hospitals. A study published in the Journal of General Internal Medicine looked at online hospital reviews by consumers on Yelp. About 25 percent of the almost 3,800 hospitals in the Medicare survey also had ratings on Yelp. The correlation between the Medicare rating received by a hospital and the Yelp reviews was very strong. Yelp reviewers reported on staff quality and compassion, access, convenience, bedside manner, cost, billing, scheduling, treatment of family and visitors. Researchers found that consumers are more savvy than the industry thinks. Hospitals that performed better enjoyed greater market share and growth. Word gets around and patients seek care where it’s the best.

Telemedicine

Many argue telemedicine will never be as effective as a real face-toface encounter between patient and provider. So far, the technology has proven effective in many scenarios,

such as: the patient is incapacitated (sick, injured, contagious); foul weather; transportation is unavailable (commercial or caregiver); patient just needs remote monitoring; patient needs encouragement or compliance pep talk; patient needs medicine checked; patient has mental issues and acts out; patient can’t leave work; on call provider can refer to video visit.

RomneyCare update

Industry observers keep an eye on what is happening In Massachusetts because it is considered the harbinger of things to come under the Affordable Care Act. The Massachusetts Center for Health Information reported that costs in 2015 were $8,424 per capita which is an increase of 3.9 percent over 2014. The benchmark or target was an aggressive 3.6 percent. (Everyone in Massachusetts has insurance.) As with the rest of the nation, drug costs were responsible for most of the cost “overrun,” accounting for a third of all costs. Larger, more efficient healthcare systems are putting a lot of financial pressure on smaller community hospitals and rural systems.

2016 election

Both candidates agree drug companies seemingly raise prices arbitrarily and something needs to be done. Trump would allow Medicare/ Medicaid and commercial payers to purchase drugs from countries like

Canada. Clinton would appoint a federal watchdog to monitor price increases and limit the amount of income consumers would have to spend out-of-pocket on drugs. But controlling the pharmaceutical industry, let alone prices, will not be easy unless the revolving door between the FDA and the drug manufacturers is controlled. The FDA has data on how many of its former employees now work as consultants or lobbyists to the pharmaceutical industry but has not released such data.

National spending

In 2014, we spent $9,523 per capita on healthcare — still the most by far of any developed country. At $3 trillion, healthcare was 17.5 percent of our GDP in 2014. (It is currently trending at 18 percent.) Medicare and Medicaid accounted for 36 percent of spending. Commercial insurance accounted for 33 percent and out of pocket another 11 percent. The remaining 20 percent is VA, federal employees, Public Health Service and other federal programs.

Specialty rankings

According to a study of online physician reviews published in Becker’s Hospital Review, consumers report the highest satisfaction levels with neuromuscular specialists, thoracic surgeons, podiatrists, plastic surgeons and colorectal surgeons.

The lowest ranking were with psychiatrists, preventive medicine

specialists, pain specialists, emergency physicians and neurologists.

Watch your scale

The good news, according to a study by a Cornell professor published in the New England Journal of Medicine, is your weight might be at an annual low right now. The bad news is that, thanks to the upcoming holidays, you will gain weight and a lot of the gain will be permanent, if you don’t pay attention. Weight gain typically starts 10 days before the holiday season and peaks around New Year. Other studies have found that after 30, most of us gain two pounds of permanent weight every holiday season.

CNY Smokeout

3K fun run to promote giving up tobacco products will take place at 8 a.m., Sunday, Nov. 6., at Onondaga Lake Park. $20 entry fee. Call 7273074 for more information.

George W. Chapman is a healthcare consultant who works with hospitals and medical groups.

He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

FamilyCare Medical Group, P.C. is pleased to announce to the local professional medical community that

Joy Commisso, MD, MPH

will be joining FamilyCare of Cicero in January 2017 Board-certified in Family Medicine, Dr. Commisso provides expertise in treating both children & adults of all ages with services including well and sick visits, immunizations, preventive health care and much more For more information about scheduling an appointment with Dr. Commisso, please call the office at

(315) 698-0290

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

My Turn

By Eva Briggs

Our Bones: Constantly Remodeling, Repairing Our Skeleton Sometimes we think of our bones as inert and unchanging. After all, once we’re adults our height and the length of our limbs pretty much remains static.

In actuality, however, our bones contain many living cells that are constantly busy remodeling and repairing our skeleton in response to the stresses that a lifetime of activity entails.

Walking, running, lifting, and practicing sports are ways that we pummel, pound and punish our bone.

Normally our bone repair cells — osteoclasts and osteoblasts — fix any microscopic damage that results.

But when someone ramps up the amount of time spent on an activity, or increases its intensity, the body’s self-repairing processes can become overwhelmed.

Daily microdamage adds up.

Tiny microscopic cracks coalesce, eventually leading to a stress fracture.

Stress fracture symptoms start insidiously. Maybe there is a little pain during an activity, but it resolves when the activity stops. It doesn’t seem much different than a mild sprain or strain, at first. So the sufferer tries the usual remedies — over-the-counter pain relievers, ice,

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stretching, taping, etc. But with time the pain lasts longer, and eventually doesn’t go away at all. Soon the area hurts when palpated. The area may swell or turn red, though not necessarily.

Even when the patient finally seeks medical care, the diagnosis isn’t always simple because many stress fractures don’t show up on an initial X-ray. An MRI is more sensitive for detecting stress fractures.

Bones in the lower leg and foot are the most commonly affected, but stress fractures can also affect the pelvis, thigh bone, vertebrae, and upper extremities. It all depends on the sport and the individual.

For example military recruits get “march fractures” in the metatarsals, which are bones of the feet, and rowers can develop rib stress fractures.

Increased activity is the biggest risk factor. But other risk factors include low bone density, female sex, muscle weakness, leg length differences, family history, Caucasian race, and inadequate dietary calcium intake.

Treatment begins with resting the area, perhaps by applying a cast or boot, and using crutches.

As the area heals, activity is slowly increased, sometimes under the guidance of a physical therapist. The

IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

length of time to healing depends on the severity of the fracture, its location, and patient factors such as age and underlying medical conditions.

Rarely, a stress fracture refuses to heal with conservative treatment and requires surgery.

Gradual increases in activity duration and intensity help prevent stress fractures. Some data suggests that insoles and orthotics might help reduce the development of lower extremity stress fractures. Runners should change their shoes every 300 -700 miles.

Stress fractures appear to have

been around long before humans existed, as some paleontologists believe that they’ve seen stress fractures in dinosaur fossils!

Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

MVP’s New Medical Chief Has Engineering Background New chief has led teams of doctors, pharmacists, nurses — and engineers as well

By Ernst Lamothe Jr.

B

eth Malko was very committed to the environmental concerns of the world. While majoring in biology at Rensselaer Polytechnic Institute, she realized that various organizations were doing very cool things in the world to improve overall quality of life.

“Engineering was something that I had a passion about. There are a number of significant health issues that people don’t know about that can be caused by the industrial waste dumps of companies,” said Malko.

“Quality of life is essential.”

Those last five words — “quality of life is essential” — have been some of the guiding principles in Malko’s career as she transitioned from engineering to the medical field.

Malko was recently named the new chief medical officer at MVP Health Care. She succeeds Allen Hinkle.

Malko — who is board-certified in family practice — has more than 20 years of managed care experience, bringing her medical expertise to both for-profit and nonprofit payor settings. She comes to MVP from a position as executive vice president for clinical transformation and operations at Evolent Health in Arlington, Va. Previously, Malko served as the executive vice president and chief medical officer for Fallon Community Health Plan in Worcester, Mass.; as the regional medical director for WellPoint Inc.’s state-sponsored business; and as a lead medical director for Anthem BCBS in New Hampshire and Connecticut. Earlier in her career, she also served as a family physician in private practice and as a chief engineer in several environmental engineering firms.

“Dr. Malko brings great talent and experience to MVP and I am confident that she will play a significant role in our ongoing transformation as we meet and manage the challenges presented by an ever-changing industry,” said MVP President and CEO Denise Gonick in a press released issued by MVP. Malko has extensive management experience, including leadership of engineers, physicians, pharmacists, nurses and administrative and managed care staff.

She led a staff of more than 350 associates at Evolent in clinical strategy and relationships.

Malko, who received a master’s degree in engineering and environmental engineering from Rensselaer Polytechnic Institute — and later earned her medical degree from the University of Connecticut — believes her engineering background gave her the technical knowledge and skillset to take on various healthcare roles.

“You learn to execute and as an engineer that is not something necessarily taught, “she added. “It has helped me have the mindset to fix healthcare one member and one

Malko provider at a time to build a system with solutions. And my love for the environment still has a tremendous impact on me as I champion clean water and air around the world.”

Born and raised in New York, when she was deciding on her next career step, coming back to her home state definitely appealed to her. “You know the saying if you can make it in New York, then you can make it anywhere,” said Malko. “People in this state are passionate about everything from life to healthcare so I think it is the perfect place for me to be.”

She understands the health care climate continues to evolve, sometimes at a pace frustratingly fast for patients, medical officials and insurers.

“When you look at the United States compared to other countries, we are not delivering health outcomes the way we need to even though we are spending so much on healthcare,” adds Malko. “We spend more than double the cost. We have to focus on giving the patient the best experience while still keeping our cost low.”

She believes healthcare will always be very local and that providers will have to take a larger role in the situation. It’s a critical time in organizations like MVP, especially any organization that deals with seniors.

“What thing that drew me about MVP is that they do great work in the Medicare and Medicaid field.

Outside the healthcare field when she does have free time, she enjoys the outdoors. Whether that is kayaking or playing golf, fresh air and water resonates through her life.

In addition, she likes travelling the world.

“I recently took my longest vacation ever which was three weeks. My husband, daughter and I spent that time all around the United Kingdom.

It was so relaxing and I am glad I did it.”

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Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Are You Facing Thanksgiving Alone?

If you are facing Thanksgiving alone for the first time, you may be anticipating a lonely and depressing fourth Thursday of November.

But it doesn’t have to be so. Whether you’re divorced, widowed or just can’t make it home for Thanksgiving, this family-centered holiday can be an opportunity for personal growth and expression.

Below are some tips and creative ways to manage and embrace what can be a challenging day in the life of those alone this time of year: Be thankful. And why not start with yourself? Consider making a list of all the things you are thankful for this year: Your health? Your children? Those good friends who have stood by you through thick and thin? A career or volunteer job you love? A beloved pet? Or perhaps even this opportunity in your life to learn and grow?

Take the long view. While you may be alone this year, it doesn’t mean you’ll be dining solo on leftover stuffing the rest of your life. This one day doesn’t dictate your destiny.

Who knows what the future holds?

Over the next year, you may meet someone special or achieve a mea-

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sure of inner peace and confidence that enables you to enjoy a holiday on your own or with a “family of friends.”

Do good. Helping others this time of year can take your mind off being alone and give you something worthwhile to do.

Shelters and food kitchens often welcome volunteers, but — truth is — many of these agencies fill up fast with regular volunteers.

You may need to plan ahead and be creative.

As an alternative, many local YMCAs host “turkey trot” races and need volunteers to register and cheer on runners of all ages. Instead of serving stuffing at the shelter, you could be serving up smiles at the finish line.

Throw your own little holiday dinner for fellow “strays” or “disconnected” persons. Have some fun! It doesn’t have to be elaborate or even planned far in advance. Sometimes last-minute dinner invitations can turn into the best, most memorable get-togethers.

Chances are you know others who may be alone this Thanksgiving.

Extend a warm invitation and ask people to bring a holiday side dish to pass. This gives everyone a chance to make a meaningful (and delicious!)

IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

contribution.

Beware of “euphoric recall.” When you are feeling lonely, it can be easy to glorify the past. Did last year’s Thanksgiving live up to the Norman Rockwell ideal? Or did all the bickering, bad blood, and woozy, overstuffed relatives make you want to run for the hills? Maybe, just maybe, being with your own good company is a blessing.

Rent a movie and indulge in a tasty guilty pleasure. Oh, why not? Rent a favorite “feel good” film and make a night of it. You might check out “Tootsie” or “On Golden Pond,” two of my favorite oldies, which never fail to warm my heart. Or find a new movie you haven’t seen and enjoy the novelty of seeing something for the first time. Top it off with a favorite treat. I love pumpkin pie ice cream this time of year!

Pick up the phone. I’ve adapted one of Abe Lincoln’s famous lines for my own purposes: Most folks are as lonely as they make up their minds to be. The difference between isolation and engagement can be as simple as dialing a seven-digit phone number.

My experience happily tells me that most folks welcome a call on Thanksgiving. An invitation to go for a walk or see a matinee while the turkey is in the oven is often seen as a nice diversion and chance to get out of the house. Others just love opening their homes, inviting friends in, and expanding the celebration. It can be a beautiful thing for everyone.

Decorate your home inside and out.

Do it for you. It may help put you in the spirit of the holiday. This past weekend, I recreated my annual stacked-pumpkin display for my front porch. It gives me a warm feeling every time I pull up to the house.

Create harvest accents for your home

and feel the essence of Thanksgiving in your heart.

Nurture yourself. On your own, Thanksgiving can be a great day to do whatever you enjoy doing. Treat yourself to well-deserved time to yourself to read, luxuriate in a warm bath, nap or take a nice walk to enjoy nature. Pamper yourself for at least 30 minutes and take a mini-vacation from your worries, doubts, and fears.

Write “thank you” notes. Now here’s an idea that’s so obvious it often gets overlooked on Thanksgiving.

“Build bridges the rest of the year, and cross them during the holidays,” said Craig Ellison, PhD, author of “Saying Goodbye to Loneliness and Finding Intimacy.” If you can’t be with friends or family this holiday, pick up a pen and thank them for their support and friendship.

Who wouldn’t love to receive a card on the day after Thanksgiving that begins, “I’m sitting here on Thanksgiving morning thinking of you. On this day of thanks, I can’t help but be thankful for our (fill in the blank).” In preparation for this kind gesture, purchase cards and stamps in advance.

So there you have it: Survival tips for a single-serving Turkey Day. The good news? It will be Friday before you know it and you can be thankful you got out of bed, rose to the occasion, and enjoyed your Thanksgiving.

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops or to invite her to speak, call 585-624-7887, or email gvoelckers@rochester.rr.com.

Flushing Unused Medications?

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By Deborah Jeanne Sergeant

D

oes your medicine cabinet contain leftover prescription medication? It’s best to get rid of it as soon as possible.

Medication loses efficacy over time, so it won’t help you eventually.

Plus, medication taken incorrectly by someone else could cause serious health problems should it fall into the wrong hands. Any guest in your home could help himself to a prescription you don’t take anymore — and you likely would not even notice since you don’t take it regularly.

“Letting it sit in a medicine cabinet is a bad idea because someone else can get a hold of it,” said Nick Chervinsky, pharmacist and owner of Brewerton Pharmacy in Brewerton.

Numerous scenarios could result in people taking unwanted drugs from your home. If you’re trying to sell your home, people viewing it during an open Chervinsky house could rifle through your medicine cabinet.

A curious grandchild or his friends may help themselves. Or what about guests at your dinner party or a person working on your home who uses the bathroom?

Even people you feel you know pretty well may secretly struggle with a drug problem.

Ideally, store medication in a locked cabinet and get rid of unused medication. As valuable as medication can be, only keep on hand what you need to take. Don’t stockpile medication you don’t take. Taking prescription drugs that have not been prescribed for you to take for a specific issue can harm your health.

Formerly, the New York Department of Health advised flushing unwanted prescriptions. But the Department of Environmental Conservation discovered that water treatment facilities cannot completely prevent traces of some medications from entering streams and rivers and

contaminating them.

In light of the prescription drug abuse problem, developing secure places to drop off drugs provides a safe way to get rid of unwanted medication.

“The best thing is to bring it to us or a local pharmacy,” Chervinsky said. “We’ll dispose of it.”

Some individuals try to dispose of a drug by mixing it with used kitty litter or coffee grounds; however, desperate drug abusers or pets may still ingest medication from the trash.

Not all pharmacies can take back controlled substances, syringes or any prescription drugs. In Cayuga County, the Auburn Police Department accepts unwanted medication.

Oswego and Onondaga counties lack permanent drop-off sites.

The National Prescription Drug Take-Back Day, Oct. 22 this year, offers an opportunity to safely dispose of unwanted medication. The Drug Enforcement Administration welcomes law enforcement agencies to take part.

“They send it to an incinerator,” said George Amendolare, pharmacist and owner of Gifford & West Pharmacy in Syracuse. “This helps prevent drug addiction to prescription medication.”

How to Get Rid of Unused Drugs

Visit www.deadiversion.usdoj. gov/drug_disposal/takeback/ index.html for a list of drop-off sites or call 1-800-882-9539.

Most drop-off locations require that medication remains in its original containers; however, you can black out your personal information from the label.

Needles, sharps, asthma inhalers and illicit drugs are not accepted at some locations. Call ahead of time to find out what the facility accepts.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

SmartBites The skinny on healthy eating

Nutritious Nut Butters Boast Healthy Fats

N

ovember is National Peanut Butter Lovers’ Month! What better time to celebrate all that’s wonderful about this healthy plant-based protein?

Some things just go together: Tarzan and Jane, socks and shoes, peanut butter and jelly. Here’s one more: nut butters and good nutrition.

Surprised? Some people are. But according to dietitians, nutritionists and people in the know, nut butters are a convenient, low-cost, nutritious addition to most diets.

Although “peanut butter” comes to mind first when considering nut butters, there are many alternatives, choice. each with their own unique health Not so surprisingly, high-quality benefits. For the most part, howevnut butters without added sweeter, all nut butters — from peanut to eners, salt or preservatives have pistachio, almond to walnut — denutrient profiles similar to the nuts liver about 200 calories, 7 to 8 grams from which they are made. My go-to of protein and 16 grams of fat per nut butter is the one with the most 2-tablespoon serving. calcium: almond butter. My husband, The calories and fat are what on the other hand, reaches for walnut deter some from consuming this butter, a nut butter that’s loaded with particular food; and, indeed, if you heart-healthy omega-3 fatty acids. are closely monitoring either, then Both my budget-conscious adult nut butters might not be right for kids, however, stock their pantries you. But for many, nut butters, when with peanut butter, a childhood eaten in moderation — say, a couple favorite that has a tad more protein, of tablespoons a day — are a healthy urologyIGH.10.25x6.75.qxp_Layout 1 8/19/16 1:12 PM Page 1

manganese and niacin than most.

Many wonder how nut butters, with their high fat content, can be considered a healthy food. Just like olive oil, nut butters tend to be richer in the types of fat that benefit heart health — monounsaturated and polyunsaturated fat — and not so rich in saturated fat. In fact, a 2-tablespoon serving of peanut butter has the same ratio of unsaturated fat to saturated fat as olive oil.

Another good reason to go crazy for nut butters: According to the Harvard School of Public Health, numerous studies have shown that people who regularly include nuts or nut butters in their diets are less likely to develop heart disease or type 2 diabetes than those who rarely eat nuts.

Last but not least? November is National Peanut Butter Lovers’ Month! What better time to celebrate all that’s wonderful about this healthy plant-based protein?

Helpful tips

Unlike some of the other nut butters, there’s tremendous variation in the quality of peanut butters sold.

Scour the labels carefully (nutrition facts and ingredients list) and opt for peanut butters that are lower in sugar and salt and that do not contain added oils, especially “partially hydrogenated oil,” which is a source of trans fat. Steer clear of reduced-fat peanut butters, which replace the “healthy fats” with add-ins and starchy fillers that boost the spread’s sugar content. Choose natural and/or organic peanut butters that contain peanuts and salt (if you prefer a little salt) and nothing more.

Peanut Butter Pumpkin Soup Serves 4 to 6

2 tablespoons olive oil ½ medium onion, chopped 2 garlic cloves, minced 1 (15 oz.) can 100 percent pure pumpkin 1 cooked sweet potato or yam (baked or microwaved) ½ cup smooth peanut butter (or, nut butter of choice) 3 ½ cups sodium-reduced stock of choice (or, water) ½ teaspoon coarse black pepper 1 teaspoon salt (or, less) 1 teaspoon curry powder ½ teaspoon dried coriander ¼ teaspoon cayenne pepper (optional) snipped fresh chives, for garnish In medium soup pot, sauté onions over medium heat until soft, about 5 minutes. Add garlic and cook 1 minute more. Stir in the pumpkin, sweet potato and peanut butter.

Add the stock and spices and stir well. Bring to a boil and then reduce the heat to a simmer and cook for 20 minutes, covered. Puree with a handheld blender.

If soup seems too thick, add more water. Garnish with chopped chives.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 13

Hire Your Own Private Doctor Some doctors in the area can provide you with home visits and 24/7 availability — and it’s less expensive than you think

By Deborah Jeanne Sergeant

W

ant a doctor who really knows you and offers 24/7 availability or even house calls? These options have become reality as physicians reinvent how they provide care.

A few doctors in the area have begun offering alternative ways to deliver care, and not just because they want to enhance their patients’ experience.

As margins grow thinner and thinner in the healthcare industry, many providers take on additional patients to receive adequate reimbursement from insurers. Since they can’t add more hours to the day, this means that each patient receives less time during visits. Physicians in general also have little opportunity to develop a close patient/ doctor relationship. If they increase the number of visits they schedule, they must work longer hours, which affects their quality of life.

All of these factors add up to less satisfaction for doctors and patients.

Some have turned to offering retainer-based care, sometimes called concierge medical care.

Robert C. Cupelo, an internal medicine physician who owns and operates a self-named practice in East Syracuse, believes that affiliation with MDVIP for the past five years has helped him solve the problem.

He initially practiced with a group affiliated with MDVIP and for the past two years, he has been solo.

Through his affiliation with MDVIP, a patient-centered wellness program headquartered in Boca Raton, Fla., he can link to top specialists nationwide to consult on tougher cases. MDVIP is not insurance, but he participates with insurance and bills them for services delivered on-

site.

Cupelo offers an out-of-pocket program that begins with a physical which lasts an hour, instead of the usual half hour with just 15 minutes provided by a physician.

The physical includes comprehensive screening and lab work to help assess patient health and benchmark vital numbers.

“You have more time to really make a personal connection with patients and spend more time with them in the office,” Cupelo said.

The $135 monthly fee includes follow-up wellness visits. His patients don’t have to wait for care, and they have 24/7 access to him via phone, email or text message. As a courtesy, he sees the children up to age 26 of an adult with MDVIP membership for a routine visit.

Most patients can schedule a visit to occur within two days. Part of the reason he can accommodate them is that MDVIP limits his patient load to 600. Many traditionally practicing physicians serve 2,500 or more patients.

He employs two part-time RNs and a secretary. Maintaining a small staff and facility helps reduce his overhead so he can keep the membership fee low.

MDVIP also pays for electronic recordkeeping, which Cupelo said saves him a lot.

“You get a sense of satisfaction,” Cupelo said. “When you cram 25 people into an afternoon, you don’t feel you’ve done your best job.”

Physician R. Paul Ferenchak owns My Country Doctor in Lafayette, a retainer practice. His patients pay $100 a month for comprehensive family care, which includes 24/7 access, more face time with the doctor

Physician Joseph Barry, an internist and geriatrician with Preventive Medicine Associates in Camillus, has operated the practice as a hybrid since January 2015.

He sees patients at his office and make house calls as well. He said he feels he’s “the Wegmans of medical care. I want no checkout lines, everything to be fresh, and everyone to be happy.”

Page 14

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

Physician R. Paul Ferenchak owns My Country Doctor in Lafayette, a retainer practice. His patients pay $100 a month for comprehensive family care, which includes 24/7 access, more face time with the doctor and in most cases, a standard visit and follow-up visits that extend to an hour or more. and in most cases, a standard visit and follow-up visits that extend to an hour or more.

Ferenchak practices from an office in his home. He employs no staff and gives his cell phone number to his patients. He works with providers of diagnostic testing, such as labs and X-ray providers to pass along savings of up to 50 percent to his patients.

He doesn’t participate in any insurance plans because “billing accounts for 40 percent of what diagnostic experts charge. With direct care, they can reduce their charge.”

He chose to offer direct care because he wanted to spend more time with patients instead of only the 10 to 15 minutes he could spare to boost the number of visits he needed.

“Physicians are forming mega groups to spread out the cost of maintaining their practice because it’s gotten so expensive with lowering reimbursements and all the regulations,” Ferenchak said. “To avoid fines for the various government programs, you need a special person to do this. You can end up going bankrupt.”

He feels he has returned to an old style practice where he can take his time in treating patients and making house calls as needed.

“It makes practice fun and rewarding,” Ferenchak said. “I have so many associates that are on the edge of retiring or abandoning. The level of frustration and disquietude is incredible. The health system we have

used to be the best. Now it’s ranked 27th in the world. Many third world countries are listed better. Something has to change. My hope is direct primary care paradigm helps.”

Physician Joseph Barry, an internist and geriatrician with Preventive Medicine Associates in Camillus, has operated the practice as a hybrid since January 2015.

“I like the model better,” he said.

“If people want to be seen, they can see my nurse practitioner. If there’s an issue, they can see me.”

After 25 years in practice as a physician, he didn’t feel fulfilled.

He accepts insurance, but patients pay an annual fee of $1,800 for ease of access, direct phone or email access, and extended visits.

“I can visit with them longer to talk about wellness, diet, sleep and stress and if they want to work on any of those four,” Barry said. “Communication is much improved with my model.”

He affiliates with Signature MD and has privileges with four area hospitals. He can visit patients while they’re in the hospital, order diagnostic work and make house calls as needed.

Though he makes less money than before, he’s content, feeling like he’s “the Wegmans of medical care. I want no checkout lines, everything to be fresh, and everyone to be happy.”

To comply with the Affordable Care Act, patients must also take part in a qualified health insurance plan.

Meet Your Provider

University Dialysis Center Operated by Dialysis Clinic, Inc which has 14 facilities in New York diet and exercise are still the foundations of both “Just because you have been diagnosed with diabetes does not mean you have to give up on your prevention and long term care. It means a long term commitment to self-care.” health,” Ralph said. “Keep trying different things.

Keep yourself aware of what new diet options or Narsipur knows that if kidney disease is education are available.” identified early, it can be managed in a way that may help someone avoid or at least delay kidney In 2014, diabetes was the primary cause of failure. To help manage kidney disNarsipur turns kidney failure for people in New York, with 3,024 people starting dialysis due to diabetes. Nationally, to REACH Kidney Care for support. diabetes remains the top cause of kidney failure, “At REACH Kidney Care, we make every with 43.9-percent of dialysis patients being diabetic attempt to keep people out of the dialysis chair,” as well. Dialysis and kidney transplantation are said Deb Polmanteer, RN, REACH Kidney Care treatment options for kidney failure. of Syracuse care coordinator. “By that I mean we want to help people manage their conditions and DCI has 14 facilities in New York that provide alph Viscardi, 83, receives peritoneal prolong kidney function for as long as possible. We a wide range of dialysis options, from in-center dialysis from University Dialysis Center hemodialysis, nocturnal dialysis, peritoneal dialysis provide nutritional counseling and review their lab (operated by Dialysis Clinic, Inc.) in work and medications. We talk about all aspects of and dialysis in the home setting, for people with Oswego. For the last seven years, Ralph kidney failure. At University Dialysis Center in the patient’s health and help each patient stick to has had to rely on his dialysis treatments Oswego, Sriram Narsipur, MD, is the medical a plan that works for them. If it looks like kidney to survive. He knows that it was diabetes that led failure is unavoidable, we encourage patients to director of the facility. him here. explore a transplant before dialysis is needed. We

“Our groups see about 300 patients with ESRD also discuss dialysis options in detail so the patient Ralph was diagnosed with diabetes when he can choose the best option for them. Kidney disease (kidney failure) including our satellite dialysis was in his 60s. He didn’t manage his blood sugar. is silent on so many levels. We need to educate units in Oswego and Auburn,” said Narsipur.

He didn’t see the point. Now he wants to let others “Prevention is obviously the most important patients so they can respond competently and in know that failing to manage your diabetes can have aspect of diabetes care. There are a number of their best interest.” severe consequences, such as kidney failure. great medications, but lifestyle mainly proper

R

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Parenting

By Melissa Stefanec

The ABCs of Electioneering How explain the current state of politics in our country to our young children

U

ntil last week, I didn’t pay much attention to what my children think about politics and the presidential election in November. After all, my daughter is 5 and my son is 2.

They are still trying to wrap their minds around things like what snack to bring to kindergarten and the importance of going the bathroom somewhere other than your pants.

However, during this high-profile campaign, our children are not immune to politics. Their porous little brains are soaking up political drivel, whether we realize it or not.

I carefully chose the word drivel, because, unless we are very watchful about the way we talk about politics to and around our children, all this political discourse is just that to their young minds — drivel. Take, for example, my ride to daycare last week.

I was muttering to myself about a certain political sign in a lawn. I wasn’t even necessarily aware I was

talking out loud until my daughter asked, “Mommy, what does that mean?”

My train of thought halted. How was I going to explain the current state of politics in our country to a 5-yea-old and a 2-year-old? How was I going to convey deeply personal beliefs to a child without maligning entire political parties or groups of people? After a few moments of silence and mental scrambling, I decided to start with the ABCs.

A is for America

One thing I try not to do as a parent is offer big or complicated explanations. This is an arduous endeavor, considering I no longer have a child’s mind and can’t be certain what my children can absorb. So, I started as simple as I could make it, and it went something like this. I reiterated that we live in a country called the United States of America, and most of the time people just call it America. We

are Americans. We are very lucky to able to say that we live in a great country. There is one person who leads our country. That person (I was very careful to never say he or she) is chosen by the American people and is called the president. Every four years, Americans get to vote for who they think should become president.

When I vote, I always bring my children along, so they have a concept of the process. I told them that in about month, we will likely choose one of two people to be president. I then explained, in very basic terms, what I thought about the two candidates’ approaches to recruiting votes and their past good deeds. I won’t elaborate on that, because, well, I want to stay employed at my lovely, non-partisan paper.

B is for Bystander

One thing I’ve been trying to be good about, and police in others when they are talking around my kids, is what I say about politics.

Politics is a topic that can spiral out of control very quickly. The spongy brains of our children are often tuned into what we say and do. So, no matter how passionate we are, we have to keep our political tirades respectful. We have to recognize the importance of our wee bystanders.

We are raising the next generation of the electorate. We can’t afford to raise a generation of inconsiderate, boxedin, preprogrammed, disrespectful voters. Thus, we owe to our kids to be none of these things ourselves. I am trying my best to let my actions speak to my politics. I want a kinder, more well-informed, empathetic and assertive electorate, so I am doing my best to exemplify those things.

So back to the car ride with my kids. After I told my daughter some very basic governmental and political November 2016 •

ideals, I stopped for a moment and said. “What I am about to say is very important. Please listen closely, this is one of the most important things Mommy will tell you in life. Are you ready and listening?” She responded yes, and I carried on. “Never stop asking questions. Just because someone tells you something or you read something somewhere, don’t assume that is the answer. Keep asking questions, keep reading, and keep listening to others. No one has all the right answers, including you and me.”

C is for Compassion

I think it’s fair to say that gridlock politics hasn’t gotten the American people to where they want to be today. People are upset and emotional, and they want this election to change something fundamental in the way America operates. Refusing to hear the other side, refusing to respect someone who thinks differently than you do, and refusing to offer any credibility to opposing arguments are not failures I want to instill in my children. Those sorts of refusals won’t work on the playground or in real life. To say everyone who thinks or feels differently than you is an idiot, is sheer folly. That just means you are someone else’s idiot.

If I could instill just one moral in my children, it would be kindness. Sometimes you have to be assertive and strong, but those traits come naturally to most people in power. What is harder to instill is compassion for your fellow person, no matter how wrong you think that person is. So, as I serve up rhetoric to my American bystanders this election season, whether they be wee or large, I am including the last C of electioneering in my line-up, because a prosperous future depends on it.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 15

When Will the Flu Hit?

Excellus doctor urges people get vaccinated regardless of the flu’s peak

G

uessing when the flu season will hit is a bit like playing the lottery, according to an analysis of confirmed cases of

the flu in New York state that was summarized recently by Excellus BlueCross BlueShield.

“To borrow the New York Lot-

tery’s expression, ‘Hey, you never know,’” said physician Jamie Kerr, medical director at Excellus BCBS. Excellus BCBS conducted a re-

Are you ready for this flu season?

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977 13,968

2013 – 2014

88

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268

133

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5,013

7,621

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3,128

504

193

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view of state statistics on confirmed cases of the flu for the past four years and found wide variations on when the flu begins to peak.

For example, during the 20122013 flu season, the virus hit state residents hardest in December and January, and then diminished month by month through May. But last flu season, the wave of cases hit hardest in February, peaked in March, and ended with the highest number of reported flu cases in years for the months of April and May. “Some common myths about flu shots are about their timing and effectiveness,” Kerr said. “Many people incorrectly think that once the flu season has started, it’s too late for the vaccination to work.

We’ve also heard people incorrectly assume that they should wait until later in the season to get their flu vaccination in order for it to last through May and beyond.”

According to Kerr, as long as the flu viruses are circulating, people who haven’t been vaccinated are at risk of getting sick. She also stressed that in most cases, getting the vaccine early will provide immunity for the entire flu season.

On average, 45,000 New Yorkers get the flu each year. Nationwide, the flu virus causes 200,000 hospitalizations and nearly 24,000 deaths each year, so Kerr cautions that the flu is not a virus to be considered lightly.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

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Navigating the Hospice Learning Curve

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‘Where I once associated hospice with death, I now regard hospice as representing the essence of life itself’

By Phil Rice

A

bout 20 years ago a group of friends and I visited an acquaintance who was in a special hospice wing of a local hospital. We were told he had been taken there to die. We visited, and the next day he died.

For several years after this experience, my immediate association with the word “hospice” was a one-dimensional scenario of hopelessness personified. But my impression would change.

In 2005, my mother, who was suffering from non-Hodgins lymphoma and various other ailments, moved in with my 11-year-old son Paul and me. Mom was still ambulatory, but osteoporosis, arthritis and phlebitis were making movement increasingly difficult. During the first year of this arrangement she acquired vascular dementia brought on by a series of mini-strokes.

My son Paul and I spent several months caring for her at our home but we were woefully unprepared for the task. When her falls became more frequent and she clearly needed fulltime attention, I reluctantly agreed to let her be taken to a hospital. Five days later she was in a nursing home, and four months after that she was in an assisted living facility.

After three difficult years of such care, my cousin Starr asked me if I had considered hospice. My response was to assure her that although mom was in deep dementia and completely dependent upon physical assistance for even the simplest of tasks, there was no indication that her passing was imminent. Nevertheless, Starr urged me to look into hospice. I finally took her advice, and thus began a profound learning experience.

How it Worked for Me

A hospice evaluation soon confirmed that mom indeed qualified — and that her insurance would cover the services. This was an amazing revelation. From that day forward a hospice caregiver would come by three times a week and make sure Mom was properly bathed and generally being treated well. A registered nurse visited at least once a week to monitor any medications and health concerns, keeping me fully informed along the way. If there was a specific concern, the nurse visited more frequently. A chaplain and social worker each made regular visits as well.

Having hospice involved was a huge benefit toward ensuring that mom was comfortable and safe, which in turn eased my own stress.

This became even more important a couple of years later when my fiancée Janice had emergency brain surgery to remove a malignant brain tumor. Unable to visit with my

usual frequency, hospice became my lifeline to Mom during those weeks.

When it became apparent that Janice was not going to win her battle, hospice again stepped to the front.

What Hospice Taught Me

After two months in the hospital we were able to bring Janice home.

Hospice provided all of the necessary equipment and supplies for us to properly care for her needs. The caregiver showed me how to bathe Janice and change her clothing and sheets with the least amount of discomfort.

The RN made sure I understood how to use the feeding tube and how to gauge her need for medication. I spent many hours a day alone with Janice, but I never felt alone. There was a team involved.

How Hospice Changes Lives

I have accrued years of experience in dealing with healthcare professionals and caregivers, from the top hospitals to the bare-boned assisted living facilities and nursing homes. Some were exceptionally dedicated and skilled, and most were genuinely compassionate and competent. But some were less than competent.

Hospice workers are different.

I’ve never encountered a hospice worker who was anything less than fully and passionately engaged with the difficult task at hand.

Where I once associated hospice with death, I now regard hospice as representing the essence of life itself.

Because of hospice Janice and I were able to experience life to the fullest in her final weeks, and I was able to share in her journey as much as humanly possible.

As a society we ascribe deep significance to the beginning of life; for many, birth is the moment where the physical is most connected with the spiritual. Hospice provides an opportunity to embrace the end of life just as profoundly and lovingly.

Easing the transition of a loved one and sharing the moment of passing are among the finest gifts we can hope to give and receive in this life. I consistently seek new ways to express my gratitude to hospice for my gaining this awareness.

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Page 17

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Cataract Surgery Has Come a Long Way

Surgeries are quicker, precise and allow many patients to discard their reading glasses

By Deborah Jeanne Sergeant

C

ataract surgery has become commonplace, but the techniques involved and results possible have improved over the past several years. Some patients may reduce their astigmatism and need for reading glasses, among other advances.

Largely associated with aging, cataracts affect many older people with yellow tinted vision, limited night vision, glare in bright light, cloudy vision and double vision.

Mostly a routine surgery widely performed at out-patient centers and hospitals, cataract surgery has developed much in recent years.

“We’re in a very exciting time,” said Mary DiMauro, administrator at The Specialty Surgery Center of CNY in Liverpool. “We have a very upto-date and current technologically savvy facility. Patient satisfaction is off the chart.”

Most patients need only light sedation and return home the same day. The surgeon removes the cataract by making an incision in the cornea, breaking apart the cataract, removing it, and then placing a manmade, permanent lens in the eye to replace the cataract.

Though it’s not suitable for all patients, candidates can improve their near vision and astigmatism.

By their late 40s, most people begin to lose near vision and need reading glasses. Monofocal lenses only helped people see mid-range and long-range.

“The choice of the new technology lenses is incredibly promising,” DiMauro said. “There are a few new ones that are multi-focal and they have a wide range of correction ability, from fairly near, like the computer, to far.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

But don’t toss those reading glasses yet.

“It’s very hard to correct the very close-up vision we lose when we get older,” DiMauro said.

Some lenses correct or reduce astigmatism as well. The “premium” lenses may not be covered under health insurance; however, DiMauro said that improving vision so significantly “is well worth the price. Patients come back and say they can’t wait to have their other eye done.”

Instead of anticipating weeks of thrice a day drops, some surgeons offer no-drop surgery. While this may seem a minor advantage, it’s a big deal when a widow who lives alone delays surgery — and her chance for clear vision — because she feels uncertain about administering the eye drops afterwards. Plus, patients won’t have to pay for the drops, which can spare them the co-pays, or a hefty pharmacy bill if their medication isn’t covered.

Pharmacist Chris Verrillo, who owns C & J’s Northside Pharmacy in Syracuse, said that patients use the drops for about a month depending upon how their surgery and recovery goes.

A month-long supply of the anti-inflammatory medication can cost up to $80. Plus, they will need antibiotic drops, which can cost as much. And that’s just for one eye.

Most people have each eye done in separate operations so that requires another round of prescriptions.

“Ask if you have trouble affording it,” said Verrillo regarding those that choose standard surgery over drop-less. “We can call the doctor and find something that’s covered and less expensive.”

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eed another reason to destress? Experts identify increased stress levels as a risk factor that could lead to Alzheimer’s disease.

Research has not yet established a direct causal relationship between chronic stress and the condition, but Cathy James, co-chairwoman of the New York State Alzheimer’s Association Coalition, says that “prolonged, chronic stress has impact on our bodies.”

Adds James, “It elevates heart rate, blood pressure, and is linked to depression. Because there’s a strong heart and brain connection, scientists are focusing on the possible causal relationship on stress and Alzheimer’s disease.”

When a person undergoes stress, the body releases stress hormones that kick in the “fight or flight” response. While this may prove useful in a physical confrontation, it’s not helpful for the type of stress most people experience. Instead, it can elevate blood pressure, damage blood vessels, and affect the ability to accurately remember data. The latter effect represents one reason why researchers believe uncontrolled stress could influence the development Alzheimer’s disease.

The subject has proven difficult to research because of the subjective nature of stress. Not everyone experiences stress the same way.

“The perception of how much stress I may be under is of interest to scientists as well,” James said.

Indirect factors may play a role.

For example, people experiencing stress may not sleep well, suffer from depression or engage in unhealthful methods of attempting to cope with the stress that could in part or all together raise their risk for Alzheimer’s disease.

James, who also leads the Syracuse-area chapter of the Alzheimer’s Association, said that people in the

early stages of Alzheimer’s disease experience disrupted sleep, but it’s not certain whether the sleep disturbance causes the disease or the disease causes the sleep disturbance.

Jennifer A. Rivier, Ph.D, owns Stress Relief Center in Amherst, Buffalo region, and has practiced holistic health 33 years. She believes that chronic stress and Alzheimer’s disease is very closely linked. “When you study the mind/body connection, you realize everything is connected. When people recognize how it affects your body, it helps them become their own best therapist.”

Many methods can help you deal with stress, such as avoiding situations that generate stress. For example, instead of procrastinating, plan and complete tasks ahead of time. Or instead of accepting invitations from difficult people, politely decline. If you take on too many responsibilities, delegate to others.

“You need to clear your mind to restore order and stop plugging in so many things,” Rivier said. “That’s how they overload the circuits.”

It’s impossible to eliminate all stress. But part of coping is knowing what you can and can’t avoid, and gracefully managing the stress you must carry.

“Unless you have the tools to regroup and reground, stress will take its toll,” Rivier said. “Eat right.

Exercise. Recognize when you’re on the edge before it’s too late. Don’t rely on pills or alcohol as coping mechanisms. Know what your mind and body need.

“Where is your getaway, like helping others or animals? Get back to nature. Learn to breathe right. People hold their breath because they’re in panic mode.”

As routine stress management, plan to decompress in ways that you enjoy, such as yoga, fun hobbies, and, especially, physical activity.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 19

U.S. Life Expectancy Lags Behind Other Wealthy Nations Diabetes, drugs and guns contribute to disappointing statistics in new global report

T

he United States lags behind other advanced nations when it comes to infant mortality and the life expectancy of its citizens,

according to a comprehensive review of global health statistics.

The health of U.S. citizens is specifically challenged by smoking, diabetes, high blood pressure, drug abuse and gun violence, said study co-author, Mohsen Naghavi. He's a professor with the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.

The United States isn't meeting the high expectations set by the country's wealth and the amount it spends on health care, mainly because not all U.S. citizens benefit equally from their nation's advantages, Naghavi said.

"This comes from inequality in access to health care, along with other social and economic factors," he said.

Infant mortality in the United States amounted in 2015 to six deaths

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

out of every 1,000 kids younger than 5, while the average for all high-income nations combined was about five deaths per 1,000, researchers said.

U.S. men and women also had poorer life expectancy, compared with the rest of the developed world.

U.S. men had an average life expectancy of 76.7 years in 2015, with about 66.8 of those years spent in good health. Life expectancy for U.S. women was 81.5 years on average, with 69.5 years spent in good health.

By comparison, all high-income countries combined had an average 78.1 years of life expectancy for men and 83.4 years for women, the study reported. Years lived in good health averaged 68.9 for men and 72.2 for women.

These findings are part of the Global Burden of Diseases, Inju-

ries and Risk Factors Study 2015, a scientific analysis of more than 300 diseases and injuries in 195 countries and territories.

The numbers show that the United States needs to rethink its approach to health care, said physician Prabhjot Singh. He is director of Mount Sinai's Arnhold Institute for Global Health in New York City.

"We are investing in the wrong stuff, and we are paying for it with our lives," Singh said.

Researchers found that drug abuse and diabetes are causing a disproportionate amount of ill health and early death in the United States, compared with other countries.

Alcohol, smoking and access to guns also pose continuing health threats to U.S. citizens, Naghavi said.

The study was published Oct. 6 in The Lancet.

By Jim Miller

Planning a Funeral?

Expect to Pay $11,000+ Dear Savvy Senior,

How much does an average funeral and body burial cost? I need to make funeral arrangements for my aunt, who’s terminally ill, and would like to have a cost idea going in so I can plan and budget appropriately.

The Executor

Dear Executor,

It definitely pays to know what charges to expect when pre-planning a funeral. Most people don’t have a clue, and can often be upsold thousands of dollars worth of extra services you may not want or need.

Here’s a breakdown of what you can expect

Funeral Prices

The first thing you need to be aware of is that funeral costs will vary considerably depending on your geographic location, the funeral home you choose and the funeral choices you make. With that said, here’s a breakdown of what an average funeral costs, nationwide, according to recent data from the National Funeral Directors Association.

• Professional services fee: This is a basic non-declinable fee that covers the funeral provider’s time, expertise and overhead. $2,000 • Transfer of the remains: This is for picking up the body and taking it to the funeral home. $310 • Embalming and body preparation: Embalming is usually mandatory for open-casket viewing, otherwise it’s not required unless the body is going to be transported across state lines. Embalming costs $695. Other body preparations, which includes hairdressing and cosmetics runs $250.

• Funeral viewing and ceremony: If the viewing and funeral ceremony is at the funeral home, you’ll be charged for use of the chapel and any necessary staff. Costs: $420 for viewing, and $495 for funeral ceremony.

• Metal casket: This is a big money maker for funeral homes, with markups of up to 300 percent over the wholesale price. $2,395.

• Funeral transportation: Use of hearse and driver $318 to transport the body to the cemetery. Use of a service car/van $143.

• Memorial printed package: This includes printed programs and memorial guest book. $155.

In addition to these costs, there are a number of other related expenses such as flowers for the funeral (around $200 to $400), the newspaper obituary fee ($100 to $600 or more), the clergy honorarium ($200 to $300) and extra copies of the death certificate ($5 to $35 per copy depending on the state).

And, a number of large cemetery costs like the plot or mausoleum fee, the vault or grave liner that’s required by most cemeteries, and the opening and closing of the grave, all of which average between $2,000 and $4,000; and the gravestone, which typically costs between $1,000 and $3,000.

All told, the average cost of a total funeral today is around $11,000 or more.

Ways to Save

If your aunt’s estate can’t afford this, there are ways to save. For starters, you should know that prices can vary significantly by funeral provider, so it’s wise to shop around.

If you need some help finding an affordable provider, your area funeral consumers alliance program may be able to refer you. See Funerals. org/local-fca or call 802-865-8300 for contact information.

There are also free websites you can turn to, like Parting.com that lets you compare prices, and FuneralDecisions.com that will provide estimates from local funeral homes based on what you want.

When evaluating funeral providers, be sure you get an itemized price list of services and products so you can accurately compare and choose what you want.

But the most significant way to save on a funeral is to request a “direct burial” or “direct cremation.”

With these options your aunt would be buried or cremated shortly after death, which skips the embalming and viewing. If she wants a memorial service you can have it at the graveside or at her place of worship without the body. These services usually run between $600 and $2,000, not counting cemetery charges.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 21

The Social Ask Security Office

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Supporting Our Wounded Warriors

very Veterans Day, the nation honors the brave men and women who risk their lives to protect our country and the freedoms we cherish. Social Security honors veterans and active duty members of the military every day by giving them the support they deserve. A vital part of that is administering the Social Security disability program.

For those who return home with injuries, Social Security is a resource they can turn to for disability benefits. Social Security’s Wounded Warriors website is at www.socialsecurity.gov/woundedwarriors.

The Wounded Warriors website has answers to many commonly asked questions, and shares other useful information about disability benefits, including how veterans can receive expedited processing of disability claims. Benefits available through Social Security are different from those available from the Department of Veterans Affairs and require a separate application.

The expedited process is available to military service members who

become disabled while on active military service on or after Oct. 1, 2001, regardless of where the disability occurs.

Even active duty military who continue to receive pay while in a hospital or on medical leave should consider applying for disability benefits if they’re unable to work due to a disabling condition. Active duty status and receipt of military pay doesn’t necessarily prevent payment of Social Security disability benefits.

Although a person can’t receive Social Security disability benefits while engaging in substantial work for pay or profit, receipt of military payments should never stop someone from applying for disability benefits from Social Security.

Learn more by visiting www.socialsecurity.gov/woundedwarriors.

With over 80 years of experience and compassionate service, Social Security is proud to support our veterans and active duty members of the military. Let these heroes know they can count on us when they need to take advantage of their earned benefits, today and tomorrow.

Q: How do I earn Social Security credits, and how many do I need to qualify for benefits?

A: We use your total yearly earnings to figure your Social Security credits. The amount needed for a credit in 2016 is $1,260. You can earn a maximum of four credits for any year. The amount needed to earn one credit increases automatically each year when average wages increase.

You must earn a certain number of credits to qualify for Social Security benefits. The number of credits you need depends on your age when you apply and the type of benefit application. No one needs more than 40 credits for any Social Security benefit.

For more information, visit our website at www.socialsecurity.gov.

them; and • Manage your benefits: – Change your address or telephone number; – Start or change your direct deposit; – Get a replacement Medicare card; and – Get a replacement SSA-1099 or SSA-1042S for tax season.

Q&A

Q: Why should I sign up for a my Social Security online account?

A: my Social Security gives you a personal online account you can securely use to check your Social Security information and do business with us. With a my Social Security account you can: • Keep track of your earnings and verify them every year; • Get an estimate of your future benefits if you are still working; • Get a replacement Social Security card if you meet certain criteria and reside in these locations; • Get a letter with proof of your benefits if you currently receive Page 22

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

Q: My spouse died recently and my neighbor said my children and I might be eligible for survivors benefits. Don’t I have to be retirement age to receive benefits?

A: No. As a survivor, you can receive benefits at any age if you are caring for a child who is receiving Social Security benefits and who is under age 16. Your children are eligible for survivors benefits through Social Security up to age 19 if they are unmarried and attending elementary or secondary school full time. Keep in mind that you are still subject to the annual earnings limit if you are working. If you are not caring for minor children, you would need to wait until age 60 (age 50 if disabled) to collect survivors benefits. For more information about survivors benefits, read our publication Survivors Benefits at www.socialsecurity.gov/pubs.

To find all of the services available and set up an account, go to www.socialsecurity.gov/myaccount.

Health News CEO John McCabe on the list of top physician leaders

P

hysician John McCabe, chief executive officer of Upstate University Hospital and senior vice president for hospital affairs at Upstate Medical University, has been named to the Becker’s Hospital Review 2016 list of “110 Physician Leaders of Hospitals and Health Systems.”

McCabe is a resident of Cazenovia.

The Becker’s Hospital Review editorial team considered nominations and conducted research to select leaders for this list.

This list features hospital and health system presidents and CEOs who also hold medical degrees.

According to Becker’s, all recipients have demonstrated outstanding leadership and clinical expertise throughout their careers, leading initiatives to improve their individual organizations and the healthcare of the communities they serve.

McCabe has served as CEO of Upstate University Hospital since 2009, prior to serving at Upstate in numerous roles including professor and chairman of the department of emergency medicine.

As CEO of Upstate University Hospital, McCabe guides the area’s largest hospital and the region’s only trauma center, serving patients from all across the state.

Under McCabe’s leadership, Upstate designed, built and opened the 90,000 square McCabe foot Upstate Cancer Center that brings most of Upstate’s outpatient cancer services under one roof. The center is equipped with some of the most advanced treatment technology for cancer in the state.

Additionally, McCabe oversaw Upstate’s acquisition of Community General Hospital, creating the largest hospital in Syracuse. Since the acquisition in 2011, Upstate has introduced new services at what is now called its community campus, including a geriatric emergency room, transitional care unit and pediatric after hours care, among other services.

Chiropractic college names next president

ing consultant.

Having earned his Doctor of Chiropractic degree from the National University of Health Sciences in 1994, Mestan completed his residency in diagnostic imaging at Southern California University of Health Sciences. In 2011 he earned a master’s degree, and in 2013 a Doctor of Education degree, both in educational administration with a specialization in higher education, from the University of Rochester’s Margaret Warner Graduate School of Education and Human Development in Rochester.

Mestan resides in Seneca Falls with his wife and three children.

Chiropractor Michael A. Mestan has been selected as the new president of New York Chiropractic College, based in Seneca Falls. He will succeed Frank J. Nicchi, who’s retiring Aug. 31.

Mestan now serves NYCC as executive vice president and provost and holds an academic appointment in the chiropractic Mestan program. He joined the college in 2002.

“Dr. Mestan is an outstanding choice,” said Thomas R. De Vita, chairman of the New York Chiropractic College board of trustees.

“We are confident in his ability and excited to support him as he leads the College to even higher levels of excellence in the future.”

Mestan held positions as department head for clinical sciences, dean of the chiropractic program, and executive vice president for academic affairs before being appointed to his current position in 2010. Previously, he held academic and administrative appointments at Parker University in Dallas.

He has also practiced chiropractic and served as a diagnostic imag-

New ACO/CIN director at St. Joe’s Mike Endries has been appointed director, ACO/CIN programs and operations at St. Joseph’s Hospital Health Center.

According to a hospital news release, Endries’ deep understanding of value-based payments and population health has been instrumental in the development of both St. Joseph’s accountable care organization and clinically integrated network.

These two entities were formed to achieve healthcare’s “triple aim” — improve the patient experience of care; improve the health of populations; and reduce the per capita cost of health care, according to the

Celebrating Crouse’s Healthy Workplace Award Crouse Wellness & Population Health Coordinator Christina Giaprakis and Crouse Health CEO Kimberly Boynton.

Crouse: A Healthy Workplace

T

he Healthy Workplace Award was presented to Crouse Health during the Sixth Annual Healthy Workplace Summit Sept.

29 at SRC Arena on the Onondaga Community College campus.

The finalists for the award were scored in five categories, including communications and engagement; wellness programs; accessibility; and tracking of wellness metrics.

Crouse received 100 percent in three of five categories, and in four out of five categories, scored well above the average of the other participating organizations.

According to a hospital news release, Crouse’s commitment to promoting employee wellness is evident in its many Simply Well

release.

In his new role, Endries will be responsible for the daily management, oversight and coordination of a variety of project initiatives designed to improve the value of health care.

“With his background in payer contracting and provider networks, Mike brings a wealth of experience and knowledge to this critical operations position within the ACO and CIN,” says Fred Letourneau, senior vice president for physician enterprise. “Mike was instrumental in the startup of the St. Joseph’s ACO. He interfaced with the Trinity System Office, organized the physicians, and put the necessary contracts together to successfully start the ACO. We are pleased to welcome him to his new leadership role.”

Mike brings to his new position more than 13 years’ experience developing working relationships with physicians and third party payers — November 2016 •

programs, such as monthly miles, weight watchers, YMCA, yoga, bowling league, club Crouse, various walks and runs in the community, HelpPeople and its employee health office services, among others.

Crouse Wellness & Population Health Coordinator Christina Giaprakis submitted employee participation and testimonials of programs, such as “Healthie Selfies,” as well as results including those of monthly miles and YMCA visits to become a finalist.

Crouse’s Simply Well mission is to promote employee and family wellness by providing resources and programs that will lead to happier and healthier lives.

most recently as manager, revenue integrity and system contracting where he was responsible for negotiating and managing contractual arrangements and relationships with third party payers.

New services to help recovery process Beginning Nov. 1 Syracuse Behavioral Healthcare (SBH) will offer aftercare services to help people maintain their recovery from a substance use disorder. The new aftercare program is available to anyone who is recovering from a substance use or mental health disorder.

This innovative service includes monthly check-in calls from an SBH peer specialist, weekly support groups led by an SBH peer specialist, warm-line supports and referrals to care, community resources or other

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 23

Health News services.

The aftercare program also includes access to a high-tech recovery app for iPhone and Android smart phones called ACHESS. The ACHESS app provides virtual supports for participants such as daily check-ins, weekly surveys, periodic messages of hope, warnings when a participant is nearing a high risk area and a safe and sober online social network of others in the program.

When participants input data that indicates a high risk, the app offers a series of interventions, including contacting a support person, listening to exercises to ease distress, or reviewing “motivations” - a collection of thoughts, ideas, pictures, and other materials that an individual creates to remind them of why they are in recovery.

Predictive analytics built into

the ACHESS app allow SBH professionals to monitor a participant’s progress and identify those who may be at risk for relapse. The weekly surveys track risk and protective factor such as sleep, mood, and urges to use which function as indicators of the participants overall well-being. Early identification helps to reduce the burden on treatment systems as SBH will have the ability to reach out and offer additional supports before a relapse occurs. Participants can also send information, such as a relapse or urges to use, directly to SBH support professionals.

Funding for this program is supported by a grant of $50,000 from the Central New York Community Foundation.

Officials, friends and sponsors help ARISE celebrate 20 years of services in Oswego County.

ARISE Celebrates 20 Years in Oswego County

S

taff, volunteers, participants, community partners, sponsors, elected officials, artists, friends, and families gathered Sept. 27 to celebrate ARISE’s 20 years of service in Oswego County.

ARISE CEO Tania Anderson welcomed guests and described the history of ARISE’s work in Oswego County. What began as a small team working with migrant farm workers is now a team of more than 150 employees offering more than 30 programs at three locations in the county.

Assemblyman Will Barclay presented a proclamation, as did David Poleto, a representative from Sen. Patty Ritchie’s office. The original members of the ARISE Oswego Advisory Committee were recognized for their dedication and service.

“In everything we do, we focus on making it possible for people to

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

live, work, and play in our community. And it’s possible because of all of the great partners in the room. We are so thankful to the Oswego community for helping us grow and for celebrating with us! We look forward to the next 20 years,” said Sabine Ingerson, ARISE Oswego County director.

ARISE is a nonprofit Independent Living Center organized and directed by people with disabilities.

The organization has been providing advocacy and services in CNY since 1979, and each year ARISE works with approximately 7,000 people of all ages who have all types of disabilities. ARISE offers services in Onondaga, Oswego, Madison, Cayuga, and Seneca counties and also operates ARISE at the Farm, a 77-acre recreational facility in Chittenango, and ARISE & Ski at Toggenburg Winter Sports Center in Fabius.

Community Campus gets national recognition The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) has recognized the Upstate Community Campus as one of only 60 out of more than 600 ACS NSQIP participating hospitals that have achieved meritorious outcomes for surgical patient care.

The Upstate Community Campus is the only institution to receive this honor in Central New York. The Community Campus is located at 4800 Broad Road in Syracuse.

“This honor reflects our outstanding surgical outcomes for patients,” said Nancy Daoust, chief administrative officer for the Upstate Community Campus, “and is a testament to the efforts of all members of the surgical team — physicians, nurses, technicians — who seek to provide the safest surgical experience possible.”

The Upstate Community Campus, along with the other hospitals selected, is honored for achieving a composite meritorious outcome related to patient management in eight clinical areas: mortality, unplanned intubation, ventilator use greater than 48 hours, renal failure, cardiac incidents (cardiac arrest and myocardial infarction); respiratory (pneumonia); SSI (surgical site infections-superficial and deep incisional and organ-space SSIs); or urinary tract infection.

ACS NSQIP tracked surgical outcomes in the following areas: general, vascular, urology, gynecology, orthopedics, ear, nose and throat, plastics and gynecology.

Risk-adjusted data from the July 2016 ACS NSQIP Semiannual Report, which presents data from the 2015 calendar year, were used to determine which hospitals demonstrated meritorious outcomes.

Alzheimer’s event raises more than $200K More than 2,000 Central New Yorkers came together at Long Branch Park for the 2016 Alzheimer’s Association Walk To End Alzheimer’s — Syracuse, NY. The 26th annual event raised $219,928.

“Alzheimer’s disease is a growing epidemic in this country and it’s already the most expensive disease in America,” said Catherine James, chief executive officer for the Alzheimer’s Association, Central New York Chapter. “The generous efforts of this community not only support local family services, but contribute to our effort to end Alzheimer’s forever.”

Walk To End Alzheimer’s participants did more than complete the three-mile walk. They learned about Alzheimer’s disease and how to get involved with this critical cause. Funds raised at the event provide care and support programs for the region, as well as medical and scientific research to find a cure for Alzheimer’s disease and other forms of dementia.

Kimberly Smith of Farmington was the leading individual fundraiser at $4,913. Just behind her was Alison Wolfe of Syracuse, who raised $4,615.

Steep Rise in Price of Older Cancer Drugs High cost might have some patients skipping meds

Many older cancer drugs took a bigger bite out of Medicare and older Americans’ wallets last year than five

years earlier, a new analysis finds.

After adjusting for inflation, nearly two-thirds of 86 cancer medicines in the study had price increases between 2010 and 2015, researchers reported.

Eleven drugs more than doubled in price, and older drugs increased more than newer drugs, the study found.

The study included oral and November 2016 •

intravenous chemotherapy drugs covered by Medicare Part B. Medicare is the federal health insurance plan for people 65 or older.

“Higher costs lead to higher copays,” said study co-author, physician Sham Mailankody. He’s a medical oncologist at Memorial Sloan Kettering Cancer Center in New York City.

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Understanding Why Insulin Prices Remain High

By Deborah Jeanne Sergeant

I

f you depend upon insulin, it’s not news to you that its price has dramatically increased.

In fact, the price of insulin jumped 200 percent in the US from 2002 to 2013, according to The Journal of the American Medical Association in a report issued in the spring.

Though it would seem that the rising number of insured people — thanks to the Affordable Care Act — would help patients absorb the price spike, the report stated that out-of-pocket expenses rose from an average of $231 to $736.

Since many people who would otherwise go without insurance must purchase a policy under the Affordable Care Act (or face a stiff fine), they choose the most econom-

ical plans that usually include high deductibles and scanty prescription coverage. Some people with Type 2 diabetes require insulin. Ironically, those with Type 2 diabetes are disproportionately represented among lower income people: those least able to purchase adequate health insurance coverage.

So why does insulin suddenly cost so much?

It’s complicated.

“Many factors influence the prices that consumers pay for drugs and medical devices,” said Christopher Rucus, national director, public relations for JDRF, a New York Citybased organization funding Type 1 diabetes research.

Drug companies must spend

CALLING ALL VOLUNTEERS!

For many people with disabilities, the joys of skiing are dreams at best. ARISE & Ski is a winter sports program that makes those dreams a reality.

Our ability to provide adaptive winter sports is directly related to the number of volunteers we have, so your participation can truly have an impact.

Visit ariseandski.org for more information!

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

copiously to research, test and manufacture medication, plus invest in future development. Once the FDA approves a drug, the manufacturers and insurers negotiate.

On the consumer side of the issue, individual health insurance plans cover varying amounts of prescription medication — and some, none at all.

“Diabetes drugs and devices are no exception, and JDRF is working in multiple ways to ensure that as many people as possible have affordable access to both existing and future therapies for Type 1 diabetes,” Rucus said.

Insulin analogues, made by genetically modifying human insulin, is the latest, most expensive insulin. It works a lot better than the previous human and animal insulin, but costs much more.

‘Older’ insulin still being made “I don’t know why the cost is going up as it has,” said physician Ruth Weinstock, medical director of Upstate’s Joslin Diabetes Center. “I feel sorry for the patients who are struggling to afford it. It is unique in that it’s lifesaving. The people who take it must take it to stay alive.

There’s not an alternative.”

Weinstock said that although the “older” insulin is still made and is the least expensive, many providers want to transition their patients to the new, more expensive insulin to better manage their condition.

“You can always look online for coupons,” Weinstock said. “Patients who need insulin therapy need to be honest with their doctors on what they can afford instead of skipping doses. Ask for the least expensive

insulin, even if it’s not the most effective.”

When renewing your health insurance, it’s important to select coverage that includes your medication. Tell your pharmacist and primary care provider if affordability has become a problem.

Patients using insulin many times need other prescriptions as well. Ask your pharmacist about any prescription discount cards available.

Or, request samples or generics that could help save money on those medications so you can better afford their insulin.

Some pharmaceutical manufacturers making insulin provides discounted medication to aid patients unable to afford needed prescriptions to ensure patients don’t skip doses.

If you have served in the US military, you may qualify for help.

“We have a low co-pay for a 30-day supply depending upon your qualifications and your income,” said Jennie A. Lynch, chief of pharmacy at the Syracuse VAMC Office. “There’s no co-pay for diabetic supplies like test strips and syringes.”

To find out more information about VA services and eligibility for VA health, visit http://www.va.gov/ healthbenefits/apply, or call 1-888823-9656.

In time, insulin may become less expensive again, according to Lynch.

“As patents on drugs expire, sometimes they’re available as generics or as competition comes onto the market,” Lynch said.

Be wary of receiving medication from an unknown source, especially outside the US, because the drugs may not be safe.

Health in good

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November 2016 •

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EXCEEDING

THE HIGHEST STANDARDS FOR

STROKE CARE

Upstate is the only comprehensive stroke center in Central New York.

This means only Upstate has met and exceeded the highest standards for stroke care. No other hospital in the region treats as many strokes as Upstate.

Strokes are an emergency, time saved is brain saved.

C A R I N G F O R P AT I E N T S

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SEARCHING FOR CURES

IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2016

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S AV I N G L I V E S