PRICELESS
New Life for Oswego Doctor
CNYHEALTH.COM
JUNE 2019 • ISSUE 234
Physician Robert Morgan ran his own practice for more than 30 years. He and his team are now part of Oswego Health. He discusses the move
Great Summer Food P. 19
When to Choose a Medical Spa Spa and medical spa: what’s the difference? And what to consider when selecting a medical spa
Do Doctors Give Better Care in the Morning?
Crouse Spine Care Aims to Reduce Surgeries, Opioid Use
Mammo Van Is Coming…
Upstate University Hospital takes breast cancer screenings on the road. P. 16
‘My worst sunburn ever was from…’
Can medical marijuana help kids with autism?
Story on p.17
Story on p.10
D E D I C AT E D T O H E L P I N G Y O U A C H I E V E P O S I T I V E , L O N G - T E R M W E I G H T L O S S
Ken Cooper, DO
Jeff DeSimone, MD
Robotic-Assisted Weight-Loss Surgery. At Crouse. The most experienced robotics team using the latest innovative techniques. As the region’s busiest – and largest – multidisciplinary robotic-assisted surgery program, Crouse Health now offers bariatric (weight loss) surgery using the most advanced robotic technology available. The da Vinci Surgical System gives surgeons Jeff DeSimone, MD, and Ken Cooper, DO, an increased view of the stomach and surrounding area, allowing for more precise and controlled movement during surgery. Compared to conventional weight loss procedures, minimally invasive robotic bariatric surgery offers patients many potential benefits, including:
• Faster recovery • Less scarring • Quicker return to regular routine
• Less trauma to the body • Shorter hospital stay
For more information and to learn if robotic-assisted weight loss surgery may be right for you, join us at one of our upcoming informational sessions — the first Monday and third Thursday of each month. Register at crouse.org/weightloss or 315-470-8974 Marley Education Center, 765 Irving Ave.| Free parking in Marley garage
As with any surgery, there is always risk. Consult your physician to learn if robotic-assisted weight loss surgery is appropriate for you.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
crouse.org/weightloss
The Surprising Benefits of Weekend Workouts
NATIONAL CANCER SURVIVORS DAY
Y
CANCER BEWARE
ou know the value of exercise for maintaining good health and managing chronic conditions like arthritis, but you also know how hard it is to fit daily workouts into a busy schedule to meet weekly minimums. As an alternative, many people try to cram in a week’s worth of fitness on the weekends. While this approach has been met with skepticism (along with worry about injuries), new research shows that you can get exercise’s health benefits this way. A British study published in JAMA Internal Medicine says there’s no reason to abandon exercise completely if you can’t do it during the work week. Packing exercise into
your weekend is actually a viable option. Based on surveys from 63,000 people, any exercise is better than none. Researchers found that people who exercise at a high rate on weekends — getting in the recommended 150 minutes of moderate exercise or 75 minutes of vigorous activity — had about 30% lower risk of early death than people who don’t exercise at all. Another interesting finding: People who exercise more often but for shorter blocks of time can also lower their risk for chronic conditions — yes, even if they fail to total 150 minutes a week. The bottom line? Get up and move whenever you can.
Most Americans Hit Hard by Medical Bills
N
early six in 10 Americans say they have suffered financial hardship due to health care costs, a new study finds. Researchers from the American Cancer Society looked at three different types of problems: difficulty paying medical bills, worrying about bills and delaying or doing without care. “With increasing prevalence of multiple chronic conditions, higher patient cost-sharing, and higher costs of health care, the risk of hardship will likely increase in the future,” wrote researchers led by senior scientific director Robin Yabroff. In the study, they analyzed data from the 2015-2017 National Health Interview Survey by the U.S. Centers for Disease Control and Prevention, and found that 56% of adults (more than 137 million) reported at least
one of the three types of medical financial hardship. Compared with those 65 and older, adults aged 18 to 64 were more likely to say they had difficulty paying medical bills (29% vs. 15%), worried about paying bills (47% vs. 28%) and delayed or went without care (21% vs. 13%). Among adults aged 18 to 64, those with more health problems and lower levels of education were more likely to have greater levels of hardship. Multiple types of hardship were more likely to be reported by women than men, and by uninsured people (53%) than those with some public (26.5%) and private insurance (23%). The study was published online May 2 in the Journal of General Internal Medicine.
Onondaga, Oswego, Cayuga and Madison Counties
CNY’s Healthcare Newspaper
A monthly newspaper published by Local News, Inc. 35,000 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. © 2019 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, Anne Palumbo, Melissa Stefanec, Chris Motola, Eva Briggs (MD), Aaron Gifford, Brian E Walsh, Payne Horning, Kimberly Blaker, Rakesh Khanna (MD) • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Nitz 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.
“Hope Grows Here”
Cancer survivors and their families are invited to attend the 4th Celebration of Life for National Cancer Survivors Day
• Free lunch • Inspirational speakers • Musical entertainment • Fun activities/games • Door prizes and exhibits
Sunday, June 2, Longbranch Park in Liverpool, 10:30 a.m. to 1:30 p.m. Sunday, June 2, Throop Fire House on Beech Tree Road, Throop, Cayuga County, Noon to 3 p.m.
The event is free for survivors with their families and guests. Reservations are requested by emailing rsvp@hoacny.com or calling 315-472-7504 ext 1362.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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CALENDAR of June 2
HEALTH EVENTS
National Cancer Survivors Day celebrated locally Hematology-Oncology Associates of CNY (HOA) is holding its fourth annual Celebration of Life for National Cancer Survivors Day. The two events will take place from 10:30 a.m. to 1:30 p.m. Sunday, June 2, at Longbranch Park in Liverpool, from noon to 3 p.m. at the Throop Fire House on Beech Tree Road, Throop,
We are now welcoming new patients and we accept most insurances.Â
Call (315) 433-9999 Our Providers:
Dr. Daniel Rancier, MD Cynthia Stresing, MSN, FNP-C Krista Krause, MSN, RN, FNP-C
We Are Open:
Monday - Friday, 8:30am - 5:00pm Christian Health Service of Syracuse 3200 Burnet Ave. Syracuse NY 13206
www.chsos.org
Cayuga County. “This event honors the members of our community who are living with and beyond cancer — the survivors and their loved ones,� said Maryann Roefaro, CEO. “Our theme is Hope Grows Here, and for the second year we will have a Celebration of Life Remembrance Garden. People wishing to order a plant for the garden should visit our website at hoacny.com. � At each location guests will be treated to lunch, inspirational speakers, musical entertainment, fun activities/games , door prizes and exhibits The event is free for survivors with their family and guests. However, reservations are requested by emailing rsvp@hoacny.com or calling 315-472-7504 ext 1362. Emails need to include RSVP in the subject line, note the number attending at which location, as well as the name and the T-shirt size of the cancer survivor. The mission of Hematology-Oncology Associates of CNY is to provide the highest level of quality care in a healing environment for the mind, body and spirit of patients dealing with cancer and blood disorders. A private practice since 1982, HOA is the only cancer center in Central New York to receive an American Society of Clinical Oncology’s (ASCO) QOPI designation for high scores on quality measures, and meeting rigorous safety measures established by (ASCO) and the Oncology Nursing Society.
June 5
SOS seminar in Oswego to focus on joint pain Syracuse Orthopedic Specialists (SOS) is holding the third of a series of seminars to discuss options for people experiencing hip and knee pain. It will take place from 5:30 to 6:30 p.m. Wednesday, June 5 at Lake Ontario Conference Center, 26 East First Street, Oswego. Presenters will be Stephen Bogosian and Seth Greenky, fellowship-trained, board-certified joint replacement surgeons. The event is intended for people who are living with chronic hip or knee pain
TO Group, Semi-Private & Private
Swim LeSSonS in the JCC’S outdoor heated PooL Children and adults. Everyone welcome!
Ask a
qua Fitnes bout our A
s Class!
5655 Thompson Rd., DeWitt • 315.445.2360 • www.jccsyr.org
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
to better understand current treatments and options. Topics covered include: what to try before having a joint replacement; steps to take if conservative care isn’t enough; and current joint replacement options including robotic and outpatient surgery. The seminar is free and open to the public. All attendees will receive a free first aid kit and refreshments will be provided. To register, visit www.sosjointreplacement.com or call 315-703-3442.
June 7
Relay For Life to take place in Oswego American Cancer Society and Oswego-Fulton are attacking cancer in the community through a Relay For Life event. Guests will join together at the annual Relay For Life of Oswego-Fulton starting 5 p.m. June 7 at 2 Buccaneer Blvd. in Oswego to raise funds to find the cure to cancer. Last year the event raised more than $45,000 thanks to participants, businesses and sponsors. “This year we are excited to present a patriotic-themed Relay to the Oswego-Fulton area,� said Jim Monahan, community development manager for the American Cancer Society. “We honor our fighters, both against cancer and all of our armed forces, together as one in our great community. Just come to support us, nothing is required to come to the event other than sharing hope for all.� Organizers encourage guests to reach out to cancer survivors, including those who are currently fighting cancer, to attend the event so they can be honored. The survivor reception is at 5 p.m.; opening ceremony is at 6:45 p.m. and the luminary ceremony at 10 pm. For more information, visit www. relayforlife.org/oswegony.
June 15
Freedom from Fear: Choosing Life Over Fright Imagine waking up each morning feeling peaceful, calm, happy, and safe in your own skin. Imagine having the courage to fulfill your dreams. What’s getting in your way? Fear of failure? Fear of not being enough? Fear can thwart your life purpose, to experience peace and joy, and to attain your dreams. In this workshop, educator and expert on fear and anxiety Monica Gullotta will help you navigate through fear and become who you long to be. Gullotta founder of “Educating with Monica� and numerous workshops on anxiety and depression, gives you tools and techniques to become free of fear and fear-based thoughts and actions. The workshop will take place from 10 to 11:30 a.m. Saturday, June 15, at Cafe 407, 407 Tulip St., Liverpool. Registration is required. Call 315-622-5596. Fee is $25 and all attendants will receive a workbook along with the workshop.
Got an event to share with our readers? Send an email by the 10th of each month editor@cnyhealth.com
June 17
Syracuse Brain Aneurysm group to meet The Syracuse Brain Aneurysm, Arteriovenous Malformation and Hemorrhagic Support Group sponsored by the Joe Niekro Foundation meets from 6-7:30 p.m. every third Monday of the month with the exception of December, at the Crouse Medical Building, Building A, 5000 Brittonfield Parkway, East Syracuse. This year’s meetings will be held June 17, July 15, Aug. 19, Sept. 16, Oct. 21, and Nov. 18. Survivors, family members, caretakers and friends are welcome. For more information, email syracuse@joeniekrofoundation.org and use “Support Group� in the subject line.
July 1 – Aug. 23
JCC offers summer camp to kids, teens
 There’s plenty of summer camp fun and adventure for children and teens to experience at the Sam Pomeranz Jewish Community Center of Syracuse this year. The JCC’s Camp Joe & Lynne Romano summer day camp will run weekdays for eight weeks from July 1 through Aug. 23. There will be plenty of non-stop excitement, fun and adventure for everyone to experience. Each week campers will have a blast making new friends and participating in enriching activities. Campers are kept active every day. Camp enrollment is broken out into three different age groups. The early childhood camp is for children 6 weeks old through entering kindergarten, school-age camp is open to children entering grades 1–6 and the SyraCruisin’ teen travel camp is for young teens entering grades 7–10. Each camp day begins and ends at the JCC on 5655 Thompson Road in DeWitt. For more information about the JCC’s summer camp, and to request the camp program guide, call 315445-2360 or visit www.jccsyr.org. Â
July 21, 28
Lifelong learning now offered at SUNY Oswego SUNY Oswego’s new lifelong learning program is open for registration. Are you interested in mind, body and health? American politics, mass media, digital photography, creative writing or painting and drawing? It is an opportunity for older adults to engage in activities that will stimulate the brain, enhance the quality of life and promote overall health and wellness. Research has proven the positive emotional, mental and physical benefits of continued participation in learning. The four-day lifelong learning sessions are scheduled for July 21 to July 25 or July 28 to Aug. 1 to coincide with Haborfest — it takes place a week before and a week after the festive. Each week participants will have several topics to choose from. For more information on current offerings or to register, please visit www.oswego.edu/obcr/lifelong-learning. If you have any questions please call 315-312-3492.Â
TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.
Partner with Your Provider
Be Heart Smart
To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.
A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure
New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 www.WellCareNow.com
Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Source: www.Heart.org.
65505
WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-699-3552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務 。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015
June 2019 •
©WellCare 2015 NA_03_15_WC IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 5
Meet
Your Doctor
By Chris Motola
Robert Morgan, M.D. About 1 in 1,000 Babies Born ‘Intersex’
C
ases in which a newborn’s genitals make it unclear whether the child is a boy or girl may be more common than once believed, researchers say. One example of what’s known as ambiguous genitalia is a baby girl with an enlarged clitoris that looks more like a small penis, the study authors explained. In some cases, infants have external sex organs that don’t match their internal reproductive organs. For example, a female infant can have external sex organs that resemble male genitals but have typical internal female organs — ovaries and a uterus. In these so-called “intersex” cases, treatment may be delayed until puberty or adulthood so that patients and doctors can make shared decisions, according to the study’s first author, Banu Kucukemre Aydin, a researcher at Istanbul University in Turkey, and her colleagues. For their study, the researchers analyzed data on nearly 14,200 newborns. Of those, 18 had ambiguous genitalia. That’s a rate of 1.3 in 1,000 births, much higher than the rate of one in 4,500 to 5,500 reported in previous studies, Aydin said in a news release from The Endocrine Society. Fifteen of the newborns were diagnosed with 46, XY DSD, a condition in which a male infant can’t use testosterone properly or testicles don’t develop properly. Babies with the condition had lower birth weights, the investigators found. In addition, preeclampsia — a pregnancy complication characterized by high blood pressure — was common in those pregnancies. “These findings support the hypothesis that early placental dysfunction and androgen deficiency might be important in the etiology of male genital anomalies,” Aydin said. The findings were recently published online in the Journal of the Endocrine Society.
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Physician discusses new life after more than 30 years running own medical practice Q: You are part of a physician group — Oswego Family Physicians — that just joined with Oswego Health. What made your team decide to take that route? A: A lot of things. One of them is changes coming down through MACRA [Medicare Access and CHIP Reauthorization Act], which are changes to Medicare. The federal government is requiring so much regulation on following up on things that you have to hire a lot of extra people to manage it. The writing is on the wall that it’s going to be very difficult for any office five years down the road. So, knowing where this was going, we had an opportunity to join up with Oswego Health, along with other primary care offices. Being one of the first, it gives us a chance to help shape where things are going down the road. Those are some of the main reasons. Q: How closely have you worked with Oswego Health prior? A: There are a lot of really good things happening with Oswego Health. I’ve been working with the hospital the entire time I’ve been here [more than 30 years]. I worked in a lab, I was an orderly, taken part in a lot of the planning; so there’s not much I haven’t done at the hospital. It’s just great to be a physician who is intimately involved in deciding where health care is going in the county. The negotiations took a year, but they were friendly, not at all adversarial. It was how negotiations should go. It just was. Q: Does it free up more time with patients? A: It does in some respects. We do still have some managerial
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
responsibilities as well as planning down the road as we expand and work with some of the outlying areas to get them closer to the model that we’re using. So, there’re things that we do in our office that help other offices in the network. We’re trying to be on the cutting edge for meeting these guidelines. We’re already past the target in terms of operating hours, for example. So, it’s kind of a win-win, both for us and Oswego Health. I do still get to do a lot of patient care. There’s a little bit less responsibility in terms of building management; I don’t have to be a landlord anymore, and that’s OK. That frees me up a little bit more. But I’ve always made sure that managerial duties don’t interfere too much with patient care. A lot of them you can do outside of the hours where you’re seeing patients. Q: You’ve been practicing in Oswego County for 33 years. The county’s often struggled in terms of health outcomes, what kinds of challenges have you encountered? A: We still have room to grow. We are one of the poorest, if not the poorest at times, counties in the state. But you look at some of the things coming down the pipeline: access is something people are talking about. We actually have excellent access, especially considering that we have such a poor population. What we’ve been able to do with a small number of physicians is phenomenal. So we’re doing very well in terms of getting people seen. We’re constantly trying to improve in our group. We have two new, young EMTs. We’re doing a new orthopedic group. We have three new surgeons. We have the new behavioral health facility where the old Price Chopper used to be. So, there are a lot of things we’re making incredible strides in. There are still things we need. We need neurologists. We still need more primary care, but we’re doing pretty well at bringing in new people. Some of the new planning that we’re doing for mental health, this is going to help us bring in and recruit more young physicians. But we’ve had a good year for recruitment. Q: What kinds of things have helped
recruitment? A: Renovations that we’ve done at Oswego Hospital. Our new offices that allow us to do more orthopedics here, so people don’t have to travel so far. We have an excellent relationship with oncology out of Upstate. Our relationship with Crouse’s radiology group has given us access to some of the best scanners in the state. So, there are a lot of things we can do very well here. We’ve done very well meeting a lot of guidelines. We could always do better. And we recognize we can always do better. Our lines of communication are great. I can call up [Chief Operating Officer] Jeff Coakley or even just show up in his office one day. It’s a very open-door policy. There’s not a lot of bureaucracy. I think that’s one of the most important things we can offer, that communication between administration and providers. You can’t usually find that in big cities. Q: Given that the county is geographically fairly large, but rather sparsely populated, how has Oswego Health done so well in terms of access? A: A lot of things. One, being open more hours. We have been the Coast Guard’s physicians for over 30 years. At the national level they talk about allowing veterans to see private physicians; we’ve been doing that for decades. They can be seen when they need to be seen on a timely basis. I think one of the things we can do to help the troops is to allow them to see private doctors. We’re an example of how that could work. There’s also a tremendous community effort here. We just work together. It’s the communication piece. It’s not a matter of what’s most cost-effective, although that has to come into it at some point, but how to reach people and serve them the best. Q: Do you think that a more level playing field in terms of bureaucracy is a big selling point for new recruits? A: I think it is. There are still regulations which can be cumbersome, but we don’t try to make more roadblocks locally. We present a united front for the things that we need. Q: What kinds of patients do you see? A: We’re probably about 40 percent pediatrics, 60 percent adult medicine. So, we see newborns up through 104, so it’s the whole spectrum. We do gynecology, minor surgery, mental health issues. Every day is a new adventure. That’s why we’re trying to get more primary care. We can prevent unnecessary use of emergency medicine. Things can get done more economically in our office.
Lifelines
Name: Robert Morgan, M.D. Position: Family medicine and
primary care physician with Oswego Family Physicians Hometown: Fair Haven, NY Education: Union College; SUNY Upstate Affiliations: Oswego Health Organizations: American Academy of Family Practice; New York Medical Society; Oswego County Medical Society Family: Wife, four adult children Hobbies: History, historical reenactment, sailing, hiking, outdoor activities, general contracting
Total Joint Replacement. Right at Home. It’s time to live pain free. Our new Center for Orthopedic Care CENTER FOR provides total hip and knee replacement surgery right at home. ORTHOPEDIC CARE A patient navigator will guide you every step of the way. Our team of orthopedic surgeons, nurses and physical therapists are providing our community with years of experience and a personalized approach that is focused on you! We will get you back to the life you’ve missed.
CENTER FOR ORTHOPEDIC CARE www.oswegohealth.org/ortho
315-349-5873 June 2019 •
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2018 KATHRYN FISH LECTURE SERIES rd
June 23 1-2 pm Dr. William Cesare – 2019 Fish Lecture Series Professor Psychology – Morrisville State College 2019ofKathryn Kathryn Fish Lecture Series
Hello Moxi!
Neuro Parasitology – Explaining Suicidal Mice Sunday April - -1-2pm Sunday April28th 28th 1-2pm
Reverend Ted Taylor – Retired Minister of Issues Affecting Aging Issues Affecting Agingand andMental MentalHealth Health Dewitt Community Church Next Lecture: May 19th Next Lecture: May 19th A Message Enjoy Reverend Mick Keville -You’ll Believing the Reverend Mick Keville - Believing theBest Best
120337 120337
Next Lecture: July 21st 1-2pm Dr.Dr. Jim Yonai Jim Yonai
Come Visit The Farm! Come Visit The Farm! SeeSee “Chocolate Cream” and the “Chocolate Cream” and thegoats. goats. Walk thethe track and enjoy thethe farm. Walk track and enjoy farm.
PU PU BLBL ICIC have 3 professional therapist that see patients. WWELISIS We We have 3 professional therapist that see patients. ELCOCO MME!E! Please more information. Please callcall for for more information.
Marshall Farms Foundation,Inc. Inc. JimJim Marshall Farms Foundation,
1978 New Boston Road, Chittenango, 13037 1978 New Boston Road, Chittenango, NYNY13037 www.jmffinc.org Please call 315.687-5064 www.jmffinc.org Please call 315.687-5064
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Sodus Rehabilitation and Nursing Center
OPEN HOUSE
Wednesday, June 5th, 2019 1pm- 4pm 6884 Maple Ave Sodus, NY 14551
We are searching for MOTIVATED, CARING, and COMPASSIONATE professionals to join our team…We are in search of RN’s, LPN’s, CNA’s, and other positions throughout the facility. We offer weekly paychecks, competitive wages, sign on bonus’s, excellent benefits, and refer a friend bonus. Please join us for our Open House to meet our staff, tour our facility, apply for an open position, and interview on the spot. Come see what we are all about!! For more information and a chance to join our caring team please call
Corinne directly at 315-521-7484.
Math • Reading • Technology • Music • Art
DĂƚŚ ZĞĂĚŝŶŐ dĞĐŚŶŽůŽŐLJ DƵƐŝĐ ƌƚ Study Skills/Writing • Social Awareness ^ƚƵĚLJ ^ŬŝůůƐͬtƌŝƚŝŶŐ ^ŽĐŝĂů ǁĂƌĞŶĞƐƐ Who: Students 6 to 11 years of age
By Eva Briggs
Meet Moxi, the Nurse Robot W hat images pop into your mind when you think of a nurse? Most people respond with adjectives related to human qualities of kindness, caring and helpfulness. In fact, Forbes.com ranks nurses as the most trusted profession, with an 84% positive rating. So, when I read about a nursing robot, naturally I was skeptical. After all, how can a robot do a nurse’s job? It turns out a lot of what nurses really enjoy doing — hands-on patient care — isn’t what they actually do all day long. In fact, a lot of a nurse’s job, as much as one third, consists of fetching items from one place to another. Your patient needs another blanket? Off to the linen supply closet. You need more wound care supplies? Another trip, this time to a supply room, to fetch them. This leads to high rate of hospital nursing burnout and turnover. Nurses want time to provide emotional support to their patients, to educate them, to coordinate their care, for discharge planning and simply providing timely care. But much of their day is spent on gathering medical supplies and restocking supply rooms. Hospital nurses can average as much as eight to 10 miles a day running back and forth to supply rooms. So enter Moxi. It would be more accurate to think of Moxi as a mechanized nursing step-and-fetchit creature rather than a full-fledged nurse. She’s not designed for direct patient interaction. But what makes her endearing (can a robot be en-
dearing?) is that she’s designed to be “socially intelligent.” She has a cute LED face and a soft gentle voice. She’s designed to be approachable, congenial, and cooperative. She’ll say hi as she passes people in the hallway, and blinks her big blue digital eyes at them. On the technological side, she uses artificial intelligence to map and learn about her environment. She travels on wheels with sensors to avoid hitting other objects. Moxi’s arm has a sophisticated gripper to allow her to perform tasks such as selecting items from storage, placing them on a tray, and delivering them throughout the facility. She has a digital screen that reads out information about the task she’s performing at any given time. A nurse can summon Moxi by pushing a button to call her. During a trial with Moxi at Texas Health Dallas, she delivered samples to the lab, all the dirty linens, and brought supplies needed by the nurses. I’m not a huge sci-fi fan, but Moxi reminds me of C-3PO. Google her for yourself and see if you agree! Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
When: July 9, 2019 to August 14, 2019 tŚŽ͗ ^ƚƵĚĞŶƚƐ ϲ ƚŽ ϭϭ LJĞĂƌƐ ŽĨ ĂŐĞ
Every Tuesday, Wednesday and Thursday from 9:00 am to 2:45 pm tŚĞŶ͗ :ƵůLJ ϵ͕ ϮϬϭϵ ƚŽ ƵŐƵƐƚ ϭϰ͕ ϮϬϭϵ
ǀĞƌLJ dƵĞƐĚĂLJ͕ tĞĚŶĞƐĚĂLJ ĂŶĚ Where: Pine Grove Middle School 6318 Fremont Road dŚƵƌƐĚĂLJ ĨƌŽŵ ϵ͗ϬϬ Ăŵ ƚŽ Ϯ͗ϰϱ Ɖŵ East Syracuse, NY 13057
tŚĞƌĞ͗ WŝŶĞ 'ƌŽǀĞ DŝĚĚůĞ ^ĐŚŽŽů Register online at ϲϯϭϴ &ƌĞŵŽŶƚ ZŽĂĚ launch.org/summer-adventures-learning or call (315) 720-9148 for more information. ĂƐƚ ^LJƌĂĐƵƐĞ͕ Ez ϭϯϬϱϳ
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My Turn
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
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Healthcare in a Minute By George W. Chapman
Medicare For All... T hanks in large part to Vermont senator and presidential candidate Bernie Sanders, “Medicare For All” — or universal healthcare — has become a hotly debated topic for the 2020 campaign. Detractors and skeptics have focused primarily on its impact on taxes. But here’s some food for thought as the debate rages on. U.S. taxes on wages and income are relatively low when compared to countries that have their own versions of Medicare for all. Our system of taxation is a “progressive” system whereby wealthiest pay a higher percentage of their income in taxes than middleand lower-class taxpayers. Unlike workers in England, France, Germany, Sweden, Finland and Canada, who are covered by universal care, American workers have health insurance contributions/ responsibilities deducted directly from their paychecks. Out-of-pocket
Healthcare Drug Fraud
The DOJ recently convicted Phillip Esformes, a Florida skilled nursing facility owner, of over $1.3 billion in fraudulent claims to Medicare and Medicaid. Patients were referred to his shabby facilities where they received inadequate or unnecessary treatment. He bribed both physicians and regulators in order to defraud. He was convicted of conspiracy to defraud the U.S. government, kickbacks, money laundering and obstruction of justice. This is the largest healthcare fraud scheme to date. In another fraud case, drug manufacturer Questor, recently acquired by Mallinckrodt Pharmaceuticals, is accused of bribing physicians to unnecessarily prescribe “H.P. Acthar
expenses like deductibles and copays are in addition to what is deducted from pay. So, unlike taxes on wages, healthcare premiums are not progressive. The lowest and middle wage earners pay the same per month as the highest wage earners. Consequently, the lower your wage or income, the higher your healthcare premium as a percentage of income. For example, a U.S. worker earning $43,000 a year pays an average of 37% in both taxes and health premiums. In high tax Finland, at the same earnings, a worker pays 23% in taxes which includes healthcare. Moving toward a universal system would make healthcare costs more “progressive” for most Americans. No matter where you stand in this debate, healthcare “premiums” must be considered as a “tax” already being paid by the American worker.
Gel,” which treats infant seizure disorders, multiple sclerosis, and rheumatoid arthritis. The price per vial went from $40 in 2000 to $39,000 today. If you’re doing the math, that’s a 97,000% increase. Medicare alone has spent $2 billion on the gel over the last several years. This was a whistleblower case. The “fraud police” only get involved in these cases when they are fairly certain of success. If convicted, Mallinckrodt would have to pay back what was deceitfully billed plus another $5,500 to $11,000 per false claim.
Primary Care Spending Low
A basic tenet of healthcare is that primary care management improves overall health outcomes and lowers
costs. Researchers at the RAND Corporation studied 16 million Medicare claims and found that primary care accounts for less than 5% of total Medicare spending on physicians, hospitals/facilities, supplies and drugs. For the study, “primary care” included family practitioners, internists, gynecologists, geriatricians, nurse practitioners and physician assistants. Clearly, there is plenty of room for more investment in primary care. One way is to pay providers more for primary care services which would encourage more medical students to specialize in primary care.
Rural ERs Busier
Despite the fact that many rural hospitals are in danger of closing, visits to rural emergency departments are up over 50% in recent years, according to a study published in the Journal of the AMA. Visits to urban/suburban emergency departments for the same time are up just 5%. Non-Hispanic white patients 18-64, Medicaid beneficiaries and the uninsured lead the charge. Rural hospitals are increasingly becoming the safety net providers in their markets. Increased ER visits, especially in rural areas, can somewhat be attributed to the shortage of primary care physicians that is much more endemic to rural areas. With limited primary care options, rural residents are forced to use emergency rooms.
Chronic Diseases Costly
The annual cost of chronic diseases like heart disease, obesity, diabetes, cancer and Alzheimer’s is staggering. According to a report by Fitch Solutions, it is $3.8 trillion a year in direct and indirect costs. That is almost 20% of our GDP. And the cost could double in the next 30 years as baby boomers age and live longer. Indirect costs include lost productivity, early retirement and premature mortality. June 2019 •
Telehealth Trending Up
Two of the necessary three factors for acceptance by physicians are in place and pushing the use of telemedicine. The first factor is the physician shortage. Telehealth gives overwhelmed physicians another tool to handle their heavy patient loads as not everyone has to be seen in the office. The second factor is consumer preference, especially among younger patients who are very comfortable using technology. The third factor for overall acceptance of telehealth by physicians is insurance payments. They are getting better, but not quite there yet. While the majority of specialties are just beginning to feel comfortable with telehealth, it has been incorporated into radiology, dermatology, psychiatry and cardiology for years. Medicare (CMS) is planning to boost telehealth benefits next year. Typically, commercial carriers follow suit. In the meantime, Humana is about to roll out a virtual primary care model called “On Hand” through the telehealth company “Doctor on Demand.” The plan offers members access to a dedicated primary care physician, urgent care and behavioral health through video visits, all at a relatively low monthly payment. Interested employers see this as a way to save money and reduce employee absences. There is no co-pay for the virtual visits.
George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Summer and Spirituality:
Uplifting Those Who Live Alone
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he anticipation of warm summer evenings. New growth. Budding possibilities. What better time to seize the moment and make vital changes — especially those healthy transformations we vowed to undertake six months ago on Jan. 1. Did you make New Year’s resolutions? Did you write them down? I know I did, but they now appear on the horizon as a distant memory.
If you agree with me that June just might be the month to begin your self-improvement quest, I have a suggestion for your summer “to do” list: Renew your spirit. I say this because, almost without exception, the women and men I’ve met who have successfully found their way after a divorce or the death of a spouse have been bolstered by a healthy spiritual life. They regularly
attend worship services, find comfort in prayer and hymns, and faithfully observe religious holidays. Others march to a different drummer and nourish their spiritual life in private moments, listening to music, communing with nature, reading or writing or just sitting in quiet meditation. However it’s expressed, my observations tell me that those who nurture their spiritual life fare better when challenged by life’s transitions. I consider them fortunate because they take time to renew their spirit, and in doing so, find the inner strength to navigate uncharted waters and to help others along the way. Even when their own sense of self-worth is fragile or failing, I’ve seen devout divorcees and widows reach out to others with encour-
s d i K Corner
Can Medical Marijuana Help Kids With Autism?
M
edical marijuana extracts appear to help children with autism, reducing their disruptive behavior while improving their social responsiveness, a new Israeli clinical trial reports. Kids treated with either a wholeplant cannabis extract or a pure
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combination of cannabidiol (CBD) and THC experienced a significant improvement in their symptoms, compared with a control group given a placebo, researchers said. But parents of kids with autism should still wait for more data before trying to treat them with
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
agement and prayer. Spiritually grounded, their empathy runs deep and their desire to support others is steadfast. Last month, I heard from a woman whose husband abruptly left her and their two teenage children after 27 years of marriage. She was in shock and consumed with pain. She shared with me how comforting it would have been to hear from her minister and church friends, but they didn’t know her situation. She had stopped going to church. It had been years, and that important spiritual touch-point had fallen by the wayside. Similarly, a neighbor of mine confided that he stopped going to temple after he lost his “bride” to lung cancer. Mad at the injustice of it all, he couldn’t bring himself to attend services without her. This led to years of isolation, during which he was overcome with loneliness. I wasn’t surprised when he talked of numbing his pain with alcohol. My message to both was simple: Renew your spiritual connections. It’s easy to imagine how difficult it might be to contact a minister, priest, rabbi or other spiritual adviser and ask for support after being absent from services for many years. But any religious congregation worthy of its mission will respond with open arms. A warm embrace is waiting for those who walk through the doors. Likewise, if other doors beckon – medical marijuana, warned lead researcher Adi Aran, director of the pediatric neurology unit at Shaare Zedek Medical Center in Jerusalem. “Thousands of parents already are treating their kids with cannabis based on rumors of this study,” the physician said. “I don’t want it to be even more.” For the study, 150 children with autism were put in one of three groups. One group received a placebo, another was treated with a whole-plant extract of marijuana, and the third received a pure blend of CBD and THC at a 20-to-1 ratio. THC (tetrahydrocannabinol) is the compound that produces intoxication when one uses marijuana. CBD is a compound in marijuana that does not produce intoxication, but does appear to interact with cannabinoid receptors in the brain. One CBD-based product, Epidiolex, has been approved by the U.S. Food and Drug Administration for use in treating epilepsy. CBD has been shown to help anxiety in several studies, so researchers thought it might aid in treating behavioral problems in kids with autism, Aran said. These include acting out and violence towards others. The THC was included in the pure blend because “we believe the THC might be important for improving the social deficits as well,” Aran said. “THC is known to impact the social area.” The whole-plant extract included not only CBD and THC, but many other compounds also found in cannabis, Aran said. The kids were treated for two four-week periods, with a four-week break in the middle. Kids taking a cannabis extract improved 49% and 53% on two scales in which doctors and parents measure autism symptoms and disruptive behavior. That compared to 21%
if nature or poetry or yoga feed your soul — go forth and embrace those opportunities. My spiritual battery gets recharged when I take time out from my busy schedule to be still and mindful. My quiet time in an inspirational setting allows me to contemplate my most deeply held beliefs. I emerge grounded and motivated. The power of a spiritual life is mighty. When you pursue your spiritual goals and teachings, life can be more manageable and your ability to cope with loss, loneliness and everyday struggles is strengthened. No matter how you pursue a spiritual connection, I encourage you to make that connection or re-connection now. Today. An idea bigger than yourself, a set of convictions, and the company of people who share your beliefs can lead to a richer, more meaningful and peaceful existence. You do not have to go through life alone. And that is a godsend. Gwenn Voelckers is the founder and facilitator of “Alone & Content” empowerment boot camps for women held throughout the year in Mendon. She is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about her boot camp, to purchase her book, or invite her to speak call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com
and 44% improvement, respectively, in kids on the placebo. The children treated with marijuana also showed 50% improvement on a scale that tracks core autism symptoms, compared with 22% for kids taking the placebo. However, children treated with marijuana were more likely to suffer from decreased appetite, sleepiness and disturbed sleep. Simon Baron-Cohen is president of the International Society for Autism Research, and reviewed the study. “From the brief information, we must advise those considering this as a form of treatment to use caution, given the report of significant rates of unwanted side effects,” he said. Researchers plan a follow-up clinical trial that will include more children from different countries, Aran said. He cautioned against becoming too excited about this potential therapy. “It’s not a miracle treatment,” Aran said. “It might be another tool in our toolbox.”
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June 2019 •
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Career in Healthcare
Medical Billing Career: Great Entry Level Job By Deborah Jeanne Sergeant
A
fter patients see a medical provider and before they receive a statement or bill from their health insurance company, the financial aspects of the visit go through a few different processes. One step along the way is the desk of a medical biller. If you have good math, customer service and analytical skills, you may be well suited to work as a medical biller. According to the US Department of Labor’s Bureau of Labor Statistics, employment for these positions is expected to grow 22% in the next few years. “In Central New York in the past 30 days alone, there have been 21 job postings for medical billing,” said Mike Metzgar, associate vice president of economic and workforce development for Onondaga Community College. “In the past year, there were 92.” Many times, people get into billing because they have a background in the medical field as a nurse or CNA, but were injured and can no longer perform the physical aspects of the work. People with experience in customer service also find a smooth transition into billing. People with entry level experience
in accounting or banking may get in a medical billing office; however, health care billing knowledge is helpful. But anyone with a high school diploma may enroll. “Once in the field, there is enormous upward potential for those who want to grow their career,” Metzgar said. “We are committed to providing people with short-term training that leads directly to living wage jobs.” According to the Bureau of Labor Statistics, the mean annual wage of billers working in a hospital setting is $38,530; for those in a physician’s office, it’s $37,690; and for those in a lab, it’s $37,730. Most people who work in medical billing take courses at a vocational school or college; however, not all billing positions require a degree. Onondaga Community College’s 300-hour, six-month medical billing program includes 80 hours of classroom time and 40 hours of lab time. Tuition is $2,700. Medical billing is complex. Each care provider, such as the hospital, diagnostic lab, X-ray technician and more, are billed separately. Medical billing can involve customer service, when patients’ insurance companies refuse to cover
services or they have questions about how their coverage works. Those working in medical billing also receive continuing education, provided by insurance companies and through the Health Care Financial Managers Association. Usually, employers pay for the latter. Some medical billers perform coding work, especially in smaller offices; however, larger medical facilities have billers, coders and others handling the various aspects of medical finances. Carla Deshaw, executive dean of community workforce development at Cayuga Community College, said that while EMRs have made the billing process more efficient and accurate, the health care industry still very much needs billers to verify information and provide customer service. Billers also have patient interaction over the phone as they help resolve claim issues. Cayuga Community College doesn’t offer a specific medical billing program; however, its medical assisting program includes billing and other administrative tasks. Onondaga Community College also offers a
medical assisting program. Though medical assistants tend to make more than billers, obtaining both the clinical and administrative skills can give workers a broader set of skills and make them more valuable to a small office. The 730-hour program for medical assisting at CCC includes a fourweek internship, and then sitting for the national examination through the National Association of Health Care Professionals. Tuition is $8,200. Deshaw said that graduates working clinically enjoy 90% job placement; however, billers are more difficult to place in Oswego and Cayuga counties. She said CCC doesn’t serve Onondaga County. “I think that most students who come into medical assisting have a passion for working in healthcare and helping people who are patients in the healthcare system,” Deshaw said. She added that many progress from assisting into license practical nurse, registered nurse and more, a process she calls “stackable credentials.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
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Crouse Spine Care Aims to Reduce Surgeries, Opioid Use Spine clinic is a “one-stop-shop” that gives patients access to chiropractors, pain management specialists, dietitians surgeons and imaging specialists in one visit By Aaron Gifford
C
rouse Spine Care is following a collaborative approach that reduces the number of surgeries, curbs the use of opioids, potentially saves patients thousands of dollars, and conforms to what providers say will soon become the new standard of care across all specialty areas. The concept of assigning a care team made up of a nurse navigator and various specialists is not brand new, explained Jameson Crumb, a Crouse Spine Care physician assistant, but the hospital is still evaluating the results since the model was Crumb put in place at the center in August 2018. Thus far, he added, the patients, providers, health care administrators and insurance companies are giving it a thumbs up. “Everyone seems to like the idea of a more comprehensive, collaborative approach and a more personalized treatment plan for patients,” Crumb said during a recent interview. In keeping with this concept, Crouse Spine Care recently entered into a partnership with the YMCA in which physical therapy patients can get a free three-month membership if they purchase personal training sessions there. “For physical therapy, there is only so much reimbursement from insurance companies,” Crumb said. “This helps them [patients] to continue working toward recovery. So far, from the results we are seeing, it’s working tremendously.” Most of the patients who visited the Spine Care center are given a
Most of the patients who visited the Spine Care center are given a conservative course of treatment that favors fitness, a healthier diet and regular communication with care team members instead of surgical intervention conservative course of treatment that favors fitness, a healthier diet and regular communication with care team members instead of surgical intervention, Crumb explained. As involved and labor intensive as a care team sounds, it’s still significantly cheaper than surgery and hospital stays. In cases where surgery is required, Crumb explained, minimally invasive options performed on an outpatient basis are preferred. And as far as recovery goes, the pain management doctors assigned to Crouse Spine Care will be unlikely to prescribe opioids and more likely to prescribe anti-inflammatory drugs or other medications that are not addictive narcotics, Crumb said. Medical marijuana may become a more common option in the years to come. Carl Butch, an internal medicine physician at Crouse, described the approach as a “one-stop shop” that give patients access to chiropractors, pain management specialists, dietitians and, in some cases, surgeons and imaging specialists. In many instances, patients have met with all of the providers on their team in one
visit. The patient also has the ability to contact their nurse navigator at any time with questions or concerns. “The quick response helps keep medications updated and accurate,” Butch said. “With this approach, our no-show [to medical appointments] rates have decreased.” In addition, Crouse works with a network or providers that offer acupuncture treatment, yoga instruction and massage therapy. Butch added, in the past year, Crouse has determined that about 90 percent of its Butch Spine Care patients do not require costly MRI exams. “It’s evidence-based medicine,” he said, “and everyone, including the insurance companies, is in favor of this approach. “This is where medicine is going, or needs to go.” Other departments at Crouse June 2019 •
are following the same model of care and additional specialties plan to incorporate it soon, Butch explained. He provided an example in which a patient recently complained to their nurse navigator that they gained three pounds in three days. As part of that patient’s initial care plan, he had been advised to report any drastic changes such as rapid weight gain, and the nurse navigator put him in touch with a cardiologist, who in turn got the patient back on track. The potential problem was not ignored, and a trip to the emergency room that might have otherwise occurred if the condition had a chance to worsen was avoided. “They were able to get to the [cardiologist’s] office, and there were no barriers to getting medicine or getting medications changed,” Butch said. “There might be more office visits in some cases, but less emergency room visits. The main idea is directing money in a different direction.” Crumb added, “Your pain doesn’t go away because you can’t get an appointment. There is definitely a need for this approach.” An underlying theme to this approach is the mutual understanding between provider and patient that a simple problem can spiral out of control if ignored. Lower back pain, for example, can lead to a person becoming inactive and gaining an unhealthy amount of weight. That opens up the potential for heart problems, diabetes and other issues, not to mention psychological complications like depression. Communication and accessibility to a nurse navigator and the appropriate physicians is key, but this system has not been set up to make money on unnecessary consultations. In fact, insurance companies traditionally did not reimburse providers for consultations if they were part of a care team arrangement. That changed in recent months so there is a code physicians and nurse navigators can bill for such services. The reimbursement amount is fairly low, and there are guidelines in place discouraging providers from initiating unnecessary services. Spine Care services can and will be expanded using online telemedicine technology, Crouse plans to extend spine care services to patients in the North Country as well as areas east and south of Syracuse. Hospital officials are also planning to expand the hours at the two existing Syracuse area locations on Irving Avenue and Brittonfield Parkway.
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Page 13
HARMLESS HERNIA?
OR DANGEROUS CONDITION?
ABOVE PHOTO, FROM LEFT TO RIGHT: MOUSTAFA A. HASSAN, MD, GENERAL SURGEON TAEWAN KIM, MD, GENERAL SURGEON PRASHANT UPADHYAYA, MD PLASTICS AND RECONSTRUCTIVE SURGEON
Hernias can be bothersome and even painful, but some can be dangerous, so ask your physician to evaluate yours. If it is determined surgery is necessary, ask for the experts. Abdominal wall hernias are one of the most common of all surgical procedures. But our team is anything but common. The Hernia and Abdominal Wall Reconstruction Program at Upstate has a dedicated team of surgeons, a nurse navigator and support staff. Our multidisciplinary team specializes in the review and repair of all types of hernias, including those that have been previously mended.
Use of Telemedicine Nearly Triples in Upstate Excellus survey shows growing awareness, use and acceptance of telemedicine options in Upstate New York
H
ealth care visits delivered via telemedicine nearly tripled over the past two years in Upstate New York, as awareness and financial support of the option has expanded, Excellus BlueCross BlueShield recently announced. According to a claims-based review of health care services delivered, health plan members made 5,137 telemedicine visits in 2016. In 2018, the number of telemedicine visits among members jumped to 14,790. “Extrapolating our experience to the state as a whole, we estimate that New Yorkers made more than 180,000 telemedicine visits last year, leading us to the conclusion that this additional method of receiving care is quickly emerging,” said physician LouAnne Giangreco, vice president and chief medical officer for Excellus BlueCross BlueShield. Private insurance, Medicare and Medicaid pay for health care services delivered via telemedicine now. Awareness and acceptance of telemedicine is growing rapidly, according to an online survey of Upstate New York adults conducted by One Research and commissioned for Excellus BlueCross BlueShield in early 2019. Among the 2,004 respondents: • More than 50% said they know about telemedicine • 5% reported to have used it • Among those who have used telemedicine, 93% rated the experience favorably • Some 43% of all respondents said they would consider using telemedicine in the future. “Telemedicine can help address several health care needs,” said Giangreco. “For many common conditions, it can be used to avoid potentially preventable visits to a hospital emergency room or an urgent care center.” Among a sample of health plan members who used telemedicine last year, about 4% reported that telemedicine helped them avoid using a hospital emergency room. Had the telemedicine option not been available, 55% reported that they would have used an urgent care center, 26% said they would have seen their primary care physician, 10% said they would have delayed getting care, and the remainder chose “other.”
“The ideal method of getting care is to see your physician,” said Giangreco. “We suspect that a number of telemedicine visits taking place are occurring because patients cannot immediately get appointments for minor conditions and feel they need to address or want to address their issues quickly; otherwise they would wait.” An estimated 78% of telemedicine visits made by a sample of health plan members in 2018 were related to medical treatments, with the balance (22%) related to behavioral health services. The top medical conditions for which members sought telemedicine treatment were: Heart disease, hypertension, skin disorders, diabetes and pneumonia. Top behavioral health conditions for which members sought telemedicine treatment were: anxiety, depression, childhood/adolescent disorders, attention disorder and bipolar disorder Psychiatrist visits were cited by the health plan as one of the fastest-growing areas of telemedicine care. “Telemedicine is helping patients see their psychiatrists for their medication management,” said Giangreco. “Patients can get quicker access to address their behavioral health needs. And, we’ve learned that our members like being able to consult with their psychiatrists from the comfort and privacy of their homes.” “Telemedicine isn’t the answer for everything, but these results are positive signs that it is seen as a valuable tool that enhances access to care,” Giangreco said. “Patients are using telemedicine for quick checkins on their chronic conditions. Families are putting their doctors in their pockets when they go on vacation. Kids are using it when they go off to college. We’re seeing folks from rural areas more easily getting basic care and follow-up care from specialists using telemedicine without having to travel long distances.” Go to https://tinyurl.com/ yyn57kkt to view the Telemedicine Educational Poster. Submitted by Excellus BlueCross BlueShield.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
Insured
National Cancer Survivors Day, June 2
Cancer: A Survivor’s Story By Brian E Walsh
T
wenty-three years ago, cancer tried to rock my world in the form of Stage 4 lymphoma. I spent three years going in and out of remission. In that time, I went through various rounds of chemotherapy and a stem cell transplant. Each time the cancer came back. During that time, my colleagues from Altmar Parish Williamstown High School bought me a golden retriever puppy, knowing that being home would be hard for me. I named that puppy Khemo. He was a huge part of my therapy. As a lifetime athlete and coach, I relied on my self-discipline and determination to get through it all. But it was not just me going through it. My wife, Christine, was right by my side. Chris was and is an information person. She researched everything there was to know about my cancer and kept
up with all possible therapies. We both had our own form of coping, but most importantly, we both had faith and we held on to hope. That hope came in 1999 in the form of a newly developed drug that put me in remission for the past 23 years. Since that fine July day, my life has changed drastically. Chris and I adopted a wonderful red-headed baby boy. He was born 1.2 pounds just shy of 24 weeks. James has autism, but just as cancer did not define me, autism does not define James. He is now 19 years old, living in his own place, in college, driving and taking flying lessons. See, he too has held onto and continues to hold onto hope. His life is better because of that positive outlook. On Sunday, June 2, the Hematology – Oncology Associates of CNY will be sponsoring its Fourth Annual Celebration of Life for National Cancer Survivors at
Longbranch Park in Liverpool from 10:30 a.m. to 1:30 p.m. This event gives us a chance to gather and to acknowledge and share our common experience. It is labeled a celebration for cancer survivors, but lest we forget that spouses, siblings, parents and children of cancer patients are also survivors. We did not go through or make it through alone; everyone around us also survived. I believe it was harder for my wife than it was for me. I admired all she did for me, and I will always be in debt for what she went through during the years of my cancer treatments. She is just as much a survivor as I am. We love this celebration because it brings us together as a community and offers continued hope. Cancer tried to rock my world, but with the support of my wife, family, Khemo (my dog), colleagues, friends and, most importantly, hope,
‘Mammo Van’ Is Coming… Upstate University Hospital takes breast cancer screenings on the road By Payne Horning
E
arly detection and diagnosis is the best protection against breast cancer. But for many women, access to these potentially life-saving screenings is out of reach. A new partnership between New York State Department of Health and Upstate University Hospital hopes to eliminate those barriers with a $1 million “mammo van.” The mobile clinic will soon travel through eight Central and Northern New York counties, bringing the same kind of state-of-the-art 3-D mammography equipment used at Upstate to a much wider range of patients. “By having a mobile mammography van in our system — in our community — we are offering this life-saving resource to all of our neighbors and friends,” said physician Ranjna Sharma, division chief of breast surgery at Upstate. “We are stating the importance of health maintenance and self-care, we are empowering members of our community to be advocates for their own health and the health of their families.” The pink and blue mammo van is more like a bus. It’s 45-feet long, 13-feet tall and weighs 44,000 pounds. Inside is a small reception area, dressing room, exam room and table, ADA-accessible bathroom, and a technologist room where patients will be screened. When it’s up and running, a staff of eight to 10 will accompany the van on its travels. The appointments are expected to take 15 to 20 minutes each, with results emailed to patients within two to 10 days. This is just one of several region-
Kaitlyn Doody, a technologist employed by Upstate University Hospital, will be one of the professionals seeing women at mobile mammography van. al mobile mammography vehicles the state is funding with its “No Excuses, Get Screened” campaign. State lawmakers have taken several steps in recent years to increase breast cancer screenings through partnerships with health care organizations and legislation that funds initiatives like the elimination of co-pays for the screenings. “This is what it’s all about — creating access and opportunity for people to remove any excuses that they may have,” said Lt. Gov. Kathy Hochul, who attended the ribbon cutting ceremony for the Mammo Van. “$91 million has been allocated to help a whole panoply of initiatives, partly which is to ensure longer hours on weekends and evenings so
women don’t have to sacrifice money from their jobs or time away, but also to the countless women and families who are under-served because they don’t have the transportation to go to an urban area where there would be screening — this is the answer to that problem.” According to the New York State Department of Health, breast cancer is the most common cancer among women in the Empire State and the second-leading cause of cancer-related death in New York women. Upstate’s physician Sharma says the mortality rate for breast cancer has seen a significant decrease since the 1990s, largely attributable to the rise of improvements in screening mammography. Detecting breast June 2019 •
I am still here and loving life. So please, hold onto hope; you never know when and how it will show up and when you might need it!
Brian E Walsh, 60, retired from Altmar Parish Williamstown High School, where he taught for 33 years, and from SUNY Oswego, where he worked as supervisor of student teachers. In January 1996 he was diagnosed with non-Hodgkin’s lymphoma Stage 4; in July 1999 his cancer went into remission.
Mammo Van Coming to Your Neighborhood The Upstate University Hospital “mammo van” will begin its journey in June, making stops at town halls, businesses and Kinney Drugs locations in Herkimer, Jefferson, Lewis, Oneida, Onondaga, Madison, Oswego, and St. Lawrence counties. cancer early as a mammographic abnormality — sometimes years before it would be detected on a physical exam — allows for more treatment options. And Sharma says those treatments may be less extensive and less aggressive when these cancers are caught earlier. Syracuse resident Janet Bacon knows how critical early detection is. She survived breast cancer after getting a screening at Upstate in 2015. Now, Bacon says it’s her time to give back. She plans to travel with the Mammo Van to encourage other women to get this test. “It means so much to me because people in rural areas probably don’t get this information, don’t get the screenings like they’re supposed to,” Bacon said. “So, this van can go out, get the mammograms, give you the peace of mind. That’s what I’m all about – helping getting people signed up, getting that very important mammogram to save their life like they saved mine.” The van will begin its journey in June, making stops at town halls, businesses, and Kinney Drugs locations in Herkimer, Jefferson, Lewis, Oneida, Onondaga, Madison, Oswego, and St. Lawrence counties. A complete list of locations and dates and is available at www.upstate.edu/mobile-mammography/ request-appt.php To schedule an appointment for a mammogram with the mobile unit, women should call 315-464-2582. Appointments can also be made online at www.upstate.edu/mobile-mammography.
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Men’s Health
The Pill for Men Men’s contraceptive may be available in the coming years. Will men take it? By Deborah Jeanne Sergeant
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ontraception has largely been dependent upon women — they are the ones who have to come up with barrier methods: spermicidal preparations or hormonal implants, patches, injections, vaginal rings or pills. But researchers want to change that. Men’s oral contraceptive — dimethandrolone undecanoate (DMAU) — may be available in the coming years. “Male contraception is probably the single best thing we can do for women’s contraceptive health,” said Hadley Narins, urologist with AMP Urology in Syracuse. “It’s nice to offer men the same sort of non-permanent but highly effective options women have available and give them more ownership of their reproductive rights.” The Journal of Clinical Endocrinology and Metabolism recently published research indicating that initial tests involving a small population — 100 men aged 18 to 50 — for 28 days indicate no serious adverse
events and the medication was “well tolerated.” Eighty-two of the men completed the double-blind, randomized, placebo-controlled study. DMAU suppresses testosterone in men’s testicles so their sperm do not develop. That impedes their ability to impregnate women. “In a committed relationship where they’re not ready for a vasectomy and there’s no desire of using condoms and the woman doesn’t tolerate birth control, the onus isn’t all on women,” Narins said. Beyond safety and efficacy, the successful use of DMAU also lies in compliance: will men take a daily pill that decreases testosterone, the main hormone that makes men masculine? Physician James Greenwald, professor of family medicine at Upstate Medical University, isn’t sure. “The side effects are going to be somewhat of an issue,” Greenwald said. “It’s going to be surprising to me if there are any men using this who are in a stable relationship. Different side effects like weight gain,
perhaps transient loss of libido and changes in cholesterol would make it a concern, especially for people who are on it long-term.” Though women’s oral contraception has been known for decades to cause weight gain, increased risk of stroke (particularly to those over 35 and smokers), and other negative side effects, it’s still the most popular means of contraception. About 25% of women who use contraception of any kind use the pill. The next closest reversible contraception method is the male condom (14.6%), followed by the intrauterine device (11.8%). Greenwald suspects that the greatest interest would be men who want to delay fatherhood and those women who cannot tolerate hormone-based contraceptives. Men taking medication like DMAU could relieve women from the risks of taking hormonal contraception. Not all women are good candidates for contraceptive medication or devices, and some couples don’t prefer spermicide or condoms. Men would also gain more control over their paternity, since they don’t have to rely on their partner’s ability to remember to take a pill, use spermicide correctly or keep her other contraceptive delivery method up-to-date. “As it is now, men must accept the word of their partners that they are practicing contraception,” said urologist David Gentile, with University of Rochester Medical Center. “If there are any trust issues within a given relationship, this might prove reassuring to men,” he added. Controlling conception can help new husbands delay starting a fam-
ily, for example, even if their wives are more inclined to have a baby right away. Gentile thinks medication like DMAU can affect other age groups. “It is not uncommon for me to see older men, perhaps divorced or widowed, who are very leery of establishing a new relationship because of fear of an unwanted pregnancy,” he said. “This would theoretically relieve that.” Without having to use condoms, men could experience greater sexual spontaneity and, if they dislike condoms, more enjoyment. Men can delay paternity without canceling it altogether, as with vasectomy, which is permanent sterilization. Gentile isn’t sure that men will view the man pill’s advantages as outweighing its side effects. He said that the research so far claims DMAU reduces testosterone without association with typical symptoms of low testosterone, such as low libido, erectile dysfunction, depression, and fatigue. Its effects are also reversible, unlike vasectomy. “However I’d be concerned about the impact on cholesterol and the impact on bone health, reflected by bone mineral density,” he said. “I also find it hard to believe that there would not be strong objection by men to the almost certain emotional liability that would likely result from such low testosterone levels. Results at the gym will also be lacking, to which men would certainly voice objection.” “On the whole I would not envision this drug taking off like the Viagras and Cialises of the world,” Gentile added.
Testosterone Supplements Not All They’re Cracked Up to Be
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uyer beware: When it comes to testosterone supplements, men should know a new study finds there is precious little evidence to support claims they will boost testosterone levels, sex drive, strength and overall energy. To come to this conclusion, the researchers first broke down 50 testosterone supplements into their component parts. The investigators then searched through a comprehensive scientific publication database for any solid proof that the supplements can do what the companies who make them say they can do. Only 12% of the products contained any ingredient shown to provide some testosterone-related benefit in human trials. And nearly half (48%) contained ingredients that studies found could have negative impacts. “In general, I’m not anti-supplements,” noted study author, physician Mary Samplaski. “I have a lot of patients who take them. But the FDA [U.S. Food and Drug Page 16
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Administration] says very clearly that these products should not claim to treat medical conditions. And 90% of these testosterone supplements do make such claims. So, I was just really curious what the scientific support was for the claims being made.” Samplaski said, “What we found is that in the vast majority of cases there was no evidence to show that any of the ingredients in these testosterone supplements were effective in any way.” The upshot, she said, is that “people should understand that just because there’s a sexy website
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
with a pic of Arnold Schwarzenegger doesn’t mean it’s the result they should expect.” Samplaski is director of male infertility with the Keck School of Medicine’s department of urology at the University of Southern California, Los Angeles. To begin their work, her team googled “testosterone booster,” and compiled a list of the first 50 supplements that came up. About 90% claimed they would boost testosterone levels. Half claimed to improve libido, and nearly as many claimed to make men stronger. About 60% promoted building body mass, while 30% claimed to increase energy, and almost as many were touted as fat burners. Supplements were then broken down by their ingredients, which included vitamins, minerals, folic acid, mushrooms and a variety of herbals. Ingredient amounts were also tallied, with an eye toward the FDA’s stated daily allowance and tolerable upper intake levels for each. On average, each supplement contained seven ingredients. Just four ingredients — fenugreek, shilajit, D-aspartic acid and vitamin D — were found to have been the subject of rigorous studies designed to track patients over time to assess their impact on testosterone levels. Of those, only the first two ingredients were shown to have a beneficial impact. Another 10 ingredients were also linked to positive impacts on testosterone levels in a variety of animal
investigations and human trials that retroactively analyzed previously collected data. But 60% of the ingredients in question had no scientific data of any kind exploring their impact on testosterone. What’s more, many of the supplements were found to contain doses of vitamins and minerals that far exceeded recommended levels. In some cases, even tolerable upper intake levels were exceeded, including zinc levels found in two supplements. The findings presented at the American Urological Association annual meeting in May. According to Cambridge Health Alliance general internist Pieter Cohen, the problem is that “supplements are regulated in a very different way than over-the-counter medications and prescription medications, which need to have strong clinical evidence before they can be advertised for use in humans.” And that means “there is great leeway in advertising supplements, which leads to many unsupported claims appearing on supplement labels,” he said. “Even worse, when clinical trials have demonstrated that a supplement does not work, the companies can still continue to make the same unsupported claims. This has led to brisk sales of supplements even after they were proven to be ineffective,” Cohen added.
Summer Care
Summer Sun-Safety ‘My worst sunburn ever was from…’ By Kimberly Blaker
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y worst sunburn ever was from lying out on an overcast day. I didn’t expect to get much of a tan, let alone sunburned, given the conditions. I was especially unconcerned since I couldn’t see any color change at the time. But by evening, my skin was pinkish-red, and the pain set in. I couldn’t wear clothes and had to call in sick for two days. Aside from a serious sunburn, there are other equally important reasons to take extra precautions in the sun, especially during the hot summer months. Skin cancer is the most widely recognized health problem resulting from sun exposure. To reduce your
risk: • Avoid afternoon sun. • Apply sunscreen with an SPF of 30 or higher at least 15 minutes before you go out and then reapply every two hours. • Look for products carrying the Skin Cancer Foundation’s blue seal of approval. • Wear clothing that covers your arms and legs as well as a hat to shade your face. The sun’s rays also damage our eyes. Exposure can cause cataracts as well as damage to part of the retina, cornea and lens. Physician Cheryl Khanna of Mayo Clinic recommends wearing sunglasses that block 99 to 100 percent of UVA and UVB rays.
Picnics, Cookouts: How to Keep Food Safe Picnics and cookouts raise the risk of issues such as cross contamination and food-borne pathogens. Follow a few simple rules to avoid the problem By Deborah Jeanne Sergeant
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ow that it’s picnic season, why not brush up on food handling tips to ensure your food is safe? Picnics and cookouts raise the risk of issues such as cross contamination and food borne pathogens because we’re cooking and handling food outside the routine environment of the kitchen. “Ninety percent of all food borne illness is preventable,” said Nancy Rissler, instructor and proctor for ServSafe at Onondaga Community College. She said that grilling safely means using a meat thermometer to
ensure the meat reaches the proper temperature — not relying on color or a prodding finger. Cook beef, pork, veal, fish, shellfish and lamb to 145 degrees F, ground meats to 160 degrees F, and all types of poultry to 165 F. Always insert the thermometer in the thickest portion, away from the bone. She also said that picnickers should use separate utensils while grilling. For example, if you place cooked meat on the same platter that held it before it was cooked, the prepared food can become contaminated with bacteria. Or if you moved raw meat
Also, some sunglass designs offer better protection. The best designs to block out as much UV rays as possible are wrap around or close fitting glasses. The risks of dehydration and heat exhaustion also increase during warmer months. It’s important to drink several glasses of water every
day of the year, but especially during the summer months. If you’ll be in the sun or heat for any length of time, carry plenty of water with you. Better yet, carry sports drinks, since they contain electrolytes. Also, try to restrict outdoor physical activity to cooler parts of the day.
with the same set of tongs that you use for serving it. Or if you marinade raw meat and later use the marinade to baste the meat as it cooks, you spread bacteria all over it. Foods that can cause cross contamination, including raw steak, chicken, ground meat and seafood. By preparing as much as you can at home, you can help prevent many cross contamination issues. Rissler said that the “danger zone” of perishable foods is between 40 and 140 degrees F. That’s when bacteria rapidly multiply. Rissler advises testing with food thermometers throughout a long picnic to ensure food stays at the right cold or hot temperature. How you transport and serve cold items can affect their temperature as well. Begin with cold foods that are already cold. Don’t try to rely on the cooler to chill foods. Keep all the drinks with the cold salads in one cooler isn’t a great idea, since constantly opening the cooler to retrieve drinks reduces the temperature inside. “It will jeopardize the stuff you want to keep cold,” Rissler said. “Put out small containers for people and refill them frequently, instead of one big macaroni or potato salad. Keep the backups on ice.” Lisa Jones manages the food program for Cayuga County Public
Health Department. She recommends packing a cooler only with prechilled foods. “Rinse cooked pasta with cold water and chill it before adding mayonnaise,” she said. Don’t count on the cooler to chill foods. Jones said to use freezer packs instead of ice at the bottom, followed by raw or marinating meat in sealed containers, followed by other foods on top, which can prevent any meat drippings from leaking into ready-toeat foods. “Pack the condiments with salads, separate from meats,” Jones added. It can also help to fill coolers up to the brim. “The more cold things in there, the colder it stays,” she said. “You could throw in a roll of paper towels.” Produce should always be washed before it’s eaten. If you’re bringing along a melon to slice, don’t forget to wash it first; otherwise, every cut of the knife draws bacteria inside, to the flesh. Cut it on a clean surface. Also bring along table cloths or a means to clean tables, plus hand sanitizer. Jones said that a small container dispensing warm, soapy water can also help with keeping clean.
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Summer Care
Should You Be Worried About Blood-Hungry ‘Kissing Bugs’? I t sounds like something out of a horror film: A blood-hungry insect feeds on its prey’s face while they sleep, leaving behind a parasite that can cause stroke and heart disease. The triatomine, or so-called “kissing bug,” is all too real and found regularly in Latin America, but also has been found in several areas of the United States, as far north as Illinois and Delaware. And while it often targets faces, the insect will settle for any patch of exposed skin. With summer barbecue season on the horizon, how worried should people be? It’s important to keep things in perspective, said physician Caryn Bern, a professor of epidemiology and biostatistics at the University of California School of Medicine. After an acute flu-like period that lasts from weeks to months, most people who test positive for Chagas disease show no symptoms. “The estimate is that 20%to 30% of people with Chagas disease will eventually develop heart or gastrointestinal disease, although heart disease is much more common,” Bern
said. “That’s over a lifetime, and it usually doesn’t show up until years after the infection occurred.” It’s not the bug that causes Chagas disease, but rather a parasite that lives in its poop. When a person inadvertently rubs the bug’s feces into the bug wound, their eye or another mucous membrane, the parasite sometimes makes itself at home. Chagas disease also can be transmitted from mother to fetus; from contaminated blood transfusions; via an infected organ donor; or in rare cases, through food or drink. While about 300,000 people in the United States have Chagas disease, most of them contracted it while living in Mexico, Central America and South America, where the Centers for Disease Control and Prevention estimates up to 6 million to 8 million have been infected. All told, the disease causes more than 10,000 deaths a year worldwide, according to the World Health Organization. But it’s important to keep in mind that since 1955, there have been fewer than 50 documented cases of people who have acquired the para-
site from exposure to the triatomine in the U.S., said physicians Susan Montgomery, who leads an epidemiology team in the Parasitic Diseases Branch of CDC’s Division of Parasitic Diseases and Malaria. “The parasite has to get into a human’s body or an animal’s body by contaminating the wound,” Montgomery said. “It’s pretty complicated.” But there is cause for concern, said Paula Stigler Granados, an assistant professor at Texas State University who leads the Texas Chagas Taskforce. Granados and her team work to raise awareness about Chagas in a state where more than 60 percent of triatomines test positive for the parasite that causes the disease. “The more we look, the more we find,” Granados said, noting that since the American Red Cross started screening new blood donors for Chagas disease, they have identified many people infected with the disease. “Al-
though the blood donation tests are extremely sensitive and sometimes have false positives, that’s an indicator that it could be a bigger problem we should be monitoring.” There is a treatment for people who have Chagas disease. In 2017, the Food and Drug Administration approved benznidazole, a 60-day medication regimen for people aged 2 to 12. Once Chagas disease becomes chronic, the medication may not cure it but could slow the progression in younger people. For older people who are affected, experts recommend doctors and patients weigh the individual benefits with the possible side effects of the medication, which can include rash, abdominal discomfort, and numbness or tingling in the hands and feet.
Don’t Let Bugs Bug You This Summer Stay safe from insect-borne illness By Deborah Jeanne Sergeant
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ou have plenty of reasons to keep bugs from bugging you this summer. Some, such as mosquitoes and ticks, can spread illnesses such as Lyme disease. The New York State Department of Health states that per 100,000 in population, fewer than 62.9 cases of Lyme disease were reported in each of Erie and Niagara counties in 2017 (the most recent data available). The counties are among the areas with lowest rates statewide. That at first seems like good news; however, reports of tick-borne disease cases reported has more than doubled statewide between 2004 and 2016, with increased rates heading westward across New York. Also, the Centers for Disease Control and Prevention believes that the number of actual cases of Lyme disease in general is 10 times the number reported. Michael R. Jorolemon, doctor of osteopathic medicine and senior quality officer for emergency medicine at Crouse Health, reported that in just one 10-hour shift recently, three people sought medical attention for ticks. And the season has only begun. “If you see a tick on you, the best thing is to seek medical treatment,” Jorolemon said. He advised heading to urgent care or the emergency room if the primary care provider is unavailable. Page 18
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Lyme spreads as black deer ticks infected with Borrelia burgdorferi bacteria bite humans. Black deer ticks also spread less common diseases, such as babesiosis, human granulocytic, anaplasmosis and deer tick virus. Other types of ticks also spread diseases by biting humans, but that scenario is rarer than Lyme disease. These include the American dog tick (Rocky Mountain spotted fever), Lone Star tick (human monocytic ehrlichiosis), and woodchuck/ groundhog tick (powassan/encephalitis virus). Only about half of adult deer ticks and one-third of nymphs carry bacteria that cause Lyme disease, named for Old Lyme, a town in Connecticut, where the disease was first identified in the 1970s. The ticks typically travel by waiting on tall grass for a passing host. Ticks can hitch a ride on wildlife to residential areas. Hikers, hunters, birders, and campers are at greater risk because they spend time in wooded areas. If a tick has been stuck to a person for more than 36 hours, the patient should contact a health care provider to see if he qualifies for a prophylactic antibiotic to treat Lyme disease. The site of the bite shows a bull’s-eye patterned rash in about half the cases. “If a tick is found, it needs to be removed to help decrease the chance
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
of contracting a potential disease that is carrying,” Jorolemon said. “Often when people try other ways, the tick breaks off leaving a part embedded in them.” Leaving the head or mouthparts of the tick embedded can increase the chance of infection. To remove a tick, use narrow tweezers to grasp its head and pull it out, taking care to remove it. Don’t use a matchstick, petroleum jelly or other ineffective home remedies. Lyme disease symptoms include severe headache, fever, joint pain, facial droop, muscle pain, and sometimes, muscle weakness. As for mosquito-borne illnesses, experts said that they’re more rare. While most otherwise healthy people recover fine from many of these diseases, it’s not the case for all. The very young, the very old and those of any age who are immuno-compromised tend to experience more complications. West Nile Virus has no vaccine or treatment; however, only one-fifth of those infected develop any illness and of those, only one percent develop serious issues. Most experience a fever and flu-like symptoms. Kristina Ferrare, forestry program specialist with Cornell Cooperative Extension of Onondaga County, said that many of the steps for preventing tick bites are the same for mosquito bites, including wear-
ing long sleeves and pants, tucking in shirts and tucking pants into socks while outside. “When outside, give ticks as little access to our skin as possible,” Ferrare said. Apply approved repellant containing 25% DEET to keep mosquitoes away. You can also purchase clothing treated with permethrin or treat your footwear and clothing with the tick-killing chemical. Ferrare said that permethrin lasts for six washings or, on shoes, about three months. Wearing light colored clothing if you’re going in a tick habitat can help you spot them. Ferrare recommends checking for ticks and knocking them off before going indoors. Extra precautions for ticks include staying on the center of hiking trails, to avoid brushing against foliage. Don’t sit directly on the ground or surfaces like stone walls. Shower after outdoor activities like hiking or gardening and wash the clothing worn as well. But Ferrare said to not rely only on showering, since ticks can “cement” themselves to skin once they bite. Family members can check each other for ticks in the hard-to-see areas. But keep in mind that ticks like dark, warm areas, like the armpits.
SmartBites
By Anne Palumbo
The skinny on healthy eating
Great Summer Food
WATERMELON
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lthough National Watermelon Day falls on Aug. 3, we’re featuring watermelon today because warm weather, picnics, the Fourth of July, and all things summery are but weeks away. And what’s more summery than a cool, refreshing slice of watermelon? Despite the popular belief that watermelon is just water and sugar, this delicious fruit is actually soaked with nutrients. Each juicy bite has significant amounts of vitamins A and C, modest amounts of potassium and fiber and varying levels of many more vitamins, minerals and antioxidants. Not so surprisingly, however, watermelon’s most abundant nutrient is water: 92%. An essential nutrient to overall good health, water does so much more than just quench our thirst. Even though it provides no calories or organic nutrients, our body uses water in all its cells, organs and tissues to help regulate its temperature and maintain other bodily functions. In addition, because we lose water through breathing, sweating, and digestion, it’s important to rehydrate by drinking fluids and eating foods — like watermelon — that brim with water. Water also helps our body remove waste through perspiration, urination and defecation. Ever experience unusually dark urine? Stools as hard as marbles? Most likely, you’re not getting enough water, which helps the kidneys, liver and intestines flush out waste. And while there is no evidence to prove that upping your fluid intake will cure constipation, consuming adequate water does help prevent constipation by keeping stools soft and moving
things along at a steady clip. Drinking fluids and eating foods like watermelon — during or after a meal — actually aids digestion. Water is needed in our mouth for saliva, which begins the digestive process, and further needed in our stomach to assist enzymes that help break down food so our body can absorb the nutrients. This all-important nutrient is also essential for digesting soluble fiber — the type of fiber that slows digestion and nutrient absorption. So, whether we eat watermelon during or after a meal, we’re giving our digestive system a healthy boost! But the claim-to-fame nutrient that has recently elevated watermelon to “super fruit” status — the nutrient that seems to be all over the news lately for its purported health perks — is lycopene, a plant-produced phytonutrient. A powerful antioxidant that gives watermelon its characteristic red hue, lycopene, like all phytonutrients, appears to be beneficial to human health and help prevent certain diseases. Furthermore, according to the Watermelon Board, watermelon contains more lycopene than any other fresh fruit or vegetable. Why the limelight on lycopene? In a nutshell, current research indicates a strong association between high intake of lycopene-rich foods, such as watermelon, and reduced risk of certain cancers (most notably prostate cancer according to the National Cancer Institute), heart disease, chronic inflammation and stroke. In a report just published in the journal “Neurology,” Finnish researchers suggested that lycopene, in addition to its ability to attack cancer-causing free radicals, may also reduce inflammation and cholesterol,
Avocado Toast with Watermelon — Take a break from traditional breakfast fare and try this tasty, nutritious alternative. It’s both creamy and crunchy and packed with flavor, along with nutrients, such as calcium and iron.
improve immune function, and prevent blood from clotting. All of these benefits, they emphasized, may help reduce ischemic strokes, the most common kind, that are caused by blockages in blood flow to the brain. Does eating a slice of watermelon a day keep sunburn at bay? Many studies say yes, thanks (again!) to its lycopene, which has been shown to offer some protection against UV-induced sunburn. While scientists caution that the level of protection in no way replaces sunscreen, they do note that since most sun exposures occur during activities when our skin is totally unprotected — such as walking to and from our car — dietary factors with sun-protecting properties might have a considerable beneficial effect. Watermelon’s antioxidant properties are further bolstered by impressive concentrations of two important vitamins: A and C. Both gobble up harmful free radicals associated with a host of age-related diseases and also boost the immune system’s defenses against infections and diseases. Individually, vitamin A is essential for growth and healthy vision, while vitamin C is a tissue-builder and wound-healer. What’s more, this quintessential summer snack is a dieter’s dream food, delivering a mere 40 calories per diced cup. It’s filling, too, thanks to its high water content. Worried about cholesterol, fat or sodium? Watermelon happily scores a big goose egg in those departments. Watermelon’s sweet flavor suggests it’s loaded with sugar and carbs. It’s not. As a comparison, a cup of watermelon has around 9 grams of sugar — about the same as a small fresh fruit, half banana or one cup of berries — and only 11 grams of carbs. Like other fruits, watermelon has a mix of carbohydrates: natural fruit sugar (fructose, a simple carb) and fiber (a different kind of
Steel-Cut Oats with Watermelon — Steel-cut oats are one of the most nutritious grains, rich in the soluble fiber called beta glucan that helps keep blood fats and sugar in healthy ranges. June 2019 •
carb). While refined foods, like many breads, pastries and sweets, also have simple carbs, their carbs are not healthy because they’ve been stripped of nearly all their fiber, vitamins and minerals. This “refinement” causes the carbs to be digested quickly and have a high glycemic index, which then leads to rapid spikes in blood sugar and insulin levels. Eating refined foods that are high on the glycemic index has been linked to drastically increased risk of many diseases, including obesity, heart disease, and Type 2 diabetes. Watermelon has a high glycemic index, but because it’s low in carbs and boasts some fiber, it does not have the same affect on blood sugar, as, say, eating a donut. However, it’s still important for people with diabetes to be aware of the sugar and carb content of any fruit and to avoid eating excessive amounts of it. According to the American Diabetic Association, watermelon is safe for diabetics to eat in small amounts and is best eaten alongside foods that contain plenty of healthful fats, fiber, and protein.
Anne Palumbo is a lifestyle colum-
nist, 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.
Watermelon and Bulgur Wheat Salad — A light main or hearty side dish, watermelon adds a sweet complement to the chewy bulgur and peppery arugula. For full recipes, visit www.watermelon.org. Photos by Watermelon Board. IN GOOD HEALTH – CNY’s Healthcare Newspaper
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7 Questions to
resources of the two organizations will facilitate greater access to care by improving communication and collaboration over time. Your agencies say this will create a more integrated behavioral health care network for the region. How so? Currently many patients who experience substance use health or mental health that require care access different services with different organizations which inevitably leads to less coordinated care. We are trying to reduce barriers by integrating care systems and access to services. For example, right now we share common patients and residents whose records are in different systems and, while we can access those records through data exchanges, that isn’t as seamless as a unified record updated in real time. Training and education are crit-
Jeremy Klemanski 5. CEO of Helio Health talks about expansion of behavioral health agency, recent merger By Payne Horning
H
elio Health and Central New York Services, two of the region’s largest nonprofits agencies that work with people struggling with substance abuse and mental health disorders, are merging. The agencies will operate under the Helio Health name with a $70 million budget and 729 employees. We spoke with Helio Health president and CEO Jeremy Klemanski, who will retain his leadership position at the newly merged agency.
1.
How did the idea for the merger originate? The CEOs of the respective organizations have discussed the opportunities for collaboration going back a few years. In 2018 those discussions became more serious as each organization examined its strategic intent, and the changing landscape of the behavioral health sector of healthcare.
2.
The decision was made that the two agencies would operate as one under the Helio Health name. Why? Helio Health is the larger of the two organizations and had recently gone through an extensive discovery and research project led by Mower to develop a brand that appealed to the people we serve. One of the issues
identified in that research was the limitation of a name tied to a specific geography when we serve people outside of that region [the agency was formerly known as Syracuse Behavioral Health]. The name Helio Health reflects our mission to be the patient-centric innovative bright spot on the recovery landscape. Helio Health is dedicated to transforming the lives of those struggling with substance use and mental health disorders and be a place where hope meets healing.
3.
How will the merger change the care that those who are currently served by Helio Health or Central New York Services receive now? The merger will not change the care that people currently served will experience except that over time the team will have a deeper bench of talent to draw from. The scale of the organizations allows for increased investments in technology and best practice research and training for the staff over time. Will combining resources lead to any growth in the number of people you are able to serve that you could not reach independently? Jeremy Klemanski, CEO of Helio Health Yes, the combined
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Loretto Memory Care Neighborhood is the First of its Kind in CNY
magine riding in an elevator, the doors open and you step into a vibrant village where people are walking in the park, visiting the salon and barber shop, and the “roads” are free of pot holes. The 11th floor at The Cunningham, Loretto’s residential floor for people with advanced-stage dementia and Alzheimer’s, is this place. The Cunningham’s advanced memory care floor on Loretto’s main campus has been completely renovated to meet the needs of those requiring skilled nursing care and their families. The renovation, which took three months to complete, represents the completion of the first phase of Loretto’s $11 million investment in memory care services announced in 2018. “The revived space at The Cunningham is the only one of its kind in our region. We are very proud of the space we have created for our most acute memory care residents and their loved ones,” said Kim Townsend, president and CEO for Loretto. “The renovation allows residents to receive the best in dementia and Alzheimer’s care while living as
ical to keeping up with the rapidly evolving research on best practices in our sector, and we can leverage the scale of the organization to bring more of that to our colleagues. What are the major issues facing those who work in behavioral health right now, both in Central New York and beyond? The major issues facing people who work in behavioral health right now are the daily stress of the opiate epidemic, patient suicide, the rising number of people seeking care without a corresponding increase in rates or funding, increasing regulatory complexity, and inadequate numbers of qualified health professionals across the larger health sector straining the existing workforce. What is the timeline for the merger? The organizations are operating under a shared services agreement currently that allows the sharing of some administrative and support functions as we work to earn regulatory approval from multiple state oversight authorities. We would hope to have the merger completed by Jan. 1, 2020, but that is highly dependent on government approvals.
independently as possible and allows residents and their families to truly live in the moment.” The once traditionally designed clinical space has been transformed into a neighborhood focused on providing excellent care while allowing residents to maintain a sense of freedom in a safe environment. The space incorporates innovative technologies and design representing a cutting-edge approach to memory care including: • Special flooring that mitigates fall risk and is gentle on joints, wayfinding cues to make walking more enjoyable and allowing residents a level of independence, • Elevators and doors camouflaged with images of landscapes and familiar home scenes to trigger memories, redirect residents and keep them safe, • Softer lighting, upgraded scent system and calming colors to address sensory needs, • A neighborhood-feel complete with gathering areas that reflect park settings and a working salon/barber shop, • Upgraded window treatments to optimize use of natural light,
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
• And new technology – headphones and computers to provide various options for residents to benefit from calming music and interactive games, and mechanized dogs and cats that meow, stretch and bark, all help to stimulate memory and reduce agitation. “Loretto has implemented wonderful changes and it feels like home,” said Sheri Freyer, whose mother-in-law Diane West is a resident. “Now when I visit, we enjoy walks in the park and activities along the way that make our interactions more meaningful. Even on the dreariest days, I come here and it feels like sunshine. There’s also plenty to do for family members of all ages making it more pleasant for visits. It really warms my heart.” It’s not just the residents and families who are reaping the benefits of the new space, employees are benefiting from expanded access to resident care tools and boosted morale. “The space itself is bustling and full of energy from residents and their families. The renovations have enhanced the way we deliver care and increased quality of life for our
residents while boosting staff morale,” said Tom Schattinger, director of operations for Loretto. “By providing employees with additional tools for care, we have improved their ability to interact with residents clinically and socially which is good for everyone.”
What’s Ahead
The changes at The Cunningham are only the first phase of advancing memory care facilities in Central New York. Loretto will be working on the Center for Aging Excellence at The Nottingham, which will include a new living community dedicated to residents living with dementia. An additional 20,000 sq. ft. of space in the center will provide classrooms, offices and common spaces to support continuing education for staff and family on the care and treatment of those with dementia, as well as to accommodate partners advancing the latest research studies. Additionally, The Heritage, the first residential program of its kind in Central New York created to care for those with Alzheimer’s disease or other dementias, will undergo renovations to incorporate the latest designs and technology to support residents with dementia. Complete details for the project are available at www.lorettocny.org/ memorycare.
Medical Spas
How to Select a Medical Spa
I
f you want to seek esthetic services above what a spa offers, turn to a medical spa. While some of your selection should be based upon the type of service you need, you may have several options. Here’s what the experts say you need to look for in a medical spa:
filler is injected into an artery, it can cause tissue to die on the face. Or blindness. With energy-based treatments, it can damage the skin.” Anthony Deboni, board-certified plastic surgeon, CNY Cosmetic & Reconstructive Surgery in East Syracuse.
• “Some medical spas are run by internists, family practitioners or emergency room doctors. I’m not saying they’re not intelligent people, but that’s not what they’re trained in. • “Frequently, the consumer doesn’t ask who’s supervising and what they’re board-certified in. We have seven-plus years’ training in Botox, fillers and [dealing with] the complications that can arise. The patients need to ask how complications are going to be handled. Does the doc have privileges to admit that patient to the hospital? “Obviously, as with any service, look for online reviews. Usually if there’s a lot of bad press it will show up someplace. “Serious complications can result with these medical procedures. If
• “It’s important to understand what’s being done, what’s being offered, who’s doing the procedures — is the place a licensed business to do so? • “Most practices may have their aestheticians evaluate at a complementary visit. They can come up with a program the patient may agree to do. The patient has to do their homework and find out who’s doing what. They may have had treatments somewhere else and are seeking another option.” Guillermo Quetell, board-certified plastic surgeon in East Syracuse. • “Look for a place with good reviews and a good reputation. Word of mouth goes a long way in this industry.”
Spas 101 When to choose a medical spa
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edical spas have become more popular in recent years for men and women alike. Medical spas, also called medi-spas or med spas, are a kind of a hybrid between the traditional day spa and a medical clinic. Medical spas strive to blend the best of two worlds—a relaxing spa experience with the procedures and expertise typically only found at a doctor’s office. Wondering if a medical spa is the right place for you to get your treatments done? Here are answers to some common questions about medical spas.
How Medical Spas Differ From Traditional Day Spas The biggest differences between a traditional day spa and a medical spa are the types of procedures that are offered. Medical procedures that can’t be done at the average day spa can be performed at the medical spa. Unlike day spas, medical spas must be affiliated with, overseen, or run by a medical doctor. While not every procedure is done by a doctor, they are performed under the supervision of the doctor, most often a dermatologist or plastic surgeon. Medical spas themselves can vary widely, depending on where you go. Some are as posh as the day spa you visited during your last
vacation; others are decidedly more clinical. While day spas focus on relaxation, most medical spas are driven by results.
Treatments Offered While the menu will vary depending on which medical spa you visit, in general, you can expect to find treatments for acne, aging skin, hair removal, and more. Like at a traditional day spa, luxurious treatments like massage, salt glows, seaweed wraps and facials can be had at a medical spa. But medical spas also offer more specialized treatments that are typically only found at a dermatology or plastic surgery clinic. Some of the more common offerings include light and laser treatments, injectables like Juvederm, Restalyne, and Botox, as well as chemical peels. As for acne treatment, you can find these at the medical spa too. Medical spas offer procedures to treat breakouts, lighten post-inflammatory hyperpigmentation, reduce scarring, and improve the overall appearance of the skin.
Amber Gilbo, licensed massage therapist, reiki master and owner, Integrative Healing Spa, Oswego. “Look at the breadth of services. Is it a comprehensive facility or a place where you can get only one thing done? “Do they have a referral base in the medical community?” Physician Norma Cooney, MedSpa Solutions, Syracuse. “Make sure that the people keep going for continuing education. This is an industry that changes on a dime. There’s something new every day. You want to make sure the product or procedure you’re offering of all procedures that fall under the medical realm. Aestheticians handle the more routine day spa therapies. Expect that an aesthetician, also known as a skin care therapist, will do all non-medical procedures. An aesthetician will do all cosmetic procedures, like massage, body scrubs, wraps, and the like. Aestheticians can also do certain non-invasive treatments like acne treatment facials, microdermabrasion, and s uperficial chemical peels. Although each state has its own regulations concerning medical
is good quality and the people will get results. “Interview your provider. We offer free consultations so that the provider can meet the patient and make sure we’re on the same page. I think the biggest problem we’re hearing about in the industry is people are lucky if they see the provider two minutes before they have the procedure. You want a provider who has the time to discuss the options. The provider should know the products, understand why he’s picking the products and knows how to correct any complications.” Giovanna McCarthy, owner and lead aestheticians, Rejuvn8, Liverpool. spas, in general, all medical procedures must be performed by a physician. This means all injectables, chemical peels that target deeper layers of the skin, and light and laser treatments will be done by the doctor. This article was written by Angela Palmer and originally published by www.verywellhealth.com, a site specialized in disseminating news related to health.
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The person who actually does your treatment depends on the treatment itself. The physician that oversees the medical spa is in charge June 2019 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Medical Spas
Medical Spas Offer Professional Grade Services By Deborah Jeanne Sergeant
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pa and medical spa: what’s the difference? At many salons and spas, clients can receive seemingly similar and overlapping services. Guillermo Quetell is a plastic and reconstructive surgeon in practice in East Syracuse. His office provides surgical and non-surgical services for improving appearance. Quetell said that care at a medical spa is physician-led, unlike at a spa where clients simply ask for the services they prefer. Instead, medical spas engage patients in discussing medical options for the issues they’re facing. “It’s a medical plan directed by a medical doctor and agreed upon and documented,” Quetell said. “It is a medical record.” Patients discuss their issue and develop a plan with the doctor, Quetell said. At medical spas, many of the procedures are more invasive in nature and are performed by or overseen by a medical doctor, physician assistant or nurse practitioner. Any elective services they provide are generally not covered by health insurance. Many medical spas, like Quetell’s, function as an extension of a plastic surgery office or sometimes a dermatologic office. State law doesn’t specify the specialty; however, a physician or physician extender must oversee the medical spa’s more advanced and invasive procedures. In addition to the procedures, the products offered at a medical spa are medical grade in nature, with an emphasis on quality of life. The services at Quetell’s office include laser skin resurfacing, laser hair removal, microdermabrasion, chemical and micro peels, photo facials, Botox injections, tattoo removal, Retin-A treatments, and collagen injections. In addition to the procedures, the products offered at a medical spa are medical grade in nature. At CNY Cosmetic & Reconstructive Surgery in East Syracuse, co-owners and board-certified plastic surgeons Gregory Baum and Anthony Deboni perform reconstructive and cosmetic surgeries, and provide
medical spa services, ranging from Botox to fillers to liposuction. “We’re the ones that should be doing medical spa services,” Deboni said of plastic surgeons. “There’s no regulation that determines what something is called. Anyone can call themselves a ‘cosmetic doctor.’ There’s no certification for that.” Deboni’s office also offers laser nail fungus treatment, vaginal rejuvenation, laser hair removal and waxing, non-invasive fat reduction, vein treatments, platelet rich plasma hair restoration, and skin rejuvenation. The medically based procedures at MedSpa Solutions in Syracuse are overseen by physicians Norma Cooney and Derek Cooney, both board-certified in emergency medicine, augmented by the dental aesthetic and peri-oral rejuvenation services of general dentist Dorothy Kassab. While many medical spas focus only on skin care, MedSpa offers cosmetic dental services as well. “You can do many things to beautify the face, but if you don’t correct the teeth — overbite, discoloration and misalignment — you won’t get the result you’re seeking,” Norma Cooney said. “It can take a decade off a patient. It makes a world of difference.” As with other medical spas, MedSpa Solutions’ physician oversight ensures treatment are safe and effective. “As physicians, we know the anatomy and patho-physiology of the medication,” Norma Cooney said. “We have insight to what’s occurring, the procedures, the benefit and any side effects that may occur. We can recognize and treat and ensure a good outcome.” The physicians lead patient care to provide the most effective solutions. “We offer comprehensive care and the supervision of physicians through the entire process,” Kassab said. “The multi-disciplinary approach works systemically from the inside out with infusion therapy.” Other services include infusion therapy, massage therapy, non-surgical facelift, skincare with hydro-fa-
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censed massage therapist, recently opened Precision Healing in Oswego. She offers therapeutic massage, including prenatal, sports, trigger point, deep tissue, oncology massage and more, along with reiki, reflexology, craniosacral work, sauna and essential oils. A standard massage business focuses on relaxation. Myers said that Precision Healing is all about “the functional outcome. The relaxation massage is based on the client’s satisfaction. The lighting, music and things like that play into it. Medical massage can be in different settings. It’s more based upon a goal.” Desired outcomes can include reducing pain, improving muscle tone, increasing range of motion and greater ability to sleep. Clients also receive “homework” such as heating, stretches and other at-home maintenance. In a similar vein, Integrative Healing Spa in Oswego, owned by licensed massage therapist and reiki master Amber Gilbo, offers massage therapy that focuses on sports recuperation, prenatal, deep tissue, trigger point, and other types of therapeutic massage. But the facility also has aestheticians providing facials, waxing and body treatments “for someone who wants to spend the day and have a whole spa experience,” Gilbo said.
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cials, micro-needling with and without plasma rich platelets, massage therapy and Botox injections. Rejuvn8 in Liverpool leans toward holistic wellness, offering both spa services and more invasive medical spa services through registered nurses, a nurse practitioner and medical doctor. “We are interested in the person as a whole, not specific to just skin,” said Giovanna McCarthy, owner and lead aesthetician. “We’re not just specific to skin. We’re working to become a wellness spa, more than a medical spa.” New offerings at Rejuvn8 are leading in that direction, including weight loss, hormone therapy and IV therapy. The facility also provides Botox injections, fillers, Sculpta, hydro-facial, microdermabrasion and fat melting with BTL products. “We refer and collaborate with a plastic surgeon’s office,” McCarthy said. “We’re not looking to doing anything we’re not good at. When clients come in, we won’t promise them results they can’t get with non-surgical procedures.” Though not medical spas, for their lack of medical doctors and invasive techniques, wellness spas provide services atypical of day spas and have personnel with some degree of therapeutic or medical training. Melinda “Mindy” Myers, li-
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
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Parenting
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By Melissa Stefanec MelissaStefanec@yahoo.com
Have We Become Too Chummy with Our Kids?
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eing the parent of young children means being on the end of societal criticism. I have to imagine this is nothing new. There are members of every generation who rejoice in finding fault in the younger generations. It’s is one of the few universal pastimes of humankind. There are many refrains regarding the ineptitude of today’s parents, but one of the most common refrains I come across is parents today make the mistake of trying to be friends with their children. Allegedly, instead of being an authoritarian and clear leader, today’s parents blur the lines of the hierarchy by trying to be liked by their children. I find this concept extremely interesting. First, I have to ask myself if I think it’s true. Do I see this strategy playing out in my daily life and in the lives of parents around me? Second, if it’s true, is it a bad thing? To answer the first question, I have to avoid another common pitfall of intergenerational politics; I have to consider the other side may have a valid point. If handing down criticism of younger generations is the national pastime of older folks, then surely the younguns’’ ignoring or dismissing the criticism is an equally practiced sport. Most of us irrationally think we know better than others, and we would be wise to give the other side an honest consideration. Do parents today think it’s more important to be a friend than a parent? So, do I think today’s parents place a higher value on being friends with their kids than on properly raising their kids? On the whole, I don’t. Sure, there are parents out there who don’t want to upset their kids and will do anything to ensure their children remain placated. However, I don’t think this is anything new or some sort of modern invention. Most of the parents I know have standards of conduct they expect their children to follow. When their children don’t follow those rules, there are consequences. What I think has changed is what sort of behavior warrants a consequence or redirection. That concept could fill another article, but it’s why I think there’s a perception that today’s parents are more interested in being friends with their kids than raising their kids. We believe our children should be seen, heard and understood. For some, that means we are striving to be friends with our kids. To me, that seems like some people have their empathy and friendship wires crossed. Let’s agree to disagree So, let’s say, for the sake of argu-
ment, that today’s parents are far too concerned with being liked by their children. Is this really the way the world finally falls apart? Maybe it is; only time will tell. However, there is one thing I am certain of: being a dictator never got anyone anywhere worth being. I know so many people my age who have strained relationships with or alienations from their parents. In many cases, this is due to parents being cruel, cold, abusive, selfish or unlikable people. Some parents never cared much about having a real, honest and kind relationship with their children; they were just there to tolerate their kids and lay down the law. I’ve seen the damage; this style of parenting reeks, and I think my generation is smart to want nothing to do with it. However, that reactionary style could pull things too far in the other direction. I think my generation needs to keep a critical eye on their parenting style to make sure it has the right balance of guidance, support and tough love.
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The compromise There was a time when Elvis Presley was going to corrupt young people. Now, many people consider Elvis and his music to be a class act (or not even noticed by younger generations and, thus, inconsequential). Every generation has a way of endorsing their own ideas, while remaining cautious or dismissive of those ideas that came before them and the ideas that come after them. Perhaps this is because each generation has an element of rebellion against the preceding generation; we are all trying to avoid the mistakes of the past, while hesitant to acknowledge the mistakes of our present. Once our present becomes the past, we tend to become nostalgic about it and whitewash the more sordid details. This is human nature, and we are all guilty of it. If we can embrace that concept, members of each generation can agree on something: no one did it 100% correctly. We all made judgment calls that time revealed to be the wrong ones. We all made mistakes that we wish we could take back. Previous generations had some great parenting solutions and approaches, but some really bad ones too. I can’t wait for my children to call out mine as they become adults. Things have a way of coming full circle. Even if generations don’t agree on how chummy parents should be with their kids, I think most parents love their kids unconditionally, and they are doing the best with the skills and knowledge they have. That includes today’s parents. Kindly cut us some slack.
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Is Herbicide Safe? By Deborah Jeanne Sergeant
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f you want your property to look like the putting green at Pebble Beach, you might rid your lawn of pesky weeds with a glyphosate-based herbicide such as Roundup. The popular brand introduced by Monsanto in 1973 has become a staple of groundskeepers, farmers and homeowners who want to kill weeds while keeping beneficial plants. The European Food Safety Authority (EFSA) and the U.S. Environmental Protection Agency (EPA) had stated that glyphosate is unlikely to pose a cancer risk to humans. However, in 2015, the World
Health Organization’s research entity, International Agency for Research on Cancer, decided that Roundup was “probably carcinogenic” like other items such as red meat on its list of possibly carcinogenic items. After a series of lawsuits were filed against Monsanto regarding Roundup’s use correlating with development of cancer, many consumers wonder about its safety. The first notable case in the US was that of Dewayne Johnson (not the actor Dwayne “The Rock” Johnson), who received an award of $78 million because Monsanto did not offer enough warning of the prod-
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
uct’s cancer risks. Johnson worked as a groundskeeper and developed non-Hodgkin’s lymphoma after regularly using Roundup and Ranger Pro, another Monsanto herbicide. The jury’s decision revolved around whether or not the company warned about health dangers, not that any dangers were present. For homeowners who use it sparingly once or twice a season as the package directs and with the proper safety equipment, any risk involved is likely less than for those who use it daily and without taking safety precautions. “Their use is not to be taken lightly,” said Rochester-based physician Joanne Wu, who practices in Syracuse. “Their use is associated with inhalation, oral, and contact injury of our organs such lungs, brain, kidneys, liver and eyes. They are meant to keep our lawns beautiful but at a price.” To remain on the safe side, physician Az Tahir warns that people should be “very, very careful” about using glyphosate-based products. Tahir practices holistic integrative medicine at High Point Wellness in Syracuse. “A number of animal studies have implicated herbicides as raising risk of cancer,” he said. Anyone who chooses to use herbicides should use approved, well-fitting personal protective equipment to protect the eyes and cover the skin, and a face mask to avoid inhaling any mist. Following the package directions on the package is also important to
minimize the risk. More isn’t better. If the formulation requires diluting, do so with care and per the package directions. Apply only what’s necessary where it’s advised to do so and avoid using it on windy days. Users can also minimize the amount of chemical products sprayed by using organic herbicide (it’s most effective on small weeds) and strategic planting. Cover crops and mulching discourage weed growth, for example. Some gardeners use boiling water to wither weeds and keep areas prone to weeds mowed before weeds go to seed. Wu also warned that eating produce grown with herbicides and pesticides can negatively affect health. She and Tahir both advise eating organic. If that is not affordable, Tahir said to at least buy the “dirty dozen” organic. These are the produce categories identified by the Environmental Working Group as most likely to bear pesticide. The group doesn’t offer a list related to herbicides. The Dirty dozen includes strawberries, spinach, kale, nectarines, apples, grapes, peaches, cherries, pears, tomatoes, celery and potatoes. “The more organic, the better,” Tahir said. “We can know what chemicals are used. Organic is much, much better.” The “Clean Fifteen” are items that pose the lowest risk when conventionally grown, including: avocadoes, sweet corn, pineapple, sweet peas (frozen), onions, papayas, eggplant, asparagus, kiwi, cabbage, cauliflower, cantaloupe, broccoli, mushrooms, and honeydew.
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The Long-Term Care Benefit Many Veterans Are Missing Out On
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Dear Savvy Senior, I have heard that the VA has a benefit that can help veterans and spouses with long-term care costs. We recently had to move my 86-year-old father — who served in the army nearly 60 years ago — into an assisted living facility, and my mom isn’t far behind. Can the VA help?
Seeking Aid Dear Seeking, The Veterans Administration does indeed have a little-known, underutilized benefit that can help wartime veterans and their surviving spouses pay for a variety of longterm care costs. This benefit, called “Aid and Attendance,” is a special pension that’s paid in addition to a basic pension. It pays a maximum of $2,230 a month to married veterans; $1,881 a month to single veterans; or $1,209 a month to a surviving spouse. The money is tax free, and can be used to pay for in-home care, assisted living and nursing home care. Today, only around 230,000 veterans and survivors receiving Aid and Attendance, but millions more are eligible and either don’t know about it, or don’t think they can qualify for it. Eligibility Requirements To qualify, your dad must have served at least 90 days of active military service with at least one day of service during a period of war, and not have been discharged dishonorably. Single surviving spouses of wartime vets are eligible if their marriage ended due to death. In addition, your dad will also have to meet certain thresholds for medical and financial need to be eligible. To qualify medically he must be either disabled, or over the age of 65 and need help with basic everyday living tasks such as eating, dressing, bathing or going to the bathroom. Being blind or in a nursing home or assisted living facility due to mental disability also qualifies him. Single surviving spouses have no age restrictions, but they must require help with basic everyday living tasks to be eligible. To qualify financially, your parents must have limited assets, under $127,061, excluding their home, vehicle and personal belongings. And their annual income (minus medical and long-term care expenses) cannot exceed the
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Maximum Allowable Pension Rate (MAPR), which in 2019 is $26,766 for a veteran and their spouse; $22,577 for a single veteran; and $14,509 for a surviving spouse. To calculate your parent’s income qualifications, add up their income over the past year (including Social Security, pensions, interest income from investments, annuities, etc.), minus any out-of-pocket medical expenses, prescription drugs, insurance premiums and long-term care costs over that same period of time. If the final tally is under the MAPR, and he meets the other requirements, he should be eligible for aid. How to Apply To learn more or to apply for Aid and Attendance, contact your regional VA benefit office (see Benefits.va.gov/benefits/offices.asp or call 800–827–1000) where you can apply in person. You can also apply by writing the Pension Management Center for your state (see Benefits. va.gov/pension/resources-contact. asp). You’ll need to include evidence, like VA Form 21-2680 (VA.gov/ vaforms) which your dad’s doctor can fill out that shows his need for Aid and Attendance. If you need some help, you can appoint a Veteran Service Officer (VSO), a VA-accredited attorney or claims agent to represent your dad. See www.ebenefits.va.gov/ ebenefits/vso-search to locate someone. If your dad is eligible, it will take between six and 12 months for his application to be processed, so be patient. You should also know that if your dad’s Aid and Attendance application is approved, the VA will send a lump sum retroactive payment covering the time from the day you filed the application until the day it was approved. Then your dad receives monthly payments going forward. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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ffordable medical coverage is something everyone wants, especially as people age. Luckily, our nation has safeguards for workers as they get older. Millions of people rely on Medicare, and it can be part of your health insurance plan when you retire. Medicare is available for people age 65 or older, as well as younger people who have received Social Security disability benefits for 24 months, and people with certain specific diseases. Two parts of Medicare are Part A (hospital insurance) and Part B (Medicare insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. Part B usually requires a monthly premium payment. You can apply online for Medicare even if you are not ready to retire. Use our online application to sign up. It takes less than 10 minutes. In most cases, once your application is submitted electronically, you’re done. There are no forms to sign and usually no documentation is required. Social Security will process your application and contact you if we need more information. Otherwise, you’ll receive your Medicare card in the mail. You can sign up for Medicare at www.socialsecurity.gov/benefits/ medicare. If you don’t sign up for Medicare during your initial enrollment
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Q: I applied for disability benefits, but was denied. I’d like to appeal. Can I do it online? A: Yes. In fact, the best way to file a Social Security appeal is online. Our online appeal process is convenient and secure. Just go to www. socialsecurity.gov/disability/appeal to appeal the decision. For people who don’t have access to the internet, you can call us at 1-800-772-1213 (TTY 1-800-325-0778) to schedule an appointment to visit your local Social Security office to file your appeal. Q: What is the purpose of Supplemental Security Income, or SSI? A: The purpose of SSI is to help aged, blind, and disabled people who have little income and few resources to support themselves. It provides financial assistance to meet basic needs for food, clothing, and shelter. You can receive SSI even if you have not worked and paid into Social Security. SSI is a federal income supplement program funded by general tax
window that begins three months before the birthday that you reach age 65 and ends three months after that birthday, you’ll face a 10 percent increase in your Part B premiums for every year-long period you’re eligible for coverage but don’t enroll. You may not have to pay the penalty if you qualify for a special enrollment period (SEP). If you are 65 or older and covered under a group health plan, either from your own or your spouse’s current employment, you may have a special enrollment period during which you can sign up for Medicare Part B. This means that you may delay enrolling in Part B without having to wait for a general enrollment period and without paying the lifetime penalty for late enrollment. Additional rules and limits apply, so if you think a special enrollment period may apply to you, read our Medicare publication at www.socialsecurity.gov/pubs/, and visit the Centers for Medicare and Medicaid Services at Medicare.gov for more information. Health and drug costs not covered by Medicare can have a big impact on how much you spend each year. You can also estimate Medicare costs using an online tool at www. medicare.gov/oopc/. Keeping your healthcare costs down allows you to use your retirement income on other things that you can enjoy. Social Security is here to help you plan a long and happy retirement at www.socialsecurity.gov.
revenues (not Social Security taxes). Find out more at www.socialsecurity. gov/ssi. Q: I worked the first half of the year, but plan to retire this month. Will Social Security count the amount I earn for this year when I retire? A: Yes. If you retire mid-year, we count your earnings for the entire year. We have a special “earnings test” rule we apply to annual earnings, usually in the first year of retirement. Under this rule, you get a full payment for any whole month we consider you retired regardless of your yearly earnings. We consider you retired during any month your earnings are below the monthly earnings limit, or if you have not performed substantial services in self-employment. We do not consider income earned, beginning with the month you reach full retirement age. Learn more about the earnings test rule at www.socialsecurity.gov/retire2/rule.htm.
Kidney Stones:
Some Key Things to Prevent the Problem By Rakesh Khanna, MD
I
n the United States, kidney stones are a common health problem that will affect nearly one in 11 individuals at some point in their lifetime — and the prevalence is increasing. On top of that, if you have had a stone episode, you’re at high risk of having another. It is estimated that the risk of recurrence is 50 percent within 10 years. Given how common stones are, how painful they are, what can we do to prevent kidney stones? If I have already had a stone episode, what can I do to prevent another one? The first thing to do is drink a lot of fluid. The components that make up stones are present in the urine. The more dilute the urine is, the less likely these components will come together and form stones. The goal is to maintain a urine output of at least 2.5 liters a day. That means you have to drink at least 2.5 liters a day and if you are physically active and sweating a lot, in effect you actually need to drink a lot more. Most types of fluid are OK to drink. The exception is probably cola. One study showed that those who reduced their cola consumption had a lower stone risk as compared to those who did not. It’s also important to try to drink fluids throughout the day and not just at one point in time — in other words, it’s better to have a glass of water every hour during the day, instead of eight glasses of water in the evening. In the first case, the urine is likely to be dilute throughout the course of the day, whereas in the second the urine will be very dilute in the evening but will be very concentrated in the daytime. For most people, their urine tends to be most concentrated in the morning when they wake up (they have been sleeping so they are not drinking any fluids). So, if you happen to get up for whatever reason, before going back to bed, have a glass of water. The second thing to do is to limit sodium intake in your diet. The goal is to limit to less than 2,300 mg daily. This is not only important to prevent recurrent stones, but it is also import-
ant if you have high blood pressure which is an important risk factor for heart disease. If you know your stone is composed of calcium oxalate (this is the most common stone type), you should try to limit your intake of oxalate-rich foods. Some common examples are spinach, potatoes, and nuts. This is not easy because oxalate is found in a lot of foods (a list of foods can be found on the internet). While low oxalate alternatives do exist, it can be quite difficult to remain on a low oxalate diet. All you can do is try your best. You should not restrict calcium intake, unless the levels of calcium in the urine are high (this can only be determined through lab testing). Lowering your calcium intake actually results in a higher stone risk. Citrate is a crucial molecule that blocks calcium stone formation. Low citrate levels are a common risk factor for stone disease. A diet high in fruit and vegetables can increase urinary citrate levels. Conversely, a diet high in nondairy animal protein is a double insult to your body: not only is it an acid load on your body (this will use up your citrate, therefore result in lower levels, and increase your stone risk), it can also increase levels of uric acid in your urine which is stone forming substance and increase your stone risk! It is a double insult. I hope this overview is helpful. Please take care of yourself. Poet and Pulitzer Prize winning Edna St. Vincent Millay once wrote “It’s not true that life is one damn thing after another—it’s one damn thing over and over.”
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atients often only have about 15 minutes with their doctors during an office visit and they often walk in unprepared for what questions they want their doctor to answer about their medical problem or treatment. To help patients prepare for their medical visits, the Agency for Healthcare Research and Quality (AHRQ) developed a new consumer mobile app that builds off the agency’s Question Builder online tool. The Question Builder app, which is available at no charge for smartphones, tablets and laptop computers on iTunes and Google Play, aims to help patients organize questions and other information prior to medical visits. “Consumers liked the ability to have questions and other information at their fingertips during medical visits, while doctors, nurses and other clinicians said that better-prepared patients would lead to more effective and efficient visits and potentially more accurate diagnoses and better outcomes,” the agency said in a release. “Patients can get better care by preparing to ask questions about their care and communicating effectively with their doctors, nurses and other providers,” said physician Jeff Brady, who directs AHRQ’s Center for Quality Improvement and Patient Safety. “Asking questions to make sure
patients understand instructions and other aspects of their care can help reduce the chance of missed diagnoses, identify the right tests that are needed, and avoid unnecessary hospital stays.” Through the app, patients can input details of their upcoming appointments, such as date and reason for the visit, and then choose questions they want to ask their doctor, starting with a list to prompt them with commonly asked questions in different situations. To talk to a doctor about medical tests, the app prompts patients to ask questions such as: How accurate is the test and what do I need to do to prepare for the test? Patients can then use the app to email information to themselves or others for reference or can use the app to make notes during the medical visit. The app organizes content and questions by type of medical encounter, such as a medical visit or preparing for surgery, and offers consumer education materials and videos about the importance of asking questions and sharing information. There’s also a camera option that allows patients to document visual information such as a skin rash, upload insurance or prescription medication information, and other photo-enabled features. To download the free app, go to the app store and type “AHRQ Question Builder.”
Rakesh Khanna is a urologist with Upstate Urology, Upstate Medical University.
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H ealth News Chris Gorecki named Excellus’ new CFO Excellus BlueCross BlueShield (BCBS) announced that Christopher Gorecki, the company’s senior vice president of finance, will succeed Dorothy Coleman as the health plan’s executive vice president and chief fnancial officer (CFO) effective July 1. Gorecki Coleman has accepted a position with one of the largest health plans in the BlueCross BlueShield system and will be leaving the organization at the end of June. She joined Excellus BCBS in 2011 and has been actively involved in Upstate New York communities, serving on several community boards. Gorecki has more than 30 years health care and finance experience with PricewaterhouseCoopers, Cigna and Blue Shield California. He joined the Excellus BCBS in 2014 as senior vice president of finance. He led and supported collaborative efforts to improve medical expense trend projections and accuracy, achieve company-wide administrative efficiencies, achieve improvements in underwriting practices, and improve the accuracy of budgeting and forecasting. “Under Chris’ leadership, our business has become more predictable as well as more agile, quicker to identify and respond to unforeseen changes,” said Chris Booth, Excellus president and CEO. “Chris also actively supports efforts to engage employees in our corporate culture, leading by example. For over a decade, he has passionately supported the work of the American Diabetes Association, in particular the annual Tour de Cure event.” “Dorothy’s tenure at the company has been marked by a modernization of finance that improved financial performance across nearly every measure,” Booth said. “We are grateful for Dorothy’s work with our health plan and for her contributions to our community. We wish her the very best going forward.”
Hearth Management employee receives national award Skip Collins, resident advocate and outreach coordinator for Hearth Management in Syracuse, was honored at Argentum’s 2019 Senior Living Executive Conference. Argentum, National AssoSkip ciation of Senior Living Management Companies, presented Collins, who was chosen from thousands of Page 28
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Excellus BlueCross BlueShield Regional President Jim Reed (far back) distributed the company’s Community Health Awards to (seated) Kerrie Ann Webb and Trish Levine, Oswego YMCA; Anne Costa, Aurora of Central New York; Liz Gesin, Cortland County Health Department; and to (standing) Kelly Quinn, Danielle Klein and Jessica Gosa, Foodnet Meals on Wheels; Lynn Fox, Clear Path for Veterans; Nilsa DeJesus and Jason Bolton, Person to Person; Derek Green, Cortland County Health Department; Gail Longcore and Caryn Hughes, Hospice of Central New York; and Christina Wilson, Integrated Community Planning of Oswego County.
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Excellus Selects Eight Nonprofits to Receive Awards
xcellus BlueCross BlueShield has chosen eight organizations from among more than 30 Central New York nonprofits that submitted applications to receive the Community Health Awards. On May 7, each recipient was awarded up to $4,000 allocated by the company to help fund health and wellness programs in the company’s five-county Central New York region. Through a competitive application process, Excellus BlueCross BlueShield’s Community Health Awards support programs that have clear goals to improve the health or health care of a specific population. Awards focus on improving the health status of the community, reducing the incidence of specific diseases, promoting health education and enhancing overall wellness. Winning organizations are selected based on the proposed program’s scope of need, goals, and the number of people expected to benefit from it. The eight nonprofit organizations are: • Aurora of Central New York, Syracuse, to fund an outreach and education program for people who have vision/hearing loss. The organization will provide public vision/ hearing screenings every other month, along with preventive programming and intervention to help individuals with vision and hearing loss manage their conditions.
• Clear Path for Veterans, Chittenango, for Family-to-Family, an evidence-based educational program to help the family and caregivers of veterans understand the effects of post-traumatic stress. The program provides problem-solving tools and resources to better assist veterans who struggle with post-traumatic stress or mental health issues. • Cortland County Health Department, Cortland, for a radon reduction program that will include a community education campaign to increase awareness of the dangers of radon and its prevalence in Cortland County. The program will also provide training in radon testing and radon mitigation. • Foodnet Meals on Wheels, Ithaca, to provide weekend and holiday meals for up to 800 older adults and individuals living with disabilities in Tompkins County. The weekend and holiday meals will address the ongoing need to supplement Foodnet’s Monday through Friday meal delivery program and include up to two frozen hot meals per weekend and one frozen hot meal per holiday. • Hospice of Central New York, Syracuse, to fund Camp Healing Hearts, a four-day camp for first- through sixth-grade children who have experienced the death of a loved one or special person. Camp Healing Hearts, held every August at YMCA Camp Iroquois in Manlius, provides children with activities to promote healthy grieving and skills for hopeful living.
• Integrated Community Planning of Oswego County, Oswego, to expand its Smoke Free for My Baby & Me program to include a maternal and child health home visiting program. Smoke Free for My Baby & Me is a multisector community partnership that strengthens clinical tobacco cessation effectiveness with broad support from local agencies. • Oswego YMCA, Oswego, to fund its Pedaling for Parkinson’s exercise program with American Council on Exercise-certified Pedaling for Parkinson’s coaches in the YMCA’s existing indoor cycle studio of 14 bikes. The program will offer people who have Parkinson’s disease a safe outlet for regular exercise. • Person to Person, Syracuse, to establish a Get Up, Get Out, Get Moving program that will allow Person to Person volunteers to schedule physical activities, along with food and nutrition events, with their proteges in three counties served by the organization. “The company’s Community Health Awards demonstrate a corporate commitment to supporting local organizations that share our mission as a nonprofit health plan,” said Jim Reed, regional president, Excellus BlueCross BlueShield. “These awards complement our existing grants and sponsorships with agencies that work to enhance quality of life, including health status, in Upstate New York.”
nominations, with the Argentum Hero Award at the conference in San Antonio April 16. The Argentum Hero Award recognizes individuals who are ideal representatives of the hundreds of thousands of people serving in the senior living field. Collins was nominated by company executives and all nominees represent the highest levels of excellence, caring and dedication across the senior living industry. “Skip has been, is, and always will be each resident and family member’s best friend, advocate and resource,” said Regional Vice President of Operations Kara Khanzadian. “Collins is the epitome of care in Hearth’s Syracuse area communities: Keepsake Village at Greenpoint, The Hearth at Greenpoint, and The Hearth on James. He is the hallmark of these communities, and everything he does
is done with compassion. Collins has been dedicated to serving seniors at The Hearth for over 22 years.” Hearth Management, LLC is a privately owned and operated management and development company based in Syracuse. Since 1988, Hearth Management manages, consults and owns 15 senior living, personal care, assisted/enriched living, and memory care communities for more than 1,800 senior residents in New York, Connecticut, Indiana and Tennessee.
(PD) programs in Syracuse. The community grant will support health, wellness and educational programs that address unmet needs in the PD community. “We are proud to announce these community grants and expand programs and resources in Parkinson’s communities across the entire nation,” said John L. Lehr, Parkinson’s Foundation president and chief executive officer. “These grant recipients share our passion and commitment to making life better for people with Parkinson’s.” The Parkinson’s Foundation awarded more than $1.5 million in community grants natiowide. This year’s grant cycle focused on three areas: programs that provide a service for underserved PD communities, initiatives that reach the newly diagnosed and clinical trial education
IN GOOD HEALTH – CNY’s Healthcare Newspaper • June 2019
Parkinson’s Foundation announces community grants recipient The Parkinson’s Foundation recently announced that it will grant $ 18,000 for local Parkinson’s disease
H ealth News and participation that reach those under-represented in the PD community. “The support we’re receiving from the Parkinson’s Foundation community grant will help over 75 people with Parkinson’s disease to access the educational, activity, social and exercise programs so vital to helping them cope with their disease,” said grant recipient, physician therapist Patrick VanBeveren, who practices in Syracuse. “We are thrilled that we can now provide people with Parkinson’s and their care partners unique programing that will change the way they live with PD for the better.” In Syracuse, the Parkinson’s Foundation community grant will fund: “Aging Backwards through Activities and Fitness Programs: A Multidimensional Program for People with Parkinson’s disease.”Programming will take place at Rock Steady Boxing Syracuse on Old Liverpool Road in Liverpool.
Medical director named at Little Falls Hospital Physician Carlton J. Rule has been selected as the new medical director of Little Falls Hospital, subsidiary of the Bassett Healthcare Network. Rule is board-certified in family
medicine and has been with the Bassett Healthcare Network since 2011. He also serves as medical director at the Bassett Herkimer Health Center. As medical director at Little Falls Hospital, Rule will be responsible for communicating and ens u r i n g compliance with the requirements set forth by the New York State Department of Health for the medical staff, Rule compliance with The Joint Commission standards relating to medical staff and medical staff leadership as well as the Little Falls Hospital bylaws, rules and regulations and policies and procedures. Part of his oversight will include serving as a confidant and adviser to all of the physicians within the hospital, as well as focusing on medical staff quality improvement programs, oversee the medical staff credentialing processes, and other medical or administrative duties as assigned. “We are honored to have Dr. Rule join our executive leadership team,” said Little Falls Hospital President Michael Ogden. “He is well-respected by his colleagues. His commitment
18.XXX_Urology_MeetTheTeam_Horiz.qxp_Layout 1 11/14/18 9:28 AM Page 1
and relationship-building skills make him an asset to our entire organization.” Rule graduated from Cornell University and New York University Medical School with honors. He is a member of the American Academy of family practice and American Association for physician leadership.
St. Joe’s named to list of America’s 100 Best Hospitals St. Joseph’s Health Hospital is the only hospital in Central New York, and the only hospital in New York state with 400 or more beds, to be named one of America’s 100 Best Hospitals for Patient Experience by the Women’s Choice Award, America’s trusted referral source for the best in healthcare. The award signifies that St. Joseph’s Health Hospital has been ranked within the top 100 hospitals of similar size based on number of beds, of which there were four categories. The methodology used to select St. Joseph’s Health Hospital is unique in that it evaluates specific Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results along with primary research about women’s healthcare preferences, according to a news re-
lease issued by the hospital. The Women’s Choice Award collects the data for the following HCAHPS survey measures and uses a weighted average to award the best hospitals for patient experience: Effective communication with nurses and doctors, responsiveness to requests for help, providing patient recovery information, explanation about medications before being administered, bathroom and room cleanliness, peacefulness of room at night, and patient recommendation rating. “This hospital was awarded because it is one of the best at treating their patients the way their patients want to be treated,” said Delia Passi, founder and CEO of the Women’s Choice Award.“ “We are honored to be the top choice for women looking for high quality health care,” said AnneMarie Walker-Czyz, chief operating officer and chief nursing officer, St. Joseph’s Health. “The leadership of our founding sisters, including Saint Marianne Cope, was grounded in faith, values and a commitment to service. Our mission has continued with unwavering commitment for the past 150 years. Delivering an outstanding patient experience is among the most important things we do.”
MEET THE UPSTATE UROLOGY TEAM Chairman Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal
General urology, andrology
GENNADY BRATSLAVSKY, MD ZAHI N. MAKHULI, MD
Male infertility, erectile dysfunction, andrology, general urology, prosthetics, and Peyronies
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JOSEPH JACOB, MD
OLEG SHAPIRO, MD
General urology, male health, urologic oncology, enlarged prostate, kidney stones At Upstate Urology of Auburn.
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MATTHEW D. MASON, MD
JC TRUSSELL, MD
Urologic oncology and endourology, robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal; kidney stones
RYAN SIDEBOTTOM, DO
Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal
General urology, male health, urologic oncology, enlarged prostate, kidney stones , and robotic surgery
MAHMOUD CHEHAB, MD
NICK LIU, MD
Incontinence, urethral stricture disease, vesicovaginal fistula, reconstructive surgery, transgender care
DMITRIY NIKOLAVSKY, MD
Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities
JONATHAN RIDDELL, MD
Female and reconstructive urology, urinary incontinence in women, pelvic floor treatment and neurourology
General urology
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NATASHA GINZBURG, MD
General Urology, Endourology and Laporoscopic Surgery
General Urology, Endourology
SERGEY KRAVCHICK, MD
EDWARD IOFFE, MD
Urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
RAKESH KHANNA, MD
General urology, female and reconstructive urology
ELIZABETH FERRY, MD
General Urology; Female Urinary Incontinence
MICHAEL CASTELLO, DO
MRI fusion, male health, prostate cancer and kidney stones
TIMOTHY K. BYLER, MD
Reconstructive urology; incontinence, prosthetics, urinary fistula, neurogenic bladder, urinary diversion. Robotic surgery.
STEPHEN BLAKELY, MD
Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal
RUBEN PINKHASOV, MD, MPH
UROLOGY FOR QUESTIONS OR TO MAKE A REFERRAL, CALL 315.464.1500 June 2019 •
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H ealth News Kinney’s $250,000 Pledge to Crouse Foundation — Back left: Stephen McCoy, Kinney Drugs Foundation secretary and treasurer, and KPH CFO; Michael Duteau, Noble Health vice president; Richard McNulty, Kinney Drugs Foundation vice president and KPH vice president; Betty O’Connor, Crouse Health director of women and children’s services; Carrie Berse, president Crouse Health Foundation; Tracey Stoffel, Kinney Drugs Foundation administrator; Bridget-ann Hart, KPH president and CEO; Brian Scott, Kinney Drugs Foundation board member and HealthDirect president; John Dyer, Kinney Drugs Foundation board member and KPH vice chairman. Front left: David McClure, Kinney Drugs Foundation president and KPH vice president; David Warner, Kinney Drugs Foundation board member, executive vice president at EVP, and president of ProAct; Alyssa Facteau, Noble Health regional manager; and attorney Warren Wolfson, Kinney Drugs Foundation board member
Kinney Drugs Foundation Pledges $250,000 to Crouse Health Foundation Kinney Drugs Foundation has announced a $250,000 pledge to the Crouse Health Foundation’s CrouseCares Campaign in support of the renovation and expansion of the Baker Regional Neonatal Intensive Care Unit (NICU) at Crouse Health. “The mission of Kinney Drugs is to help people live healthier lives through health and wellness initiatives,” said Dave McClure, president
of the Kinney Drugs Foundation. “This pledge will enhance care in an expanded and modernized NICU, giving the region’s critically ill and premature infants a fighting chance at a bright and healthy future.” In 2018, Crouse Health announced plans to expand its Regional NICU to provide more space for parents to bond with their fragile newborns and for state-of-the-art
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Services. The Kinney Drugs Foundation has been a generous supporter of Crouse Health,” said Carrie Berse, president of the Crouse Health Foundation. “This recent gift is their largest commitment to Crouse, underscoring the life-saving importance for babies who need treatment in the Baker Regional NICU.” The renovation and expansion of the NICU is a priority project of the CrouseCares Comprehensive Campaign, which has surpassed $16 million in donations to support capital projects and initiatives at Crouse. For more information on the renovation plans or to make a contribution, call Director of Philanthropy Jeffry Comanici at 315-470-7054 or visit www.crouse.org/littlefighters. Kate Rolf, president and chief executive officer at Nascentia Health (second from right) accepts CenterState CEO’s 2019 Business of the Year Award, nonprofit category, from Joe Convertino, president, C H Insurance (far left); Robert Simpson, president, CenterState CEO (second from left); and Melanie Littlejohn, first vice chairwoman, CenterState CEO, and vice president, New York jurisdiction, National Grid (far right).
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equipment for monitoring and treating critically ill infants. A team of nationally recognized neonatologists, nurses and pediatric specialists from the Crouse NICU annually care for more than 1,000 babies from 14 counties across Upstate New York. With this commitment from the Kinney Drugs Foundation, the Crouse Health Foundation has now raised $1.8 million to support the expansion project. “The Kinney Drugs Foundation is the philanthropic arm of KPH Healthcare Services, Inc., a 100% employee-owned organization based in Gouverneur, which consists of the familiar Kinney Drugs regional drug store chain, as well as three commercial businesses, ProAct Pharmacy Benefits Management, HealthDirect Pharmacy Services and Noble Health
Nascentia Named 2019 Business of the Year, Nonprofit Category
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ascentia Health has been named 2019 Business of the Year, nonprofit category by the CenterState Corporation for Economic Opportunity (CenterState CEO). Presented at CenterState’s annual meeting on April 24, the business of the year awards recognize the outstanding achievements of regional businesses and organizations in five categories: more than 50 employees, less than 50 employees, nonprofit, community involvement and minority-owned business. A total of 15 finalists — three in each category — were chosen from a highly competitive pool of nominations and announced in March. According to award presenter Joe Convertino, president at C H Insurance, Nascentia was honored in recognition of its commitment to improving the community and creating tangible impacts on the local economy. In his award presentation,
Convertino noted Nascentia’s significant growth, which has enabled the system to have a greater impact on the community, as well as the completion of its new 47,000-sq.-ft. operational headquarters, which has ushered in a sense of renewal and hope along the West Genesee Street corridor. Also highlighted was Nascentia’s commitment to finding new and innovative ways to achieve greater results, improve access to care, and serve more community members in the system’s 48-county service area. “The greater Syracuse business community is rich with impressive and accomplished companies and individuals,” said Kate Rolf, president and chief executive officer at Nascentia Health. “We’re proud to have our efforts recognized and celebrated alongside those of our fellow honorees, and we look forward to playing an integral part in the next chapter of our community’s growth.”
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