in good The Revenge of Bedbugs
cnyhealth.com
May 2016 • Issue 197
They’ve grown thicker skin, which helps protect against pesticides and may explain why population is growing worldwide, scientists suggest
Drinking
Teenage girls now try alcohol before boys do, says study
free FREE
Meet CNY’s Pot Doc Physician Scott Treatman is one of the first in CNY to obtain the required state registration for prescribing medical marijuana. He talks about about the process, his new practice in Cazenovia and who would qualify to get the drugPage 12
CNY’s Healthcare Newspaper
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Syracuse Grows Excellus Pharmacist: Drug makers must stop their pricing games Page 8
STROKE 5 THINGS YOU NEED TO KNOW
NYS Hospital Mergers Driving Up Prices Volunteer organization, Syracuse Grows, helps groups start and maintain community gardens in Syracuse. The group is involved with 24 gardens, a number organizers expect to rise Page 11
Living Alone: Create Your Own Perfect Day!
Why You Should Fall for Mangoes
A study by the conservative think tank, the Manhattan Institute, concludes that the 100-plus hospital mergers in NYS have served to only increase costs and decrease competition with no perceptible increase in quality. See “Health in a Minute” on page 8
Q&A with MaryCunningham, MD
Mangoes, the world’s most popular fruit (who knew?), bring a wealth of powerful nutrients
Gynecologic oncologist is a regional pioneer in women’s robotic surgery. She discusses how robotic surgeries Page 16 may benefit some patients. Inside May 2016 •
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Fighting Back, Bedbugs Grow a Thicker Skin
The courage and determination of cancer survivors is an inspiration to all. On National Cancer Survivors Day®
Sunday, June 5, 2016
Hematology Oncology Associates of CNY will honor those in our community who are living with and beyond cancer and those who have supported them along the way. Come celebrate life at
Willow Bay @ Onondaga Lake Park on June 5, 2016. Our celebration will include:
Speakers • Fun Activities • Entertainment Door Prizes • BBQ Lunch. This event will be held from 10:30am until 1:30pm and is free for survivors and guests.
We encourage RSVP to pcase@hoacny.com or (315) 472-7504 ext 1133.
Thicker skin helps protect against pesticides and may explain why population is growing worldwide, scientists suggest
B
edbugs may be developing thicker "skins" that help them resist common pesticides, a new study suggests. This might explain why bedbug populations are increasing worldwide, the researchers added. "If we understand the biological mechanisms bedbugs use to beat insecticides, we may be able to spot a chink in their armor that we can exploit with new strategies," study author David Lilly, from the University of Sydney in Australia, said in a university news release. Bedbugs are parasites that feed on the blood of people and animals as they sleep; the insects can pro-
duce painful bites in their victims. The new findings, published April 13 in the journal PLoS ONE, may lead to the development of more effective pesticides to fight bedbugs, the researchers said. "Bedbugs, like all insects, are covered by an exoskeleton called a cuticle. Using scanning electron microscopy, we were able to compare the thickness of cuticle taken from specimens of bedbugs resistant to insecticides and from those more easily killed by those same insecticides," Lilly explained. The thicker their cuticle, the more likely the bedbugs were to survive when exposed to the insecticides, the study found.
NOT TAKING YOUR PRESCRIPTIONS AS DIRECTED?
YOU’RE TAKING
A CHANCE.
If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember:
If you’re not taking your prescriptions as directed, you’re taking a chance. To learn more, visit ExcellusBCBS.com/TakeAsDirected. #TakeAsDirected
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
New Non-Surgical Protocol for Neuropathy What is Neuropathy?
Neuropathy is a collection of disorders that occur when nerves of the peripheral nervous system are damaged. The condition is generally referred to as peripheral neuropathy. In the United States, over 20 million people suffer from peripheral neuropathy. Neuropathy can be brought on by a number of different causes including Diabetes, Back Problems, Chemotherapy and certain prescription drugs such as Gabapentin, Lyrica, Neurontin and Cholesterol Lowering Drugs (statin drugs). Damaged nerves send incorrect signals back to the brain causing scattered signals resulting in numbness, burning, tingling and sharp pain sensations that are usually felt in the feet, legs, hands and arms. Symptoms associated with the motor portion of the nerve may include muscle weakness, cramping and spasms as well as a lack of coordination and poor balance.
Are you Experiencing Pins & Needles? Numbness and Tingling? Pain or Burning in your Feet or Hands?
Traditional Treatments:
Over the years neuropathy treatments in general have had poor results at best. Many medications are used that have significant side effects and poor treatment outcomes. Only recently have we had a promising breakthrough to help reduce symptoms of neuropathy with lasting results.
New Non-Surgical For Neuropathy:
Protocol
A new development in Class IV laser technology called Deep Tissue Laser Therapy has been shown to improve the function of the blood vessels and tissues that surround the injured nerves. This improves the elasticity and function of the blood vessels. As the blood vessels become healthier, the nerves begin to thrive. Another choice of treatment, Peripheral Neuropathy Vibration Therapy, is used to
expedite healing by increasing blood circulation to the muscles by repeated contraction and relaxation of your muscles. This brings freshly oxygenated and nutrient rich blood to all tissues causing accelerated healing. This treatment also increases the transmission of nerve signals to the affected area to reduce neuropathy pain. Additionally, a landmark study demonstrates the benefits of an arginine based nutritional protocol for patients. This pharmaceutical grade supplement containing L-Arginine boosts the production of Nitric Oxide in your body and has been labeled The Ultimate Cardio Health Solution. The Nobel Prize in Medicine was awarded in 1998 validating the effects of nitric oxide on the cardiovascular system and how L-Arginine is critical to the production of nitric oxide in the body. Ironically the use of L-arginine was also found to deliver dramatic results to patients with diabetes and peripheral neuropathy by improving circulation.
If you would like to learn more about this successful drug-free and pain-free protocol for neuropathy and other nerve and pain conditions call 622-0102 Mention This Article to Qualify For A Free Consultation.
Home Treatment Program Now Available! 3452 Route 31 • 622-0102 • Baldwinsville, NY 13027 (located across from Hickory Hill Golf Course) May 2016 •
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CALENDAR of
HEALTH EVENTS
May 7
Kentucky Derby Party to benefit cancer patients If you can’t make it to the 142nd annual Kentucky Derby in Louisville, Positively Pink Packages welcomes you to one of the best bets in town: its 12th annual derby-themed fundraiser to benefit local breast cancer patients. The event runs from 5 to 9 p.m., May 7, at BAR in Armory Square in Syracuse. Exquisite hats, mint juleps, Kentucky cocktails, a sumptuous buffet and desserts, and a festive attitude will prevail as the crowd cheers on their favorite horses while watching the "Run for the Roses" on giant-screen TVs. Proceeds from the event will support Positively Pink Packages, a local nonprofit organization that provides free care packages and vital resources to newly diagnosed breast cancer patients, ensuring that no one faces breast cancer alone. Positively Pink Packages has provided more than 6,000 free care packages throughout Central New York. Several traditions have been born with the Kentucky Derby, one of the most well-known being the wearing of the derby hats. In support of this tradition, the first 50 women and men through the door will receive a fun, derby-fashionable hat. For the more fashion-forward and fearless, a derby hat contest is part of this year's fun. Tickets are $75 in advance and $100 at the door. For more information or for tickets, go to www. positivelypinkpackages.org or call Positively Pink Packages at 315-2780645.
May 9
Healthy living classes at Oswego Hospital To help residents improve their health status, Oswego Health is offering free workshops developed by Stanford University. The healthy living classes will be held from 1 to 3:30 p.m. on Mondays, starting May 9 and ending June 20, at Oswego Hospital’s medical affairs conference room. Class will not be held May 30 in observance of the Memorial day holiday. This evidenced-based program is designed to help those with any chronic disease, such as arthritis, heart disease, osteoporosis or diabetes to improve their health status through its living healthy workshops. The workshops will cover nutrition and exercise, as well as how to get support, deal with pain and fatigue and talk with your physician and family members about your condition. Participants will learn goal setting techniques and establish a step-by-step plan to improve their health. Those taking part in the program will be provided a free workbook and healthy snacks at each class session. To register, or if you have questions, please call 349-5513.
May 11, June 7
Free Medicare classes offered in Auburn Are you turning 65 soon? Are you overwhelmed by all the mail, calls and Medicare options? The Cayuga County Office for the Aging
Community Information Seminar:
Bariatric Surgery May 10, 2016 • 6:00 pm Presented by
Gregory Dalencourt, MD Medical Office Center St. Joseph’s Hospital Campus 104 Union Ave. • Suite 809 • Syracuse, NY
To register call 315-477-4740 or toll free 877-269-0355 Parking will be validated
offers complimentary monthly classes to help you make sense of Medicare. You will learn how to determine whether the plan you are considering will give you peace of mind or potential headaches. You’ll learn about how Part D drug plans work and whether EPIC co-pay assistance is an option for you. If your income is limited, the classes will provide information about programs to help pay for your insurance coverage, as well as a listing of the free and lowcost preventive care under Medicare. The next classes will be held from 1 to 3 p.m., May 11, and from 5 to 7 p.m., June 7, in the basement training room of the Cayuga County office building. Seating is limited, so registration is required. For more information or to register, call 315-2531226 or visit www.cayugacounty.us/ aging under the News & Activities section.
May 14
People For Animal Rights holds fundraiser People For Animal Rights, a Syracuse-based organization that promotes animal rights, is sponsoring a fundraising event that will feature live music, homemade and store-bought vegan goodies (some gluten-free), dancing, educational material and original animal notecards. The event will be held from 2 to 5 p.m., May 14, May Memorial Unitarian-Universalist Society, 3800 E. Genesee St., Syracuse. Cost: is $8 per person and $13 per family if you pay ahead. If you pay at the door, $10 per person and $15 per family. For those paying ahead, mail a check to People for Animal Rights, P.O. Box 15358, Syracuse 13215-0358 or pay by credit card at peopleforanimalrightsofcny.org. For more information, call 315-488-PURR (7877) from 8 a.m. to 10 p.m.or email Ldestefano3@ twcny.rr.com.
May 17
St. Francis hosts Alzheimer’s workshop St. Francis Commons Assisted Living Residence in Oswego is partnering with the Alzheimer’s Association, Central New York Chapter to provide a monthly series of educational related to Alzheimer’s disease. The first program, “Memory Loss, Dementia, and Alzheimer’s Disease: The Basics,” will take place from 7 to 8 p.m, May 17, at St. Francis Commons, 12 Burkle St. in Oswego. The educational program is free of charge and open to the public. This workshop explains the basics of memory loss, dementia and Alzheimer’s disease that will include information on symptoms and effects of Alzheimer’s disease and other types of dementia, causes and risk factors, how to find out if your loved one has Alzheimer’s, the benefits of early detection, treatment and ways the Alzheimer’s Association and other community resources can help. For more information about this event or other workshops scheduled in the series, contact the Alzheimer’s Association of CNY at 1-800-272-3900 or St. Francis Commons at 315-3260870.
May 19
Onondaga holds luncheon to to honor seniors The Onondaga County Department of Adult & Long Term Care Services will hold a Celebration Luncheon for Onondaga County Seniors event at noon, Thursday, May 19 at Drumlins, 800 Nottingham Road, Syracuse. Registration is required Friday May 6. The event, sponsored by Onondaga Elders, Inc. and organized by the Onondaga County Office for Aging, celebrates Older American’s Month and recognized three Onondaga County residents for the their work in the community. The categories of those who will be honored are senior citizen of the year, esteemed elder of the year and senior services professional of the year. For more information, or to receive a registration form, call 315435-2362 ext. 4945. The registration form is also available at www.ongov. net/aging. The meals costs are as follows: seniors age 60-plus: $5 each and their guests under age 60, $17 each. Checks can be made payable to Onondaga County Elders, Inc. and should accompany the registration form.
May 28
Run/walk event in Van Buren helps foundation The public is invited to attend a kid's fun run at 8:30 a.m. and a 5K run/walk starting at 9 a.m., Saturday, May 28, at Van Buren Park (Connors Road) in Baldwinsville, All proceeds go to support Friends of Van Buren Park and The Corporal Kyle R. Schneider Foundation, a nonprofit foundation that renders support to assist active duty, reserve and retired United States Armed Forces members, their families and injured and recovering heroes. The race is geared for runners and walkers of all levels. Pre registration is $20 per person or $15 for high school and college students. Race shirts will be given to all pre-registered 5K participants. Day of race registration is $25 per person. Kids fun run is free. For more information and registration, go to www.friendsofvanburenpark.org. or Facebook at friendsofvanburenpark.
May 30
LaFayette church to raise money for food pantry The Columbian Presbyterian Church in LaFayette will host its annual Memorial Day Benefit for LaFayette Outreach from 8 a.m. to noon, May 30. All proceeds will be donated directly to LaFayette Outreach, which is the local food pantry and service-referral agency. The event consists of a silent auction, bake sale, plant sale, "Red, White & Blue Ice Cream Sundaes," and a free kids' craft area. The church is located on the corner of routes 11 and 20 in LaFayette. For questions or donations, call 677-3293 or email cpresbyt@twcny.rr.com.
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Man’s Health Special Issue of In Good Health
For advertising, call 342-1182 or email editor@cnyhealth.com Page 6
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Meet
Your Doctor
By Chris Motola
Mary J. Cunningham, M.D. Gynecologic oncologist is a regional pioneer in women’s robotic surgery. She discusses how robotic surgeries may benefit some patients Q: Give us an overview of your practice. A: I'm a board-certified gynecologic oncologist, so I specialize in the treatment of gynecologic cancers. Another part of my practice is doing complex surgeries on patients who are either suspected of having cancer, a benign mass or have another complicated surgical issue when they need pelvic surgery. Then they'll come to me. So our practice is not just surgery, but chemotherapy, surveillance of patients who have had a diagnosis, or who we've operated on, to make sure their cancer doesn't reoccur. Q: What determines whether a cancer is treated with surgery or chemotherapy? A: There are a couple different things surgery can accomplish. So sometimes surgery is required in order to make the diagnosis of the cancer. A patient who has a mass in the pelvis may not know before the surgery whether they have cancer or not. Sometimes we already have the diagnosis ahead of time. So for a uterine cancer, it may be diagnosed by a small biopsy done in the office. It depends on the type of cancer and individual situation. For patients with masses in the pelvis — which is fairly common for women — there are a set of guidelines we use to determine whether or not it's likely to be a cancer. Some women have a cyst in the ovaries and there's no suspicion of cancer. If there is, I can operate, take the mass out, and we can test it right then. If it is cancer, I can perform the necessary procedures. Q: You do a lot of robotic surgery. A: I do a lot of robotic surgery. Robotic surgery for gynecology is laparoscopic, where we do surgery through several small incisions. They're about half an inch in length rather than several inches long. We insert the cameras and instruments so we can perform the surgery. The robotics give us a 3-D view and better instrumentation to do the surgery. Q: What kinds of procedures can you perform with the robot? A: The most common reasons for doing robotic surgery for gynecologic oncology is that the patient has cancer of the uterus. So we can do hysterectomies. We can also take out lymph nodes. The thing that's a recent development with the technology is a technology called Firefly. With that technology, we can inject a dye into the cervix while the patient's under anesthesia. The most important nodes will light up when we're looking inside with the laparoscope.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
So instead of having to take out a lot of lymph nodes, this allows us to just take out the most important lymph nodes and see if there's any spread.
started off being exclusively gynecologic oncology, but it's expanded over time to urology, general surgery, bariatric surgery, general gynecology. So we have many specialists using it now, and using it successfully. Q: Is there any comparable evolution going on on the chemotherapy side of the equation? A: There's a constant quest to make chemotherapy treatments more effective and less toxic. I can't tell you that there's a perfect chemotherapy drug, but I can tell you that the management of side effects has come a long way over the last decade. Most people getting chemotherapy are able to manage their side effects pretty successfully. The recognition that we need to be looking at side effects is pretty well developed. So we're measuring quality of life indicators as well as lab tests.
Q: To what degree does operating this way improve outcomes? A: The biggest advantage of doing surgery robotically versus making a big incision is that the recovery time is faster. So typically patients who have robotic surgery for endometrial cancer will go home the day after the operation and recover over the course of about three weeks. Versus if we make a large incision, the patient will be in the hospital for three to five days and recover in about six weeks. There's also a lower risk of infections and lower blood loss associated with robotic surgeries. Q: Are there patients for whom robotic surgery is not possible? A: Every surgery needs to be planned with each particular patient in mind. Some of the reasons a patient may not be able to have robotic surgery are if the mass is large, or if the patient has had extensive previous surgeries and extensive internal scar tissue. Q: You’re one of the first people in the area to use the robot for women's surgery. What influence have you had in guiding the Crouse Institute for Robotic Surgery? A: We've been fortunate in having a multidisciplinary team as well as the support of the Crouse administration in building the program. There's so much more than just the surgeon involved in taking the patient successfully through an operation. Q: My understanding is that the program is the busiest of its kind in the region. Is that correct? A: I think it's the busiest robotic program because it's such a strong program. Crouse's robotic program
Lifelines Name: Mary J. Cunningham, M.D. Position: Partner at GYN-Oncology of CNY PC, director of gynecologic oncology at Upstate Medical Specialty: Specializes in the comprehensive care of women with gynecologic malignancies, including radical surgery and chemotherapy for patients with cancers of the uterus, ovary, cervix and vulva. She is also an expert in gynecologic surgery for benign disease. Since 2006, she has been using the da Vinci robotic system to perform complex laparoscopic procedures, including radical hysterectomy, lymph node dissection and cancer staging, as well as procedures for ovarian cyst and fibroids. Hometown: New Hartford, NY Education: Northwestern University Medical School, Chicago Affiliations: Crouse Hospital Certifications: Obstetrics and gynecology (1992); gynecologic oncology (1994) Organizations: Society of Gynecologic Oncology; American Congress of Obstetricians and Gynecologists; Medical Society of the State of New York Family: Married, two children Hobbies: Skiing, cooking
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Prescription Drug Makers Must Stop Their Pricing Games By Mona Chitre
D
rug spending in the U.S. approached $300 billion in 2014, up by more than $30 billion over the previous year. That jump in spending didn’t go unnoticed. Seventy-seven percent of respondents to a recent Kaiser Family Foundation poll said that the high cost of prescription drugs is their top health care priority. Here’s an example of what’s fueling public concern. Daraprim is a drug prescribed for 25 million people to treat a parasitic infection that mainly threatens individuals with weak immune systems, including pregnant women and HIV and organ transplant patients. You've likely seen the news coverage about Turing Pharmaceuticals buying the U.S. rights to sell Daraprim last August and immediately raising the price from $13.50 to $750 per tablet. More galling than the 5,000 percent price increase is the fact that this isn’t a new drug with high research and development costs to recoup (the reason often given by drug makers for raising prices). Daraprim has been
around for 60 years. Turing is following the example of many drug makers, hedge fund managers and others who purchase the rights to old, cheap medicines, which are the only treatments for serious diseases, and then hike prices. Typically, when a drug’s patent expires, other manufacturers begin to produce lower-priced, generic versions. Excellus BlueCross BlueShield is a leading voice in promoting generic medications as being safe, effective and affordable. The average percentage decrease in cost of a generic compared to a brand-name drug is 85 percent. In the case of Daraprim, a generic version has yet to come to market, even though the drug’s patent expired decades ago. The state Attorney General's office reports it is looking into whether Turing may have taken steps to prevent competition by not permitting Daraprim to be sold in retail pharmacies and instead distributing it only through a small number of specialty pharmacies.
This could prevent generic drug manufacturers from obtaining samples to use in bio-equivalency studies, which would inhibit them from obtaining Food and Drug Administration approval for their generic versions. So what’s to be done about the pricing and distribution games being played by drug makers? Public outrage is a start, as evidenced by the Kaiser survey. But that needs to be channeled into a national solution, which avoids other problems, such as price fixing, rationing and stifling research and innovation. This is the time for elected officials, and those hoping to be elected, to join with medical professionals, health care consumers, insurers and even drug makers to find a solution that allows sick people to get the medications they need at prices they can afford.
Mona M. Chitre, Pharm. D., CGP, is the chief pharmacy officer and vice-president, workplace wellness for Excellus BlueCross BlueShield.
Healthcare in a Minute By George W. Chapman
VA privatization?
Recent problems within the VA healthcare system have prompted a special VA commission to consider allowing vets to receive their care at private facilities while the VA begins to close their own hospitals, beginning with the obsolete and little used. Several veteran’s groups have expressed opposition to the proposal saying their opinions have neither been considered nor solicited. The VA operates 150 medical centers and 1,400 outpatient clinics, employs 53,000 licensed professional and cares for 8.3 million vets.
NYS mergers driving up prices
A study by the conservative think tank, the Manhattan Institute, concludes that the 100-plus hospital mergers in NYS have served to only increase costs and decrease competition with no perceptible increase in quality. The institute recommends greater price transparency among hospitals and the establishment of a commission mandated to monitor healthcare consolidation and costs. Mergers that result in price increases would be subject to antitrust litigation. Accounting firm PWC agrees. According to its market analysis that included 5,600 hospitals, bigger hospitals have obvious economies of scale advantages over small hospitals; but it doesn’t carry over (so far) when these hospitals merge. Hospital mergers have not resulted in noteworthy cost savings or improved quality.
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Cyber-attacks
The hacking of healthcare data is becoming more frequent and sophisticated. Most of the attacks come from Russia, China and Eastern Europe. Hackers are looking for protected health information and medical technology intellectual property to sell on the black market. “Ransomware” is designed to destroy backup files and databases unless the victim pays a ransom to have their data unlocked. The FBI is encouraging victims not to pay the ransom as to do so would only encourage the hackers. The defenses against these attacks are costing the healthcare industry billions.
MD assisted suicide
California is moving toward legalizing physician-assisted suicide for the terminally ill. It’s already legal in Washington, Montana and Vermont. Of course, the eventuality of California entering the market has prompted the manufacturer of Seconal, developed over 80 years ago, to gouge the public. In 2009, a lethal dose of Seconal cost about $200. Valeant Pharmaceuticals has raised the price to $3,000.
Employer-sponsored insurance
Many thought the ACA would cause a decline in business-sponsored health insurance. According to the Congressional Budget Office, 57 percent of Americans, about 155 million, will still get insurance through their employer this year. The CBO predicts this will drop slightly to 152 million in three years, but then remain stable through 2026. The main reason for this stability
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
is probably employees have come to expect coverage through their employer.
Controlling drug prices
In an effort to control spiraling drug prices, Medicare is trialing a new payment model whereby physicians who prescribe drugs that are cheaper but equally effective as the higher priced options will be rewarded. The thought is to have both the physician and patient do the math. Physicians are still free to prescribe the most expensive drug if they truly believe it is in their patient’s best interest.
War on cancer
This is one war we are actually winning. Cancer-related deaths have decreased from 215 per 100,000 deaths in 1990 to 166 per 100,000 deaths in 2012. That is a 23 percent decrease in just 22 years. Cancer mortality has dropped across the board for all cancers. Since 1990: breast, 36 percent; prostate, 50 percent; colorectal, 39 percent; nonHodgkin’s lymphoma, 28 percent; ovarian, 22 percent; cervical, 34 percent; leukemia, 15 percent; lung, 24 percent; kidney, 12 percent; liver, 70 percent; oral, 29 percent; pancreatic, 3 percent; stomach, 47 percent; thyroid, 25 percent; brain, 10 percent.
NYS No. 21
The annual United Health survey of states ranks No. 1 Vermont as the “healthiest” and No. 50 Louisiana as the “sickest.” The study considers factors like diet, smoking, alcohol
intake and obesity in its ranking.
Measuring and reporting “quality” is expensive
Your physician spends about $40,000 a year in staff time and money just to measure their progress against several quality measures imposed by Medicare and commercial payers. Many are calling into question the return on investment when it comes to value-based payment. What it costs a physician to comply and report almost negates any increased payment or rewards for meeting quality metrics. While measuring and rewarding quality is a laudable goal, the inefficiency in collecting and reporting the data clearly contributes to the negative attitude in the medical profession toward the whole concept.
Good Samaritans
A survey of North Carolina physicians revealed that 93 percent took action in a medical emergency outside of their office. The most common place for emergency services was on an airplane.
George W. Chapman is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
Sunday, May 15th from 1 - 2 p.m. Karen Schwarz - Syracuse Psychiatrist What to do when your loved one or friend has a mental illness?
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National Stroke Awareness Month
5
Things You Need To Know About Stroke
When every moment matters By Sami Abdul Malak, MD
W
hen it comes to stroke care, every moment matters. That's because a stroke can cause much damage, such as longterm disability. A stroke occurs when there is an interruption of blood flow to the brain due to a clot or bleeding. Without a fresh supply of blood, the brain is robbed of oxygen, which causes brain cells to die quickly. Once brain cells die, they’re lost forever. Did you know? • About 795,000 Americans each year suffer from a new or recurring stroke. • On average, strokes happen every 40 seconds, and every four minutes someone dies of stroke. • Stoke is the fifth cause of death and a leading cause of adult disability in the United States. May is stroke awareness month. Help increase awareness by educating yourself and you could potentially save a life — perhaps even your own!
What you need to know . Risk factors include high 1 blood pressure, uncontrolled diabetes, high cholesterol, smoking,
excessive alcohol intake and obesity. . When it comes to stroke, moments matter. Stroke causes damage to brain cells, so quick treatments can help dramatically reduce the severity of impairments. . Some people experience warning signs. A transient
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ischemic attack (TIA) occurs when blood flow to part of the brain is temporarily blocked or reduced. This “mini stroke” includes all the symptoms of a stroke, but does not last as long or cause permanent damage to brain cells. It is very important to seek medical care to prevent a full stroke and long-term disability. . African-Americans are twice as likely to experience stroke and more women experience stroke than men . How do you know if someone is having one? Remember FAST: Face: Does the face look uneven? Ask the person to smile Arm: Does one arm drift down? Ask the person to raise both arms Speech: Does the person’s speech sound strange? Ask the person to repeat a phrase Time: Every second, brain cells die If you suspect someone is having a stroke call 9-1-1 immediately and get to the nearest stroke center. For more information: crouse.org/stroke
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Sami Abdul Malak, MD, is medical director, neurology, Crouse Hospital.
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Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by
Health CNY’s Healthcare Newspaper
Local News, Inc. 5,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.
In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Chris Motola, Mona Chitre (Pharm. D.), Sami Abdul Malak (M.D.), Aaron Gifford, • Advertising: Amy Gagliano, Cassandra Lawson Design: Eric J. Stevens • Office Manager: Alice Davis 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.
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Want to Grow a Garden? Syracuse Grows Can Help Volunteer organization helps groups start and maintain community gardens in Syracuse By Matthew Liptak
T
he growing season is upon us once again and many Central New Yorkers have chosen to put their green thumbs into the rich soil of a community garden. Syracuse Grows is an all-volunteer organization that advocates for and assists community gardeners in the area. “Our mission is really one of food justice,” said Syracuse Grows chairwoman Sarah Brown. “Our ideal would be a community where everyone has access to healthy, safe, affordable and culturally appropriate food.” There are 24 community gardens in the organization's network, Brown said. She said the number has been growing. “They're pretty well spread out throughout the city,” she said. “We
really work to provide a framework and a network for these gardens. We're not in the business of starting gardens. We will wait for an organization or the community, a group of neighbors to come to us.” Syracuse Grows takes a back burner approach to instigating gardens because it has found what works for long-term success. Without a core group of garden coordinators for a garden, the community garden will often fail down the road, Brown said. The organization exists to make the creation and maintenance of those gardens a little easier. Syracuse Grows provides compost in larger amounts and other resources that city community gardeners might not have easy access too. The nonprofit also acts as a liai-
son between community gardeners and partner organizations. Syracuse has many partners, including the Onondaga County Resource Recovery Agency, the city of Syracuse, the Greater Syracuse Land Bank and Cornell Cooperative Extension. There are many benefits of community gardening. “I think first and foremost, the community garden brings people together in the community to grow their own food,” she said. “For children and youth, we can be a really powerful teaching and learning tool. Many children by working and volunteering in a community garden discover where their food comes from and how it is grown.” Community gardens also often turn vacant lots from eyesores into productive parts of the city landscape.
Water at a premium
While that is beneficial, finding water is often an issue on these lots. Brown said Syracuse Grows will often obtain fire hydrant wrenches from the city for water and gardeners can also collect water in rain barrels. “I would like to see the Syracuse area get more involved,” said Mable Wilson, garden coordinator for the West Newell Street Community Garden for the last two decades. “I would like to see the city and the land bank more encouraging of
May 2016 •
community gardens in the various neighborhoods so that there wouldn't be a water issue about watering the garden.” Aggie Lane is the garden coordinator for the 341 Midland Ave. Community Garden. Finding water for the garden was challenging too until Syracuse Grows stepped in. “SG built a tool shed with a metal roof,” she said. “This allows our garden to collect water in rain barrels for watering the garden. Without the shed, we would have no water source.” Both coordinators are looking forward to the coming season. Lane said she is particularly excited because her garden will be part of an education program for nine children between the ages of 9 and 14 through Partnership for Onondaga Creek. They will be learning nutrition, cooking and how to grow their own food. Wilson ran off a whole list of why she's looking forward to the garden this year. “Because of my health,” she said. “Also to be around my friends and buddies that garden with me and to be with my grandchildren. [I enjoy] sharing different growing ideas with our garden members or new members that come to the garden.” For more information on Syracuse Grows, call 315-443-4890 or go to www.syracusegrows.org.
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Meet CNY’s Pot Doc
Physician Scott Treatman of Cazenovia is one of the first in CNY to obtain the required state registration for prescribing medical marijuana. He talks about the process and how patients may benefit from the product By Aaron Gifford
M
edical marijuana is now legal in New York state, but it will take awhile to gauge the local demand for it, to decide if the pot law should be amended to cover prescriptions for additional ailments, and to determine if the provisions for dispensing the drug need to be more or less restrictive. Scott Treatman of Cazenovia was one of the first of about half a dozen physicians in the area to obtain the required state registration for prescribing medical marijuana. Treatman also works as an occupational health consultant at Crouse Hospital in Syracuse, where he is responsible for the wellbeing of its workforce. Treatman and his wife, Linda Lemay, a certified acupuncturist, operate the Complementary Health Services practice on Pompey Hallow Road in Cazenovia. In a recent interview, Treatman discussed his background and the process for medical marijuana prescriptions. His practice had just opened at the time of this interview, and he had just begun seeing patients. “It’s off to a slow start,” he said, “but I think the need is going to grow.” The Brooklyn native followed in the footsteps of his uncle, the late Ben Cohen, a pediatrician. In medical school, Treatman pursued the doctor of osteopathic medicine credential instead of a doctor of medicine because he believed the holistic approach was a better fit for practicing primary care. Treatman is also a certified acupuncturist and treats Crouse Hospital staff, and he has a degree in public health. As a physician, his philosophy has been to do anything possible to stop pain and suffering. “I want to have an impact on the population,” he said. Getting registered to prescribe medical marijuana was another way to do that. Treatman completed the required four hours of continuing education and reached out to the medical community to inform practitioners that he is now available for referrals. Under the state law, physicians must have this state Department of Health registration to prescribe marijuana. Many doctors don’t have the time or interest to obtain that credential, often because they don’t regularly see patients that would qualify for medical marijuana. “There’s a need for this,” Treatman explained. “There’s good research coming out about the benefits, but a lot of practices still may not Page 12
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Treatman also works as an occupational health consultant at Crouse Hospital in Syracuse, where he is responsible for the wellbeing of its workforce. have the interest or resources to do this.” The sale of marijuana and possession of it is still illegal in the eyes of the federal government, so companies that conduct business between states, including banks, credit card companies and insurance plans, cannot be involved in the transactions. Also, the U.S. Food and Drug Administration has yet to approve marijuana. Complementary Health Services does not participate with insurance companies, so patients can still submit “super bills” to their insurance companies after they pay the bill out-of-pocket and attempt to get reimbursement. After receiving the referral from another physician, Treatman then reviews the patient’s diagnosis, current condition and potential complications. Based on his own intake, Treatman decides whether a marijuana prescription should be issued and the appropriate dosage of THC (the active ingredient in marijuana), the method for consuming it and the duration of the prescription. The dispensary pharmacist however, has the final say on all of that.
There are currently three dispensaries in Central New York — two in the Liverpool area and one in Syracuse. New York state does not accept certifications or registry ID cards from other states. The state has limited marijuana prescription to a list of severely debilitating or life-threatening conditions. This list includes cancer, HIV or AIDS, amyotrophic lateral sclerosis, Parkinson’s disease, multiple sclerosis, damage to the nervous tissue of the spinal cord, epilepsy, inflammatory bowel disease, neuropathies, Huntington’s disease, wasting syndrome, severe or chronic pain, severe nausea, and severe or persistent muscle spasms. Glaucoma and anorexia are not on that list. “I’m optimistic that the list will be expanded,” Treatman said. The allowed medical marijuana products include extracts, tinctures, oils and edible forms. Smoking marijuana is not an allowed use in New York state. While Treatman agrees that smoking marijuana can be harmful to the lungs and respiratory system, he believes that mandating the manufactured forms of it increases the price of THC products and may put it out of reach for many patients, especially since insurance doesn’t cover it. The cost of the allowed products ranges from $300 to $800 a month. Medical marijuana products also carry an excise tax of 7 percent. As for the local share of those tax revenues, 22.5 percent go to the county
where the marijuana was produced, 22.5 percent goes to the county where the product was dispensed, 5 percent goes to the local Office of Alcohol and Substance Abuse Services, and 5 percent goes to local Department of Criminal Justice Services. Treatman discusses the appropriate THC levels with the patient. Someone who suffers from seizures, for example, might prefer low levels. A patient who needs the drug to combat chronic pain might need a balanced level if they are “THC naïve,” or don’t have much experience with marijuana. A chronic pain patient who is comfortable with the drug might be fit for high THC levels, as would a patient who needs it to combat severe pain. Treatman also discusses potential side effects, which could include paranoia, anxiety or sleepiness. “There’s a place for it,” he said. “I don’t think it’s the answer for everything, but for some people it could be of value. People can try it. Either it works, or it doesn’t work.” From what Treatman has heard from medical marijuana consumers who used the drug in other states, pot has also been highly effective in combating stress and anxiety, and others have reported that it is the best short-term remedy for chronic pain. “It is temporary, but they get relief,” Treatman said. “When you are in pain 24-7, you welcome any relief you can get.”
Registration, please
Treatman decides if the patient should be issued a state registry identification card that is required for purchasing medical marijuana at a dispensing facility. There is also a $50 registration application fee for obtaining a card.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
Physician Scott Treatman and his wife, Linda Lemay, a certified acupuncturist, just opened their private practice, Complementary Health Services, on Pompey Hallow Road in Cazenovia. They will offer a variety of services, including yoga, acupuncture, reiki and medical marijuana.
Will Syracuse be AIDS Free by 2020? ACR Health expert says goal is within reach; says Syracuse can become role model for other cities across the country
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By Matthew Liptak
T
here is increasing optimism among local administrators in the health sector that Gov. Cuomo's initiative to end AIDS in New York state by 2020 is within reach, but some are concerned that the current opioid-abuse epidemic could threaten the plan. Erin Bortel, the director of prevention services for ACR Health in Syracuse, was asked if she thought the city could be AIDS free by 2020. “I think it's possible,” she said. “I think with the momentum that we have Bortel right now, the community collaboration that's happening at the moment. In the 10 or so years that I've been in the field I have not seen this level of connectiveness among provider agencies. That's exciting to see.” The latest available statistics are sobering. According to the state's department of health there were 3,500 new HIV cases in the state in 2013 and 112,000 New Yorker's were living with AIDS or HIV. In Syracuse, Mayor Stephanie Miner assembled an end-the-epidemic task force. Those on the task force include the nonprofit ACR Health, which services those with chronic disease, Liberty Resources, the Southwest Community Center, Upstate Medical University, Planned Parenthood, Family Planning Services, the Onondaga Medical Society, individuals from the department of social services and even private practice providers. “In this type of effort you really do need to attack it from all angles,” Bortel said, “That's really one of the objectives of the task force.” The first step is changing the conversation, Bortel said. Efforts will be made to destigmatize the disease, especially in minority groups, by engaging in targeted advertising and submission of op-ed pieces to publications, she said. The public should also be aware that rapid HIV testing is available now where you get results in a private setting in 10 to 15 minutes. Mobile testing units are expected to
be used in the community at local festivals and events to increase accessibility and participation. “We can do outreach and actually offer HIV testing on the street in a really private way so that people can very quickly. We're talking within 10 or 15 minutes, walk away knowing that they are HIV negative or positive,” Bortel said. “If that's the case, then connecting them to the care that they need. You have a result that's about 99.8 percent reliable within 10 minutes.” Bortel said AIDS is a “very present threat” in everyone's lives. She said there is a tendency for many people to not consider themselves at risk for HIV. Her organization has estimated though that there are up to 300 people locally who are infected and haven't been diagnosed. The current heroin and pain killer epidemic that is raging throughout Central New York is also a challenge to Syracuse becoming AIDS-free by 2020. Bortel said that there were six new cases of confirmed hepatitis C in Syracuse in March alone. That disease often coincides with HIV transmission. “Currently with our heroin issue that we're dealing with in the region and across the country I'm really concerned we haven't seen the worst of it,” she said. But there are multiple ways to prevent infection. ACR sponsors a needle exchange program that has served more than 1,800 drug users. The organization also teaches injection drug users ways to inject that will make infection less likely. And there are condoms and PreP — or pre-exposure prophylaxis — which is the use of medication for those at high risk to make infection less likely. Another step the task force is taking is to reach out to those who have been diagnosed but fallen out of treatment to get proper health care. The mayor's task force is enthusiastic that AIDS can be ended in Syracuse by 2020, but they know they have a fight on their hands. “Right now the entire country is looking at us,” Bortel said. “That's a lot of pressure as much as it is exciting. I think in terms of implications this is a moment that we can really role model the entire country about putting the resources in the right places and creating localized regional strategies.” May 2016 •
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Q&A
with Tania Anderson By Matthew Liptak
New director at ARISE talks about challenges, opportunities Q. What does ARISE do? A. ARISE is an independent living center which means that it's an organization that's run by and for people with disabilities. What makes ARISE unique is that it deals with any kind of disability — people with physical disabilities, mental health issues, people with developmental disabilities — really anything. It's very person-centered. The people accessing the service direct what they need, how they need it, when they need it. That's how service is delivered. Q. How do you feel about your new position? A. I'm very excited, very excited. Tom McKeown has been a great leader for ARISE for the last 14 years. He's my predecessor and my mentor. During his tenure ARISE quadrupled in size. We expanded geographically. We expanded with programs. We're really well positioned for the future and I'm very excited to take over. Q. What's your background? A. I'm a lawyer. I worked for 20 years as a lawyer in public service in the federal and state courts. I Page 14
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was on the ARISE board for the last 17 years, the last eight years as the board president. I have a child who has a disability. She is soon to be 11 years old. When she was diagnosed with her disability 10 years ago my connection to ARISE became much more immediate in terms of living in that world — my daughter accesses services through ARISE. My personal connection to the community of people with disabilities really informs every decision I make. I live it. My daughter is the center of my universe and I want the best world possible for her. By extension I want the best world and the best services possible for any person with a disability. It really permeates my life and the way I view the world, the way I make decisions. I always had a passion for ARISE, but this kicked it up to another level. Q. What do you see as the future of ARISE? A. ARISE is very well positioned for the marketplace. It's a tough marketplace. Medicaid managed care is something that's happening. ARISE is diverse geographically. We're in five counties — Onondaga, Oswego,
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
Cayuga, Seneca and Madison. We're diverse in terms of programming. We're also very diverse because we're in the community. The way the marketplace is going is to deliver services to people in the community and we are already doing that. We're really well positioned for the future. Q. What are the challenges facing you? A. One of the biggest challenges facing not only ARISE, but a lot of community-based organizations is Medicaid reform. We're going from a fee-for-service model to a model of service delivery and payment, which is based on performance measures and outcomes which haven't been determined yet. Almost all of the human service agencies are trying to figure out what that's going to mean for them — how it means they deliver service; how it means they balance their budgets; how it means they pay their staff. That's going to be a challenge. Another challenge is the push to increase wages. ARISE agrees that our direct-care professionals need to make a living, but on the flip side the rate that New York state provides us
to reimburse us for the services has to build in an increased wage rate. ARISE can't afford to pay directservice workers $15 an hour if the rate New York state pays us for that service does not have an attendant increase. Q. What are the opportunities you see ahead? A. The fact that the independent-living philosophy that ARISE embodies is becoming the philosophy of choice for the entire marketplace. Self directed services—people choosing what they want when they want, how they want it in a community setting in a lower cost environment. (They) are really empowered to live their lives the way they want them to be. It's a great opportunity.
SmartBites
The skinny on healthy eating
Why Eating Mangoes Does a Body Good
M
y mother adored mangoes: the tropical taste, the luscious texture, the yummy smell. And I adored her for adoring a fruit that seemed inconsistent with her crisp, tidy nature. An apple? Yes. A mango? Total surprise. On that sweet note — and because it’s May — I dedicate this month’s column to mangoes, the world’s most popular fruit, and a quite nutritious one to boot. Thanks to its bounty of a natural sugar called fructose, mangoes are an excellent source of steady energy. Unlike sucrose (refined table sugar that has been stripped of its nutrients) or the fructose-based sweeteners used in processed foods, the fructose in mangoes — and all fruits, for that matter — is digested more slowly because of the fruit’s fiber. One cup of sliced mangoes weighs about 3 grams. The American Diabetes Association supports the consumption of fruits, even fruits that have more natural sugar in them — like mangoes, pineapples and grapes. Yes, they have carbs; and yes, their intake requires monitoring; but — just like many starchy vegetables — they’re simply too delicious and too nutritious to pass up. What kinds of nutrients do mangoes bring to the table?
We don’t have space here to review all 20 vitamins and minerals — yes, 20! — but we can talk about the top three: vitamin C, vitamin A and vitamin B6. One cup of sliced mangoes boasts 75 percent of our daily needs for vitamin C, 25 percent of our needs for vitamin A, and 11 percent for vitamin B6. A powerful antioxidant and essential nutrient, vitamin C works hard to keep our tissues and immune system in great shape. Although no studies confirm that vitamin C prevents colds, it may shorten the length of a cold. Vitamin A is needed for proper bone growth, reproduction, eyesight and immune system health, while vitamin B6 plays a “behind the scenes” role in all kinds of key functions, from brain development during pregnancy to helping the body make hormones that affect mood. On the research front, recent studies conducted at Texas A&M University suggest that mangoes may have cancer-fighting properties. According to physician Susanne Talcott, “Our team found that a compound in mangoes prevented or stopped cancer growth in certain breast and colon cell lines.” And contrary to what their sweet flavor may suggest, mangoes score fairly low in calories (only 100 per
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sliced cup) and super low in fat, sodium, and cholesterol (as in zero). As for carbs, one cup of sliced mangoes has about as much as one medium apple or banana: 25 grams.
Helpful tips
Don’t focus on color when choosing a mango. The red color that appears on some varieties is not an indicator of ripeness. Always judge by feel: a ripe mango will give slightly when squeezed. Mangoes will continue to ripen at room temperature. Once ripe, move mangoes to the refrigerator, where they may be stored for up to five days. Note: Those with a latex allergy may also have a cross-reaction to mangoes.
Mango-Swirled Cheesecake Perfect for Mother’s Day! Crust: ¾ cup graham cracker crumbs 2 tablespoons brown sugar 2 tablespoons butter, melted 1 teaspoon vanilla 1 teaspoon water
Filling: 2 large ripe mangoes 3 (8-ounce) blocks fat-reduced cream cheese, softened 1 cup sugar 1 teaspoon vanilla 4 large eggs Garnishes: fresh mango slices, blueberries, toasted coconut Preheat oven to 375 F.. To prepare crust, combine first three ingredients, tossing with a fork. Add vanilla and water, tossing with a fork until moist and crumbly. Gently press mixture into bottom of lightly oiled nine-inch springform pan. Bake at 375 F. for eight minutes. Remove from oven,
and turn oven down to 325 F. Peel the mangoes and slice off the flesh (discard the seed); transfer to a blender and puree until smooth. Pour into a small glass measuring cup; set aside. To prepare filling, beat cream cheese until smooth. Add sugar and vanilla; beat well. Add eggs, one at a time, beating well after each addition. Blend in half of mango puree. Pour into prepared crust. Spoon remaining mango puree over filling, and swirl together using the tip of a knife. Bake at 325 F. for one hour and 20 minutes. Remove cheesecake from oven, and cool to room temperature. Cover and chill at least eight hours. Garnish with fresh mango slices, berries or toasted coconut (optional).
Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
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Cancer Crusader Upstate's Stewart Loh takes lead on finding cure for cancer
By Matthew Liptak
U
pstate Medical University basic scientist Stewart Loh has science in his blood. He comes from a long line of scientists going back to his physicist grandfather, H.Y. Loh. Now he finds himself on the frontline of cancer research at Upstate in Syracuse. “My grandfather was a physicist,” Loh said.” My father was a physicist. My three uncles are physicists. In my generation in my family, we're still scientists but my brothers are chemists not biochemists.” Loh is a biochemist who runs a lab at Upstate, where his wife, Jenny Ha, works too. They met in grad school and both have PhDs. They did their post-docs at Stanford University. “I always say, ‘I'm like the right
half of the lab brain and she's the left half,’” Loh said. They work hard at their lab and have made potential inroads in the fight against cancer. Recently Loh, in collaboration with Darren Carpizo and David Kimball of Rutgers Cancer Institute of New Jersey, became part of a startup called Z53 Therapeutics. The company will develop agents to repair P53, a defective protein related to many cancers. “This is probably the most exciting work that's going on in my lab simply because the goal is for there to be a product that will make it to the public,” Loh said. “There's not many scientists who can say that they've done that at the end of the day. In order to bring a drug to the market,
it is an incredibly long and incredibly expensive process.” The trio made a real breakthrough when it discovered a way in which zinc could be reintroduced to P53. “Normally when you think of a cancer drug, these drugs inhibit some type of protein,” Loh said. “What our drugs do is they activate this protein. Many people believe that in many, most or probably all cancers, this P53 protein is somehow asleep — it's not active. If you can wake it up, many people believe this is a way to treat many different types of cancers.”
Making significant inroads
Loh's lab has found that just one mutation of P53 they have researched
Suicide Mission Liverpool music event to raise money for suicide awareness, prevention By Matthew Liptak
M
ay is Mental Health Awareness Month and one local organization is drawing attention to suicide prevention with a music-related fundraiser. Band Together is an event put on by the CNY chapter of the American Foundation for Suicide Prevention to raise money to provide evidence-based prevention efforts in the area. ”Our mission is to save lives and bring hope to those affected by suicide through scientific research, through our educational programs, and to promote and advocate for policies for better mental health coverage and care,” said Debra Graham, the chapter’s director. According to the latest Centers for Disease Control statistics, there Page 16
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were 1,700 suicide deaths in New York state in 2014. That’s one every five hours. “We have to change our way of thinking that it can never happen to us,” Graham said. “Nobody I knew will die by suicide or have a mental illness. That’s like saying no one we know or love will ever be diagnosed with cancer.” Graham said suicide passes through all social, economic and racial categories. It is the 10th leading cause of death of all illnesses. Suicide is now the second-leading cause of death in people aged 15 to 34, and the third-leading cause of death in those aged 10 to 14. Band Together is a fun way to combat this terrible trend. Three bands will be playing at Sharkey’s
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
in Liverpool from 2-6 p.m. May 21. Admission is $20 at the door or $15 in advance. Tickets include food and performances by the bands Driftwater, The Lightkeepers andDR RAS and the Lizard. There will also be raffles, a 50/50 and a roulette wheel. For advance tickets, call 315-6640436 or go to www.afsp.org/centralny.
Complex set of circumstances
The causes of suicide can be complex, according to Graham. It often has to do with mental illness, so keeping lines of communication open and avoiding stigma is vital. “It’s not just one trigger that can cause someone to take their life,” she said. “It’s bigger than that. There’s
affects over 70,000 cases of cancer and they expect the drugs developed to impact other mutations too. The Upstate researcher is a basic scientist, a field that researches the basic elements of a disease and what's going on at the molecular level. He said he was attracted to biochemistry in college, but joked breaking away from his family's traditional path of physics made him a bit of a black sheep. “Physicists are kind of elitist when it comes to science,” Loh said. “They think that if you're a physicist you can figure everything out — life is just a subset of physics, when in fact that's really, really not true.” When not pursuing his passion for biochemistry, the scientist can sometimes be found pursuing a passion for coffee. He admits he is a bit of a coffee aficionado. He roasts beans at home and also makes his own espresso. “I think my coffee's the best but when I run out or if I just need that extra bit, then I like Funk 'N Waffles,” he said. He has worked at Upstate for almost 20 years now and is looking forward to what Z53 Therapeutics produces. He may soon be in that set of scientists that actually sees something they've helped develop go on to save lives. “If you can go from understanding basic mechanisms to a drug, very few people can say they've done that in their career,” Loh said. “If that happens. I will be super-happy.” Kimball also heralded the significance of what the trio had accomplished. “The effective reactivation of mutant p53 is an exciting development in oncology that has eluded drug-discovery scientists for years,” he said. Loh said the technology already exists for a patient to find out if he or she has the defective P53 mutation. Right now drugs are not ready to treat patients, but he hopes that will soon change. “The goal is within roughly one year from now to have something that's suitable for taking it to clinical trial,” Loh said.
biological and genetic factors, and there’s life events.” It’s important to be able to ask someone if they have thought about or are considering taking their own life. Scientific research has conclusively proven that bringing up the subject will not cause a person to move toward suicidal thinking, but ignoring the subject can prove dangerous, Graham said. So what are the warning signs? Changes in behavior and mood can be a red flag, Graham said. “If someone is very outgoing and now they’re isolating, not participating in activities that they used to get pleasure from,” Graham said. “Maybe they’re angry all the time. Very often depression, especially in young people —that’s how it presents itself, in angry outbursts. It could be more than that.” The foundation wants us all to be on the look out for signs of suicide. It is one of the most preventable deaths, Graham said. Those who are concerned about suicide or if you are considering taking your own life, call 1-800-273-8255 for help or 1-800-273-TALK.
Meet Your Provider
Scolaro, Fetter, Grizanti, McGough & King, P.C. Syracuse estate planning firm helps clients protect their assets, save in tax expenses
The team at Scolaro, Fetter, Grizanti, McGough & King, P.C.: top row, from left, Steven A. Walker, John S. King, Richard D. Boyle, Shane M. McCrohan, Anthony J. Grizanti and Jeffrey M. Fetter. Seated from left are Stewart M. McGough, Carol A. Christiansen and Meghan A. McGrattan
Q: What does your firm do? A: We assist clients with ensuring that their estate planning is in proper order. This area of practice is quite challenging in that not only must you address the client’s personal wishes with respect to their assets, but we do so in a manner that will ensure that their wishes are fulfilled as efficiently as possible and with as little if any tax consequences to our clients or their families. Q: Can you be more specific? A: We provide a very unique product — peace of mind. This is true whether we are working with a client on their estate or business planning or if we are involved in working with them through a difficult time in their lives, which could be as a result of litigation or even getting them through the estate and trust administration process after the loss of a loved one. Like the services we provide, the people who provide those services are uniquely talented as well to ensure that the client is satisfied.
estate tax exemptions have been increased significantly. More and more, we see that clients are concerned with asset protection and wealth preservation, rather than relief of estate taxes. While there has been much talk in the past of repealing the “death tax,” the large increases in the estate tax exemptions was not foreseen, at least not to the magnitude that was actually enacted into law.
Q: What changes have you seen in this field recently? Q: How important is for people to hire a estate A: Much of the estate planning for the past 30 planner? years was driven by the extremely high state and A: For many people, planning will become federal estate taxes that were imposed on a great simpler because their estate will not be subject to number of families. Since 2010, federal and state state and federal estate taxes. A growing number
of clients, however, are focusing their planning on protecting their estates from creditors’ claims, lawsuits and the like. We see that component of our practice as continuing to grow and this firm is well positioned to meet that need. Q: What are your leadership goals in the Scolaro, Fetter, Grizanti, McGough & King, P.C? A: I want to see the firm continue to be a great place to work, where legal professionals provide services to our clients of the highest quality in a positive and productive work environment.
507 Plum St., suite 300, Syracuse • 315-471-8111 • www.scolaro.com
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Providing Medical Library Services to Smaller Hospitals Medical librarian is available 24/7 to CNY hospitals By Aaron Gifford
P
hysicians can’t memorize every fact they learned in medical school, let alone all of the more recent developments in their field. That’s where medical libraries come in handy. But smaller, more rural hospitals may not have the space or resources for a library. That’s where professionals like Angela Thor come in handy. “You have to be available 24/7,” the Syracuse resident says, “because you never know when you’ll get a call.” Thor is a medical circuit librarian for Central New York Library Resources Council. She is primarily assigned to assist nurses, physicians and other health care providers at hospitals in Oneida, Rome and Hamilton. She visits those facilities regularly but mostly works from home, where her phone is always on. There is no such thing as a typical call. One time, a veteran physician needed a YouTube video that demonstrated the current protocol for a specific surgery. On another occasion, a nurse needed a quick update on the latest standards for preventing infections. Thor stresses that all of the questions directed to her must be relevant to treating a condition, not diagnosing it. The Central New York Library Resources Council is part of the state-funded Hospital Library Service Program, which assists nonprofit hospitals and is licensed by the New
Angela Thor is a medical circuit librarian for Central New York Library Resources Council. She is primarily assigned to assist nurses, physicians and other health care providers. “You have to be available 24/7,” the Syracuse resident says, “because you never know when you’ll get a call.”
York State Health Department. The state Board of Regents sets the standards of quality. The job is challenging, Thor said, but not necessarily as complicated as most health care consumers would think. She doesn’t have a repository of saturated book shelves in her home. Much of her research is conducted through two websites — Pubmed for scientific research, and Medline Plus for consumer research.
Parenting By Melissa Stefanec
Where is Mommy?
F
or the past few months, I’ve been shuttling my daughter and her friend to pre-school once a week. The ride is short and usually a lot of fun. A couple of weeks ago, my daughter’s preschool had a little Easter play. When I picked up my daughter and her friend, who is 3 years old, her friend was in tears because her mommy couldn’t make it to the singalong. Her grandma was on the way, but that wasn’t cutting it. I loaded the tearful little girl into my van and thought about what I was going to say. Her mom works a full-time job that is in high demand this time of year. I am sure if either of her parents could have made it, they would have. However, I didn’t think this explanation was going to dry her tears. So, I went in another direction. “In the fall, I couldn’t go to the Thanksgiving show to see StelPage 18
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la,” I said to the tearful face in the rearview mirror. “I was really sad I couldn’t go, and Stella was sad too. Mommies and daddies hate going to work and missing fun stuff like this. Sometimes, it makes us cry too. I am sure your mommy would give anything to see you sing today. She loves you so much.” To my amazement, a small smile spread across the face of my daughter’s friend. She pulled it together for her singalong. That made me smile. When I talk to other parents and rate my own experiences, not being there for your kids has to be in the top five list of parenting gripes. Not being there sucks. In this life, the demands are real, and balancing those demands pulls at my heartstrings. Most of the parents I’m acquainted with are part of dual-income households.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
The New Jersey native began her career as a librarian in 1986, initially specializing in science and engineering. Thor’s first job in Central New York was with the Simmons Institute of Funeral Services, where she was responsible for building a reference collection and developing information search tools. While she enjoys the job immensely, Thor said the toughest part is joining the fight against advanced stage cancers where the prognosis for survival is not good. “I find that very hard to deal with,” she said. One of Thor’s favorite parts of the job is working with senior citizens at health fairs, educating them about diets, lifestyles, and identifying pills. She especially enjoys teaching them how to perform their own research. “Once they have been made aware that no one is going to ask them for their information, they gain more confidence and seem to be OK searching for information and visiting the right sites,” Thor said. While Thor encourages health care consumers to conduct their own online research, she cautions that not every website can be trusted. The Centers for Disease Control and the Mayo Clinic sitea are among the more trustworthy sites. When visiting other sites, she advises, be sure to take note of when it was last updated and who produced the site. “Ask yourself; is this from a When both parents have careers, it makes it even tougher to juggle the demands of parenting and working. There are days where I feel my sanity unhinging while trying to bridge the gap between the two. Sometimes, the balancing act leaves my kids shortchanged, because, by their very nature, balancing acts require give and take. The problem is, taking from your kids is difficult and emotionally draining for everyone involved. To that end, I have drafted a short letter to my children. I will read it to them now, and give it to them when they are older. It goes something like this: As you look out upon the smiling faces in the crowd, you are probably noticing there are one or two missing. They are the one or two that you want to see the most. You check a few times, just to be sure, and then the sadness sets in. Mommy and daddy aren’t going to make it this time. You are probably feeling like mommy and daddy don’t care or don’t love you as much as they should. You are probably feeling neglected. You see the other mommies and daddies and probably even grow a little jealous. I get all of that. Mommy and Daddy know first-hand how this feels. It wasn’t that long ago (OK, it was kind of long ago) that we were scanning crowds of people for our own parents’ faces. Not seeing those faces hurt, and we felt many of the same things you are feeling right now. However, there is something you have to know. You have to believe it with every inch of your beautiful self. We
pharmaceutical company that has an obvious interest in trying to sell you something? Who are their sources?” Thor said. “The other thing to be aware of is reading into the symptoms too much. How many people visit a site and then think right away, ‘I’ve got cancer.’ ” Thor’s co-workers have high praise for her work. “Since Angela works in several facilities, she is also a wonderful source of what is happening on a local level at other facilities — what works, and [what] doesn’t work,” said Juliana H. Chrysler, director of education/volunteers/employee health at Rome Memorial Hospital. “She helps us to network with others in this regard.” “Angela essentially IS the library for these hospitals,” said Debby Emerson, Central New York Library Resources council executive director. “Without her, they would not have library services and would not be meeting the state standards for hospital libraries. Angela also makes sure all of our area hospitals have updated information and are in touch with each other. This is tremendously important, as she can often encourage people to work together if they are planning similar projects or engaged in similar efforts.” The future for aspiring medical librarians is bright. A recent study by the University of Rochester determined that the quality of care is better with physicians who utilize their hospital’s library and/or librarians. As more hospitals are embracing the concept of forming teams for individual patient care, it is not unusual now for medical librarians to accompany doctors and nurses on their rounds. “It’s exciting to hear that we’ll continue [to play a major role in] improving the quality of health care,” Thor said.
want to be there. We want to be there as much as you want us to be there. If life didn’t have consequences, we would be there every single time. If life could be perfect, we would never disappoint you. But, as you are finding out, life has consequences, and it isn’t perfect. Every time you make a choice, it has an impact on something else. Life is funny like that. Life is funny in a lot ways. Life is bound to be disappointing, and I’m sorry that sometimes mommies and daddies have to be the cause of that disappointment. We are going to disappoint you sometimes, but know this — no matter how many times we fall short of your expectations, we love you as deeply as ever. Also know this, when it’s really important for us to be there, when you don’t want, but need us to be there, we will be there. Let us know when these times are. Especially as you grow older, don’t make us read your mind. Let us know what you need, and we will find a way to make that happen. You are more important than any deadline, client or meeting. Few things in this world can bring us more joy than your smiling face. Making that face smile is one of the important things we want to accomplish each and every day. When we can’t be there, please know that the thought of your smiling face is what is getting us through the day. Maybe we can’t be there every time, but we are always in your heart and mind, just like you are in ours. I just read this letter to my daughter, who is almost 5, and she said it’s OK that I missed her Thanksgiving show. She said she just wants to snuggle, snuggle.
NURSES WEEK
NICU Nursing: Caring for the Tiniest Patients By Deborah Jeanne Sergeant
N
urses in a hospital's neo-natal intensive care unit (NICU) care for premature, sick and injured newborns. Because of their patient's needs, their role differs from nurses in other parts of the hospital in a few important ways. "The babies in the NICU are very vulnerable, and so are their parents," said Carol Weeks, a registered nurse in the NICU at St. Joseph’s Hospital Health Center. "In addition to the babies who are our patients, we also provide care
to the parents who are experiencing an even wider-than-normal range of emotions. Nursing at St. Joseph’s NICU means viewing the 'patient' as a larger family unit, not just one baby or one mom. And this is foremost in our care." Since babies can't express their needs in words, NICU nurses look for cues and vital sign changes to know if babies are uncomfortable. NICU nurses also care for the babies' family members as patients on many levels since they tend to spend many
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hours in the NICU as well. Most people possess little familiarity with the NICU environment. The clear incubators, monitor leads, feeding tubes and beeping monitors may intimidate parents. That's why NICU nurses can help parents understand the aspect of their child's care and ways they can begin parenting right at the NICU. "Other than the few who have had previous children in our NICU, most families have never experienced the NICU environment before their baby’s admission," Weeks said. "It can be confusing and sometimes scary for the families, as they are entering a highly-technical environment. Our NICU nurses understand this, and we make sure they know we are here to answers their questions and help them in every way." NICU babies often appear much more swaddled and supported that typical newborns. Positioning aids in the incubator mimic the snug feel of the womb again to help babies feel safe and comfortable. That decreases emotional stress and conserves energy that can be used for growing. "Parents and family members often experience a wide range of emotions while their baby is in the NICU," Weeks said. While most parents feel elation at the new addition to their family, it's normal to feel grief as well because of their losses. NICU nurses help parents through the mourning process. At the very least, parents grieve the loss of the normal pregnancy and may face their child's disability
or death. Parents expecting to go home with a healthy baby now face an extended hospital stay fraught with uncertainty about their child's short-term and long-term prognosis. Nurses help keep parents updated about their child's condition, which can change from day to day, and encourage bonding with the child, despite unusual circumstances. Nurses also help look out for the babies' security. Kidnappings are rare, but still a possibility which NICU personnel work to prevent through various safety protocols. Hospital NICUs typically use sensors on the baby's ID bracelet or umbilical cord clamp that can trigger a lock down and alarm if a baby is removed from the NICU. The doors of NICUs remain locked and staffed at all times. Family members have hospital-issued identification that corresponds to their baby's. Only people with the correct identification and the few guests they admit are permitted to see the baby. Legislators enacted HIPAA regulations to protect patients' privacy. They include the hospital's tiniest patients as well. Though it may seem hard for some visitors to not peek at newborns, they're permitted to see only the babies they have come to visit. Weeks said that NICU nurses at St. Joseph's complete a detailed orientation for working in the NICU, which includes one-on-one mentoring with an experienced NICU nurse.
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Golden Years Longevity of a 65 year old: Woman to Reach 85; Man, 82
Improvements in sanitation, environment, the ability to treat infectious disease and healthier lifestyle choices are some of the causes that have pushed longevity up By Deborah Jeanne Sergeant
H
ow long should you expect to live? It's longer than it was a hundred years ago. According to the Centers for Disease Control and Prevention, life expectancy for a 65-year-old as of 2013 was 17.9 more years for males (82.9 years total lifespan) and 20.5 for females (85.5 years total lifespan). In 1900, the lifespan for men was 46.3 and 48.3 for women. Reduction of child mortality rates and maternal deaths, as well as improvements in sanitation, environment and the ability to treat infectious disease have helped increase the average lifespan. In more recent years, lifestyle choices have helped seniors stay healthier longer. "What we're seeing is because our younger seniors are working longer," said Sara Sunday, administrator with Oswego County Office for the Aging. "Many have healthier habits."
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Sunday said that many people are paying better attention to what they eat, for example. A healthful diet includes plenty of whole fruits, vegetables and grains and lean sources of protein and dairy, while eschewing processed and sugary foods, all within a moderate calorie count. "There are a lot more healthy options that are availSunday able," Sunday said. "They usually come with a higher price tag, but having more options helps." For older seniors, the county
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
can arrange home-delivered meals to improve nutrition and offer daily contact with someone who can check on them. "It can help them stay upbeat," Sunday said. "That's very important for their mental and physical health." Don't use tobacco products. Any alcohol consumed should be in moderation. Keep in mind that as you age, you may need modifications in your home to keep you safer such as brighter lights to avoid tripping in the evening. Many agencies offer home assessments for seniors. Staying active helps with weight control and can help you stay healthier as you age. Even if you already feel the effects of arthritis, it's important to keep moving. Sunday encourages seniors to stay active to stay healthy, seeking the help of friends, family, community resources such as
a senior group or center, and social media for fitness ideas and tips. Strive to exercise vigorously for 30 minutes most days of the week, such as briskly walking or playing an active sport you enjoy. Get involved with a fitness program, physical activity class or walking club. The socialization helps you stay motivated and can help you stay connected, which is another factor in aging well. Volunteering, joining a club or place of worship, and spending time with friends and family helps keep the mind active. Kelly Schalk teaches yoga, mindfulness and fitness for seniors at Metro Fitness East in Syracuse. She encourages seniors to de-stress. "More mindfulness relieves stress and unblocks energy channels," she said. She said that modalities such as acupuncture and chiropractic have become popular because they promote wellness for both the mind and body. "We're not really listening to our emotions and we're just reacting," Schalk said. "We're not digesting and processing and that shows up in the heart and liver. That's the center of Eastern healing." It's also important to remain vigilant about your health. Write down questions you have for your care provider. At routine appointments, ask questions about your health. Follow your care provider's orders, and take any prescription medications or supplements suggested. Ask for help if you don't understand. Pharmacists may also help you understand prescription directions, for example.
Golden Years Local Groups Fight Back Against Senior Poverty
Overall poverty rate for those 65 and older in Syracuse is 16.7 percent. By Matthew Liptak
P
overty among the older population is a problem. In Syracuse alone 34 percent of Latino residents 65 and older are living below the federal poverty line, according to a report put out earlier this year by the New York State Community Action Association. The overall poverty rate for those 65 and older in the city is 16.7 percent. Those are daunting numbers and community leaders don't take them lightly. They see the increasing need to help aging Central New Yorkers every day at work and they are trying to increase their organizations' ability to serve them. “We're seeing more food insecure seniors,” said Mason Kaufman, executive director of Meals On Wheels Syracuse. “That means they're going to end up with more hospitalizations, longer hospital stays. They're going to end up with more Kaufman chronic conditions. That impacts health care costs. It impacts Medicaid. Individuals end up in nursing homes. So tax payer dollars are affected as well.” Meals on Wheels Syracuse served nearly 197,000 low-cost meals to program participants last year. With an aging baby boomer population those numbers are only likely to grow. Kaufman puts the blame of senior poverty primarily on two
culprits, the one-two punch of a fixed income and rising healthcare costs. “For almost everybody it cuts your income at least in half when you retire,” he said. “To think that you were just about making it when you were working I don't know how you make it when you're not working. I think Social Security for some might be adequate, but for most you really got to watch your pennies.” Increasing health care costs can cause a vicious cycle of declining quality of life as you get older. Some seniors may choose to buy food rather than pay for medicine or pay for medicine and refrain from eating as much. Either way they may be called on to sacrifice truly healthy choices, which can lead their health into decline and hospitalization. There is also the reality of trying to maintain a home with all that entails when your income is limited. There can be a lot of challenges. Fortunately there is help out there. There are many organizations including Meals on Wheels, who are on a mission to help seniors. Lisa Alford is Onondaga County's Commissioner of the Department of Adult and Long-term Care Services. She is quick to point out that her department can put all seniors, not just low income, in touch with over a 100 Alford programs in the community that may be of help.
“It's tons of organizations that we work with,” Alford said. “That's part of our role. We are a clearing house of information and assistance on services for seniors. They don't have to know what they need. They call our office. That's why I always tell people don't think you don't need to call us if you don't exactly know.” The county department hosts its own services for seniors too, some of them for older low-income residents. And it is always reviewing ways it can better serve them. At the end of October last year the department held public hearings in two locations to find out what they could do to better serve older residents. Alford said there were about 50 attendees at the hearing that took place in Syracuse and 80 people that came to the hearing that took place farther out in the county. She called the feedback received “robust.” They got suggestions including everything from improving the transportation options for seniors to adding more programs that would help with home and auto care. “We have lots of great ideas,” Alford said. “What we try to do is see if there are ways in which we or someone else in the community can address those needs and develop those types of programs or maybe make some adjustments so people are able to get some of what they need.” There are already some transportation options for seniors. There is also a shopping program. That program helps seniors who can prepare their own meals, but can't get out to shop for the food. It covers a gap that Meals on Wheels, which provides prepared meals, doesn't. May 2016 •
Alford also said the county has 40 dining sites that provide meals to seniors 60 and above. There is a suggested donation, but patrons don't have to pay anything to eat. “We have those dining sites where folks can actually have a meal as well as an opportunity for socialization,” she said. Other programs include legal aid for simple matters such as wills and landlord issues, health insurance counseling and assistance, a small home repair program, non-medical in-home care and a senior employment program. “That's what we always want to get across to seniors,” she said. “We have the ability to help you stretch those dollars.” Keeping older residents in their homes not only can increase the quality of life, but it helps other taxpayers by lowering healthcare costs. The longer someone can stay in their home the longer they avoid more expensive institutional care. Alford said the services the department provided were also a way to help seniors put off spending down to Medicaid. Spending down is the process of spending excess income in order to qualify for coverage by a healthcare plan like Medicaid. Older residents are a vital part of the Central New York community. That includes those who are coping with poverty. They have not been forgotten by their neighbors. Local leaders are working to improve the quality of life for the population. “It's the right thing to do to help people be able to age in place and continue to be vibrant and active members of our community,” Alford said. “There are just some many things that older adults add.” Kaufman, too, believes everyone should care about senior poverty. “Just as a human being, knowing that your neighbors are suffering and you don't care about it — you have to look yourself in the mirror,” he said. “Because it could happen to you as well. As you get older these issues will face you.” For more information on programs of the Onondaga County Department of Adult and Long-term Care Services call 315-435-2362. For information on Meals on Wheels Syracuse call 315-470-5940.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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The Social Ask Security Office By Deborah Banikowski District Manager, Syracuse
R Home Care by Seniors for Seniors There’s a huge difference in the kind of home care you can receive from someone who really understands what your life is like as a senior. The concerns you have. The need for independence. Someone who, like you, has a little living under his or her belt. Our loving, caring, compassionate seniors are there to help. We offer all the services you need to stay in your own home, living independently. • Transportation • Shopping • Doctor Appointments • Companion Care • Housekeeping services • Meal preparation/cooking • 24-Hour Care • and more Call us today. Like getting a little help from your friends.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
What is FICA?
eceiving your first paycheck is an empowering milestone. Do you remember being a little shocked by the taxes that Uncle Sam takes out of each paycheck? Understanding how important your contribution is takes some of the sting away because your taxes are helping millions of Americans — and financially securing your today and tomorrow. By law, employers must withhold Social Security taxes from workers’ paychecks. While usually referred to as “Social Security taxes” on an employee’s pay statement, sometimes the deduction is labeled as “FICA.” This stands for Federal Insurance Contributions Act, a reference to the original Social Security Act. In some cases, you will see “OASDI,” which stands for Old Age Survivors Disability Insurance, the official name for the Social Security Insurance program. The taxes you pay now mean a lifetime of protection — for retirement in old age or in the event of disability. And when you die, your family (or future family) may be able to receive survivors benefits based on your work as well. Right now you probably have family members — grandparents, for example — who already are enjoying Social Security benefits that your Social Security taxes help provide. Social Security is solvent now and will be through 2033. At that point, we’ll be able to fund retirement benefits at 75 percent unless changes are made to the law. In the past, Social Security has evolved to meet the needs of a changing population — and you can count on Social security in the future.
Q&A Q: I received a notice from Social Security recently. It said my name and Social Security number do not match Social Security’s records. What should I do? A: It’s critical that your name and Social Security number, as shown on your Social Security card, match your employer’s payroll records and your W-2 form. If they don’t, here is what you need to do: • Give your employer the correct information exactly as shown on your Social Security card or your corrected card; or • Contact your local Social Security office (www.socialsecurity.gov/ locator) or call 1-800-772-1213 (TTY 1-800-325-0778) if your Social Security card does not show your correct name or Social Security number. For more information, visit our website at www.socialsecurity.gov.
Because you’re a long way from retirement, you may have a tough time seeing the value of benefit payments that could be many decades in the future. But keep in mind that the Social Security taxes you’re paying can provide valuable disability or survivors benefits in the event the unexpected happens. Studies show that of today’s 20-year-olds, about one in four will become disabled, and about one in eight will die, before reaching retirement. Be warned: if an employer offers to unlawfully pay you “under the table,” you should refuse. They may try to sell it as a benefit to you since you get a few extra dollars in your net pay. But you’re really only allowing the employer to deprive you from earning your Social Security credits. This could keep you from qualifying for any benefits, or result in you receiving less than you should. Also, don’t carry your Social Security card around with you. It’s an important document you should safeguard and protect. If it’s lost or stolen, it could fall into the hands of an identity thief. Check out our webinar, "Social Security 101: What's in it for me?" The webinar explains what you need to know about Social Security. You can find it at http://go.usa.gov/ cdNeY. If you’d like to learn a little more about Social Security and exactly what you’re earning for yourself by paying Social Security taxes, take a look at our online booklet, How You Earn Credits, at www.socialsecurity. gov/pubs/10072.html. You can also learn more at www. socialsecurity.gov.
Q: How do I report a lost Social Security card? A: You don’t have to report a lost Social Security card. In fact, reporting a lost or stolen card to Social Security won’t prevent misuse of your Social Security number. You should let us know if someone is using your number to work (call 1-800-772-1213; TTY 1-800-325-0778). If you think someone is using your number, there are several other actions you should take: • Contact the Federal Trade Commission online at www.ftc.gov/ bcdp/edu/microsites/idtheft or call 1-877-ID-THEFT (1-877-438-4338); • File an online complaint with the Internet Crime Complaint Center at www.ic3.gov; • Contact the IRS Identity Protection Specialized Unit by calling 1-800-908-4490, Monday – Friday, 8 a.m. to 8 p.m.; and • Monitor your credit report.
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Booster Shots Recommended for Seniors Dear Savvy Senior, I just turned 65 and would like to find out what types of vaccinations are recommended to Medicare beneficiaries, and how they are covered. Health Conscious Dear Conscious, Most people think that vaccinations are just for kids, but adults, especially seniors who tend to have weaker immune systems, need their shots too. Here’s a rundown of what vaccines the Centers for Disease Control and Prevention (CDC) recommend for seniors 65 and older, and how they’re covered by Medicare. Flu (Influenza): While you probably already know that flu shots are recommended every fall to all seniors, you may not know that those over 65 also have the option of getting a high-dose flu vaccine instead of a regular flu shot. This vaccine — known as the Fluzone High-Dose — has four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. All annual flu shots are covered under Medicare Part B. Td/Tdap (tetanus, diphtheria, pertussis): A one-time dose of the Tdap vaccine, which covers tetanus, diphtheria and pertussis (whooping cough) is recommended to all adults. If you’ve already had a Tdap shot, you should return to getting a tetanus-diphtheria (Td) booster shot every 10 years. All Medicare Part D prescription drug plans cover these vaccinations. Pneumococcal: This vaccine protects against pneumonia, which kills about 50,000 Americans each year. It’s now recommended that all seniors, 65 or older, get two separate vaccines — Prevnar 13 and Pneumovax 23 — at different times. Medicare Part B covers both shots if they are taken at least 11 months apart. Shingles (zoster): Caused by the same virus that causes chicken pox, shingles is a painful, blistering skin rash that affects more than 1 million Americans each year. All people over age 60 should get the Zostavax vaccine, even if they’ve had shingles
before. All Medicare Part D prescription drug plans cover this one-time vaccination, but coverage amounts and reimbursement rules vary depending on where the shot is given. Check your plan. Varicella (chickenpox): If you’ve never had the chicken pox, this two-dose vaccine (called Varivax) is recommended to adults, and is also covered by Medicare Part D plans. Hepatitis A: This is a two-dose series of shots recommended to adults that have chronic liver disease, a clotting-factor disorder, have samesex male partners, illicit injectable drug use, or who have close contact with a hepatitis A-infected individual or who travel to areas with a high incidence of hepatitis A. These shots are covered by Medicare Part D drug plans. Hepatitis B: This three-dose series is recommended to adults who are on dialysis, have renal disease or liver disease, are sexually active with more than one partner, have a sexually transmitted disease or HIV. These vaccinations are covered under Medicare Part B. Meningococcal: Adults 56 and older, who have had their spleen removed, have certain blood deficiencies or plan to travel to parts of the world where meningitis is common, should receive the meningococcal polysaccharide vaccine. This is covered by Medicare Part D. To help you get a handle on which vaccines are appropriate for you, take the CDC’s “What Vaccines Do You Need?” quiz at www2.cdc. gov/nip/adultimmsched. Also, talk to your doctor during your next visit about what vaccinations you should get. If you can’t remember which vaccines you’ve already had, check with your past doctors to see if they have any records, or contact your state’s health department. Some agencies have vaccination registries (see vaccineinformation.org/state-immunization-programs) that may help you. If you can’t locate your records, your doctor can give you blood tests to see if you’re immune to certain vaccine-preventable diseases. Or, they may just give you the shot. It’s safe to repeat vaccines, according to the CDC.
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Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. May 2016 •
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H ealth News AccessCNY executive director to retire Prudence York, executive director of AccessCNY, has announced her retirement from the agency, effective Sept. 1. The agency’s board of directors anticipates hiring a new leader this summer to shadow the outgoing director for a period of several weeks before her departure. “After a York career that began in 1979 working directly with people with disabilities, I am retiring to spend time with my husband kayaking, hiking and finding new ways to give back to our community,” York stated in an announcement to staff. “Over 37 years I had the rare privilege of being part of a revolution — a revolution that fought to establish basic human rights for people with disabilities.” York’s leadership was one of many guiding forces that led to the creation of AccessCNY in 2015. The agency was formed as the result of the merger of Enable and Transitional
Living Services. Under York’s guidance, the agency grew from serving 1,500 individuals with development disabilities with a budget of roughly $18 million to an agency that serves over 3,000 people with developmental disabilities, acquired brain injuries or mental health issues. AccessCNY has an annual operating budget is currently over $32 million. York joined Enable in 1986 as a recognized pioneer in developing innovative employment programs for people with disabilities. Prior to being named executive director in 2012, York served as the agency’s director of community services for individuals with development disabilities. “I have been rewarded with a career that has taught me that challenge brings opportunity, perseverance brings rewards, and that we are stronger when we work together,” York said.
Lab Alliance opens location at Township 5 Those who reside or commute west of Syracuse soon can have their lab work done at Laboratory Alliance of Central New York’s patient service center at Township 5 in Camillus, just off Route 5 at Hinsdale Road. The center, which opened April 4, is located at 260 Township Blvd., suite 40 in the Township 5 Medical
Ribbon cutting at HCR Home Care in E. Syracuse. Company serves more than 600 people in the CNY region and expects that number to rise.
HCR Home Care Opens CNY office HCR Home Care has chosen East Syracuse as headquarters for its Central New York operations. The new, 2,862 sq.-ft. office is located at 6007 Fair Lakes Road, suite 200. “HCR Home Care provides high-quality, in-home health care services in Central New York, from nursing and social work, to physical, occupational and speech therapy,” said Elizabeth Zicari, president of HCR Home Care. “This new, centralized office enables us to expand our services to more people in the region and to provide greater support for our local clinical staff.” HCR also has an office in Homer in Cortland County. HCR began serving Cortland and Madison counties in 2011, and it expanded Page 24
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into Onondaga, Cayuga, Jefferson and Oswego counties in 2014. Patient care needs in the region are met by HCR’s team of nearly 90 local health care professionals dedicated to the company’s mission of fostering and advancing people’s health. Under the leadership of Shannon Youmans, director of patient services, HCR’s clinical staff provides home care visits to people across the region, including care visits from registered nurses; home health aides; physical, occupational and speech therapists; and medical social workers. The company currently serves more than 600 people in the Central New York region of Cayuga, Cortland, Jefferson, Madison, Onondaga and Oswego counties.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
Buildings. It is in the same plaza as Costco and numerous retailers and restaurants. “When a doctor orders lab work, patients will choose convenience,” said Jeff Coyne, director of support services. “Prompt and courteous attention from our healthcare professionals should keep them coming back.” Appointments are not necessary at any of the 12 Laboratory Alliance patient service centers, and parking at this location is nearby and free. The center is open weekdays from 8 a.m. to 4:30 p.m., and closed for lunch from 12:15 to 1 p.m. daily. Laboratory Alliance employs more than 400 local professionals.
Primary Care Center West adds physician Physician Karla Martinez-Dulmer has joined the Primary Care Center – West location, operated by St. Joseph’s Health. Martinez-Dulmer earned her Doctor of Medicine from University of Guadalajara, College of Medicine in Guadalajara, Martinez Jalisco, Mexico. She completed her residency in obstetrics and gynecology at the Mexican Institute of Social Security in Guadalajara and most recently completed her residency in family medicine at St. Joseph’s Hospital Health Center in Syracuse. The Primary Care Center – West provides primary health care for children and adults and offers 24-hour physician coverage, seven days a week, and offers Spanish translation. “We are pleased to welcome Dr. Martinez-Dulmer to our team as we continue to enhance services and options for primary care services at our westside location,” said physician Luis Castro, medical director and primary care physician at St. Joseph's Primary Care Center. “Her experience in caring for women and children is exceptional and will be a great asset to our prenatal services.” Martinez-Dulmer has worked as a primary care physician and in women’s health outpatient and surgical management. She is a member of the American Academy of Family Physicians and is fluent in English and Spanish.
Physician Michael Tong returns to Liverpool St. Joseph's Physicians Family Medicine, an affiliate of St. Joseph's Health, announced the return of physician Michael Tong to its North Medical Center location in Liverpool. Tong came to the United States from Vietnam when he was just 13 years old. Although he spoke no
English when he arrived in Syracuse, Tong went on to graduate from Marcellus High School, Hobart College and received his Doctor of Medicine degree from Upstate Medical University. "We are Tong very excited that Dr. Tong has chosen to return to our practice," said Julianne Himes, chief operating officer for St. Joseph's Physicians. "Dr. Tong lives his passion for helping the people of our community every day. His expertise, values and innate desire to provide care to underserved populations strengthens our ability to provide excellent care throughout Central New York." "Immigrant populations are often underserved by the medical community because of language barriers or cultural issues," said Tong. "I am so happy to be back with my colleagues at St. Joseph's; the facilities and staff make it possible for me to help patients thrive." Fluent in Vietnamese, Tong is one of the primary physicians serving the growing Vietnamese community in the area.
St. Joe’s: 14 residents in family medicine program The St. Joseph's Hospital Health Center family medicine residency has filled all 14 positions for the class of 2020 with highly qualified medical students from eight different medical schools. The family medicine residency program at St. Joseph’s is the largest in New York state. The program started in the late 1960s and has almost 600 graduates, over 80 percent of whom practice or have practiced in New York state. These nearly 600 graduates represent the second highest total of all programs in the country. “About 70 percent of family physicians practicing in Onondaga County have graduated from the St Joseph's program,” said physician James B Tucker, director of St. Joseph’s family medicine residency Program. “Several of our current students have roots in Syracuse and we are hopeful they will practice here upon graduation.” Additionally, the St. Joseph's Hospital Health Center transitional residency program had a successful Match Day, filling all six positions for the class of 2017 with medical students from five different medical schools. And the St Joseph's Hospital Health Center general practice dental residency filled all five positions for the class of 2017. Residents in these programs have access to many different ambulatory, inpatient, clinical and other patient care experiences at institutions throughout the community, includ-
H ealth News ing specialized programs in sports medicine and nursing homes.
St. Joe’s has new PR, marketing chief Jamie Arnold has been named communications and marketing officer for St. Joseph’s Hospital Health Center. He will oversee all marketing, public relations, internal and external communications and media relations programs and will provide strategic oversight on network integrity Arnold and patient alignment efforts. “Jamie is a communications veteran with extensive knowledge of the health care industry gained from an impressive mix of corporate and agency experience which will be instrumental to the success of our hospital system,” said Kathryn Ruscitto, president and chief executive officer of St. Joseph’s Hospital Health Center. “He will work closely with me and other members of my staff to help us execute our mission to provide the best possible health care services to our patients and advance the health of the communities we serve.” Most recently, Arnold served as corporate communications manager at Welch Allyn in Skaneateles Falls. Prior to joining Welch Allyn, Arnold worked as an account supervisor in the public relations and public affairs
group at Eric Mower and Associates, a leading advertising agency with a public relations practice that consistently ranks in the top 5 percent of all PR firms in the U.S. by PR Week magazine. Arnold earned his bachelor’s degree from Le Moyne College, and is currently pursuing a master’s degree in communications management from the S.I. Newhouse School of Public Communications at Syracuse University. He is a past-president of the Central New York Chapter of the Public Relations Society of America (PRSA-CNY) and a former member of the board of directors of Junior Achievement of Central New York. An accredited member of PRSA, Arnold was a recipient of the Central New York Business Journal’s 40 Under 40 Award and PRSA-CNY’s Rising Star Award. He resides in Baldwinsville, New York with his wife and daughter.
Murtaugh
nity Tennis Association; board member of Sedgwick Farms Tennis Club; longtime influential member of the 17th ward Democratic Committee in Syracuse; and a strong advocate for United Way. He is married to Bill Louer and resides in
Syracuse. He has been instrumental in expanding ACR Health’s work through new programs: health homes, which expands care management services to
non-HIV positive clients; the criminal justice initiative, which educates inmates about HIV in state correctional facilities; and the syringe exchange program, which makes clean needles available to injection drug users and curtails HIV and hepatitis infections; Narcan trainings for the public; extensive insurance and health care advocacy programs; expanded HIV and STD testing opportunities; 340b pharmacy service; and a larger fleet of mobile prevention outreach units, among other projects. “The board of directors has absolute confidence that Wil has the experience, integrity, and vision required to guide ACR Health into a successful future while maintaining quality and lifesaving programs,” said Andrew London, chairman of ACR Health’s board of directors.
ACR Health Has New Executive Director ACR Health has named Wil Murtaugh as executive director to replace Michael Crinnin, who retired in March after serving in that position since 1989. Murtaugh has been with ACR Health for 23 years, beginning in 1993. He became deputy executive director in 2009. He received a Bachelor of Science degree in business administration with concentrations in human resources and finance at Syracuse University in Utica. He holds a master’s degree in economics from the Maxwell School of Syracuse University. Murtaugh is the past president of the Central New York CommuTeam of nurses who work at Crouse Hospital’s Kienzle Family Maternity Center. The center was recently recognized by Onondaga County Health Department for its effort to prevent hepatitis B in babies.
Crouse’s Maternity Recognized for Preventing Hepatitis B in Babies
Bishop’s Commons Celebrates Sweet 16 Anniversary Residents at Bishop’s Commons Enriched Housing residence in Oswego gathered recently to mark a very special milestone — 16 years of providing a unique residential setting combining care and supportive services for seniors in the community. Pictured getting ready to cut into the birthday cake as part of the celebration are (left to right),
residents Phyllis Blake; Mae DeCastro; Karen Murray, executive director; and Frances Cliff. During the party, Murray recalled both the excitement and satisfaction of being the first provider in Oswego County to bring a much needed level of service to the area, and all of the many wonderful people who have over the years called Bishop’s Commons “home.”
The Onondaga County Department of Health recently presented a certificate of excellence to Crouse Hospital’s Kienzle Family Maternity Center for its higher-than-average birth dosing rates to newborns to prevent hepatitis B, a serious infection that affects the liver and can result in chronic infection or death. In 2015, 99.1 percent of all babies born at Crouse were vaccinated against hepatitis B. Crouse has the highest hepatitis B vaccination rate among hospitals in Syracuse. Crouse is the largest provider of maternity care services in the region, delivering nearly 4,000 babies annually and caring for more than 1,000 premature and critically ill infants in its Baker Neonatal Intensive Care Unit. Babies normally receive three doses of hepatitis B vaccine: the first dose within 12 hours after birth; a second dose at 1 to 2 months of age; May 2016 •
and a third dose at 6 to 18 months of age. Hepatitis B is caused by the hepatitis B virus. In 2013, about 19,764 people became infected with hepatitis B. Some people go on to develop chronic hepatitis B infection, which is more common among infants and children than among adults. People who are chronically infected can spread hepatitis B virus to others, even if they don’t look or feel sick. Routine hepatitis B vaccination was recommended for some U.S. adults and children beginning in 1982, and for all children in 1991. Since 1990, new hepatitis B infections among children and adolescents have dropped by more than 95 percent — and by 75 percent in other age groups, according to the Centers for Disease Control and Prevention. Vaccination gives long-term protection from hepatitis B infection, possibly lifelong.
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M A Y
I S
S T R O K E
A W A R E N E S S
M O N T H
Stroke. When every moment matters, say “Take me to Crouse.” Is it a stroke? Check these signs FAST: Face: Does the face look uneven? Ask the person to smile. Arm: Does one arm drift down? Ask the person to raise both arms. Speech: Does the person’s speech sound strange? Ask the person to repeat a phrase. Time: Every second, brain cells die. CALL 911 at any sign of a stroke.
CEO Aileen Balitz Gets Highest Honor from LeadingAge New York LeadingAge New York recently announced that it has awarded its highest honor, the Lawrence E. Larson Memorial Award of Honor, to Aileen M. Balitz, president and chief executive officer of The Centers at St. Camillus in Syracuse. LeadingAge New York represents nonprofit, mission-driven and public continuing care providers, including nursing homes, senior housing, adult care facilities, Balitz continuing care retirement communities, assisted living and community service providers. The organization’s highest award honors the late Larry Larson, the association’s first chairman, and pays tribute to his distinguished service, dedication and foresight in aging services. The award is given to a member who has made outstanding contributions to the field and is a recognized leader at the state and
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national level with a reputation for humanitarian achievement and professional vision. Aileen Balitz began her career as a speech therapist in Jacksonville, Fla., which soon brought her to the then-named St. Camillus Health & Rehabilitation Center in Syracuse. Here she was then promoted to director of speech and audiology services, followed by director of professional services, and assistant administrator. In 1991, Aileen was appointed to her current position as president and CEO of The Centers at St. Camillus. According to a news release, LeadingAge New York chose to bestow its highest honor on Balitz because she inspires her colleagues with her steadfast compassion, commitment to quality and dedication to the individuals St. Camillus serves. In addition, she leads by example and by doing, and is known and highly respected for her work ethic. She is equally active in day-to-day operations as she is in long-term planning. Balitz has been actively involved in community and state organizations, such as Leadership Greater Syracuse, the Long Term Care Executive Council, LeadingAge New York,
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
the Healthcare Financial Management Association, the Foundation for Long Term Care, the Long Term Care Coalition, and Project Home. Aileen earned a Bachelor of Science degree from St. Bonaventure
crouse.org/stroke
University, and two graduate degrees, a Master of Science degree and a Master of Business Administration degree, from Syracuse University. She resides with her husband David in Jamesville.
Oswego Health Recognizes Its Volunteers and Auxilians
Oswego Health honored its volunteers and auxilians at a special luncheon held during National Volunteer Week at Springside at Seneca
Hill. More than 60 volunteers and auxilians attended the event. “You make the equation complete. We can’t do what we do every day without you folks. You touch virtually everything that goes on in our organization,” said Oswego Health President and CEO Chuck Gijanto. He had special recognition for Emma Corradino, who has been volunteering her time at Oswego Hospital for 30 years. “That is a career, and from the bottom of our hearts we thank you, as well as all the other volunteers for all that you do.” The volunteers who celebrated milestone years and those who donated the most hours this past year were honored at the luncheon. Seated from left are Terri Smith, 25 years; Emma Corradino, 30 years; and Gladys Little, 15 years. Standing from left are Wanda Watkins, ten years; Don White, five years; Orlando Testi, who has volunteered 630 hours, the second most of any volunteer; Maurice “Mo” Laws, who volunteered the most hours this year, with 1,600; Arlene Townsend, ten years; and Dawn Smith, Oswego Health Volunteer/Clinical Support Coordinator. Residents interested in volunteering at Oswego Health, can call Smith at 349-5566.
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Oswego Now Partners with Orthopedic Specialists (SOS) Oswego Health and Syracuse Orthopedic Specialists (SOS) have announced a collaboration, which will bring SOS orthopedic surgeons to Oswego County to provide care. The SOS physicians will provide office visits in Oswego Health’s orthopedics suite and will conduct surgeries in the Oswego Hospital Surgery Center. It is expected that SOS will begin to provide care alongside Oswego Health orthopedics staff, this summer. “This collaboration will complement the excellent skills of our orthopedic team here at Oswego Health,” said President and CEO Chuck Gijanto. “We look forward to adopting their protocols that have enabled SOS to become one of the best-known groups for orthopedic
care in the region.” Mike Humphrey, SOS CEO said, “This is a great opportunity for us to offer high-quality efficient care in Oswego County. Healthcare keeps changing and I think the future is all about collaboration and looking at the best way to provide effective care.” Oswego Health currently has one independent orthopedic surgeon and two employed orthopedic surgeons on the medical staff. “We realize that in order to continue to be successful in offering orthopedic care, we needed to enhance our services,” Gijanto said. “Gone are the days of a single orthopedic provider or a small practice. Specialization has become the norm and it’s what the patient expects.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016