2015 Medical Directory

Medical 2 01 5

DIRECTORY

A supplement to the Daily Record

IN SIDE : Healthy recipe makeovers How to keep from getting sick Health benefit exchange update And More

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A special publication of the Daily Record

2015 Medical Directory

Table of contents

Help with health care signups Page 8

Swapping out meat for veggies Page 2

Helpful app for dieting Page 12

Delicious quinoa recipe Page 6

Employer-led health plans Page 14

Avoiding winter illness Page 10

New ideas in world of back pain Page 18 1 | Medical Directory 2015

Brian Myrick / Daily Record

A large group gathers to dine during a vegetarian potluck dinner at the Oddfellows Lodge in Ellensburg in December

Swapping out the meat How to make over your recipes with more vegetables

By LAUREN TAKORES staff writer

E

llensburg resident Willow Jean Lyman, 77, credits her vegan diet, free of animal products like meat, dairy and eggs, as the reason for her good health.

She takes no medications and doesn’t get sick with colds currently. But at age 60, Lyman started having health problems, so she tried

a vegetarian diet, eliminating beef, pork, poultry and fish. After about five years, she became vegan, further eliminating dairy, eggs and other animal byproducts from her diet.

At the Ellensburg Vegetarian Society monthly potluck on Dec. 16, an event held third Tuesdays at the Oddfellows Hall in Ellensburg, Lyman discussed plant-based diets with a couple other guests.

Her biggest health result came from eliminating dairy, Lyman said.

“Dairy is the worst,” Lyman said, “because you’re getting hormones, fat, the bad kind of fat.”

Miquelle Radich, 20, went vegetarian after graduating from Ellensburg High School two years ago.

“When I don’t eat dairy, I feel way better,” she said.

Radich attended the potluck

2 | Medical Directory 2015

with Tess Maczis, 20, who has been vegetarian on and off for about six years.

“After I go back to eating meat, I definitely feel horrible,” Maczis said, like experiencing “the sweats” for two weeks.

Dropping the meat makes a huge difference, she said.

“I had so much more energy,” she said. “I adjusted to (the energy boost), but I feel so much better.”

Health benefits It’s always a good idea to talk to a health care professional before introducing diet and other lifestyle changes.

Kelly Pritchett, PhD, RD and national media spokesperson for the Academy of Nutrition and Dietetics, is assistant professor of nutrition and exercise science at Central Washington University. She said there are several advantages to eating less meat and more vegetables.“One thing we can do is swap out meat with vegetables,” Pritchett said. For example, adding spinach, cannelloni beans or vegetables from fridge that need to be eaten right away to a meal of spaghetti and sauce can be an easy way to create a nutrientrich meal.

“Swapping out meat for vegetables and beans means meals that are lower in calories, higher in fiber, and you’ll feel fuller,” Pritchett said.

Meals high in vegetables also mean decreased cholesterol levels, reduced risk for heart disease and a better weight.

See Veggies, Page 4

Brian Myrick / Daily Record

Diners sit down to full plates during a vegetarian potluck dinner at the Oddfellows Lodge in Ellensburg in December.

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VEGGIES Continued from Page 3 Nutrients commonly found in meat — like iron and protein — can be found in the plant world and offer the vitamins without the fat and calories of meat. Dried beans, fortified cereals, enriched grains, dried fruit, lentils, peas, leafy greens, nuts and seeds are protein- and iron-rich. Eating iron-rich foods with vegetables high in vitamin C, like red bell peppers, will help absorb iron into the body.

Another way to boost iron is to cook in a cast iron skillet.

The more watery the food, like sauces or tomatoes, the more iron from the skillet will be absorbed into the food.

Flexitarian Any dietary change takes time to adjust, Pritchett said, and eating less meat and more vegetables is “not something average person would think about. It’s more of a personal preference.”

Some people call themselves “flexitarian,” meaning they incorporate vegetable-only meals into their diets but aren’t full blown vegetarians.

Participating in Meatless Monday, a campaign which began more than a decade ago, is a good way to introduce the idea of meatless meals and the consumption of more vegetables.

“By eating vegetable meals on a regular basis, it reduces cholesterol and saturated fats easily in our diet,” Pritchett said.

Meat isn’t the only food that can be replaced. Try using spaghetti squash instead of noodles in a recipe, or load up a pizza with spinach and vegetables.

Vegetarian and vegan Some people choose to abstain from animal products completely, including meat, dairy, eggs and sometimes honey.

Brian Myrick / Daily Record

Serving spoons dig in to the various offerings on the table during a vegetarian potluck dinner at the Oddfellows Lodge in Ellensburg.

4 | Medical Directory 2015

Ellensburg resident Cynthia Murray went from vegetarian to vegan 10 years ago, a move which lead her to try more interesting vegetables and fresh herbs.

“With vegetables you can eat lots, and you don’t have to worry about calories or cholesterol,” Murray said.

For Murray, a plate of food with a variety of colors and textures is important, carried over from her mother, who was a nutritionist and vegan for last 15 years of her life.

“The first thing to consider (is to) move the meat,” Murray said. “Look at the Asian diet, they use meat as a condiment, a small amount of something you add to a dish,” like adding meat or seafood to a bowl of rice and vegetables, instead of the other way around.

Commercial imitation meat is available, but Murray said those products are often full of salt, taste dry and come in lots of packaging.

Murray makes lots of soups and stews to preserve garden vegetables, adding kale, pumpkin, garlic, onions, beans, carrots and potatoes to a vegetablebased broth from stock or bullion.

Substitutes for animal products in baking were the biggest challenge for Murray. She said she learned to use applesauce, flax seed, bananas or egg replacer

six-ounce steak.”

“And you have to fill it up with something,” Radich said.

Protein comes from whole grains, oatmeal, nut butters, rice, beans and green vegetables. Calcium can be found in leafy vegetables, the darker the better, and fortified soy products and orange juice.

Vitamin B-12 can be found in fortified cereal, soy milk, nutritional yeast and in supplements. Omega-3 fatty acids come from walnuts, flax, flaxseed oil and soybeans.

Lyman suggested juicing Brian Myrick / Daily Record organic fruits and vegetables Nutrients commonly found in meat — like iron and protein — as a way for older or sick can be found in the plant world and offer the vitamins without people to consume nutrients the fat and calories of meat. without the fiber.

Murray said having support during dietary powder to bond baked goods opens up a world of dietary possibilities. changes is important, together without eggs.

“When you go vegetarian, whether by slowly moving Many foods are technically the proportions on your away from meat, dairy and vegan but not healthy, like plate change,” Maczis eggs, or going cold rutabaga chips and cookies. Taking said. “You don’t have that (instead of turkey). time to buy, prepare and eat good food will lead to a better diet and a greater variety of food choices.

The oldest and most “Roasting makes every affordable residential vegetable you would turn your nose up at delicious,” alcohol and drug Murray said.

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Getting enough to eat Successfully incorporating more vegetables and less meat depends on this variety. It’s not about what you can’t eat, but what you can. When this mental light switch is flipped, it

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AP Photo/Matthew Mead

A winter quinoa dish with apples and dried cranberries.

Vegetarian delight A quinoa dish that can be a side or delicious main

By MELISSA D’ARABIAN Associated Press

T

he first time I heard of quinoa was more than 14 years ago.

Like many of us, I pronounced it incorrectly.

But however I said it, I was glad I tried it. I was immediately hooked on those nutty little grains, and I ordered quinoa every time I ate there. Sometimes I made it the star of a meat-

less meal. Sometimes it nestled up to whatever meat I opted for.

One cooked cup of this “pseudo-cereal” (it’s actually the seed of a plant in the same family as spinach) offers 5 grams of fiber and 8 grams of protein, along with plenty of iron (a big plus for non-meat eaters) and B vitamins, but no saturated fat or cholesterol.

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Winter quinoa dressing with apples and dried cranberries Start to finish: 30 minutes Servings: 6

1 1/4 cups uncooked quinoa 1 3/4 cups low-sodium broth (chicken or vegetable) 1 tablespoon olive oil 2 tablespoons butter 2 sweet Italian turkey sausages, casings removed (optional) 2 small celery stalks (or 1 large), chopped (about 1 cup) 1/2 yellow onion, chopped (about 1 cup) 6 ounces fresh mushrooms, roughly chopped 1 apple, cored and diced 1/2 cup dried cranberries 1/4 cup pine nuts 2 cloves garlic, minced 1 teaspoon minced fresh rosemary

Directions In a large microwave-safe baking dish, combine the quinoa, broth and olive oil.

Cover and microwave for 11 minutes, then allow to sit in the microwave for another 2 minutes. Remove the dish from the microwave and stir the quinoa.

Depending on the power of your microwave, you may need to adjust the cooking time.

Meanwhile, in a large saute pan over medium heat, melt the butter. Add the sausage and cook, breaking up the meat with a spoon, until the meat is golden, about 7 minutes. Add the celery, onion and mushrooms, and cook until the vegetables are tender, another 7 minutes.

Add the apple, cranberries, pine nuts, garlic, rosemary and sage, then cook an additional 2 minutes.

Combine the quinoa with the sausage

use it during the week much as I would cooked rice — in cold salads, in hot side dishes like a stir-fry, or with stews and sauces. Sometimes I’ll drizzle warm quinoa with maple syrup and top it with berries and almonds for a hearty breakfast.

My recipe for winter quinoa dressing is a perfect dish for both newbies and quinoa pros.

It complements the gorgeous roasts of winter as a side dish, or can be served as a main event for a simple supper.

and vegetable mixture and serve immediately.

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The exciting protein news on quinoa isn’t necessarily the quantity (though that’s good, too), but the quality.

Quinoa offers all nine essential amino acids in the quantities required to make it a complete protein (unusual for vegetablebased protein sources).

Another bonus: It’s gluten-free, which makes it a great option for hosting gluten-free guests or for families (like mine) that have gluten-free members.

I like to cook up a batch of quinoa on the weekends, then

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Contributed

Julianna Salazar, left, an in-person assister at Yakima Neighborhood Health Services, assists Estephanie Lopez, 19, of Yakima, with applying for coverage through Washington Healthplanfinder.

Affordable Care Act II Washington health plans enter second year

By LAUREN TAKORES staff writer

T

ens of thousands of Washingtonians have enrolled in or renewed their health insurance plans through Washington Heathplanfinder, an online marketplace for health insurance.

Between Nov. 15 and Dec. 10, nearly 56,000 people either enrolled in qualified health plans or renewed their coverage for

2015 through Washington Healthplanfinder.

Another 480,000 new adults enrolled between October 2013 and Dec. 4 in Washington Apple Health, the state’s Medicaid program, and more than 60 percent of current Washington Apple Health clients have been automatically renewed.

A qualified health plan needs to meet minimum standards under the Affordable Care Act, also known as

Obamacare, and be certified by the state exchange, like Washington Heathplanfinder, or federal exchange.

Those enrolling between Dec. 24 and Jan. 23 will have coverage Feb. 1, 2015, and between Jan. 24 and Feb. 15 will have coverage March 1, 2015. Washington Apple Health enrollment is year-round.

This is the second enrollment period for Washington Heathplanfinder, which launched on Oct. 1, 2013.

8 | Medical Directory 2015

About 130,000 customers currently are enrolled in qualified health plans for 2014 coverage. Washington Heathplanfinder expects to gain an additional 85,000 customers during the current open enrollment period, which ends on Feb. 15, 2015.

“We are hoping to provide county level data in our December report that will come out in early January,” said Bethany Frey, Washington Heathplanfinder senior communications specialist.

Under the Affordable Care Act, the penalty for not having health insurance is increasing in 2015 to $325 per individual, or up to 2 percent of household income, whichever is greater.

Navigators To help customers use the Washington Healthplanfinder, navigators are available to help individuals and families sign up for medical coverage by walking through the steps with them.

Stephanie Black, Central Washington Heathplanfinder project coordinator at Yakima Neighborhood Health Services, the designated lead agency for Central Washington Healthplanfinder, said navigators have basic knowledge of medical insurance terms and can answer questions about the Washington Heathplanfinder system.

Help is given face-to-face and sometimes over the phone, she said.

Insurance-seekers can ask for assistance in Kittitas County at two partner agencies, the Kittitas County Public Health Department and Community Health of Central Washington.

Navigators also can be found by visiting the Washington Healthplanfinder website and using a zip code search.

For employers The Washington Healthplanfinder Business allows small business owners in Washington with up to 50 employees to compare health plans, decide their contribution level, manage payment and access broker

Enrollment numbers These numbers reflect qualified health plan enrollments through Dec. 10 and Medicaid Enrollments through Dec. 4.

Currently Enrolled

Qualified Health Plans New: 10,082 Qualified Health Plan Renewals: 45,843 Total: 55,925 Washington Healthplanfinder Business

Accounts Created: 1,550 Total Completed Applications – Link sent to employees: 73 Total – Employee plan selection complete: 3 support in one place. Enrollment is year-round.

The majority of businesses that have completed applications will provide their employees with a range of options in one metal tier of coverage–gold, silver or bronze–a benefit that is currently unavailable in the outside market, according to Washington Heathplanfinder.

with events and venues that attract “young invincibles,” as the campaign calls 18- to 34-year-olds.

The goal is to educate young adults about the benefits of finding and enrolling in health care coverage through Washington Healthplanfinder.

Outreach locations include concerts like the Sasquatch Music Festival, sports events like Seattle Seahawks football games and local roller derby bouts and places with heavy foot traffic, like happy hours in bars on Capitol Hill in Seattle.

The campaign also is reaching out through social media.

During the first open enrollment period, young adults made up 25 percent of new enrollees, and 29 percent of enrollments in the last month alone.

Website problems Washington Healthplanfinder hit a couple technical bumps since the open enrollment period started on Nov. 15.

The website was taken offline soon after opening due to a problem with the 2015 tax credit amounts coming from the state’s Department of Social and Health Services eligibility system, which were incorrect.

“There were fewer than 800 customers who had their eligibility determined incorrectly,” a Washington Healthplanfinder press release stated, “and less than 150 hundred customers who scheduled payment.”

On Dec. 2, an automated cancellation process error affected coverage for 6,000 customers enrolled in qualified health plans starting on Jan. 1. Outreach efforts have helped, according to a Washington Healthplanfinder press release.

Customers having trouble with the website may call the Washington Healthplanfinder Customer Support Center at 1-855-923-4633, or contacting a navigator through partner agencies.

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TNS

One simple way to help keep from getting sick during the winter is to wash your hands often.

Avoiding winter illness How to keep from getting sick when everyone else is

By LESLIE BARKER Tribune News Service

H

ere’s the most important way to avoid getting sick. In three words: Wash your hands.

Wash them long enough to sing the ABC song, says Dr. Laura Hanson of Texas Woman’s University.

Otherwise, microorganisms you’ve brought to the surface with that initial scrub won’t be completely

washed away.

During the winter, more people get sick because colder weather forces us indoors, says Jan Jowitt, director of nursing and infection-control officer at the University of North Texas Health Science Center. “You have a lot more contact with individuals in closed areas.”

Plus, the same people who may stay home the rest of the year when they’re sick

feel compelled to stagger into public places during November and December.

Every time you touch a doorknob, refrigerator-door handle, remote control, water faucet, gas nozzle, or you reach into a bowl of peanuts — all well-utilized places — well, let’s just say you’re not the first person to do so.

Although sometimes getting sick is inevitable, simple steps can stack the

10 | Medical Directory 2015

stay-well odds in your favor.

In general Maintain your routine.

Make sure you’re meticulous about this, says Christina Vargas, a Dallas ayurvedic health practitioner. Veering from your usual bedtime, types of foods eaten, as well as sleep and exercise regimens can throw off your schedule and thus, your immune system.

See Sick, Page 17

Get moving outside to stay healthy

By DAILY RECORD STAFF

Flu shots: The best protection against flu A flu shot is best protection against the seasonal flu, and it’s not too late to get one.

The most common influenza strain this season is influenza A (H3N2). According to the Centers for Disease Control, when this influenza A strain is the most common, flu season tends to be more severe. There is concern that as flu activity increases, this flu season could become severe, according to the Kittitas County Department of Public Health.

The CDC recommends that

everyone over the age of 6 months receive the flu shot every year. This year’s vaccine covers influenza A (H1N1 and H3N2) and an influenza B strain.

It is possible to get the flu, even after receiving the vaccine. You may have been exposed prior to the vaccine taking effect, or you may have been exposed to a strain of flu that is not covered in the vaccine.

Both nationally and in Washington State, some influenza A specimens have been character-

spreads germs.

Other winter health tips: ■ Use a humidifier in your house.

■ Cold weather does not make arthritis worse. People tend to do less in the winter, which makes it worse, Horsley said.

■ Don’t use the cold weather as an excuse to drink more alcohol. While it might feel warm in your stomach, it causes you to lose heat faster.

It’s also a depressant.

■ You can still get sunburned in the winter, so use sunblock, especially in higher elevations.

For runners and other

people exercising outside, dress appropriately.

“If it’s 25 degrees, dress for 10 to 15 degrees,” Horsley said.

“We have a pocket of air above our skin and when that gets moved away with wind, you need to warm up that area.”

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ized as strain that has drifted from this year’s vaccine. However, vaccination can still provide some protection against viruses that have drifted, and the vaccine will also protect against other flu strains that may become more common later in the flu season, according to public health.

For more information, go tocdc.gov/flu/index.htm. For questions about the flu vaccine or to schedule an appointment, call the Kittitas County Public Health Department at 509-962-7515.

Quality

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If you want to stay healthy in the long, cold Kittitas Valley winter, don’t hibernate.

Dr. Jack Horsley, medical director of the Central Washington University student health and counseling clinic and the medical director of Kittitas County Emergency Medical Services, said staying active can help people remain healthy. He recommends getting outside every day.

“People who tend to hibernate inside tend to have less energy,” he said. “Going outside and spending time going for a walk can help your brain and your metabolism.”

Getting cold or wet doesn’t make people more susceptible to getting sick in and of itself, studies have shown, he added.

To avoid getting sick, the best thing people can do is wash their hands, and use good hygiene.

“The way colds are transmitted is nose-to-hand, hand-to-nose contact,” Horsley said. “Regular hand washing and avoiding touching your face reduce your risk.”

Use a tissue or your elbow to cover your nose and mouth if you sneeze or cough.

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There’s an app for that Fitness software helps keep at-risk dieters on track

By ERYN BROWN Los Angeles Times

L

OS ANGELES — Qiana Sago knew she had a problem.

Three years ago, at age 30, she weighed 269 pounds.

She was taking pills for high blood pressure. Her triglycerides were “the highest you can have,” she said.

Working as an LAX airport custodian, she was surrounded by fast food, which became a daily staple.

“You ate (it) when you got to work, you ate it again midday,” she said. “Then I’d get off work and eat more.”

But, partly because she was provided access to unique fitness technology, the Inglewood, Calif., resident has turned things around — losing more than 40 pounds and working toward the day she can stop taking blood pressure medication.

Sago and 39 other young African-American women at Faithful Central Bible Church recently participated in a UCBC-backed clinical trial that used a smartphone app to track their eating and activity and teach them healthful diet and exercise habits.

Many such mobile health, or “m-health,” programs are in their infancy. But researchers and advocates for underserved, hard-to-reach patient groups hope they soon will contribute to major advances in the treatment of diabetes, heart disease and other chronic conditions.

Cellphones provide unprecedented, low-cost access to patients, experts say, because the technology is so widely used and the socioeconomic digital divide is shrinking. The Pew Research Internet Project reported earlier this year that

Francine Orr/ Los Angeles Times/TNS

Qiana Sago, 32, of Inglewood, Calif., took part in a UCLA heart health study that used cell phones to improve participants' eating and exercise habits. She lost weight during the study and reduced her high blood pressure medicine by half.

84 percent of U.S. adults with incomes below $30,000 a year had cellphones; 47 percent had smartphones.

Increasingly, phones — not home-based broadband connections — are the gateway to the Internet for all Americans.

“Anything that you’re doing online, that you want to extend to a low-income population, the way they’re most likely to access it is through mobile,” said Margaret Laws of the California Health Care Foundation in Oakland. Laws runs a program that hopes to use technology to help at-risk groups.

“Everyone has a phone,

even if it’s a throwaway,” added UCLA psychologist and researcher Vickie Mays.

Mays, who leads a center that focuses on addressing health disparities, collaborates with the university’s Wireless Health Institute, which backed the Inglewood study. Mobile technology offers a powerful tool to assist people seeking to change bad eating and lifestyle habits, she said, because it can reinforce medical advice after a patient leaves the doctor’s office.

Heart disease among young black women — a long-recognized problem — appeared to be an ideal condition to target with m-health programs, said Jo-Ann Eastwood, a nurse

12 | Medical Directory 2015

practitioner and associate professor at UCLA’s School of Nursing who ran the church group study.

“I was tired of seeing women come in at 55 years old and they’ve already had a heart attack,” she said. “Their illness hadn’t been picked up early enough. That’s what drew me to this population: Where could I do the most good?”

Busy lives Sago and the other women selected for the study all were between 25 and 45 at the time and had at least two risk factors for heart disease. They knew that they needed to eat well and exercise. But many

said they were too busy caring for their children and parents — and working long hours — to find time to care for themselves. They also needed help understanding nutrition labels.

Smartphones Eastwood taught the women about healthy-heart lifestyles and stress reduction in four diet-and-exercise classes before handing out custom-configured Android phones.

The devices were disabled for voice calls but could be used to text others in the study group. The phones were loaded with an app, developed at UCLA, that interacted with the women, sending daily and weekly questions — “Did you eat five to six servings of fruit today?”

— and tracking how much exercise they got via built-in accelerometers.

Study participants were supposed to wear the smartphones whenever they were awake. They also had to measure their blood pressure on Sunday nights, using Bluetooth-equipped blood-pressure cuffs that sent readings to the phones, which then streamed the data to the researchers. It took time to make the system work as planned, said Nabil Alshurafa, a PhD candidate who spent many days at Faithful Central tweaking the phone app. One

challenge was figuring out a comfortable way for the women to wear the phones during waking hours. He and Eastwood ultimately opted for passport pouches worn around the waist.

Eventually most of the women got used to lugging around the phones, which logged movement data several times a second.

Tracking patterns Blood-pressure readings spiked after the Fourth of July, the researchers noticed — a holiday when the women had loaded up on salty foods.

Due to signal and data variations, Alshurafa could also tell when one participant faked her workouts by shaking the phone in her hand instead of taking walks.

When unusual patterns of data were spotted, a nurse would give the subject a call, which at wavering moments reinforced the idea that someone was watching and that the diet and exercise goals were important, Alshurafa said.

Preliminary results from the study have been promising.

Compared with a control group, the church women had significant improvements in blood pressure and cholesterol levels, lower levels of anxiety and stress and improved eating and exercise habits.

The UCLA team reported their findings last month at an

American Heart Assn. scientific meeting in Chicago.

"They changed things that are very important for heart disease," Eastwood said, adding that many participants said the program had made them and their families healthier.

Sago, now 33 and a full-time student, cut red meat out of her diet and loaded up on vegetables. In addition to losing weight, she significantly improved her blood pressure and triglycerides.

No excuses The smartphone helped keep her honest.

"Everybody lies to themselves," she said. "But when you use the phone, you can't really lie. You can't cheat.

The phone showed that you did the work. It kept track every time you moved."

The phones appear to have been key in prompting

transformations like Sago's, Eastwood said.

"Women like to be connected," she said. "This was a good way for them to have some social support ... someone to cheer them on and keep them on the right track."

Eastwood will continue analyzing results in the coming months and hopes to revisit the women in a year and see how they've fared.

The Rev. Jackie Russell, Faithful Central Bible Church's director of community services and an early champion of the UCLA project, said such programs won't help everyone. But she thinks that if a cellphone app gets even a few of the 3,000 who come to the church each Sunday to improve how they eat or increase their exercise, it will be a success.

"If we throw a wide net, we expect to catch some," she said.

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Bob Mannschreck, 51, stretches his back as he lays on his living room floor after work on Nov. 3, in Renton. He has suffered from back pain since a skiing accident in his 20's. Bob has gotten treatment at the Virginia Mason spine clinic and is now able to return to an active lifestyle, including running.

Innovative medical care Employer-shaped medical system leads to better health, happier patients

By NOAM N. LEVEY Tribune Washington Bureau

E

VERETT — Forty miles north of Seattle, in the largest building in the world, Boeing assembles its biggest commercial airliners.

Thousands of workers on a 98-acre factory floor piece together hulking wings and fuselage pieces, miles of electrical wiring and millions

of rivets on a production line so precisely choreographed that Boeing can roll out a new jet every other day. The largest plane built here, the 747, has about 6 million parts.

With similar attention to detail, Boeing has helped shape medical care in and around Seattle, one of the healthiest regions of the country.

Employer-provided

coverage is the backbone of the U.S. health system, with more than half of Americans getting insurance through work. Most businesses, however, are reluctant to manage medical providers as they might other key suppliers.

It’s different on Puget Sound. Boeing and other major employers here, including Starbucks and

14 | Medical Directory 2015

Costco, have pushed local hospitals and doctors to meet the kinds of rigorous standards they use to build airplanes or brew coffee.

That has nurtured an unusual relationship between employers and medical centers that has affected how patients are treated for back pain, how they are counseled for depression, and even how they schedule doctors’ appointments.

The results include better health, higher patient satisfaction and in some cases lower costs, making the community a model as

employers and governments nationwide look to improve care. “In most communities, medical providers and employers don’t even talk,� said Dr. Gary Kaplan, chief executive of Seattle’s Virginia Mason Medical Center, one of the nation’s top hospitals. “Here, that conversation has made a profound difference in everything we do.�

Inspired in part by Boeing, Virginia Mason is among several local medical centers that use the same quality assurance system the aircraft company relies on at its plants, including standardized processes and precise scheduling to boost efficiency.

Different kind of care That translates into a different kind of medical care for such patients as Bob Mannschreck, a 51-yearold manager for a logistics company. He has suffered from back pain since a skiing accident in his 20s.

When the pain worsened, radiating down his right leg and making standing difficult, Mannschreck called Virginia Mason’s Spine Clinic in downtown Seattle.

He got an appointment right away. When he arrived for his 9:50 a.m. slot, his 70-minute session moved like a production line.

There was no wait. In the exam room, a medical assistant began to put information about

Mannschreck’s pain, medications and medical history into an electronic record within minutes.

At 10 a.m., a physical therapist arrived and began gently probing Mannschreck’s back for pain, testing his reflexes and running him through exercises to check his mobility.

At 10:21 a.m., Dr. Alison Putnam, a rehab physician, joined them in an unusual team system developed by the clinic.

Putnam asked the therapist to describe Mannschreck’s symptoms, which shows patients their concerns are understood. She then conducted a short exam of her own.

Putnam told Mannschreck that the pain could be from a herniated disk or an irritated joint in his lower back or pelvis.

She suggested an anti-inflammatory drug and four to six weeks of physical therapy.

If the pain remained or worsened, she said, he should call immediately and they would discuss more aggressive steps, including an MRI or an injection.

Putnam finished by 10:40. In the remainder of the appointment, the therapist worked with Mannschreck on abdominal exercises to relieve pressure on his hips and lower back before scheduling his next therapy appointment.

Mannschreck was done by 11 a.m.

His rigidly scheduled exam was no accident. For more than a decade, Virginia Mason, a

V.I.P. / A.F.H.

nearly century-old community medical system, has worked to adapt a production system pioneered by Toyota and used by Boeing to cut waste and standardize high-quality outcomes.

Implementing the system took on new urgency when a group of Seattle-area employers working with insurer Aetna threatened to stop using the medical center because it was too expensive.

Instead of fighting the employers, Virginia Mason began working with them to redesign the care they were concerned about most: treatments for back pain, sinusitis and other common conditions that kept employees out of work. “When we started looking at where our costs were too high and where our inefficiencies were, we found them everywhere,� said Kaplan, the chief executive.

Patients with back pain frequently waited a month or

more to get an appointment.

They were given unnecessary tests or referred to specialists when they actually needed physical therapy. The consequences for patients were higher bills, spotty access and uneven results.

Starbucks, which worked with Virginia Mason on spine care, demanded a straightforward bottom line: same-day access for employees, no unnecessary medical care and 100% customer satisfaction. “They said this was a supply chain issue,� said Dr. Robert Mecklenburg, who led Virginia Mason’s redesign initiative. “They expected certain standards from their suppliers.

We were no different.�

Some of the changes Virginia Mason made were simple. The spine clinic began reserving slots in the schedule for same-day appointments for patients with acute pain.

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EMPLOYER Continued from Page 15 Doctors at the clinic created a new form for ordering MRIs that requires doctors to attest that patients meet one of eight criteria. Unnecessary imaging drives up costs and exposes patients to potentially harmful radiation, studies suggest.

Most revolutionary is the clinic’s carefully structured system for seeing patients like Mannschreck, which is designed to maximize use of physicians’ time and better respond to what patients want: quick care that gets them well quickly.

A patient spends most of an exam with a therapist, who can do basic diagnostic testing and is often better at communicating with patients than a doctor, clinic leaders concluded.

The doctor comes into the exam after 30 minutes, gets a briefing, then develops a care plan with the patient and therapist and can usually leave after 20 minutes.

Backlogs eliminated Better use of doctors allowed Virginia Mason to eliminate backlogs nearly overnight.

Fewer unnecessary tests and more use of therapists — which the medical center calculated cost about $1 a minute, compared with $4 a minute for a doctor — led to lower costs.

The more standardized, efficient system also meant better outcomes.

Virginia Mason patients with back ailments typically need four to five visits to recover, compared with 10 nationally.

The clinic’s patients also return to work more quickly, missing two days on average compared with five elsewhere, survey data show.

That’s key for employers.

“Our ability to keep people healthy and get them back to work quickly is critical,” said

TNS

Dr. James Babington, left, shakes patient Robin Lawens’ hand on Nov. 4, in Seattle. They are at Virginia Mason Medical Center.

Jeff White, director of Boeing’s health benefits strategy.

Patients also appreciate the efficiency. “When you are immobile and in pain, time is of the essence,” said Marcy Naismith, a 36-year-old interior designer who got in right away after injuring her back lifting one of her 2-year-old twins.

Other employers In recent years, Virginia Mason worked with other employers, including Costco, Nordstrom and the city of Seattle, to redesign care systems for headaches, joint pain and noncancerous breast lumps.

Similar relationships between employers and medical systems are transforming care elsewhere in the region.

Prompted by the state of Washington, which provides coverage to some 350,000 public employees and retirees,

Group Health Cooperative, another leading Seattle-area system, implemented a groundbreaking method for improving communication between doctors and patients who may need surgery.

North of Seattle, Boeing helped the Everett Clinic build what is considered a national model of team-based care for very sick patients.

Now, the aviation giant is working with the state’s largest health systems — University of Washington Medicine, Providence Health & Services and Swedish Health Services — on a new project to deliver higherquality, lower-cost care for about 30,000 Boeing employees and retirees.

“When Boeing says, ‘We need better care,’ you listen,” said Dr. Joseph Gifford, who heads an alliance of the Providence and Swedish systems that works

16 | Medical Directory 2015

with the company.

It remains unclear whether that kind of business leadership will develop elsewhere.

Few companies have as much local clout as Boeing, which employs about 80,000 people in Washington state. And few communities have as many health systems that are willing to work with local employers as Seattle.

But as businesses increasingly move workers to high-deductible health plans that force them to pay more out of pocket, employers may get more engaged with local health systems to help employees shop for care, said Leah Binder, president of the Leapfrog Group, a national nonprofit formed by employers to track hospital quality.

“Employers,” she said, “may not have a choice.”

SICK

better. Moving is a good thing.

Plus, it will help limit your risk of blood clots.

Continued from Page 10 “Our bodies are made to protect us from getting infections,” says Dr. Emily Hebert, a preventive medicine physician at the Cooper Clinic in Dallas. “But when we’re in the prime for illness — lack of sleep, stress, coming off a recent illness — that revs up our risk.”

Carry hand sanitizer. “I’d never even given thought to the gas pump,” Jowitt says. “But you can imagine, thousands and thousands come through and start pumping gas. You don’t know where their hands have been. Then after you touch the pump, you get into your truck and see, ‘Oh, there’s my McDonald’s burger.’ That’s how people get what they call the stomach bug. There may be fecal matter present that doesn’t belong to you. I know it sounds disgusting.”

Exercise Even if you can’t do what you normally do, modify.

“Exercise helps with metabolism, it helps with our good humor, it keeps us energetic and healthy,” Jowitt says.

Respiratory-wise Cough and sneeze into your elbow. Particles from a sneeze can contain the influenza virus, Jowitt says.

In a restaurant “If you’re having a conversation and use your hands or a tissue to catch the sneeze, some of the particles come through your fingers and through the base of the Kleenex. Say I’m standing next to you and about the time I need to take a deep breath to go on about my conversation, that’s where I can be exposed.”

Bring out more hand wipes. Most travel infections reported come from restaurants, Hanson says.

“Just do a quick wipedown.

How do you know the last group who sat at your table didn’t have a kid who sneezed and then reached out for the ketchup bottle or the syrup?” Additionally, she says, despite the “Employees Must Wash On an airplane Hands” signs in restaurant Wear a mask if you’re sick. restrooms, studies have Preferably, don’t travel at shown sometimes as few all. “You also don’t know as 5 percent of employees what other people have,” heed them.

Hebert says. “There could be a cancer patient, and if you Food-wise Be diligent about eating give them the flu, that could produce. Take probiotics. be potentially fatal.”

Whether in pill form or in Bring your own snacks.

Maria-Paula Carrillo, a regis- yogurt, they can help if you have a sensitive stomach tered dietitian nutritionist, makes sure to have packets and are eating foods you’re of nut butters, which she spreads onto fruit or onto whole-grain crackers.

Limit sodium intake and carbonated beverages. “You risk feeling bloated,” Carrillo Alcohol Drug says. “By the time you get Dependency Service off the plane, your shoes may be tight. You may not feel so good.” Limit alcohol intake, too, she says; it’ll hit you a lot harder when you’re 35,000 feet above the Earth.

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Stay hydrated. “Drink tons of water,” Hebert says.

Not ice water, Vargas warns, because it “reduces our digestive fire, our metabolism. Soda, coffee, alcohol, excessive amounts of sugar weaken the immune system.”

Don’t share. If your sister’s drink or your kid’s mashed potatoes look delicious, get your own, Jowitt says. Saliva is, after all, a bodily fluid, and “other people’s forks, food and glasses have plenty that could be contaminated with virus bacteria.”

A final reminder about the most important step: Wash your hands. The experts just can’t seem to say that enough, with a caveat.

“If everyone’s in the house together, even with the best hygiene practices, it’s hard to keep from getting sick,” Hebert says. “It stinks.”

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Back pain: A pain in the back Teacher discovers new twist to easing chronic back pain

By HARRY JACKSON St. Louis Post-Dispatch

S

T. LOUIS — Carly Richmeyer, 32, can move again without her back torturing her to be still. More than that, she’s back to exercising, standing more than she sits and making plans for her June wedding.

Richmeyer as recently as six months ago had debilitating lower back pain, a common affliction. About 80 percent of Americans will have some degree of non-specific lower back pain over the course of their lives.

She said she started noticing lower back pain around age 25.

“I’ve always been really active, fitness oriented; when I would do certain things, it would hurt, even day-to-day things,” she said.

She had difficulty exercising, wrestling with her pets or even teaching her middle school classes at Holy Cross Academy in Webster Groves, Mo. “I’d started teaching sitting down,” she said. Her middle school students pushed her around her classroom in a chair.

“I didn’t go to the doctor, because one day it would be OK, then it would start again,” she said.

In July 2013, she returned from a vacation almost bedridden.

She went to a chiropractor who said her right leg was shorter than her left. “I went through all of this, physical therapy and adjustment and insoles for my shoes, and I still had back pain.

“I was very depressed. I’m a fitness-oriented person, and for me not to be able to work out ...

I couldn’t do anything. I put on

TNS

Sara Bohall, clinical research coordinator, demonstrates how the sensors are placed so they can map how movement may be causing lower back pain in test subjects.

18 | Medical Directory 2015

a good 20-30 pounds. I wanted to be able to lift my kids, play with them — when I have kids.

And I wanted to be that active mom. This was like taking it away.”

In March, she saw a television spot about a Washington University study aimed at relieving lower back pain and qualified for it.

The study is run out of the program for physical therapy at the university.

Linda Van Dillen, professor of physical therapy and orthopedic surgery, said the study is aimed at finding ways to relieve lower back pain that has no apparent cause, which includes the vast majority of such complaints. The study does not include people with back pain caused by injury and illness, she said.

The study approaches therapy in two ways: Strength and flexibility focuses on building muscles that have been overloaded when people compensate for pain.

Motor skills therapy targets how people move around in ways that can cause lower back pain. “Then we show how to do that differently,” Van Dillen said.

(Incidentally, chief researcher Van Dillen doesn’t know which group Richmeyer is in and won’t be reading this story until the study is finished three to four years from now.)

Richmeyer is in the motor skills group. “At my first appointment, they told me I was twisting my pelvis,

my lower back constantly,” Richmeyer said. “I used to sit on one leg and that would tilt my pelvis; I was crossing my legs too much, when I did certain tasks, I’d twist because it was more comfortable.”

Her therapists learned that by placing adhesive sensors over her pelvis, back and upper body. Then she did simple movements. The sensors produced a three-dimensional picture on a computer screen.

“They didn’t determine which came first, the pain or (the effect from) the twisting,” Richmeyer said. “But everything I was doing was causing a twist, drawing in my abs, bending over, sitting at my desk reaching for things, everything.”

That explained what an orthopedic surgeon had told her, that a disk had been worn down to half its depth. “The twist wore down my disk, which caused the pain,” she said.

Next, a physical therapist watched her do household tasks. “Movements that seemed normal may have been contributing to my pain,” she said. “Taking dishes from the dishwasher, I’d plant my feet and twist as I removed or replaced dishes.

“When I was sleeping in bed, all night long my torso was twisting.”

The physical therapists in the program showed her how to sleep on her side with a pillow between her knees and how to sit and stand without using other muscles to compensate for the pain in her lower back.

“Once I knew the problem, the cause, I could adapt,” Richmeyer said. Still, she had to break some old habits. “Once you move a certain way for 30 years, you just get used to it.”

She experienced some soreness in the new muscles she was strengthening. “It was like going to the gym and exercising after being off a while,” she said.

Three sessions after she started, the back pain had eased enough that she was getting back to the self she’d lost seven years ago.

Six sessions into it, “I was kind of excited,” she said. “I asked the therapist when I could start exercising again; she said I could do anything I want that didn’t cause pain.”

Van Dillen said the study so far is finding a few things they expected. Either method works if the person does what they’re told — easier said than done.

The study takes people up to 60 years old. Bad habits could have been around for more than half

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Researchers are finding new things as well as putting older knowledge into context.

For example, “Activity is necessary,” Van Dillen said.

Change the load on your back about every half hour. “If you’re standing, sit,” she said. “If you’re sitting, stand and move around.

Change positions. You’re changing how your weight is distributed on the spine.”

Staying in one position can “change the tissue,” she said. So muscles you avoid can become atrophied, and lower extremities can lose strength.

Another finding is that bed rest is not good for you when it comes to back pain. “There are a lot of physical issues associated with bed rest, and they’re not good,” Van Dillen said.

Richmeyer says she’s still adapting. “The hardest thing to adapt to was the sleeping,” she said. “I was so used to sleeping in that twisted position that my body didn’t want to sleep any other way.”

Some of the reasons I’ve found that Meadows Place is where I chose to live are because of the convenience of the rehab center being right next door. It’s really easy to go across the

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Daniel Hanson, M.D. Physician & Owner – Accepting New Patients Dear Community, It has been just over three years since I took over at Boys Smith Vision Center. My goal has been to provide the level of care that our loyal patients have come to expect while continuing to make this practice truly my own. Within these last three years I have expanded the scope of the practice to include retinal injections, astigmatism correcting lenses with cataract surgery, and am currently purchasing an SLT laser as an alternative to glaucoma medication.

I am pleased to announce that I have received my board certification with the American Academy of Ophthalmology. While the certification doesn’t change the care I provided to my patients, it does reassure some that the level of care provided meets the highest standard set by the governing board of ophthalmology.

I am in the process of changing the name of the practice to KV Eye to reflect the change in ownership. Changes in letter heads, signage, etc. will occur over the next year. KV Eye will remain dedicated to being the premier center for lifelong eye care in the Kittitas Valley.

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MEDICAL directory Addiction & Rehabilitation Centers ADDS Alcohol Drug Dependency Service 507 Nanum, Room 111 Ellensburg, WA 98926 509-925-9821 Hours: 8 am - 5pm www.adds-info.org

Hyatt Family Facilities www.HyattFamilyFacilities.com Serving three locations: Landmark Care and Rehabilitation 710 N. 39th Avenue Yakima, WA 98902 509-248-4102 Selah Care and Rehabilitation 203 W. Naches Selah, WA 98942 509-697-6503 Willow Springs Care and Rehabilitation 4007 Tieton Drive Yakima, WA 98908 509-966-4500

Barth Clinic 401 S. Main Street Ellensburg, WA 98926 509-933-1388 Fax: 509-933-1387 Hours: Mon-Thur, 12 pm-6:30 pm Fri & Sat by appointment www.barthclinic.com jimbarth@barthclinic.com Jim Barth, CDP-Administrator Brittany Schill, CDP-Clinical Director Sundown M Ranch | Drug & Alcohol Treatment Center 2280 State Route 821 Yakima, WA 98901 800-326-7444 www.sundown.org

Assisted Living, Retirement and Rehabilitation Centers, Retirement Life, Adult Communities & Care Homes Cascade Manor Senior Apartments 101 Pearl Street Ellensburg, WA 98926 509-925-3061 Dry Creek Retirement & Assisted Living 818 E. Mountain View Avenue Ellensburg, WA 98926 509-925-1220 Fax: 509-925-1230 www.emeritus.com Where our family is committed to yours!

Huntington Court Senior Apartments 306 E. Manitoba Avenue Ellensburg, WA 98926 509-925-5178

Kittitas Interactive Management (KIM) 781 Kaynor Road Ellensburg, WA 98926 509-968-4432 Kittitas Valley Health and Rehabilitation Center 1050 E. Mountain View Ellensburg, WA 98926 509-925-4171 Rosewood Adult Living 1101 E. Umptanum Road, Suite 500 Ellensburg, WA 98926 509-962-2100 Royal Vista Nursing and Rehabilitation 1506 Radio Road Ellensburg, WA 98926 509-925-1404 www.prestigecare.com

Audiology, Hearing Centers, Hearing Aids & Accessories

Genteel Establishment 781 Kaynor Road Ellensburg, WA 98926 509-968-3469

Divers Professional Hearing Aid Sales and Service 407 E. 2nd Avenue Ellensburg, WA 98926 509-962-8711

Hearthstone Cottage Retirement 802 E. Mountain View Avenue Ellensburg, WA 98926 509-925-3099

Inland Hearing Aids Inc. 207 W. Tacoma Avenue Ellensburg, WA 98926 509-962-8488

21 | Medical Directory 2015

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MEDICAL directory Northwest Audiology 601 N. Main, Suite 1 Ellensburg, WA 98926 509-962-9575 Fax: 509-962-5575 www.nwhearingcenter.com hearingquestions@nwhearingcenter.com Linda Lee Nelson, MSPA, CCC-A Certified Clinical Audiologist

Cancer Treatment & Information Centers North Star Lodge Ellensburg Office: 100 E. Jackson Avenue Ellensburg, WA 98926 Please call the Yakima Office to schedule an appointment Yakima Office: 808 N. 39th Avenue Yakima, WA 509-574-3400 Hours: Mon-Fri, 8 am-5pm

Thompson Audiology 3810 Kern Road, Suite B Yakima, WA 98902 509-248-0933 Ellensburg: 509-925-5883 www.thompsonaudiology.com

Cardiovascular Diseases Specialists Cardiac & Thoracic Institute of Central Washington 111 S. 11th Avenue, Suite 120 Yakima, WA 98902 509-574-4433

Valley Vision and Hearing Associates 2201 W. Dolarway Road Ellensburg, WA 98926 Hours: Mon-Fri, 8:30 am-5:30 pm 509-925-1000 www.valleyvisionassociates.com

Memorial Cardiovascular Imaging Center 509-248-7716 Yakima, WA 98902

Robert Davis, O.D., F.A.A.O. Abel W. Li, M.D. Scott Oltman, O.D. Jennifer Crown, O.D. Audiology Department Dr. Jenci Randall, AuD, CCC-A Leo Oltman, H.I.S.

Yakima Heart Center 406 S. 30th Avenue, Suite 101 Yakima, WA 98902 509-248-7715

Chiropractors Birth Control, Sexual Health, and Pregnancy Centers Care Net Pregnancy Center of Kittitas County 111 E. 4th Avenue Ellensburg, WA 98926 509-925-2273 24-Hour Helpline info@pregnancyhelpellensburg.org www.pregnancyhelpellensburg.org Hours: Tue-Fri, 11 am-5 pm Planned Parenthood – Ellensburg Health Center Hours: Mon, Tue & Thur, 9 am-6 pm 613 N. Pine Street Ellensburg, WA 98926 866-904-7721 www.ppgwni.org Planned Parenthood – Yakima Health Center Hours: Mon-Thur, 9 am-6 pm Fri, 9 am-5 pm 1117 Tieton Drive Yakima, WA 98902 509-248-3625 www.ppgwni.org

Dave Bridgeman, M DC 120 E. 1st Street Cle Elum, WA 98922 509-674-4448 Central Washington Chiropractic 801 S. Ruby Street, Suite1 Ellensburg, WA 98926 509-962-8008 Ellensburg Chiropractic PS 109 S. Water Street, Suite 2 Ellensburg, WA 98926 509-962-2225 Bridgeman Chiropractic 304 S. Water St., Suite 103 Ellensburg, WA 98926 509-925-7246

22 | Medical Directory 2015

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MEDICAL directory Linder Chiropractic Center 1011 N. Alder Ellensburg, WA 98926 509-962-2570

Kittitas Valley Counseling Center LLC 413 N. Main Street, Suite D Ellensburg, WA 98926 509-925-4400

Shaw Chiropractic Center 305 N. Anderson Ellensburg, WA 98926 509-962-9633

Mosaic Counseling Services 112 W. Railroad Cle Elum, WA 98922 509-674-5144

Counselors Central Washington Comprehensive Mental Health 220 W. 4th Avenue Ellensburg, WA 98926 509-925-9861 402 S 4th Avenue Yakima, WA 98907 509-575-4084 www.cwcmh.org Christian Care Service 415 E. Mountain View Avenue, Suite 301 Ellensburg, WA 98926 509-933-2273 James Cole, Psychologist 514 N. Pine Street Ellensburg, WA 98926 509-925-5226 Crossroads Counseling 603 N. Main Street, Suite 1 Ellensburg, WA 98926 509-962-4300 Laura Doughty, MS 109 E. 3rd Avenue, Suite 7 Ellensburg, WA 98926 509-925-2258 Eastside Vocational Services 907 N. Enterprise Way Ellensburg, WA 98926 509-962-1950 Ellensburg Counseling Services 200 N. Pearl Ellensburg, WA 98926 Johnson, Philip 617 S. 48th Avenue Yakima, WA 509-966-2794

Comprehensive on Pearl 707 N. Pearl, Suite E Ellensburg, WA 98926 509-925-7507 Jill Schwarz 603 N. Main, Suite 1 Ellensburg, WA 98926 509-962-6110 Stillwater Counseling Service 1206 N. Dolarway Road, Suite 203 Ellensburg, WA 98926 509-925-1840 Andrea Utzinger Counseling Services Thomas Logan 103 E. 4th Avenue, Suite 200 Ellensburg, WA 98926 509-929-1984 Yoga Enhancement 509-899-0010

Dental Big Country Family Dental 309 E. 2nd Avenue Ellensburg, WA 98926 509-962-6172 www.bigcountryfamilydental.com bigcountryfamilydental@hotmail.com Hours: Mon-Thur, 8 am-Noon and 1 pm-5 pm Dr. Robert Moon Dr. David Wright Central Washington Pediatric Dentistry Serving Two Locations 925 Seattle Slew Run Yakima, WA 98908 509-248-2973 315 S. Sprague Street Ellensburg, WA 98926 509-859-2646 Dr. Neal H. Smith, DMD Dr. Amy B. Smith, DMD

23 | Medical Directory 2015

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MEDICAL directory Cle Elum Dental Clinic 311 E. 1st Street Cle Elum, WA 98922 509-674-2307

Parker Orthodontics 315 N. Sprague Ellensburg, WA 98926 509-962-6902

Creekside Dental 2601 Triple L Loop Ellensburg, WA 98926 509-933-4800

Pearl Care Dental 2401 W. Dolarway Road Ellensburg, WA 98926 509-925-6553

Ellensburg Dental Care 1206 N. Dolarway Road, Suite 101 Ellensburg, WA 98926 509-933-2400 Fax: 509-933-4804 Hours: Mon-Fri, 7 am-5:30 pm Opening on Saturdays soon! www.chcw.org dental.reception@chcw.org Dr. Brenden Davis, DMD, MPH Dr. Daniel Whitemarsh, DMD Dr. Jacob Butler, DMD

William Phillip, DDS, PS 201 E. Mountain View Avenue Ellensburg, WA 98926 509 962-8299 Fax: 509-962-8289 Hours: Mon & Wed, 8 am-5 pm Tue & Thur, 7 am-2 pm www.wpdds.com drphillip@fairpoint.net Reep Family Dental 3804 Kern Road, Suite A Yakima, WA 98902 509-248-0986

Endodontics Exclusively 1020 S. 40th Avenue, Suite F Yakima, WA 98908 509-965-7668

Sullivan Dental 305 E. 2nd Avenue Ellensburg, WA 98926 509-962-9020 Hours: Mon - Thurs, 8 am - 5pm www.ellensburgdds.com sullivandental@gmail.com Drs. Kevin & Margie Sullivan

Travis Howey and Associates 601 N. Main, Suite 2 Ellensburg, WA 98926 509-933-3300 Ivory Denture Care, Inc. 210 S. 11th Avenue, Suite 45 Yakima, WA 98902 509-454-2273 www.ivorydenturecare.net Hours: Mon, Tue, Thur, Fri, 9:00 am-4:00 pm Sat, 9 am-12 pm Wed/Sun, Closed Siks Mark 215 E. 4th Avenue Ellensburg, WA 98926 509-925-3200 Mountain View Dental Center 708 E. Mountain View Avenue Ellensburg, WA 98926 509-962-2755 O’Connor Family Dental 1015 S. 40th, Suite 15 Yakima, WA 98908 509-966-0660

Summitview Pediatric Dentist 6201 Summitview Avenue, Suite 100 Yakima, WA 98908 509-966-4433 Sunny Smile Orthodontics Local Location 708 E. Mountain View Avenue Ellensburg, WA 98926 509-962-2755 Main Location 1725 E. Lincoln Avenue Sunnyside, WA 98926 509-837-7933 Sunrise Dental 306 S. Main Street, Suite1 Ellensburg, WA 98926 509-925-3160

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MEDICAL directory Yakima Oral and Maxillofacial Surgery Assoc.

4207 Tieton Drive Yakima, WA 98908 509-965-8911 Yakima Pediatric Dentistry 3909 Creekside Loop, Suite 140 Yakima, WA 509-834-2004

Dermatology Dermatology Arts 1701 Creekside Loop, #120 Yakima, WA 98902 509-853-7546

KVH Family Medicine – Cle Elum Hours: 8 a.m. to 5 p.m., Monday - Friday Address: 201 Alpha Way, Cle Elum Phone: 509-674-5331 or 509-962-5060 Website/email: www.kvhealthcare.org or using secure patient portal Resources Available at Facility: Complete comprehensive medical care for newborns to adults of all ages. Lab and x-ray on site.

Paul Schmitt, MD, Family Practice Elizabeth Wise, MD, Family Practice Rob Merkel, PA-C, Family Practice KVH Family Medicine - Ellensburg Address: 716 E Manitoba Ave, Ellensburg Phone: 509-933-8777 Website/email: www.kvhealthcare.org or using secure patient portal Resources Available at Facility: Complete comprehensive medical care for newborns to adults of all ages. Lab and x-ray on site.

Bruce Herman, MD, Pediatrics and Obstetrics Mark Larson, MD, Family Practice John Merrill-Steskal, MD, Family Practice Wendy Owens, MD, Family Practice Don Solberg, MD, Family Practice Krista Summers, MD, Family Practice Megan DeSelms, PA-C, Family Practice Jan Paxton, PA-C, Family Practice Tricia Robertson, ARNP, Family Practice David Wood, PA-C, Family Practice Sonja Wright, ARNP, Family Practice

Dialysis Davita Inc 2101 W. Dolarway Road Ellensburg, WA 98926 509-925-2333

Electrolysis Ellensburg Electrolysis 171 Brown Road Ellensburg, WA 98926 509-962-4800

Nancy Wells 611 S. Chestnut, Suite C Ellensburg, WA 98926 509-925-9355

General Practice Community Health of Central Washington 521 E. Mountain View Avenue Ellensburg, WA 98926 509-962-1414

General Surgery

Family Health Care of Ellensburg 107 E. Mountain View Avenue Ellensburg, WA 98926 Phone: 509-962-6348 Fax: 509-962-2003 Hours: Mon-Thur, 7:30 am-8 pm Fri, 7:30 am-5 pm Sat, 8 am-4 pm www.fhcoe.com, clinic@fhoe.com Byron Haney, MD - Family Practice & OB John Walters, MD - Family Practice & OB Chad Mongrain, DO - Family Practice & OB Stephanie Brower, MD - Family Practice & OB Ryan Beachy, PA-C - Family Practice & OB Aaron Long, ARNP - Family Practice

KVH General Surgery Hours: 8 a.m. to 5 p.m., Monday – Friday Address: 611 S Chestnut St, Suite A, Ellensburg Phone: 509-962-7390 Website/email: www.kvhealthcare.org Timothy O’Brien, MD, General Surgeon Frank Smith, MD, General Surgeon

Home Health Services Home Care Services 1206 N. Dolarway Road, Suite 217 Ellensburg, WA 98926 866-291-3017

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MEDICAL directory KVH Primary Care and Specialty Centers KVH Family Medicine – Cle Elum KVH Family Medicine – Ellensburg KVH General Surgery KVH Home Health KVH Home Respiratory KVH Hospice KVH Internal Medicine KVH Occupational Therapy KVH Orthopedics KVH Physical Therapy KVH Speech Therapy KVH Urgent Care – Cle Elum KVH Women’s Health

KVH Home Health KVH Home Respiratory KVH Hospice Address: 401 E Mountain View Ave, Suite 3 Phone: 509-962-7438 Website/email: www.kvhealthcare.org Lisa’s Tender Care 11852 Hwy 10 Ellensburg, WA 98926 509-899-1196 Total Care Inc. 307 S. 12th Avenue Ellensburg, WA 98926 509-925-2299

Yakima Regional Medical & Cardiac Center 110 S. 9th Avenue Yakima, WA 98902 509-575-5000

Hospice KVH Hospice 401 E Mountain View Ave, Suite 3 509-962-7438 www.kvhealthcare.org

Insurance – Life, Medical, Hospitalization, Long Term Care & Surgical American Family Insurance 2101 W. Dolarway Road, Suite 3 Ellensburg, WA 98926 509-933-2200

Hospital Equipment and Sales Keeler’s Medical Supply 2001 W. Lincoln Yakima, WA 98902 509-452-6541

Country Financial Joe Shannon 302 N. Pearl Street Ellensburg, WA 98926 509-933-3000 301 E. Railroad, Suite C Cle Elum, WA 98922 509-674-7422

Hospitals Cle Elum Urgent Care 201 Alpha Way Cle Elum, WA 98922 509-674-6944

Farmer’s Insurance Shaun Montgomery 300 N. Main Ellensburg, WA 98926 509-925-9633 Cle Elum 98922 509-674-2535

KVH Hospital Hours: Open 24 hours Address: 603 S Chestnut St, Ellensburg Phone: 509-962-9841 Website/email: www.kvhealthcare.org Hospital Services Critical Care Emergency Services Family Birthing Center Imaging Services Laboratory Services Surgical Services – Inpatient and Outpatient Community Education Birthing Classes Cancer Support Community Health Library Diabetes Education and Support

Fevergeon Financial 1206 N. Dolarway Road, Suite 219 Ellensburg, WA 98926 509-925-5105 Lael Insurance and Financial Solutions Custom Medical Plans 2301 W. Dolarway, Ste. 5 Ellensburg, WA 98926 509-962-8800 Cell: 509-899-1851 Jerrylael@hotmail.com

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MEDICAL directory Libke Insurance 1300 N. Dolarway, Suite 2 Ellensburg, WA 98926 509-962-2511

Ellensburg Chiropractic 109 S. Water, Suite 2 Ellensburg, WA 98926 509-962-2225

State Farm Scott Rollins Insurance Agency INC 400 N. Pearl Ellensburg, WA 98926 509-925-1483 415 E. 1St Cle Elum, WA 98922 509-674-5107

Ellensburg Massage Therapy 3420 Reecer Creek Road Ellensburg, WA 98926 509-962-3424 For Your Image 314 E. 4th Ellensburg, WA 98926 509-925-4394

Virginia Gayken Insurance 205 S. Main Ellensburg, WA 98926 509-925-1811

Gaia Center 104 E. 4th Ellensburg, WA 98926 509-929-2822

Internal Medicine KVH Internal Medicine Hours: 8 a.m. to 5 p.m., Monday - Friday Address: 700 E Manitoba Ave, Suite 101, Ellensburg Phone: 509-925-6100 Website/email: www.kvhealthcare.org or using secure patient portal Larry Birger Jr., MD, Internal Medicine Jamin Feng, MD, Internal Medicine David Jackson, MD, Internal Medicine Gretchen Archer, ARNP, Internal Medicine Andy Schock, PA-C, Internal Medicine

Massage

Jackie Gause 1011 E. 1st Ellensburg, WA 98926 509-962-4132 Healing Touch Massage 219 W. 3rd Ellensburg, WA 98926 509-929-3540 JoAnn’s Therapeutic Massage 708 S. Tamarack Ellensburg, WA 98926 509-962-4968

A Cathy’s New You 111 W. Tacoma Avenue Ellensburg, WA 98926 509-929-7111

Adrienne Martin 605 N. Main, Ste 3 Ellensburg, WA 98926 509-962-8008

Alente Spa and Salon 310 N. Pine Street Ellensburg, WA 98926 509-925-2500

Massage for Body and Feet Craig’s Hill Ellensburg, WA 98926 509-929-3636

Awakening BodyMind Spirit 814 E. 5th Avenue Ellensburg, WA 98926 509-962-9656

Jane McClenney Move Lightly 109 E. 3rd, Suite 1 Ellensburg, WA 98926 509-929-3838

Body Nirvana 103 E. 4th, Suite 201 Ellensburg, WA 98926 509-925-1196

Rose Minda 310 S. Sprague Ellensburg, WA 98926 509-859-3897

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MEDICAL directory Scents of Touch Massage 305 N. Andersont St Ellensburg, WA 98926 509-899-3136

Nephrology Services Nephrology Associates of Yakima 315 Holton Avenue, Suite 100 Yakima, WA 98902 509-248-6292

Shiatsu Therapy 105 W. 5th, Ste 107 Ellensburg, WA 98926 509-925-4903

Neurologists Northwest Neurosciences 3911 Castlevale Road, Suite 301 Yakima, WA 98902 509-834-7050 Fax: 509-834-7060 Hours: Mon-Fri, 8 am-5 pm www.nw-mc.com Eduardo Meirelles, MD,PhD, FAANS, FRCSC Peter Gilmore, MD

Two Hands and Heart 509-929-2639 Valley Natural Health 502 N. Anderson Ellensburg, WA 98926 509-925-1525

Mental Health Services OBGYN Central Washington Comprehensive Mental Health 220 W. 4th Avenue Ellensburg, WA 98926 509-925-9861 Lori Drews 415 E. Mountain View Avenue Ellensburg, WA 98926 509-925-2460 Horizons Club 220 W. 4th Avenue Ellensburg, WA 98926 509-925-1372

Naturopathic Bonnie S. Reay, ND 108 W. 2nd Street Cle Elum, WA 98922 509-260-1226 Valley Natural Health Julie Figgins 103 E. 4th Ave., Suite 205 Ellensburg, WA 98926 509-925-1525

KVH Women’s Health Hours: 8 a.m. to 5 p.m., Monday – Friday Address: 700 E Manitoba Ave, Suite 109 Phone: 509-933-8720 Website/email: www.kvhealthcare.org, womenshealth@kvhealthcare.org Resources Available at Facility: Obstetric and gynecologic care Ginger Longo, MD, FACOG, Gynecology and Obstetrics Teresa Beckett, ARNP, PA-C, Gynecology Obstetrics and Gynecology of Ellensburg 611 S. Chestnut Street, Suite B Ellensburg, WA 98926 509-962-5000 Hours: Mon-Thur, 8 am-5 pm Fri, 8 am-4 pm 24/7 call coverage John H. Sand, MD, OBGYN Paula J. Lins PA-C

Occupational Therapy KVH Occupational Therapy KVH Speech Therapy 302 E 2nd Ave 509-933-8677 www.kvhealthcare.org

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MEDICAL directory Valley Vision and Hearing Associates 2201 W. Dolarway Road Ellensburg, WA 98926 Hours: Mon-Fri, 8:30 am-5:30 pm 509-925-1000 www.valleyvisionassociates.com

Ophthalmologists, Optometrists & Optical Goods Advanced Eye Care 3999 Engelwood Avenue, Suite 101 Yakima, WA 98902 509-452-2020

Robert Davis, O.D., F.A.A.O. Abel W. Li, M.D. Scott Oltman, O.D. Jennifer Crown, O.D. Audiology Department Dr. Jenci Randall, AuD, CCC-A Leo Oltman, H.I.S.

Boys Smith Vision Center 109 N. Pine Street Ellensburg, WA 98926 509-962-3937 Fax: 509-962-4057 Hours: Mon-Fri, 8 am-5 pm Optical Shop hours Mon-Fri, 8 am-5:30 pm www.boyssmithvision.com Daniel W. Hanson, MD - Owner Mitchell V. Brinks, MD

Orthopedic Shoes Appliances & Prosthetic Kittitas Orthotics & Prosthetics 1206 N. Dolarway, Suite 110 Ellensburg, WA 98926 509-925-7700

Cascade Eye Center 1211 S. 40th Avenue Yakima, WA 98902 509-966-2966

Vaux Shoes 4001 Summitview Avenue, Suite 4 Yakima WA 98908 509-965-7170

Family Eye Clinic 707 N. Pearl Street, Suite D Ellensburg, WA 98926 509-925-9873 Hours: Mon, Wed, Thur, 8 am-5 pm Tue, 9 am-5 pm Fri, 7am-1 pm Closed for lunch Mon-Thur, Noon-1 pm Cle Elum OfďŹ ce: 807 W. Davis Street, Suite 102A Cle Elum, WA 98922 509-674-4313 Fax: 509-962-1639 fec@fairpoint.net Hours: Mon,Thur, Fri, Closed, Tue, 10 am-4 pm Wed, 8 am-5 pm, Closed for lunch Noon-1 pm www.familyeyeclinicwa.com Dr. Sarah K. Storrs O.D.

Yakima Orthotics & Prosthetic 313 S. 9th Avenue Yakima, WA 98902 509-248-8040

Orthopedics, Orthopedic Surgery, Bone & Joint KVH Orthopedics Hours: 8 a.m. to 5 p.m., Monday – Friday Address: 611 S Chestnut St, Suite D, Ellensburg Phone: 509-933-8700 Website/email: www.kvhealthcare.org Gary Bos, MD, Orthopedics Accepting new patients

Anthony Longo, MD, Orthopedics Accepting new patients

James Repsher, PA-C, Orthopedics Figgs Eye Clinic 1410 Lakeside Court, 103 Yakima, WA 98902 509-453-2010

Accepting new patients

Daniel Hiersche, M.D. Orthopedics and Sports Medicine 700 E. Manitoba Avenue, Suite 106 Ellensburg, WA 98926 509-962-6727

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MEDICAL directory Orthopedics Northwest 1211 N. 16th Avenue Yakima, WA 509-454-8888

Jazzercise 307 W. 1st Avenue, Suite 1 Ellensburg, WA 98926 509-933-2348

Pharmacies

William Pace 700 E. Manitoba, Ste 105 Ellensburg, WA 98926 509-962-6500

Bi-Mart 608 E. Mountain View Ellensburg, WA 98926 509-925-6996

Pain Management Waters Edge Memorials Pain Relief Institute 1460 N. 16th, Suite D Yakima, WA 509-574-3805

Pediatrics Community Health of Central Washington 521 E. Mountain View Avenue Ellensburg, WA 98926 509-962-1414 Ellensburg Pediatrics 611 S. Chestnut Street, Suite E Ellensburg, WA 98926 509-962-KIDS (5437) Fax: 509-962-5438 Hours: Mon-Fri, 8:30 am - 5 pm Elise J. Herman, MD Victoria A. Perkis, ARNP

Personal Trainers/Fitness

Cavallini’s Pharmacy 106 E. 1st Street Cle Elum, WA 98922 509-674-2571 Downtown Healthmart Pharmacy 414 N. Pearl Street Ellensburg, WA 98926 509-925-1514 Fax: 509-925-1545 Hours: Mon-Fri, 9 am-6 pm Sat, 9 am-5 pm Resources Available: Retail Pharmacy, Immunizations, Convalescent and Home Health Supplies and Rentals, Cards and Gifts Roger Glaser, Registered Pharmacist David Cross, Registered Pharmacist Clinton Knight, Pharm D (Director of Pharmacy) Fred Meyer Pharmacy 201 S. Water Ellensburg, WA 98926 509-962-0533

Anytime Fitness 2305 W. Dolarway Road Ellensburg, WA 98926 509-925-5445

Rite Aid Pharmacies 700 S. Main Ellensburg, WA 98926 509-925-4232

Cle Elum’s 24 Hour Gym 113 Harris Avenue Cle Elum, WA 98922 509-674-5696

Safeway Pharmacy 400 N. Ruby Ellensburg, WA 98926 509-925-5096

The Gym 427 N. Main Street Ellensburg, WA 98926 509-962-6200 Health Fitness Complete 306 S. Main, Suite 3 Ellensburg, WA 98926 509-925-1810

Schwabs Compounding Pharmacy 108 Railroad Avenue Kittitas, WA 98934 509-968-9545 Super 1 Foods 200 E. Mountain View Ellensburg, WA 98926 509-962-7777

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MEDICAL directory Physical Therapy

Vascular Surgery

Argonaut Peak Physical Therapy 722 E. University Way Ellensburg, WA 98926 509-962-1553

Central Valley Vascular Center 111 S. 11th Avenue, Suite 201 Yakima, WA 98902 509-454-6545

Canyon View Physical Therapy 100 E. Jackson, Suite 201 Ellensburg, WA 98926 509-925-6220 Fax: 509-925-6221 Natalie Joyce, MPT Cheri McCoy, DPT

Yakima Vascular Associates 3999 Englewood Avenue, Suite 202 Yakima, WA 866-253-3732 100 E. Jackson, Suite 104 Ellensburg, WA 98926 Please call the Yakima ofďŹ ce to schedule an appointment

KVH Physical Therapy Address: 301 E Mountain View Ave Phone: 509-962-7386 Website/email: www.kvhealthcare.org

Senior Citizen Service Organizations Aging & Disability Resource Center 206 W. 1st Avenue Ellensburg, WA 98926 509-925-8765

Northwest Physical Therapy 112 W. Railroad Cle Elum, WA 98922 509-674-0908

Ellensburg Adult Activity Center 506 S. Pine Ellensburg, WA 98926 509-962-7242

Podiatrists Cascade Foot & Ankle 100 E. Jackson, Suite 105 Ellensburg, WA 509-925-4633 3919 Creekside Loop Yakima, WA 509-225-3668

Retired Senior Volunteer Program 707 N. Pearl St, Suite I Ellensburg, WA 98926 509-962-4311 Senior Nutrition Program 804 Elmview Road Ellensburg, WA 98926 509-933-3333

Donald W. Orminski D.P.M. Central Washington Podiatry Service 307 S. 12th Avenue, Suite 9 Yakima, WA 98902 Hours: Mon-Thur, 8:30 am-5 pm Fri, 8:30 am-12 pm 509-248-4900 Fax: 509-248-0609 www.cwpods.com clinic@cwpods.com Dr. Donald W. Orminski

Speech Pathologists KVH Occupational Therapy KVH Speech Therapy Address: 302 E 2nd Ave Phone: 509-933-8677 Website/email: www.kvhealthcare.org

Pulmonary Lung & Asthma Center of Central Washington 303 Holton Avenue Yakima, WA 98902 800-442-4282

Speech Pathology Associates 508 N. Ruby Ellensburg, WA 98926 509-925-2850

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MEDICAL directory Urgent Care

NOTES:

KVH Urgent Care – Cle Elum Hours: 3 p.m. to 11 p.m., Monday – Friday 8 a.m. to 11 p.m., Weekends and Holidays Address: 201 Alpha Way, Cle Elum Phone: 509-674-6944 Website/email: www.kvhealthcare.org Resources Available at Facility: After hours medical care for patients with minor illnesses or injuries. Lab and x-ray on-site. No appointment needed.

Urologist Yakima Urology Associates Adult & Pediatric Urology Clinic 2500 Racquet Lane Yakima, WA 98902 509-249-3900 Surgery: 509-249-3910

Vitamins & Food Supplements Better Life Natural Foods 111 W. 6th Ellensburg, WA 98926 509-925-2505 Mike’s Herbal & Nutrition Service 550 Strange Road Ellensburg, WA 98926 509-962-6105

Wheelchair Lifts and Ramps and Handicap Construction Arbor Design Construction 407 S. Sprague Street Ellensburg, WA 98926 509-925-9875 Alterations, remodel and construction for disabled and aging Fred Padjen Custom Technology 460 McLaughlin Yakima, WA 98902 509-965-3333

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The news you want to know doesn’t always happen on your doorstep. It happens out in the community. It happens fast and you want to know about it as soon as it does. At the Daily Record, we’re delivering more news in more ways than ever, because we know you want to know.

We’re putting the community in your hands.

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Clinics Family Medicine – Cle Elum 509-674-5331 Family Medicine – Ellensburg 509-933-8777

Focusing on patients and families…

General Surgery 509-962-7390 Internal Medicine 509-925-6100 Orthopedics 509-933-8700 Urgent Care – Cle Elum 509-674-6944 Women’s Health 509-933-8720 Specialty Services Home Health 509-962-7438 Home Respiratory 509-962-7438 Hospice 509-962-7438

hospital 24-Hour Emergency Care | Critical Care Family Birthing Center | Imaging Services Laboratory Services | Surgical Services 509-962-9841

… your home for health.

Occupational Therapy 509-933-8677 Physical Therapy 509-962-7386 Speech Therapy 509-933-8677 1207645.MedDir15.cnr