USA Health N E W S
MARCH 2018
JUPITER • WEST PALM BEACH • ROYAL PALM BEACH • WELLINGTON • BOYNTON • BOCA RATON
PBACO is Number 1 in Quality in the United States! Palm Beach Accountable Care Organization (PBACO) is a partnership of over 500 healthcare providers who elect to work together to improve the quality, coordination and efficiency of the care they deliver to their patients.
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he goal of the Accountable Care Organization is to ensure that patients, especially the chronically ill, receive the most appropriate care at the correct time while avoiding unnecessary duplication of services and preventing medical errors.
tributed their success to hard work and dedication to the best patient care possible. The Palm Beach ACO also touts an outstanding reputation in the community due to the fact that they are completely physician owned, organized and operated. There are no outside influences regarding the ACO strategies and pillars and how it pertains to patient outcomes.
Since 2012 PBACO has strived to coordinate care for patients in the community. Palm Beach ACO serves over 160,000 beneficiaries through Medicare and Commercial plans such as Florida Blue, Cigna, and United Healthcare.
In addition, newer physicians have equal representation and voice as the funding members and physicians. PBACO continues to be a foundation for health care reform that simultaneously reduces costs while improving quality.
PBACO has received a quality performance score of 99.4% which places it at the #1 spot in the country. The leadership, employees and physician members at-
If you have any question or are interested in joining the Palm Beach ACO, please call 561-315-683 or visit pbaco.org.
Sea swimming ‘increases illness risk’ Swimming in the sea substantially increases the chance of developing stomach bugs, ear aches and other illnesses, researchers have found. The University of Exeter Medical School and Centre for Ecology and Hydrology carried out the study. It concluded, compared to non-sea swimmers, the likelihood of developing an earache increases by 77% and for a gastrointestinal illness rises by 29%. As well as swimming, the risks also apply to water sports, such as surfing. Researchers reviewed 19 studies linking sea bathing to illness from the UK, US, Australia, New Zealand, Denmark and Norway. They analysed results from more than 120,000 people “In high-income countries like the UK, there is a perception that there is little risk to health of spending time in the sea,” said Dr Anne Leonard. “However, our paper shows that spending time in the sea does increase the probability of developing illnesses, such as ear ailments and problems involving the digestive system, such as stomach ache and diarrhoea. “We think that this indicates that pollution is still an issue affecting swimmers in some of the world’s richest countries.”
“However, it is important people are aware of the risks so they can make informed decisions.”
nto the sea, which has many health benefits such as improving physical fitness, wellbeing and connecting with nature.
Dr Gaze said most people will recover from infections with no medical treatment but they can prove more serious for vulnerable people, such as the very old or very young.
He added: “We have come a long way in terms of cleaning up our waters, but our evidence shows there is still work to be done. “We hope this research will contribute to further efforts to clean up our coastal waters.”
2 | USA HEALTH NEWS
Wearable tech aids stroke patients
MARCH ISSUE • 2018
USA Health N E W S
Scientists in the US are developing wearable sensors to speed up the recovery of stroke patients.
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he sensors are able to send information to doctors continuously. The team developing the system says it could allow therapists to more closely monitor the effectiveness of their care. Details of the study were released at the recent annual meeting of the American Association for the Advancement of Science in Texas. Lizzy McAninch had a stroke two years ago. She could not move or speak or swallow for several weeks. Lizzy is testing out wearable sensors that might speed her recovery. They look like small white sticking plasters, but they send information wirelessly to her medical team. She is a doctor herself and can see how they could help her. “This technology to put sensors on the body to assess which muscle groups work or not can really pinpoint the areas affected by the stroke and can target therapies to specifically improve those issues,” she told BBC News. The sensors continue to send back readings even after she has finished her exercises. This means
Jennifer Justo Publisher Gianna M. Trombino, EMHA Editor in Chief Sergio Aguilar Creative Director Eduardo Sam Distribution USA HEALTH NEWS Contact Us: 4516 Brook Drive West Palm Beach, FL 33417
that her therapist Kristen Hohl, from the Shirley Ryan AbilityLab in Chicago, can monitor her progress at home. “As a therapist, I think about what my patients are doing at home. Are they able to carry through the recommendations I’m giving them as a therapist to do more? Do we see that they are walking more or do we see them engaging in conversations? “Those are the types of things that I can get feedback from the
sensors where currently I have to rely on what they tell me they have done.” The challenge for the scientists was to pack a lot of electronics on to a small flexible material and still make it comfortable for the patient to wear for a long time. “It is almost mechanically imperceptible to the patient who is wearing the device,” according to John Rogers, of Northwestern University in Chicago, who developed the sensors.
“And you can embed all sorts of advanced sensor functionality, microprocessor computing capability, power supplies and WiFi into this very unusual platform, and that is the uniqueness of what we do.” By the end of this year, the research team will have more information than ever before on stroke recovery. The scientists believe that their study could transform the way patients are treated in the future.
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Upcoming events in Palm Beach County FESTIVAL OF THE ARTS BOCA
February 23, 2018 - March 4, 2018 Mizner Park Amphitheater & Mizner Park Cultural Arts Center, Plaza Real, Boca Raton, FL 33432
LAKE WORTH STREET PAINTING February 24,2018 – February 25, 2018 Lake and Lucerne Avenues, Downtown Lake Worth, FL
3RD ANNUAL WELLINGTON BACON & BOURBON FEST
SOUTH FLORIDA GARLIC FEST February 9, 2018 February 11, 2018 John Prince Park, Lake Worth, FL 33461
March 23, 2018 - March 25, 2018 12100 Forest Hill Boulevard Wellington, FL 33414
TURTLEFEST
ARTIGRAS
March 24, 2018 Loggerhead Marinelife Center, 14200 U.S. Highway One, Juno Beach, FL 33408
February 17, 2018 – February 19, 2018 Abacoa Town Center, 1155 Main Street, Jupiter, 33458 FL
HONDA CLASSIC
February 19, 2018 February 25, 2018 PGA National Resort & Spa, 400 Avenue of the Champions, Palm Beach Gardens, FL 33418
SPRING TRAINING - WASHINGTON NATIONALS & HOUSTON ASTROS February 23, 2018 March 28, 2018 The Ballpark of The Palm Beaches 5444 Haverhill Road West Palm Beach, FL 33407
DELRAY BEACH, FLORIDA - ST. PATRICK’S DAY PARADE & FESTIVAL March 16, 2018 March 17, 2018 Atlantic Avenue Downtown Delray Beach Delray Beach, FL 33483
PALM BEACH INTERNATIONAL BOAT SHOW March 22, 2018 March 25, 2018 Flagler Drive, West Palm Beach, FL
56TH ANNUAL DELRAY AFFAIR April 13, 2018 - April 15, 2018 Atlantic Avenue Delray Beach, FL 33444
2018 • MARCH ISSUE
USA HEALTH NEWS
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ALZHEIMER’S CAREGIVERS: Preparing your home for your loved one
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4. Creating a safe environment Finally, you’ll want to provide the safest environment possible for your family member. You need to be aware of the risk that falling poses. To avoid falls, handrails in your bathrooms are a must, and you might also add some non-slip padding beneath any rugs in your living areas.
ou’ve been watching over your family member’s Alzheimer’s carefully for several years and now you believe that it’s time that they move into your home. You probably planned on this day coming back when you were first informed of their diagnosis, but now that the moment is here you are feeling a little overwhelmed.
Additionally, you will want to take steps to protect your loved one from themselves. This includes locking away potentially dangerous items such as sharp objects, poisonous home cleaners and household appliances that can burn or electrocute.
If you are unsure how to modify your home to fit the needs of your loved one, here are four important steps you shouldn’t overlook. 1. Ensuring accessibility Your first consideration when preparing your home for your loved one, needs to be logistical: How will they get around? While your home may be perfectly suited for your own needs, your elderly family member has their own special needs to be accounted for. If your home is spread over several stories, then your first challenge will be either making the stairways more accessible, or rearranging your home’s current setup so that your loved one can easily access all the rooms they need on one floor. 2. Sharing the space So, what rooms does your loved one need access to? Obvi-
ously, they will need their own bedroom and easy access to a full bathroom, but you might also want to give them greater freedom around your home and encourage their own independence and selfcare. Therefore, you should also consider sharing the kitchen and living areas of your home with them. Doing so will promote an active lifestyle for them and also lessen the burden of you tending to their needs. When sharing the rooms of your house, you need to be sure that these rooms have enough space for you and your loved
one to share. Your current bathtub might be hard for an elderly person to comfortably enter and exit without your assistance. In this instance, you might consider some home improvement to fit their needs. Installing handrails, lowering cabinets, and perhaps even changing your bathtub could be necessary remodels needed to make your home the best environment for your loved one. When making remodels you can expect the average cost to remodel a bathroom to come out being $8,820, and $19,589 to remodel your kitchen.
3. Providing comfort Next, you’ll want to ensure that your family member is absolutely comfortable in their new environment. Remember, that as stressful as it is to adjust your living space to fit their needs, being displaced from a home that they have lived in for many years can be just as stressful for them. There are several ways you can make your loved one feel more at home in yours. Having the right kind of seating is a good place to start, with a firm back and cushion to provide hours of comfort while they read or watch television.
Keeping these items out of reach reduces the risk of your loved one injuring themselves if they become confused. According to the Alzheimer’s Association, 2017 saw nearly 5.5 million Americans living with Alzheimer’s disease. When someone you love is affected by this disease, it requires the entire family to help bear the responsibility of their care. As you take them into your home, remember that this responsibility is not something to be taken lightly and requires plenty of planning and forethought to provide the best care possible.
4 | USA HEALTH NEWS
SOCIAL EVENTS
MARCH ISSUE • 2018
Red White and Blue Jeans: Celebrating Our Wellington Heroes By Gianna M. Trombino, EMHA
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he second annual Red, White and Blue Jeans: Celebrating Our Wellington Heroes event hosted by The Wellington Community Foundation was held on Friday November 10th at the Wellington National Golf Club. The special event was hosted to honor the veterans of the armed forces, prisoners of war and those missing in action. Mickey Smith, secretary of the foundation, stated that the event was the largest fundraiser of the year and that all money raised, over $55,000, will be used to benefit the community of Wellington, mainly children and senior citizens.
Dr. Arthur Hansen, Anthony Hansen, Dr. Lori Lane Hansen; Robbin Lee, CEO of Wellington Regional Medical Center, and Robert Lee.
Table Sponsors included: Lesser, Lesser, Landy & Smith; Wellington Regional Medical Center; Regis and Tom Wenham; Jim & Paula Sackett; Dr. Gordon and Linda Johnson; Palm Beach Urology; Wellington The Magazine; and the Town-Crier newspaper, as well as PAY IT FORWARD SPONSORS MediValue, Above & Beyond Party DĂŠcor and Kenny Mondo Productions. The Wellington Community Foundation is a nonprofit organization, and its mission is to continue working toward supporting Wellington children and seniors. If you would like more information on The Wellington Community Foundation please visit, http://www. wellingtoncommunityfoundation.org
Ernie Zimmerman and Dennis Mach, U.S. Army Veterans.
Jeff Hmara, Councilman Royal Palm, Carolyn Hmara; Christina and Frank Gonzalez; Marylou and Scott BedfordCentral Palm Beach Chamber
Susan and Reed Kellner.
Alan Gerwig and Wellington Mayor Ann Gerwig.
Leo Buquicchio and Maggie Zeller.
Bill and Stacy Schearhouse.
Ed Becker, Christina & Frank Gonzalez.
Dr. Linda Gordon & Dr. Johnson Gordon, Board Members.
Jeff Ciskin and Bob Salerno.
Karlene and Gene Bryan.
Joan and Bob Wellman.
2018 • MARCH ISSUE
Brian and Mary Anne Hanley.
Gladys & Damian Portella, Michael Marina.
Kim and Mike Odell.
Elizabeth Paine, Gianna Trombino, and friends.
Juanita and Ben Shenkman.
Paul Alter, Scott Bedford, and Kim Alter.
SOCIAL EVENTS
Ralph and Carmen Torrez.
USA HEALTH NEWS
Chris and Lara Facka.
Vinny & Lynn Barisi; Joann & Roddy Padula, and Phyllis Manning.
Barry and Elinor Schimel.
Dr. Jeff and Sharlene Bishop.
Tonya and Henry Mosby.
Dr. Daxa Patel and Sanjay Nayee.
Bradlee and Shannon Dorczbcher.
Nick and Tracee Sama.
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MARCH ISSUE • 2018
The Center for Wound Care and Hyperbaric Medicine at Wellington Regional Medical Center By Dr. Dina Hansen-McCoy, Dr. Elizabeth Davis and Marie Neshe R.N Program Director
fats, calories, vitamins, and minerals. Proteins are especially important as they aid with repair and replacement of tissues. It is important to undergo the full screening process in order to classify the wound for appropriate treatment.
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id you know that 6.7 million Americans suffer from a non-healing wound? Most chronic wounds are ulcers associated with ischemia (poor blood supply), diabetes, venous stasis disease, or pressure. A wound is described as the breakdown in the protective function of the skin and may be caused by many different factors. Once the body encounters a wound, hemostasis (bleeding is stopped) is achieved within the first few minutes by platelets in the blood sticking to the injured site in order to promote clotting and stop bleeding. After hemostasis is controlled, the three phases of wound healing begin. The inflammatory stage is the first stage and lasts for approximately 3-4 days. During this stage, cells are recruited to the wound site in order to begin the healing process. These cells aid with clearing out damaged and dead cells to prepare for the second stage, proliferation. Proliferation phase consists of new collagen and capillary buds that stimulate growth
The Center for Wound Care and Hyperbaric Medicine at WRMC has a multidisciplinary team of physicians who along with the nursing staff are all trained in the science of wound healing.
of new tissues and aid with contraction of the wound. This stage can last up to 21 days and increases the strength of the wound up to 35%. The final stage of wound healing is maturation or the remodeling stage, which can last from 21 days up to one-year post injury/wound. During this phase, the collagen is realigned and cells that are no longer needed are removed by programmed cell death until the wound is fully healed. The wound healing process is not only complex but also fragile. It is susceptible to interruption
leading to the formation of chronic wounds. Contributing factors are arterial disease (poor blood delivery), venous reflux/disease, infection, diabetes, autoimmune disorders, and metabolic deficiencies. Peripheral arterial disease (PAD) is a major contributing factor to impaired or decreased wound healing. Circulatory disorders lower the amount of oxygen transported to the wound, oxygen is necessary for wound healing. Diabetes is another common factor that is associated with decreased sensation, peripheral neuropathy. Peripheral neuropathy contributes to long-standing
wounds due to the patient not being able to feel the onset or traumatic experience causing an open wound. The duration a wound is present increases the possibility of associated infections, cellulitis, osteomyelitis (Infection of bone), and hospitalization. Venous disease is associated with malfunctioning of the valves inside the veins, which lead to venous reflux and possible wound formation. Venous wounds present typically in the lower leg and are associated with excessive swelling (edema). Nutrition also plays a large role in wound healing. Wounds require adequate supply of nutrients including protein,
We work to identify the underlying cause of your non-healing wound, develop a treatment plan with you and your Primary Care Physician to heal your wound. We also have the ability to provide Hyperbaric Oxygen which is 100% oxygen therapy, this is used in select cases as an advanced therapy for wound healing. We have been awarded the Center of Distinction and Center of Excellence for our Quality measures. Our goal is to heal and improve the quality of life for as many patients as we can. If you have an open wound or know someone who does call us at 561-753-2680 The Center for Wound Care and Hyperbaric Medicine @ WRMC is located at 1397 Medical Park Blvd Suite 180, Wellington Fl. 33414
Quality & Convenience You Can Depend On... • State-of-the-Art Equipment • Board Certified Radiologists • Evening and Weekend Hours • Complimentary transportation • Accepts All Insurance
Open & Hi-Field MRI • 64 Slice CT Nuclear Medicine • PET/CT • Ultrasound Digital Mammography • Digital X-ray DEXA Bone Density • Echo • Cardiac Stress Test/Cardiac PET • Holter Monitor Coronary CTA
phone 561-795-5558 • fax 561-792-7300 www.independentimaging.com Wellington • Belle Glade • Lake Worth
8 | USA HEALTH NEWS
MARCH ISSUE • 2018
Clinical Research... Is your practice benefitting? By Michelle LoMonaco
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he importance of medical research is well understood by healthcare providers. They know it is the only way to discover and bring to market promising new drugs and therapies. It is how they understand diseases and conditions and more importantly, how they can be treated, managed, and prevented. It is how they know the way in which to educate their patients and the public at large. This crucial step in scientific advancement has long been out of reach for many physicians and as a result, out of reach for their patients. The complexity of clinical research, with its heavy regulations and required additional resources, has kept interested physicians away.
Directly witnessing this disparity over the last 15 years of her career, Michelle LoMonaco, a certified clinical research professional, decided it was time to help further bridge that gap. Having spent 11 of those years in oncology research under the medical directorship of a world-renowned breast cancer specialist at a non-profit organization, she saw this first hand in the community. The need was further crystallized over the last few years where she worked in other sub-specialties like orthopedics, dermatolo-
gy, pulmonology, endocrinology, cardiology, and otolaryngology. With a goal to support doctors and practices with research interests, LoMonaco launched O2 Clinical Research (O2CR). “Research is a very specialized industry.”, says LoMonaco, “Compared with the number of doctors who would involve themselves in research, there are few individuals and companies with the knowledge and experience to properly guide them from a clinical and regulatory perspective. Not having that trusted guidance is precisely why more doctors are uninvolved. O2CR is changing that.” LoMonaco speaks passionately about what O2CR brings to the table. She is confident in her and her team’s abilities and notes the positive experiences doctors and their clinic staff have had with her over the years. “We know the rules of research and the high standard it holds for a doctor/ investigator and their practice. Our goal is to learn how a practice operates, really understand the flow of a patient’s experience there and how the doctors administer their standard of care. It is only then that we design an integration plan for research into the practice. We do not want to turn it upside down by advising everything be changed in order to participate in research. This method really forges a good relationship and sets us all up for success.”
The company offers full research support to existing and new programs but also offers services ala carte. A move that, aside from her expertise and seemingly respectable reputation, sets O2CR apart. She indicates that few companies, if any, provide such tailored services. “Most research companies want doctors to sign over their entire program. While that is sometimes the desire of the doctor as well, there are many others who want specialized support” she says, also admitting that in her experience, the latter usually morphs into the former. “Bullying
a doctor into services they may not need at the time is not how we do business. Clients appreciate we are open and willing to support them at any stage and in any capacity.” She lists locating trial opportunities, contract and budget negotiations with pharmaceutical companies, clinical management of a trial, quality assurance, and doctor/staff training as just a few of the services O2CR offers. “Research is a triple win for doctors who have the right support in their corner. It increases their revenue stream in a way that is not dependent on insurance, it allows
them to offer additional treatment options to their patients and contributes to the overall advancement of science.” She adds that the company’s tagline, “A breath of fresh air to your practice.” is the best representation of this because according to her, that is exactly what O2CR provides. Michelle LoMonaco, CCRP can be contacted by phone at 561-203-5859 or by e-mail at mlomonaco@o2cr.com. She welcome inquiries from doctors as well as patients who want to know more about clinical trials.
Olive oil compound found to reverse the damage of high-fat diet The health benefits of extra-virgin olive oil are well-known, but less is known about the biological and physiological mechanisms behind these benefits. New research shows that a compound found in extra-virgin olive oil can reverse the adverse health effects of a high-fat diet.
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revious research has shown that olive oil - and especially extra-virgin olive oil - may reduce the risk of cardiovascular disease. However, not much is known about the mechanisms responsible for this association between olive oil consumption and cardiovascular health benefits.
known as the “good” cholesterol because it transports the cholesterol from other parts of the human body back to the liver, where it is processed and eliminated. The researchers fed four groups of mice, each comprising 12 to 14 rodents, either a high-fat diet (consisting of 60 percent fat) or a control diet (with only 10 percent fat). Additionally, some mice were also administered 5 milligrams of hydroxytyrosol per kilogram of body weight over a period of 12 weeks.
This is why a team of researchers - led by Dr. Rodrigo Valenzuela from the University of Chile in South America - set out to investigate the effects of a compound found in extra-virgin olive oil on the health of mice. The compound is called hydroxytyrosol and, as the scientists explain, it is a polyphenol with well-known antioxidant properties. These properties have been suspected to be the reason behind the many health benefits of olive oil. This new research, however, shows that hydroxytyrosol also has a protective effect on the liver. The findings were published in the journal Lipids in Health and Disease.
Analyzing the effect of hydroxytyrosol on mice
cardiovascular health, brain function, and cell growth.
Dr. Valenzuela and colleagues examined the effects of hydroxytyrosol on mice that were fed a diet high in fats.
The so-called bad cholesterol is also known as low-density lipoprotein (LDL) cholesterol. It is referred to as the “bad” cholesterol because it is the kind of fat that can build up inside the arteries, hardening or blocking them over time and contributing to a number of cardiovascular diseases.
Specifically, they looked at certain enzymes that play a key role in the synthesis of some polyunsaturated fatty acids. Polyunsaturated fats are beneficial to one’s health because they can lower “bad” cholesterol levels, improve
By contrast, high-density lipoprotein (HDL) cholesterol is
Dr. Valenzuela and team took blood and tissue samples from the mice at the end of the experiment. They analyzed the effects of the diet on the composition of fatty acids, the activity of the enzymes considered, and on oxidative stress. Hydroxytyrosol reverses signs of fatty liver disease In the mice that had been fed a high-fat diet, both the total cholesterol levels and the levels of LDL-cholesterol increased, while
the HDL cholesterol remained unchanged. However, hydroxytyrosol seemed to reduce the negative effect of these types of cholesterol in the mice that had taken it. A high-fat diet also seemed to raise the markers of insulin resistance. Again, in the mice that had also taken hydroxytyrosol, these markers were reduced. However, they were not as low as the levels of the mice that had been on a regular diet. Importantly, mice that had been on a high-fat diet showed decreased levels of the liver enzymes that help to synthesize the beneficial polyunsaturated fatty acids. The reduction in the liver enzymes was connected with an imbalance in the fatty acids found in the liver, brain, and heart. However, the mice whose highfat diet was also supplemented with hydroxytyrosol showed enzymatic activity and fatty acid composition similar to that of the mice that were fed a normal diet. This suggests that hydroxytyrosol may have reversed the damaging effects of a high-fat diet.
2018 • MARCH ISSUE
USA HEALTH NEWS
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Going the Extra Mile at Independent Imaging By: Staci Martin
ple... “We must have a heart when speaking to our patients.” Lucy tells a story of a recent cancer patient who wanted to cancel his appointment due to lack of finances.
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hy are we so captivated by stories of great customer service? Perhaps it is because they serve as a much needed reminder that there are companies (and amazing support reps) who still care about their customers.
Lucy took the time to explain his high deductible and how insurance works. She went as far as not cancelling his appointment and giving him her name and direct extension and asked him to reconsider the importance of this scan. The patient called Lucy back the next day and decided to keep his appointment.
Every company says that their customers are their #1 priority, but stories show us that many businesses are ready, willing, and able to go the extra mile for each and every one of their customers. Going the extra mile is an old expression. It describes people who provide better customer service, do a little more than expected and try a little harder. This is a great concept for customer service and is further enhanced by Roger Staubach, the Hall-of-Fame football player who played quarterback for the Dallas Cowboys. He said:
the “baker’s dozen,” which is getting more than you thought you were paying for.
There are no traffic jams along the extra mile.
Because customer service and experience is the backbone of our philosophy at Independent Imaging, I thought what better way to gage our service than to hear how our employees view servicing our customers.
This is a great metaphor that can be used in a variety of ways and is especially applicable to Independent Imaging, and specifically the concept of our customer experiences.
I distributed one question to staff members at Independent Imaging. “What does customer service excellence mean to you pertaining to how you treat our patients?”
Going the extra mile is about
Employee Audre Boehm had
this response, “how you treat people is a reflection of you....... so treat every patient how you would like to be treated...... and I always try to remember they count on us in their time of need which should make us all feel special.” Audre understands that most patients come to our facility as a method to further diagnose a pain or illness. Audre feels privileged to be a support to our patient’s. MRI Technologist Melissa Fricano said, “ Customer service means treating customers with the respect and decency they deserve and not treating them like just another number.”
Dr. Dina Hansen-McCoy Dr. Elizabeth Davis Dr. Khoa Pham Dr. Daniel Heck Dr. Lori Lane Dr. Shelley Plumb Dr. Arthur Hansen
Personal & Gentle Care For: • Diabetic Foot Care • Fracture Care • Plantar Fasciitis • Ankle/Heel/Foot Pain • Neuropathy • Custom Molded Orthotics
• Hammer Toe • Ingrown Nails • Bunions • Poor Circulation • Wound Care • Diabetic Shoes
Conservative & Surgical Treatments Available
Eduardo Sam manages the complimentary transportation offered by Independent Imaging. When asked, he said, “ “We recognize our patients come for a diverse community of cultures and languages, our staff is prepared to making them feel understood and at ease during the stressing diagnostic process. As a driver, I spend a long time with the patients. Some just need to share their story. Being a good listener is part of the job” Lucy Valdes works with patients of Independent Imaging to ensure they are prepared for their upcoming appointment. Lucy’s philosophy on patient care is sim-
“You never know the source of someone’s pain. I always try to put myself in the patient’s position and see their point of view. Empathy and compassion is what I pride myself on.” Nicole Compagnone assists patient’s that have been in accidents and she prides herself on this philosophy. Give the customer more than they thought they were going to get. The old saying of going the extra mile is a sound customer service strategy. It’s taking some extra time, making an unexpected phone call to make sure the customer is happy or adding a little “something” extra. At Independent Imaging, that is what we strive to do every day. To schedule an appointment for diagnostic services, please call 561.795.5558.
10 | USA HEALTH NEWS
SOCIAL EVENTS
MARCH ISSUE • 2018
Palm Beach Accountable Care Organization Annual Gala
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he Palm Beach Accountable Care Organization (PBACO) held its Annual Holiday Gala on December 9th, 2017 at the Kravis Center in West Palm Beach. The employees, leadership and physician members celebrated their success in achieving
the highest amount of savings in the country! Around 400 attendees enjoyed dinner and dancing well into the night to revel in their hard work and achievements. PBACO is a growing network of physicians and healthcare professionals dedicated to working in a
Dr. Lori Lane, Dr. Shariffa & Dr. Ishan Gunawardene and Dr. Arthur Hansen (CEO of PBACO).
Kalpana & Ravi Patel, Brian Chaney & Colin Campbell.
Dr. Aden, Dr. Aguirre, Gina & Larry Melby.
Richard & Karen Weisberg (Chairman of the Board).
Heidy Krammer, Mark, Dr. Khan, Ryan Singh, Ingrid Enamorado.
Lindsey and Dr. Peymon Zarreii.
Dr. Robin Sykes, Dr. Thomas Rowe.
Dr. Bhanmatie Singh & Dr. Luis Otero.
consistent and cohesive manner to improve the care of the community patient population and lower health care expenditures. If you would like more information on PBACO please visit www.pbaco.org or contact us at (561) 429-2680.
Felice Levine & Barry Simons.
Dr. Arthur Hansen (CEO), Mr. & Mrs. Kevin Johnson, Dr. Lori Lane.
Dr. Elizabeth Mohr, Dr. Yehia Abdelwahed, Carol & Norman Erenrich.
Tori Yazell, Marcella Knauss, Daimarys Angela Georgopolos, Matt Mindick, Lauren Golen. Elio Nova, Sue Ann Yockey, Lubna Chaudhary, Dr. Chaudhary, Dr. Rajendra Bansal, Stellie Ott. Torres, Cori Ardelean.
2018 • MARCH ISSUE
Mr & Mrs. Brown, Dr. Khanna.
Kendall Shapiro, and Jill Kline
Jennifer Boss, Dawn White, Bonnie Stein.
David & Kathleen Klebonis, Jennifer & Colin Campbell.
Heidi Oquendo, Dr. Dina Hansen-McCoy.
Dr. Elizabeth Davis & Guest, Dr. Dina Hansen- McCoy
SOCIAL EVENTS
Dr. Jose & Lilliam Barrios, Dr. Manjula Nayyar, Dr. Ramesh Nayyar.
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Dr. Sirtaz Sibia, K.P. Sibia, and Alex Zopo.
Dr. Khan, Dr. Arthur Hansen, Dr. Kishore Dass.
Justin Patton, Natalie Navarro, Matt Reese.
Justin Patton, Toba Bross.
Dr. Mohanty , Sami Dharia, Seema Dass, Beth Mohanty.
Dr. Louis Rosainz, MD , Elizabeth Rosainz, ARNP , Glenda Giles , Dr Chester Maxson, MD.
Sabrina & Peter Schwarts, Michael & Nicole Shiman
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12 | USA HEALTH NEWS
MARCH ISSUE • 2018
The Opioid Epidemic in America: Landscape and Options for Policy
By Gianna M. Trombino, EMHA
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he abuse of opioid narcotics is one of the most widespread and dangerous epidemics that the United States currently faces. These dangerous opioids are highly addictive and deadly if ingested too frequently or at higher doses. The devastation caused by opioid epidemic in America is staggering and widespread.
“Public health officials have called the current opioid epidemic the worst drug crisis in American history, killing more than 33,000 people in 2015. Overdose deaths were nearly equal to the number of deaths from car crashes. In 2015, for the first time, deaths from heroin alone surpassed gun homicides.” (Bosman, 2017). While these statistics are bleak there are strategies that can be implemented to help alleviate and eventually prevent the amount of people affected by opioid addiction and death associated with the use of these drugs. Opioids are a class of narcotic which include illegal drugs such as heroine and legally prescribed medications such as vicoden, fentanyl, oxycodone, morphine, codeine, and others. Opioids can cause harmful and long-term effects on behavior and the physical body including its functions. “Opioids reduce the perception of pain by binding to opioid receptors, which are found on nerve cells in the brain and periphery (as well as in other organs in the body). The binding of these drugs to opioid receptors in reward regions in the brain produces a sense of well-being, while
stimulation of opioid receptors in deeper brain regions results in drowsiness and that can lead to respiratory depression, which can lead to overdose deaths.” (Volkow, 2015). Opioids can wreak tremendous physical damage to the human body. On a molecular level the opioids can destruct cells that are responsible for the tissue which makes up the organs of the body. “Presence of opioid receptors in other tissues is responsible for side effects such as constipation and cardiac arrhythmias. The effects of opioids are typically mediated by specific subtypes of opioid receptors that are activated by the body’s own (endogenous) opioid chemicals.” (Volkow, 2015). Opioids are a class of narcotic that slow lung function and in turn cause labored breathing. Long term use of the drug can cause damage to lungs and a greater susceptibility to pneumonia. As well as inhibiting lung function opioids can severely damage tissue in the body especially the kidneys. Chronic use of these dangerous painkillers can degrade the tissue components of the kidneys and its use is one of the leading causes of renal dysfunction, need for dialysis and transplants. Quite possibly one of the most dangerous side effects to the body is the effect of opioids on the human heart. These dangerous drugs can cause irregular heart beat known as arrhythmias as well as heart attacks. As well as horrific and damaging physical effects to the
organ, opioids are one of the most addictive narcotics available. “They are most dangerous and addictive when taken via methods that increase their euphoric effects (the “high”), such as crushing pills and then snorting or injecting the powder, or combining the pills with alcohol or other drugs. Also, some people taking them for their intended purpose risk dangerous adverse reactions by not taking them exactly as prescribed (e.g., taking more pills at once, or taking them more frequently or combining them with medications for which they are not being properly controlled); and it is possible for a small number of people to become addicted even when they take them as prescribed.” (Volkow, 2014). After understanding the severity of the effects of opioids on the body and how harmful these addictive substances are it is crucial to understand whom these drugs affect. Since opioids are a class of drug that is commonly prescribed to those after surgery, after a pain-
ful accident or to ease the severity of pain from previous injuries it has become one of the most widely over prescribed narcotics in America. Citizens from all walks of life are affected and can become addicted after taking the drug for even a short amount of time. As well as those who are legitimately prescribed opioids there are those who synthesize the drug in the form of heroine, an illegal opioid, to feed their dangerous habit. “In 2015 more than 52,000 Americans died of drug overdoses, according to the Centres for Disease Control and Prevention. That is an average of one death every ten minutes. Approximately 33,000 of these fatal overdoses—nearly twothirds of them—were from opioids, including prescription painkillers and heroin. Although the absolute death toll from opioids is greatest in big cities like Chicago and Baltimore, the devastation is most concentrated in rural Appalachia, New England and the Midwest. Many of the vic-
tims hail from white middle-class suburbs and rural towns.” (The Economist, 2017). Due to the fact that the prescriptions of opioids often leads to addiction to opioids as well as the issue of prescription addiction leading patients to heroin, it is increasingly important to manage the amount of prescriptions being written by doctors. “There is also significant variability across counties in the U.S., with prescribers in some areas of America writing 6 times more opioid prescriptions per person than the lowest prescribing counties. These findings suggest inconsistent prescribing patterns that are not being guided by evidence based practice guidelines.” (Blumenthal, 2017). Options for different policies to handle the opioid epidemic are plentiful. There have been implementation of policies throughout the past few years but nothing has slowed the devastation of these drugs and their affects on the nation. Some strategies to prevent addiction and ultimate death include educational initiatives delivered in school and community settings (primary prevention), supporting consistent use of prescription drug monitoring programs (PDMPs), implementation of overdose education and naloxone distribution programs to issue naloxone directly to opioid users and potential bystanders, aggressive law enforcement efforts to address doctor shopping and pill mills, and diverting individuals with substance use disorders to Drug Courts. (Volkow, 2014). All of these models show promise and if done collectively will reduce the amount of victims claimed by opioids.
Independent Physicians may see beneficial deal under new Republican formed Tax Bill example, they can convert their office building into a real estate investment trust and charge themselves an exorbitant rent, artificially reducing their income. Kamin has even predicted that hospital systems will begin restructuring their arrangements with employed physicians and other healthcare professionals to enable those professionals to take advantage of the lower pass-through tax rate.
By Gianna M. Trombino, EMHA
W
ith many in healthcare and other industries are displeased with the newly formed Republican tax cut bill, primary-care physicians and dentists in independent practices may be receiving a sweet deal. The bill, which passed Congress mid-December, sharply reduces the personal income tax rate for owners of pass-through entities such as partnerships and sole proprietorships, and gives a smaller tax break to owners of Subchapter S corporations. “Under the Tax Cuts and Jobs Act, owners of pass-through entities will receive a 20% deduction on their taxable income, dropping their maximum effective tax rate from the current 39.6% (or 37% under the bill) to about 29.6%.” (Meyer, 2017). Healthcare providers and other skilled service professionals may quality for the tax break if
they earn no more than $415,000 annually for a married couple filling jointly, or no more than $207,500 for a single filing professional. There is no income limit on the tax break for other types of owners of pass-through entities who fall outside the bill’s definition of specified service trades or businesses, which includes medical providers. For instance, very high-income real estate developers in passthrough entities will receive the
20% deduction while very high-income physicians and other healthcare professionals will not. Conversely, lower-paid employees of medical practices, such as nurses, medical assistants and billing clerks, will not benefit from the tax break, while their physician-bosses may qualify. This plan has drawn derisive reviews and criticisms from several experts. One expert, David Kamin, a professor of law at New
York University states “If you’re going to reduce tax rates, don’t set haphazard lines,” he continues by stating, “High-income doctors and lower-income employees don’t get the lower tax rate but super-rich real estate developers do. It’s a crazy provision. There’s no principle behind it.” Kamin said conversely, that high-income physicians and other service providers still may find ways to qualify for the lower pass-through rate by restructuring their business. In
Other experts have far more positive take away on the new pass-through provision. They argue that the lower tax rate will help independent physicians, independent physicians practicing in small towns, and those who may be their communities only healthcare provider stay in business. The lowered rate can help those small town or rural physicians remain independent rather than having to sell out to a hospital system or become acquired by a larger corporation.
2018 • MARCH ISSUE
USA HEALTH NEWS
| 13
The Central Palm Beach County Chamber of Commerce Medical Board of Governors Lead the Way By Mary Lou Bedford
T
he Central Palm Beach County Chamber of Commerce Medical Board of Governors, is a unique group of leading physicians, hospital CEO’s and heath care professionals in Palm Beach County. Their stated mission: To Lead the Way as a Health Care Organization, to Advocate, Explore, Integrate, Develop, Promote, Mentor and Inspire. The Medical Board discusses and get behind issues that involve the latest advances in science, patient care and operational innovation. They have made themselves available to the county’s business community, schools and local governments to provide recommendations and address issues that require the expertise of the medical leadership that’s represented on this Board. They recently partner with the United Way to promote the County’s 211 program, providing the pamphlets with important phone numbers patients can access. “A well-informed patient has a better opportunity for sustained health or a more successful recovery” says Dr. Lori Lane, the Chair of the Medical Board of Gover-
nors and Podiatrist of LA Podiatry Group in Wellington. This Board has been successful in guiding the community on issues addressing healthcare matters. Some of the initiatives the Board has taken on the past couple of years: continuity of patient care, the Opioid crisis, a proposed free standing emergency room that would have caused saturation of an already well served area, with an unintended negative impact on healthcare jobs and on the community. This past June at the Chamber’s Economic Luncheon, the Medical Board hosted guest speaker, State Attorney Dave Aronberg to address the Opioid Crisis and its impact on the county and state wide before it was declared an emergency by the state or the nation. Most recently, in November at a public forum for Palm Beach State College, the Medical Board members Robbin Lee, CEO of Wellington Regional Medical Center, Eric Goldman, CEO of Palms West Hospital and Dr. Lori Lane Medical Board Chair, presented on behalf of the Board and supported the Palm Beach State College Dental program being moved to the new Loxahatchee Groves campus in recognition of the healthcare hub that has been created in the Central / Western Communities. According to Mary Lou Bedford, CEO,
From top left to right: Ryan Lewis, Welltower; Dr. Mike Mikolajczak, Wellington Orthopedic Institute; Dr. Edward Becker, Palm Beach Urology Associates; Dr. George Patsias, Palm Beach Urology Associates; Dr. Harvey Montijo, Center for Bone and Joint Surgery of the Palm Beaches; Dr. Ishan Gunawardene, Advanced Medical Clinic, P.A.; Bruce White, Fyzical Therapy & Balance Centers; Dr. David Soria, Emergency Specialists of Wellington, The Emergency Department Experts at Wellington Regional Medical Center; Dr. Jeffrey Bishop; Mary Lou Bedford, Central Palm Beach County Chamber; (new row) Dr. Kathleen Minnick, Florida Breast Care a Division of 21st Century; Robbin Lee, CEO, Wellington Regional Medical Center, Dr. and Chair Lori Lane Hansen, LA Podiatry Group; Dr. Daxa Patel, Complete Healthcare for Women; Dr. J. Daniel Ghiragossian, Independent Imaging. Members not present for photo include Eric Goldman, CEO, Palms West Hospital; Dr. Kishore Dass, South Florida Radiation Oncology; John Hornberger, Orthopedic Center of Palm Beach County; Adam Bromberg, Wellington Regional Medical Center; Dr. Nick Sama, Center for Bone and Joint Surgery of the Palm Beaches
of the Central Palm Beach County Chamber, “With economic sustainability as a focus of our chamber’s vison, we are always aware of issues that can impact an industry cluster.
medical leaders who are willing to give of their time and expertise to weigh in on the issues that can impact the healthcare community or public health in a positive or negative way”.
We have a very large healthcare presence in the our Chamber footprint and are fortunate to have
In 2018, The Chamber’s Medical Board of Governors will be busy continuing to serve the com-
munity and staying on top of issues relating to healthcare. To contact the Central Palm Beach County Chamber of Commerce’s Medical Board of Governors for a consultation or speaking opportunity, call at (561)717-9907 or go on our website: cpbchamber.com.
Ryan Lewis, Welltower; Dr. Jeff Bishop; Medical Board Chair, Dr. Lori Lane, LA Podiatry Group; State Attorney Dave Aronberg, Central Palm Beach County Chamber Chair; Robbin Lee, CEO, Wellington Regional Medical Center; Dr. Daxa Patel, Complete Healthcare for Women; Dr. Edward Becker, Palm Beach Urology .
14 | USA HEALTH NEWS
MARCH ISSUE • 2018
For love of your lungs
Advanced procedures support earlier lung cancer detection
T
he Comprehensive Lung Program at Wellington Regional Medical Center (WRMC) now offers navigational bronchoscopy and endobronchial ultrasound (EBUS), which can enable earlier detection of lung cancer using an advanced, minimally invasive approach. These procedures can help doctors make a diagnosis if they find something concerning identified on a low-dose computerized tomography (CT) scan or other screening test, explains Interventional Pulmonologist Adam Wellikoff, MD, FCCP. The goal is to find and diagnose lung cancer earlier, when it is more treatable, so patients can experience the best possible outcomes, he notes. How are these diagnostic tools different? In order to make a lung cancer diagnosis, doctors must obtain cell samples and examine them under a microscope. Traditionally, this has involved conventional surgery and a hospital stay; but with advanced techniques, diagnosis can now be achieved in an outpatient procedure that provides even greater precision. Both navigational bronchoscopy and EBUS are performed non-surgically by inserting a thin, flexible tube into the airways. Navigational bronchoscopy uses electromagnetics and advanced imaging to help locate tumors in the lungs. “It can reach remote
sive Lung Program are guided throughout the treatment process by a caring, dedicated staff. Director of Clinical Operations Sonia Polack, RN, MSN, OCN, notes that she and Clinical Navigator Chris Collins can help with things like setting up appointments, connecting patients with community resources or just providing a shoulder to lean on. Adam Wellikoff, MD, FCCP, Interventional Pulmonologist
Mark Meyer, MD, Thoracic Surgeon
spots that may not be accessible with conventional methods,” explains Dr. Wellikoff. With EBUS, which is supported by ultrasound technology, doctors are able to obtain lung samples and determine right away if cancer exists. They can also use the findings to determine the “staging” or severity of cancer. This enables doctors to more effectively determine the best, most appropriate treatment. What if lung cancer is diagnosed? Patients at the Comprehen-
They can also follow up with patients’ primary care providers, as needed. “We’re on this road with patients together,” says Collins. “It’s our job to make the next step the easiest it can be.” Because the hospital has a comprehensive program, patients can get all the care and resources they need in one place, says Thoracic Surgeon Mark Meyer, MD.
Should you be screened? The Centers for Medicare and Medicaid Services (CMS) lists the following criteria for lung cancer screening:
In addition to traditional surgery, treatments may include minimally invasive procedures that can support shorter recoveries, as well as stereotactic radiation – which is a more intense, targeted therapy – for patients who are not candidates for surgery.
• Age 55 to 77 years
All of the pieces are in place to ensure that patients are treated appropriately and optimally, starting with screening and diagnosis to help detect cancer as early as possible, Dr. Meyer says. “We want to catch it at an early stage,” he notes.
Wellington Regional Medical Center is designated a Lung Cancer Screening Center by the American College of Radiology (ACR).
To contact a Clinical Navigator, call 561-500-5864 (LUNG) or email wrmclungprogram@ uhsinc.com.
Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if minimally invasive surgery is right for you.
• Asymptomatic (no signs or symptoms of lung cancer) • Have smoked a pack or more of cigarettes a day for at least 30 years • Currently smoke or have quit within the past 15 years
To find out more about our lung care program, visit www.wellingtonregional.com/lung.
2018 • MARCH ISSUE
USA HEALTH NEWS
| 15
Post-Holiday Recovery Recipes Gianna M. Trombino, EMHA As we ring in the new year it’s time to get over the post-holiday blues with healthy light foods. Below are two deliciously easy recipes to help clean up your diet after all the holiday festivities!
Marinated Shrimp Salad Total Cook Time: 25 mins Serves: 4 INGREDIENTS: 3 scallions, white part only, sliced. 3 tablespoons of capers 2 large garlic cloves, minced ¼ cup of freshly squeezed lemon juice 1 teaspoon grated lemon zest ½ cup extra- virgin olive oil 3 tablespoons coarse sea salt 1 teaspoon fine salt 2 pounds raw large shrimp, peeled and deveined 2-4 cups of mixed field greens, washed and dried thoroughly DIRECTIONS:
Vegan Friendly Rice Noodle Salad with Peanut Crunch and Rice Wine Vinegar Dressing: Total Cook Time: 25 min
Serves: 4
INGREDIENTS: Peanut Crunch peanut oil, for frying 2 red finger chilies cut in half, seeded and sliced 2 shallots, peeled cut in half and sliced 5 Tbsp cornstarch 1 cup toasted peanuts, finely chopped salt Rice Wine Vinegar Dressing 1 cup seasoned rice wine vinegar 1 clove garlic, minced 1 lime, zested 1 tsp sesame oil salt to taste Rice Noodle Salad 1 pkg vermicelli rice noodles, cooked according to package directions (227 g) 2 cup bean sprouts 1 carrot, peeled and julienned 1 cucumber, peeled, seeded and diced DIRECTIONS: Peanut Crunch 1. In a large pot, fill with oil to 1/3 full. Using a deep frying thermometer, heat to 350 degrees. 2. Line a baking tray with paper towel. 3. Place chilies in a bowl, coat well with 2 tablespoons of cornstarch and fry until golden brown, remove from oil, place on lined baking tray and season with salt, set aside. 4. Place shallots in a bowl, coat well with 3 tablespoons of cornstarch and fry until golden brown, remove from oil, place on baking tray and season with salt, set aside. 5. Place crispy fried chilies and shallots on a cutting board and finely chop. 6. Combine chopped peanuts, fried chilies and shallots in a bowl and set aside. Rice Wine Vinegar Dressing 1. Place all ingredients in a bowl, stir and set aside. Rice Noodle Salad 1. Place rice noodles in the center of the plate and dress with half of vinegar dressing. 2. Sprinkle the peanut crunch over rice noodles. 3. Place bean sprouts over rice noodles. 4. Place carrots around the outside of the rice noodles and bean sprouts. 5. Sprinkle cucumber and green onion over carrots then pour remaining vinegar dressing over.
1. In large shallow bowl combine scallions, capers, garlic, lemon juice and olive oil. 2. Fill a large pot with 3 quarts of water and bring it to a boil over high heat. Add the coarse salt and the shrimp and cook until shrimp are pink (about 30 seconds). Drain and immediately transfer to the marinade. At this stage, you can serve and eat immediately or refrigerate overnight. 3. Mix together the lemon zest and the fine salt in a spice blender or mortar and pestle. 4. Place a handful of the cleaned spring mix onto a plate, drain the shrimp and portion out onto the bed of lettuce. 5. Sprinkle with the lemon zest/salt mix.
Our goal is to provide superior patient care. Of course, technical training
and expertise are important to achieving this goal, yet we believe other attributes also contribute to our special care. Jupiter Medical Group understands the need for consistent care and we treat each patient as if they are a part of our family. We believe that a physician should not only possess skillful hands and a keen mind, but also a kind heart. We have found our practice on this principle of providing superior patient care. Of course, technical training and expertise are important to achieving this goal, yet we believe other attributes also contribute to our special care. Our team understands the need for consistent care and we treat each patient as if they are a part of our family. Call us TODAY and schedule a visit with one of our physicians!
www.jup ww ww.jjup rm ww rmed med
g oup.com
1117 Royal Palm Beach Blvd
1447 Medical Park Blvd, Suite 405
Royal Palm Beach, FL 33411
Wellington, FL 33414
561-784-4481
561-792-7454