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THE PILL It remains the most common method of birth control followed by IUDs

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Rochester–Genesee Valley Healthcare Newspaper

January 2015 • Issue 113

RESOLUTIONS Why do we keep making them year after year? Experts explain how to make resolutions we can achieve

Should you get one?

Also: What your doctor wants you to do in 2015 PTSD Not Just a Soldier’s Problem

Kidney Transplant

Although many people picture post traumatic stress disorder as a mental problem afflicting soldiers who experienced battle, anyone can suffer from it

New rules for those awaiting kidney transplants in the United States went into effect in December

A talk with Chris Burke, M.D., chief of the Stroke Center at Unity Hospital

Good Bye Paper Scripts

US Birth Rate Hits All-Time Low

If your physicians still write paper prescriptions, they won’t much longer. As of March 27, New York state mandates electronic prescriptions. Says Mohammed Chhipa, pharmacist at Warrens Pharmacy, Inc. in Rochester: “It’s excellent. You don’t have to call the doctor to figure out what it says.”

Find out why this is happening now

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SUNSCREEN IN THE WINTER? Page 9 January 2015 •

Mobile Anesthesiology Comes to Upstate NY

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Suicide Risk Falls Substantially After Talk Therapy

BABIES US Birth Rate Hits All-Time Low

he U.S. birth rate reached an alltime low in 2013, as the number of babies born in the country declined for the sixth straight year since the peak in 2007, a new report finds. The country’s birth rate dipped to 62.5 births per 1,000 women between ages 15 and 44, according to a Dec. 4 report from the Centers for Disease Control and Prevention (CDC). That is 10 percent lower than the birth rate in 2007, which was 69.3 per 1,000 women, and a record low since the government started tracking birth rates in 1909, when birth rate was 126.8. In 2013, there were 3.93 million ba-

bies born in the U.S., down less than 1 percent from 2012, and down 9 percent from 2007, when a record-breaking 4.32 million babies were born in the U.S. But trends in the birth rate varied among age groups. Among women under age 30, childbearing is on the decline, whereas it continues to rise among women older than 30, in line with the general trend over the last three decades. In fact, 2013 birth rates for women aged 35 and over was “at the highest levels seen in approximately 50 years,” the researchers wrote in their report. In 2013, the birth rate for wom-

en aged 35-39 reached 49.3 births per 1,000, and for women aged 30–34, the rate reached 98 births per 1,000, both small increases from the previous year. The rate for women aged 40 to 44 was unchanged from the previous year, at 10.4 births per 1,000, whereas for women aged 45 to 49, the birth rate increased from 0.7 to 0.8 per 1,000. In contrast, among teenagers the birth rate fell 10 percent from 2012, dropping to 26.5 births per 1,000. Rates also declined by 3 percent for women aged 20 to 24, continuing the general decline of birth rates for women under age 25 over the last two decades, the researchers said.

epeat suicide attempts and deaths by suicide were roughly 25 percent lower among a group of Danish people who underwent voluntary short-term psychosocial counseling after a suicide attempt, new Johns Hopkins Bloomberg School of Public Healthled research suggests. The findings are believed to be the first to show that talk therapy-focused suicide prevention actually works, averting future suicide attempts in this very high-risk population. Although just six-to-10 talk therapy sessions were provided, researchers found long-term benefits: Five years after the counseling ended, there were 26 percent fewer suicides in the group that received treatment as compared to a group that did not. A study on the findings is published online Nov. 24 inLancet Psychiatry. “We know that people who have attempted suicide are a high-risk population and that we need to help them. However, we did not know what would be effective in terms of treatment,” says the study’s leader, Annette Erlangsen, an adjunct associate professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. “Now we have evidence that psychosocial treatment — which provides support, not medication – is able to prevent suicide in a group at high risk of dying by suicide.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

Jan. 6

Jan. 17

Brains and hearing to be explored in meeting

‘Healthy Mommy & Me’ workshop in Pittsford

Hearing Loss Association of America, Rochester chapter, will explore the brain’s role in understanding sound and in vestibular disease at the group’s two meetings on Tuesday, Jan. 6. Meetings take place at St. Paul’s Episcopal Church, East Avenue at Westminster Road, across from George Eastman House. At the noon meeting, audiologist Kendra Marasco explores the connection between ears and brains in “Our Hearing and Our Brain.” Sounds are interpreted by our brains in instantaneous pathways if they function properly. Marasco, founder and director of the Communication Center for Hearing and Speech. has devoted over 40 years to working with individuals with hearing loss . At 8 p.m. physician Benjamin Crane will discuss the diagnosis and treatment of vestibular disease. The vestibular system includes parts of the inner ear and brain which help control balance and eye movement. If damaged, conditions associated with vertigo and dizziness, imbalance and spatial disorientation, hearing changes and tinnitus can result. Crane’s research “aims to better understand human motion perception and spatial orientation...using head motion and its interaction with visual stimuli.” Hearing Loss Association is a nationwide organization dedicated to advocacy, education and support for people with hearing loss. For more information visit www.hlaa-rochester-ny.org or telephone 585-266-7890.

Physician Christine Wood will lead a panel on “How to Get Kids To Eat Great and Love It!” during a ‘Healthy Mommy & Me’ workshop, which will take place from 2 – 4 p.m., Saturday, Jan. 17, at Inner Sage Healing Arts Center, 1 Grove St. suite 103, Pittsford. During the workshop, moms will learn creative ways to spruce up meals and snacks; will get ideas of fun activities for the entire family and will learn how to get kids to eat healthy and why nutritional supplements are important. The event is free and open to the public. Attendees will be entered to win a gift basket valued at $100. Reservation is required by contacting Jane Giambrone at 585-281-8841 or by email at janeegiambrone@gmail.com or Lisa Scott, 585-451-2788, email llhamlin@gmail. com.

Jan. 27

New Fibromyalgia Support Group meets The New Fibromyalgia Support Group will hold a meeting from 6:15 – 8:30 p.m. Jan. 27 at Westside Family YMCA, 920 Elmgrove Road, Rochester. It will be a round table discussion format where participants share their experience deadline with fibromyalgia. It’s free and open to the public. The group also hold meeting every fourth Tuesday of the month at the same location. For more information, visit www.newfibrosupport.com or email brendal@rochesterymca.org.

Common Knee Surgery May Boost Arthritis Risk, Study Suggests “Increasing evidence is emerging that suggests meniscal surgery may be detrimental to the knee joint,” says study’s author

common type of knee surgery may increase the chances of arthritis, a new study suggests. The procedure repairs tears in the meniscus, a piece of cartilage that acts as a shock absorber. There are two in each knee, and they stabilize the knee joint. Meniscal tears are one of the most common knee injuries, and surgery is often performed to reduce pain and improve joint function, the researchers said. In their study, the scientists used MRI scans to look at 355 knees with ar-

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thritis, and compared them to a similar number of knees without arthritis. The average age of the patients was about 60 and most were overweight. All 31 knees that were operated on to repair meniscal tears developed arthritis within a year, compared with 59 percent of knees with meniscal damage that did not have surgery. Cartilage loss occurred in nearly 81 percent of knees that had meniscal surgery, compared with almost 40 percent of knees with meniscal damage that did not have surgery, the study found.

New U.S. Kidney Transplant Rules Take Effect Changes intended to make organ allocation more equitable

ew rules intended to create a more level playing field for those awaiting kidney transplants in the United States went into effect in December. The changes are designed to lengthen the time younger patients will have working transplants, increase kidney availability and improve the odds for patients with hard-to-match donors, according to physician Richard Formica, who chairs the kidney transplantation committee of the Organ Procurement & Transplantation Network and United Network for Organ Sharing. “Our intention was to make allocation of kidneys as class-, race-, age- and gender-free as possible,” said Formica, who is also director of transplant medicine at the Yale School of Medicine in New Haven, Conn. “So if you got kidney disease, everybody is treated exactly the same — that’s the goal.” Demand for lifesaving kidneys is far greater than the supply, said Tonya Saffer, the senior federal health policy director at the National Kidney Foundation. “No policy for allocating donor kidneys can possibly match every patient in need with a donor, but this new system is expected to decrease re-transplantation and waiting times,” she said. About 16,000 kidney transplants are performed each year in the United States, while more than 100,000 peo-

ple are on the waiting list, the kidney foundation estimates. Although waiting time for a transplant varies across the country, the average wait is 36 months, Formica said. Last year, more than 4,400 people died while waiting, he added. Under the new rules, which apply to kidneys from deceased donors, people will get credit for being on the kidney waiting list from the time they start dialysis, not from the time they get on the list, Formica said. In the current system, someone with kidney failure could be on dialysis for years before being added to the transplant waiting list, he explained. “We think it is important people get credit for all the time they spent on dialysis,” he said. Also, under the new proposals young patients will receive healthy kidneys from younger donors. This may help cut down on the need for re-transplants, Formica explained. “Over 15 percent of people on the waiting list are waiting for a repeat transplant. By taking kidneys that are going to last longer and giving them to people who are going to last longer, we can reduce the amount of return to the waiting list and make things better for folks coming on to the waiting list,” he said. The new program will also move people to the top of the waiting list if they have hard-to-match blood or antibodies that can cause organ rejection, Formica said. Kidneys from older donors will be put to greater use under the new guidelines, Formica said. These organs are often overlooked because they can’t be transported over long distances without deteriorating. Now, patients will be able to get older donor kidneys in their area, he noted.

The study was presented recently at the Radiological Society of North America annual meeting in Chicago. Even though surgery to repair meniscal tears is common, “increasing evidence is emerging that suggests meniscal surgery may be detrimental to the knee joint,” study author Frank Roemer, a physician from Boston University School of Medicine and the University of Erlangen-Nuremberg in Germany, said in a society news

release. “The indications for meniscal surgery might need to be discussed more carefully in order to avoid accelerated knee joint degeneration,” he suggested. An alternative to surgery is physical therapy to help maintain and restore knee muscle strength and range of motion. Ice and nonsteroidal anti-inflammatory medications (NSAIDs) are also used to treat pain and symptoms, according to the release.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

Nurse Practitioners Opening First Medical Practices in Upstate NY Thanks to a new legislation, nurse practitioners can now work more independently from doctors — and they are opening their own medical practices By Ernst Lamothe Jr.

ary Cerrillo and Virginia Valenti were just having a conversation about health care when an idea struck them. They both had extensive experience when they were working at Mercy Hospital of Buffalo and other Upstate New York facilities. The topic that continued to come up was doctor shortage and how would so many patients find the primary care physician that they needed? “There were patients that went to urgent care to fulfill their needs because they couldn’t find doctors that would take new patients. Sometimes it got even worse if it was a Medicare or Medicaid patient. I just knew something had to change,” said Valenti, a board-certified family nurse practitioner. Cerrillo and Valenti are heads of Hamburg’s first nurse practitioner owned and operated practice Hamburg Primary Care, 4535 Southwestern Blvd. south of Buffalo. They have experience in adult and family medicine and have the philosophy that they diagnose and treat patients along with promoting positive health care habits through education and counseling. A new law taking effect Jan. 1, may open the door for more nurse practitioners to start their own medical practice. The Nurse Practitioners Modernization Act has been called by some an ideal way to advance patient access to care and recognize the roles that nurse practitioners play as independent healthcare professionals. It has been called by others a nice first step, but far from a victory lap. There are 13 states that allow nurse practitioners to practice with complete independence — Alabama, Arizona, District of Columbia, Iowa, Idaho, Maine, Montana, New Hampshire, New Mexico, Oregon, Utah, Washington and Wyoming. New York is 14th. There are more than 20,000 nurse practitioners in New York. The profession began in 1965 and it took until 1988 for

the career to be fully recognized. “I think that the new law has tremendous potential for meeting the needs of underserved areas,” said Jeanine Santelli, chairwoman of the Nazareth College nursing program. “Nurse practitioners have always, and will continue, to work collaboratively with our physician and other health team colleagues to ensure that clients receive the most appropriate level of care to meet their needs.” The new law removes the requirement of a written practice agreement between an experienced nurse practitioner and a doctor as a condition of practicing on their own. Any nurse practitioner with more than 3,600 hours of practice — or two years worth of full time work — will be able to continue extending their expertise and freedom beyond the current limitations. Previously, they had to sign a written collaborative agreement with a physician, which was as narrow or broad as the medical doctor allowed. “I am very excited about the future of advanced practice health care in New York state because of this new law,” said Joyce P. Griffin-Sobel, a registered nurse who is also the dean and professor of the College of Nursing in SUNY Upstate Medical University in Syracuse. “It gives advanced practice nurses the freedom to be more entrepreneurial in how they manage their practices, and consumers will have enhanced opportunities to receive their primary care from a nurse practitioner. With their patient-centered care approach and commitment to patient education, consumers will enjoy individualized and engaged health care.”

Mixed feelings

Marilyn Dollinger, a member of the Nurse Practitioner Association of Greater Rochester board, attended the December board meeting, the last before the new law comes into effect. While she said the mood of the room was generally supportive that

Virginia Valenti (left) and Mary Cerrillo, both nurse practitioners, are opening their own medical clinic in Hamburg. “We see patients, diagnosis, can order any kinds of tests and treat them. I think a lot of people don’t recognize the wide range of things that a nurse practitioner does,” says Cerrillo. A new law in New York state gives nurse practitioners the ability to work independently from a doctor. New York state finally passed the NP Modernization Act, she and others had concerns because the law did not go as far as they would have liked. While the law allows nurse practitioners to practice without a mandatory written collaborative practice agreement with a physician after 3,600 hours of practice, she said some hospitals have already said they will not credential those nurses in their system as independent. There appears to be some confusion related to Medicare regulatory requirements for NP practice and it would require them to track the NP practice hours. Although nurse practitioners could open up their own offices and practice independently after the 3600 hour requirement is met, there are some financial barriers to that option. “The overhead costs associated with starting your own practice are significant. Office space, staff, exam room furniture and equipment is expensive as well as many other factors

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that make costs a challenge when going out on your own,” said Dollinger, an associate dean of the Wegmans School of Nursing at St. John Fisher College. “Although this new law is a step forward, the problem is that the language is permissive that allows something to happen without requiring it. From what we are hearing, some hospitals are keeping the same requirements for a written collaborative practice agreement in place.”

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Your Doctor

By Chris Motola

Chris Burke, M.D. When it comes to strokes, it all depends on where in the brain it occurs, says chief of the stroke center at Unity Hospital. He talks about what leads to a stroke and ways to prevent it Q: What is your role at Unity Hospital? A: I’m the medical director of the stroke center at Unity Hospital and the Rochester Regional Health System. The stroke centers at Unity Hospital and Rochester General Hospital are what’s called primary stroke centers, which are where the rubber meets the road in terms of stroke care and where some of the few interventions we have for stroke are available. The stroke center is a very comprehensive operation that takes patients from the time they hit the hospital, through the hospitalization, through the rehabilitation, through the clinic afterwards where we work on prevention. It’s a pretty lengthy interaction with patients and it’s not something that’s done in a lot of places. We’re proud of it and hope to expand services to a larger group of patients in the region. Q: Who is most susceptible to stroke and what can you do for them? A: Like a lot of disease processes, the older we get, the more likely it is to occur. It’s the fourth leading cause of death in this country, but it’s the leading cause of disability. While we think of them as being conditions of the older population, more than 30 percent of strokes occur in patients under the age of 65. It’s a consequence of all the things we think of as being bad for us: high blood pressure, diabetes, high cholesterol, smoking, heavy drinking, poor dietary choices, lack of exercise. Basically the stuff we think of being the worst parts of our culture in terms of health. So we’re all at risk. Q: For the under 65 group, what in particular will make you more vulnerable to stroke? A: When we see it in younger patients, it’s often in patients who developed medical conditions early and either ignored it, didn’t get advice from physicians, or people who have made extremely bad life choices. Really heavy smoking. No exercise. That tends to be what catches us early, particularly if you have a familial history of vascular disease. Then it’s the perfect storm to end up with a stroke in your 50s, 40s, even 30s or 20s.

stroke through a full-blown one? A: So when it comes to stroke, I stay away from phrases like ‘ministroke,’ and I’ll explain why. I can show you an MRI of a stroke no bigger than the tip of your finger that could have a devastating effect on a patient; they’ll never walk again. And I can show you a stroke the size of your fist, and that patient will be out shopping at Wegmans six months from now. It’s like real estate: location, location, location. For symptoms, it depends where it occurs, but the major signs of stroke are facial droop or weakness, numbness or weakness in one side of the body or another. Problems with language. Slurred speech. Vision loss. In some patients, headache or confusion. Those are the major ones. There are also little ones that can manifest. Now, there are other conditions that can cause facial weakness or droop, but with stroke the symptoms are going to manifest very quickly. That’s where the name “stroke” comes from, as in to be suddenly struck down. Q: Prior to the actually stroke event, are you likely to see any preliminary symptoms. A: Not typically. That’s what makes them so dangerous. Lots of other conditions are going to give you warning signs. Chest pains, shortness of breath during exertion, these might show up in advance of a heart problem. Strokes don’t tend to work that way. Occasionally, there’ll be what many people are referring to when they say “mini-stroke,” which are TIAs (transient ischemic attacks). These are exactly the same thing as strokes,

Q: Stroke symptoms seem to creep up on people very suddenly. What should people look out for, from a mini-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

with bloodflow being blocked to a certain part of the brain. That starved area will begin to exhibit neurological symptoms, but in TIAs, the body finds a way to reroute blood to that part of the brain. It either reroutes blood or reopens the blocked artery and there’s no damage and the symptoms go away. That can be a harbinger that stroke is coming within the next seven to 14 days. Q: You mentioned it’s more location than the size of the stroke. Does that mean that the larger stroke’s just not presenting with as many symptoms, or did it actually do less damage? A: It’s a combination of location and volume and the fact that not all parts of the brain are equal. There are parts of the brain that are “eloquent,” where you’re going to see symptoms and there are parts of the brain that are more associative that help out the more eloquent parts of the brain. If you have a stroke in one of these areas, it may not present with symptoms at all and be a silent stroke. In most cases, though, you’ll be very cognizant that something has happened. Q: As the administrator of the stroke center, do you still practice? A: I mostly practice. As far as the administering of it, we have a number of people who help me out, but I’m primarily a clinical person. What we know about stroke changes yearly. If you don’t stay abreast of it clinically, it’s difficult to guide that clinical program. Q: Given how hard it is to intervene with strokes, are we getting better at helping people recover from strokes? A: It’s definitely something we’re getting better at, like how to manage blood pressure and blood sugar within the first few days after the stroke. Rehabilitation is a science unto itself and we have a group of physicians and providers who help maximize recovery. Not too long ago, when you had a stroke, you threw your hands up and said there’s not much you can do. This generation of stroke care has changed that quite a bit. We don’t give up on patients. I can show you patients who, six to 12 months after their stroke were still having difficulty with language, but two or three years later you might not be able to tell they’d ever had a stroke. Q: What’s changed? A: I think a more proactive physical, occupational, and language therapy. It’s a much more comprehensive effort to get them to be able to live as independently as possible. Medically, we are very aggressive about reducing the risks of a second, third or fourth stroke. Every stroke you lob on top of the first one, the chance of disability exponentially increases. In the past, you’d get an aspirin. If an artery was blocked, you might be able to get that cleared, but otherwise you were mostly on your own.

Lifelines Hometown: Hollidaysburg, Pa. Education: Tulane Medical School, University of Rochester Affiliations: Rochester Regional Health System Organizations: Academy of Neurology Family: Married (Joy), three children Hobbies: Active tri-athlete, Iron Man participant Something people might not know about you: “I was a US Park Ranger for seven years.”

Goodbye Paper Scripts Starting in March, all medical prescriptions will be in the electronic form By Deborah Jeanne Sergeant

f your physician still writes paper prescriptions, they won’t much longer. As of March 27, 2015, New York state mandates electronic prescriptions. Area pharmacists sound positive about the change, as most primarily work from electronic prescriptions already. “It’s excellent,” raved Mohammed Chhipa, pharmacist at Warrens Pharmacy, Inc. in Rochester. “The print is legible. You don’t have to call to figure out what it says.” Instead of calling the office whenever a doctor’s handwriting lives up to the stereotypical scrawl, all the prescriptions are completely legible since they’re transmitted in a uniform font. Electronic prescriptions also make it easier for recordkeeping, since the prescriptions automatically enter the patient’s electronic health records. “That’s great for providers and patients,” Chhipa pointed out. “Everything is accurate.” Evan Kowal, pharmacist at New Clinton Pharmacy, LLC in Rochester, likes electronic prescriptions. “They make things pretty easy,” he said. “A good portion of the input is just transmitted automatically. I think it will be helpful for all of them to be electronic.”

Katherine Deiss, a physician with Greece Medical Associates in Rochester, likes electronic prescriptions in general and could only think of one drawback. “There’s not always a good electronic connection that the pharmacy uses,” she said. She said that most patients like it, since they can’t lose a prescription. “E-scribing is safer on the doctor’s side because there’s an exact record on what was prescribed,” said Mark Cohen, internal medicine physician and pediatrician with Lifetime Health. “If it’s on paper, you have to make sure it’s in the notes. In the past, they’ve had to [photocopy] it and put it in the notes.” Nixing paper scripts also means greatly reducing fraud since the only way to generate a prescription is using the encrypted, password-protected system accessible only through the medical system’s mainframe. Lifetime Health uses its own private network run off servers, so no individual has patient information store on his own desktop or laptops. Electronic prescribing can help reduce incidences of contraindication. Some health conditions and prescriptions preclude a patient from taking certain medications. While doctors and

pharmacists work to eliminate these conflicts, electronic prescribing adds another layer of oversight, especially if patients forget to mention medication or if they use more than one physician and/or pharmacy. A small percentage of prescriptions will still require a call to the doctor’s office for clarification. Faris Pharmacy in Rochester is a compounding pharmacy that makes prescriptions not available commercially. For example, if a patient needs a capsule without dye that is normally available only with dye. Pharmacist Carolyn Huntress of Faris Pharmacy said that electronic prescriptions sent to her often need additional clarity because of the unusual nature of the drugs. “E-prescriptions aren’t a benefit to us,” she said. “We have to go with them or otherwise we wouldn’t.” The problem lies in the electronic forms doctors use. The forms don’t include many of the quirks that qualify a drug to be made by Faris Pharmacy. Although the forms allow comments and notes, doctors don’t always enter the information accurately, which requires Faris Pharmacy personnel to follow up. “There are ways to...add notes, but we need to train doctors’ offices on how to do this, to override the system,” Huntress said. As with paper prescriptions, elec-

tronic prescriptions are only as precise as the input entered. “It happens if you’re not paying attention,” Cohen said. “The tool is only as good as its user. But there are problems with paper scripts, too.” The electronic system helps snag data entry errors, but the doctor, pharmacist and patient should work together to spot human errors and increase prescription accuracy. In case of technical problems, power outages, or a few other exceptions, paper prescriptions will be honored after the March deadline.

Healthcare in a Minute By George W. Chapman

U.S. Still No. 1 When it Comes to Healthcare Spending

ur annual spending on healthcare increased 3.6 percent in 2013, which has been about average since 2009. We spent $2.9 trillion or $9,255 per person in 2013 to once again retain the dubious No. 1 ranking in the cost of care among developed countries. Healthcare spending is 17.4 percent of the nation’s gross domestic product. Many experts attribute the historically modest increases to lingering effects of the recession. The fear is that as the economy picks up, so will the annual increase in healthcare spending. Despite another year of modest medical inflation (3.6 percent) most likely your premium (through the exchange or through your employer) for next year will increase two to three times the medical inflation rate. Almost half of that increase is attributable to taxes on insurers for: Obamacare subsidies, number of participants or insured in their plan and health information technology. Insurers must charge the same for comparable plans offered on the exchange or through employers. Retail clinics gaining acceptance. Walgreens, RiteAid, CVS and Target all offer primary care services. The Advisory Board, a healthcare consultancy group, surveyed users of these retail clinics and found the following to be the main reasons for user satisfaction: centralized online scheduling, extend-

ed hours, price transparency, less than 30 minutes waiting time and a broad range of services. Some see these clinics as a threat to traditional private practices and others see them as the future of primary care and a way to mitigate the shortage of primary caregivers. In any event, these successful and growing companies have seized upon opportunity in the market and are becoming more popular with consumers. 2014 is active year for hospital mergers. Odds are if your favorite hospital hasn’t already merged with another hospital or hospital system, it may do so in the next couple of years. 2014 was a busy year in the industry for healthcare mergers and acquisitions. Worldwide, healthcare related deals reached $438 billion, which is about 14 percent of all mergers and acquisition business. Hospitals also continued to gobble up physician practices to shore up their market share and achieve operating efficiencies. Rural hospitals continue to be most at risk if they continue to stand alone. There are too many hospital beds in the US and mergers/ acquisitions often result in the reduction of beds. Twenty years ago there were about one million licensed beds in the US. Today, there are about 800,000 and on an average day, 35 percent are vacant/unused.

Integrating your medical device with your EHR. There are a lot of personal medical devices on the market ranging from heart, blood pressure and sugar monitors to Fitbits. iHealth is a leading developer in taking these devices a step further by integrating the information from them with your electronic medical record. iHealth is working with Apple, Duke, Stanford and Epic, which is the largest EHR vendor in the country. Critics caution that while the intent is great, already over taxed clinicians could be further overwhelmed with this additional data. Paying upfront. More and more providers are requiring their patients to pay their deductible or coinsurance upfront prior to an elective procedure. In the past, the provider would bill the insurance company after the procedure was performed. The insurance company would pay the provider the negotiated fee less whatever the patient owes in deductible or coinsurance. The provider would then, in turn, bill the patient. However, with 20 percent of us now having a high deductible plan, bad debt for providers has increased significantly. Consequently, they are requiring payment up front. Many hospitals offer payment plans directly or through outside loaners like Banker’s Healthcare Group.

January 2015 •

Future of Obamacare. Republicans now control both houses in Congress. They are proposing to repeal the 2.3 percent excise tax on medical device sales, which will cut $30 billion in revenue over the next 10 years from the Affordable Care Act. Experts predict that this cut alone, if not replaced, could increase premiums by 45 percent. The G.O.P. also wants to increase the work week definition (hours an employee works per week to receive health insurance from their employer) from 30 hours to 40 hours. The Congressional Budget Office estimates 1 million people would lose their employer based coverage if hours were increased to 40. Finally, the US Supreme Court will hear a challenge to the federal government offering tax payer subsidized insurance rates through the 34 federally run exchanges. The 16 state-run exchanges could continue to do so.

GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.

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Page 7

Blood Test That Gauges Heart Attack Risk Approved by FDA The screen is meant for people without history of heart disease, agency says

he U.S. Food and Drug Administration in December approved a new blood test that can help determine a person’s future odds for heart attack and other heart troubles. The test is designed for people with no history of heart disease, and it appears to be especially useful for women, and black women in particular, the agency said. “A cardiac test that helps better predict future coronary heart disease risk in women, and especially black women, may help health care professionals identify these patients before they experience a serious [heart disease] event, like a heart attack,” Alberto Gutierrez, director of the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health, said in an agency news release. The test tracks the activity of a specific biological signal of vascular inflammation, called Lp-PLA2. Vascular inflammation is strongly associated with the buildup of artery-clogging plaques in blood vessels, the FDA explained. As plaque accumulates, arteries narrow and the chances of a serious cardiovascular event increase. “Patients with test results that show Lp-PLA2 activity greater than the level of 225 nanomoles per minute per milliliter are at increased risk for a [heart disease] event,” the FDA said. The FDA said its approval of the new blood test comes from data compiled in a study funded by the U.S. National Institutes of Health. Almost 4,600 people aged 45 to 92 with no prior history of heart disease took part in the study, and were followed for an average of just over five years. In subgroup analyses, the test seemed especially sensitive for black women, because they experienced a “higher jump” in the rate of heart attack and other heart disease events when their blood levels of Lp-PLA2 exceeded a certain level. “As a result, the test’s labeling contains separate performance data for black women, black men, white women and white men,” the FDA said. The test is manufactured by San Francisco-based diaDexus, Inc. According to the U.S. Centers for Disease Control and Prevention, heart disease remains the leading killer of Americans, and coronary heart disease is the most common form of the illness, killing over 385,000 people each year. “Almost two-thirds of women and half of men who die suddenly of coronary heart disease have no previous symptoms,” the FDA noted.

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

A Dozen Don’ts for 2015

’ve shared lots of “do’s” in the past to help people live alone with more success. Here are a few “don’ts” — some lighthearted — that may also help you on your journey toward contentment in the New Year: Don’t isolate. Get up, get dressed, lose the PJs or sweat pants, and get out of the house (or get on the phone). We humans are social animals; we’re meant to be with others. Solitary confinement is for criminals, not for people who live alone. Stay connected! Don’t go on a shopping spree to fill an emotional void. Your savings account will thank you. Don’t make Cocoa Puffs your main course for dinner. Well . . . maybe on occasion. But as a general rule? No. Create a nice place setting, fill your plate with something healthy, light a candle, pour yourself a glass of wine or cranberry juice, and enjoy some well-deserved time to yourself. A favorite magazine or book can make for a nice dining companion. Bon appetite! Don’t label yourself a loser just because you are spending Saturday night alone. It’s not the end of the world. It doesn’t define you. Stream a Netflix movie or clear some clutter and call it a night. If the prospect of a Friday or Saturday night alone is too difficult, reach out to a friend today and make plans for next weekend. Don’t put too much stock in that Dreamcatcher. If you find yourself wide awake in the middle of night fighting demons, you might try meditation, journaling or aromatherapy. I fill my diffuser with lavender oil and do some deep breathing while I repeat the phrase, “Sleep is

healing.” If that doesn’t do the trick, I get up and prepare myself some warm milk or herbal tea. I return to bed with fingers crossed and eyes closed. If all else fails, consider sleep aids. Don’t avoid dancing lessons because you don’t have a partner. Good teachers know how to incorporate singles into their classes by making introductions or by partnering with single members to demonstrate steps. Lucky you! Don’t jump into someone’s arms out of loneliness. Feelings of desperation can make you easy prey for a “suitor” with dubious intentions. It’s a risky place to be. Getting good at living alone will build your self-esteem and improve your chances of meeting someone who appreciates your strengths, not your weaknesses. Don’t get behind the wheel after a night of drowning your sorrows with friends. No explanation needed. Drink and drive responsibly. Don’t be afraid to travel alone. Some of my best trips have been taken with my favorite traveling companion: myself. I create my own itinerary, go at my own pace, and meet all kinds of interesting people along the way. Even a small jaunt can boost your confidence. On your own, you’ll discover your own resourcefulness, ability to solve problems, and capacity to spend some time alone. It can be an enlightening adventure in self-discov-

KIDS Corner Higher Birth Weight Indicates Better Performance in School

t’s no secret that low-birth-weight babies face significantly greater risks for certain health problems early on, such as respiratory distress or infection. Now, a new study from researchers at the University of Florida and Northwestern University shows that lower weights at birth also have an adverse effect on children’s performance in school, which is likely due to the early health struggles small babies often face. Using a unique set of data that matched birth and school records from 1.6 million children born in Florida

between 1992 and 2002, the researchers found that the higher the weight at birth, the better children performed on reading and math tests in school. The findings held true throughout elementary school and into middle school regardless of the quality of the schools children attended. These findings held true when socioeconomic and demographic factors were equal among children’s families, said Jeffrey Roth, Ph.D., a research professor of pediatrics in the UF College of Medicine and a co-author of the study.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

ery. I highly recommend it. Don’t decline an invitation because it means walking in (and walking out) alone. You can do it. Make a beeline for the host to say “hello” and ask for an introduction to someone, if you are surrounded by strangers. Or, get in line at the refreshment station. You’ll be engaged in conversation before you know it. Be yourself, be sincere, and be curious about others. Go and have fun! Don’t act your age. You are free, unencumbered, and on your own. What better time to spread your wings, be silly, and otherwise express your glorious, outrageous self. Put yourself with people who make you laugh. For me, that’s my sister. So keep your sense of humor. After all, life can be funny. Don’t take these “don’ts” too seriously. You are in the best position to decide what to do or not to do — no shoulds, musts, or other people’s agendas. That’s one of the best benefits of living alone. Don’t I know it! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops or to invite Gwenn to speak, call 585-624-7887, e-mail gvoelckers@rochester.rr.com

But when socioeconomic factors and demographics are not equal, higher birth weights don’t always translate to better performance in school. For example, lower-birth-weight babies of highly educated parents tend to perform better in school than heavier babies of high school dropouts because the educational level of a child’s mother is a stronger predictor of school success, Roth said. But when researchers compare children with similar family backgrounds, birth weight plays a key role in predicting future school success. “We tend to think that good schools are places where struggling kids get special attention and motivated teachers can correct any problems with learning,” he said. “This research indicates that is not always the case. Good schools are good for everyone, but even the best schools don’t seem to differentially help kids with early health disadvantage.”

Sunscreen in the Winter?

Experts say it’s a good idea to keep it handy — and use it By Deborah Jeanne Sergeant

ou’ve likely packed up your flip flops, swimsuit and shorts weeks ago, but don’t stow sunscreen. The summertime essential is really meant for year-round use to protect against the signs of aging and skin cancer. “In all seasons, you should use sunscreen,” said Sara Drew, dermatology nurse practitioner with Geneva General Dermatology. “In the winter, you can still get those cancer-causing rays through the clouds and thru the windshield when driving, even through tinted windows, unless they’re very dark but those aren’t legal in New York State.” Mansi Ladrigan, dermatologist with Comprehensive Dermatology Of Rochester, PLLC, said that “a lot of people think since it’s overcast, you don’t need SPF in winter, but UV is always in the air. It’s not just a summertime thing.” Although your skin may be more prone to burning in the summertime, the effects of sun damage is cumulative—and the sun is more dangerous when reflected by snow. Fortunately, winter apparel covers most skin normally exposed to the sun other times of the year; however, for the face, neck, ears and hands, it takes sunscreen to stay safe from ultraviolet rays. “Most people don’t use enough sunscreen,” Ladrigan said. “Use at least a quarter-sized dollop for your face, neck and backs of your hands if you’re otherwise bundled up for winter. It’s a little different for everyone, though.” Balding men, for example, may need more unless they wear a hat. Bearded men may need less. Re-apply about every 90 minutes when engaging in outdoor recreation. Physician Mary Gail Mercurio, associate professor in the Department of Dermatology University of Rochester Medical Center, also advises patients that at higher elevation, they should be more vigilant about sun protection. “Winter sports are a particular risk,” she said. In addition to the reflection of ice and snow, “skiing and snowboarding put you at higher elevation and even closer to the sun, increasing the intensi-

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Audrey Berger, Ph.D. - Life Coach ty of ultraviolet exposure.” Wearing a ski mask and goggles that have UV lenses can help protect you, as can SPF-rated lip balm. Mercurio warned that “chafed, windburned skin makes it even more vulnerable to the damaging ultraviolet rays.” She recommends a moisturizing sunscreen with gylcerin or lanolin, not an alcohol-based formula, which can dry skin. Daily moisturizer with SPF 15 suffices for most people, and SPF 30 while engaging in outdoor activities. Higher SPF does not offer any additional protection. Before buying sunscreen, check the bottle’s expiration date. Expired sunscreen may not be as effective as new sunscreen. Sun exposure stimulates the body to produce vitamin D, a pre-hormone that regulates many bodily functions; however, dermatologists recommend dietary and supplemental sources of D instead of sunlight exposure. Technology can help protect your skin too. Wolfram Sun Exposure Reference App, (http://products.wolframalpha.com/referenceapps/sunexposure. html, $1, iOS, and versions for other platforms) calculates sunburn risks related to skin type, whether you’re wearing sunscreen (though you should wear it regardless of apps), and the UV

index at that time and location. The app can help you calculate how long you can safely spend time outdoors.

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Page 9

SmartBites

By Anne Palumbo

The skinny on healthy eating

What Makes Romaine So Remarkable

h, January…month of snug waistbands and shirts that won’t button, no thanks to the endless supply of goodies over the holidays. But the eating season has come to a close and we all know what that means: Time to get back in the saddle and “eat clean” for a while until those favorite jeans fit again. My favorite go-to “clean” food is lettuce; and of all the varieties, romaine finds its way onto my plate more than any others. Crunchy like iceberg, but much more nutritious because of its darker green color, romaine delivers the goods: it’s tasty, it’s super low in calories, and it’s loaded with nutrients. To begin, romaine is a vitamin A heavyweight, providing over 100 percent of our daily needs in an average serving (about two cups). A nutrient we can’t live without, vitamin A benefits the body in several ways: it promotes good vision; it helps keep our immune system healthy; and it’s needed for normal bone growth and proper tooth development. While deficiencies are rare in countries like ours, they do occur and typically present with a decreased ability to see in dim light. Romaine also packs an impressive vitamin K punch, knocking off over 100

serving), this delicious green, with its incredibly high water content, keeps me hydrated, happy and full.

Helpful tips Choose crisp, compact heads of romaine lettuce that are free of holes or discoloration. To help romaine last longer in the fridge: cut off the core, separate the leaves, wash it, pat it dry, then wrap it with paper towels to remove excess moisture. Store away from ethylene-producing fruits, such as apples, bananas and pears, since they will cause the leaves to turn brown. Limp leaves can be revived by immersing them in ice water for a few minutes.

Charred Romaine with Gorgonzola and Toasted Pecans percent of our daily needs with just a few cups. Vitamin K, which helps blood clot properly, is a key ingredient in maintaining strong, healthy bones. As a middle-aged boomer with budding osteoporosis, I’m always looking for foods that will fortify my bones. I also reach for romaine because it’s a decent source of two more vital nutrients: folic acid (a B vitamin that reduces the risk of birth defects and may reduce the risk of heart disease and stroke) and heart-healthy fiber (2 grams per serving). Romaine is not only my go-to “clean” food during January, it’s also my yearlong salad staple. Remarkably low in calories (only 15 per average

Adapted from Bon Appetit Serves 4 3 cups crumbled Gorgonzola cheese ½ cup light mayonnaise ½ cup plain yogurt ¼ cup water 1 to 2 cloves garlic, minced ¼ teaspoon hot pepper sauce (optional) 2 heads of romaine lettuce, outer leaves removed, halved lengthwise 1 to 2 tablespoons olive oil Kosher salt ½ cup pecan halves, toasted, coarsely chopped Blend 1½ cups cheese, mayonnaise, and yogurt in food processor. Add 1/4 cup water, garlic and hot pepper sauce;

blend until smooth. Season with salt and pepper. (Can be made 1 day ahead. Cover; chill. Whisk before using.) Prepare grill for medium-high heat. Drizzle cut sides of romaine with oil; season with salt. Grill, cut side down, until charred, about 3 minutes. Turn and grill just until warmed through, about 30 seconds. Place romaine on plate, charred side up, and drizzle dressing over lettuce. Sprinkle with pecans and remaining cheese. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Got Leftovers? Tips for safely savoring food the second time around

hether you cook all your food for the week on Sunday or have extra food left at the end of a meal — for many families, leftovers are key to solving the problem of “what’s for dinner.” Meals like pastas, soups, chili and other home-cooked meals can easily be reheated for lunch at the office the next day or packed in a heat-insulated thermos for kids’ lunches. Some foods like casseroles, chicken salad, and foods with many different spices can even taste better the next day once all the flavors meld together. But in order for your leftovers to keep that “first bite” taste, properly handling of them can help ensure the leftovers you love stay delicious and bacteria-free. “Leftovers the next day can be a lovely reminder of the meal you shared with loved ones,” says food scientist Kantha Shelke, PhD, a spokesperson for the Institute of Food Technologists (IFT). “They’re also a great way to stretch your food budget. Properly handling and storing leftovers can help ensure your family gets the most value and enjoyment out of the food you’ve prepared.” Shelke offers some tips for managing leftovers:

Refrigeration

Of course you know food needs to be Page 10

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preserved in a refrigerator, but does it need to be cooled off first? Your grandmother probably cooled or chilled cooked foods before refrigerating them for a couple of reasons. First, to save energy; hot food would make the fridge work harder. Also, there was a risk of a hot dish breaking when coming in contact with a cold shelf. Modern refrigerators, however, are built to cool hot dishes. Still, chilling food promptly after cooking and then placing in the refrigerator is both safe and energy conscious. The temperature in your refrigerator should be at 40 degrees Fahrenheit (0 degrees Celsius) or lower. It’s best to use an appliance thermometer to make sure you have the correct temperature rather than relying on refrigerator controls and displays. Generally, food can go in the refrigerator when it’s reached a temperature of 90 to 100 degrees Fahrenheit — the dish should be just warm to the touch. You can chill food in an ice bath or cold water, sit it in front of a fan, or divide it into smaller portions that can be placed into shallow containers. The key is to store leftovers quickly, within two hours of cooking (one hour on hot summer days or in warm climates).

Storing

The debate over dish or dispos-

able wrap is a matter of personal preference. Thin-walled metal, glass or plastic containers that are shallow (no more than 2 inches deep) are ideal for storage. Bags, foil and plastic wrap also work well, especially if you have a piece of food that is large or oddly shaped. Cooked meat can be stored three to four days in the fridge, while uncooked ground meats, poultry and seafood will last only a day or two. Raw roasts, steaks and chops (beef, veal, lamp or pork) can be refrigerated for three to five days. Casseroles, veggies and similar side dishes, as well as pie, will usually last three to five days. If you have a lot of leftovers, you may choose to freeze them. Freezing completely halts bacterial activity, so food can stay safe and usable for months in the freezer, versus three to five days in the refrigerator. Most frozen foods will stay safe for several months; recommended storage times are merely for nutritional value and quality. Uncooked meats can last eight to 12 months in the freezer, while frozen cooked meats will begin to lose

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

their flavor after three months. Freezer temperature should be at 0 degrees F (-18 degrees C).

Reheating

When it’s time to serve those leftovers again, a thermometer is the best way to ensure food has been heated to a safe temperature. Most foods, especially meats, should be heated to 165F in the center. Bring sauces, soups and gravies to a boil. Never reheat leftovers in crock pots, slow cookers or chafing dishes. It’s safe to leave steak or other whole cuts of beef or lamb a little bit rare when you reheat them, as long as they were initially cooked at a high temperature to sear the outside only and kill bacteria on the surface of the meat. Whether you use the stove top or microwave to reheat will depend on the type of food. When reheating in a microwave, use a lower power setting to reheat without overcooking.

Flavor Trends to Watch in 2015

ver half of Americans consider themselves adventurous eaters and most are open to trying new flavors. Fortunately, consumers have more varieties of flavors to choose from than ever before and the choices are expanding every day. In the November issue of Food Technology magazine published by the Institute of Food Technologists (IFT), Senior Digital Editor Kelly Hensel writes about the top five flavor trends that flavorists, chefs and trendspotters predict consumers will be seeking out in the coming year. These include:

1. Sweet + Heat More consumers today are indicating they enjoy spicy food, and the spicy snack category is growing because of millennials’ love for bold flavors. The current obsession with sriracha, a Taiwanese hot sauce made from

chili peppers, is a key example of the new trend. Sweet and hot flavor profiles can also be found in beverages sector with drinks such as Mexican hot chocolate and jalapeno margaritas.

over a century ago by a Japanese chemist. The flavor is evoked by glutamic acid, a compound that is found in authentic ramen noodles and new seaweed snack foods. Umami even has health benefits, since it enables manufacturers to use less sodium while adding a depth of flavor.

2. Sour, Bitter & Tangy Consumers are starting to reach for bold, tangy, bitter flavors — both at the dinner table and at the supermarket. Kimchi, a common ethnic dish from Korea, has contributed to the popularity of sour and fermented flavors. It is made by salting and preserving fermented cabbage in a bed of pepper, garlic, ginger, and scallions. In addition, an increased prevalence of pickling has added to the sour, tangy trend.

3. Umami

4. Smoke & Oak Smoke — a flavor typically associated with meat — can now be found in soda, spirits, and craft beer. In the future, it is likely consumers will see more oak and other woods in combination with cranberry, sorrel, and honey in nonalcoholic beverages. Smoke adds a depth to any flavor, and depending on what wood or material is smoked, the result can be very different.

5. Middle Eastern & North African Middle Eastern and North African foods are increasingly becoming menu items at restaurants. Even if the dish itself isn’t Middle Eastern, many of the traditional spices — sumac, za’atar, coriander, and cardamom — are gaining popularity with chefs. Flavor innovation is on the rise and new food products continue to permeate the consumer market. In addition to food scientists, innovative chefs are always experimenting with flavor; and if those flavor profiles are popular in a restaurant, they are bound to end up on supermarket shelves. Consumers are ready to experiment and try new things, and if the flavor is tasty, it’s likely to be a success.

The concept of umami — the fifth basic taste — was born

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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NEW YEAR’S RESOLUTIONS

What Your Doctor Wants You to Do in 2015 Losing weight and quitting smoking are on top of doctors’ wish lists for their patients By Deborah Jeanne Sergeant

o many people, New Year’s Day represents a clean slate and an opportunity to do better in the new year. Maybe you’d like this year to be the year you get a raise, get organized or spend more time with your family. Area doctors have a few ideas of New Year’s resolutions they would like their patients to make. Maria Enecilla, a family medicine physician with Finger Lakes Health, simply stated, “Stop smoking.” Smoking negatively affects nearly every function and organ of the body. It can contribute to the development of cancers, and lung and heart diseases. Smoking also makes it harder to ward off illness. Mignon Enecilla, also a family medicine physician with Finger Lakes

Health, hopes more patients will resolve to “eat healthy and exercise regularly, avoid smoking and drinking. Keep an attitude of gratitude to stay healthy and happy.” Marcy Mulconry with Rochester Regional Health System, echoed the other physicians’ thoughts on smoking and weight control. “They’re difficult to face, but set small goals to improve,” said the doctor. “If you’re a smoker, work with your physician on the steps to quitting.” It may seem like if you’ve smoked for decades it won’t make any difference if you quit now; however, the American Cancer Society states that 20 minutes after quitting, the heart rate and blood pressure drop. Just 12 hours after quitting, the carbon monoxide level in the blood drops to normal. In only two weeks to three months after quitting, circulation improves and lung function increases. A year after quitting, the excess risk of coronary heart disease

is half that of someone who continues to smoke. If you keep up the resolution, five years from now, your risk of cancer of the mouth, throat, esophagus and bladder decrease by half. Risk of cervical cancer risk falls to that of a non-smoker. After 10 years of quitting, your risk of dying from lung cancer is about half that if you kept smoking. “These are just a few of the benefits of quitting smoking for good,” the American Cancer Society’s site states. “Quitting smoking lowers the risk of diabetes, lets blood vessels work better, and helps the heart and lungs. Quitting while you are younger will reduce your health risks more, but quitting at any age can give back years of life that would be lost by continuing to smoke.” Mulconry hopes more people consider losing weight as a resolution, even if it’s just a few pounds. “The benefits are huge if you’re even able to make a small reduction in weight,” Mulconry said. “When you look at the number of hospitalizations for smoking and obesity, it’s clear these are so important.” Mulconry also wants patients to “know your numbers” such as blood pressure, blood glucose, weight and what the terms mean.

“Become engaged in your own health and your profile,” Mulconry said. “Many health care organizations are giving people more access to their records online so patients can be a bigger part of their health care team. They are more involved in the conversation.” Katherine Deiss, a physician with Greece Medical Associates in Rochester, wants patients to “talk with their doctor and make at least one goal that would be good for them,” she said. “It’s easier to make one that’s realistic than to make many that are hard to reach. They need to ask their doctor or others for help if they need help.”

Why You Should Hire a Life Coach By Audrey Berger

his time of the year people tend to think about what they want to accomplish over the course of the year, but sometimes they’re not sure how to make it happen. Does this sound like you? If it does, you’re not alone. Studies have found that only about 12 percent of people who make New Year’s resolutions actually accomplish their goals. To increase your chances of being among the 12 percent who successfully achieve their goals, you could consider working with a life coach. Life coaching helps you to close the gap between where you are in your life and where you want to be, so you can live your life to the fullest. In life coaching, you focus on the things you want to accomplish, the changes you want to make, and strategies you can use to get there. Your coach does not tell you what you should want or what

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you should do. Rather, you commit to an action plan that you and your coach develop together during your sessions. Your coach supports and guides you, inspiring and motivating you to stay on track toward the goals you set, celebrating your efforts and achievements. When you participate in life coaching, your coach asks you thought-provoking questions and listens carefully to your answers. Using a combination of well-established behavior change techniques and intuition, your coach helps you clarify what you want, as well as identify steps you can take to get there. Your coach emphasizes the strengths you already have and helps you recognize how you can use those strengths in pursuing your goals. Together you work to discover and address any obstacles that may be stopping you from achieving your goals, such as self-limiting beliefs.

Sometimes people confuse life coaching with psychotherapy; although there are similarities between them, there are also important differences. Psychotherapy is a remedial health service that addresses emotional distress, problems or crises, in order to facilitate emotional healing and improved functioning. Life coaching is more of a wellness service that focuses on helping you to create the life you desire. The psychotherapy process tends to be directed by the therapist, whereas life coaching is more of a collaborative process between you and your coach. Unlike psychotherapy, which generally can only take place in an office setting, life coaching can occur either in an office or over the phone. Whether your goal is to create a more fulfilling life, establish a healthier lifestyle, become more organized, pursue more education, re-create your

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

life during major transitions, creatively manage significant life challenges, increase your resilience or resourcefulness, make your relationships more fulfilling, unblock and unleash your creativity, add more enjoyment, excitement or meaning to your life, achieve better life balance, or better manage stress, life coaching might be for you. Audrey Berger, Ph.D., operates Life Coach at Turning Point Life Coaching. She can be reached at audreybergerphd@gmail. com. More information about her practice at www. turningpointlifecoaching.com.

Resolutions: Why Are They So Hard to Keep?

By Deborah Jeanne Sergeant

bout a year ago, you felt sure 2014 would be the year you’d get in shape, keep your regular check-ups and kick your bad habits to the curb. Yet it’s a new year and nothing has changed. Why is keeping New Year’s resolutions so hard? Margie McCarty, mental health counselor for Perspectives and Pathways in Rochester, said that the above resolutions are simply too hard to achieve because they’re not specific. “People make generalized resolutions,” she said. “’I McCarty want to get organized’ or ‘I want to lose weight’ or ‘I want more balance in my life’ all sound good but they’re too broad.” Instead, she encourages smaller, more specific sub-goals, such as cleaning out one closet per week on a specific day to help get organized. Or joining a fitness group and cutting back on high-calorie snacks to lose weight. Or spending each Sunday afternoon without electronics to increase relaxation and family time. “Goals aren’t reachable unless

they’re broken down into smaller goals,” McCarty explained. “They need to make it a lifestyle shift.” She encourages people to write down and review goals to help track progress. Thomas Campbell, a physician who sees patients at UR Medicine Primary Care’s Canalside Family Medicine practice, says that people who succeed at making resolutions feel confident at the outset, “have a personal reason and skills for reaching the goals, and make the goals specific and time-limited,” he said. He gave as an example, “eat five servings of vegetables at least three days a week for one month. This is a Campbel modest goal. Then reevaluate.” Another example could be eating three meatless dinners per week for a month, and then reevaluating the goal. Or walking 7,000 steps three times a week for a month, followed by reevaluation. Beth Jelsma, counselor and PhD in private practice in Rochester, said that

adding a healthful practice tends to be easier than breaking a habit. “It really depends what underlies your habit,” she said. If you have a habit of leaving your desk and buying a cookie at the vending machine every afternoon at 3 o’clock, you should evaluate why. “What you really need is to get up and talk to people,” Jelsma suggested. “You have to figure out what need your habit is serving.” Is it nutrition, socialization, movement? Could you find more healthful ways of meeting those needs, such as an apple instead of a sugary cookie, sharing a positive story instead of gossip, and a vigorous walk instead of ambling? If you want to figure out how to Jelsma get more activity in your routine, Jelsma suggested considering how you enjoy moving. If you hate going to the gym, buying a gym membership likely won’t motivate you enough. She suggested sharing your goals with a workout buddy or personal trainer to provide more motivation. Joining a class or group can also

motivate you. “Or maybe you don’t go to the gym because you don’t have a sense of feeling worthy or you don’t have a sense of value,” Jelsma said. “You’ll need a therapist if that’s the reason. Willpower isn’t the issue.” Eliminating a negative habit without replacing it with a healthful alternative nearly always results in reverting to the old habit. Stefanie Greisch, who earned a master’s in social work and is a licensed social worker, says that consistent encouragement helps reinforce positive behavior. “If you can interrupt that cycle of negative thinking, you can reinforce the [positive] behavior and positive emotions,” she said. Greisch practices at Westfall Associates in Rochester and is in private practice in Rochester For people who want to lose weight, experiencing a small weight loss helps them see that their efforts are paying off. “Once you start to see the scale go down, it’s reinforced and the cycle continues,” Greisch said. If you experience a setback, “don’t beat yourself up over it,” she added. “See what you can change in the future.”

Activity Bracelets Offer Accountability By Deborah Jeanne Sergeant

ctivity tracking bracelets, such those made by Fitbit, Microsoft and Misfit, can help you get and stay fit. Ranging from nondescript, rubbery bracelets to gold-tone and silver-tone fashion jewelry (Fitbit’s higher-end bracelets were inspired by designer Tony Burch), the bracelets include a bevy of features. The bracelets work by recording

the body’s statistics and wirelessly transmitting them to the user’s handheld device or other computer. Users can set personal goals and receive real-time feedback as to how close they are to achieving them. Depending upon the brand and model, they track resting time and movement, monitor heart rate, display calories burned and compare the user’s performance from day to day. The devices’ interface with mobile devices also allow users to seamlessly track caloric and fluid intake and weight, too. Activity tracking bracelets are popular, but do they work in keeping people fitter? Area fitness experts weighed in. At L.A. Fitness in Henrietta, Fathama Bedum, personal trainer, said, “They are useful. If people are competitive, it helps people track how fast they’re getting.” For non-competitive people, “it can help them stay on track and accountable. Once someone gets on track it can keep them there.” Chris Ruiz Garay, personal trainer at Downtown Fitness Club in Rochester, said that one of his clients uses an activity tracking bracelet. “It’s extremely helpful to me as a personal trainer,” he said. “It helps the client know his heart rate at all times. I think that people

will use them more now that they look more like jewelry.” Initial bracelets were most widely available in sporty, rubber designs. Michael Knapp, personal trainer and owner of At Your Home Personal Training in Rochester, agrees that it’s helpful for his clients. “Most who have it like it and it’s exciting to set and monitor their goals,” Knapp said. “Some people swear by it. It helps generate improvements in overall health and it helps people stick with a routine longer.” He also cautions clients to not take the data too seriously. “Like any equipment, you have to give yourself a 20 percent leeway,” Knapp said. “If it says you burned 100 calories, you probably burned 80.” He said that when he’s using fitness equipment that estimates how many calories he has burned, he increases his activity by 20 percent to make up for errors. For example, instead of feeling satisfied with “200 calories burned” he pushes himself to burn 240 to account for the margin of error. Knapp thinks that the different generations like activity tracking bracelets for varying reasons. “The younger generation is more

January 2015 •

attuned to applications and want to monitor things,” he said. “Older people are more about maintaining a lifelong fitness habit and increasing their longterm health.” He estimates that about one-third of people he knows using the jewelry continue to use them for an extended period of time. Another third give them up after six months and the final third don’t bother after three months.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Women’s issues Hyperemesis Gravidarum: More Than Morning Sickness By Deborah Jeanne Sergeant

he former Catherine Middleton, Duchess of Cambridge, has brought hyperemesis gravidarum again into the spotlight with her second pregnancy. With each of her pregnancies, the royal mum has experienced what’s commonly known as “severe morning sickness.” Although caused by pregnancy, hyperemesis gravidarum represents far more than the run-of-the-mill morning sickness most women suffer as their hormones elevate for pregnancy. Regular morning sickness causes moderate nausea and sensitivity to odors and flavors for all or part of each day, and not necessarily in the morning. Going on an empty stomach or eating foods poorly tolerated can cause vomiting. Patients with hyperemesis gravidarum vomit up to 50 times per day and can become debilitated. Doctors are not certain as to why some women have hyperemesis gravidarum. Only about one-half to 2 percent of pregnant women experience it. “It has no clinical definition,” said physician Marcy Mulconry with Rochester Regional Health System, “but loss of body weight, signs of dehydration and starvation” indicate hyperemesis gravidarum. Physicians can test for keytones in

the urine, which indicate the body is breaking down its own stores of fat and its muscle for survival. “For practitioners, that helps us recognize the severity of the nausea and vomiting,” Mulconry said. The earlier women start treating hyperemesis gravidarum, the more likely they are to minimize its effect. Taking a prenatal vitamin before pregnancy can, in general, reduce nausea. Beginning with conservative treatment, Mulconry first suggests what helps ordinary morning sickness, such as eating small, frequent meals, eating before rising from bed, and sticking with bland foods. Some women find relief in taking doctor-recommended vitamins. Doctors can also prescribe anti-nausea medication. Intravenous fluids and nutrients can also help hospitalized patients recover. Thankfully, hyperemesis gravidarum doesn’t harm baby. “You don’t need all that much nutritional intake during the first part of pregnancy,” said Loralei Thornburg, an OB/GYN with University of Rochester Medical Center. “The baby grows just fine. It’s more about mom who’s suffering. Those long-term mineral deficiencies aren’t a problem in the first part of pregnancy. Starvation is impact-

Loralei Thornburg ing moms ability to function. “Our goal is not ‘no nausea or vomiting’ but maintaining hydration and managing symptoms.” She said that many women tolerate sweet or salty things, in addition to bland foods like crackers, plain noodles and oatmeal. A few tolerate sour foods. In general, most women better tolerate bland food than dairy, seasoned, spicy, “green” or fatty foods. Women who aren’t coping well at home may need to be admitted to the hospital to receive intravenous fluids and nutrition and for observation. Some patients need IV help so frequently throughout their bout with

The Pill Remains Most Common Method of Birth Control But long-acting IUDs are gaining in popularity, experts note

he pill remains one of the most popular methods of birth control for women, along with female sterilization and condoms, a new report shows. Among the two-thirds of women aged 15 to 44 who used birth control between 2011 and 2013, approximately 16 percent used the pill. Female sterilization, where women have their fallopian tubes closed or blocked, was used by 15.5 percent of women, while 9.4 percent used male condoms, according to the report published Dec. 11 by the U.S. National Center for Health Statistics (NCHS). But intrauterine devices (IUDs) and implants, both types of long-acting reversible contraceptives, are close on the heels of these other forms of birth control, with 7.2 percent of women using them. “Use of long-acting reversible contraceptives is becoming more popular,” said report author Kimberly Daniels, of the NCHS. Their use has nearly doubled since the last report on findings from five years earlier, when approxiPage 14

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mately 3.8 percent of women were using them, Daniels said. The most popular long-acting reversible contraception is the IUD, used by 3.5 percent of women in 2006 to 2010 and by 6.4 percent of women in 2011 to 2013, according to Daniels. The IUDs available in the United States include two hormonal versions, Mirena and Skyla, and one containing copper, ParaGard. This increase in long-acting reversible contraception has followed changes in guidelines by leading health care organizations that now recom-

mend their use to younger women and those without children, said Laura Lindberg, a senior research associate at the Guttmacher Institute. When IUDs came out years ago, there were concerns they might raise the risk of pelvic infection and jeopardize a woman’s fertility. But IUDs currently on the market don’t carry those risks, according to the American Academy

of Pediatrics. The academy now recommends these contraception devices as the first option for teens.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

hyperemesis gravidarum that they opt for a peripherally inserted central catheter (“PICC line”), an IV inserted into the arm that travels between the heart and junction in the shoulder. University of Rochester Medical Center, in conjunction with University of Buffalo, is currently studying medication for women with hyperemesis gravidarum to help them through the first portion of their pregnancy. “It will pass, but it’s very, frustrating,” Thornburg said. By 15 to 20 weeks of pregnancy, hyperemesis gravidarum ends for 90 percent of women.

Global Life Expectancy Continues to Climb

eople around the world are living much longer than they did a few decades ago, a new study indicates. Worldwide life expectancy rose from 65.3 years in 1990 to 71.5 years in 2013, but women had slightly greater gains than men. During that time, life expectancy at birth increased 6.6 years for females and 5.8 years for males. If current trends continue, life expectancy in 2030 will be 85.3 years for females and 78.1 years for males, said researchers led by the Institute for Health Metrics and Evaluation at the University of Washington. “People today are less likely than their parents to die from certain conditions, but there are more people of older ages throughout the world,” said Christopher Murray, institute director. “This is an encouraging trend as people are living longer. We just need to make sure we are making the right health policy decisions today to prepare for the health challenges and associated costs that are coming,” Murray said in an institute news release. The average age of death rose from 46.7 in 1990 to 59.3 in 2013, says the study, published Dec. 18 in The Lancet.

STDs: Young Women Face the Most Serious Consequences By Deborah Jeanne Sergeant

exually transmitted diseases (STDs) continue to spread among US teens. The Centers for Disease Control’s surveillance data shows that the rates of reported Chlamydia and gonorrhea cases are highest in Americans between the ages of 15 and 24. “Both young men and young women are heavily affected by STDs, but young women face the most serious long-term health consequences,” the CDC states. “It is estimated that undiagnosed STDs cause 24,000 women to become infertile each year.” The national statistics on STD prevalence bear out among local teens. Holly Biggs, nurse practitioner in family health and women’s health at Jordan Health in Rochester, said that both diseases are common among teen clients with STDs, though more new gonorrhea cases are appearing than Chlamydia. Biggs sees many teen clients with both gonorrhea and Chlamydia, and more often, gonorrhea by itself. Herpes is also pretty common among teenagers seeking testing or treatment. “This age group is in a certain state of denial,” Biggs said. “STDs are pretty rampant. The magical thinking with adolescence is ‘it will never happen to me.’ It’s a developmental glitch to be reactive instead of proactive.” Kate Ott, public health educator with Ontario County Public Health, said that Chlamydia is trending upward in the number of new cases each year, and is, by far, the most common STD among teens, with 250 to 300 cases per year in the county. In 2011, Monroe county reported 5,009 cases of Chlamydia among all ages. Ott thinks that widespread and frequent promiscuity is causing the increase in infection among teens. “Teens are new to sex and having more sex, so they ‘re likely not married

or monogamous,” Ott said. As Biggs alluded, teens tend to react to, not prevent problems. When it comes to STDs, that response causes more transmission. “A lot of men in particular don’t get symptoms,” she said. Statistics tend to show more girls with Chlamydia than men; however, Ott said that women tend to receive diagnosis more than men because they receive examinations for oral contraceptives, and because women exhibit more symptoms. “Guys that get diagnosed are either the few who have symptoms or their partner was tested,” Ott said. Chlamydia also causes more devastating consequences for some women. “It’s a bacteria that can move up to the pelvis and cause scar tissue that’s wrapped around fallopian tubes and ovary so when you do want to become pregnant, you can be infertile,” Ott said. “It increases the risk that the egg will get fertilized in the fallopian tube and it can get stuck: a tubal pregnancy. That is very serious. You can bleed to death internally if it’s not caught.” Since gonorrhea exhibits more symptoms and does so equally between the sexes, the rates between males and females are similar. Chlamydia and gonorrhea are both curable with doctor-prescribed antibiotics. If left untreated, they can render men and women infertile. Not all STDs are curable. Any person who engages in non-monogamous, sexual relationships or in a monogamous relationship with someone who has had other sexual partners, should be tested for STDs. Although many STDs exhibit no symptoms, any itching, burning, genital discharge, swelling or pain should receive prompt medical attention.

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lthough many people picture post traumatic stress disorder (PTSD) as a mental problem afflicting soldiers who experienced battle, anyone can suffer from PTSD. Experiences such as victimization, including domestic violence, assault, and robbery, can cause PTSD. Nonacute trauma, such as a lengthy illness, can cause it as well. For some people, witnessing a frightening event, such as a loved one dying in a house fire, watching a horrific car accident or viewing a catastrophe on television, can cause PTSD. “It has become a catch-all phrase, but it is a mental health diagnosis that has very specific symptoms,” said Rebecca Nancy Martin, licensed mental health counselor and nationally certified counselor in Rochester. “It has very specific criteria.” The Mayo Clinic defines PTSD as “a mental health condition that’s triggered by a terrifying event, either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and Juszczak severe anxiety, as well as uncontrollable thoughts about the event.” Instead of the fear and stress fading as time passes, the response remains as intense or becomes more intense. Typical responses to stress triggers can include irritable behavior, angry outbursts, acting in a reckless or self-destructive fashion, hyper-vigilance, flashbacks, sweating, nausea, an exaggerated startle response and problems with concentration and with sleep. For some people, prolonged neglect or the cumulative effect of bullying and abuse can cause PTSD. Martin said that some people experience or witness trauma before they are verbal and even as babies can experience PTSD. “They may not even remember,” Martin said. “One of the ways we cope with trauma is we forget it. People may bury it.” Adults may know something’s wrong, but not realize what. “It often looks like anxiety,” said Kara Juszczak, licensed clinical social worker and therapist at Tree of Hope Counseling in Rochester. “Most people identify they’re anxious about something. “We often minimize exposure to violence in our community, homes or elsewhere. People may have symptoms related to their exposure and not understand the degree, nature or intensity of how it’s impacting them. “It does take some sorting out with a therapist to find the triggers.” Juszczak helps clients identify themselves as survivors, not victims, become aware of triggers, and develop coping skills to manage them. At that point, they can “start to find purpose in their re-identification as a person and all the roles they play in addition to being a survivor.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

Among her tools are mindfulness and other relaxation strategies. These help to cope with the anxiety that accompany PTSD. Once clients can self-regulate their symptoms, they may have triggers for the rest of their lives, but they can manage them. Lori L. McCabe, licensed clinical social worker practicing in Rochester, uses a combination of approaches. One she calls psycho-education, so that her clients learn about trauma. She helps clients become more aware of their own feelings by journaling, which many find a safe outlet for their thoughts. “It transforms feelings into something concrete, which gives them validation,” McCabe said. “We’re also giving ourselves a release and McCabe letting off steam. Humans are like pressure cookers: if we don’t let off the steam, the top comes off.” Throughout treatment, she strives to build a trusting relationship with clients and create “an atmosphere that feels safe and secure and is judgment-free,” McCabe said. Desensitization and reprocessing helps many of her PTSD clients to retrain their brain’s thinking about the trauma they experienced and how the client relates to it. McCabe said that mentally reliving the trauma and viewing it more objectively helps clients categorize the trauma as just something that happened, not a threat that terrorizes them in the present. Jennifer M. Thompson, licensed clinical social worker with Healing Path Counseling Services in Rochester, explained that with PTSD, “we are putting ourselves and how we feel about ourselves into the trauma. It’s not just about the event but about ourselves. ‘If I’d spent more time with mom, she wouldn’t have died.’ or ‘If I’d given her the medication an hour sooner, she would’ve lived a few more weeks.’” “The story behind the trauma is more important than the trauma,” she added. “We use a specific type of therapy to learn coping, reduce the amount of association to keep people in the present rather than going too far in the future or in the past. We help the brain heal itself.”

By Jim Miller

How to Improve Your Balance as You Age Dear Savvy Senior, I’ve always been a walker, but when I fell last month my doctor suggested I start doing some balance exercises. Is this really something I need to practice? What can you tell me? Avid Walker Dear Walker, Most people don’t think much about practicing their balance, but you should, the same way that you walk to strengthen your heart, lungs and overall health, or you stretch to keep your body limber.

As we age, our balance declines — if it isn’t practiced — and can cause falls. Every year more than one in three people age 65 years or older fall, and the risk increases with age. A simple fall can cause a serious fracture of the hip, pelvis, spine, arm, hand or ankle, which can lead to hospital stays, disability, loss of independence and even death.

How Balance Works

Balance is the ability to distribute your weight in a way that enables you to hold a steady position or move at will without falling. It’s determined by a complex combination of muscle strength, visual inputs, the inner ear and the work of specialized receptors in the nerves of your joints, muscles, ligaments and tendons that orient you in relation to other objects. It’s all sorted out in the sensory cortex of your brain, which takes in the information from those sources to give you balance. But aging dulls our balance senses and causes most seniors to gradually become less stable on their feet over time. Poor balance can also lead to a vicious cycle of inactivity. You feel a little unsteady, so you curtail certain activities. If you’re inactive, you’re not challenging your balance systems or using your muscles. As a result, both balance and strength suffer. Simple acts like strolling through a grocery store or getting up from a chair become trickier. That shakes your confidence, so you become even less active.

Balance Exercises

If you have a balance problem that is not tied to illness, medication or

some other specific cause, simple exercises can help preserve and improve your balance. Some basic exercises you can do anytime include: • One-legged stands: Stand on one foot for 30 seconds or longer, then switch to the other foot. You can do this while brushing your teeth or waiting around somewhere. In the beginning, you might want to have a wall or chair to hold on to. • Heel rises: While standing, rise up on your toes as far as you can. Then drop back to the starting position and repeat the process 10 to 20 times. You can make this more difficult by holding light hand weights. • Heel-toe walk: Take 20 steps while looking straight ahead. Think of a field sobriety test. • Sit-to-stand: Without using your hands, get up from a straight-backed chair and sit back down 10 to 20 times. This improves balance and leg strength. For additional balance exercises visit go4life.nia.nih.gov, a resource created by the National Institute on Aging that offers free booklets and a DVD that provides illustrated examples of many appropriate exercises. You can order your free copies online or by calling 800-222-2225. Some other exercises that can help improve your balance and flexibility is through tai chi and yoga. To locate a beginner’s class in your area that teaches either of these disciplines, call your local senior center, health club or wellness center, check your yellow pages or try online directory sites like americantaichi.net and yogafinder.com. If nothing is available near you, there are DVDs and videos that offer tai chi and yoga instructions and routines for seniors that you can do at home. Some good resources for finding them are amazon.com, collagevideo.com and iefit.com, or check with your local public library. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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

New Study: Jogging Keeps You Young A new study by researchers at Humboldt State University and the University of Colorado in Boulder is shedding light on an unexpected benefit of jogging in older adults. The study looked at adults over the age of 65 —some of whom walk for exercise and some who run for exercise. The researchers found that those who run at least 30 minutes, three times a week were less likely to experience age-related physical decline in walking efficiency than those who simply walked. In fact, the older runners were 7-10 percent more efficient at walking than those who didn’t jog. The paper was published online in the journal PLOS ONE Nov. 20. “What we found is that older adults who regularly participate in high aerobic activities — running in particular — have what we call a lower metabolic cost of walking than older, sedentary adults. In fact, their metabolic cost of walking is similar to young adults in their 20s,” said Justus Ortega, a Kinesiology Professor at Humboldt State and director of HSU’s Biomechanics Lab. Metabolic cost is the amount of energy needed to move and naturally increases as we age. High metabolic cost contributes to making walking more difficult and tiring. Decline in walking ability is a key predictor of morbidity

January 2015 •

in older adults. In the study, researchers looked at self-reported older joggers over the age of 65 — those who ran at least 30 minutes a day, three times a week — and self-reported walkers, those who walked three times a week for 30 minutes. Participants were asked to walk on a treadmill at three speeds (1.6, 2.8 and 3.9 miles per hour) as researchers measured their oxygen consumption and carbon dioxide production. Overall, older joggers were 7-10 percent more efficient at walking than older adults who just walked for exercise. Their metabolic cost was similar to young people in their 20s. Researchers aren’t yet sure what makes joggers more efficient than walkers but they believe it may have something to do with the mitochondria found in cells. Evidence suggests that people who exercise vigorously have healthier mitochondria in their muscles. “The bottom line is that running keeps you younger, at least in terms of efficiency,” said Rodger Kram, a professor of integrative physiology at the University of Colorado, Boulder, and a co-author of the paper. Future studies are planned to examine whether other highly-aerobic activities—such as swimming and cycling—also mitigate age-related physical decline.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Unflinching In The Fight Against Fraud

f you’re like most people, you protect what’s valuable to you. To protect your family financially, you buy health and life insurance. To protect your home, you get homeowner’s insurance, a security alarm or perhaps a large dog. To protect your jewelry, you hide it in a safe place or buy insurance in case you need to replace it. To protect your money, you invest it, perhaps in a bank that offers FDIC coverage. Social Security is much the same. We value the people we serve, our employees who work hard to provide world-class customer service and the integrity of our programs. We protect these by using many tools to identify, prevent and stop fraud, and we seek the maximum punishment for those who commit it. The tools we use help us predict

Q&A Q: I’m creating my budget for 2015. How much will my benefit increase at the beginning of the year? A: The monthly Social Security and Supplemental Security Income benefits for nearly 64 million Americans will increase by 1.7 percent in 2015. This annual cost-of-living adjustment (COLA) is tied to the Consumer Price Index as determined by the Department of Labor’s Bureau of Labor Statistics. This New Year, you can enjoy your COLA starting in January. Q: I’d like to change the healthcare coverage that I signed up for through Healthcare.gov. How can I do that? A: The open enrollment period for Affordable Healthcare coverage takes place from Nov. 15, 2014 to Feb. 15, 2015. During this four-month period, you can enroll in a new plan or change current plans using the Affordable Care Act’s Marketplace. To continue health coverage in 2015, simply renew the current health plan or choose a new plan through the Marketplace between now and Feb. 15, 2015. Once the open enrollment deadline passes, the only way to get coverage for 2015 is to qualify for a “Special Enrollment Period” due to a qualifying life event as specified by HealthCare.gov. You have four months to decide what type of coverage you want, but the sooner you act, the sooner you will enjoy the security of affordable healthcare. Q: I went back to work after retiring, but now the company I work for is downsizing. I’ll be receiving unemployment benefits in a few weeks. Will this affect my retirement benefits?

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

where fraud may occur and, by monitoring cases closely, we identify fraud sooner rather than later. We also have stiff penalties that discourage people from committing fraud. Social Security has a zero-tolerance policy for fraud. While we cannot prevent every instance of fraud any more than law enforcement can prevent all crime, we aggressively investigate and pursue prosecution of those who try to cheat the system. Our message to those who would defraud Social Security is clear: We will find you; we will prosecute you; we will seek the maximum punishment allowable under the law; and we will fight to restore to the American public the money you’ve stolen. Social Security takes fraud seriously and so should you. If you suspect someone is committing Social Security fraud, report it online at http://oig.ssa. gov/report or call the Social Security Fraud Hotline at 1-800-269-0271.

A: When it comes to retirement benefits, Social Security does not count unemployment as earnings, so your retirement benefits will not be affected. However, any income you receive from Social Security may reduce your unemployment benefits. Contact the state unemployment office for information on how your state applies the reduction to your unemployment compensation. Q: I was wounded while on military service overseas. What are the benefits for wounded warriors, and how can I apply? A: Through the Wounded Warrior program, Social Security expedites processing of disability claims of current military service members or veterans disabled while on active duty on or after Oct. 1, 2001. Also, service members and veterans who have a Veterans Administration compensation rating of 100 percent permanent and total (P&T) may receive expedited processing of applications for Social Security disability benefits. Keep in mind, this expedited process applies to only the application for benefits. To be eligible for benefits, you must meet Social Security’s strict definition of “disability,” which means: • You must be unable to do substantial work because of your medical condition(s); and • Your medical condition(s) must have lasted, or be expected to last, at least one year or to result in death. You can apply online at www. socialsecurity.gov/applyfordisability or call our toll-free number, 1-800-7721213 (TTY 1-800-325-0778). You can find more information for veterans at www.socialsecurity.gov/ people/veterans.

H ealth News Trillium Health has new chief executive officer Trillium Health, formerly known as AIDS Care in Rochester, has a new president and CEO, Andrea DeMeo. She started on the position Jan 1, succeeding Jay Rudman, who retired at the end of the year. DeMeo was previously the executive director and chief operating officer of the Center for Community Health at the University of Rochester Medical Center. Prior to her position at URMC, DeMeo was employed by Visiting Nurse Service of Rochester & Monroe County, Inc., where she began as agency administrator and director of quality manageDeMeo ment, advancing to vice president of service delivery operations and then to chief operating officer. According to Trilliam, DeMeo is a community leader who brings a history of outstanding accomplishments and service to both the organizations she has served and to the community at large. She is an accomplished fundraiser and directed the University of Rochester’s annual United Way campaigns since 2006, raising more than $1 million annually for community programs. DeMeo currently serves on the board of directors of the United Way of New York State and the Greater Rochester Chapter of the American Red Cross board of directors. Trillium Health represents the future of health care: comprehensive, individualized, and affirming of each person’s identity. Trillium Health is a local community health center offering three dimensions of care: primary care, supportive services, and community outreach. It has expanded its offerings to serve HIV negative patients, including women and the LGBT communities.

MVP Health earns highest accreditation status MVP Health Care has earned the highest accreditation status of “Excellent” for its commercial and Medicare HMO/POS products by the National Committee for Quality Assurance. MVP was recognized for “service and clinical quality that meet or exceed NCQA’s rigorous requirement for consumer protection and quality improvement.” MVP’s Healthcare Effectiveness Data and Information Set (HEDIS) results are in the highest range of national performance. HEDIS is a tool used by more than 90 percent of America’s health plans to measure performance on important dimensions of care and service. Because so many plans collect HEDIS data, and because the measures are so specifically defined,

HEDIS makes it possible to compare the performance of health plans on an “apples-to-apples” basis. Health plans also use HEDIS results themselves to see where they need to focus their improvement efforts. “We are very proud of this ‘excellent’ accreditation status, which affirms that MVP Health Care is serving its members and our communities well, ensuring that they have the best possible access to health care,” said MVP President and CEO Denise Gonick. “Our goal is to be a leader in creating healthier communities and to achieve that we continually evaluate how we are performing and make adjustments for improvement as appropriate. The NCQA results are proof that we are on the right track.”

VNS hospice recognized for veteran services Visiting Nurse Service of Rochester recently achieved We Honor Veterans Partner Level Four, the highest recognition of this program. According to WeHonorVeterans.org, there are only three other organizations in New York state that have achieved this level to date, and all are located outside of the greater Rochester area. By voluntarily participating in We Honor Veterans, a program through the National Hospice and Palliative Care Organization in collaboration with the Department of Veterans Affairs, Visiting Nurse Service of Rochester gives veterans on their hospice program the proper care and a hero’s welcome home. During a moving ceremony, the organization publicly acknowledges the patient’s military service and presents a flag pin, a personalized certificate, and a flag blanket. It also meets veterans’ unique medical and emotional concerns that can result from combat, and connect families to organizations that can uncover veterans’ benefits. “By recognizing the unique needs of our nation’s veterans who are facing life-limiting illness, We Honor Veteran Level Four Partners are better able to accompany and guide veterans and their families toward a more peaceful ending,” said National Hospice and Palliative Care Organization President and Chief Executive Officer J. Donald Schumacher. “In cases where there might be some specific needs related to the veterans’ military service, combat experience or other traumatic events, these partners are capable of providing tools to help support those they are caring for.” Visiting Nurse Service is UR Medicine’s nonprofit, Medicare-certified home health care agency.

for lesbian, gay, bisexual and transgender employees (LGBT), administered by the Human Rights Campaign Foundation. Excellus BCBS joins the ranks of 366 major U.S. businesses which also earned top marks this year. “We are proud Searles to be recognized by the Human Rights Campaign’s Corporate Equality Index for our company’s progressiveness with respect to equal treatment of our lesbian, gay, bisexual, transgender and questioning (LGBTQ) employees and their families,” said Joseph Searles, corporate director of diversity and workforce inclusion, Excellus BCBS. “Our presence and support of the LGBTQ community overall also contributed to this achievement for which we are honored.” The 2015 CEI rated 971 businesses in the report, which evaluates LGBT-related policies and practices including non-discrimination workplace protections, transgender-inclusive health care benefits, competency programs and public engagement with the LGBT community. Excellus BCBS’ efforts in satisfying all of the CEI’s criteria resulted in a 100 percent ranking and the designation as a Best Place to Work for LGBT Equality. For more information on the 2015 Corporate Equality Index, or to download a free copy of the report, visit www.hrc.org/cei.

Stephen L. Ruchlin, DDS, relocates to new office

Excellus earns top marks on LGBT index Excellus BlueCross BlueShield received a perfect score of 100 percent on the 2015 Corporate Equality Index (CEI), a national benchmarking survey and report on corporate policies and practices related to workplace equality January 2015 •

Stephen L. Ruchlin, a long-time

Rochester-area dentist, recently relocated his office in Rochester — from White Spruce Boulevard to a new, more modern facility at 377 White Spruce Blvd. His new address is just across the street from his former location. Ruchlin and his Ruchlin team offer comprehensive dental care, including smile makeovers, dental implants, traditional dentures, implant-supported dentures, root canals, teeth whitening, mouthguards, and Invisalign. In addition, his office offers oral conscious sedation and nitrous oxide sedation. The office’s “Whitening for Life” program provides patients with a convenient and affordable way to keep their pearly whites looking bright for a lifetime. His new office features state-of-theart technology, including digital X-rays to provide clear, precise images of the teeth and gums that may be missed by standard examinations. “We are very excited to be able to offer our patients a beautiful, new facility designed to make each patient’s dental experience as comfortable as possible,” added Ruchlin.

Lifetime Health doctor receives ‘Fellow’ status Josephine Ellis, a board-certified family physician with Artemis Health of Lifetime Health Medical Group, has achieved the Degree of Fellow of the American Academy of Family Physicians (AAFP). The degree recognizes her service to family medicine and ongoing professional development. Ellis

Refugees Now Can Seek Health at Center for Refugee Health Rochester Regional Health System in December opened the Center for Refugee Health in Rochester, the first and only primary healthcare facility dedicated exclusively to serving the medical needs of newly-arriving refugees. Each year approximately 750 refugees are resettled in Rochester, according to the health system. A refugee is defined by the United Nations as “someone who flees a country in search of safety as in times of war, political oppression, or religious persecution and applies for admission to a different country while overseas.” Once resettled in this country, refugees are given an opportunity to apply for US citizenship. It is estimated that about 10 percent of the population in the City of Rochester includes previously resettled refugees. With the establishment of a ref-

ugee healthcare program in 2009, Rochester Regional Health System has been a leader in providing care to this unique population. Today, RRHS treats more than 5,000 refugee patients. “Our goal is to provide newly arrived refugees with highly specialized, culturally appropriate care that will better prepare them to navigate the complex western healthcare system the rest of their lives,” said James Sutton, a physician’s assistant who directs Office of Community Health, part of the Rochester Regional Health System. “With our new center dedicated exclusively to the care of refugees, we will have the opportunity to further our on-going efforts to create evidence-based treatment protocols that can be shared world-wide.”

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H ealth News was one of more than 200 family physicians who received the honor during the AAFP’s national meeting in Washington, D.C. “My colleagues and I wish to congratulate Dr. Ellis on her recent election as a Fellow of the American College of PhysiEllis cians. We’ve had the pleasure of working closely with her over the past two years,” says Robert Cole, a family medicine physician and medical director with Lifetime Health Medical Group. “She combines genuine, heartfelt concern for her patients with a deep understanding of current medical practices. We applaud her accomplishment.”   The AAFP is the national medical association representing nearly 115,900 family physicians, residents and medical students. Criteria for receiving the AAFP Degree of Fellow consist of a minimum of six years of membership in the organization, extensive continuing medical education, participation in public service programs outside medical practice, conducting original research and serving as a teacher in family medicine. Recipients often use “FAAFP,” for “Fellow of the American Academy of Family Physicians” after their names in recognition of this honor. Ellis joined Artemis Health in 2012. She came to Rochester from Olean, where she was a family physician with the Southern Tier Community Health Center Network and Olean General Hospital. Ellis completed her residency in family practice at the Olean General Hospital and her internship at Buffalo General Hospital. She earned her medical degree from The Chennai Medical College in Chennai, India. She is board certified in family medicine, and is a member of the American Academy of Family Physicians as well as the Medical Society of the State of New York.

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Fleet Feet Sports gets recognition Fleet Feet Sports Rochester, a local specialty running retailer with two locations was recently recognized as one of The Best Running Stores in America by two leading trade and consumer publications, Competitor Magazine and Running Insight. Fleet Feet Sports took its place among the country’s elite retailers following an extensive nomination and review process throughout 2014. The judging culminated in the store’s recognition at a gala awards ceremony in Austin, Texas on Dec, 4, 2014, as part of The Running Event, an annual conference and trade expo for specialty running retailers. The nomination process began early in 2014 with readers nominating their favorite shops on Competitor. com. This was followed by a rigorous evaluation process, including runner nominations, mystery shopping to assess customer service, credit ratings from vendors, and assessments about local programs and community involvement. According to Competitor, “The best running stores in the US offer exemplary customer service for every type of runner, organize training programs, group runs and local races, and provide knowledge and insights about the latest trends, the newest gear, proper running form, local trails and injury prevention. In other words, it’s much more about spreading the joy and passion of running than it is about selling new shoes and gear.” “This recognition is so exciting not only for Rochester, but for our staff, who work day in and day out to provide exemplary service to our customers,” said Ellen Brenner, co-founder of Fleet Feet Sports Rochester and YellowJacket Racing with her husband, David J. Boutillier. “Our staff prides themselves on their knowledge and ability to help change people’s lives. This award is a testament to their success.” Fleet Feet Sports will be featured in a special issue of Competitor Magazine distributed nationally. The store will also receive a commemorative plaque to mark the award and a special window sign supplied by Competitor that indicates the store as a 50 Best 2014 winner.

DePaul Celebrates Completion of Carriage Factory Apartments

At the centerpiece of the DePaul Carriage Factory Apartments is a late-19th century brougham-style carriage purchased from the Greenall Carriage House of Windsor, Vt. DePaul joined with city, state, public and private partners to celebrate the opening of the Carriage Factory Apartments. An open house and dedication ceremony marked the transformation of the over 100-year-old Cunningham Carriage Factory into 71 studio, oneand two-bedroom loft apartments for income-eligible tenants. The $23 million project was completed with a $3.3 million award from the Finger Lakes Regional Economic Development Council, a $600,000 loan from the city of Rochester and a payment in lieu of taxes (PILOT) agreement. “DePaul is pleased to be a community partner in meeting the need for quality affordable housing options in Rochester and throughout New York state, in addition to bringing back to life a building that once was home to a thriving manufacturing business with historic significance to our city,” said DePaul President Mark H. Fuller. “We are so proud to be part of the revitalization of this community. The DePaul Carriage Factory Apartments are an example of progress and partnership in action.” “DePaul has long been an important community partner, providing services and housing to some of our most vulnerable citizens,” said Mayor Lovely Warren. “We congratulate

DePaul on the opening of the Carriage Factory Apartments and a job well done! It is gratifying to see the transformation of this landmark building into quality, affordable apartment homes that will enrich the quality of life for our citizens and beautify the historic Susan B. Anthony District.” DePaul’s renovation of the historic Cunningham Carriage Factory memorializes the thriving manufacturing business that was once housed in this 73,000 square foot building. The Cunningham name was recognized worldwide as the maker of superior quality vehicles from coaches and carriages to automobiles and airplanes. The renovation of the formerly vacant, four-story building celebrates its history with an original brougham-style Cunningham carriage purchased from John and Sue Greenall of the Greenall Carriage House of Windsor, Vt., on display in the lobby and a gallery of drawings, photographs and artifacts. Generations of the Cunningham family came to celebrate the event, includng Tyrrell Cunningham Dryer, the grandson of James Cunningham who served as the president of the company in the mid-1800s, as well as James Cunningham’s great-grandchildren Michael Cunningham and Mary Cunningham.

Local organizations form new healthcare plan A group of 17 leading community-based organizations in December introduced iCircle Care, a locally based and provider-driven Medicaid managed long-term care (MLTC) plan. Community members, partners, board members, area influencers and health care supporters gathered at CDS Monarch to celebrate the official launch and open enrollment of iCircle Care. Serving individuals in the Western, Central and Southern Tier regions of New York, iCircle Care is licensed by the New York State Department of Health. This state-apPage 20

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proved MLTC operates under the licensed nonprofit managed care organization iCircle Services. iCircle Care was founded by a collaboration of 17 leading community-based providers. The new plan offers a wide range of home and community-based long-term care and health-related services to individuals enrolled in Medicaid in 22 counties. The governing agencies include Advocates Inc., Catholic Charities Community Services, CDS Monarch, CP Rochester, Epilepsy-Pralid Inc., Exceptional Family Resources, Finger Lakes United Cerebral Palsy

(Happiness House), Grace Community Services, Ibero-American Action League, Lifespan of Greater Rochester, Onondaga Community Living, Southern Tier Independence Center, Stepping Stones Learning Center, United Neighborhood Centers of Greater Rochester (Settlement Houses: Baden Street Settlement, Charles House, Community Place) and Urban League of Rochester. “iCircle Care is hometown care centered on you,” said Sankar Sewnauth, board chairman for iCircle Care and president and CEO of CDS Monarch. “We don’t have to answer to

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

a large, distant corporation and our members have choices. We provide our members with a high-quality health plan and social services that are culturally appropriate, community integrated and tailored to meet their individual needs, ensuring a positive impact on their personal health, lifestyle and independence. We are proud to say that we provide local expertise and access in our members’ neighborhoods.” For more information about the new organization, visit www.icirclecarecny.org

Fruit Flies with Better Sex Lives Live Longer Can sexual frustration be bad for your health? Male fruit flies that expected sex — and didn’t get it — experienced serious health consequences and aged faster

ex may in fact be one of the secrets to good health, youth and a longer life — at least for fruit flies — suggests a new University of Michigan study that appears in the journal Science. Male fruit flies that perceived sexual pheromones of their female counterparts — without the opportunity to mate — experienced rapid decreases in fat stores, resistance to starvation and more stress. The sexually frustrated flies lived shorter lives.

Mating, on the other hand, partially reversed the negative effects on health and aging. “Our findings give us a better understanding about how sensory perception and physiological state are integrated in the brain to affect longterm health and lifespan,” says senior author Scott D. Pletcher, Ph.D, professor in the department of molecular and integrative physiology at the U-M Medical School and research professor at the U-M Geriatrics Center. “The cutting-edge genetics and neurobiology used in this research suggests to us that for fruit flies at least, it may not be a myth that sexual frustration is a health issue. Expecting sex without any sexual reward was detrimental to their health and cut their lives short.” U-M scientists used sensory manipulations to give the common male fruit fly, Drosophila melanogaster, the perception that they were in a sexually rich environment by exposing them to genetically engineered males that produced female pheromones. They were also able to manipulate the specific neurons responsible for pheromone perception as well as parts of the brain linked to sexual reward (secreting a group of compounds associated with anxiety and sex drive). “These data may provide the first direct evidence that aging and physiology are influenced by how the brain processes expectations and rewards,” Pletcher says. “In this case, sexual rewards specifically promoted healthy aging.” Fruit flies have been a powerful tool for studying aging because they live on average 60 days yet many of the discoveries in flies have proven effective in longer-lived animals, such as mice.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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veryone experiences pain at some point but millions of Americans experience chronic

pain. Pain medicine is certainly one approach but may not be an option if it interferes with other medications. Some people can’t tolerate the side effects of certain drugs. Surgery may be considered for some pain but may not be appropriate or affordable. But those experiencing pain may have more options to treat the problem. Two of the techniques that people might consider for chronic pain include low-level laser therapy (LLLT) and deep tissue massage focusing on trigger points. Heather Nitching of Regain Physical Therapy and Wellness in Pittsford is a licensed physical therapist who uses low-level laser therapy to relive acute and chronic pain, reduce swelling and inflation and break up scar tissue formed by an injury or surgery or to reduce muscle spasms or rejuvenate nerves. “Laser treatment is appropriate for a wide range of conditions including joint replacement, trigger points, nerve damage, carpal tunnel syndrome, fibromyalgia, bursitis and tendinitis,” says Nitching. “Some of the things our clients like most about laser treatment is that it is non-invasive, painless, and has no side effects. It is safe for people of all ages with a wide range of pain issues including people who have had knee or hip replacements and have metal joints.” Nitching explains that the laser looks like a small flashlight which goes through skin and multiple tissue layers, as far as two inches deep to stimulate tissue and encourage cells to function. The laser is placed on the skin — the patient feels no discomfort. Depending upon the size of the area being treated, the process can take

Alternatives to Medication for Pain By Lynette Loomis “Laser treatment is appropriate for a wide range of conditions,” says Heather Nitching of Regain Physical Therapy and Wellness in Pittsford

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Drug Overdose-related Deaths Double from 1999 to 2012

he number of yearly deaths from drug overdoses in the United States more than doubled between 1999 and 2012, according to a new report. In 2012, more than 41,000 people died of drug overdoses in the United States, compared with about 17,000 in 1999, according to the report released Dec. 2 by the Centers for Disease Con-

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a few minutes to 10 or 15 minutes and is usually done several times a week until healing occurs. “The brief amount of time it takes for the benefits achieved make it one of the most time-efficient therapies. Many of our physical therapy clients also ask for laser treatments while other clients come in exclusively for laser therapy.” A common form of pain is neck or lower back pain that can range from irritating to a decreased range of motion to immobilizing. One focus of both laser treatment and massage therapy is the treatment of trigger points which are localized points of pain that can be caused by repetitive motion, disease, muscle overload or injury or trauma. Trigger points are tight muscles that can cause in other parts of the body (referral pain) and can cause pain in muscles even when the muscle is at rest making it difficult for a person to escape the pain. Shawn Thompson of Vital Massage is a licensed massage therapist with offices in Bergen and Pittsford who says, “For people who do not wish to use muscle relaxants, or who have not found them to be effective, deep tissue massage therapy focusing on specific triggers points can offer relief. In a cycle, I apply pressure, then release the pressure and begin again. There are 620 potential muscle trigger points in the body. One of my clients refers to her back pain as the Appalachian Trail as she has a string of very tight muscles that not only cause her significant pain, but affect her gait and her posture.” Laser and massage therapies can be very effective, non-invasive treatments to alleviate pain. As with any treatment, you may wish to consult your physician, understand if a referral is needed, check your insurance policy to see if it is a covered service and understand your out-of-pocket costs.

trol and Prevention. However, the report also found that the number of yearly deaths due to an overdose of opioid pain relievers, such as oxycodone and hydrocodone, actually decreased 5 percent between 2011 and 2012. Still, about 16,000 of the deaths in 2012 involved opioid pain relievers, according to the report.

There are a variety of reasons drug overdoses have increased over the past few years, said Rich Hamburg, deputy director of Trust for America’s Health, a nonprofit organization that advocates for public health policies. Some of those reasons include increased availability of prescription drugs and the tendency for physicians to overprescribe, said Hamburg, who was not

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015

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involved in writing the new report. The report also found that the overall national drug-overdose death rate increased from an average of 6.1 deaths per 100,000 people in 1999 to 13.1 deaths per 100,000 people in 2012. In some states, the death rate was much higher. West Virginia had the highest rate, with 32 deaths per 100,000 people, followed by Kentucky (25 deaths per 100,00 people), New Mexico (24.7 per 100,00 people), Utah (23.1 per 100,00 people) and Nevada (21 per 100,00 people).

Mobile Anesthesiology Comes to Upstate NY By Deborah Jeanne Sergeant

obile Anesthesiologists of Western New York hopes to offer another way for the region’s medical professionals provide anesthesiology services. Founded in February by physician Stefan Lucas, Mobile Anesthesiologists serves Buffalo, Rochester and Syracuse medical and dental facilities with scheduled and on-call anesthesiology. Mobile Anesthesiology, LLC in Chicago (www.zzzmd.com) originated the concept 17 years ago and offered Lucas the first franchise in the state. The firm helped Lucas fund the new business with an initial line of credit and provides billing services from their headquarters. “Physicians tend to want to take care of patients and we’re not trained or skilled in running a business,” Lucas said. “This model and having a marketing team and billing team has made it easy for me.” New York regulations require locations such as out patient surgical centers and doctor’s offices to obtain accreditation that allows Lucas to offer anesthesiology services as a subcontractor. Dental offices aren’t required to do so. For years, more and more patients

have opted for a surgical-center setting instead of the hospital setting. They perceive the surgical-center setting as more convenient and less costly. But that has changed, according to Lucas. “Surgery centers are now looking like day hospitals and their costs have gone up so that from an insurance or patient perspective, there’s not a significant advantage to doing things in a surgery center as compared with a hospital.” Minor surgery in a doctor’s office may offer less exposure to germs because of the building’s smaller size and smaller volume of traffic. With concerns over health care-associated methicillin-resistant staphylococcus aureus (HA-MRSA) and other potentially deadly, communicable diseases, many patients want to avoid exposure to large facilities when undergoing surgery. Some patients prefer a visit to a familiar, nearby office for minor surgery instead of driving into the city for a procedure. Lucas regularly works with a pediadontist (pediatric dentist) and performs contract work with a few smaller hospitals and surgical centers whenever they need extra help.

Caption “If someone gets sick, you can’t do all that work with one less person, but you can’t really hire someone to fill in,” Lucas said. “Having someone in the community who’s a known entity and is credentialed at five hospitals and a few surgery centers makes a difference. When they need me, they call.” His services also help medical facilities experiencing growing pain. If a building expansion project leaves a healthcare provider short staffed, he can fill in until they hire all the staff they need. Lucas hopes he can help more

physician’s offices turn into surgery centers for a day at whatever frequency they need it. “I want to help bring down the cost of healthcare by moving it into the least restrictive setting,” Lucas said. “A lot of simple surgery is done in-patient that doesn’t have to be. We want to improve the convenience and user-friendliness of minor surgery procedures. I want to need multiple physicians and nursing staff to help me cover the number of requests I’ve got. From the hospital and surgery center staffing I’m doing, I have to turn away work.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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LEADING-EDGE STROKE TREATMENT

With Stroke, Time Isn’t On Your Side. Dr. Chris Burke Is. dŚƌĞĞ ŽƵƚ ŽĨ ĨŽƵƌ ƐƚƌŽŬĞ ƉĂƟĞŶƚƐ ŶĂƟŽŶ-

wide aren’t treated fast enough for the best chance of a full recovery. That’s why ZŽĐŚĞƐƚĞƌ ZĞŐŝŽŶĂů ŚŽƐƉŝƚĂůƐ ƐŚĂǀĞ ƉƌĞĐŝŽƵƐ ŵŝŶƵƚĞƐ Žī ŶĂƟŽŶĂů ƐƚƌŽŬĞͲĐĂƌĞ ƐƚĂŶĚĂƌĚƐ͘ KƵƌ ƐƚƌŽŬĞ ƚĞĂŵƐ ʹ ŝŶĐůƵĚŝŶŐ hŶŝƚǇ͛Ɛ ƌ͘ ƵƌŬĞ ʹ ĂƌĞ ŶĂƟŽŶĂůůǇ ƌĞĐŽŐŶŝǌĞĚ ĨŽƌ ĚĞůŝǀĞƌŝŶŐ ĐĂƌĞ ƚŚĂƚ ƌĞƐƚŽƌĞƐ ĨƵŶĐƟŽŶ ĂŶĚ ƐĂǀĞƐ ůŝǀĞƐ͘

ĞƌƟĮĞĚ WƌŝŵĂƌǇ Stroke Centers Rochester General Hospital Unity Hospital Newark-Wayne Community Hospital

If stroke symptoms appear, don’t panic. Think F.A.S.T. – &ĂĐŝĂů ĚƌŽŽƉ͕ ƌŵ ǁĞĂŬŶĞƐƐ͕ ^ƉĞĞĐŚ ĚŝĸĐƵůƟĞƐ ĂŶĚ dŝŵĞ ʹ ĂŶĚ ĐĂůů ϵϭϭ͘ Learn more at www.rochesterregionalhealth.org/stroke. Page 24

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2015