Rochester In Good Health by In Good Health: Rochester's Healthcare Newspaper

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Rochester–Genesee Valley Healthcare Newspaper

June 2011 • Issue 71

Pregnancy & Yoga

FREE

TheVanishing

Solo Practice

Find out what benefits prenatal yoga can offer to moms-to-be

Out to Get You

The number of doctor-owned medical practices continues to decline. Find out what that means for health consumers. P. 10

Rowing for a Cause Don’t let bugs bug you this summer. Find out how

Cancer & Bankruptcy Bankruptcy rates among cancer patients increase along with survival time

Meet Your Doctor

Ronald Epstein ABVI embarks on $8.8 million expansion

A nonprofit organization, Cross Currents Minority Rowing, is raising money to make rowing affordable, and in the process is putting Rochester on the national rowing scene.

WOMEN’S ISSUE • Women’s Mid-life Weight Gain • Most American Women Experience Complications During Delivery • Liposuction: Lose Here, Gain Elsewhere July 2011 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

Bankruptcy Rates Among Cancer Patients Increase A n analysis linking federal bankruptcy court records to cancer registry data from nearly 232,000 adult cancer cases in western Washington during a 14-year period has found a hidden cost to survival: Insolvency rates increase along with the length of survival. “Patients diagnosed with cancer may face significant financial stress due to income loss and out-of-pocket costs associated with their treatment,” said Scott Ramsey, a health care economist and internist at Fred Hutchinson Cancer Research Center who led the study. “On average, bankruptcy rates increased fourfold within five years of diagnosis.” Ramsey presented the findings June 6 at the 2011 annual meeting of the American Society of Clinical Oncology in Chicago. The study found that compared to the general population, bankruptcy rates were nearly twice as high among cancer patients one year after diagnosis, and that the median time to bankruptcy was two and a half years after diagnosis. “The risk of bankruptcy for cancer patients is not well known, and previous studies have relied on individual self-reports about medically related reasons for bankruptcy filing,” said Ramsey, a member of the Hutchinson Center’s public health sciences

division. “By linking two irrefutable government records of cancer and bankruptcy, we are able to determine how financial insolvency risk varies by cancer type, treatment and other factors,” he said. For the study, Ramsey and colleagues linked Washington state cancer registry data with federal bankruptcy court records in 13 western Washington counties. They measured the rate of bankruptcy after a first cancer diagnosis and identified factors that increased bankruptcy risk among people with common cancers. They found that bankruptcy risk varies widely across cancer types. The risk is highest for lung, thyroid and leukemia/lymphoma cancer patients. In contrast, patients over 65, who are typically on Medicare, have a much lower risk of bankruptcy than younger patients. The researchers also found that bankruptcy rates among cancer patients have increased significantly since the U.S. financial crisis. Ramsey and colleagues in the Hutchinson Center’s Public Health Sciences Division, along with researchers at the University of Washington, conducted the study in collaboration with the U.S. Bankruptcy Court, Western District of Washington, Seattle. The National Cancer Institute funded the research.

49 Percent Rise in Drug-Related Suicide Attempts by Females Aged 50 and Older

new national study shows that from 2005 to 2009 (the most recent year with available figures) there was a 49 percent increase in emergency department visits for drugrelated suicide attempts by women aged 50 and older — from 11,235 visits in 2005 to 16,757 in 2009. This increase reflects the overall population growth of women aged 50 and older. The report by the Substance Abuse and Mental Health Services Administration also shows that, while overall rates for these types of hospital emergency department visits by women of all ages remained relatively stable

throughout this period, visits involving particular pharmaceuticals increased. For example, among females, emergency department visits for suicide attempts involving drugs to treat anxiety and insomnia increased 56 percent during this period — from 32,426 in 2005 to 50,548 in 2009. Similarly, emergency department visits for suicide attempts among females involving pain relievers rose more than 30-percent from 36,563 in 2005 to 47,838 in 2009. The rise in the number of cases involving the misuse of two narcotic pain relievers, hydrocodone and oxycodone was particularly steep.

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In Good Health is published 12 times a year by Local News, Inc. © 2011 by Local News, Inc. All rights reserved. 106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone:(585) 421-8109 • E-mail: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto Associate Editor: Lou Sorendo Writer: Mike Costanza Contributing Writers: Dr. Eva Briggs, Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Amy Cavalier, Sheila Livadas, Chris Motola, Jason Schultz, Valerie DeBenedette Advertising: Marsha K. Preston, Beth Clark Layout & Design: Chris Crocker Ofﬁcer Manager: Laura Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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HEALTH EVENTS

July 6

RHSC offering speech/ language therapy for kids Children with speech and language difficulties can enhance their learning skills during the summer through programs offered by the Rochester Hearing and Speech Center. RHSC is providing pre-school speech-language therapy sessions and school-aged learning programs from July 6 to Aug. 19, at its three locations in Greece, Webster and Rochester. Individual and group sessions are available for children and young adults ages 2 to 18 years old. The programs focus on a range of learning issues, including articulation; attention-span issues; language comprehension and expression; expressive and receptive language; fluency; language skills; listening and memory; pre-academic concepts; spelling; and writing difficulties. “Summer is always a time for fun, but many of the children receiving speech and language services during the school year simply cannot afford to take that time off,” said Rochester Hearing and Speech Center President Tom Gibbons. “Our summer clinics are designed to help these children continue making progress and not fall too far behind before the next school year begins in the fall.” Registration for RHSC’s summer programs is open until the sessions begin on July 6. For more information about the program content, financing options and insurance accepted, contact RHSC at 585-210-4049.

July 7

Adoption information meeting held in Rochester Children Awaiting Parents, a nonprofit organization, will hold an adoption information meeting. It will take place at 6 p.m., July, 7, at the Rochester City Hall, 30 Church St., room 008A. Several topics will be addressed, including adoption services and financial assistance that are available to

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help meet the needs of the child. For more information about the Adoption Information meeting, contact Veronica Black, community outreach specialist, at veronica@capbook.org or (585) 2325110. For other information, visit www. ChildrenAwaitingParents.org.

July 8

Gay Alliance sponsors Pride Parade in Rochester The Gay Alliance of the Genesee Valley is organizing its 22nd Annual Rochester Pride Parade. The event will take place Friday, July 8, and will continue all month long Join the 21st Rochester Pride Celebration. The theme this year is “It’s a Gay World After All…Animated on Park! This year the group is celebrating LGBT (lesbian, gay, bisexual and transgender) local, regional, national and international history with a variety of events to appeal to everyone. For more info and a complete schedule of events, visit www.gayalliance.org

July 30

Tour de Thompson to beneﬁt aftercare program The 9th annual Tour de Thompson bicycle tour of the Bristol Hills will be held on Saturday, July 30, at Onanda Park, West Lake Road, Canandaigua. Registration begins at 7 a.m. with a mass start at 8 a.m. Riders can choose from three scenic routes: 15 miles with 1,350 feet of hill climbing, 31 miles with 2,800 feet of hill climbing or a “Metric Century,” a 62.5-mile course that includes over 6,800 feet of elevation gain. The tour includes commemorative shirts for the first 75 registered riders, rest stops with refreshments, a SAG vehicle and bike mechanic, leg massages and free parking on the upland side of the park, plus a free post-ride picnic for all participants. Tour de Thompson benefits the aftercare program at Thompson Health, a

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

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rehabilitative service which helps those with chronic disease maintain their level of function and independence in the community. To register, visit www. ThompsonHealth.com or mail in a registration form to F.F. Thompson Foundation, Tour de Thompson, 350 Parrish St., Canandaigua, N.Y., 14424. The cost is $30 if postmarked by July 15 and $35 afterwards. For more information, contact Dudley Hallstead at (585) 396-6050 or dudley.hallstead@thompsonhealth. com.

July 30

USRowing to hold ﬁrst-ever event in Rochester USRowing announced the inaugural USRowing Diversity Invitational is set for July 30, in Rochester. Sponsored by MVP and hosted by Cross Currents Minority Rowing, the event features competition among USRowing’s America Rows partner programs. ”The USRowing Diversity Invitational offers more than great rowing,” said USRowing Inclusion Manager Richard Butler. “This event is a way to inspire athletes from ethnically diverse and economically disadvantaged populations to become leaders and role models for the sport of rowing.” USRowing Diversity Invitational Regatta partners include Brighton Rowing Club, City of Rochester Bureau of Parks & Recreation, Community Rowing, Inc., Fairport Rowing Club, Genesee Waterways Center, Genesee Rowing Club, Pittsford Indoor Rowing Center, Pittsford Rowing Club, Rochester City School District Department of Athletics, University of Rochester and UROW. America Rows is a nationwide diversity and inclusion initiative aimed at increasing awareness of rowing and introducing the sport of rowing to a diverse group of Americans, specifically the underserved urban youth who may not have the opportunity to participate in rowing. To learn more about Cross Currents Minority Rowing visit www.ccminorityrowing.com or contact Lydia Boddie-Rice at 585-244-2263 or lydbod@gmail.com. To learn more about Genesee Waterways Center visit www.geneseewaterways.org.

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The Rochester Academy of Medicine moved into the East Avenue mansion in 1939, and has continued to grow. It now boasts more than 820 members.

For Love of Medicine Rochester Academy of Medicine has helped local physicians come together to learn and grow through the decades. By Mike Costanza

early 112 years ago, local physicians came together for the first meeting of the Rochester Academy of Medicine “The whole idea…is to promote, advance and cultivate the art and science of medicine,” says Dr. Hechmat Tabechian, executive director of the Rochester Academy of Medicine and clinical professor of medicine at the University of Rochester School of Medicine and Dentistry. Twenty-nine physicians, 27 men and two women, gathered in 1899 for the first meeting of the Rochester Academy of Medicine, according to the book, “Let the Art Dr. Hechmat of Medicine FlourTabechian, ish,” the centenexecutive director nial history of the of the Rochester institution. The Academy of gathering drew from the top of Medicine and the local medical clinical professor community—18 of medicine at who attended had the University of headed or would Rochester School head local medical of Medicine and societies. Three held Dentistry. the presidency of the New York State Medical Society during their lifetimes. The academy initially met in the Reynolds Library on Spring Street in Rochester, which also housed the institution’s medical library. Since many hospitals did not have medical libraries at that time, the local physicians needed such collections. “This was the source of getting the information to the medical people,” Tabechian says.

The academy moved to different locations around the Rochester area, and eventually combined with a similar local organization, the Rochester Medical Association. “They became the Rochester Academy of Medicine,” Tabechian says. As the academy grew, it cast about for larger quarters. In 1938, the three daughters of Rochester lawyer Edmund Lyon and his wife, Carolyn, donated their family’s East Avenue home to the organization in memory of their parents. “They donated this building to be used by the medical community, and [for] the advancement of medicine,” Tabechian says. The academy moved into the East Avenue mansion in 1939, and has continued to grow. It now boasts more than 820 members, including physicians, about 300 medical students, and a smattering of other health care professionals, Tabechian says. Its quarters have undergone renovations and expansions down through the decades, while retaining an old-world charm. The facility boasts thick wood paneling, high ceilings, a sunlit atrium, an auditorium that seats over 280, and smaller meeting areas, among other features. It hosts more than 400 functions a year. Tabechian says. The academy also sponsors lecture series on medical subjects, Tabechian says, including the annual Lyon daughters lecture on bioethics, which celebrated its 20th anniversary in April. The guest speaker for that event, anthropology professor Nancy ScheperHughes of the University of California, Berkeley, gave a talk titled “Saving Lives or Selling Organs/The Ethics of Transplant Trafficking.” Not content to just host group educational events, the academy awards cash prizes to local medical practitioners, residents and students for their

work in nine different categories and it recognizes professional accomplishments and service to the community with appropriate decorum, Tabechian says. It also reaches beyond purely medical scholarship through its Life Fellow/Retired Physician Luncheon Lecture Series. The series has brought noted local author David Cay Johnston, popular WHAM-TV News anchor Don Alhart, former Rochester mayor William Johnson, Joel Seligman, president of the University of Rochester and many other luminaries to the Academy to speak of important issues. “We invited William Johnson to talk about the city,” Tabechian says. While lectures and awards might draw the attention of the medical community, many have come to the academy down through the years for other reasons. Thomas Campbell, chair of the URMC’s department of family medicine, began coming to the facility for his department’s annual retreat decades ago, while he was a medical resident. Last April, he brought another group of his department’s residents to the academy to relax and recharge during a daylong retreat. “We take time off from our busy schedules to all come together to reflect on the work that we do,” Campbell says. “This is an ideal environment to do it, because it’s very homelike.” Campbell’s is but one of the many thousands of medical professionals who have joined with their peers to enjoy the Academy’s ambience and charm down through the years. “We actually promote the fellowship amongst physicians,” Tabechian says. For information on the Rochester Academy of Medicine, go to www.raom.org. To contact the Academy, call (585) 271-1313, or email raom@choiceonemail.com.

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Meet

Your Doctor

By Chris Motola

Dr. Ronald M. Epstein URMC to research quality of doctor-patient communications when it comes to cancer Q: The University of Rochester Medical Center recently received a $2.9 million research grant to test new approaches to patient/doctor interaction. What about that interaction needs improvement? A: I think it’s a two way street. I think that physicians, in general, assume several things about patients that may or may not be true. So they often assume that the first thing the patient says is the most important. They may assume that patients only have one concern when they may have many. And they may assume they share values and preferences and belief systems when, in fact, their own may be very different than those of the patient. On the patient side, patients often don’t know how to ask physicians or prioritize their concerns. Patients, for example, don’t know that doctors assume that the first concern they mention is the most important. Patients often don’t have a clear list of their concerns; they often emerge over the course of the visit. Sometimes the most important ones come up at the end of the visit. And I think there are some things that are just particularly hard to ask about: depression, sexual dysfunction, risk of HIV or prognosis if you have a very serious disease. Q: As a doctor, what information are you looking for from the patient? A: I’m looking for a full range of the patient’s concerns. I also want to find out what impact those concerns have on their physical and psychological functioning—that is, what they’re really worried about in addition to what hurts them. I want to hear what they think is the cause of their illness and what they’ve done for themselves. Most people, when they’re ill, try something at home. It may work or it may not, but it’s useful for me to know that. That would probably be the starting point.

Just a few questions to figure out who this person is, not just what their illness is. The next thing I try to do is give the patients a few minutes to just talk without my interrupting them and find out what they’d like the next step to be. Only at that point do I start asking more details: When did it start? What were you doing? What did it feel like? More close-ended questions. But I think giving the patient a chance to tell their story in some detail is very important. Q: The new research project deals specifically with patients with incurable cancer. What are the communication issues specific to that? A: Nobody likes to think about death, especially their own death. It’s often very difficult to predict. Even though your disease may be incurable, it doesn’t mean you’re going to die today or tomorrow. You could have some period of time that is high-quality or not high-quality. The unpredictability makes it difficult. I think the complexity of treatment options make it difficult.

There’s always another treatment option, but the question is, does the treatment really work or not? Will it cause more harm than good? I think it’s a difficult conversation to have. And also, I think even though people sometimes think about what they’d like to do if this happened to them, when it actually happens, often their feelings change. They may feel conflicted. They may be telling them different things. It’s a time of not only dealing with the illness, but of having to make choices. What our project is trying to do is make those conversations a little more possible. So you really need input from both the patients and doctors to make them go more smoothly. One thing we do is help patients formulate questions. They may have an idea [of] what they want to ask but not how to ask it. We encourage them to make a list of their concerns. On the physician side, we encourage active listening and responding to patients’ emotions. If the patient seems really upset, we might say, “This seems like it’s a very difficult time for you, let’s discuss how we can move forward together.” Q: What kinds of concerns does a patient with a terminal disease have beyond the obvious fear of death? A: Concerns like, “Will this treatment make me feel better? Will it give me more energy? Is the burden of the treatment worth the benefit I might achieve? Will I live long enough to see my grandson graduate from high school?” Often people link hope to specific life events. So those things are really important to understand from a patient’s perspective. Q: What other research projects have you been involved in? A: I’ve done a number of projects that

Q: Given that you usually only have a few minutes with your patients, how do you establish a rapport that will encourage the sharing of information? A: It depends. If it’s a new patient, often they’ll come in with a concern. I’ll listen to the concern first, but before we get too deep into it, I try to find out more about them as a person. What kind of work do you do? Where do you come from? What’s important to you?

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use what’s called “standardized patients.” They’re actors trained to portray patients. With physicians’ prior permission, we have these actors make appointments with physicians so we can understand what really happens during consultation. You can think of it kind of a like a secret shopper. Physicians know someone’s going to come at some point, but they don’t know who it is. They come with a hidden tape recorder and capture those conversations. We did a study on how physicians deal with uncertainty. We did another one on how physicians deal with patients’ requests for medications that they saw advertised on TV. We found that patients actually can influence doctors in pretty important ways. Very often physicians will comply with the patient’s request and not dig as deeply into why the patient is requesting the medication. Q: What got you interested in these communication projects? Was it your experience as a doctor? A: I think it really comes from my experience as a patient more than anything else and knowing just how important it is to be understood. Also, a lot of my work early on in my career was with patients infected with HIV before there were any good treatments. And so the issues of talking about stigmatized topics—talking about sex, talking death, talking about a disease that was far more stigmatized back then—really for me raised issues about how doctors and patients talk to each other and how that can really impact outcomes for the patient. Q: Do you still practice or are you mostly doing research now? A: I have a family practice. I see patients in the office and I also practice palliative care at the hospital, taking care of people at the end of life.

Lifelines Position: Professor of family medicine, psychiatry, oncology and nursing at the University of Rochester Medical Center. He is board-certiﬁed in family medicine and hospice and palliative medicine. Other activities: Epstein is also director of the Center for Communication and Disparities Research, which focuses on how to improve communication between clinicians, patients and their loved ones. He is also very active in medical education and educational research. He has over 160 publications. Education: Graduated from Wesleyan University (1976) and Harvard Medical School (1984). Awards: Recipient of the Lynn Payer Award from the American Academy on Communication in Healthcare for lifetime achievement in communication research. He has been a Fulbright scholar at the Institute for Health Studies in Barcelona, Spain, and a visiting scholar at the University of Sydney, and continues collaborations with both institutions. Hobbies: Enjoys playing music, cooking, bicycling and cross-country skiing. Personal: Wife, Deborah Fox (she is a founding artistic director of Pegasus Early Music), and two children, Malkah and Eli. He can be reached at (585) 279-4700

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Don’t Let Bugs Bug You! Redness, swelling and size of the bite — anything more than a centimeter in diameter is reason to see a doctor By Deborah Jeanne Sergeant

asp and hornet stings and insect bites can take some of the pleasure out of a summer day. But with first aid, the pain and itching can be minimized. Terri Haskins, certified pediatric nurse practitioner for Finger Lakes Health Transitional Care Unit, recommends removing any stinger left behind by an insect and washing immediately with soap and water to help decrease the subsequent pain and lower the chance of infection. Use a magnifying glass if you need a closer look and gently lift from underneath with a credit card. Grasp the stinger with tweezers and pull it out. Ticks, which can burrow into the skin, should also be entirely removed with tweezers. Carelessly grabbing a tick can result in its head remaining in the skin, which can Gargano cause an infection. Most people recognize mosquito bites but may not immediately know what a chigger bites looks like. Intensely itchy, chigger bites can be red, flat or raised and may look like a blister. They tend to be located in areas with thin skin such as the ankles or where chiggers can hide such as the groin, under waist bands and in armpits. Chiggers don’t suck blood like mosquitoes. They inject an enzyme which dissolves human skin so they can drink it. The skin reacts to the invading enzyme by hardening. Although it prevents the enzyme from spreading, the reaction forms a handy drinking tube for chiggers to continue sucking up liquefied skin. They cannot bite again once they are removed from the skin. Symptoms of chigger bites are pronounced itching and areas that may be reddened, flat or raised and sometimes will resemble a blister. It may take two weeks for the bites to heal entirely, but the intense itching should taper off during the first few days. Bathing immediately after exposure can prevent or minimize chigger bites. As with any bite, “if chigger bites are scratched, then the area is at risk for infection and that would require treatment with an antibiotic,” Haskins said. “Apply a cold pack to the bite area to reduce pain and swelling,” Haskins said. “Next, apply hydrocortisone cream, calamine lotion, or a baking soda paste over the area every few hours until the symptoms subside.” Taking an oral antihistamine can help reduce itchiness and keep you more comfortable. Dr. Matt Devine, family practitioner with Highland Family Medicine, tells patients to watch the redness, swelling and size of the bite. “Anything more than a centimeter in diameter and redness that spreads are reasons to see a doctor,” he said. “Infection is rare, but this type of infection is a cellulitis. It can spread through lower layers of the skin and require

antibiotic treatment.” Ticks carrying Lyme disease are more prevalent in the New England states than in New York; however, Devine warns anyone visiting the North Country or New England to watch for a “bull’s-eye rash around the bite,” he said. “Blood testing and other testing can confirm it. It takes days to present itself. By then people have joint pain or general fatigue or not feeling well.” Other rare illnesses such as West Nile virus, spread by mosquitoes, usually manifest with fever, aches and general malaise. “If at any time the symptoms do not resolve or get worse, this can be a severe allergic reaction to the insect’s venom,” Haskins said. “Urgent medical attention should be sought out with any severe symptoms such as difficulty breathing, swelling of lips or throat, dizziness, confusion, hives, nausea, cramping, or vomiting.” This type of serious reaction is unusual; however, Bryan Gargano, who practices emergency room medicine at Rochester General Hospital, said that his department sees a few cases a year because of an insect bite or sting, usually an allergic reaction or infection. What makes most people delay treatment is that with almost any type of insect bite, pain and swelling will occur at the site for two or three days. Apparently, patients keep hoping it will get better. “If it gets worse or spreads after three days, especially with fever or chills, you need to get medical attention,” Gargano said. “Allergic reactions that are serious will come on within 30 to 60 minutes. Typically, the true anaphylactic reactions are from bees or wasps.” It’s hard to tell who will be allergic to stings until a person has been stung. Family history can be one indicator but is not a certain predictor. “With true allergies, you don’t have a reaction the first time you’re stung,” Gargano said. “The next time,

you could have an overwhelming reaction. It’s not the first, but the second, third or fourth. Usually about 50 people a year die from bee stings.” Doctors treating people who have such profound anaphylactic reactions usually prescribe them with EpiPen® (Epinephrine Auto-Injectors). “They do go a long way in saving people’s lives,” Gargano said.

Minimizing Exposure to Bugs Want to minimize your exposure to bugs that bite and sting? Try these tips from Walt Nelson, agriculture and horticulture program leader for Cornell Cooperative Extension of Monroe County: • “With a wet year, there are more puddles for mosquitoes to breed in. There are a lot of areas you don’t have control over, but if it’s an old tire behind the garage, eliminate standing water. • “Any kind of fish will eat mosquito eggs and larva. That’s a great meal. If you have a garden pond or earthen pond, have fish in there. You’ll have fewer mosquitoes. • “Wear light-colored clothing. • “If you’re inclined, use some sort of mosquito repellent. Citronella-based to those based on DEET: there are lots of them that can keep bugs away. I have had some success in reducing the mosquito count when I burn a citronella candle on the porch. • “I’ve seen just one, but a CO2 generator designed for mosquito management might help. Carbon dioxide is one of the first attractants to mosquitoes. A woman told me that it’s a small burner that runs off a propane tank. It runs 24/7 from late spring through summer and she can now be outside in the evening at dusk, prime mosquito time, and there isn’t one mosquito around. Mosquitoes get attracted to the burner and gets cooked or get con-

fused. They can’t differentiate where the CO2 is coming from so they can’t find you. From an unbiased researcher’s perspective, I can only pass it on as anecdotal. • “For ticks and chiggers, protect your legs. Tuck pant legs into socks so your skin is not exposed as you walk through fields. Use insect repellent on your clothing, especially on legs. They won’t hang on long if they smell repellent. • “There doesn’t seem to be a direct correlation between the number of critters in a mown lawn and the meadow beyond the fence. You’re just not picking them up on your calf because the grass is only 2 inches high. They jump off the back of a deer or meadow vole. We don’t have as many of those in our mowed areas because animals are wary. • “Since I’m allergic to bee stings, I look under eaves for small nests and I take it out when there are only one or two in the nest. • “For the ground-dwelling ones, I’m really cautious about going out in the fields in the summer once the ground dwelling wasps get going. I don’t want to inadvertently brush by their nest and send them chasing me. I watch where I step. I watch to see a beeline where they’re heading into or out of a particular point around you. That focus is my sight to look for the hole.

Don’t Let Allergies, Asthma Spoil a Summer Soiree

ummertime means outdoor fun at weddings, graduations, festivals and picnics. But uninvited guests ranging from stinging insects to grass pollen can ruin the fun for the millions of Americans with allergies and asthma. Allergies and asthma can lead to sneezing, wheezing and itchy misery – and sometimes more serious reactions – turning a joyous occasion into agony. “By planning ahead, people with allergies can still enjoy outdoor events,” said Dr. Myron Zitt, past president of the American College of Allergy, Asthma and Immunology (ACAAI). The ACAAI and its allergist members suggest following a few simple

tips to make summer soirees more enjoyable: • Treat before you go. Take allergy medication before walking out the door. If you wait until symptoms kick in, the medication won’t be nearly as effective. • Go undercover. Big, wrap-around sunglasses help keep pollen from getting into your eyes. • Avoid bees. If you’re allergic to bees or other stinging insects, avoidance is your best bet. Keep your distance from uncovered food, be cautious of open soft drink cans and resist wearing bright clothing or perfume, all of which attract bees. If someone near you gets stung, move away – some bees give off a chemical after they sting that

July 2011 •

can attract other stinging insects. • Be cautious at the food table. Avoid foods in which nuts, dairy and other common allergens can be lurking, such as mixed salads, barbecue sauces and salad dressings. If grilling is involved, have your portion cooked on aluminum foil to avoid cross-contamination with other foods. • Stick to the middle. Poison ivy can lurk in bushes and other foliage, so stay in open areas where you’re less likely to brush up against it. • Pay attention to Ozone Alerts. High temperatures mixed with pollution can pose a problem for people with asthma. Carry a quick relief inhaler.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Suddenly Single: Finding New Friends is Key to a Fulfilling Life

could see the disappointment (or was it fear?) in her eyes. My newly divorced friend was sharing the details of her divorce settlement: “I got the house and the riding mower; he got the friends.” Her voice trailed off and she stared into the distance. I could tell she thought he got the better end of the deal. Losing close friends can be one of the toughest aftershocks of divorce. It can feel like heartbreak on top of heartbreak. I know the feeling. I remember feeling socially alienated after my marriage dissolved. Some friends chose sides, others simply disappeared. I missed the impromptu deck parties and weekend outings. I missed the sharing, the laughing, the belonging. Making new friends can be one of the biggest challenges for those suddenly single and living alone. It certainly was for me. But I discovered something along the way — an open space for self-awareness and healing. The opportunity to find new friends that fit into the newly independent version of myself gave me a renewed sense of purpose and enjoy-

ment. It became an adventure. So how do you meet new people and cultivate friendships after a divorce or the loss of a spouse? Here are a few things I discovered: First, be your own best friend. Taking care of yourself matters. Loving yourself shows. The better you feel about yourself, the better friends you’ll meet. Positive people appreciate and gravitate to other healthy, positive people. Do what you like doing. You won’t make friends sitting alone at home, watching reruns of “Two and a Half Men.” Get out of the house and do those things you enjoy, whether it’s going to the gym, walking your dog, taking golf lessons, joining a book club, or any number of activities that are fun and active. You’ll meet people who share your interests and love of life. Friendships will likely follow! Consider a support group. It’s not uncommon for new friendships to be born out of compassion and empathy. A divorce or grief support group will put you in touch with others facing similar challenges. A friend of mine met her second husband in a divorce

KIDS Corner Most U.S. Kids Get Recommended Vaccines

lthough nearly all American children get the recommended vaccinations to prevent serious diseases, many parents express concerns about the shots, and a small number refuse to have their kids inoculated, according to the U.S. Centers for Disease Control and Prevention. About 95 percent of parents said their kids had received all the vaccinations or would get them all, which was a record high, a 2010 survey found. But about 5 percent of parents said they would decline some vaccines, and 2 percent said their little ones would receive no vaccines, the researchers said. “We are reassured that, overall, parents are vaccinating their kids according to the recommended schedule,” said lead researcher Allison Kennedy, an epidemiologist in CDC’s Immunization Page 8

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Services Division. “But we did find that most parents do have questions or concerns about vaccines,” she said. Better education efforts could resolve those doubts, Kennedy said. Doctors need information on the value and safety record of vaccines so they can help parents make an informed decision. Recent outbreaks of mumps, measles and whooping cough show that these deadly diseases still exist, Kennedy said. “Because of successful vaccination programs,” many young parents don’t remember when these diseases were epidemic, she noted. The report is published in the June issue of Health Affairs. For the study, Kennedy’s team used data from the annual Health-

support group. She shared, “We got to know each other as friends first, and have remained ‘best friends’ throughout our marriage. It’s the best thing that ever happened to me.” Say “yes” to invitations and opportunities to be with people. Circulating at parties, neighborhood gatherings, or any social event is one of the easiest ways to make new friends. You’ll be out and about with people with whom you share something in common. Show up and don’t be shy about extending an invitation to someone you meet. It could be a cup of coffee, drinks after work, or a game of tennis. Don’t overlook your family. My sister is my best friend, and she helped me re-establish a network of friends after my divorce. I had gone into the proverbial “cave” and lost contact with practically everyone. Her friends became my friends, and now, years later, I enjoy the company of her friends, as well as my own. Rekindle relationships with old friends. Sometimes old friends drift away when marriage, kids, and careers take precedence and require time and focus. That’s not unusual. But now, with the passing of time, a reconnection might be a welcome possibility. And who knows? Your old college roommate, high school pal, or former neighbor may be needing a friend, as well.

Styles survey, which gathered information on parental attitudes toward childhood vaccination from 376 households. While 23 percent of the parents said they had no concerns about vaccines, most had one or more concerns, the researchers found. Parents mentioned pain from the injection, getting too many shots at one time and the safety of ingredients in the vaccines. Some parents also worried that vaccines could cause disease or are being given for illnesses children are unlikely to get, the investigators found. Parents who said their kids would not get all the recommended vaccinations were likely to think too many vaccines are given in the first two years of life or that vaccines can cause learning difficulties, especially autism. The autism theory has been widely refuted. One in three parents added that they are not satisfied with the information they get from their children’s doctor about the safety and necessity of vaccines. Much of the information parents get about vaccines comes from their doctor or friends, Kennedy said. Onequarter said they took their information from the Internet, twice the number seen in a different survey in 2009, the researchers pointed out. Paul Offit, chief of the division of infectious diseases and director of the Vaccine Education Center at Children’s Hospital of Philadelphia, is concerned — but not surprised — that resistance to vaccination still exists.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

Friends from the past were an important part of your life at one point, and may still have lots to offer. Pick up the phone. Give “singles” events a try. Many divorced or widowed men and women find fun and friendship in community activities organized just for singles. It could be a hike, wine tasting event, dinner club, or dance. These opportunities are often included in community calendars you’ll find online or in your local newspaper. Volunteer or join a cause. Supporting an organization or cause you believe in will put you in contact with people working toward a greater good. Charity walks, political parties, hospitals, museums, animal shelters and many other organizations often need volunteers. Strong connections can be made when you work alongside others who want to make the world a better place to live. Good friendships are key to a fulfilling life. The company of someone who makes you laugh, who provides a shoulder to lean on, and who is just plain fun to be with is vitally important to health and happiness, especially for those who live alone. As the Buddhists say, “The only way out is through.” Coming to grips with your losses and working to rebuild a network of friends will help you regain your sense of belonging and social footing. One step at a time, and I’m confident you’ll discover, as I did, many new friends and kindred spirits along your path. 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 upcoming workshops or to invite Gwenn to speak, you can call her at (585) 624-7887, email her at gvoelckers@rochester.rr.com.

Offit, an outspoken advocate of vaccination, said the movement against vaccinations has resulted in outbreaks of diseases all but unheard of just a few years ago. “I try to reassure parents with the science,” he said. And he tells them that a decision against vaccination is not risk-free. “It’s a choice to take a different and more serious risk,” he explained. “We are seeing outbreaks of measles, mumps and whooping cough to degrees we haven’t seen in the previous 10 years. It’s a dangerous and, frankly, a misinformed choice not to get a vaccine,” he said. Before vaccines, whooping cough killed 8,000 children in the United States annually, diphtheria was a common cause of death among young people, and polio caused tens of thousands of cases of paralysis, he pointed out. Measles resulted in 3,000 to 5,000 deaths, Offit said. Even though the data linking vaccines to autism has been discredited, some people still believe it, he noted. “We are far more compelled by fear than reason, and fear wins,” Offit said. “We don’t fear the diseases, so it’s very easy to scare us about these other things,” he stated. But as outbreaks of preventable diseases become more common, “we will get to a level where we will be scared enough of the diseases again that we will start to vaccinate again,” Offit said.

The Association For The Blind and Visually Impaired-Goodwill Industries of Greater Rochester Inc. has begun an $8.8 million expansion to its headquarters on South Clinton Avenue in Rochester. Rendering provided by Bergmann Associates.

ABVI embarks on $8.8 million expansion Nonprofit has seen a growing number of people seeking its services By Sheila Livadas

U.S. Environmental Protection Agency’s National Lead Information Center, the 211 human-service hotline and the state-sponsored health insurer Healthy New York. ABVI also provides jobs to people through its manufacturing and fulfillment operation. The business accounts range from producing Post-it notes for the federal government to sewing athletic shorts for the U.S. Coast Guard and warm-up suits for the Air Force. Clients are not obligated to work for ABVI after receiving career and adaptive technology training from the organization, Pipitone says. Many, in fact, land jobs with other businesses. “So [the training] really does provide the foundation…for them to find meaningful work,” Pipitone says. The expansion also will bring additional exam-room space for ABVI’s state-of-the art low vision center. During an initial evaluation, the center’s doctors typically assess patients’ visual acuity, use different techniques to determine if glasses will provide any benefit and recommend visual aids and coordinated services from other providers. The physicians, who are specialists in low vision, also share results with patients’ referring eye doctors. The expansion also will enlarge the InSight Shop, which is open to the public and sells large-print calendars and check registers, large-button phones, talking clocks and other items. The Optical Shop, staffed by opticians who fit and dispense prescribed glasses and visual aids, also will have more space in the plan. Jobs created by the expansion will include ones in the social work, adaptive technology and administrative areas. ABVI currently employs roughly 500 staffers, 25 percent of whom are visually impaired or blind. ABVI is now accepting donations for the capital campaign through its website, www.seegreatthings.com. Donors also may make a $10 gift by texting the letters ABVI to 50555. Supporting ABVI means giving the gift of self-sufficiency, Pipitone says. What we’re trying to do is help people understand that a diagnosis of blindness or significant visually impairment isn’t the end,” he adds. “And we’re trying to help them find happiness after that diagnosis.” For information on ABVI’s services, call (585) 232-1111.

he Association For The Blind by four alumni of the still-functioning and Visually Impaired-Goodwill New York State School for the Blind in Industries of Greater Rochester Batavia, Genesee County, ABVI proInc. has begun an $8.8 million expanvides most services for free. Co-pays sion that will add 60 jobs and meet the do apply to low-vision evaluations. rising demand for vision-rehabilitation Demand for the nonprofit’s serservices. The plan also will enlarge vices is climbing, Pipitone says. In ABVI’s career-training center that helps the 2009-2010 fiscal year, ABVI served clients learn skills such as keyboarding 3,100 people and projects that numand emailing. ber will reach 4,000 by 2012. Even so, ABVI’s plan calls for a new threethere is not currently a waiting list for story, 30,000-square-foot building that services. will open in the spring of 2012 and The national unemployment rate adjoin the organization’s headquarters for the blind and visually impaired is on South Clinton Avenue in Rochester. roughly 70 percent, so many ABVI serGroundbreaking and the kickoff of the vices prepare clients for work, Pipitone capital campaign’s public phase ocsays. ABVI’s own contact center, staffed curred in May, with the goal of raising by the sighted as well as the blind and $2.6 million for the project. visually impaired, answers calls for the Celebrating its 100th anniversary this year, ABVI strives to give clients practical and marketable skills, says Todd Pipitone, public relations manager for the organization. Daily activities that sighted people handle with ease often prove challenging for the blind and visually impaired, he adds. To help more clients overcome those obstacles, ABVI’s expansion will broaden its multidisciplinary services, which already include instruction for using kitchen appliances. A model grocery store and model ATM are slated for the new building. “So in the new facility, we are also going to provide a safe training area for our clients to learn how to be more Dr. Elizabeth Harvey performs a low-vision evaluation at the Association For The Blind and Visually independent,” Pipitone Impaired-Goodwill Industries of Greater Rochester Inc. ABVI recently announced an $8.8 million says. expansion. Provided photo. Founded in 1911 July 2011 •

Most Primary Care Physicians Don’t Address Patients’ Weight By Valerie DeBenedette

ewer than half of primary care physicians for adults talk to their patients about diet, exercise and weight management consistently, while pediatricians are somewhat more likely to do so, according to two new studies. These findings come from two National Cancer Institute surveys of family physicians, internists, obstetrician-gynecologists and pediatricians. Participants reported how often they advised patients on diet, exercise and weight control; how often they tracked patient weight or assessed their body mass index (BMI); and how often they referred patients for further management of their weight. The differences in weight-related counseling among medical specialties stood out, said Ashley Wilder Smith, program director in the Applied Research Program at the National Cancer Institute, and lead author of the studies. ”Obstetrician-gynecologists were much less likely to be participating in a number of areas of counseling. That was a surprise, especially considering the focus on overweight and pregnancy.” Both studies appear online and in the July issue of the American Journal of Preventive Medicine. One study evaluated the responses of physicians who treat adults and the other those who treat children. In the pediatric study, about 61 percent of all primary care physicians treating children, either family physicians or pediatricians, regularly assessed obesity using the BMI percentiles of their patients, although almost all measured height and weight regularly. However, Smith said, pediatricians were more likely than family physicians to assess BMI–74 percent compared with 53 percent–and to provide behavioral counseling to patients and their parents. Tracking BMI is one of the National Institutes of Health guidelines for all physicians. In treating children, pediatricians were much more likely to consult on all areas of weight control than family physicians, Smith said. “But family physicians held together as a specialty on the separate surveys. Those treating adults had strikingly similar findings to those treating children.” “We found that physicians were more likely to counsel on physical activity than on diet or weight control, and more likely to counsel on diet than on weight control,” Smith said. “Though I was surprised that physicians discussed physical activity the most, in retrospect, I think diet is a more complicated behavior. The messages are a bit more difficult to deliver.” Part of the problem could be the limited time that physicians have with patients during the usual office visit and the attitude that this is not enough time to address weight issues. “But it is doable,” said Thomas McKnight. “Most people do not believe it is.” McKnight is a family physician with the U.S. Air Force at Hurlburt Field, in Florida. Valerie DeBenedette is a contributing writer with Health Behavior News Service.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

Number of Solo Medical Practices Shrinking By Ken Little

rivate medical practices are alive and well in the Rochester area, but doctors choosing to work alone or with a few partners must contend with sweeping changes in the healthcare industry. Overhead continues to rise, and more physician groups are merging or being acquired by hospital systems. Area doctors like Stephanie Siegrist, who has her own private practice in Rochester, is guardedly optimistic about the future. Siegrist, whose specialty is orthopedic surgery, took a job at St. Mary’s Hospital in 1995 after completing her residency and then worked in a private practice orthopedic group. She opened her own practice four years ago, and firmly believes it’s still possible for doctors to make it on their own. “I would think with homework and more attention to the business end, yes,” said Siegrist, Siegrist whose practice website is www.knowyourbones.com/ “Working for a hospital, someone else is watching the bottom line. In private practice, I make the decisions,” Siegrist said. “I made the decision four years ago to go out on my own and it took some homework and a skill set to run a small business.” The primary advantage? “You only have to answer for yourself and not a bigger entity.” Siegrist’s advice to others: “Be aware and nimble.”

Declining Numbers

Two-thirds of medical practices were doctor-owned as recently as 2005. By 2008, physician-owned practices slipped to below 50 percent of the total, according to the American Medical Association. Only about 12 percent of doctors listed themselves as self-employed. Siegrist and others in the area medical field are well aware of ongoing nationwide trends for existing medical groups to consolidate and grow, and of the acquisitions by healthcare systems. “We’re seeing fewer and fewer small, independent practices. It used to be common to see two doctors leave their training programs and hang out a shingle and one of their spouses would work in the office until they got established,” said Dr. Jerry Svoboda, the immediate past president of the Monroe County Medical Society. Today, Svoboda said doctors are offered more job security by joining a larger medical group or affiliating with a hospital. They don’t have to have to cope on their own with issues like liability insurance and increased government requirements for electronic record-keeping. In medical school, “doctors receive little, if any, training to become a business person,” Svoboda said. “At the state medical society, we are trying to do what we can.” Page 10

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The traditional notion of doctors caring for patients in smaller, individually owned clinics is rapidly giving way to physicians working on a salary basis for hospitals and health systems, Svoboda said. “In the Rochester area we have three basic hospital systems. We’re seeing primary care doctors turning over their own duties,” he said. “The three basic systems are continuing to acquire primary care doctors.” More primary care physicians and specialists like ob/gyn and family practitioners will be needed in the next 10 years, especially in single and smaller private practices where many doctors are Svoboda approaching retirement age. “We have some of the most devoted physicians and devoted patients in those practices,” Svoboda said. Particularly in rural areas, “I think there’s a pendulum that swings too far to the technological and away from a personal setting. People want to have a relationship with a physician who is knowledgeable but personal,” he said.

More Time With Patients

Lisa Schwartz is an internal medicine specialist practicing in Rochester. After 10 years as a staff physician with University Health Service at the University of Rochester, she opened her own practice several years ago. “What I love about my solo practice is that I have a much more personal relationship with my patients,” Schwartz said. “I have control over my practice pace and environment, which is much more relaxed, and I have more time to spend with each patient.” Schwartz doesn’t have to meet a corporate productivity quota, “so I am not constantly watching the clock because I have to see a patient every 15 minutes.” “This is vital to prevent physician burnout, and I can tell you that patients appreciate and need the time that we spend with them. Patients also have direct access to me by email and make their own appointments online, thus eliminating barriers to care,” said Schwartz, whose practice website is www.drlisschwartz.com. Schwartz recognizes the challenges facing smaller practices. She said she practices in a particular model called an “IMP” — idealized design of office practice. For more information on the model, go to www.impcenter.org. “I see the challenges mostly being related to the toxic burden of administrative hassles in dealing with insurance companies and insurance reimbursement issues,” Schwartz said. Other time-consuming tasks include obtaining prior authorizations for medications and tests, “administrative trivia,” and coping with shrinking reimbursement for primary care.

“Payment policies are driven by procedures performed and not the time and effort spent taking care of patients, administering care, and educating people about their illnesses,” Schwartz said. “For example, if I spend 15 minutes talking to a patient about how to manage their diet and exercise habits to improve their diabetes, that is not valued as much in economic terms as freezing a wart off of someone’s foot.” The wart procedure only takes about one minute, “but gets reimbursed at a higher level by insurance,” she said.

Decreasing Overhead

“I purposely have a small practice to decrease my administrative overhead, and yet this does occupy a significant amount of time and energy. Larger practices have more staff to deal with the administrative trivia, but that drives us to see more and more patients to cover overhead,” Schwartz said. One result of recent healthcare reform will be a jump in the number of people looking for medical treatment, Svoboda said. Shwartz “We expect to see as a result of the new health care reform act, several million people who haven’t been receiving health care will be receiving it now,” he said. “There are a lot of things going on at once, including reimbursement. Physician practices will have to make the decision whether they want to accept Medicaid patients.” Svoboda, a vascular surgeon, spent many years working at a private practice and now is affiliated with Unity Health System, www.unityhealth.org. Young doctors just coming out of training have student loans and other immediate expenses to consider. “They’re more likely to take a job as a system-employed physician rather than start their own practice, or become an employee in another practice,” Svoboda said. Just as patients are seeing medical bills increase, all doctors face higher insurance premiums. The issue of tort reform remains largely unaddressed, Svoboda said. “A big cloud that hangs over medical care is the liability of being a doctor,” he said. “All of us will share that financial burden. This, I believe, is the main factor in driving up medical care in the U.S.” Svoboda said progress in tort reform is moving slowly. Not coincidentally, he said, many of the nation’s policy makers are lawyers. The primary role of all physicians, Svoboda said, “is to maintain the doctor-patient relationship as pure as I can without outside interference.” Overall, there is a shortage of 1,000 physicians across the state, according to a study by the Medical Society of the State of New York.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

Advantages In Size

There are advantages to becoming part of a larger organization, said Moe Auster, counsel to MSSNY’s division of governmental affairs. “It definitely is an ongoing trend. What we are beginning to see is hospitals buying out physician practices or merging into large groups,” Auster said. “If they affiliate with larger groups they have less administrative hassles to deal with.” Larger medical groups “sometimes have a little bit better ability to negotiate with insurance companies,” he said. “Single doctors are handed contracts by the insurance companies and told to either take it or leave it.” Siegrist, who also presided over the Monroe County Medical Society a few years ago, wonders where the next generation of private practice doctors will come from. Her residency experience in the early 1990s included a significant percentage of time rotating through private practices and hospitals. “It was invaluable,” she said. “The way residents are trained now is very, very different.” Because there is now an 80-hour weekly limit on the amount of time residents can work, “Academic centers say if we’ve got a limited amount of time with this trainee, we will keep them here at the mother ship,” Siegrist said. “The residents coming out of training don’t choose to go into private practice because they’ve never seen it. They are fellowship-trained in an academic practice,” she said. Siegrist’s office has already completed the transition to electronic medical records. “I made it a hobby to know the business end of my business, so it’s kind of fun,” she said. “It’s fair to say that for all of us, business as usual is over. We’re not going to be able to practice medicine like we did in the past, and that is true for smaller medical practices.” Smaller practices can survive, Siegrist said, “but we will have to learn new ways of collaborating and sharing information.” Health care reform is partially responsible for the consolidation of practices and recent purchases of medical groups by hospitals and health care systems, Schwartz said. “As the model moved to a ‘primary care medical home,’ you need more staff with different levels of training to fulfill these administrative requirements. Payment will eventually be tied to this model, and smaller practices will suffer” she said. The future of health care remains shrouded in mystery, Siegrist said. “The decision makers out there are making it up as they go along, so nobody knows where it’s going,” she said. “At the end of the day, the doctorpatient relationship is the most important thing. I find that it’s easier to serve the patient and stay aware of all these changes that are going on if we keep it simple.”

Goodbye Pyramid! By Jason Schultz

earching for a more useful and intuitive way for Americans to make healthy eating decisions, the government has abandoned the geometry of the food pyramid for the familiarity of the dinner table with the introduction of the MyPlate campaign June 2. Designed around the image of a normal-sized dinner plate, the MyPlate chart is divided into sections of approximately 30 percent grains, 30 percent vegetables, 20 percent fruits and 20 percent protein, along with a smaller circle representing dairy. Confusing talk of undefined serving sizes has been replaced with simple edicts such as “enjoy your food, but eat less; make half your plate fruits and vegetables; and make at least half your grains whole grains,” according to suggestions mentioned on the campaign’s website at www.choosemyplate.gov. The site also includes detailed information on each food group, a diet planner, weight-loss and exercise help and daily food tips. Jennifer Glen, chief clinical dietitian at Strong Memorial Hospital, said she sees the new effort as a boon to both in-patient and out-patient care. “I really like this new diet model; I think it’s much easier for clients to understand the dietary recommendations that we’ve been making for years,” said Glen. “The old pyramid didn’t differentiate between good fats and bad fats, while the MyPlate website mentions omega fats and unsaturated fats, along with an emphasis on low-fat dairy and whole grains.” Introduced by the USDA in 1992, the iconic food pyramid placed food into six hierarchical categories based on the number of daily serving sizes for each food group. Criticisms of the original food pyramid included a confusion over the definitions of serving sizes, an over-emphasis on grains as compared to fruits and vegetables and no differentiation between whole and refined grains, or saturated fats and unsaturated fats. Those oversights were partially addressed in 2005, when the food pyramid was replaced by the MyPyramid campaign, which displayed each food category as a more abstract vertical wedge of the pyramid. The MyPyramid model was the first to discriminate between healthy and unhealthy grains and fats, while also lowering the proportion of grains and increasing the recommended servings of fruits and vegetables. Sally Poole, senior dietitian at Rochester General Hospital said MyPlate differs more in its presentation of government diet philosophy than in its content compared to the previous food pyramid. “We’ve been recommending all along to limit grain and protein intake and encourage more fruits and vegetables,” Poole said. “This MyPlate idea just takes the lessons we’ve been imparting to our patients for years and displays it in a more intuitive way.” Amanda Maskovyak, a pathology resident at the Cleveland Clinic, said the core advantage of the MyPlate initiative lies in moving away from serving size definitions to a more intuitive and flexible representation of a healthy diet. “I think simplicity is key to any situation that is going to apply to a

large number of individuals,” Maskovyak said. “People are busy and don’t have the time or energy to decipher a food pyramid. This is an easy, recognizable, and widely applicable

guideline. Trying to micromanage your food and nutrition intake can backfire and make people overwhelmed and shut down because they feel they can’t get it perfect.” Poole said it was too early to determine the efficacy of the new campaign, though the switch to a new dietary model hadn’t caused any patient confusion. One improvement to the MyPlate system Poole did recommend

was a greater emphasis on low-fat and low-sodium food choices. She said the nutrition information at www.eatright. org complements the resources of the MyPlate Web site. Portion control, Poole concluded, was one of the most important messages imparted by the MyPlate campaign, especially in an age of supersized meals and ever-growing restaurant servings.

What is

meningococcal disease type B (MnB)? Meningococcal disease type B (MnB) is caused by a certain type of bacteria that can make your adolescent very sick. No vaccine to prevent MnB is currently available. Your adolescent (ages 11-18) may be eligible to take part in a clinical trial* to test an invesitgationl^ vaccine for MnB.

*A clinical trial is a carefully managed study done by doctors to learn more about potential new medications and treatments. ^An investigational vaccine is an unapproved vaccine that is being tested in a clinical trial.

585-288-0890

e-mail: Volunteer@rcrclinical.com • Learn more on www.facebook.com/RochesterClinicalResearch

July 2011 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

Dedicated to Providing Quality Woman’s Healthcare Obstetrical Care Includes High Risk Complete Gynecologic Care Pediatric / Adolescent Gynecology

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HIGH CHOLESTEROL? Brand-name drugs are just

generics in disguise. If you take a brand-name prescription drug, you should know that there are new generic and over-the-counter options that can save you money. Not every brandname drug has a generic equivalent, but there are generic and over-the-counter alternatives for treating many conditions, including high cholesterol. Generic drugs are real medicine. They are approved by the FDA as safe and effective, but they cost less. A lot less. Ask your doctor or pharmacist if generic drugs are right for you.

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A nonprofit independent licensee of the BlueCross BlueShield Association

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go.excellusbcbs.com/generics

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

SmartBites

By Anne Palumbo

The skinny on healthy eating

For the chips: 1 bunch kale 1 tablespoon olive oil 2 cloves garlic, minced Sea salt and coarse black pepper, to taste

Why Kale is King

rue confession: Before today’s column, I had nothing to do with kale. We didn’t meet weekly in the produce department, we didn’t share favorite recipes, we were total strangers. Like many of my peers, I was a deadbeat kale consumer. But all that changed when I got to really know kale. Now, I can’t get it out of my mind or, off my shopping list. A close cousin to cabbage and broccoli, kale rocks with so many health benefits it has reached “superfood” status. To begin, it teems with betacarotene, an antioxidant believed by some experts to be a major player in the battle against cancer, heart disease and other age-related diseases. Antioxidants, according to the National Cancer Institute, are substances that may protect cells from the damage caused by unstable molecules known as free radicals (byproducts of daily living and digestion). This curly green may also inhibit the development of macular degeneration and cataracts. Research attributes this benefit to kale’s high concentration of lutein and zeaxanthin, two carotenoids that act like sunglass filters for our eyes, protecting them from excessive exposure to ultraviolet light.

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Crispy Kale Chips with Sesame Dipping Sauce

In addition, kale is a spectacular source of vitamin K, with one cup providing 684 percent of our daily needs. Vitamin K, a vitamin typically associated with blood clotting and bone health, also prevents calcium build-up in tissues. Since a build-up of this mineral may lead to cardiovascular disease and stroke, it behooves all of us to make a beeline for kale. Anyone looking to shed a few pounds before swimsuit season starts in earnest? Kale is a dieter’s dream food! Low in calories (33 per cup), fat and cholesterol, this tasty vegetable boasts a decent amount of filling fiber, along with impressive amounts of vitamins C and A.

For the dipping sauce: 1 tablespoon tahini (sesame paste) 2 teaspoons soy sauce 2 tablespoons light mayonnaise 1 teaspoon honey 1 tablespoon water 1 tablespoon toasted sesame seeds Salt and pepper, to taste Preheat oven to 375 degrees. Rinse kale and, holding bunch by stems, shake water from leaves. Pat dry. Remove leafy part from stem and rip into chip-size pieces. Toss with olive oil, garlic, salt and pepper in a large bowl, kneading kale gently with hands to disperse oil. Spread on a large cookie sheet and bake for about 16 minutes, flipping chips after 8 minutes to assure even baking. Since ovens vary, watch kale carefully so it doesn’t burn. To make sauce: Thoroughly mix ingredients in a small bowl.

Helpful tips:

When purchasing kale, choose firm, deeply colored leaves with hardy stems. Store kale, unwashed, in a zip-lock plastic bag for up to five days in the refrigerator. Note: The longer it is stored, the more bitter its flavor becomes.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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Find out more: www.BeAHealthyHero.org Cool tools. Simple tips. Visit today.

July 2011 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Women’s issues Prenatal yoga: beneficial for mom and baby

By Deborah Jeanne Sergeant

uring pregnancy, even the most graceful female figure turns bulky and cumbersome. Participating in yoga may seem counterintuitive considering the typical twisted-up yoga poses, but prenatal yoga offers many benefits to moms-to-be. “Yoga addresses body, mind, and spirit, so taking a prenatal yoga class is one of the best things you can do for yourself and your baby during pregnancy,” said Erin McCollough, a licensed yoga teacher at CNY Fertility and Healing Arts Center in Rochester. McCollough, who also completed training as a doula to assist with childbirth, listed many pregnancy-related issues with which prenatal yoga can help, including carpal tunnel syndrome, poor balance, constipation, fatigue, headaches, heartburn, hip pain, insomnia, leg cramps, backache, nausea, indigestion, sciatic joint discomfort or pain, shortness of breath, and varicose veins. Many prenatal yoga instructors teach how specific yoga postures can help with each of these issues. They say the benefits go beyond alleviating the physical discomforts caused by carrying a baby, however. “You will develop a deeper understanding and connection with your body and your baby and learn important relaxation techniques and positioning options that can be used McCollough during birth,” said Christa Corsaro Tyson, hatha yoga instructor at CNY Healing Arts and birth doula. “The strength and stamina you will build during the classes will help lead to a faster postnatal recovery.” Sound too good to be true? Medical science backs up her claims. Judy Kerpelman, anob/gyn physician with West Ridge ob/gyn in Webster, said, “There are physiological changes that yoga can help with. Studies show that women who practice mindfulness yoga may experience less pain, stress and anxiety through their pregnancy and the sooner they started, the more benefits they had. “Studies show that women who practice integrated yoga had better response to stress in pregnancy and labor. It also helps with labor and delivery. There are all sorts of different types of yoga.” Sandy Hicks, certified in interdisciplinary yoga and massage, practices at Grounded by Wellness, which operates studios throughout the Rochester area. She uses specific yoga postures that “create more fluidity in the spine,” she said. “For swelling and inflammation around the joints, gentle standing poses

increase lower body circulation, in turn, reducing swelling and inflammation around ankles and wrists.” McCullough believes that prenatal yoga helps prepare the body for birth as well by toning the pelvic floor muscles and helping moms-to-be to know where these muscles are to facilitate labor. Many yoga positions share similarities with comfortable laboring positions. Practicing the positions in advance can help women stay more comfortable and relaxed during labor. Prenatal yoga can also affect the connection between mind and body. Hicks teaches that yoga helps the individual learn where she holds tension in her body, which is important to birthing mothers. “A tense body is not going to facilitate the birth process as easily as one that is relaxed,” Hicks said. “Moreover, when the body is tense, you may experience tension in thought and a withholding of breath. Consequently, a regular prenatal practice can reduce the length of your labor.” Yoga may also help some women take their focus off the pain of laboring. “Extra use of guided meditation or guided imagery fully benefits when it comes time to ride through the most powerful of contractions,” Hicks said. “Visual imagery combined with breath work can be one of the most useful labor tools. Additionally, the opportunity to develop a moment by moment awareness in yoga practice can assist you in attending to labor moment by moment and is an asset to managing labor.” Laboring is a busy time for moms. With various medical personnel and relatives telling them what to do, extreme pain, and intense emotions distracting them from pushing long enough and hard enough. Corsaro Tyson said that prenatal yoga can help women keep a clear head. “You will remember and draw upon the tools you learned in class to facilitate the labor process, soothe and empower yourself by finding your own rhythm, and improve your physical comfort,” she said. “Most importantly, you will be familiar with the muscles of the pelvic floor and be more likely to use them effectively. You will also know ways to relax during and between your contractions. These benefits can all lead to a safer and more emotionally satisfying birth.” McCullough has also found that many moms-to-be enjoy a deeper connection with their babies and emotional support from the other mothers in their classes. Of course, the stereotypical tiedin-a-pretzel poses associated with yoga aren’t suitable for expectant moms. Kerpelman advises pregnant patients to avoid “hot” yoga and stick

Christa Corsaro Tyson, a hatha yoga instructor at CNY Healing Arts in Rochester and birth doula, practiced yoga while pregnant and now teaches other pregnant women. Her belly was decorated with henna paint. “The strength and stamina you will build during the classes will help lead to a faster postnatal recovery,” she says.

July 2011 •

with gentle yoga. Prenatal yoga avoids extremes and makes use of bolsters and supports to make some positions safer. Corsaro Tyson often hears clients worry about lying supine since their doctors have told them to avoid lying flat on their backs after week 20 of pregnancy because doing so can allow the growing uterus to compress the mother’s major blood vessels and intestines. Corsaro Tyson said that standing upright and still during the third trimester “can reduce maternal cardiac output by as much as 18 percent. Lying on the back with legs extended can reduce cardiac output by as much as 9 percent in the second and third trimester. “In order to keep your body safe during pregnancy you will need to develop confidence to listen to your body and act accordingly,” she said. “If standing still starts to feel uncomfortable move and sway the hips, shift your weight or better yet, sit down. If lying on your back starts to feel uncomfortable roll to your left side. Lying on the left side during pregnancy brings more blood flow to the uterus.” She always gives her students the choice of participating in supine or standing poses or selecting other poses that are more comfortable. For those standing or supine, they spend no longer than three minutes in those positions. “Studies show that three to five minutes of exercise in supine positions had no adverse effects,” Corsaro Tyson

said. She also encourages students to discuss their prenatal yoga poses with their doctor or midwife. “Although I am trained to keep women safe in my prenatal yoga classes, your doctor knows you much better than I do,” Coraso Tyson said. “Trust their advice and remember we can always find yoga poses specific to your needs and comfort level in my prenatal yoga classes.” Hicks tells her students “to use common sense and listen to your body. Should they feel lightheaded, or their feet or legs start to tingle or ‘fall asleep’ then your body is sending you a clear message that it’s time to get off your back.” Carsaro Tyson adjusts the poses to the individual’s needs, such as avoiding squats for a woman struggling with varicose veins. “In general I would avoid crossover twists, deep back bends and any strenuous poses for the woman,” Corsaro Tyson added. “The practice should be gentle and slow.” As for when to stop prenatal yoga, most instructors agree that unless the doctor or midwife objects, pregnant women may continue indefinitely. “Many of my students practice prenatal yoga with me up to or past their due dates, again it is up to the woman and how she feels,” Corsaro Tyson said. “I taught prenatal yoga up to the day both my kids were born.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

Women’s issues

Women’s Mid-life Weight Gain

It’s a gradual process but when women realize it, they’re already much heavier

By Deborah Jeanne Sergeant

t seems like when many women hit their 30s, they tend to gain a few pounds here and a few there until 10 years later, they’re noticeably overweight. “A sedentary female burns 60 fewer calories a day over that decade,” said Bridget Bigelow, certified diabetes educator and registered dietitian. “That’s six pounds per year. Over 10 years, that’s 60 pounds. It’s slow and gradual for most people.” Bigelow coordinates the diabetes education program at Endocrine Diabetes Care and Resource Center in Rochester. Does that mean those in this age range or older are doomed to gain weight? Or those who have can never drop the pounds? Area experts weigh in on why women in midlife gain weight and what they can do to ward it off. Part of the reason many women gain weight as they approach 40 is metabolism. “As we age, Cobbins our metabolism may slow down which means we gain weight easier and it takes much longer to work it off,” said Lorri Cobbins, board certified plastic surgeon with Aesthetic Plastic Surgery, PLLC in Clifton Springs. For women, it’s a double whammy because the female body naturally has less muscle tissue than a man’s, making it even harder to burn calories. By this time, many women have established themselves in a more sedentary line of work or career level or have completed the busy years of Page 16

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rearing active toddlers. These factors can mean that in addition to a slower metabolism, a woman at this stage of life experiences less movement, too. A healthy pregnancy requires women to gain around 25 to 35 or more pounds. Some of those are maternal fat stores that take a while to lose. Nursing helps moms lose weight (among other health benefits to her and baby), but it’s no guarantee that nursing will make all the weight disappear. “A lot of women don’t take off that last five or 10 pounds,” Bigelow said. “They have a little left over and when things get crazy with having a young child, they don’t have time to exercise or eat right.” Penfield Fitness & Racquet Club personal trainer Bonnie Sunderville agrees. “Women tend to put themselves at the end of the list of things to take care of so they don’t always exercise,” she said. Decreasing caloric output while maintaining or increasing caloric input can only result in gaining weight. “Women need fewer calories in their mid-40’s than they did in their younger years,” said Caitlin Sexton, a certified dietitian with Clifton Springs Hospital. She believes Sexton that women need to dedicate themselves to lifelong healthful eating, not just a “diet” to drop dress sizes. Only making one change — eating 500 fewer calories per day — can produce “a healthy weight loss of one pound per week,” Sexton said.

Take a few other healthful steps, such as eating a breakfast with whole grains, protein and dairy every morning (such as a bowl of oatmeal topped with fruit and a cup of low-fat yogurt); drinking water and reserving soda for special occasions; cooking more at home and eating only half portions at restaurants; and snacking only on whole fruits or raw vegetables. Sexton likes the portion control strategy of filling half a salad plate (not the larger “dinner” plate) with vegetables, one-quarter with lean meat and one-quarter with a whole-grain side dish. “Begin with a few realistic goals at a time,” Sexton said. “Specific achievable goals will increase chances of success.” To rev up the metabolism, get moving. Most women are accustomed to performing heart-pounding aerobic exercise by running, participating in classes like Zumba or using exercise equipment such as stair climbers or elliptical machines but Sutton

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

if that’s all they do, they’re missing an important element: resistance training. “Women tend to avoid it because they are afraid that they will bulk up,” said Chris Sutton, a personal trainer with Wergo, Inc. Personal Training in Rochester. “Most women do not have to worry about this and if done correctly will help with the weight loss and all their other fitness goals. As we increase our lean body mass, it helps burn more calories.” Resistance training can include lifting dumbbells, medicine balls or kettle bells; stretching fitness bands, tubing, or rods; performing calisthenics in water or using one’s own body weight in movements like push-ups, pull-ups, or squats. If you’re unfamiliar with how to use these pieces of equipment or perform these movements, seek the help of a trainer at a gym. “We offer all new members to have an opportunity to sit down and have a goal setting session,” Sunderville said. “We go over body fat composition and come up with some realistic cardio, flexibility, and strength goals. We try to help them develop fitness habits.” Most exercise equipment manufacturers offer workout plans and you can find many online, too. “By eating healthfully, staying active and feeling good about life one can keep those pounds off,” Sutton said.

Women’s issues Liposuction: Lose Here, Gain Elsewhere Study shows that the weight lost after liposuction is back elsewhere in the body within a year By Deborah Jeanne Sergeant

mong the mid-Atlantic and New England states, liposuction was the fourth most popular cosmetic procedure in 2010, accounting for 34,844 procedures or 17 percent of all types of surgeries, according to the American Society of Plastic Surgeons. Usually, liposuction is performed on problem areas such as hips or thighs after patients have unsuccessfully tried to lose weight through exercise and diet. Those stubborn pockets of fat may be suctioned out through the procedure, but a study recently published in “Obesity” indicated that some patients seem to subsequently gain fat in different areas of the body within a year. Doctors. Teri L. Hernandez and Robert H. Eckel of the University of Colorado found that although the study participants’ fat did not return to the previous problem areas of the thighs and lower abdomen, within a year they gained the weight elsewhere, mostly in the upper abdomen, shoulders, and triceps of the arms. Each participant had an average of 5.8 pounds removed and that’s what each gained. The study was performed on a group of non-obese women and included a control group who did not have the procedure done. “It’s a really interesting study and well done,” said Dr. Jeffrey Gusenoff, director of Life After Weight Loss in the Department of Plastic Surgery at the University of Rochester Medical Center. Gusenoff pointed out that the study didn’t clarify if the weight gained after the surgery was comprised of new fat cells or enlarged, pre-exist-

ing fat cells. “These are lean, non-obese people,” he said. “The gain may not be visible to the naked eye.” Visceral fat which gathers around the internal organs may not be cosmetically disconcerting, but it has been linked to increased rates of heart disease, although “there’s no certainty of medical repercussions,” Gusenoff said. Women seeking liposuction should also realize the procedure’s purpose. “Liposuction isn’t good for losing weight but in changing areas that don’t respond to diet and exercise,” said Stephen M. Evangelisti, who practices cosmetic surgery in Rochester. “Let’s say there’s a woman of ideal body weight with fat on the lower abdomen and inner thigh who has liposuction. She’ll never gain weight in those areas. But people tend to gain weight over their lifetimes. I doubt that removing one area with liposuction would cause another area to get bigger than it otherwise would. That’s my belief from 25 years experience.” The research did not Evangelisti indicate that the women who regained weight followed their surgeon’s directions postoperatively, nor that the weight they

gained elsewhere is abnormal for their age, diet and activity level. “Maintaining a healthy lifestyle is the only way to maintain the results of liposuction,” Gusenoff said. “You don’t know what these people were doing on the outside. That’s another variable. “It’s not a weight loss method where you go eat as much as possible after.” While the study appeared to confirm that the cosmetic surgery worked (the fat did not return to the areas that were treated with liposuction), it also underscored the necessity for patients to follow their doctor’s instructions. A healthful lifestyle should include engaging in vigorous exercise at least

30 minutes per day most days of the week and reducing the calorie count to a level consistent with the person’s activity level, height, ideal weight and any health issues as directed by their physicians. The diet should include lean protein, low-fat dairy, whole grains and plenty of vegetables and fruits in their natural state. Processed foods and those high in sugar and fat should be minimal. Choose My Plate (www.choosemyplate.gov), which replaces the Food Guide Pyramid, gives the government’s guidelines for what kind of food and how much is needed daily for healthful eating.

Many causes, treatments for unwanted hair By Deborah Jeanne Sergeant

ealing with unwanted hair is bad enough for women. Culturally, Western women typically eschew hairiness and deem it unfeminine. But aside from cosmetic issues, sprouting hair in unusual places can indicate underlying health issues. Genetically, some women are simply prone to darker, coarser or more excessive body hair than others. Race can influence hair’s texture and density as can family history. But some hormonal conditions can cause excessive growth, too, such as polycystic ovary syndrome (PCOS). “It’s a hormone imbalance,” said Judy Kerpelman, an ob-gyn physician with West Ridge OB/GYN and medical director of Allur MedSpa in Webster. “Women with it can often struggle with excess hair growth. Perimenopausal and menopausal women can get excess growth at that stage of life.” Of course, treating PCOS is important because women with the condition are at higher risk for several health

conditions, including cardiovascular disease, diabetes, infertility, and certain gynecologic cancers. “Rarer causes of unwanted hair include tumors of the ovary or adrenal gland,” said Dr. Mary Gail Mercurio, associate professor of dermatology and obstetrics & gynecology at University of Rochester Medical Center. “In these cases, the hair is often of sudden onset and there are other signs of male hormone excess including a male pattern of hair loss on the scalp, acne, deepening of the voice.” Some women experience some of these symptoms without any serious underlying medical reasons. It may seem tricky telling what’s normal and what’s not, so Mercurio advises women to tell the difference by “looking at the other female members of her family to determine what pattern of hair ‘runs in the family,’” she said. “Features that would suggest the possibility of an underlying condition causing the excessive hair growth include sudden

onset of the hair growth [in contrast to gradual accumulation beginning with puberty], irregular menstrual periods, and the presence of other features of excessive male hormones.” To decrease unwanted hair, women with underlying medical conditions should follow their health care provider’s advice for treating the condition. “A lot of things can help with PCOS,” Kerpelman said. “Exercise and a healthful diet can help. There are medications, both hormonal and non-hormonal, that can help control all manifestations of PCOS, but not cure it.” Decreasing male hormone levels may cause unwanted side effects and women must continue taking the medication or the hair and other symptoms will return. Most women with excess hair control it through shaving, waxing, tweezing or using depilatory; however, the hair comes back eventually. Minimizing the hair’s pigmentation through

July 2011 •

bleaching can also help improve appearance. Vaniqa, a topical medication, may offer some help. “When used twice daily, it slows the rate of hair growth,” Mercurio said. “It is usually used in combination with some other hair removal modality so over time woman can decrease the frequency with which they perform their usual method of hair removal.” Women can get truly rid of unwanted hair with laser therapy. “It gets to the hair follicles and prevents them from growing new hair,” Kerpelman said. “It can be permanent after several treatments. If new hair comes in over time that would need to be treated.” Regardless of hair type or race, laser treatment is very effective. “Its greatest disadvantage is the cost as it often requires numerous treatment sessions to achieve the desired effect,” Mercurio said.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

Veneers can restore an attractive smile By Deborah Jeanne Sergeant

What They Want You to Know:

Dental Hygienists By Deborah Jeanne Sergeant

he New York State Dental Association views a dental hygienist as a professional who in the setting of a dentist’s office “help to prevent disease while assisting patients to maintain their health.” • “One of the best pieces of advice that I can give patients is to get into the habit of daily floss, stimudent or pikster use. No matter how great they are at brushing their teeth, the bristles just don’t get in between the teeth. • “What I stress to patients is that the number one cause of adult tooth loss isn’t decay; it’s periodontal disease. • “Dr. Sussman can do just about anything to save a tooth, but if there is not a solid foundation surrounding the tooth, no matter how perfect the tooth is, it will fall out. • “This is where I use my story about how you wouldn’t build a $500,000 home on a faulty foundation. It won’t last. It’s the same with teeth. • “I also congratulate patients for taking the first step in coming in when they haven’t been in a long time This is where patients need the most encouragement. Patients are so afraid that they are going to get ‘yelled at’ and are embarrassed because they have let their teeth go for so long.” Paula Montanarello, dental hygienist for the office of dentist Paul I. Sussman • “See your dental hygienist two times a year. • “People need to open wide. • “Oral health is a good indicator of overall health like cardiovascular health. • “If people would only confirm their appointments! If someone’s not able to keep the appointment, we can fill that time slot for someone else and re-arrange for their convenience. We don’t want open slots. We need to keep our patients healthy and happy.” Nancy Stewart, hygienist at the office of dentist Mark R. Alvino • “The most important part about your oral hygiene is your technique in brushing and flossing. We’re creatures of habit and we don’t brush for the full two minutes. People think they are, but in actuality, they aren’t. • “Angle that brush at a 45-degree angle and using a circular, back and forth brushing motions over two to Page 18

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three teeth at a time. • “Only about 11 percent of the population flosses on a regular basis: seven days a week. Brushing takes only 60 percent of the plaque on your teeth; flossing takes care of the remaining 40 percent. • “Floss by wrapping the floss around the tooth in a ‘c’ shape and shimmy it under the gum line. Then come back to the contact, wrap it around the opposite tooth and do it again. Most people don’t floss where they rub the teeth. • “Our time is very important and when you come late, it makes me late. We try to do our best to stay on schedule. It’s courteous to be on time. It will snowball if you’re late.” Linda Brown, hygienist at the office of Joseph L. Dulski, Adult Dentistry of Rochester • “I recommend Listerine twice a day because it gets into the gum tissue for about 12 hours. I have some patients who don’t like the burn and Listerine Zero is a great product for those. • “X-rays are a big controversy. A lot of people are afraid of radiation and they don’t know what we’re looking for or the frequency we’re taking. Yearly bitewings are a close-up view of the teeth. The most common thing we see are cavities and bone level. About every year it’s recommended. The other thing we do every three to five years is a full mouth series or a panoral. That goes all the way around the head and shows all the teeth, including wisdom teeth, and the bone in the jaw. It can show tumors or cysts and calcification in arteries. In this office, we use digital x-rays, so it cuts in half the amount of radiation from traditional film x-rays.” Christina Thompson, hygienist with Ridgecrest Dental

Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.

orcelain veneers can offer dental patients with discolored, chipped, broken, gapping or even slightly crooked teeth a new smile with little time in the dentist’s chair. In recent years, porcelain veneers have become very thin and more realistic than ever. Custom-designed in a dental laboratory to create replicas of the patient’s teeth, properly applied veneers look natural, but without flaws. They bear the same Before and after photos showing teeth a “shine, opacity, translutransformation of the person’s front teeth. The ‘after’ cency and shape,” said photo shows off a smile that has beneﬁted from Paul Sussman, a dentist whitening and veneers on the front teeth. Courtesy of practicing in Rochester. “Once the veneers are Dr. Ralph De Felice of Geneva. cemented into place they appear as beautiful natural teeth.” It sounds like the ideal solution for anyone wanting a perfect smile; however, porcelain veneers have a few drawbacks and may not be suited for all patients. With most patients, the teeth must have part of the enamel ground off to make room for the veneer so it aligns properly with the gums and doesn’t make the tooth appear too thick. “Ordinarily, this is one-half of a millimeter, about the thickness of important to replace a chipped or missa fingernail,” Sussman said. “When ing veneer right away. the porcelain veneers are bonded on, Unlike dentures or orthodontic they are bonded securely so that they appliances, porcelain veneers do not become an enamel replacement…The restrict the patient’s diet much. veneers become a part of your tooth, Paul Schwedfeger, a dentist with creating a natural, gorgeous smile.” Village Smiles in Pittsford, said, “Most Veneers can last indefinitely; hownormal food is fine. I wouldn’t chew on ever five to up to 20 years is average, depending upon how well patients care anything extremely hard or chewy but a normal diet is expected.” for their teeth at home. Since porcelain veneers are ap“Porcelain veneers don’t make the teeth harder to clean,” said Richard Ro- plied to the front side of the front mano, dentist with Ridgecrest Dental in teeth — surfaces not used for chewing Rochester. “Veneer covers and bonds to — this presents little problem to most patients. the tooth so there’s no risk of anything Schwedfeger said that it takes getting under it.” about half an hour per tooth to apply Patients who use their teeth as the veneer. Most patients have their tools for opening packages or who veneers applied during two to three grind their teeth at night can expect visits. that their veneers will not last as long Porcelain veneer application is not as those who are careful. A mouth covered by insurance for most patients. guard can help prevent grinding probIt can rage between a few hundred lems. to $1,100 per tooth. For patients who “It is extremely important that a require veneers to repair damaged patient with porcelain veneers or any teeth, insurance may cover part of the type of restorative treatment such expense. as crowns or fillings, have excellent “Once enamel is removed, it cannot oral hygiene and have regular visits be replaced with anything as long-lastto their dentist for routine cleanings ing,” said Joseph L. Dulski, a dentist and exams,” Sussman said. “The bond with Adult Dentistry of Rochester. between the tooth and the veneer is “Bonding damaged, lost or unatvery strong, however, the enamel at tractive enamel with porcelain with the the junction between the natural tooth goal of preserving tooth structure is a and veneer is susceptible to decay if a reality today.” patient has poor oral hygiene. Like most dentists, Dulski recom“If a patient neglects proper oral mends that patients “consider a nonhygiene and the veneers are not well invasive procedure like orthodontics cared for, the bonding material can ditch and deteriorate or the veneers can to close gaps to straighten teeth if the enamel is healthy and attractive.” become scratched or chipped and need For people with chips, discolorto be replaced.” ation or appearance problems, porceSince the underlying tooth may lain veneers can be a good solution. have had enamel removed, it can be

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

By Jim Miller

Simplified Computers for Seniors Dear Savvy Senior Do you know of any home computers that are specifically designed for senior citizens? I would like to get a computer for my 73year-old mother, but she’s not computer savvy at all. Look Around Dear Looking, There are actually several computers on the market today that are designed specifically for older boomers and seniors who want, and need, things simple. Here are some top options to check out. Telikin

For seniors that have little or no computer experience the new Telikin “touch-screen” computer is a wonderful option. Ready to go right out of the box, this innovative computer comes pre-loaded with simplified software that makes accessing the web, email, games, video chat, photo sharing, news, weather and more, just a touch of the screen away. And since it runs on Linux software instead of the standard Windows or Mac OS, it’s a virus-free computer too. The Telikin comes with a sleek 18.6-inch LCD touchscreen (a 20-inch touchscreen will be available within a month), 320-gigabyte hard drive, builtin speakers, webcam, microphone, wired keyboard and mouse, and provides a unique “tech buddy” feature that can help seniors get computer assistance when needed. Priced at $700 (the 20-inch model will retail for $995), Telikin comes with a 60-day trial period, one-year warranty and free support for the first 60 days. Visit telikin.com or call 800-230-3881 to learn more. It’s also worth noting that Telikin has a partnership with firstSTREET (firststreetonline.com, 800-704-1209), a senior product direct marketing company which is also selling this computer rebranded as the “WOW! Computer for Seniors.”

Senior PCs

Sold through Enablemart (enablemart.com, 888-640-1999), Senior PCs are Hewlett-Packard computers that also come completely set up and ready to use, but depending on your

mom’s needs, you’ll have several options to choose from. If you’re your looking for simplified “goof-proof” operation, the Autopilot desktop is the best model. This PC comes equipped with QualiWorld software that provides one-click solutions for tasks like letter writing, preparing a document, surfing the Internet, sending and reading e-mails and much more. The Autopilot also comes with OnTimeRx medication and appointment reminding software, HOYLE Crossword and Sudoku puzzles, a high contrast keyboard, mouse, 17-inch monitor, speakers and a color printer all for $1,125. They also offer this same Autopilot computer in a laptop edition for $1,165. Or, for seniors with low vision their Vision Plus model may be a better fit. This computer comes pre-configured with everything you need to see your PC, including state-of-the-art screen magnification software, a high visibility keyboard, and an all-in-one printer/ scanner for scanning in books, mail and other reading materials for magnification. It also comes with OnTimeRx medication reminder software, HOYLE Crossword and Sudoku puzzles, a 17-inch monitor, mouse and external speakers. The price: $1,255 for the Vision Plus desktop, or $1,895 for the laptop edition.

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If you’re looking for something more affordable, the new Linux-powered Kiwi PC for seniors is another option to consider. Priced at just $380, this user-friendly computer provides a simplified navigation system, with oversized tool bar, large icons and text that makes it easier to see and use. Other features include a customizable “Me Menu” that provides quick and easy access to frequently visited websites, email and programs straight from the desktop, a color-coded keyboard, 19-inch monitor, and a toll-free phone support line that’s available 24/7. See kiwipc.com, or call 855-255-5494. Savvy Tip: While it’s not designed specifically for seniors, the Apple iPad2 ($499) is another user-friendly option that has gotten great reviews from older users. See apple.com to learn more. 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. July 2011 •

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ummertime is here, and for many people that means vacation. Some of the best vacations are the ones that allow you to spend time with family members who live far away. If you’re planning to visit your kids and grandkids this summer, why not make the most of your time with them? You may know your way around a computer. But youngsters today who grew up on a computer can teach most of us some new tricks. And they’d probably be thrilled to share some online time with their grandparents. Ask them to pull out their tablet, iPad, or laptop and show you how to find your way around Social Security’s website, www.socialsecurity.gov. Ask them to show you how to use www.socialsecurity.gov to avoid unneeded trips to a Social Security office. Have them show you our library of online publications containing all the information you might want to know on an array of Social Security, retirement and Medicare subjects. The publications can be found at www.socialsecurity.gov/pubs/index.html. If you’re thinking about retirement, for example,

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Q: When a person who has worked and paid Social Security taxes dies, who is eligible for survivors benefits? A: Social Security survivors benefits can be paid to: • Widows or widowers — full benefits at full retirement age, or reduced benefits as early as age 60; • Disabled widows or widowers — as early as age 50; • Widows or widowers at any age if they take care of the deceased’s child who is under age 16 or disabled and receiving Social Security benefits; • Unmarried children under 18, or up to age 19 if they are attending high school full time. Under certain circumstances, benefits can be paid to stepchildren, grandchildren, or adopted children; • Children at any age who were disabled before age 22 and remain disabled; and • Dependent parents age 62 or older. Even if you are divorced, you still may qualify for survivors benefits based on the earnings record of a former spouse. For more information, go to www.socialsecurity.gov. Q: What is a Social Security “credit?” A: During your working years, earnings covered by Social Security are posted to your record. You earn Social Security credits based on those earnings. The amount of earnings needed for one credit rises as average earn-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

you may want to check out “When To Start Receiving Retirement Benefits” at www.socialsecurity.gov/pubs/10147. html. (Unlike some libraries, there’s no due date to remember). That was easy! With the young ones helping you, you might as well go ahead and spend another 15 minutes to get the job done. No need to put on your shoes and sunglasses — you can apply online without having to leave your home. Visit www.socialsecurity. gov/applyonline where you can apply for retirement benefits in as little as 15 minutes. Once you click the “submit” button, you’re done; in most cases there are no forms to sign or documents to mail in. Here’s a way to get the attention of the young ones: ask them about Facebook and Twitter. Once they’ve got you on Facebook, you’ll have a new way of connecting with them. Did you know Social Security is on Facebook and Twitter too? Just go to www.socialsecurity.gov and click the Facebook and Twitter icons on the main page. Visiting your kids and grandchildren can be a lot of fun. Make it productive as well by asking the young whiz kid in your family about www. socialsecurity.gov. ings levels rise. In 2011, you receive one credit for each $1,120 of earnings. You can earn up to a maximum of four credits a year. Most people will need a minimum of 40 credits (or 10 years of work) to be eligible for retirement benefits. Learn more by reading the online publication How You Earn Credits at www.socialsecurity.gov/pubs/10072. html. Q: What is the earliest age that I can begin receiving retirement benefits? A: You can get a reduced benefit as early as age 62. Keep in mind that your monthly benefit amount would be about 33 percent higher if you wait until age 66 and nearly 80 percent higher if you defer payments until age 70. Visit our Retirement Estimator to find out how much you can expect to receive. You can find it at www. socialsecurity.gov/estimator. Q: How does Social Security decide if I am disabled? A: For an adult to be considered disabled, Social Security must determine that you are unable to do the work you did before and, based on your age, education, and work experience, you are unable to adjust to any other work that exists in significant numbers in the national economy. Also, your disability must last or be expected to last for at least one year or to result in death. Social Security pays only for total disability. No benefits are payable for partial disability or short-term disability (less than a year).

H ealth News New VP of sales and marketing at ACM Todd Meyers recently joined ACM Medical Laboratory, a division of Unity Health System, as vice president, sales and marketing and will be responsible for the business development efforts for all lines of ACM’s business around the world. Meyers brings to ACM a wealth of experience in global sales management, strategic marketing, proposal development and market research that has been gained through a highly successful career in the pharmaceutical and pharmaceutical support services Meyers industries. He is coming to ACM from i3 Global, a pharmaceutical services company, where he was head of business development and therapeutic planning for the clinical drug development services division. Prior to that, he was senior vice president, sales, marketing and consulting for the Zitter Group, and executive director, business development for Covance’s North America Clinical and Periapproval Services business. Meyers also spent several years at Innovex, a division of Quintiles, where he served in roles of increasing strategic responsibility, including the general manager, vice president of operations and sales for the primary care and specialty

Lifetime Health earns highest rating for care Lifetime Health Medical Group has announced that four of its medical practices have each received recognition as a Level 3 Patient-Centered Medical Home from the National Committee for Quality Assurance (NCQA). Level 3 is the national agency’s highest designation, and it was awarded to Lifetime Health Medical Group’s Perinton Health Center in Rochester and Amherst, Mosher and West Seneca Health Centers in Buffalo. Lifetime Health’s practices represent four of the 264 Level 3 practices in New York state recognized as Patient-Centered Medical Homes. “This recognition acknowledges both our commitment to quality and our guiding principle of putting patients first,” says Mark F. Perry, chief medical officer, Lifetime Health Medical Group. NCQA recognizes primary care practices that function as patient-centered medical homes, a model of care where the patient is at the center of his or her health care team and has an ongoing relationship with a personal physician who leads the team. Medical home physicians demonstrate the benchmarks of patient-centered care, focusing on coordination of care, quality, preventive care, and patient communication and outreach. To receive recognition, Lifetime Health Medical Group’s practices demonstrated the ability to meet the

program’s key criteria embodying the characteristics of the medical home. Level 3 recognition for the remaining eight practices is expected later this year. Lifetime Health Medical Group met key program measures in several areas, including appropriate use of charting tools to track patients and organize clinical information; responsive care management techniques with an emphasis on preventive care; and measurement and reporting of clinical and service performance

VNS president/CEO receives HCA’s highest honor Victoria G. Hines, president and CEO of Visiting Nurse Service of Rochester and Monroe County, Inc. (VNS) was recently honored at the 2011Home Care Association of New York State Annual Conference (HCA). She was named recipient of the Ruth F. Wilson Award. HCA’s highest honor — the Ruth F. Wilson Award — is bestowed upon an individual who has demonstrated exceptional dedication and Hines made a significant contribution to home care over a period of time. With this award, HCA recognizes those whose work has had a dramatic effect on home care, reaching beyond a single agency. The recipient is recognized for strengthening the practice of the home care profession, raising the standards of quality and care for patients, or advancing the level of understanding and mutual cooperation among the home care community, legislators, federal and state agencies, health care providers and the public. This prestigious award recognizes an individual who has made home care services stronger and more visible, and one who has never wavered from his/her support of home care. In November 2001, Hines was appointed president and CEO VNS and Visiting Nurse Signature Care as well as vice president for Home

St. Ann’s wins international marketing award The 17th Annual Communicator Awards has bestowed an award of distinction to St. Ann’s Community for its website, www.StAnnsCommunity. com. St. Ann’s received this honor in the interactive category. The 2011 Communicator Awards received 6,000 entries from around the world, and these awards honor creative excellence in communications, recognizing the best in advertising, corporate communications, public relations and brand identity work. The Communicator Award is sanctioned and judged by the International Academy of the Visual Arts, an invitation-only body consisting of top-tier professionals from a “Who’s Who” of acclaimed media, communications, advertising, creative and marketing firms. St. Ann’s Community’s website was redesigned approximately one year ago and includes a helpful resources section that contains current news relating to seniors, an encyclopedia of medical issues, helpful links, and a section of recipes created by St. Ann’s Community’s chefs and chief clinical dietitian. The website also includes “Betty’s Blog,” a blog written by St. Ann’s President and CEO, Betty Mullin-DiProsa.

Thompson honored for its stroke care F.F. Thompson Hospital recently received the American Heart Association/American Stroke Association’s Get With The Guidelines Stroke Gold Plus Achievement Award. The award recognizes Thompson’s commitment and success in implementing excellent care for stroke patients, according to evidence-based guidelines. Thompson is a New York statedesignated stroke center. To receive the Gold Plus award, the hospital achieved of 85 percent or higher adherence to all Get With The Guidelines-Stroke Achievement indicators for two or more consecutive 12-month intervals and achieved 75 percent or higher compliance with six of 10 Get With The Guidelines-Stroke Quality Measures, which are reporting initiatives to measure quality of care. In addition to the Get With The Guidelines-Stroke award, Thompson has also been recognized as a recipient of the association’s Target: Stroke Honor Roll, for improving stroke care. “With a stroke, time lost is brain

lost, and the Get With The GuidelinesStroke Gold Plus Achievement Award demonstrates Thompson’s commitment to being one of the top hospitals in the country for providing aggressive, proven stroke care,” said Dr. Anthony Geraci, vice president of emergency and outpatient practices for Thompson Health. “We will continue with our focus on providing care that has been shown in the scientific literature to quickly and efficiently treat stroke patients with evidence-based protocols.” According to the American Heart Association/American Stroke Association, stroke is the third leading cause of death in the United States and a leading cause of serious, long-term disability. On average, someone suffers a stroke every 45 seconds; someone dies of a stroke every three minutes; and 795,000 people suffer a new or recurrent stroke each year. Get With The Guidelines-Stroke uses the “teachable moment,” the time soon after a patient has had a stroke, when they are most likely to listen to and follow their healthcare professionals’ guidance. Studies demonstrate that patients who are taught how to manage their risk factors while still in the hospital reduce their risk of a second

July 2011 •

Care for Strong Health and associate dean of community care of the University of Rochester School of Nursing. At VNS, she directs the certified and licensed home health agencies, as well as oversees the hospice, long-term home health care and Meals On Wheels programs. Hines has served the University of Rochester, Strong Health, and Strong Memorial Hospital in numerous administrative positions since 1990, and from 1987 to 1989. Just prior to her appointment with VNS, she directed the Ambulatory Redesign Project for the University of Rochester and Strong Health, standardizing business practices and making significant financial and process improvements. Hines previously served as associate dean for administration and finance at the University of Rochester School of Nursing, where she was chief architect of a strategic plan that has significantly improved the competitive and financial position of the school. Before returning to Rochester, she served as director of ambulatory services and clinical program support for The Francis Scott Key Medical Center at Johns Hopkins Health System from 1989 to 1990. Hines is an assistant professor at the University of Rochester School of Nursing and teaches in the master’s program. She is a native of Alexandria, Va., and resides in Fairport with her husband, Thomas, and three children.

heart attack or stroke.

Foundation donates $30,000 to Alzheimer’s The Alzheimer’s Association Rochester New York Chapter is the recipient of a $30,000 gift from the Golisano Foundation. The grant will help underwrite a portion of the chapter’s dementia support services program, beginning May 2011 and ending in April 2012. David Midland, the chapter’s CEO/president, applauded the commitment. “We are thrilled with this generous donation from the Golisano Foundation,” said Midland. “This grant will help leverage opportunities for individuals living with dementia and a developmental disability by integrating independence, self-determination and productivity into all facets of their lives.” The chapter’s dementia support services program promotes aging in place throughout the Finger Lakes region with great sensitivity for the health and safety of persons with developmental disabilities and

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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H ealth News Alzheimer’s disease and other dementias. This program blends support and management strategies to delay or avoid nursing home placement by increasing collaboration and crossagency responses to the needs of both the person with special needs as well as their caregivers. Services provided include care consultation; education and discussion for professional care providers as well as family caregivers; peer discussion groups; and safety assessments of the residence and day program.

percent from about $250,000 to nearly $1 million, purchasing a 30,000 square foot building in Rochester, establishing a satellite in Newark and increasing service offerings to include day and residential habilitation, independent living skills training, pre-vocational training and community integration counseling.

Hickok Center’s CEO receives “Founders Award”

Clifton Springs Hospital & Clinic has achieved national accreditation from DNV Healthcare, the newest and first Medicare-approved hospital accreditation program that integrates the ISO 9001quality management system with the Medicare hospital standards and which requires the organization to evaluate the continuum of patient care throughout an entire healthcare system and take measured steps to improve when it is warranted. “The DNV program is consistent with our long-term commitment to patient safety and total quality,” says Ethan Fogg, director of community relations. “DNV’s ability to help us integrate the ISO 9001 quality management system into our clinical and financial processes is a major step forward.” “It’s a much more holistic system” says Fogg. “While very thorough, DNV’s process doesn’t feel like an ‘inspection’, rather a collaboration. The DNV program helps us find and address opportunities throughout the organization to improve the way we provide care and conduct business. We now look upon accreditation as a strategic business tool and as source of

The Hickok Center Chief Executive Officer Elaine Comarella has been selected to receive the 2011 “Founders Award” from the Brain Injury Association of New York State. The award was recently presented to her at the New York State Brain Injury Conference in Albany. The Founders Award is given in recognition of outstanding efforts to help establish new services or opportunities for persons with brain injuries and their families. Comarella became CEO of the Hickok Center for Brain Injury Comarella in 2005 after 25 years in the human services field. Since then, the Hickok Center for Brain Injury has made significant accomplishments including increasing revenue by 75

Clifton Springs Hospital gets national accreditation

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New GRHF Hero: Yvonne Clinkscales Her motto: “Get Out, Get Up, Get Moving and Stay Healthy” Yvonne Clinkscales has earned a Healthy Hero Award from Greater Rochester Health Foundation, (GRHF) for her work with the Mighty Liberators Drum and Bugle Corps at Baden Street Settlement. Clinkscales remembered how much being a part of the corps meant to her growing up. She wanted Rochester’s children to have a chance to achieve that same sense of pride and acClinkscales complishment so she helped revive the Mighty Liberators. Now, some 60 young people

empowerment for our staff. The DNV program keeps us moving forward.” The DNV accreditation program was authorized by the US Centers for Medicare and Medicaid Services in 2008 and is the only program that integrates the ISO quality management

march, twirl, drum and play in the Mighty Liberators and get plenty of exercise mastering the intricate steps while tossing flags and playing instruments. Weekends often find them marching in local parades. Clinkscales doesn’t stop there — she makes sure that the children have healthy snacks at practices and holds healthy cooking classes for families. Her motto is “Get Out, Get Up, Get Moving and Stay Healthy.” “Mighty Liberators Drum and Bugle Corps provide opportunity for kids who may not have a chance to participate in or enjoy traditional organized sports to be physically active. The Mighty Liberators combines love of music with rigorous physical activity, and is a great outlet for kids to burn off energy and learn to work as a team,” says John Urban, president of GRHF.

system with Medicare’s Conditions of Participation, the core requirements for hospitals set forth by the federal government. Clifton Springs Hospital & Clinic will have three years to become compliant with the ISO 9001:2008 standards maintain its accreditation.

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edical malpractice premiums for physicians in different regions of the state can vary as much as five times the amount paid between regions and the difference can exceed $100,000 for some specialties, according to an analysis issued in June by Excellus BlueCross BlueShield. “Medical malpractice rates for Upstate New York physicians are considerably less than those in downstate regions and are similar to the amounts paid by physicians in states that report the lowest premium rates in the country,” said a spokesperson for Excellus BlueCross BlueShield. “The Facts About New York State Medical Malpractice Coverage Premiums” shows that the standard malpractice premium for an internist in Buffalo, Syracuse, Binghamton and Utica ($9,874) is significantly lower than for an internist practicing on Long Island ($35,028). A similar differential exists for physicians in other specialties. For example, a general surgeon’s premium rate in those same Upstate areas is $32,663, contrasted with a Long Island surgeon’s rate of $115,872; and obstetricians/gynecologists in many Upstate regions may pay $52,650, while their

Long Island counterparts face a standard rate of $186,772. According to the study, doctors in the Rochester area have the lowest malpractice rate. Physicians pose varying risks of liability based on their specialty, experience factors and the experience of other physicians in the regions where they practice medicine. Standard rates are reviewed and approved by the New York State Insurance Department. From the standard rates, discounts, credits, experience factors and other considerations are used to determine the actual premium paid by individual physicians. The data presented in the fact sheet for New York state physicians is based on current standard premium rates of the Medical Liability Mutual Insurance Co., which insures most physicians in the state. Standard medical malpractice premiums for typical physicians in New York state are referred to as “occurrence policies” that provide up to $1.3 million in liability coverage for a single injury and up to $3.9 million for a single policy year. “Regardless of the regional differences in premium rates, physicians

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

and hospitals that pay their physicians’ medical malpractice insurance premiums believe that the rates are too high and want to see them lowered by reforms to the state’s tort system,” Vercillo said. The fact sheet reviews reports that provide cost estimates on the impact that malpractice insurance coverage and defensive medicine may have on total health care spending. “We share physicians’ concerns about malpractice premium rates,” Vercillo said. Excellus BlueCross BlueShield has advocated, together with such organizations as the Medical Society of the State of New York and The Business Council of New York State, for tort reforms that would help lower medical malpractice costs and other liability expenses faced by businesses in the state. One step taken this year by Gov. Andrew Cuomo and the New York state Legislature to help address rising malpractice insurance costs – particularly in response to downstate hospital pleas for help – was the establishment of a statewide medical indemnity fund to cover medical expenses for eligible children with birth-related neurological injuries.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Rowing for a Cause Rochester’s Cross Currents Minority Rowing is making it possible for more minorities to get into the highly underrepresented water sport By Amy Cavalier

he sport of rowing has fascinated Lydia Boddie-Rice since she was a college student attending Brown University. “I always thought it was a very majestic activity,” she said. “From the perspective of a team activity, the synchronization, the amount of team work and support to be manifested in this entity gliding down the river was just so beautiful to me.” Her class schedule conflicted with crew practice, so she couldn’t join. When her oldest daughter joined crew at Northeastern University, it piqued BoddieRice’s interest in rowing again. At the age of 50 her interest got the best of her. Six years ago, she agreed to help pull together a team, and she’s been rowing ever since. “This really was a personal Boddie-Rice journey; a health and fitness quest,” she said. “It’s a lifetime sport for me. I’ll do it until my body gives out and I can’t do it anymore.” Now a competitive rower, BoddieRice is making a difference by engaging more minorities in the underrepresented sport, raising money to make rowing affordable, and putting Rochester on the national rowing scene. It started when Boddie-Rice asked a former co-worker, who was also executive director of the Genesee Waterways Center, about getting involved in rowing. It just so happens the co-worker was in the midst of setting up an urban corps to encourage more minority participation in water sports and rowing. Boddie-Rice, who was an outreach specialist for RG&E at the time, agreed to help apply for a grant Page 24

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and get the team going. In 2006, Boddie-Rice founded Cross Currents Minority Rowing, a group aimed at encouraging minorities to participate in water-related activities, with a focus on rowing, by providing equipment, training and resources to participate in the sport. It started with eight people, including Boddie-Rice’s husband Greg, and Cross Currents has since exposed hundreds of minorities, from 14 to 70 years old, to rowing. With the assistance of teammates and supporters, Boddie-Rice has raised over $100,000 to support the cause. “My passion is around never saying no to anyone who wants to participate,” she said. “I do not want economics to be a barrier to participating in the sport because I feel it’s technically challenging and physically demanding. That kind of dedication should be rewarded.” Cross Currents was able to purchase their first eight-person shell through a sponsorship from Rochester Gas and Electric. Last year they purchased a four-person shell with help from Rochester General Hospital and the Wilson Foundation. Boats cost somewhere in the neighborhood of $20,000 and up. Cross Currents has a corps of about 20 to 24 active rowers. Members come from all walks of life, Boddie-Rice said, from executives, educators and students to physicians, health and social workers, and finance, business and legal professionals. The same year Cross Currents was founded, USRowing’s Diversity Task Force began researching the reasons for a lack of diversity in the sport of rowing. USRowing is the national governing body of rowing in the United States. The association makes the policies, safety rules, and oversees all university, high school, for-profit and non profit rowing teams. It is the national governing body over the US Olympic

and National Rowing Team, according to Richard Butler, inclusion manager for USRowing. “What we found out is that there’s a huge American perception that it’s an elitist, white sport,” said Butler. “If most Americans think of it like that, then it’s going to be even tougher to reach the low income, economically challenged youth because of the perception of not being accessible.” Butler was hired in 2009 to change the perception of rowing and to reduce some of the obstacles that stood in the way of minority involvement in the sport. Not long after, he received a call from Oscar Pedroso, executive director of Cross Currents. Butler was ecstatic. He said Cross Currents exemplifies a model America Rows team. Most of the America Rows diversity programs are youth-focused. Cross Currents is one of only two adult masters programs in the country. “We’ve kind of flipped the model, and that’s what National liked, that there were adults interested in the sport that then could model the sport for younger people,” Boddie-Rice said. In 2010, the group was endorsed as America Rows Rochester team by USRowing’s Diversity and Inclusion Program. Cross Currents was not only one of the first American Rows affiliates, Butler said, and the group is at the forefront of USRowing’s Diversity

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2011

Rochester will be the site of the first ever America Rows Invitational on Saturday, July 30 at the Genesee Waterways Center. Initiative. “Today they are part of my main presentations and I’m in cities all across America,” he said. Rochester will be the site of the first ever America Rows Invitational on Saturday, July 30 at the Genesee Waterways Center. Butler hopes to have at least 10 to 15 crews from all over the country row in the invitational to showcase their diversity, inclusion and community outreach programs, and to compete. “It’s exciting,” Boddie-Rice said. “It’s also very intimidating.” Butler said Boddie-Rice’s passion for sharing the sport with others is amazing. And her level of commitment is matched by hers and the other members of the Cross Currents corps’ skill as rowers. “They’re not just rowers, they’re good rowers, and they have fast boats, and she would like the national rowing community to know that they exist so she works tirelessly raising money for the program to purchase boats, coaches, equipment, and this is all free, pure sweat equity,” said Butler. “Oscar and Lydia do this on a volunteer basis. People quit PTAs that do less.”