in good March 2015 • Issue 115 Physician Robert McCann talks about being recognized by the American College of Physicians and about his work at Highland, where he serves as chief of medicine
Hip Replacement
GVhealthnews.com
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Rochester’s Healthcare Newspaper
VACCINES • Understand the ‘Herd Immunity’ Effect • Mother: Why I Don’t Vaccinate My Kid • Vaccination Myths: What’s True, What’s Not Page 21-22
Report: number of hip replacements has skyrocketed
Do You Need To File a Tax Return in 2015? Many don’t need to. See the Savvy Senior column inside
YOGA
More children, adults and seniors trying the ancient discipline, researchers report Page 23
Getting Geared Up Group of people at JCC in Brighton getting ready for a March 29 triathlon Page 9
Your deli sandwich may come with a side of listeria: study
Come March — when snow and ice still have a death grip on our climate — I pine for pineapples more than at any other time of year. See why at this month’s SmartBites column
NANCY ADAMS: Helping physicians in the Rochester area for nearly two decade. She recently was recognized by the American Medical Association Page 16
Page 14
March 2015 •
Energy drinks tied to inattention, hyper behavior in middle schoolers says study
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Page 10 •
Page 1
Number of Hip Replacements Has Skyrocketed, Report Shows Procedure becoming more common in younger adults, but hospital stays now a day shorter
T
he number of hip replacements performed in the United States has increased substantially, and the procedure has become more common in younger people, new government statistics show. The numbers reveal the rapid evolution of the procedure, which “remains one of the most dramatic and cost-effective ways to improve the quality of life for patients,” said physician Mark Pagnano, chairman of the department of orthopedic surgery at the Mayo Clinic in Rochester, Minn. “Recovery is dramatically easier for patients, the durability of hip replacements has improved, and the baby boomer generation is less willing to accept the limitations that accompany arthritis,” added Pagnano, who was not involved in the study. For the report, researchers looked at hospital statistics on total hip replacement — replacement of the head of the femur (thigh bone) and its socket — from 2000-2010. The researchers focused on patients 45 and older, who accounted for 95 percent of the procedures.
What’s going on?
Report lead author Monica Wolford, a statistician with the U.S. National Center for Health Statistics (NCHS),
said: “The main hypothesis is that osteoarthritis is becoming more common,” but the statistics in the study don’t reveal why the procedures are taking place. Pagnano said the growing number of cases of arthritis is a major factor in the trend. Most hip replacements in middle-aged patients are due to degenerative arthritis caused by wear and tear, he said. So higher numbers of active people translate Year...........Number of procedures into more 2000..........138,700 arthritis. “Thus, the 2010..........310,800 number of patients who are appropriate candidates for hip replacement at a younger age grows,” he noted. The report also found the average What’s next? hospital stay for total hip replacement Report co-author Anita Bercovitz, a patients has shrunk from nearly five health scientist with the NCHS, said the days in 2000 to just under four days in numbers suggest a challenge down the 2010. line: Many of these hip replacements “The early recovery from hip will have to be replaced when they replacement has become dramaticalwear out. “This will have implications ly easier from a patient standpoint,” for planning for the future,” she said. Pagano said, because of improved Physicians first developed modern rehabilitation procedures, better pain “total hip replacement” surgery in the management and better control of early 1960s. But it remained a fairly rare blood loss during surgery. procedure until the late 1980s, when the
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Money leads the list of major stress generators, followed by work, family responsibilities and health concerns
M
oney continues to be the leading cause of stress for Americans, a new survey finds. Overall, stress in the United States is at a seven-year low, and average stress levels are declining, the American Psychological Association poll found. But money worries continue to nag at the American psyche, despite the ongoing economic recovery, the association says in its report released Feb. 4, titled “Stress in America: Paying With Our Health.” Financial worries served as a significant source of stress for 64 percent of adults in 2014, ranking higher than three other major sources of stress: work (60 percent), family responsibilities (47 percent), and health concerns (46 percent). Nearly three out of four adults reported feeling stressed about money at least some of the time, and about one in four adults said they experienced extreme stress over money during the past month, according to the report. “Money is a very important component of establishing a secure life,”
said Norman Anderson, CEO and executive vice president of the American Psychological Association. “When people are financially challenged, it makes sense that their stress level would go up.” The good news is that, on average, Americans’ stress levels are trending downward. The average reported stress level is 4.9 on a 10-point scale, down from 6.2 in 2007, the report found. Despite this, the association found that Americans are living with stress levels higher than what psychologists believe to be healthy, and 22 percent say that they are not doing enough to manage their stress. Financial stress particularly affects women, parents and younger adults, the survey found. For instance, three out of four parents and adults younger than 50 said money is a somewhat or very significant source of stress. Women are more likely than men to report money as a significant source of stress, 68 percent versus 61 percent.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2015
Dr. Anna Belous and Dr. Arlene Messer
Happy 26th Birthday! In 2015, more than 280,000 young adults in New York state will turn 26, with many of them aging off of their parent’s health insurance
I
f you’re an uninsured young adult in Upstate New York and you break your leg while skiing, you could face almost $8,000 in medical bills, according to research by Excellus BlueCross BlueShield. Likewise, an unanticipated visit to the emergency room could cost you $1,000 — the equivalent of up to 10 months of cell phone bills for the average iPhone user, according to the research in the study, “Happy 26th Birthday! Feeling Lucky?” In 2015, more than 280,000 young adults in New York state will turn 26, with many of them aging off of their parent’s health insurance. “When it comes to obtaining health insurance, some may weigh the risks and rewards of receiving coverage,” said physician Jamie Kerr, vice president, Kerr chief medical officer for utilization management, Excellus BCBS. “Even if they’re willing to gamble, they may still be saddled with a financial penalty for not having health insurance coverage when they file their income tax. “Those who are uninsured in 2015 could face a financial penalty of $325 per person or up to 2 percent of household income, whichever is higher. Cost is often a contributing factor when choosing to forgo coverage. But individuals who make less than $46,680 annually could qualify for financial help. In 2014, New Yorkers received an average of almost $2,600 in tax credits. Another reason some go without coverage is because they don’t believe
Majority of New York young adults (ages 26-29) are healthy, but… 1 in 5 smokes 2 in 5 binge drink 1 in 10 does things that increase his or her risk of getting HIV Health costs that Upstate New Yorkers uninsured young adults may face: $16000 for having a baby $7,800 for a broken leg $2,700 for a concussion $1,000 for an ankle sprain $1,000 for ER visit
they will get hurt or sick and need coverage, said Kerr. “Thousands of Upstate New Yorkers will face unexpected health problems, such as developing a concussion or a severe case of bronchitis,” she said. “An individual’s health plan protects him or her from the unexpected costs of health care.” When it comes to purchasing coverage, individuals may be able to turn to their employers, government programs, health insurers, college plans, or the NY State of Health Marketplace. The deadline to buy health insurance through the NY State of Health Marketplace was Feb. 15. But if you experience a major life event — such as a marriage, a birth of a new baby or you age off your parent’s plan when you turn 26 — you may be able to purchase coverage for 2015 after the Feb. 15 date. To access the research and the infographic Excellus put together, go to http://brand.excellusbcbs.com/infographics/turning26.php
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Serving Monroe and Ontario Counties in good A monthly newspaper published by
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Local News, Inc. Distribution: 30,000 copies. To request home delivery ($15 per year), call 585-421-8109.
In Good Health is published 12 times a year by Local News, Inc. © 2015 by Local News, Inc. All rights reserved. 106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Chris Motola, George W. Chapman, Jessica Spies, Jessica Gaspar, Lynette Loomis, Cathy Miller Jessica Gaspar • Advertising: Donna Kimbrell, Marsha Preston • Layout & Design: Chris Crocker • Officer Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
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March 2015 • InIN GOOD – Rochester / Genesee Valley Healthcare Newspaper Good HealthHEALTH | 5"W x 6.75"H | release 6/13/2012
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Page 5
CALENDAR of
HEALTH EVENTS
March 4, 11, 18, 25
Vegan classes offered at Unity at Ridgeway Rochester Regional Health System brings back its popular Seeds of Change vegan class. A plant-based vegan approach, coupled with exercise to manage diseases such as diabetes, high cholesterol, weight gain, and hypertension, Seeds of Change consists of four two-hour sessions over the course of four weeks. Attend four, two-hour sessions and learn about the benefits of a plant-based meal plan, including: weight reduction, improved cholesterol and triglycerides, improved diabetes control, possible risk reduction for heart disease Presenters will be registered dietitians and certified diabetes educators from Rochester Regional Health System. The classes will take place March 4, 11, 18, 25 at the Diabetes and Endocrinology Center Unity at Ridgeway, 2655 Ridgeway Ave., Suite 220, Rochester, NY 14626. Cost is $120, payable to “Unity Health System.” Class costs include cooking demonstration, samples and a start up kit Space is limited. Register by calling 585-368-4560 or visit unityhealth.org (click on “classes and events”).
March 11
of art from among 25 different categories will be exhibited. Categories consist of fine art such as painting, drawing, sculpture and photography; applied art that includes ceramics, woodcarving, needlework and leatherwork; and craft kits such as string art, fabric art and wood building. Local artists will judge the artwork to determine first, second and third place in each category. The first place winning pieces will advance on to the national level where they will compete with entries submitted by veterans from other VA facilities around the country. The competition is an annual event that provides veterans receiving treatment at VA facilities the opportunity to participate in creative self-expression in art, creative writing, dance, drama and music as part of their therapy, and to gain recognition for these artistic accomplishments. First place winners from the national competition will be invited to attend the National Veterans Creative Arts Festival, hosted this year by the Durham VA Medical Center in Durham, North Carolina, the week of Oct. 12 – Oc. 19. Veterans wishing to enter artwork into the competition or have questions, contact the Canandaigua VA Recreation Therapy Department at 585-393-7371.
March 12
Seminar to discuss breathing and heart health
Canandaigua VA local veterans art show Artwork by veterans will be on display to the public at the Canandaigua VA Medical Center Auditorium from 10 a.m. – 1 p.m. on Wednesday March 11. It is estimated that more than 50 pieces
Physician Justin M. Weis will present “Breathe, It’s Good For Your Heart: Thoughts from a Pulmonologist on Heart Disease” during an event sponsored by Mended Hearts Rochester. The meeting will be held in the
RG&E Family Room, in the M.M. Ewing Continuing Care Center, Thompson Health, 350 Parrish St, Canandaigua. After medical school at the University of Iowa, Weis completed his internship, residency and fellowship at Strong Memorial Hospital. He is assistant professor of medicine in the URMC’s pulmonary and critical care division, and interim director of pulmonary and critical care at F. F. Thompson Hospital in Canandaigua. Mended Hearts Rochester is in its 49th year of giving support to people with heart disease and their families, by visiting those recovering from heart surgeries at Strong Memorial and Rochester General Hospitals and through its informative monthly meetings. . For more information, call 585-671-0481.
March 14
Colon wellness program offered in Clifton Springs The public is invited to join the Cancer Services Program of Ontario, Seneca and Yates Counties on Saturday, March 14, for its first ever “Rollin’ Colon Wellness Fair.” This event features a 20-foot inflatable, walk-through colon and countless opportunities to interact with local businesses and agencies devoted to health and wellness. This free event welcomes community members of all ages and will be conveniently located in the Midlakes Intermediate School gymnasium in Clifton Springs, between 10 a.m. and 2 p.m. Physician Daniel Biery will lead a discussion about colorectal cancer. Experts on zumba, acupuncture, men’s strength and other topics will be on hand. Door prizes will be available.
March 17
‘Living with Heart Failure’ topic of seminar
Living alone can be a challenge, especially for women in mid-life who are divorced or widowed. But it can also be the start of a rich and meaningful chapter in your life. Need a jump start?
Registered nurse Annette Grindle will discuss “Living with Heart Failure” during a seminar sponsored by Mended Hearts Rochester. Grindle received her nursing degree from Alfred State College and St. John Fisher and her master’s degree from the University of Rochester. She is currently nurse manager of the Heart Failure & Cardiac Transplantation Step Down Unit at URMC. The meeting will be held at the Jewish Community Center, senior adult lounge, 1200 Edgewood Ave., Rochester. For more information, call Sharon Feldman at 585-544-1565.
Living Alone: How to Survive and Thrive on Your Own
April 14, 21, and 28
Do you live alone? Tuesday, April 14, 21 and 28 6:30 pm - 8:30 pm House Content B&B, Mendon, NY
In the workshop led by Gwenn Voelckers — a women who’s “been there” — you’ll discover how to overcome loneliness and other emotional pitfalls, rediscover your true self, and socialize in a couples’ world. $145 fee includes manual, empowerment exercises and lots of helpful resources. For more information, call (585) 624-7887 or email gvoelckers@rochester.rr.com Page 6
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Workshop for women who live alone Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own,” is a three-part workshop offered for women who want to find joy again and gain the know-how to forge a meaningful and enriching life on their own. You’ll meet others in similar situations and learn practical strategies to overcome loneliness, rediscover your true self and socialize in a couples’ world. The workshop takes place at House Content Bed & Breakfast in Mendon from 6:30 – 8:30 p.m. on three consecutive Tuesdays: April 14, 21, and 28. The workshop fee of $145 includes a Living
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2015
Alone binder, empowerment exercises, and helpful resources you can trust. To learn more, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@ rochester.rr.com
April 25
Celiac group sponsors gluten-free food fair, walk The Greater Rochester Celiac Support Group (GRCSG) is sponsoring “Making Tracks for Celiacs Walk & Gluten-Free Food Fair,” an event that will be held from 10 a.m. – 1 p.m. Saturday, April 25 at Monroe Community College. Wegmans Food Markets and 13WHAM ABC, FOX Rochester & CW Rochester are the presenters. This is a day of fun for the whole family featuring a two-mile walk, gluten-free food fair, raffles for prizes, and activities for children. The Making Tracks for Celiacs Walk is a fundraiser for the local Greater Rochester Celiac Support Group and the Massachusetts General Hospital’s Center for Celiac Research (CFCR). Locally, the Greater Rochester Celiac Support Group uses funds to help educate the Rochester celiac, gluten sensitive, and wheat allergic community. CFCR is engaged in clinical care, diagnostic support, education, and research in the field of celiac disease. Their mission is to increase awareness of celiac disease on a national level in order to provide better care, better quality of life, and more adequate support for the national celiac disease community. Gluten-free samples and hot/cold items will be available from local and national companies, and food trucks will be selling gluten free food just outside the gymnasium. The raffle drawing for exciting local and national prizes will occur at noon. Pre-registration is now available at www.celiacwalk.org. Walk-day registration and sign-in including T-shirt pickup begins at 10 a.m. For additional information, visit www.rochesterceliacs.org.
May 16
Guided spring walk to take place in Clifton Springs Clifton Springs Hospital & Clinic Auxiliary, Ontario Pathways and Main Street Arts invite the community to walk the pathways and capture the beautiful scenery on camera. The goal of this collaborative effort is three-fold: make people more active and healthy by hiking local trails; encourage people to connect with their local environment; and give photo-enthusiasts of all levels and abilities the opportunity to exhibit their photographs in a contemporary art gallery. Tim Wilbur, Ontario Pathways president, will lead a spring walk starting at 10 a.m. May 16, from the Flint BOCES. Guided walks are optional as photographs can be taken at any time, on any of the Ontario Pathways trails now through May 24. To register for the guided walks please email Tim Wilbur at TWilbur@rochester.rr.com. Photos must be digitally submitted to Main Street Arts via their website, www.mainstreetartsgallery.com by May 25, those chosen will be displayed from July 9 - 31, 2015 at the Gallery and other locations throughout the area. For more information, please call 315-462-0120.
Helping Others Learn from Her Experiences at East House
“Successfully helping the disabled obtain their Social Security Disability/SSI benefits for 23 years.”
By Jessica Spies
O
ver 21 years ago, with no home and little support, Karen wasn’t sure where to turn. Through the recommendation of her psychiatrist, she applied for a group home situation with the Rochester-based East House. Now, Karen, 66, is thriving as an employee of East House working as a peer support specialist. “East House for me was kind of like a second family. When I was so estranged from the abusive nature of my family at the time, it became like a second family,” she said. “I had the support, trust and confidence of my service worker. She gave me just what I needed to work on my recovery alone.” East House is a nonprofit organization that started in 1966 to provide safe housing for those in need. It’s now become a network of services for those recovering from mental illness and chemiAward-winning singer and songwriter Judy Collins attended the 6th Annual East House Hope and cal dependency, providing residential, rehabilitation and Recovery Luncheon in September last year. The event helps the organization raise funds for its career service programs. programs. After being a client with East House for more than 20 point. Everyone has a different goal for dence of East House’s motto of “movyears, Karen was inspired to provide themselves,” Way said. ing lives forward.” She was a client in support to others who were in her Some of those who come in have the group home for five months and position. a doctoral degree or career and then was in the independent living program “When I heard of the opportunity for 21 years. two and a half years ago that they were have a setback with their illness. “We’re helping them to get back “I have had a phenomenally wonmoving in the direction of using peers to a point derful and productive experience with who are where they East House,” she said. using lived can work She has an educational background experience, again,” she in psychology and a master’s degree in I leapt to it,” said. religious studies. Karen said. Some of “I never used my degrees actively In her the clients because I was too busy recovering from position, are homemy own mental illness,” she said. “I Karen — less or living at the psychiatric center have a desire to share my lived expewho asked her last name not be used and “are not sure what goals they have rience with other consumers because I in the story — makes weekly phone for their life … [they work on] finding was interested.” calls of support and encouragement to a life that’s meaningful for them,” Way Karen was diagnosed with bipolar a more than a dozen clients and speaks said. disorder and general anxiety disorder, to them about their goals and the Some learn how to cook for and is formerly morbidly obese. Since personalized plan for their recovery. themselves, how to budget and how to working with East House, she has lost She also attends outings with clients, 75 pounds and is no longer obese, and co-leads a weekly support group where manage a home environment. “There’s a continuum and people feels in control of her disorders. clients learn how to build community enter it all different points along the “As a bipolar, I had 25 years of and social skills, and sends more than way,” Way said. not being on pills, psychotic and de30 handmade birthday cards a month. While there are many successes, pressed,” Karen said. “We hire people who have been there are inevitable setbacks. “We all Before East House, Karen worked former consumers to provide a unique experience change,” Way said. “To help full-time and “hid out not letting peoperspective: ‘Hey, I’ve been there. I a person make meaning out of it and ple know that I was crazy,” she said. know what it’s like. I’ve been homeKaren said that one of her biggest less.’” said Valerie Way, senior program learn from it is ideal.” Having the client refocus on their accomplishments since becoming director of East House. goals proves to be an important motiinvolved with East House has been This unique peer support program vational technique, Way said. to help others who have been in her provides hope that the client can make “We’re here to help people have situation. “I very much enjoy using my a different path for their life, Way said. that overall meaningful goal for themskills and abilities and experience in Another segment of the peer supselves in their mind,” she said. helping a client get ahead in their life,” port system is the Connections RecovFor those who aren’t able to move she said. ery Center, a social, health and wellness past the setback, particularly with subKaren recently worked with a center. Hearing stories of peer success stance abuse, they “may need a higher client for five months to help declutter helps clients see that success can be level of care,” Way said. her entire apartment from her closet to achieved in different ways. “We’re here. We always keep an her kitchen. “We find that recovery is different open door for people. We’re non-judg“We went through everything,” she for different people,” Way said. mental; we like to help people with said. “We must have thrown out oneAs recovery differs, so do the where they’re at,” she said. third of her stuff.” milestones a client is able to reach. Karen said that her journey is evi“Everybody comes in at a different March 2015 •
Mary Perry, ADR 585-385-6855
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 7
Meet
Your Doctor
By Chris Motola
Robert M. McCann, M.D. Physician talks about being recognized by the American College of Physicians and about his work at Highland, where he serves as chief of medicine Q: Tell me about the Mastership award you recently received. A: Mastership is an award given by the American College of Physicians. It’s bestowed upon a few people each year. The organization has about 120,000 internists who are a part of it. We have a lot of international chapters too, even though it’s called the American College of Physicians. There’s a big ceremony every year. While I’ve already received the award in name, that’s when I’ll get the formal recognition in front of my peers. Q: What’s the process for being selected for the award? A: It’s decided by a committee staffed by a group of people who know what’s going on with internal medicine throughout the world. People make nominations. There’s several letters they have to write; generally the person being nominated has no knowledge it’s happening. They make the decision based on how you helped move medicine forward clinically or in terms of education, research or the role you’ve played in an organization. Sometimes a foreign candidate outside of the organization will receive the award and then go on to establish an international chapter. Our membership in Asia has been growing. I’m not sure how much longer it’s going to be the American College of Physicians. Q: What are your feelings about being selected? A: I’m very much honored by it, but it’s sort of a surprise to me. I’ve been the governor of the Western New York chapter of the American College of
Page 8
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Physicians for a five-year period that just ended in 2015. I think it’s a wonderful organization that puts patients first. Even though I’m a geriatrician and certified in palliative care, I think it’s the organization I relate to most. Q: What accomplishments are you proud of that may have played a factor in your nomination? A: I’ve been very vocal in the organization. I think it’s a combination of the work I did as the governor and our educational efforts. I think we brought Highland [Hospital] to a better place even though I
know we always need to keep improving on safety and patient satisfaction. We’ve developed an incredible hip transplant program that’s now internationally known. We have over 30 publications. I think it has really been something that has moved orthopedics and geriatrics forward. We’ve developed a palliative care service and an acute geriatrics program that’s very good. We’re creating meaningful qualities of scale between Strong and Highland. So I think it’s a lot of those types of activities that helped lead to that award. Q: On that note, what role have you played in the merger between Highland and the University of Rochester Medical Center? A: We developed a good team of people. It took up about half my time. The other half was spent running the Highland department of medicine. We’ve got wonderful faculty, great private groups. There’s a lot of overlap with a lot of the same providers. We’re building a great network and looking at ways to deliver great health care at a reasonable cost. Q: A lot of hospitals seem to be branding themselves nowadays, promoting a particular service that they hang their hat on. What would be Highland’s brand? A: I think of us and our brand as the best of both worlds in a lot of ways. We have an affiliation with a worldclass medical center and can dip into cutting edge medical research. At the same time we have expertise in geriatric fractures and joint replacement here. We’re very close to having the highest number of births in the area for obstetric care. We do a lot of bariatric surgery. I look at it as being a real gem. It’s user-friendly for the staff and patient-centered for the community. Q: As the chief of medicine at Highland, how much are you still able to practice? A: I’d say about 20 percent of my time is clinical care. That includes a small private practice and consultations in the hospital. The administration work has been taking up more time. I don’t think I’ve ever seen this much change taking place in such a
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2015
Physician Robert McCann has served as Highland Chief of Medicine since 1999. Among other accomplishments, he helped develop the Hospital Elder Life Program to prevent delirium in older hospitalized patients; the Acute Care for Elders Unit; outpatient practices in geriatrics; and the Geriatric Fracture Center at Highland. Since 2011, McCann has served as a principle investigator for a national geriatrics training project funded by a $1 million Donald W. Reynolds Foundation grant. The four-year grant is allowing geriatricians at Highland to teach and collaborate with hospitalists and physicians across several specialties, including orthopedics, physical medicine and rehabilitation, emergency medicine and neurology. short amount of time. New York state is moving toward pushing Medicaid care into large, global systems and we definitely want to be at the table as that gets designed. Strong and Highland are big safety net hospitals and we want to make sure that we’re still able to serve the most vulnerable people in the community. Q: Do you think this plan will improve Medicaid? A: Hard to know. One in five people in the state are on Medicaid now. There’re going to be more and more people on some level of public funding and less on private funding. As long as the funds are reasonable, if we’re getting global payments, it’ll be easier to pay for a lot of the things that don’t involve a face-to-face encounter. It’s complicated. Q: Where do you see an opportunity to improve care in all of this? A: We can decrease the fragmentation of care. You know, when people go the hospital, to a provider, to social services, to specialists; I think we’ll be able to communicate in a way that we haven’t before and create systems of accountability where outcomes help determine what we get paid. For instance, when patients get conditions related to their hospitalization — hospital-related infections, broken limbs — the hospital doesn’t get paid for treating those anymore. So there’s a financial incentive to avoid those. If people get readmitted within 30 days of being discharged, the hospital won’t get paid for that. So hospitals have an incentive to look at their discharge plans more closely. So we’ll be aligning financial incentives with the best care practices. Now, all of it’s not good. If a patient gets a hip replacement that’s done perfectly and happens to catch pneumonia 28 days later for unrelated reasons, we’ll still be penalized for that.
Lifelines Position: Chief of medicine at Highland Hospital Hometown: Buffalo Education: SUNY Upstate Medical University Affiliations: University of Rochester Medical Center, Strong Organizations: American College of Physicians, American Geriatrics Society Family: Three children Hobbies: Golf, exercise, activities with his children What disease would you discover a cure for if you could: Alzheimer’s disease.
Getting Geared Up
Group of people getting ready for a March 29 triathlon By Jessica Gaspar
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ne girl. One wedding. One triathlon. Those are some of the things Joshua Van Horn sees every Wednesday evening as he hops onto a spin bike. He sweats and thinks. Van Horn is one of 35 people who will be participating in this year’s indoor triathlon at the Jewish Community Center (JCC) in Brighton. “I want to get back in shape for my wedding in May,” Van Horn, 31, of Victor said. Van Horn, who is also the adventure director at the JCC, was always intrigued by the idea of participating in a triathlon since he has a friend who’s done them. From now until March 25, the JCC is offering a training class for folks who want more triathlon preparation. JCC’s triathlon is scheduled for 8:30 a.m. Sunday, March 29. Both the class and triathlon are open to the public and to
all skill levels from beginners to pros. “It’s getting me back into the gym,” Van Horn said after he admitted he fell off the exercise wagon for a little while. “It’s making me go.” Kimberly Levitsky is the instructor who leads the triathlon training class. The goal of the course is to have the participants ready within 12 weeks — hence the course name “12 weeks to tri.” “Every week is different and the expectations increase as we move through the 12-week training plan,” she said. Levitsky will assign weekly workouts, which equate to about three-tofour hours of training each week in addition to the Wednesday class. The class is typical an hour and a half long and includes time on the spin bike, on the treadmill, and workouts in the pool, she said. While the JCC’s triathlon is in its
A group of people train on spin bikes for the upcoming indoor triathlon at the Jewish Community Center. About eight people train weekly while 35 are signed up to participate in the JCC’s annual triathlon, which is scheduled for Sunday, March 29. fifth or sixth year, the training class is only in its second year, according to Levitsky. The course has received positive reviews. “We have one [participant] who
enjoyed it so much that she is repeating the course this year,” Levitsky said. For more information on the JCC and its indoor triathlon, visit www. jccrochester.org.
Healthcare in a Minute By George W. Chapman
V.A. Reins in Hospital-Acquired Infections
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udos to Veteran Administration. After well-deserved and highly publicized criticism for lengthy appointment delays, which in some cases contributed to vets dying, credit should be given when due. In 2007, the Veterans Administration began to focus on hospital-acquired infections (MRSA) that kill 75,000 people per year. One-in-25 patients will acquire an infection while hospitalized. By 2012, five years after the V.A. began its rigorous program, hospital acquired infections had dropped an astounding 68 percent. This is even more impressive when you consider that V.A. patients are older and sicker than patients in private hospitals. V.A. is the healthcare model for the future. Ironically, the nation’s oldest healthcare system, in business since the Civil War, is basically the exact “system of care” currently being touted. There are basically six characteristics of near-future healthcare systems: 1. Multi-hospital. The V.A. operates 150 medical centers, 140 nursing homes and 1,400 community-based clinics across the country. 2. Employed providers. The V.A. employs 53,000 physicians and other licensed providers. 3. Pay for performance/value. The V.A. operates on a fixed budget. It has never been fee for service. 4. Population management. The V.A. is responsible for the overall
health status of a specific population: 8.7 million vets. 5. Incentives to control costs while improving care. As mentioned above, for example, the V.A. drastically reduced its infection rate that drastically reduced the cost of hospitalization and improved the health of vets. 6. Electronic medical records. The V.A. has had EMR system-wide for years and is credited for being a pioneer in EMR that is critical for population management.
CBO lowers cost estimate
The non-partisan Congressional Budget Office has lowered its estimate of providing health insurance to previously underserved Americans under the Affordable Care Act. The CBO originally estimated the cost would be $710 billion from 2015 through 2019. That has been lowered 20 percent to $570 billion over the next five years. The CBO estimates this year 12 million people will purchase insurance through an exchange with 75 percent being eligible for subsidy. The number of people on expanded Medicaid will be about 70 million this year. Minimum essential coverage. Beginning in 2014, you must have had minimum essential healthcare insurance. That can be either employer sponsored, purchased through an exchange, Medicaid or Medicare purchased directly through an insurance company.
Unless exempt, the uninsured will pay a penalty (when they file their tax return) which is the greater of 1 percent of family income over $10,150 or $95 per person up to a maximum of $285 per family. The penalty increases to 2 percent and $395 per person in 2015. The penalty increases again in 2016.
Medicare to pay physicians on quality vs. volume
Medicare just announced its intention to take the lead by basing 85 percent of payments to physicians on quality or value by the end of 2016. Commercial carriers typically mimic Medicare. This doesn’t mean the end of fee-for-service reimbursement quite yet. It means the end of “blind” fee for service based purely on the act of providing a service. But by 2018, Medicare intends to base 50 percent of its payments to physicians for population management or episodes of care that are not fee for service. The bottom line here is that payment for simply providing a service, regardless of quality or value, is being phased out.
Employer-sponsored insurance declining
Many advocate separating health insurance from employment. Market forces may make that happen. In the past, employees often felt “trapped”
March 2015 •
by an employer fearing if they left they could be denied coverage by their new employer. That all changed with the passing of HIPAA (Health Insurance Portability and Accountability Act) which allows individuals to carry their insurance to their new job. Every year, fewer private-sector businesses offer insurance to their employees, most likely accelerated by online exchanges. In 2014, less than half of all private-sector employees were covered by employer-sponsored plans.
NYS passes telemedicine law
Commercial insurers now have to offer the same reimbursement to physicians for “seeing” patients via telemedicine versus seeing them in person. Deductibles and coinsurance must also be the same for a telemedicine “visit” as they are for an office visit. To date, very few physicians have offered telemedicine services to their patients because most carriers would not reimburse. Expect this to be commonplace within the next two years. GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Forging a new life on your own. Need some help?
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nmarried in midlife . . . could there be anything worse? Or maybe, just maybe, that’s an outdated myth that warrants examination. My experience leading empowerment workshops tells me that, with a little help and support, women and men are discovering that living alone can be far more complete and satisfying than most could ever have imagined. The ending of my own marriage years ago was not a welcome change for me. I never intended to be on my own in midlife. But it was a change nonetheless and one I had no choice but to accept and to ultimately embrace. It took some time and some hardknock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to organize and offer workshops to support other women in similar circumstances. “Living Alone: How to Survive and Thrive on Your Own” is a threepart workshop I developed to help women discover the know how to create a satisfying and enriching life on their own. I’ve been leading the workshop for over 10 years now, and often get questions from In Good Health readers about what the workshop covers and how it is organized. In this month’s col-
umn, I am pleased to answer the most frequently asked questions: Q. What is the purpose of the workshop and what do you cover? A. Because I’ve walked in a similar pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude, and my workshop will help you think differently about living alone. Specifically, I cover how to overcome loneliness and other emotional pitfalls, banish negative thinking, rediscover your true self, socialize in a couples’ world, and otherwise embrace what may be a once-in-a-lifetime opportunity to create a wonderful and rewarding life on your own. Getting good at living alone takes practice. There’s no magic pill and it doesn’t happen overnight. But it can happen, and good things can result. Feeling comfortable with your independence will improve your chances of finding happiness, and it will improve your chances of finding a new healthy relationship, if that’s what you desire. When you feel better about yourself — more confident and resourceful — life on your own or with a special someone can be richer and
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more satisfying. Q. Who attends the workshop? A. Most, but not all, of the women who attend the workshop are between the ages of 40 and 70, and have come out of long marriages or relationships. Some are on their own for the first time in their lives. All have one thing in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist or their congregation. Q. I’m still grieving the loss of my marriage/spouse. Is this workshop right for me? A. Good question. My Living Alone workshop is a “nuts and bolts” practical workshop to help women become more confident and independent on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend grief counseling or the help of a professional counselor. Q. What are your credentials? A. I’m not a licensed professional. My expertise is born out of real-life experience. I’ve “been there.” I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of
Energy Drinks Tied to Inattention, Hyper Behavior in Middle Schoolers: Study Kids shouldn’t drink sugary, caffeinated beverages, researchers conclude
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nergy drinks are linked to hyperactivity and inattention in middle-school students, a new study reveals. Yale University researchers looked at more than 1,600 students at middle schools in one urban school district in Connecticut. Their average age was around 12 years. Boys were more likely to consume energy drinks than girls. The research-
ers also found that among boys, black and Hispanic students were more likely to drink the beverages than white students. Children who consumed energy drinks were 66 percent more likely to be at risk for hyperactivity and inattention symptoms, according to the study in
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2015
living alone. After some “hits and misses,” I found my way and now thoroughly enjoy the freedom and independence that comes with living alone. My time-tested experience, valuable resources, and tried-and-true tips and techniques have inspired and helped many workshop participants. My workshop has been the jump-start they needed to reclaim their lives. Q. How large are the workshops? A. Ideally, I like to have eight women in each workshop, although, on occasion, I have led workshops with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly gives way to a comfortable camaraderie and it’s not unusual for nice friendships to develop among participants. Q. Where are the workshops held? A. At House Content Bed & Breakfast in Mendon, south of Rochester. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshops. Q. I’d like to sign up for the workshop. What’s my next step? A. I like to speak with potential participants by phone, as a first step. That way, I can answer your questions and you’ll know better whether this workshop is right for you. Just call me at 585-624-7887 or email me at gvoelckers@rochester.rr.com. You’ll find information about my upcoming workshop in the Calendar of Health Events included in this issue. 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, call 585-6247887 or email: gvoelckers@rochester.rr.com.
the current issue of the journal Academic Pediatrics. Energy drinks have high levels of sugar and also often contain caffeine, the researchers noted. For the study, the investigators took into account the number and type of other sugar-sweetened drinks consumed by the students. “As the total number of sugar-sweetened beverages increased, so too did risk for hyperactivity and inattention symptoms among our middle-school students. Importantly, it appears that energy drinks are driving this association,” study leader Jeannette Ickovics, a professor in the School of Public Health, said in a Yale news release. “Our results support the American Academy of Pediatrics recommendation that parents should limit consumption of sweetened beverages and that children should not consume any energy drinks,” she added.
Managing Diabetes? There’s an App for That By Deborah Jeanne Sergeant
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onsidering the intense personal effort required for effective diabetes management, phone apps offer portable, easy ways to lighten the load. Joy Valvano, certified diabetes educator with Rochester Regional Health System, recommends Glucose Buddy (iPhone, free). “It allows people to store data to manage diabetes without hassle,” she said. The app allows users to input glucose, how many carbohydrates they have eaten at each meal, track blood pressure and weight and more. “You can view data online or print it out” which could also help health care providers, too, Valvano said. She added that Glooko (iPhone, free) is similar to Glucose Buddy. “[It] allows you to upload glucose readings from the meter,” she said. “[The] food database helps you learn more about your food. You can track Valvano your goals and share with your doctor.” Camaraderie and practical tips from other diabetics can help you feel less isolated. Diabetic Connect (iPhone, free) “allows you to interact with other people who have diabetes for support,” Valvano said. “That is a way to connect with other people to learn about management techniques.” Valvano also likes Diabetes App
(iPhone, $6.99). “It gives information about how many grams of sugar are in foods you’ve eaten and keeps track of things that affect blood sugar levels,” she said. “It has a vast food database,” Valvano said. “You can track weight, water intake and other things. You can share info via Twitter.” Positive peer pressure can help you stay on track to better health. The American Association of Diabetes Educators (AADE) developed Goal Tracker (Android, iPhone, free) to provides diabetes education and goal-setting tips. “You’re able to set your own personal goals within the app,” Valvano said. “It’s informational but allows you to set goals.” Numerous apps can also assist, such as My Fitness Pal (Android, iPhone, free), Lose It (Android, iPhone, free) and others. “These allow you to put in personal information and set goals around dietary management,” Valvano said. “They track activity, weight and your daily food. They have a huge food database.” My Fitness Pal allows users to scan food package barcodes for easy food logging and tracking. By analyzing your diet, you can determine what food to cut to stay within a healthful calorie count and how many carbohydrates you eat. Calorie King Food Search (iPhone, free) stores thousands of nutrition facts labels. The format found on all store labels provides a familiar glance at nutrition information, even if it’s for
a food that typically doesn’t bear a label. “I can put in banana and it pulls up info on a nutrition facts label form,” Valvano said. “I can put in half a banana or whatever serving size.” Visit the websites of your local grocery stores to see what apps they offer. Wegmans.com, for example, offers an app Valvano likes. “You can put in your store where you shop and search any food,” she said. “It will tell you where it is and if it’s in stock, and prices. They also have a lot of healthy eating and cooking tips and recipes.” Many free pedometer apps can help you track your steps or miles. Some also monitor calories eaten and burned, sleep, weight and pulse. “They’re coming up with more and more of them,” Valvano said. “The iPhone 8 has a health and fitness integrated into the phone. “A lot of the smart phones you can ask how many carbs are in foods, so that’s another fun thing to do. I like the apps with the bar code scanners because it integrates it and it’s there for you the next time you eat.” Endocrinologist Victoria Hsiao, with University of Rochester Medical Center, said that some of her patients use apps to improve their health. “It really helps them manage what they eat, their blood sugar and that the serving they’re eating is in the right amount,” Hsiao said.
The apps also help her since doctors don’t have as many hours with their patients as they would like. One doctor visit can only include a small amount of education and interaction needed to effectively manage diabetes. “It’s like trying to teach people algebra in 20 minutes one time a month, “ Hsiao said. “It’s hard to generate the reinforcement people need. In the past, it was about paper handouts and books. Apps are an extension of that.” Feeling more in control of the condition helps her patients feel more empowered to make necessary lifestyle changes. Apps also bolster accountability. Diabetes and general health apps do bear a few caveats. They’re only as effective as users are honest. If you underestimate portion sizes or round up a workout’s time or intensity, your results will appear better than what they actually are.
Cannabidiol (CBD) Products According to a 2013 review published in the British Journal of Clinical Pharmacology, studies have found CBD combats nausea and vomiting seizure activity, inflammatory disorders, tumor and cancer cells and anxiety and depression disorders.
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Get in the Swim!
Avoid the summer rush and schedule your child’s camp, sports or school physical this spring.
Finger Lakes Medical Associates’ Pediatric appointment schedules are open through June. For best availability, call and schedule your child’s physical today. In Geneva Call:
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(315) 787-5200
Dr. Coulter received her medical degree from Case Western Reserve University School of Medicine. She completed her general surgical residency at the nearby University Hospitals of Cleveland, and a subsequent fellowship in vascular surgery at the State University of New York at Buffalo. She is board certified in vascular and endovascular surgery by the American Board of Surgery.Prior to joining Vascular Surgery Associates Dr. Coulter was most recently an Assistant Professor of Surgery at Louisiana State University Health Sciences Center, Director of LSU Health’s Shreveport Vein Clinic, and Assistant Director of Undergraduate Education for the LSU Department of Surgery. Active in research, and a frequent publisher and presenter of her findings, Dr. Coulter looks forward to becoming an engaged member of the greater member of the greater Rochester clinical and social community.
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March 2015 •
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Think your kids won’t smoke?
Think again. They see more tobacco marketing than you realize.
1 2 3 4
Posters, displays and rows of tobacco products behind the counter are all forms of tobacco marketing. The Surgeon General’s Report warns that tobacco marketing is a known cause of youth smoking. And studies show, the more tobacco marketing kids see, the more likely they are to smoke. More than 135,000 New York teens are regular smokers.
1/3 of them will die prematurely from diseases caused by smoking.
The tobacco companies think there’s nothing wrong with this kind of marketing.
What do you think? The Smoking & Health Action Coalition of Monroe County works in Monroe County, NY, to eliminate exposure to secondhand smoke, to educate youth about tobacco marketing and to promote living tobacco-free.
A Community Partnership of the New York State Tobacco Control Program.
smokefreemonroe.com
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2015
21784 _GoodHealth_Ads_F.indd 1
5/9/13 1:17 PM
This is tobacco
marketing. Kids who see it are more likely to smoke.
Our kids have seen enough.
It’s a fact:
Research shows that kids who shop at stores with tobacco marketing two or more times a week are 64% more likely to start smoking than their peers who don’t.
Take action to protect them at
Source: Henriksen, Schleicher, Feighery and Fortmann. Pediatrics: The Official Journal of the American Academy of Pediatrics, July 19, 2010. DOI: 10.1542/peds.2009 3021
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SmartBites
By Anne Palumbo
The skinny on healthy eating
The Perks of Eating Pineapples
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ome March — when snow and ice still have a death grip on our climate—I pine for pineapples more than at any other time of year. All it takes is a bite and I’m transported someplace exotic and warm. So long, winter blues: hello, spring joy! The rest of the year, I reach for pineapples because they deliver the nutritional goods in a big way. Surprised? You’re not alone. Pineapples are so yummy that we often forget about what’s behind all that sweetness. Pineapples are bursting with vitamin C — just one cup gives you more than you need for a day. A powerful antioxidant, vitamin C can help combat the formation of free radicals known to cause cancer. And though studies show that consuming vitamin C can’t actually prevent colds, loading up on this immune-boosting nutrient may help shorten the time you’re sick and reduce the severity of your symptoms. What’s more, vitamin C plays an important role in maintaining healthy, resilient skin. Concerned about your bone strength? Level of energy? Pineapples may be your ticket to standing tall
For all its sweetness, one cup of pineapple chunks contains only 82 calories and has no fat or cholesterol and scant sodium. Like all fruits, they contain sugar: 16 grams per cup. As a comparison, one cup of grapes has 23 grams; a medium apple, 19, and a medium banana, 14.
Helpful tips
and feeling peppy. This tropical fruit contains nearly 75 percent of our daily needs for the mineral manganese, which is essential for strong bones and energy production. One study suggested that manganese, along with other trace minerals, may be helpful in preventing osteoporosis in post-menopausal women. Also great: Pineapples contain significant amounts of bromelain, a digestive enzyme that has a whole slew of health benefits. Unique to pineapples, this well-researched compound aids digestion quells inflammation and may help reduce certain kinds of pain.
Eat fresh whenever possible. Choose firm, plump pineapples with a sweet smell at the stem end. Exterior colors — from green to golden brown — indicate country of origin, not ripeness. Since the pineapple you buy is as ripe as it will ever be, consume within a few days. Sections not eaten right away may be wrapped in plastic and stored in the refrigerator for one to two days. If consuming canned pineapple, select varieties canned only in pineapple juice, not heavy syrup.
Pineapple-Avocado Salsa Adapted from Gourmet
1 cup 1/4-inch-dice fresh pineapple 2 plum tomatoes, seeded and cut into 1/4-inch dice 1 ripe avocado, cut into 1/4-inch dice 2 cloves garlic, minced 1/2 cup chopped sweet onion (option-
al) 1/4 cup chopped fresh cilantro 1 1/2 teaspoons minced jalapeño chile (include seeds for extra heat) juice from fresh lime 1 tablespoon extra-virgin olive oil salt and pepper Stir all ingredients together and season with salt and pepper. Terrific with chips or alongside any grilled meat or fish. 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.
IT’S ONLY SUPER IF YOU TAKE IT. According to the National Institutes of Health, up to 20 percent of patients fail to fill new prescriptions, and 50 percent of people with chronic health conditions discontinue their medication within six months. If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember: If you’re not taking your prescriptions as directed, you’re taking a chance. To learn more, visit ExcellusBCBS.com/ TakeAsDirected.
#TakeAsDirected A nonprofit independent licensee of the Blue Cross Blue Shield Association
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2015
National Nutrition Month
Does Your Family Strive to Eat Right? By Deborah Jeanne Sergeant
T
he Academy of Nutrition and Dietetics designates March as National Nutrition Month. Eating a well-balanced diet helps support good health and prevent disease. But does your family strive to eat right? “Most parents say their children’s nutrition is very important to them but it’s clear most adults aren’t eating healthful foods and as a result most children aren’t either,” said Cassie Wright, certified diabetes educator with Rochester Regional Health System. Many clients tell Wright their offspring aren’t eating their vegetables; however, when the truth spills out, the parents model poor eating habits. Wright often assesses family eating habits by asking a parent to fill a plate as they normally do, and then comparing it to the My Plate model (www. choosemyplate.gov). The US Department of Agriculture developed My Plate to illustrate healthful eating. It shows one-quarter of a plate filled with lean protein, one-quarter with starchy foods (mostly whole grains), and half with fruits and vegetables. “Most of the time they don’t consider fruits and vegetables as part
of their meals,” Wright said. “Most children ages 3 to 10 consume less than one-quarter cup of vegetables per day.” Families can ramp up their produce consumption in a variety of ways, both at the table and otherwise. Offer a couple vegetable choices with each meal, such as a tossed salad and a steamed vegetable. “I know a mom that purees vegetables into the foods they regularly eat,” Wright said. Tomato sauce, for example, easily hides extra peppers, onions and garlic. Macaroni and cheese, a kid stand-by, conceals pureed squash and carrots. Homemade smoothies can also serve up cucumbers, carrots and kale, easily masked by berries (avoid sugary additions, like ice cream). Fruits or vegetables pureed with beans or lentils make “a spread or dip for crackers or pretzels,” Wright offered. Keeping the children in the know can encourage more healthful eating. “A strategy we use at home is go from A to Z with fruits and vegetables,” Wright said. “It teaches kids about all the fruits and vegetables out there and exposes them to what they
normally don’t eat.” Older children may enjoy charting their produce variety with devices such as “eating the rainbow” (www. todayiatearainbow.com, among other sites). Enlist their help in shopping and preparing food. Take them to farms to see how food is grown and plant a garden or at least some potted plants they can grow and harvest. Some community supported agriculture (CSA) farms allow members to help. Rachel Reeves, registered dietitian with University of Rochester Medical Center, encourages parents to make fruits and vegetables easier to choose by placing them in plain sight. “If you see it, you’ll eat it,” she said. “The easier it is to prepare, the better. Make unhealthful foods out of sight, out of mind.” With chips on a top shelf and a
bowl of apples on the countertop, kids will more likely choose an apple than if the apples hide in the crisper. Making healthful snacks fun can also divert children from wanting candy and junk. Reeves makes banana “butterflies” by using one-third of the peeled fruit for the body. Pretzels can form wings, and raisins the eyes. Pepper strips make delicately curved antennae. Frozen vegetables cook quickly since they’re always washed and cut. Reeves also likes to make double batch meals, freezing half for an easy meal another time. “If portion control is an issue, use smaller plates and smaller spoons,” Reeves said. “Dish up the food in the kitchen, not on the table, so you’re less likely to grab seconds.”
What if you could choose?
5 Days or 45 Days
hoacny.com March 2015 •
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Nancy Adams: Nearly two decades helping physicians Medical society executive director recognized for her services By Lynette M. Loomis
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n early November in Dallas, the American Medical Association (AMA) presented Nancy Adams, the longtime executive director at Monroe County Medical Society, with the Medical Executive Lifetime Achievement Award. The award recognizes medical executives that have made significant contributions to their county medical society, state medical association, or national medical specialty society. Among Adam’s accomplishments in her 15 years at the medical society were cited as the creation of a $3.1 million grant-funded electronic medical record (EMR) service bureau to support local medical practices with health information technology, and a New York State e-Collaborative Regional Extension Center grant to assist clinicians with requirements for the federal government’s EMR incentive programs. Growing up in a family of four in Rochester, Adams did not daydream about becoming the executive director of the Monroe County Medical Society working with hundreds of physicians in Monroe, Livingston, Ontario, Seneca, Steuben, Wayne and Yates counties. Nor did she envision becoming executive director of the American Academy of Pediatrics Chapter 1. As a young child in school, she enjoyed reading and science and thought she would grow up to be a teacher. She was a Girl Scout like most girls her age and after school she loved to play baseball with the boys in her neighborhood. During high school she worked part time at a bakery and also became a candy striper at Rochester General Hospital. That is when she knew she would
like to have a job where she could help people. She became a certified medical assistant and worked in a primary care practice. She married her high-school sweetheart, Peter Adams, and went back to school to study laboratory
technology at Monroe Community College. Adams is a great example of the adage, “Just because it’s tough doesn’t mean it’s not worth doing.” She went to Monroe Community College nights when her children, Dale and Kristen, were young and served as a hospice volunteer. “It took me 10 years to get a two-year degree but I was following my heart at home and in helping people at the end of life. It wasn’t until I began my current position at the medical society that I earned my Bachelor of Science and Master of Science degrees in management from Roberts Wesleyan College.” After nine years as student, wife, mother and volunteer, Adams returned to the workforce, again in a primary care practice where she served as the practice manager. “There is no better training for the position I hold now than experiencing first-hand the challenges facing both physicians and patients. How medical care is being paid for and delivered has undergone change at an almost dizzying pace.” To help other practices stay abreast of these changes, Adams and a colleague started the Monroe County Medical Society office manager committee. As Adams decided to pursue greater responsibility in her field, she asked the Monroe County Medical Society executive director, Lisa Brubaker, if she would serve as a reference.
Instead, Brubaker offered Adams a position at the medical society as a project coordinator. In that role, Adams had the opportunity to create and present practice management education programs. When Brubaker announced her resignation from the medical society, she encouraged Adams to throw her hat in the ring for the executive director position. The search committee agreed with Brubaker: Adams was a great fit for the position. “When I began working at the Monroe County Medical Society in 1998, health care was in a state of flux, much as it is today. The HMO model was in full swing and physicians struggled with this ‘Mother, May I?’ approach to providing care. Some of the ways in which we seek to support physicians is to help them understand and implement new technology such as electronic medical records and how to effectively participate in the Rochester Regional Health Information Organization (RHIO). “It can be as difficult for a one-physician rural medical practice to implement massive changes just as it can stress a 20-physician practice to implement news protocols consistently.” “Over the past 16 years I have had literally thousands of conversations with physicians. There have been some consistent themes that they speak about and the challenges they face in treating their patients. We are all adjusting. My role is to help physicians and their office staff understand all these changes so they can spend more time caring for their patients.”
Nancy Adams supports hundreds of doctors in her role as executive director of the Monroe County Medical Society but she said her role as a grandmother to Jeanette ranks first on her list of heart-felt passions.
Colon Cancer: Preventable, Treatable & Beatable
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2015
Dr. Stephen M. Rauh Dr. Mary Lou O’Neill Dr. Asim Farid Dr. Steven Ognibene Dr. Bastian Domajnko Dr. Claudia Hriesik Dr. Brian Teng
Men’sHealth Breast Cancer vs. Prostate Cancer Why awareness of breast cancer is so much higher than that of prostate cancer? By Deborah Jeanne Sergeant
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he pink ribbon symbolizing breast cancer appears on innumerable pieces of merchandise to raise awareness. But it seems like prostate cancer receives little press, despite its status as the most common cancer in men and the second leading cause of cancer death in men. Martha Ryan, senior director of community engagement for the American Cancer Society Central and Western New York Region said that compared with other types of cancer, such as breast cancer and colon cancer, the guidelines for prostate screening aren’t as clear-cut. “We recommend if you’re 50-plus, you need to talk to your healthcare practitioner about getting screened,” she said. “African American men have a higher rate of prostate cancer than other races. They should talking with their practitioner at age 40.” In addition to an exam, the doctor may also order a PSA blood test. Some prostate cancers grow so
slowly that doctors recommend a waitand-see approach. “When a woman has any kind of growth in her breast, they usually want to get it out of there because it grows • You may or may not have symptoms. Some symptoms are urinary and could indicate other diseases, not just cancer. • “If a man is getting up multiple times in the night to go to the bathroom, it could be a sign of prostate cancer. • “Men need to research their treatment options to make an informed decision; and always, always seek a second or third opinion. Perhaps talk with others who have already been there.” Source: Patrick Fisher, founder of Us TOO in Rochester and WNY
and spreads,” Ryan said. Since some prostate cancers grow so slowly that treatment is never needed, it may seem less serious than other types of cancer and warrant less awareness. However, since prostate cancer death rates remain so high, men need to know about screening. Patrick Fisher leads the Rochester and Western New York chapter of Us TOO. The nationwide organization raises awareness about prostate cancer and advocate for those whose lives have been touched by prostate cancer. “More men should ask their doctors about screening,” Fisher said. “We also want more insurance coverage for screening.” Fisher said that the US Preventive Services Task Force decided in 2012 that routine PSA screening raises the risk for false positives, resulting in unnecessary surgery for men who aren’t aware of other options, such as active surveillance. Surgery bears the risk of urinary incontinence and erectile
Colonoscopy Anyone?
Several tests can check for color cancer, however, colonoscopy remain the golden standard for prevention, say experts By Deborah Jeanne Sergeant
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ince 2000, March has been recognized as National Colon Cancer Awareness Month. Campaigns such as this have helped more people understand the importance of screening; however, colon cancer remains the second most common cancer killer and the third most common type of cancer. “The thing with colon cancer is if people would get screened, two-thirds of colon cancer could be prevented,” said Martha Ryan, senior director of community engagement with the American Cancer Society Western and Central New York Region. Since most colon cancer starts with a polyp, most screenings can identify a polyp and allow doctors to immediately remove it. But only about 69 percent of the eligible population — generally those 50 and older — receive colon screening. Colonoscopy isn’t the only screening for colon cancer. “Talk to your provider about which test is best,” Ryan said. Though many doctors feel it’s the gold standard for screening, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) may fit a patient’s profile better instead or in addition to colonoscopy. FOBT, an annual test, uses three samples of stool from three different
bowel movements. FIT also uses three different samples, but these are taken from the water in the toilet bowl with the bowel movement in it, and not the stool itself, to detect enzymes in the water released by the fecal matter. If either test is positive, a colonoscopy follows. Generally, colonoscopy is recommended every 10 years. If a polyp is removed, that changes to every five years. If there’s family history and a polyp, that can change to every three years. Anyone experiencing rectal bleeding likely needs a colonoscopy. CT colonography requires the same preparation — completely emptying the bowel first — but doesn’t require a long scope. “If they see something, you still need a colonoscopy,” Ryan said. “But some believe the colonoscopy is too invasive.” CT colonography isn’t always covered by insurance but some people cannot receive standard colonoscopy. Some providers feel CT colonography does not provide the same level of screening as colonoscopy. With colonoscopy, a lighted flexible scope views the entire colon. Most people start receiving colon screening at age 50, unless African American, which represents a risk
factor and lowers the starting age to 45. But anyone with a near family member diagnosed with colon cancer should begin screening 10 years prior to the age of the relative at diagnosis. For example, if a relative received a colon cancer diagnosis at 45, his relatives should begin screening at 35. Unfortunately, many people dislike and fear colonoscopy or don’t understand when they should start receiving colon screening. “All of that combines to make it a challenge to get the majority of people screened for it,” said Asim Farid, a physician with Rochester Colon & Rectal SurGoldstein geons, P.C. Patients receive various degrees of sedation to help them relax and remain as comfortable as possible. Since most polyps may be removed during the same procedure, many cases resolve the same day. “If it’s very large and difficult to remove, either from the appearance and sometimes where it’s located, a biopsy would be taken,” Farid said. “Sometimes, it’s really difficult to remove
March 2015 •
dysfunction. “But some local primary care providers misinterpret the guidelines meaning no screening, instead of just not using it for routine screening,” Fisher said. Since some forms of prostate cancer grow slowly, PSA testing becomes very important as a monitoring tool. Since 2012, new and more advanced tests have become available to help physicians detect if a man carries a gene indicating an aggressive type of cancer. More advanced, 3-D MRI of the prostate can also help physicians help their patients make more educated decisions. Image guided radiation can also more closely target cancer cells. Fisher hopes all of these advances encourage men to seek screening since, if a man does discover he has prostate cancer, he has many more choices. Anyone interested in Us TOO should contact Fisher at 585-787-4011 or email ustoorochesterny@gmail.com.
one completely and the biopsy would determine what kind of polyp it is.” It’s important to know whether a polyp is malignant or benign; however, doctors remove most polyps regardless. “Cancer arises from polyps and removing it interrupts the cancer sequence,” explained Jeffrey Goldstein, a doctor in gastroenterology with Rochester Regional Health System. “It’s curable if we catch the polypus or if it’s treated early enough.” To support good colon health, Goldstein recommends limiting high fat foods, alcohol and processed meats and avoiding tobacco. “These increase the risk of colon cancer,” he said. “Some people feel antioxidants and fiber may be helpful. We know fiber is good to keep the bowel moving along. “We want people to be healthy and regular so toxins in the stool are removed promptly. A good, healthy diet and regular exercise is good for us.” Craig Collins, colorectal and general surgeon with Geneva General Surgical Associates, said that he still sees people in their 70s and 80s with colon cancer that could have been prevented. Collins “The earlier it’s detected, the better chance people have of effective treatment,” Collins said. Modern equipment such as high definition scopes and screens help physicians like Collins. “We have different dyes and scopes that allow us to see better,” he said. “They’re more maneuverable.”
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Rochester Walks!
Brings A Fresh Take on Physical Activity to City Neighborhoods.
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ver the past five and half years, neighborhoods in Rochester have transformed into hubs for outdoor physical activity. Residents are taking walks around their neighborhoods, learning the history of their area, and becoming more active citizens thanks to Rochester Walks!, a city of Rochester initiative aimed to increase physical activity. Rochester Walks! is carried out by the URMC Center for Community Health and Action for a Better Community, Inc., whose staff partnered with neighborhood associations and block clubs in all four city quadrants to answer the call for more opportunities for local, accessible and affordable exercise in emerging neighborhoods. The result of these collaborative efforts were marked walking routes in four up-and-coming neighborhoods: Beechwood (SE quadrant), Marketview Heights (NE quadrant), Jefferson (SW quadrant), and Dewey/Driving Park (NW quadrant). These half-mile and one mile routes encourage residents to get moving and become more visible in their communities with clearly identified with map signs, quarter-mile marker signs and sneaker stencils on the sidewalks. However, the routes aren’t just for neighborhood residents. The unique, urban walking routes also feature plaques along the way that describe historical landmarks such as the Hamm
By Deborah Banikowski
In March Americans Recognize Middle Name Pride Day
House (Jefferson), the Rochester Public Market (Marketview Heights), the Driving Park Race Track (Dewey/Driving Park), and the Sully Branch library (Beechwood), to give all Rochester residents something to be proud. Visiting the Rochester Walks!’ walking routes is a great way to add moderate exercise to your routine or inject a change of scenery to your existing exercise regimen. Walking just one mile a day can increase bone density and help control your weight, plus taking a stroll with a friend or social group is a great way to build relationships, increase safety, and enjoy the beauty of Rochester. Walking is also the safest, most inexpensive, and is the form of physical activity recommended most by physicians. For more information and route maps, call 585- 224-3050 or visit ]www. cityofrochester.gov/rochesterwalks.
Upstate New York’s low uninsured rate already exceeds 2024 national health care reform goal
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pstate New York’s health insurance coverage rate for residents younger than age 65 continued to eclipse the national rate by more than 7 percentage points in the final year of U.S. census data collected just before federal and state exchanges were opened for business by federal health care reform, according to a report issued recently by Excellus BlueCross BlueShield. The report, based on the latest set of 2013 data, will serve as a baseline in determining future gains in providing access to health coverage following the implementation of federal health care reform with the opening of exchanges in 2014. “Our region is in much better shape than most of the country,” said Christopher Booth, chief executive officer of Excellus BlueCross BlueShield. “We’re already where the nation wants to be by the year 2024.” Booth was referring to a Congressional Budget Office report which predicted that health insurance coverage rates for the U.S. population younger than 65 would reach 89 percent by the year 2024. In 2013, Upstate New York’s comparable insured rate was 90.8 percent. The report points out that the Upstate New York region studied has a population larger than 28 other states, but its uninsured rate is lower than all states in the nation, excluding Massachusetts and the less populous states of Vermont and Hawaii. The Excellus BlueCross BlueShield report also looked at the three-year averages for health insurance coverage Page 18
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(2011-2013) for all age groups. Upstate New York’s uninsured rate of 8.1 percent was significantly below the state uninsured rate (11 percent) and the national rate (14.8 percent). “What that means,” said Booth, “is that 324,000 more Upstate New Yorkers have health insurance than would have coverage if we were at the national rate.” In addition, the report contains information on the percent of the population that has health insurance through an employer. Upstate New York’s employer-based health insurance coverage rate of 61.3 percent compared favorably to the state rate of 57 percent and national rate of 54.5 percent, according to the Excellus BlueCross BlueShield analysis. “We have 330,000 more Upstate New Yorkers covered due to job-based benefits than we’d have if we were at the national rate for employer-based coverage,” said Booth. Upstate New York, for purposes of analysis, was defined as an area bounded by Buffalo to the west, Utica to the east, Binghamton to the south and the Adirondacks to the north. The Excellus BlueCross BlueShield report is based on data collected from 2011 to 2013 by the U.S. Census Bureau’s American Community Survey, the largest and most current national data source available. To view the report, “The Facts About Health Insurance Coverage in Upstate New York,” and an entire library of fact sheets on health, wellness and health care cost and access issues, go to ExcellusBCBS.com/factsheets.
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t the Social Security Administration, our middle name is “Security,” and every day, we do everything we can to live up to that name. As part of protecting our vital services, we safeguard against all forms of Social Security fraud. Social Security has zero-tolerance for fraud and those who try to cheat the system. While we can’t prevent all fraud schemes any more than the best police force can stop all crime, we work aggressively with our Office of the Inspector General to investigate and prosecute people who commit fraud. Acting Commissioner Carolyn Colvin’s message to those who would defraud Social Security is clear: “We will find you; we will prosecute you; we will seek the maximum punishment allowable under the law; and we will fight to restore to the American public the money you’ve stolen.” We provide benefits to one-fifth of the American population, including elderly retirees, people with severe illnesses, and widows and children after
Q&A Q: I’m gathering everything I’ll need to file my taxes this month. Do I have to pay taxes on Social Security benefits? Also, where can I get a replacement 1099? A: Some people who get Social Security must pay federal income taxes on their benefits. Still, no one pays taxes on more than 85 percent of their Social Security benefits. You must pay taxes on some portion of your benefits if you file an individual federal tax return and your combined income exceeds $25,000. If you file a joint return, you must pay taxes if you and your spouse have combined income of more than $32,000. If you are married and file a separate return, you probably will have to pay taxes on your benefits. You can read more about tax preparation in relation to Social Security at www.socialsecurity.gov/planners/taxes.htm. Social Security benefits include monthly retirement, survivor, and disability benefits. They don’t include Supplemental Security Income (SSI) payments, which are not taxable. You can also get a replacement 1099 or 1042S when you open your own personal my Social Security account at www.socialsecurity.gov/myaccount. (Editor’s Note: Read the column under Ask Your Social Security for more information on taxes). Q: I’ve been planning my retirement throughout my career, and I’m
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2015
the death of a wage earner. Our beneficiaries also include wounded warriors and the chronically ill, all of whom tend to be the most vulnerable of our population. Protecting our critically important programs from fraud can be challenging. Yet, our standard is absolute — any fraud is unacceptable. And, our focus on preventing fraud works. Our Office of the Inspector General works in concert with our frontline employees to identify fraud and bring offenders to justice. Together, we use a number of tools to help us accurately predict where fraud may occur. By monitoring cases closely, we identify fraud sooner rather than later — and often we prevent it before it happens. We also have stiff penalties that discourage people from committing fraud, including hefty fines, suspension of benefits, and even jail time for the most severe offenses. We take our middle name seriously and so should you. If you suspect someone is committing Social Security fraud, we ask that you report it online at http://oig.ssa.gov/report or call the Social Security Fraud Hotline at 1-800269-0271 immediately.
finally nearing the age when I can stop working. What is the earliest age I can start receiving Social Security retirement benefits? A: You can receive Social Security retirement benefits as early as age 62. Keep in mind that if you retire at age 62, we’ll reduce your benefits by as much as 30 percent of what you’d get if you wait until your full retirement age. If you wait until your full retirement age (66 for people born between 1943 and 1954), you’ll get your full benefit. You can also wait until age 70 to start your benefits. Then, we’ll increase your benefit because you earned delayed retirement credits. When you’re ready to apply for retirement benefits, use our online retirement application, the quickest, easiest, and most convenient way to apply. Visit www.socialsecurity.gov/ retireonline. Q: I recently retired and am approaching the age when I can start receiving Medicare. What is the monthly premium for Medicare Part B? A: The standard Medicare Part B premium for medical insurance is currently $104.90 per month. Since 2007, some people with higher incomes must pay a higher monthly premium for their Medicare coverage. You can get details at www.medicare.gov or by calling 1-800-MEDICARE (1-800-6334227) (TTY 1-877-486-2048).
RGH introduces new technology to treat PAD
By Jim Miller
Do You Need To File A Tax Return in 2015? Dear Savvy Senior, What are the IRS income tax filing requirements for retirees this tax season? I didn’t have to file last year, but I picked up a little income from a part-time job in 2014, and I’m wondering if I need to file this year. Part-Time Retiree Dear Retiree,
Whether or not you are required to file a federal income tax return this year will depend on how much you earned (gross income) — and the source of that income — as well as your filing status and your age. Your gross income includes all the income you receive that is not exempt from tax, not counting your Social Security benefits, unless you are married and filing separately. Here’s a rundown of the IRS filing requirements for this tax season. If your 2014 gross income was below the threshold for your age and filing status, you probably won’t have to file. But if it’s over, you will. Single: $10,150 ($11,700 if you’re 65 or older by Jan. 1, 2015). Married filing jointly: $20,300 ($21,500 if you or your spouse is 65 or older; or $22,700 if you’re both over 65). age.
Married filing separately: $3,950 at any
Head of household: $13,050 ($14,600 if age 65 or older). Qualifying widow(er) with dependent child: $16,350 ($17,550 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554), or see irs.gov/pub/irs-pdf/ p554.pdf.
Special Requirements There are, however, some other financial situations that will require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment in 2014
Rochester General Hospital, an affiliate of Rochester Regional Health System, is the first in the area to use the Lutonix drug coated balloon catheter to treat peripheral artery disease (PAD). PAD is a life-threatening condition that affects millions of Americans by narrowing arteries and reducing blood flow to the limbs. Worldwide it is estimates that 200 million people suffer from PAD. “Minimally invasive endovascular procedures such as angioplasty balloons and stents, medications and vascular bypass surgery are some of the accepted ways to treat PAD,” said
of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file. To figure this out, the IRS offers a tool on their website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. You can access this page at irs.gov/ filing — click on “Do you need to file a return?” Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get faceto-face help at a Taxpayer Assistance Center. See irs.gov/localcontacts or call 800-829-1040 to locate a center near you.
physician Jeffrey Rhodes, a vascular surgeon at Rochester General. “What makes the Lutonix catheter unique is the drug coating, which is designed to prevent scaring once the arteries are opened by the balloon catheter.” Left untreated, peripheral artery disease (PAD) can result in the loss of limbs. In fact, PAD is the leading cause of amputation in people over the age of 50 and accounts for up to 90 percent of amputations overall. For more information on this latest technology and how it may benefit you or a loved one, please call Vascular Surgery Associates at 922-5550.
Maybe it was something I ate.
Check Your State Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency before concluding that you’re entirely in the clear. For links to state and local tax agencies see taxadmin.org — click on “State Agencies/Links” on the menu bar.
Tax Prep Assistance If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, aged 60 and older. Call 800-906-9887 or visit irs. treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 5,000 sites nationwide. To locate an AARP Tax-Aide site call 888-227-7669 or visit aarp.org/findtaxhelp. You don’t have to be an AARP member to use this service.
But maybe that stomach pain is a sign of a deeper problem.
Editor’s Note: Read the column under Ask Your Social Security for more information on taxes. 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. March 2015 •
To Schedule an appointment call 315.462.9478 IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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H ealth News Lifetime Health Medical names new president Andrew L. Wilson has been named president of Lifetime Health Medical Group. He began his appointment Feb. 2, and will oversee the group’s operations in Buffalo and Rochester. Most recently he served as president and senior principal for Shoreline Associates, a national consultative consortium focusing on national health care legislative initiatives, Accountable Care Organization development and physician/hospital clinical integration and bottom line improvement. Wilson Prior to that, Wilson was president and chief executive officer for St. Alexius Health System and Medical Center in Bismarck, North Dakota, and president and executive director of the Atlanta-based managed care integrated delivery network, Synergy at Saint Joseph’s, Inc. He has also held executive positions in Michigan. A native of Michigan, Wilson has a bachelor’s degree in communications/ business from Michigan State University and an MBA from Saginaw Valley State University. He has served on numerous boards, health care councils and advisory panels throughout his career, including as a member of Dow Chemical Health Care Advisory Panel, Michigan State Senate Health Policy Task Force on Managed Care, The Leapfrog Group regional hospital review committee, and United States Sen. Kent Conrad’s Health Care task force. He played a significant role and advocate in Washington for the Frontier State Amendment that was included and approved as part of the historic national Health Care Reform Bill. The amendment pays providers in rural states a 1.0 floor for Medicare reimbursement, bringing millions of additional dollars to those providers and states each year, greatly improving both the providers’ and states’ economic status. Lifetime Health Medical Group provides primary and specialty care, urgent care, pharmacy, and imaging services, serving the Buffalo and Rochester communities for more than 40 years. For more information visit www. lifetimehealth.org.
ACM Medical Laboratory names new CIO ACM Medical Laboratory, Inc., an affiliate of Rochester Regional Health System, announced that Steve Kasay has joined ACM as chief information officer. As CIO, Kasay is responsible for providing leadership and strategic direction for ACM’s IT initiatives around the world. Kasay has extensive experience with regulated systems applications Page 20
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and infrastructure support for contract research organizations, pharmaceutical companies and the health care industry. He began his career as a chemist for Becton, Dickinson and Co., and moved into progressively more challenging IT roles Kasay with Ciba-Geigy Corp. He spent several years in senior leadership positions at Covance, Inc., where he managed applications development and support and the global infrastructure operations for the company. Kasay led the global statistical/scientific programming function at Merck, and was the Chief Information Officer for inVentiv Health Clinical and then at ReSearch Pharmaceuticals Services (“RPS”). Most recently, he served as a consultant on technology evaluation, technology integration and strategy. Kasay earned a bachelor’s degree in biology from Gettysburg College, as well as a Master of Science degree in computer science from Fairleigh Dickinson University. He will relocate to Rochester from his current home in New Jersey. “Over a very successful career in the pharmaceutical and clinical research industries, Steve has demonstrated a consistent ability to develop and implement effective IT strategies,” said Angela J. Panzarella, president of ACM. “We are thrilled to welcome Steve to our team, and we are confident that having our global IT efforts backed by his exceptional leadership will result in long-term success.”
Juan Godinez MD Joins Lipson Cancer Center Physician Juan Godinez has recently joined the medical and dental staff of Rochester Regional Health System. Godinez specializes in radiation oncology and completed his radiation oncology residency at the University of Chicago. He has been honored by the American Cancer Society (ACS) as an ACS Research Fellow. Prior to joining Rochester Regional Health System, Godinez Godinez worked in private practice in Florida.
RHSC initiates search for a new president and CEO Rochester Hearing and Speech is searching for a new president and CEO to succeed Thomas Gibbons, who is retiring. Gibbons has served as the nonprofit agency’s president and CEO since
2008. He has agreed to remain in his position until a successor is in place. “Rochester Hearing and Speech Center is extremely grateful for Tom Gibbons’ outstanding service over the last seven years,” said David Pitcher, RHSC’s board chairman. “Tom has played an instrumental leadership role in helping children and adults in our community ‘communicate for life’ through innovative audiology and clinical services as well as programs for children with autism and special education and early intervention services for preschoolers.” RHSC has assembled a search committee to find its next executive, and the committee is seeking applications from qualified candidates.
Alzheimer’s groups: new board members, officers The Alzheimer’s Association Rochester & Finger Lakes Region has appointed several new members and officers to its board of directors. The new board members include: • Mildred Reynolds, the retired director of minority affairs at the University of Rochester School of Medicine and Dentistry. Reynolds serves on the Anthony Jordan Foundation board and Rochester Police Departments Police Citizen Interaction Committee. She resides in Rochester. • Tom Santobianco, the president/ CEO of Bethany Village, which has a variety of senior residential and day programs in Chemung, Schuyler and Steuben counties. Santobianco’s leadership involvement in New York state’s Southern Tier makes him a great representative of this region. Santobianco completed his undergraduate work in business administration at Elmira College. In addition, he completed his masters’ degree in education also at Elmira College and completed a graduate program in industrial labor relations at Cornell University. He resides in Watkins Glen. The board also elected new officers: • Physician Brian Heppard, medical director of OPTUM/United Health Group, as chairmain. • Todd Butler, president and CEO of Ad Council of Rochester, as vice chairman. • Susan Halpern, financial adviser of UBS Financial Services, as treasurer. • Tara Germano, project manager of Wegmans Food Market, as secretary.
Susan B. Anthony Center honors Dr. Linda Chaudron Physician Linda H. Chaudron, senior associate dean for diversity at the School of Medicine and Dentistry (SMD), has received this year’s Susan B. Anthony Lifetime Achievement Award for her work as a champion of women in science and medicine. “Linda’s tenacious spirit guides her to mentor younger scholars to be their best and accomplish their goals. She is always there to provide a listening ear and encouraging word,” said Catherine Cerulli, director of the Susan B.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2015
Anthony Center at the University of Rochester. Chaudron accepted the award early in February at the Susan B. Anthony Legacy Dinner, a long-standing university tradition that celebrates Anthony’s campaign for equal rights and to win women admission to the university in 1900. Chaudron is a professor of psychiatry, obstetrics and gynecology, and pediatrics at the SMD. She has held many administrative leadership roles and most recently served as vice chair for clinical services in the department of psychiatry. She has earned national recognition for her clinical and research efforts to treat women with mental illnesses during pregnancy and postpartum. “Over the past 16 years, I have been fortunate to hold many different roles, including leading various educational, research, and clinical programs,” said Chaudron. “In my current role as senior associate dean for diversity, I have a wonderful opportunity to work across the institution to develop and collaborate on educational and career development programs that contribute to a diverse and inclusive community at the University of Rochester.” Chaudron was recently elected to the board of directors of the Women Executives in Science and Healthcare, and was named a distinguished fellow in the American Psychiatric Association in 2009. Her research and clinical care have helped many patients who suffer from perinatal depression.
New president at Rochester Clinical Research Rochester Clinical Research, the multispecialty clinical research site, has promoted Adam Larrabee to the position of president. Larrabee, who previously held the role of director of business development, has been with the company for 13 years. “Adam is well-suited for this role and will do an outstanding job leading the company,” said Patricia Larrabee, CEO and founder of Rochester Clinical Research. “He has Larrabee been recognized within the industry for his innovative and forward-thinking approach to clinical trials and patient recruitment.” In his new leadership role, he will guide the company strategy toward researching advanced pharmacology and new medical device technology as the company continues to grow. “I am pleased to accept this position, and I am excited to continue to further the success of this great company. We have a great team and are well-positioned for the future,” said Adam Larrabee.
MythsVs. Reality
Herd Immunity Protects the Community By Deborah Jeanne Sergeant
H
erd immunity — the effect of reducing the spread of communicable disease through majority vaccination — only works with “at least 92 to 94 percent immunization rate,” according to Cynthia Rand, a vaccination expert and pediatrician with University of Rochester Medical Center. In addition to the people vaccinated, herd immunity helps protect those who cannot receive vaccination or who are at higher risk for contracting diseases: chemotherapy patients, organ recipients or patients treated with immune-suppressing drugs Berg for conditions such as lupus, fibromyalgia or rheumatoid arthritis. Many people born before vaccination became widely available in the 1960s face a greater risk of infection
because of their lack of vaccination, advanced age and greater likelihood of certain age-related illnesses. Although it’s extremely rare, vaccines don’t provide optimal protection for certain individuals and they won’t know if they’re the unlucky ones until they become infected. Babies rely upon the antibodies from Mom for the first few months after birth. Breastfeeding bolsters the effect. But for many diseases, vaccinations don’t start until 2 months old and most aren’t complete until age 4. Kathrin Berg, pediatrician with Finger Lakes Medical Associates in Geneva, said, “At 2 months, the antibodies from their mothers begin to wane.” Most public and private schools require up-to-date vaccination for nine communicable diseases before children may enroll. RocDocs, provided by The Democrat & Chronicle, reports that “at least 25,000 elementary and secondary students in Upstate schools are not fully vaccinated against communicable diseases.” Nearly 2 million children attend school in Upstate. The paper also reported that about 1,200 under-vacci-
nated students attend school in Monroe County. Of those, approximately 510 have religious exemptions and 115 have medical exemptions. Parents can also avoid vaccinating their children if they home school or enroll them in a privately-funded school that doesn’t require vaccination. The ideology that causes some parents to opt out can also place their children at higher risk. “Large clusters of those who don’t vaccinate cause the spread of disease,” Berg said. “We are not comfortable being your pediatrician if you don’t vaccinate. We need to protect our other patients.” RocDocs reported that in Monroe County, vaccination among schoolchildren in the 2013-2014 school year ranged from as low as 64 percent to the norm for most of the schools: the high 90s to 100 percent. Only seven schools rated below 90 percent vaccination. In Ontario and Wayne counties, most schools ranged in the upper 90s to 100 percent vaccination. To look up your children’s school, visit http://rocdocs. democratandchronicle.com/database/ vaccination-rates-new-york-schools.
Myth: All the terrible diseases have been eradicated. “There are pockets of measles in various areas in the world. As proven by the recent outbreaks, we can still have those disease come to the US. We live in a very mobile world.” Myth: Vaccines just weaken your immune system from defending the body. “It’s untrue. Vaccines protect you from diseases.” Cynthia Rand, a vaccination expert and pediatrician with University of Rochester Medical Center Myth: I’ll help build up my child’s immune system by exposing him to a child infected with the measles. “Getting the measles vaccine is much safer than getting the measles infection. MMR is one of the most effective vaccines we have today.” Myth: Vaccines can carry bad side effects. “MMR side effects are usually minimal pain and swelling at the injection. Less than one in a million experience a severe reaction. Reactions are so rare it’s hard to tell if it’s from the vaccine. One or two who get measles in 1,000 will die.” Myth: Too many vaccinations will overwhelm the baby’s system. “There’s a court on immunizations, ACIP, which looks at adverse event information to determine the recommended schedule of vaccines so a family can feel confident that when their baby needs four vaccines, they know that it’s safe. Its members aren’t just government officials.” Myth: The Internet says that immunizations are dangerous. “We live in an instant information society. I caution parents to look carefully at where they get information. Ask your healthcare professional as to where you should study it on the Internet. The Internet gives the same megaphone to good and bad information.”
Understanding Herd Immunity
H
ave You “Herd” of Herd Immunity (also known as community immunity)? “Vaccines can prevent outbreaks of disease and save lives. When a critical portion of a community is immunized against a contagious disease, most members of the community are protected against that disease because there is little opportunity for an outbreak. Even those who are not eligible for certain vaccines—such as infants, pregnant women, or immunocompromised individuals—get some protection because the spread of contagious disease is contained. This is known as ‘community immunity.’ “In the illustration below, the top box depicts a community in which no one is immunized and an outbreak occurs. In the middle box, some of the population is immunized but not enough to confer community immunity. In the bottom box, a critical portion of the population is immunized, protecting most community members. “The principle of community immunity applies to control of a variety of contagious diseases, including influenza, measles, mumps, rotavirus, and pneumococcal disease.” From Vacines.gov, a site operated by the U.S. Department of Health and Human Services, using information provided by the National Institute of Allergy and Infectious Diseases.
Sue McNear, RN immunization program coordinator for Ontario County Public Health Myth: Vaccines are a big money racket for pharmaceutical companies. “They are so worth whatever we spend on them to protect the babies. In the scheme of things, they’re not a big money maker for pharmaceutical companies across the board.” Myth: No one dies from childhood diseases; they’re just inconvenient. “We live in a society today where we have the luxury of our children not dying because we have vaccine. The reality is it’s still possible for these disease to still present. As a mother, how would you feel if your child were to die if you could’ve prevented it?” Mary L. Beer, RN, public health director for Ontario County Public Health March 2015 •
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athryn Schulz of Buffalo is the mother of four daughters ranging in ages from 6 to 18. While Schulz has chosen a traditional course of vaccinations for her oldest three children, with slight variations, she has chosen to forego vaccinating her youngest daughter, Maria, who struggles with the challenges of Down’s syndrome. “Maria was diagnosed with Down’s syndrome a few days after she was born. At the age of 6 months, she received the pertussis vaccine for whooping cough and then developed a seizure disorder,” said Schulz. “I don’t mean to say that the immunization caused the seizure condition. She would likely have had the disorder, regardless, but I think it may have accelerated it.” Schulz is quick to state that she is not a doctor, and that her beliefs are backed by her personal experiences, discussions with doctors and research she has done into her daughter’s condition, and immunizations in general. “At the age of 3, Maria was vaccinated for measles and immediately contracted the disease,” Schulz said. “That is when we realized that Maria’s immune system could not handle live vaccines.”
Takes her own approach
From that point on, Schulz discontinued conventional course of immunizations and viewed each vaccination
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on its merits, weighing the risks of contracting the condition with the risk of a reaction occurring after the inoculation. While live and inactive vaccines vary with regard to adverse reactions that may occur, each still carries some risk, especially in the case of a person with a compromised immune system, according to experts. For the most part, Schulz has discontinued all but the pneumonia vaccine for Maria, as people with Down’s syndrome have a high risk of contracting pneumonia and it can prove to be a serious condition in Down’s syndrome individuals. As for her older daughters, while they were past the immunization stage at the time Schulz began to question vaccinations, she carefully considered future immunizations and the timing of them, delaying some when she felt the need to do so. “I believe that not every child should follow the conventional immunization schedule,” Schulz said. “I believe the schedule is built around the time periods that the child is most likely to be seen for a doctor’s visit, and not necessarily at times when it is most likely that the child would need that particular vaccine.” She said her older daughters have received all necessary immunizations for their own health and to assist in not contracting a medical condition that could be transferred to Maria.
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Yoga Gaining in Popularity Among Americans
Y
oga is increasingly popular among U.S. adults and children, two new government surveys reveal. One survey found a little less than 6 percent of adult Americans said they had tried yoga, tai chi or qi gong back in 2002, but that figure jumped to slightly more than 10 percent in 2012, fueled mostly by yoga. And a second survey that focused on children found a similar trend: Yoga had been tried by about 1.7 million children in 2012, representing an increase of about 400,000 since 2007. Even seniors seem to be getting into the practice of yoga. Though just over 1 percent of adults over 65 had
tried yoga in 2002, that figure increased to 3 percent by 2012. The upshot: 21 million American adults now say they’ve tried yoga in the past year. As to what may account for yoga’s surge in popularity, physician Josephine Briggs, director of the U.S. National Center for Complementary and Integrative Health, said during a recent
news conference that the researchers could only identify trends, not explain them. Both surveys, which were published Feb. 10 by the U.S. National Center for Health Statistics (NCHS), looked at the overall use of alternative or complementary medicine among Americans.
“Overall, Americans’ use of complementary health approaches has not changed much, but the use of individual approaches has,” said Tainya Clarke, lead author of the adult survey and an associate research fellow with the NCHS, which is part of the U.S. Centers for Disease Control and Prevention.
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Your Deli Sandwich May Come With a Side of Listeria, Study Finds
T
he next time you order that pastrami-on-rye at your local deli, you may get an unwanted ingredient — the illness-inducing listeria bacterium. That’s the finding from a Purdue University study of dozens of delicatessens. Researchers say that on any given day, up to one in 10 deli swab samples tested positive for the Listeria monocytogenes germ. “This is a public health challenge,” study leader Haley Oliver, assistant professor of food science, said in a university news release. “These data suggest that failure to thoroughly execute cleaning and sanitation protocols is allowing L. monocytogenes to persist in some stores,” she added. While listeria infection can cause serious but transient gastrointestinal illness in most people, the Purdue team noted that foodborne illness is potentially deadly in people with weakened immune systems. Those people include the elderly, infants and small children, and people living with HIV. “We can’t in good conscience tell people with weak immune systems that it is safe to eat at the deli,” Oliver said. In the study, Oliver’s team first collected samples from 15 delis before they opened for the day. They examined swab samples from deli surfaces that came into contact with meat (such as slicers or countertops), as well as surfaces that did not, and found that nearly 7 percent of the samples tested positive for listeria bacteria. A second round of testing at 30 delis over six months found that 9.5 percent of the samples tested positive for the bacteria. In 12 of the delis, the same subtypes of the bacteria were found in several of the monthly samplings. This suggests that the bacteria can persist in certain areas over time, the researchers said. Only about 30 percent of delis never tested positive for listeria over the course of the study. But in some of the delis, samples came back positive for listeria about 35 percent of the time. Ready-to-eat deli meats are most often associated with listeria, the study authors noted, since the germ can grow even when foods are refrigerated, unlike other bugs such as E. coli or salmonella. The study was published recently in the Journal of Food Protection.
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