in good Oh No, I’m Pregnant!
August 2015 • Issue 120
“I am single and 31 years old. I had been on birth control for more than 10 years. When I conceived, I had forgotten that I missed my last dose. Whoops!” Check out “Pregnancy Diaries” inside
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Rochester’s Healthcare Newspaper
CYBERBULLYING Is Your Child a Perpetrator?
Page 5
Canandaigua VA Michael Swartz of Webster named interim director at VA
Social Security Turns 80
Frank Nicchi of NYCC
All About the SilverSneakers Page 8
Sweet News About Sweet Corn
Chiropractic College President: 35 Years Leading Students Page 18
Paying the Heart by Playing a Part
Page 10
Physician Tim Malia (left) and his foundation continue their mission to help poor kids in Bolivia. He poses with two doctors from the Hospital Arco Iris in La Paz, during a January 2014 visit to Bolivia.
Meet Your Doctor Gerald Gacioch, RGH chief of cardiology: Don’t hesitate to call 911 if you’re having chest pain or shortness of breath you can’t explain. Many lives could be saved if more people did that. Page 6 August 2015 •
How to Protect Your Eyes from Macular Degeneration
See Savvy Senior inside
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Get vaccinated with Flu Prevention Partners! Providing the 4 strain (QIV) flu vaccine for maximum protection
2015 - 2016 Public Flu Clinic Schedule Our experienced Registered Nurses will vaccinate all 3 years of age and older, plus pregnant women. Most insurance accepted. No up-front out-of-pocket cost. We bill insurance directly! Employers, call us today to schedule a flu clinic for your employees and their families! Flu Prevention Partners has expanded its locations and is now serving New York State areas from Buffalo to Albany and Downstate to New York City. We offer multiple cost-effective vaccination services for the community and employer organizations. Center for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older get a flu vaccination and for people to get vaccinated as soon as the vaccine becomes available. Please see below for a complete list of scheduled public flu clinics for the 2015-2016 flu season. Preservative-free vaccine will be available on request. If none of the clinics listed below work with your schedule, call us to make an appointment to get vaccinated. BRIGHTON 09/12 Legacy at Clover Blossom 09/17 Jewish Community Center 09/20 Brighton Fire District 09/23 Lifespan 09/27 Jewish Community Center 10/15 Jewish Community Center 10/17 Brighton Fire District 10/25 Jewish Community Center CANADAIGUA 10/27 Finger Lakes Community College FAIRPORT/PERINTON 09/09 Perinton Community Center 09/15 Perinton Community Center 09/28 Perinton Community Center 10/08 Perinton Community Center 10/17 Perinton Community Center 10/30 Perinton Community Center 11/14 Perinton Community Center FARMINGTON 10/14 Finger Lakes Race Track GATES 09/14 Italian American Comm. Center 09/24 Westside YMCA 10/14 Italian American Comm. Center 10/17 Westside YMCA GENEVA 09/29 Geneva CSD: North St. School 10/21 Geneva CSD: North St. School GREECE 09/11 Greece Town Hall 09/13 Ridge Road Fire District 09/19 Georgetown Pk. Apartments 09/24 Greece Town Hall 09/26 Ridge Road Fire District 09/29 Greece Town Hall 10/05 Greece Town Hall 10/10 Ridge Road Fire District 10/21 Greece Town Hall 10/24 Ridge Road Fire District 11/01 Ridge Road Fire District 11/02 Greece Town Hall
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HENRIETTA 10/02 Legacy at Erie Station 1545 Erie Station Rd HONEOYE FALLS 10/21 Honeoye Falls Volunteer Amb. 210 East St IRONDEQUOIT 09/12 Laurelton Fire Department 405 Empire Blvd 09/13 Herrema's Marketplace 125 Pattonwood Dr 09/17 Irondequoit Senior Center 154 Pinegrove Ave 10/01 Herrema's Marketplace 125 Pattonwood Dr 10/04 Laurelton Fire Department 405 Empire Blvd 10/10 Herrema's Marketplace 125 Pattonwood Dr 10/15 Irondequoit Senior Center 154 Pinegrove Ave 10/31 Laurelton Fire Department 405 Empire Blvd 11/05 Herrema's Marketplace 125 Pattonwood Dr PENFIELD 10/06 Eastside Family YMCA 1835 Fairport Nine Ml Pt Rd 10/22 Eastside Family YMCA 1835 Fairport Nine Ml Pt Rd PITTSFORD 09/13 Pittsford Fire Station #1 8 Monroe Ave 09/19 Pittsford Fire Station #1 8 Monroe Ave 09/30 Pittsford Fire Station #1 8 Monroe Ave 10/04 Pittsford Fire Station #1 8 Monroe Ave 10/18 Pittsford Fire Station #1 8 Monroe Ave 10/20 Pittsford Ambulance 40 Tobey Rd 8 Monroe Ave 10/31 Pittsford Fire Station #1 11/15 Pittsford Fire Station #1 8 Monroe Ave SPENCERPORT 10/01 BOCES II, ESC Bldg. 3599 Big Ridge Rd 11/03 BOCES II, ESC Bldg. 3599 Big Ridge Rd 12/03 BOCES II, ESC Bldg. 3599 Big Ridge Rd VICTOR 09/12 Legacy at the Fairways 681 High St 10/10 Victor Fire Department 34 Maple Ave WEBSTER 09/16 Hegedorn's Market 964 Ridge Rd 09/26 Hegedorn's Market 964 Ridge Rd 10/03 Hegedorn's Market 964 Ridge Rd 10/12 Christian Reformed Church 1344 State Rd 10/18 Hegedorn's Market 964 Ridge Rd 11/08 Hegedorn's Market 964 Ridge Rd
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Flu Prevention Partners accepts the following insurance plans:
● BCBS/EXCELLUS/RMSCO ● MVP ● AETNA ● BCBS of WNY ● CIGNA ● INDEPENDENT HEALTH ● ● MEDICARE ● POMCO ● UNIVERA ● UNITED HEALTHCARE ●
Please be sure to bring your insurance card. For those with different plans and for those who are uninsured, the cost is only $45 (cash or check). For more information about Flu Prevention Partners please visit www.flupreventionpartners.com or contact Rebecca Locke at 585-737-7673 or email Rebecca at rlocke@wpvinc.com. As we may add more public flu clinics, please visit us online for the most up-to-date schedule at schedule.flupreventionpartners.com or call us at 585-568-8340. Follow us on Twitter for flu tips and information at @flu_prevention.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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HEALTH EVENTS
Aug. 11
Sept. 26
Fibromyalgia group to discuss health issues
Walk to End Alzheimer held at various locations
The Fibromyalgia Association of Rochester New York is sponsoring a support group meeting from 7 – 8:30 p.m., Tuesday, Aug. 11. The event will feature Diane Macchiavelli as keynote speaker, who will talk about “Health and Wellness Fitting with Fibromyalgia.” Macchiavelli is director of Brighton Pathways to Health and a member of the Acupuncture Society of New York. The meeting will take place at Greece Town Hall Meeting Center, 1 Vince Tofany Blvd., Rochester. It’s free and open to the public. For more information, visit www.farny.org, email publicity@farny.org, or call 585-2257515.
The Alzheimer’s Association Walk to End Alzheimer’s is a movement to reclaim the future for millions. Several events around the area will mark the the date. They are: • Sept. 26 at Monroe Community Hospital (435 E. Henrietta Road) in Rochester. • Oct. 17 at the Granger Homestead (295 N. Main St.) in Canandaigua. Oct. 24 at The College at Brockport (Alumni House, 142 Utica St.) in Brockport Nearly 4,000 people from the Rochester area are expected at this year’s event to raise awareness and funds to fight Alzheimer’s disease. Alzheimer’s Association Walk to End Alzheimer’s participants will complete a two-mile walk and will learn about Alzheimer’s disease, advocacy opportunities, clinical studies enrollment and support programs and services from the Alzheimer’s Association. Start or join a team today at alz. org/walk or contact Vanessa Pschirrer at 585-760-5472 or vpschirrer@alz.org.
Sept. 11
Nonprofit holding gala for Bolivian children’s health The AAVia Foundation for the Health of Bolivian Children is holding its Second Annual Gala Sept. 11, at Casa Larga Vineyards in Fairport. The event celebrates another year of support to the AAVia Foundation partners in Bolivia, and is a primary fundraiser for the local nonprofit. Tickets are available on the AAVia Foundation website, www.AAViaFoundation.org. The event will feature special guests visiting from La Paz, Bolivia. MC for the gala is Rachel Barnhart, anchor of News 8 First at Four, and music will be provided by Freddy Colón of The Mambo Kings. The event will feature a silent auction, including pieces of original photography by Nia Haf Photography. For more information about the event and organization, or to schedule an interview, please contact Mackenzie Malia at 585-880-7022 or by email at mackenzie.malia@aaviafoundation.org.
Cardiac Life offers CPR/ AED classes The public is invited to attend classes on cardiopulmonary resuscitation / automated external defibrillator (CPR/AED) at the Cardiac Life Training Center to learn the skills to save a life. The classes offered are: • Aug. 6 from 5:30 – 9:30 p.m. • Aug. 12.from 9 a.m. – 1 p.m. • Aug. 22.from 9 a.m. – 1 p.m. • Aug. 27.from 5:30 – 9:30 p.m. • Sept. 12.from 9 a.m. – 1 p.m. • Sept. 23 from 5:30– 9:30 p.m. The Cardiac Life Training Center Is located at 349 W. Commercial St., Piano Works Mall, suite 1400, E. Rochester. Call to reserve your spot as class sizes are limited. Cost is $45. For more information, call 585-286-3811 or send an email to training@cardiaclife.net
Serving Monroe and Ontario Counties in good A monthly newspaper published by
Health Rochester–GV Healthcare Newspaper
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 Gaspar, Patricia Bomba, M.D., John Addyman • Advertising: Donna Kimbrell, Marsha Preston, Cassandra Lawson • 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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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015
Cyberbullying: Is Your Child a Perpetrator? By Deborah Jeanne Sergeant
W
orse than knowing another student is bullying your child is learning that your child is the bully. Bullying online can be harder for some parents to detect and understand, since today’s children have been brought up in the digital age, saturated with smart devices. For one thing, bullying of any sort is different from garden-variety teasing. “Bullying is repetitive patterns that cause emotional harm, especially if the behavior is addressed and the perpetrator refuses to stop,” said Despina Mitchell, licensed marriage and family therapist and senior primary therapist at Rochester Regional Health Care, which is associated with Via Health. Children and teens who are “just joking” stop when it goes too far. If they continue, and especially if the attack escalates, that’s bullying. Many bullies enjoy the thrill of hurting someone else who cannot defend himself and the anonymity of the Internet makes it easier. “The impulsivity of it has increased because of social media,” Mitchell said. “Even the person who sends out a Snapchat photo, by the time they realize they shouldn’t have
done it, who knows how many thousands of people have seen it.” Instead of just a handful of classmates viewing an unflattering photo, the entire world can see and weigh in on it. The dynamics of bullying have also changed as far as who can perpetrate it. It’s no longer about who’s biggest on the playground but who can best mask his footprints online. That is where parental monitoring comes in. “As parents, we have to monitor all those sites and be aware of what’s going on with our kids,” Mitchell said. In addition to his victim, your child can be harmed by his actions of bullying. They may crave more and more victims or perpetrate acts with large significance. “The bully needs some self inventory so they know what made them engage in that kind of behavior so they can understand what’s going on and make amends with whomever they were bullying,” Mitchell said. Insincere apologies won’t make amends, and shaming the bully only reinforces the power trip that bullying provides. “Show them the right way to make
up for what they have done,” Mitchell said. Bullying children with deeply rooted issues may need professional counseling. “We encourage schools to develop a definition and lay down consequences,” said Ramona Palmer, executive director of Victim Resource Center of the Finger Lakes, Inc. in Newark. Many times, cyberbullying carries over into face-to-face bullying. Getting the student body involved can help more than grown-ups realize. “If the parental and school intervention isn’t successful, kids are more likely to respond positively to a peer than a parent or school representative,” Palmer said. Students such as a well-liked football player often do well advocating for bullying victims in the organization’s
active bystander program, in which students learn how to intervene safely in a bullying scenario. Mitchell encourages parents of children who bully to seek counseling and teach them how to solve problems with their peers in a positive way. “When you get upset, don’t encourage a physical response back,” she said. “We encourage parents to monitor text messaging and Internet activity. Be aware who the child is talking to, what the child is saying, and other friends that may be involved with. They may go to other kids’ homes to do bullying online. Every parent should stay on top of this. Keep an open line of communication with the school.” Helping children find positive means of gaining respect, such as excelling in a hobby, can go a long way toward preventing bullying.
Healthcare in a Minute By George W. Chapman “Government” healthcare Like it or not, almost half (47 percent) of us receive care paid for or provided by Uncle Sam. The number of people/enrollees in millions are: Medicaid, 70; Medicare, 53; Tricare, 13; Veteran’s Administration, 9; Bureau of Indian Affairs, 5. That’s a total of 150 million out of 320 million Americans receiving their healthcare through a government program. The vast majority of the 150 million receive their care from a private physician. Majority of enrollees happy with ObamaCare According to a survey by the politically neutral think tank the Commonwealth Fund, 86 percent of people insured through healthcare exchanges report they are either “somewhat” or “very” satisfied with their coverage. Other figures: • 68 percent of exchange enrollees have a “silver” plan, which is typically what employers offer. • 77 percent reported that finding a primary care physician to care for them was either “somewhat” or “very” easy. • 60 percent reported they got an appointment within two weeks. The number of people without health insurance is at an all-time low of 12 percent. SCOTUS upholds ACA As most predicted, the Supreme Court upheld the Affordable Care Act 6 – 3. The overall intention of the law, to provide affordable care to all Americans, regardless in what state they reside, was tantamount to some poorly
worded phrases in the law. Sixteen million Americans still have access to healthcare and most of them are insured by private insurance companies. The ruling has had a positive impact on both commercial insurer and for-profit hospital stocks, which saw a mini surge upon the ruling that prevented what many called a “death spiral” for insurance companies. NYS offers the most insurers through its exchange (16) than any other state. Baby boomers impact Medicare Those born between 1946 and 1964 are creating a double whammy as they enroll in Medicare. Boomers tend to have more chronic conditions and live longer than their predecessors. Roughly two thirds of seniors now have multiple chronic conditions and about 15 percent have more than six chronic conditions. The 15 percent accounts for 40 percent of all Medicare spending. Annual Medicare spending could exceed $1 trillion by 2023, according to the Congressional Budget Office. The average senior with five or more chronic conditions fills 50 prescriptions and has 13 physicians visits a year. All the more reason for the development of comprehensive, coordinated and integrated care systems like Accountable Care Organizations. Physicians split on ACA While the AMA has been fairly silent, according to a poll of primary care physicians by the Kaiser Family Foundation, physicians are pretty much split right down the middle 50/50 when it
comes to like/dislike the ACA. Not surprisingly, 87 percent of Democratic physicians favor the law and 87 percent of Republican physicians don’t. In any event, despite their opinion of the ACA, 83 percent of the primary care physicians said they were still accepting the newly insured patients. Systems slowly evolving to value based care About 12 percent of payments to physicians and hospitals are now value- or outcome-based. This percentage will increase considerably every year as pure volume-based fee for service payments are phased out. The timing couldn’t be better considering the influx of seniors with multiple chronic conditions as discussed above. Unfortunately, about 40 percent of the healthcare systems out there report they are ill prepared for the dramatic paradigm shift in how care will be provided and paid for. Value-based care requires huge cultural, philosophical and operational adjustments among providers. The keys are interoperability of electronic medical record systems, strategic business intelligence, seamless and effective physician-to-physician communication, the ability to data mine, inspired leadership, excellent transition management, and real time date access. New coding requirements As if your physician doesn’t have enough to worry about with all the rapid changes in healthcare, effective Oct. 1 they will be required to adopt
August 2015 •
a new coding system (ICD-10) when submitting bills to Medicare and commercial insurers for payment. Staff must be trained and billing systems modified, which is very expensive. Critics of the new system say the data required for payment is far too detailed and picayune. It should be noted that most other countries have been using the ICD-10 coding system for years. Here are some examples: w55.21— cow bite; w61.33 — chicken peck; v00.01— collision with a roller skater; (I am not making this up.) y92.146 — injured in a prison pool; z63.1 — problem with in-law; w56.22 — struck by orca; y93.01 —injured while knitting. Healthcare question? Check out “Ask the Oracle” at www.newyorkhealthcareforum.com. The site is designed to help consumers navigate the often confusing and frustrating healthcare system. It’s free and anonymous. A volunteer panel of industry experts is at your disposal to answer your question and educate.
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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Your Doctor
By Chris Motola
Gerald Gacioch, M.D. RGH chief of cardiology: Don’t hesitate to call 911 if you’re having chest pain or shortness of breath you can’t explain Q: As the chief of cardiology at Rochester General, what are your administrative duties? A: It’s one of those things that doesn’t divide easily. My clinical and administrative duties overlap all the time. The main thing is making sure we provide all the services we can to the community with regard to cardiology. We’re coming to the end of a recruitment cycle, so I actually have nine new cardiologists who will be bringing some new skills to the area this summer. It’s really about making sure that we have all the services covered and the quality of the work we do is up to par. It’s also about supporting the nursing staff and hospital administration. Basically, if it has to do with cardiology, I have a piece of it. Q: It seems like a lot of progress has been made in reducing mortality from heart attacks. Is that the case? A: Yes. I’ve been in practice for over 25 years and there’s been huge progress in terms of what we’re able to do in the cath lab. An example is, in the past we would give a patient anti-blood clotting medications and hope they worked. Now we bring them to the cath lab and, in much less than an hour, we have the artery open with a stent, the heart attack is over, and the heart is already beginning to heal. In the past it was common that someone who had a heart attack would be in the hospital a week to 10 days. Now 90 percent of them are ready to go home in three days. So it’s remarkable progress. The whole field of cardiology has really been influenced by the drugs that have become available. There’s also been progress on the behavioral side with the population smoking a lot less. Unfortunately that part is counterbalanced by our epidemic of diabetes and obesity. Q: How much of an effect has patient behavior had one way or another? A: One of the frustrating things that we haven’t made progress on is getting patients to the hospital quickly. If you get to us quickly, there are tons of things we can do for you. There’s kind of a clock that starts ticking as soon as a heart attack starts. Most people wait almost two hours before activating the system. That’s two hours
of heart muscle that’s wasted. So one of the behaviors we’d love to see is, if patients are having chest pain or shortness of breath they can’t explain, call 911. It sort of has become a bimodal population in America, where we have great medicine and fresh foods as well as information about exercise. Some of the population is taking advantage of that. Some of the population is still smoking, consuming too many calories or being sedentary. So we’re losing some of our gains on longevity. There’s worry that the next generation may be shorter lived than the current generation. Q: In the interest of getting people to the emergency room more quickly when they’re having a heart attack: what are the symptoms of a heart attack. Are they different for men and women? A: So classic symptoms would be pain in the chest area. That pain could be an ache, burning, pressure, or just a sensation that isn’t supposed to be there. A lot of people will misdiagnose themselves as having reflux or gas. It’s usually more uncomfortable than excruciating. Other symptoms would be shortness of breath, dizziness. In women, for reasons that currently aren’t well understood, sometimes it can just be a profound fatigue. There’s the thought that women tend to have higher pain tolerance than men, so they might be more likely to ignore pain than men.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015
Q: Do you think it would be obvious to most people that they were having a heart attack? A: Sometimes yes, sometimes no. Some heart attacks are what we call “silent heart attacks.” That might mean it happened while they were sleeping and it wasn’t painful enough to wake them up, or that the symptom just wasn’t bad enough to raise their concern. So around 25 percent of heart attacks are discovered incidentally down the road after they’ve happened. The best thing to do is to try to know your own body and, when something isn’t right, get it looked at. Q: So are 25 percent of heart attacks are non-lethal? A: There are extremes on both ends. Sometimes the way heart attacks present is with an irregular heart beat. You may be dead within minutes. On the other hand, you might have a heart attack while you’re sleeping, sleep right through and wake and be more or less fine the next day. It depends on which arteries are involved and which part of the heart is being killed by the heart attack. Back in the day, the mortality from a heart attack was about 30 percent within the first month. Now, if you make it to calling 911, your chances of dying from within the first month after the heart attack is 2 or 3 percent. So if you think something is wrong, call us and we’ll figure it out. Q: With so much progress having been made, what’s on the horizon for your specialty? A: One of the bigger breakthroughs coming up is the ability to replace heart valves with artificial valves by making a tiny incision in the leg rather than doing open heart surgery. With the elderly, very often heart valves will build up calcium deposits and not open very well, which can cause a lot of symptoms and eventually cause death if it isn’t treated. Traditionally you could only replace them by cracking open the chest. These new valves come mounted on a catheter and allows us to go in through the leg and place the artificial valve within the diseased valve. This can be done under light sedation and the patient can go home in a day or two. Another device would affect people who have fibrillation who need to take blood thinners to reduce their risk of strokes so that they wouldn’t have to take blood thinners. With medicine, it’s usually not big dramatic things, but incremental improvements that add up over time. Heart attacks are still the No. 1 killer in this country, but that won’t be for long. We’ve been able to reduce heart attack mortality a bit faster than our colleagues in oncology have with cancer.
Lifelines: Name: Gerald Matthew Gacioch, M.D. Position: Chief of cardiology at Rochester General Hospital Hometown: Syracuse Education: SUNY Albany (undergrad), John Hopkins (medical), University of Michigan (fellowship) Affiliations: Rochester General Hospital Organizations: American College of Cardiology, American Medical Association, Monroe County Medical Society Family: Married, two sons, two daughters, one granddaughter Hobbies: Traveling, hiking, backpacking, kayaking, biking, running, church activities
Pregnancy Diaries By Jessica Gaspar
Whoops! I’m Pregnant
I
will never forget the moment I realized I might be pregnant. I was lying down for bed late one Wednesday night when the realization hit me — I was almost three weeks late for my period. Panic and excitement swarmed my head. Two days later, I took two pregnancy tests (for good measure!), and both came back positive. I remember my anticipation as I sat in the bathroom watching the two pink lines illuminate. Lyrics to one of my favorite Eric Church songs, which is appropriately titled “Two Pink Lines,” ran through my head: “Yeah, these days the rabbit doesn’t die, you just sit around waiting on two pink lines praying that fate is on your side, sitting around waiting on two pink lines… sitting around waiting on two pink lines. Again, my emotions were mixed — fear and excitement. I had not been trying to get pregnant. In fact, it was quite the opposite. I am single and 31 years old. I had been on birth control for more than 10 years. When I conceived, I had forgotten that I missed my last dose. (Whoops!) If you had asked me 10 years ago whether or not I would ever have children, my response would have been a firm, “No!” In my early 20s, I was busy with college and then making a life for myself. I only thought of myself, of advancing my writing career. I couldn’t value the way a child would change my life, the way I’d love a little stronger, pray a little harder, and worry a little more. When I was 26, my sister gave birth to my first niece — Camryn. That little girl changed my life from the moment I laid my brown eyes on hers. Even though she isn’t my child, I have loved her as if she were my own from that moment on. I slowly started to understand the ways a child can change your own. One of my favorite memories is of 9-month-old Camryn crawling to the door looking for me after I had left my sister’s house. She was calling out for me in baby talk. My sister caught it all on her cell phone video. Then a year or two later, when she was first really starting to put words together, she turned to me and said, “Aunt Jess is my best friend.” My heart melted. You could say that Camryn, in her own special way, prepared me to be a mother. I learned a great deal of patience after she was born. I learned how to mix formula, how to properly change a diaper, how to apply diaper ointment. I opened my heart to the idea
“I am single and 31 years old. I had been on birth control for more than 10 years. When I conceived, I had forgotten that I missed my last dosage. Whoops!” of being a mom for the first time ever. Since Camryn was born five and a half years ago, my sister had another little girl, Emma, last August, and my brother had a little boy, Carson, in May. Ironically, the day before Carson was born was the day I took those two pregnancy tests. Carson was delivered nearly eight weeks early in an emergency cesarean section due to pregnancy complications. He was transported over to the neonatal intensive care unit (NICU) at Strong Memorial Hospital, where he stayed for about three weeks. After I left my brother and his wife in the hospital the night Carson was born, I went down to the hospital’s chapel. I prayed and cried for little Carson and my own child. I was scared for all of us. Since I hadn’t been anticipating the pregnancy, there were a few things I had to change. For instance, I was a social drinker. I would have a few drinks a week, which I quickly eliminated. I was also on a few prescription medications that I checked for pregnancy safety. I did have to come off a few of them, and I had to switch my high blood pressure medication to one that is safer for pregnancies. I am overweight, which was an obvious concern of mine, so I have been especially more health conscious since becoming pregnant. I haven’t felt the slightest bother by any of these changes I’ve had to make. I am making these changes for someone else — someone’s whose life depends solely on my decisions and actions. There is no better feeling. I have had two sonograms so far. The latest revealed I will be having a little boy. His estimated due date is Jan. 2. Every time I look at those images, my only thought is how I can’t wait to hold him. Even though he wasn’t expected and was very much a surprise, there will be no shortness of love in his life.
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Page 7
SmartBites
By Anne Palumbo
The skinny on healthy eating
Sweet News About Sweet Corn
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o you suffer from corn-a-phobia? It’s a worrisome condition brought on by corn’s high carb content and its potential for genetic modification (GMO). Yes? Pull up a chair; we need to talk. I, too, once shunned corn because I thought it was bad for me. But not anymore. Once I got savvy to the “good carbs” in corn and learned more about GMO, I can’t get enough of this nutritious vegetable — especially now. First, the carbs. It’s true: Corn is high in carbs, with a medium ear posting about 30 grams. But unlike the simple carbs in, say, a glazed doughnut, that zip through your system lickety-split, the carbs in corn are complex and take longer to digest. According to a study published in the “Archives of Internal Medicine,” foods that are absorbed more slowly into the bloodstream and have a more gradual effect on blood sugar levels may help lower the risk of Type 2 diabetes. Go, corn! A belief that corn is high in both sugar and calories also triggers corn-aphobia. Guess what? Corn is surprisingly low in both, clocking in at around 3 grams of sugar
and 100 calories per medium cob. As a comparison — a medium banana has about the same number of calories and nearly 15 grams of sugar; a medium apple: 95 calories and 19 grams of sugar. Now, the genetic engineering of corn. While 90 percent of “field corn”— the virtually inedible commodity crop used to make everything from livestock feed to ethanol to corn syrup — is genetically modified, most sweet corn is not. Recent tests conducted on sweet corn samples by several grassroots environmental organizations found that less than 4 percent of the sweet corn grown in the U.S. was GMO. When asked, major grocery store and farmers markets representatives in our area said that their corn was not GMO. More reasons to get sweet on corn: One medium ear boasts about 3 grams of fiber (good for bowel health), 4 grams of protein (a workhorse nutrient), decent doses of B vitamins (brain and nerve boosters), and especially high concentrations of two antioxidants that may promote healthy vision.
Plus, corn is super low in both fat and cholesterol.
Helpful tips
Look for husks that have good green coloring and golden, supple silks. Kernels should be tightly packed, plump, and come to the tip of the cob. Store corn, still in its husk, in the refrigerator for no more than two days (the sweetness declines as it ages). Purchase organically grown corn for 100 percent assurance that it is not GMO. Curious about GMO? Wegmans’ website (wegmans.com) is full of good information.
Charred Corn Salad with Basil and Tomatoes Adapted from Bon Appetit 4-6 servings 2 ears corn, husked 3 tablespoons olive oil, divided ¼ cup thinly sliced red onion 1 clove garlic, minced 1 cup cherry tomatoes, halved or quartered 1 cup black beans, rinsed ½ cup fresh basil leaves, slivered juice from 1 lime 1 small red jalapeno pepper, diced (optional) ½ teaspoon salt ¼ teaspoon coarse black pepper Heat a gas grill to high. Rub corn with 1 tablespoon oil. Grill, turning frequently, until corn is charred and heated through, 10-12 minutes. Remove from grill; when cool enough to handle, cut kernels from cobs and transfer to a large bowl. Stovetop method: Cut the kernels from the cobs and place in a small bowl. In a large skillet, heat 1 table-
spoon oil over medium-high heat and add corn. Cook, stirring frequently, until corn looks slightly charred and is heated through—about 5 minutes. Reduce heat to medium if corn starts to burn. Transfer to a large bowl and let cool. DO AHEAD: Corn can be made 3 hours ahead. Let stand at room temperature. Place onion in a strainer and rinse with cold water to mellow its flavor. Drain well. Mix remaining 2 tablespoons oil, onion, garlic, cherry tomatoes, black beans, basil, fresh lime juice, and diced pepper into corn. Season to taste with salt, pepper, and more lime juice or oil, if desired. AHEAD: Salad can be assembled 1 hour ahead. Let stand at room temperature. 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.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Dollars and Sense: Becoming Your Own Sole Supporter
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I’ll end up alone and penniless.” That pretty much sums up one of the biggest fears divorced and widowed women have when they find themselves living alone — by choice or by chance — in mid-life. I discovered this seemingly universal fear around money management when I interviewed more than 50 women in preparation for my threepart workshop, “Living Alone: How to Survive and Thrive on Your Own.” I wanted the workshop curriculum to be relevant, so I conducted these interviews to identify the key concerns of women on their own. I learned that managing finances was near the top of the list. While shared responsibility for financial matters is becoming more common these days, it is still the case that many women continue to hand over the purse strings and financial decision-making to their husbands. It’s the “way it was” for many traditional couples, when the man was the primary bread winner, but it’s also the “way it is” for more progressive couples who simply want to divide and conquer when it comes to managing household responsibilities. Problem is, once a woman is out of
the financial loop, she often remains uninvolved forever, which can put her at a real disadvantage. Her knowledge of and self-confidence around money matters becomes very diminished. Simply put, when one spouse — man or woman — controls the finances, the other can be left in a vulnerable position when the marriage ends. This vulnerability was expressed over and over again in the interviews I conducted, which is why I devote a portion of each workshop to getting one’s financial house in order. I consulted with my financial adviser and together we identified a few essential steps to help women gain control of their money and make progress toward financial autonomy: Come out from under the covers. Ignorance is not bliss when it comes to financial management. Women, and men alike, need to find the courage to get “up close and personal” with their financial circumstances. I avoided looking into my financial mirror for years until the fear
of not doing anything was greater than the fear of facing reality. Fear, in my case, turned out to be a blessing in disguise — a real motivator. It prompted me to get my act together and seek help. There’s no time like the present to take charge of your money and your destiny. Find your stuff. David Bach, renowned financial expert and author of “Smart Women Finish Rich” says it best: “Getting organized is one of the keys to financial security. It begins with finding your stuff.” Before you can plan your financial future, you need to figure out where you stand financially in the present. It starts with gathering together all your financial documents in one place. I cleared out a file drawer in my desk, purchased new hanging file folders, and started labeling the files according to the instructions in David Bach’s book. It didn’t take as long as I thought it would and I felt a great sense of accomplishment once I had everything
collected together. And guess what? This simple step helped me feel in more control. Almost immediately, my fears began to lessen. Get help, if you need it. Once I had my “stuff” together, I was in a much better position to make sense of my financial situation. I continued to work through Bach’s book, but I found I needed more — I needed a real, live person to help me take the next step and make more progress. That’s when I engaged the help of a financial representative who helped me align my spending, saving and investing with my needs and priorities. He’s been an invaluable coach and motivator. If you’re like me, you may benefit from engaging a professional. If you’re more self-directed and inclined to educate yourself on money matters, there are excellent resources out there in books, magazines and on the Web. Peace of mind and a sense of empowerment are the rewards for women who get their financial house in order. Solid information, personal discipline, and good help from a trusted advisor can turn financial uncertainty into financial security. With increased self-confidence and awareness, you can better protect your future and more fully embrace the pleasures of living alone . . . with a little left over to splurge on something special just for you! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, N.Y. For information about her upcoming workshop or to invite Voelckers to speak, call 585624-7887 or email gvoelckers@rochester. rr.com.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 9
Paying the Heart by Playing a Part Dr. Tim Malia and his foundation continue mission to help poor kids in Bolivia By Jessica Gaspar
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that drive, is something we wanted,” the physician said. It was only natural that the AAvia Foundation be a family business. Malia’s daughter, Mackenzie, helped co-found the organization and is the president and chief financial officer. Malia met his wife, Ana, in 1989 while attending Johns Hopkins University in Baltimore. A year later, the couple made a trip to Bolivia, his wife’s home country, where they would become engaged. They have returned nearly every year since. The family also belongs to the Rochester Latino Rotary Club. Rotary International pushes community service, and its motto is “Service above self.” The Malias try their Timothy Malia poses with two doctors from the Hospital Arco Iris in La Paz, Bolivia, during a January best to live up to that 2014 visit to the country. The trio spent the day visiting a women’s prison and giving medical care in a adage. city plaza. Though the Malias effective.” “We noticed there are a lot of have been bringing medical supplies Other improvements include a cross-cultural similarities,” Malia said. and techniques to Bolivia since the earsuccessful hand-washing initiative in “It’s always interesting to bring lessons ly 1990s, the AAVia Foundation was the Lake Titicaca region, but that didn’t home and to realize we share a lot of not formally founded and incorporatcome as easily as one would think givthe same goals. We share a lot of the ed until 2012. The charity received its A family affair en many rural Bolivian residents don’t same lessons and how we can make 501(c)(3) nonprofit status in 2014. AAVia gets its name from Malia’s have access to clean running water, things better.” “The entire idea of the AAVia mother-in-law, Bolivian-native Adriana Timothy Malia said. Foundation is to transition from pieceMore work to be done Aguirre Via, who died last year just shy A recent study done of 500 schoolmeal things that we had been doing One of the largest problems the of her 96th birthday. age children showed 70 percent were for 20 years and formalize it so we can Malias have noticed is the limited “She had seen a lot of changes in infected with intestinal parasites from have a greater potency,” Malia said. access to care many Bolivian residents her life in Bolivia,” Malia said. drinking the water. A great deal of Malia’s work is have. Take common vaccinations, for Via had been the matriarch in her “You can treat [the children], but concentrated in La Paz, the country’s example. household for more than 50 years. She if the water source hasn’t improved, large city in the western portion of There are a lot of infections that raised her own children and had many a number of them can be re-infected,” Bolivia. La Paz is bordered to the east could be prevented by a vaccine at grandchildren, great-grandchildren, Malia said. by the Andes Mountains, which are infancy or when the child is younger, and even great-great-grandchildren. Some of the Bolivian doctors and portrayed in the foundation’s logo. according to Malia. “The idea that she had been matriresidents who are involved in the “They are still having trouble with Improvements in healthcare arch in this household for more than AAVia Foundation on the ground in those because vaccines are expensive,” In his 25 years of visiting Bolivia, half a century, that maternal instinct, Bolivia are the eyes, ears and hearts he said, naming meningitis and pneuMalia has noticed some who keep the Malia family up-to-date monia as common diagnoses for which statistics have imon projects and improvements. there are common and easily-accessible proved. “They actually approached us and treatments or vaccinations available in “One thing is the they said, ‘Listen, we’ve got a few extra the United States. overall infant mortality dollars in the project…may we use The other facet is the level of trust rate has dropped nicely. that money for water assessment for many Bolivian residents have for docIt’s probably about half different towns?’” Malia said. “These tors and other healthcare workers. of what it was 20 to are good people. They want to get the “In Bolivia, there are longtime 25 years ago,” he said, water assessment because that can be a traditional medicines and practices that citing better access to huge step forward later.” can be different from our Westernized prenatal care. Cross-cultural similarities or modern healthcare,” Malia said. One recent imMalia spent three months at a “If the doctors approach it with just a provement was the adBolivian pediatric hospital in 1993 modern medicine mindset, they’re at dition of two bilirubin while attending medical school at the risk of not pulling in the trust of the lights in a neonatal unit University of Rochester. He met several patient,” Malia said. at a hospital in La Paz. doctors at that time with whom he still A bilirubin light is an Want to Get Involved? works with today when he visits the effective treatment for The second annual gala to benefit area. infants with jaundice the AAVia Foundation’s mission of In 2003, the team of doctors noticed — a condition whereby providing medical care to Bolivian chilmany similarities between Bolivian and the infant’s skin is yeldren will be held in September. Rachel American patients. lowish in color due to Barnhart of News 8 will be the event “We went down [with a] team an increase in bilirubin emcee. of anthropologists and pediatricians, levels in the liver. • COST: $75 per person. Sponsorand we did an assessment of pediatric “They did not have ship levels are also available. emergency services in Las Paz. We the best resources for • WHEN: Friday, Sept. 11 came back and did a similar study at treating a child with • WHERE: Casa Larga Vineyards, Strong’s pediatric emergency room,” jaundice,” daughter 2287 Turk Hill Road, Fairport Malia said. Mackenzie said. “What For more information on the AAVia In the Rochester-area, he primarily they had been using beFoundation, visit www.aaviafounfore was just fluorescent noticed the similarities affected the dation.org, call 585-678-6798, or find poor who did not have affordable or A mother stands next to her baby who is being treated in a lights. A bilirubin light AAVia Foundation on Facebook. easy access to healthcare resources. was four times more Bolivian hospital.
t’s been said that you can find the answer to just about anything on Google. Got a stubborn stain on your favorite shirt? Google has the answer. What are the best colleges in the United States? Google will tell you. How to pay the heart? Well, that’s where Google loses its dependability. But, ask Timothy Malia how to pay the heart and he will likely tell you by giving others something for which they could never repay you. Malia, a physician who works for Immediate Care East in Victor, is the heart behind the local AAVia Foundation for the Health of Bolivian Children. The nonprofit’s sole purpose is exactly what the foundation’s tagline suggests: to improve the health of Bolivian children. Malia will tell you his work at the urgent care center may pay the bills, but his work in Bolivia pays his heart. According to statistics released by the Central Intelligence Agency (CIA), Bolivia’s population was about 10.6 million people with 45 percent living in poverty as of July 2014. That same report indicates Bolivia ranks “at or near the bottom among Latin American countries in several areas of health and development, including poverty, education, fertility, malnutrition, mortality and life expectancy.”
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015
Golden Years SilverSneakers Motivates, Educates Program is available at several locations in the region By Deborah Jeanne Sergeant
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veryone needs exercise to age well. Exercise aids in weight loss, reducing blood pressure, controlling blood sugar, maintaining good balance and keeping bones and muscles strong. It takes some effort, and most people could use a little more motivation to get out and get moving. That’s what SilverSneakers Fitness is all about. Offered at numerous gyms and community organizations, the program provides seniors with discounted memberships and programs well-suited to their needs. About 13,000 facilities nationwide offer the SilverSneakers Fitness program (www.silversneakers.com), which is handy for snowbirds or those who enjoy traveling during retirement. Members may use as many different facilities as they would like and any of the equipment or classes they wish (with some exceptions). About one-fifth of people 65 and older qualify, according to the organization’s website. Many insurers and Medicare plans include SilverSneakers Fitness. Joining is easy. “You bring in your insurance card, fill out the membership card, and there’s nothing additional to pay,” said Julie Coogan, membership services at Jewish Community Center of Greater Rochester. “If someone’s 65-plus, we ask about their insurance
benefit because it’s a lot cheaper than paying out of pocket.” By working through SilverSneakers, gym owners don’t have to worry about seniors’ budgets prohibiting their gym patronage, unlike a scenario where they pay the membership outof-pocket. Community centers can also benefit from attracting new members who may be interested in other, paid programs or volunteering. Typically, a gym offering SilverSneakers receives reimbursement each time the member visits the gym up to a certain maximum number of visits, equivalent to most gym’s membership fees. Additional visits won’t be covered; however, most gyms offer members unlimited use anyway. It makes business sense for the facility owner to make his gym as welcoming an environment as possible to seniors by offering senior-oriented programming, classes and equipment. SilverSneakers programs typically include walking, light weights, chairbased exercise and other ways to keep seniors moving, all led by personnel trained by SilverSneakers. These meet the fitness requirements of seniors needing lower-intensity exercise. “We also participate in Silver Fit and have some other [programs] that are geared toward seniors,” Coogan said. “Some of those may have a small fee. Our quarterly magazine has all
In a typical SilverSneakers class, seniors do a number of exercises, including stretching. Offered at numerous gyms and community organizations, the program provides seniors with discounted memberships and programs well-suited to their needs. those programs in it.” Insurance companies typically cover SilverSneakers and gym memberships since staying fit can reduce the severity and prevalence of health issues. A planned monthly expense—the gym membership—can help prevent a large expense, such as surgery and recovery from a broken hip. Seniors can’t beat the deal. As part of the insurance coverage they already
Healthful Dining for Seniors Where you go to dine makes a big difference, say experts By Deborah Jeanne Sergeant
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or many seniors, eating out fills both social and nutritional needs. But it’s important to choose wisely to support good health. Where you go to dine makes a big difference. Fast food restaurants offer fewer nutritious choices than many sitdown restaurants, for example. Most of their offerings contain too many calories, too much sodium and too much fat. Since each of these areas can contribute to health problems for many seniors, it pays to order carefully. Jane Braband, registered dietitian with Rochester Regional Health System, recommends ordering a la carte items from the menu. “If you buy a meal deal or a plate, you will be more likely to eat everything on it,” Braband said. Ordering a broth-based soup and a salad (dressing on the side) represents an a la carte order that goes easy on calories, fat and your wallet. Or ask for shrimp cocktail as your meal. “It is healthful and low in sodium and calories,” Braband said.
As another example of portion control, you could also think like your grandchildren when it comes to portion sizes. “If you see something nutritious on the children’s menu, you can order it,” Braband said. “Don’t let them fool you with super sizing. Soda is not good for you.” Ask for low-fat milk, unsweetened tea or coffee or water instead of soda. To maximize your meal’s nutrition, Joy Valvano, dietitian with Rochester Regional Health System, suggested choosing brown rice or whole grain pasta as your side dish since it contains more fiber. For Italian meals, ask for a marinara sauce, not a fat-filled creamy sauce. Broiled or grilled meat or fish help reduce calories and fat. “You need about 3 oz. of lean protein, the size of a deck of cards,” Valvano said. Stick with a cup of starchy foods, like potatoes, rice or pasta, choosing whole grain pasta and baked potatoes,
when available. Always ask for a salad and steamed vegetable. “Be aware that a food may be listed as a healthful choice, but pay attention as to how it is prepared,” Valvano warned. “Looks can be deceiving. A Caesar salad can seem healthful because it’s a salad, but if it’s in a dressing and has cheese, that tacks on so much fat and many calories.”
August 2015 •
receive, they get unlimited access, and, in many locations, programs that are easy on the joints. “It gives them the incentive to come to the gym and work out,” said Chris Purcell, general manager at Empire Fitness, Inc. in Rochester. “I believe it helps our business. It allows us to reach out to more people and help them reach their success with fitness and health.”
Planning ahead can make ordering easier. Rachel Reeves, registered dietitian with UR Medicine, encourages patients to do their homework before going out. “Lots of restaurants have their nutritional information online so you can look it up if it’s a place you go a lot,” she said. Especially if you go out often, you can forgo the “extras” that tack on unneeded calories and fat. “A plain, grilled burger or chicken sandwich is better than all the extras like bacon and cheese,” Reeves said. You can also “spoil” your appetite by eating a nutritious snack such as a piece of fruit 30 minutes before going out. That way, “you’re not so hungry that you make a poor choice,” Reeves said. “Your hunger signals aren’t as strong.” You can also prevent overeating by pacing yourself with the table’s slowest eater. Or take one bite for every three bites of your dining companions. It’s easy to attack the bread basket if you’ve finished your entree and others are still eating. Marge Pickering-Picone, nutritional coach and owner of Professional Nutrition Services in Webster, suggested sharing a meal, or boxing half to save it for another meal. “The next day, it’s just as good,” she said.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 11
Golden Years Local Doctors Call for Geriatricians to Lead Efforts to Increase Healthy Aging In an article in the Journal of American Geriatrics, Highland doctors say more research and programs should focus on successful aging
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majority of studies done on senior citizens focus on frailty, but only a small percentage of older adults are actually frail. In “Failing to focus on healthy aging: A frailty of our discipline?” set to be published in the “Journal of American Geriatrics Society,” Highland Hospital physicians Susan Friedman, Krupa Shah and William Hall call on geriatricians nationwide to provide leadership for keeping older adults healthy as opposed to just focusing on care that is provided after people become ill. The doctors reviewed relevant field research and found that studies on frailty are far more common in geriatric literature than those targeting success-
ful or healthy aging. Successful aging has a variety of definitions. It can mean the absence of disease while maintaining physical and cognitive function, but it can also include positive coping, freedom, comfort resources, independence and beneficial contribution to society. The concept of successful aging is more critical than ever before because of the rapidly growing number of seniors. The physicians, Friedman, Shah and Hall, acknowledge that there is a shortage of geriatricians in the country and currently most of them are caring for frail elderly with multiple chronic conditions. “But if nothing is done to delay older people becoming frail
we will continue to drain clinical and financial resources, and older adults will have a poorer quality of life as they age,” said Friedman. In Monroe County and across the U.S., the combination of an increased life expectancy and an aging baby boomer population means the number of people over 65 is growing rapidly. According to the U.S. Census Bureau, more than 500 New Yorkers are expected to turn 65 every day in the next few years. In 2010, one in seven people in Monroe County was over the age of 65, and in 2035 it is projected to be one in five. According to Friedman, “We know many of the successful elements that contribute to aging well. What
we need to do is to understand which elements are most important, and to develop environments to allow healthy aging to be the norm.” Hall, Friedman, and Shah specialize in geriatrics at Highland Hospital. In addition to practicing medicine, Friedman also co-teaches a course on successful aging for seniors at OASIS. Located on Monroe Avenue in Rochester, OASIS provides classes on a wide range of topics to anyone over the age of 50. The successful aging course teaches seniors how to optimize healthy living based on the results of studies conducted around the world that show what works best.
Medicare on the right path with end-of-life planning By Patricia Bomba
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edicare, the federal program that provides health insurance coverage to 55 million older and disabled Americans, plans to reimburse physicians for having conversations with patients about the care they receive in their final days when they may not be able to speak for themselves. The proposal is expected to take effect in January. Excellus BlueCross BlueShield endorses Medicare’s efforts and strongly urges everyone to support the plan. Patients nearing the end of their lives often worry about having their wishes honored regarding the level of medical care they want to receive or avoid. These patients fear that if they can’t speak for themselves, well-meaning family members or health care professionals may authorize extraordinary
medical interventions that may slightly prolong life, but not its quality. That’s why it’s important for physicians to initiate conversations with their patients who are seriously ill or frail to discuss and appropriately document care goals and individual preferences. For patients and their loved ones, making end-of-life wishes known can be one generation’s gift to the next. Since 2001, Excellus BlueCross BlueShield has been training physicians and other health care providers how to initiate these conversations and complete the required documentation. Since 2009, our health plan has reimbursed them for conducting these discussions. We believe reimbursement incentivizes providers to incorporate end-of-life discussions into regular practice for appropriate patients. Our health plan’s program sup-
ports New York State’s Medical Orders for Life-Sustaining Treatment protocol, an eight-step process spanning multiple sessions that allows seriously ill or frail patients who are likely to die within the year to specify the level of health care they want and don’t want. The physician then completes a MOLST form, a legal document that physically travels with the patient throughout all levels of care and/or uses the electronic eMOLST to complete the form online and ensure the patient is included in New York’s eMOLST Registry, which can be accessed by medical professionals across the state. We are proud of our involvement in creating New York’s MOLST protocol and prouder still that in the next few weeks we’ll be meeting with Medicare to discuss its interest in our reimbursement model and eMOLST
platform as a best practice template for use nationwide. Medicare’s plan to reimburse physicians for initiating end-of-life discussions will result in even more people avoiding unwanted interventions by writing their own final chapter. We urge everyone to support this plan.
Patricia Bomba, M.D., is vice president and medical director/geriatrics for Excellus BlueCross BlueShield. She served on the Institute of Medicine’s Committee on Transforming Endof-Life Care.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015
By Jim Miller
How to Protect Your Eyes from Macular Degeneration Dear Savvy Senior, Is macular degeneration hereditary? My mother lost her vision from it before she died a few years ago, and now at age 65, I’m worried I may get it. What can you tell me? Nearsighted Susan Dear Susan, Having a parent or sibling with macular degeneration does indeed increase your risk three to four times. But the good news is there are things you can do to protect your eyesight, and a number of treatments that are available if you do happen to get it. Here’s what you should know. What is AMD?
Macular degeneration, also known as age-related macular degeneration (or AMD), is the most common cause of vision loss in people over age 50, affecting about 10 million Americans. AMD is a progressive eye disease that damages the macula, the part of the eye that allows us to see objects clearly, causing vision loss in the center of your vision. This affects the ability to read, drive, watch television and do routine daily tasks, but it does not cause total blindness. There are two types of AMD — wet and dry. Dry AMD, which affects about 90 percent of all people that have it, progresses slowly and painlessly over a period of years. While wet AMD is much more aggressive and can cause severe vision loss in a matter of weeks or months. Factors that can increase your risk of getting AMD include age (60 and older); smoking; excessive exposure to sunlight especially if you have light-colored eyes; certain genetic components; a family history of AMD; high blood pressure; obesity; and being Caucasian. For anyone over the age of 60, it’s
a smart idea to get your eyes examined by an ophthalmologist every year. They can spot early signs of AMD before vision loss occurs. Early signs, however, may include shadowy areas in your central vision or unusually fuzzy or distorted vision. The Amsler grid at amslergrid.org, is a good tool to check your eyes for AMD.
Preventing AMD
While there’s currently no cure for AMD there are some things you can do if you’re high risk. One option is to talk to your doctor about taking a daily dose of antioxidant vitamins and minerals known as AREDS — vitamins C and E, plus copper, lutein, zeaxanthin, and zinc. Studies by the National Eye Institute have shown that AREDS can reduce the risk by about 25 percent that dry AMD will progress. Most drug stores sell these eye supplements in tablet or soft gel form over-the-counter for around $20 to $30, but be aware that not all eye supplements contain the proper formulation. Choose either the PreserVision Eye Vitamin AREDS Formula, PreserVision Eye Vitamin Lutein Formula, PreserVision AREDS2 Formula, or ICAPS AREDS. These four options contain the right formula mix. Other lifestyle adjustments that may help prevent or delay AMD include eating antioxidant-rich foods such as dark green, leafy vegetables and cold-water fish for their omega-3 fatty acids; protecting your eyes from the sun by wearing UV protective sunglasses; controlling high blood pressure; exercising regularly; and if you smoke, quit.
Wet AMD Treatments
For wet AMD, there are several effective medications (Lucentis, Avastin and Eylea) available that can stop vision loss and may even restore it. These medications are given by injection into the eye, and repeated every month or two, perhaps indefinitely. Note that each of these three drugs works equally in treating wet AMD, but there’s a big cost difference. Avastin costs just $50 per month, compared with $2,000 for the other two. So experts recommend Avastin as the first choice for most people with wet AMD, especially if you don’t have supplemental Medicare coverage. 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. August 2015 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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ocial Security has provided critical financial help to people of all ages for the last 80 years and, despite its age, it’s not retiring any time soon. As the Social Security program celebrates its historic birthday this August, we’re reflecting on our diverse history, our current strengths, and ways we can continue to improve our services to you. On Aug. 14, 1935, President Franklin D. Roosevelt signed the Social Security Act into law. In doing so, he promised the law would protect “the average citizen and his family against the loss of a job and against poverty-ridden old age.” Today, we continue to provide financial security for our country’s most vulnerable citizens. In fact, Social Security provides worldclass service to millions of people every day — online, on the phone and in our network of field offices across the country. As we celebrate 80 years, we’re proud to present our “Celebrating the Past and Building the Future” anniversary website. There, you can read 80 interesting facts about an agency that touches everyone’s life at some point or another. For example, did you know the original name of the Social Security
Q&A
Q: I lost my Medicare card. How can I get replacement? A: The easiest and newest way to get a replacement Medicare card is by using your my Social Security account. Go to www.socialsecurity.gov/myaccount for more information on how to create an account. You also can get a replacement Medicare card by calling us toll-free at 1-800-772-1213 (for the deaf or hard of hearing, call our TTY number, 1-800-325-0778). Keep your card in a safe place. You don’t want anyone getting hold of your Social Security number. They could steal your identity. Q: Why is there a five-month waiting period for Social Security disability benefits? A: The law states Social Security disability benefits can be paid only after you have been disabled continuously throughout a period of five full calendar months. Social Security disability benefits begin with the sixth full month after the date your disability began. You are not able to receive benefits for any month during the waiting period. Learn more at our website: www.socialsecurity.gov/disability. Q: Do I have to give my Social Security number whenever I’m asked? A: Giving your Social Security number is voluntary. If requested, you should ask why the person asking
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015
Act was the Economic Security Act? The anniversary website also includes a timeline of our history. It begins with the signing of the act in 1935 and ends with this year’s announcement of Vision 2025, our bold vision that will guide the agency as we work to meet the future customer service needs of the public. A memorable spot on the timeline is Nov. 2, 2000, the date when we started taking retirement claims online. Since our agency’s beginning, we’ve relied on our passionate and hard-working employees to face challenges and provide exceptional service. Throughout the 80 days leading up to our anniversary, we’ve been posting employee testimonials that answer the question, “Why do you serve?” We also invited you to share your story with us. You can tell us how Social Security has made a difference in your life or the lives of your family and friends. We would love to hear from you, the people we serve every day. When the Social Security program started 80 years ago, our goal was to provide an economic lifeline for people in need. Today, Social Security continues to protect millions of people. Join us in commemorating this significant milestone! Visit www.socialsecurity. gov/80thanniversary.
needs your Social Security number, how it will be used, what law requires you to give your number and what the consequences are if you refuse. The answers to these questions can help you decide whether to give your Social Security number. However, the decision is yours. Keep in mind that requestors might not provide you their services if you refuse to provide your Social Security number. For more information, visit www.socialsecurity.gov/pubs to read or print our publication. Q: My neighbor said he applied for Social Security retirement benefits online. Can you really apply for retirement without traveling to an office? A: Yes, you can. And, what’s more exciting, it’s the easiest, fastest and most convenient way to apply for retirement benefits. Our secure website makes it simple, allowing you to apply for retirement benefits in as little as 15 minutes. You can get started now at www.socialsecurity.gov/applyonline. Q: What is the earliest age I can begin receiving Social Security retirement benefits? A: The earliest age you can begin receiving Social Security retirement benefits is age 62. If you decide to receive benefits before your full retirement age, which for most people is age 66 or 67, you will receive a reduced benefit. Keep in mind you will not be able to receive Medicare coverage until age 65.
H ealth News RRH CEO appointed to Premier, Inc.’s board Rochester Regional Health President & CEO Eric Bieber has been appointed to the board of directors of Premier, Inc. “We are pleased to have Dr. Bieber join Premier’s board of directors,” said Susan DeVore, president and CEO, Premier. “As both a noted surgeon and a health system CEO, Dr. Bieber brings to the board a unique perspective that will be invaluable in helping us conBieber tinue our mission to improve the health of communities nationwide.” Premier is a healthcare improvement company that unites approximately 3,400 U.S. hospitals and 110,000 other providers to transform healthcare by enabling better care and outcomes at a lower cost. “It’s a privilege to be invited to serve as a member of the Premier board,” said Bieber. “Like Rochester Regional Health, Premier is dedicated to improving the health of our communities by transforming how care is provided. I will be honored to help their organization identify and develop innovative healthcare delivery models, while advancing the national healthcare discussion.” Bieber is president and chief executive officer of Rochester Regional Health, an integrated health services organization serving the people of Western New York and the Finger Lakes. Prior to this, he held a variety of positions at University Hospitals, Cleveland, including president of Community Hospitals West Region and president of University Hospitals Accountable Care Organizations. Bieber has also served as a physician leader at Geisinger Health System in Danville, Pa. He is a board-certified obstetrician/gynecologist and reproductive endocrinologist.
Strong recognized for improvement programs Celebrating significant achievements in improving patient care and outcomes, the Healthcare Association of New York State (HANYS) presented its Pinnacle Award for Quality and Patient Safety to Strong Memorial Hospital and two other organizations, Elizabethtown Community Hospital and the Silvercrest Center for Nursing and Rehabilitation. “The award winners — and all 113 applicants — show the diverse and innovative ways our hospitals and health systems across the state are transforming and improving care for a safer and better patient experience,” said HA-
NYS President Dennis Whalen. IMPACT — Inpatient Multidisciplinary Pediatric Asthma Care Team — at Strong Memorial Hospital in Rochester received HANYS’ Pinnacle Award for quality and patient safety for the category of hospital system or hospital with 100 beds or more. According to a HANYS news release, front-line clinicians identified an opportunity to improve outcomes by standardizing care for children with asthma through an inpatient “admission-to-discharge” clinical pathway. A standardized respiratory scoring system helps facilitate communication between members of the care team, and administration of asthma medication was altered based on recent evidence of toxicity and side effects. Inter-professional online education was provided to nurses, residents and attending physicians, and tools were built into the electronic medical records to facilitate the pathway. As a result of this initiative, the length of stay for children admitted with an asthma exacerbation shortened by nearly 35 percent, and variability in care of pediatric asthma patients decreased.
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2:00-2:30PM Public Hearing CELEBRATING 50th ANNIVERSARY OF MEDICARE!
For information call 315/483-3200 Sponsored by: Wayne County Rural Health Network and Wayne County Department of Aging and Youth
Highland nurse chosen for national fellowship program Deborah Jo Kummer, a nurse with Highland Procedure Center, has been accepted into the National Society of Gastroenterology Nurses and Associates, Inc. (SGNA) Nurse Fellowship Program for 2015. Only 10-12 fellows per year are chosen from professionals across the country. Fellows receive in-person training using curriculum developed by SGNA and the Texas Christian University (TCU) Center for Evidence-based Practice and Research. Over the next year, Kummer each fellow will focus on developing innovative evidence-based projects designed to address a GI/endoscopy related practice issue in their current practice setting. Their project findings will be shared through SGNA resources, including the annual course and the SGNA Gastroenterology Journal “This is wonderful for Highland, a magnet hospital, as we head towards re-designation this year,” said Chief Nursing Officer Tommye Hinton. “This will also enhance the knowledge of our GI team and allow Highland to again be recognized on a national level by the SGNA as Debbie will be leading a project based on nursing practice over the next couple of years.” Evidence-based practice is a vital part of advancing gastroenterology and endoscopy nursing. The purpose of the SGNA Nurse Fellowship Program is to educate and support GI/endosAugust 2015 •
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H ealth News copy staff nurses in the area of evidence-based practice that can be then applied to their day-to-day practice. Nurses that are chosen to be SGNA fellows are at the point of care and in the best position to determine knowledge gaps in nursing practice and assess what the needs are to improve practice. These fellows work hand in hand with GI nurse scholars (advanced practice, PhD’s, DNP’s) who conduct systematic reviews on topics chosen as a high priority by the GI nurse fellows.
Knickerbocker appointed at Jewish Senior Life Jewish Senior Life, a leader in senior health care and senior living, announced the addition of Jane Knickerbocker to its senior management team as vice president of marketing. She will have brand oversight and lead the development and execution of marketing, public and community relations for Jewish Senior Life and its affiliates, including Summit at BrighKnickerbocker ton, Wolk Manor, Lodge at Wolk Manor, Jewish Home of Rochester, Atkin Center for Outpatient Rehabilitation, Physician House Calls, and JSL Companion Services. Knickerbocker brings a wealth of relevant marketing experience to Jewish Senior Life, having held senior marketing and communications roles at MVP Health Care, Preferred Care, Gannett and Xerox.
She began her career in marketing at Young & Rubicam, a communications agency. Her expertise and approach has been recognized with dozens of health care and communications awards. Knickerbocker serves on the board of directors of Ad Council of Rochester. She holds a Bachelor of Arts in communications, cum laude, from SUNY Oswego. “We feel very fortunate to have Jane leading our marketing and public relations at Jewish Senior Life,” says Michael King, president and CEO. “She brings a wealth of experience and proven results.” “I’m honored to join the Jewish Senior Life family,” said Knickerbocker. “The organization is clearly committed to ensuring that older adults lead meaningful lives with choice and dignity. Thanks to its visionary leadership, Jewish Senior Life is changing the way we think about elder care. It’s very exciting to be a part of that.”
Rochester General Hospital awarded for stroke care Rochester General Hospital, part of Rochester Regional Health, has been selected by the Women’s Choice Awards as one of the top 50 hospitals in the country for stroke care. The Women’s Choice Awards was created by Medelia Inc., an organization that was founded by Delia Passi, former publisher of Working Mother magazine. Medelia works with Fortune 500 companies to support their efforts to increase sales and loyalty among women. Rochester General was one of two hospitals recognized in the state. The rating comes from a variety of performance metrics including: accreditation
New COO Starts This Month at Trillium Health Trillium Health announced that William E. Belecz will be its new chief operating officer and senior vice president of programs. He is expected to start on the position Aug. 17. Trillium Health is a local neighborhood health center offering comprehensive primary care, supportive services, and community outreach and education. Trillium Health also specializes in HIV and Hepatitis C care and prevention, as well as LGBT health. As its new COO, Belecz will oversee Trillium Health’s expansion and provide new services, barrier-free access to medical care and supportive services, and help earn the center the designation as a federally qualified health center (FQHC). Most recently, Belecz worked Page 16
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at Visiting Nurse Service (VNS), an affiliate of the University of Rochester Medical Center, where he had served for more than 24 years. As the chief information officer and vice president of operations and business analysis at VNS, he successfully headed the overall operations of a licensed home care agency, Visiting Nurse Signature Care, as well as the Meals on Wheels Program, all while continuing his oversight of the information systems and technology functions and also served as project director for URMC School of Medicine & Dentistry. “Bill brings a skill set vitally important to our future. His experience in a community based organization and the leadership that he provided to VNS over the years is immediately transferable and I am excited about him joining our team,” said Andrea DeMeo, Trillium’s CEO.
from the Joint Commission, patient satisfaction scores and the American Heart Association’s Get with the Guidelines performance measures. “We’re very proud of the team that has made this possible,” said Brian Bixler, director of the neurosciences program at Rochester General Hospital. “This award is the culmination of hard work and collaboration across many departments to provide the best care to these patients and increase their chances for a positive outcome.”
Geriatrician chosen for national fellowship program Krupa Shah, geriatric hospitalist at Highland Hospital, has been named an American Geriatrics Society (AGS) fellow by the American Geriatrics Society’s board of directors. Shah is one of only a handful of AGS fellows in the Rochester area. Fellowship status is awarded to AGS members who have demonstrated a professional commitment to geriatrics, contribShah uted to the progress of geriatric care and are active participants in the Society. A resident of Penfield, Shah routinely presents her research to the American Geriatrics Society. She is a member of the society’s public education committee and research subcommittee. She also received the division of geriatrics and aging’s research award in 2014 from the University of Rochester and is a two time recipient of the Center for AIDS Research Early Career Investigator Award. “Dr. Shah is a rising star in the field of geriatric research,” said physician Robert McCann, chief of medicine for Highland Hospital. “Her attainment of fellowship in the American Geriatrics Society is an affirmation of her success.” Receiving this honor puts Shah in a specially recognized group of healthcare providers who are dedicated to geriatrics, education, clinical care and research. Fellows who attain this honor are distinguished among their colleagues and in their communities for their service to geriatrics,according to a news release by Highland Hospital.
Lifetime Health welcomes new optometrist Clinton Sugnet, a doctor of optometry (D.O.), is joinning Lifetime Health Medical Group’s eye care services practice at the Marion B. Folsom Health Center (1850 Brighton-Henrietta Town Line Road). Sugnet received his D.O. degree from the SUNY College of Optometry in New York. Prior to joining Lifetime Health Medical Group, he practiced at several other eye care facilities in the Rochester area.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015
Sugnet will be providing care to patients of all ages, including eye exams, contact lens fittings, diagnosis and treatment of eye diseases and management of visual conditions. Sugnet will join Thuy Dao-Priest O.D. in the practice. Lifetime Health Medical Group proSugnet vides primary and specialty care, urgent care, pharmacy, dental, optical, behavioral health and imaging services, serving the Rochester and Buffalo areas for more than 40 years.
RGH bariatric center receives certification Rochester General Hospital’s bariatric center, Bariatrics of Western New York, has been designated as a comprehensive bariatric center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, a joint initiative of the American College of Surgeons and the Americans Society for Metabolic and Bariatric Surgery. In order to earn this distinction, the bariatric program must meet essential criteria for staffing, training, facility infrastructure and protocols for support. This designation ensures that bariatric surgical patients receive a multidisciplinary program, not just a surgical procedure. This comprehensive, patient-centered approach helps improve patient outcomes and longterm success.
VNS has new patient financial services chief Visiting Nurse Service of Rochester appointed Alicia Dockrell of Victor as its director of patient financial services. Dockrell, who has worked in health care billing for 28 years, is responsible for planning, directing and evaluating the management of timely and successful follow-up of all outstanding account balances. She most recentDockrell ly worked as director of revenue cycle for a local human services agency and manager of patient financial services for Unity Health. A Lean Six Sigma Green Belt, Dockrell is a past president of the Rochester Regional Chapter of the Healthcare Financial Management Association. “Alicia came to us with exceptional experience,” said Barry Palatas, VNS chief financial officer. “She is very qualified for the position and demonstrates excellent leadership and organizational skills. We are very happy she joined our team.”
Happiness House now manages Rochester Rehab Happiness House/Finger Lakes United Cerebral Palsy, Inc., based in Ontario County is now providing senior leadership to Rochester Rehabilitation on Elmwood Avenue in Monroe County. After the move, Happiness House President and CEO, Mary Walsh Boatfield, became the CEO of Rochester Rehabilitation. The agreement is similar to the one established in May 2013 when Boatfield became president of CP Rochester/ United Cerebral Palsy Association of the Rochester Area following the retirement of that agency’s president. Happiness House and CP Rochester further enhanced their relationship in December 2014 by forming Ability Partners, Inc., a passive parent corporation overseeing both agencies as independent subsidiaries. “The boards of directors of Happiness House, CP Rochester and Rochester Rehabilitation have worked together over the past few months and recognize the immense value to be gained for all three agencies via this executive staffing agreement,” said Boatfield. “It will enhance the scope of high quality services of the organizations, provide a larger operational platform, leverage resources, and enhance cost-effectiveness.” Founded in 1919, Rochester Rehabilitation operates six services in the rehabilitative areas of adaptive sports and inclusive recreation, employment and job support, driver evaluation and training, and mental health services. It is a partner agency of the Al Sigl Community of Agencies.
Strong Memorial programs ranked as “Nation’s Best” Four adult specialties at UR Medicine’s Strong Memorial Hospital have captured a spot in the top 50 programs in the nation for treating complex conditions, according to U.S. News & World Report’s 2015-16 ranking of America’s Best Hospitals. The rankings consider data on nearly 5,000 eligible hospitals, only 137 of which had one program or more that made it to the national list. Strong Memorial specialties that ranked are diabetes and endocrinology as the nation’s 34th best, gynecology in a three-way tie for 22nd best, nephrology as 39th best and neurology/neurosurgery as the 41st best, which is the program’s fifth consecutive year of top 50 results. Earlier this year, Golisano Children’s Hospital’s pediatric diabetes and endocrinology was listed as 42nd and nephrology was 41st best in the nation in the Best Children’s Hospitals ranking. In the remaining specialties ranked by U.S. News, Strong Memorial’s programs for cardiology and cardiothoracic surgery, otolaryngology (ear, nose and throat conditions), gastroenterology and GI surgery, geriatrics, orthopedics, pulmonary, and urology all scored in the top 25 percent of eligible hospitals. UR Medicine’s Highland Hospital is considered high-performing in gynecology. UR Medicine’s Strong Memorial Hospital is the only hospital in Upstate New York with multiple programs that earn top 50 rankings. In addition, Strong is ranked as the No. 1 hospital in the greater Rochester metro region, defined as Monroe County and its five contiguous counties.
New Interim Director at Canandaigua VA Has Full Plate Michael Swartz of Webster also accumulates the position of medical center director at the VA in Bath By John Addyman
M
ichael Swartz of Webster, with 31 years of Veterans Administration leadership in Upstate New York, has been appointed the interim medical center director at the Canandaigua VA Medical Center. He steps in just as the Canandaigua VA gets ready to implement a $309 million project that will include a new outpatient center and 10-cottage, 120bed nursing home. “The design is complete, the funding has been acquired, and the groundbreaking is a year away,” Swartz said. The new facilities will expand the ambulatory care, primary care and specialty services available to veterans in the first phase of the project, and construct the new homelike nursing home’s cottages in the second phase. Also on tap is the relocation of the Rochester Outpatient Clinic to a new facility that will be double in size, on Westfall Road. “I opened that place 18 years ago,” Swartz said. “We were serving 4,000 vets at the State Street location. Now we’ll serve 14,000.” Swartz, 52, has made VA administrative services his life’s work. When he was working on his bachelor’s degree at Ithaca College, he did an internship at the Batavia VA. “I shadowed the medical center director and learned how hospitals work,” he said, “and how the political system works. I did a lot of financial systems projects.” He was offered a job after the internship. “It was nice to know going into my senior year that I had a job when I graduated,” Swartz said. Starting out as a full-time administrative assistant at Batavia, working on projects, he transferred to the Syracuse VA after five years, where he was the assistant to the director. “I collected jobs,” he said. His capacity for workload meant he was doing two or three things at once. He handled finance, collections and was the facility’s planner. Swartz married his college sweetheart, Lisa, and the couple was on the move. Kids followed — Stephanie is now working on her MBA at St. John Fisher and she’s a supply chain analyst; Megan has a degree in business administration from Geneseo; Tyler, at Webster Thomas High School, is an outstanding defensive back in soccer. Wife Lisa is a marketing executive with Kodak. Swartz spent some time in the Buffalo VA doing management efficiencies and system redesign. He also picked up a master’s degree in public administration from Brockport. In 2004 he became the associate medical center director at the Syracuse VA during a period the VA was building an eight-story addition that would include the spinal cord project. “We also improved the infrastructure of the entire facility — that took five years,” he said. Swartz then became a VA medical center director — very much the CEO of the facility — in Bath. That’s a position he still holds, and now he’s also the interim medical center director in Canandaigua. Two big August 2015 •
jobs a lot of miles apart. Just how far is the commute from Webster to Bath? “80 minutes,” Swartz said, smiling. “I do enjoy driving.” By the time you read this, his 2007 Toyota Prius will have more than 300,000 miles on it. When Craig Howard, the former medical center director in Canandaigua retired, Swartz raised his hand. “I volunteered,” he said. “I told them, ‘I’m here to help.’ It’s a temporary assignment while they do their recruiting.” “Temporary” could mean three months, six months, Swartz doesn’t know. And the multi-tasker in him likes being active in two places. “A lot of the same issues here are also in Bath,” he said from his office in the Canandaigua VA. The temporary nature of the job is clear when you walk in — there are no photos of his family on the wall yet. “The programs here and in Bath are pretty identical; they’re very similar facilities,” he said. With today’s technology and connectivity, he added, it isn’t difficult to keep abreast of what was happening. “If you have good people you work with, they keep you in the loop and you trust them,” he said. As the director, “if you have good people skills and know the talents of your staff, it’s easy to manage. Working with people and problem-solving are the keys to success.” Swartz acknowledged there’s a public perception that the VA has troubles. “Our biggest challenge is keeping the public informed about what we do,” he said. “A lot of our [local] vets come to us and don’t understand what’s going on nationally, because our Upstate VAs are OK. The VAs in the south and southwest have the problems because the growth of their client base has been so rapid; our population in Upstate New York is more stable. In Florida, they’re adding 1,000 vets a month.” Canandaigua and Rochester VAs have about 20,000 vets in their care; Bath has 12,000. “For those not familiar with the VA, when they hear of the programs we have, they’re amazed,” Swartz said.
Swartz In Canandaigua vets can avail themselves of medical, mental health, social, educational, housing and long-term care services. “We have pretty much all the services a vet needs,” he said. When services aren’t available at the VA facilities, vets are sent to local hospitals and providers for care. Swartz also said that the VA system is the largest trainer of medical professionals in the country. “Half the doctors in America have been done internships in VAs,’ he said. He clearly likes his job and is comfortable in it. “I like working in hospitals,” he said. “It’s invigorating. Every day is different.” What’s different these days is the new national push to provide increased accessibility to outpatient services — there are 32 community-based outpatient clinics in this part of the state. “We do a really good job of providing services that are close to home,” he said. “Most of our vets have a clinic within 30 miles of their homes That means great access and timely service.” Swartz has 900 employees working in Canandaigua, 700 more in Bath, and 32,000 vets who rely on what his teams provide. All that doesn’t seem to wear him down; in fact, he’s energized. “I’ve got at least 10 more good years in me,” he said.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Chiropractic College President: 35 Years Leading Students Frank Nicchi has served NYCC in various capacities and in the process has become of the most important voices in chiropractic education today By John Addyman
O
nly six men have served at the helm of the New York Chiropractic College in the 96 years it has been in existence. The latest, Frank Nicchi, has been president for 15 years, and in his time, has led the college in making strides he himself thought were impossible when he started his career. In June, Nicchi was honored for his 35 years of service to the New York Chiropractic College as a teacher, clinician, administrator and now, president. His is a career so long the name of the college changed and the whole place moved 315 miles to the west during his tenure. Circumstance and opportunity have slowly, deliberately, pulled him into his position as one of the most important voices in chiropractic education today. He has become a national leader, president of the Association of Chiropractic Colleges. The pull might have been deliberate, but it was also serendipity. “My dream was to be an English teacher,” he said. “But when I graduated from St. John’s University in 1973, there were few English-teaching jobs.” His older sister had married a chiropractor, and Nicchi had treatments himself when he suffered with severe headaches as a teen. “I thought I’d look at chiropractic,” he said. “My brother-in-law was doing well. He seemed to be happy. It just seemed like something that was natural. It allowed me to interact with people. I enjoyed doing it. I could get sick people well…what more could you want? “Chiropractic appealed to me because I could explain how people could participate in their own care. I tell my patients, ‘We are in a partnership in your care.’” But he had a problem: Chiropractic colleges required a background in the sciences which Nicchi, an English major, had none. He lined up to take courses and worked odd jobs at clothing stores, and finally was accepted in a program in Lombard, Ill. He spent six months there but when Columbia College of Chiropractic received New York state accreditation, he came back home to New York City, graduating in 1978. The new Dr. Nicchi started his practice and two years later, Columbia College of Chiropractic had morphed into the New York Chiropractic College, and administrators were looking for a part-time instructor. “They knew I was interested in teaching,” Nicchi said, and he took the job. His responsibilities increased, and his practice prospered. He taught chiropractic techniques and differential diagnosis (“teaching students what diseases may mimic others to differentiate the more serious from the less serious and make referrals”). The trip from the college to his practice in Maspeth, Queens, to the college along the expressway took an hour and 15
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Frank Nicchi: “My dream was to be an English teacher,” NYCC president says. minutes. Today, he says, he could go from Seneca Falls to Buffalo in the same amount of time. By 1989, the college was suffocating in its Long Island campus and needed someplace to grow into. Kenneth Padgett, who was the president then, had driven by Eisenhower College in Seneca Falls many times and suggested that the chiropractic college take over the recently vacated campus. When the move was made, Nicchi was invited to be a full-time member of the faculty, remaining downstate at what was now a satellite health center. In 1995, the invitation came to move his family to Seneca Falls and take over continuing education and post-graduate education programs. That forced a family decision. Sitting behind his desk, Nicchi opened his hands wide, explaining. “I’m a city boy,” he said. “Sure, I’d made frequent trips to Seneca Falls. And, frankly, I looked forward to coming up here, never thinking I might spend the balance of my career here.” His wife, Carol, liked the area, but the change from the city was huge. Son Chris was in college, and daughter Car-
rie was younger, her transition a little more difficult. Things worked out. Chris is a senior underwriter for a mortgage company today; Carrie is a career counselor at the University of Rochester, working on her second master’s degree in mental healthcare counseling. The kids are both in Rochester now — Mom and Dad are grateful for that. Once he assumed the presidency at the college, Nicchi led many changes — some evolutionary, some innovative. He insists he hasn’t led from the front of the pack. “The key is surrounding yourself with the best people you can,” he said, “and feeling free to empower them to do what their expertise lends. It’s always been about people here at NYCC, and everybody seems to enjoy working here. We’ve had accrediting teams come through and tell us, when their work is done, how much people like to work here. We care about our students; we care about each other; we care about our patients. These are caring, giving people here. “I believe in the servant-leader concept,” he said. “We have shared governance with our senior administra-
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015
tors. As a college we believe in academic excellence, quality patient care and professional leadership.” One of the major changes in chiropractic education has been the clinical practice students are now involved with, particularly with patients at VA health centers in Canandaigua, Bath, Buffalo, Miami and Rochester, and at Monroe Community Hospital. These and other experiences, Nicchi said, “helps build the cultural authority of our profession…it’s an acceptance for our students and an awareness of their training and how extensive it is…we’re part of a healthcare team.” He noted that a vast percentage of healthcare professionals do some clinical work in VA hospitals — and now there were chiropractic interns working right alongside them. That’s a groundbreaking change in chiropractic. Nicchi turned to David Odiorne, the college’s vice president of institutional advancement. “When Dave and I were students in the 1970s, if we were told that part of our training would be in a VA hospital, with all those veterans and their host of co-morbidities [other illnesses and conditions], we would have said, ‘You’re not living on this planet — that does not happen!’” The widening acceptance of more natural treatments, forgoing the drugs and invasive procedures, has brought chiropractic professionals onto more healthcare teams. Nicchi explained that chiropractic treatments have always been part of Medicare, and there are provisions of the Affordable Care Act that allow chiropractic treatment as an option. NYCC has 700 chiropractic students today, with another 70 students getting degrees in acupuncture and 90 are matriculating in clinical nutrition programs. The college has added online courses in clinical nutrition and the mostly online HAPI program (for human anatomy and physiology instruction) for healthcare professionals who want to teach anatomy and physiology. One other thing Nicchi oversees is the business of the college, with 200 full-time employees and another 120 part-timers, and a student body that has kept local businesses humming — like those that deliver pizza to the dorms after midnight and otherwise cater to the student population. Put the salaries of employees and all the commerce they and the student body generate, and that means $67.6 million charging the local economy, based on data from the Council on Independent College and Universities. Today’s graduates of the New York Chiropractic College, Nicchi believes, are so much better prepared for their profession in every way because of the quality of the instruction and the opportunities provided to students. On his watch, with the innovators who work with him, he expects even more.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • August 2015