Lancaster Thriving Winter 2025 by Hoffmann Publishing Group

Goals for 2025

GLP-1 MEDICINES FOR TREATING CONDITIONS BEYOND DIABETES AND OBESITY

WHAT EXACTLY IS “WALKING PNEUMONIA"

BY JENNIFER BRUBAKER, MD, FAAP

LEADERS, NEVER STOP ASKING, “WHY?” BY CHRISTOPHER MCCARTY,DO, MBA

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2025 BOARD OF DIRECTORS

OFFICERS

Sarah E. Eiser, MD President

Penn Medicine Lancaster General Health Physicians Lancaster Physicians for Women

Stacey S. Denlinger, DO

Immediate Past President

Highlands Family Practice & UPMC Wound and Hyperbaric Center

Robin M. Hicks, DO President-Elect

UPMC Supportive Care & Palliative Medicine

Christopher R. Scheid, DO Vice President College Avenue Family Medicine

James M. Kelly, MD Treasurer

Penn Medicine Lancaster General Health Physicians Family Medicine Lincoln

David J. Gasperack, DO Secretary WellSpan Health

DIRECTORS

Lena Dumasia, MD

Laura H. Fisher, MD

Anna Goetze, DO | Resident

Saima Khalid, MD, MPH, FAAFP, FACOEM

Logan Lawson, DO, MPH | Resident

Jessica Miller, MD | Resident

Karen A. Rizzo, MD, FACS

Daniel J. Schlegel, MD, MHA, FAAFP

Susanne E. Scott, MD, MPH

Danielle Rubinstein, DO

Osvaldo Zumba, MD

Mentzer

h E.

Stacey S. Denlinger, DO

Family

LancasterPhysicianis a publication of the Lancaster City & County Medical Society (LCCMS). The Lancaster City & County Medical Society’s mission statement: To promote and protect the practice of medicine for the physicians of Lancaster County so they may provide the highest quality of patientcentered care in an increasingly complex environment.

Practices

Hello Lancaster County,

The past few months have gone by in a flash, and now the winter season is upon us. At the end of October, delegates gathered from around the state for the annual Pennsylvania Medical Society House of Delegates (HOD) meeting, held both virtually and in-person at the Hershey Lodge. The theme of this year’s event was “make a connection” and new connections are always made—which is one of the many benefits of participating in such an important meeting. Many interesting and varied resolutions were introduced for review and discussion and then voted on for adoption or amendments. Read more about the activities of this year’s HOD on page 27.

This issue of Lancaster Physician covers a very popular topic right now, GLP-1 drugs, specifically new studies looking at off-label treatment uses. You will also read about walking pneumonia and RSV, which have both been diagnosed much more frequently than we typically see in young patients this season.

Recurring segments include health care system Best Practices, Legislative Updates from PAMED, a Frontline Group Spotlight, a Member Spotlight, a member’s Passion Outside of Practice, and more.

As always, if you have thoughts or ideas for upcoming issues, and/or you would like to be considered to contribute an article, please let us know!

Have a happy and safe winter season!

Sarah Eiser, MD Penn Medicine Lancaster General Health Physicians Lancaster Physicians for Women

You’re proud to be a physician. Support the organization dedicated to serving you and your passion.

United we are stronger and can work together to make a positive impact in Lancaster County medicine and beyond.

If you aren’t already a member, we hope you’ll consider a membership investment in LCCMS.

Scan the QR code below to learn more.

best pr ctices

• Penn Medicine Lancaster General Health Provides a Well-Being Coach to Help Health Care Workers Build Resilience Against Burnout

• Penn State Health Lancaster Medical Center Expands Treatment Options for Vascular Disease

• Practice Management Insights: Leaders Never Stop Asking, “Why?” ALSO IN THIS SECTION

WELLSPAN OUTPATIENT CENTER AT CITYGATE

Opens Outside of Lancaster

New facility offers specialty surgery and medical care

The WellSpan Outpatient Center at CityGate is bringing specialty surgery and medical care to Lancaster in a stateof-the-art $23 million facility on the northern edge of the city, close to Route 283 and Route 30.

The 34,000-square-foot outpatient surgery center and medical office building opened in early January. It initially is offering ear, nose, and throat (ENT) surgery for both children and adults as well as urology, gynecology, and plastic surgery.

“Our patients asked us for access to care closer to their homes. As our network of providers expands in Lancaster County, this was a natural outgrowth of that,” says Jim Stuccio, WellSpan senior vice president for the East Region, which includes Lancaster County. “We will be able to meet and treat patients where they are in this brand-new facility. We want to offer the right care, in the right place for our community.”

The surgery center features three outpatient operating rooms and an adjacent 20-bed pre-/post-anesthesia care area, including two private rooms. Surgery patients also can obtain outpatient lab services in the center. And the center offers imaging services, including X-ray and MRI services, by appointment.

Medical offices are located on the top floor of the two-story building, situated between Fruitville and Manheim pikes, just

north of Dillerville Road. The WellSpan Urology practice and WellSpan Plastic Surgery practices will be situated in the medical office building, with additional practices opening there in the future.

The surgery center and medical office building is a testament to the convenient care that WellSpan offers its patients, Stuccio says.

Parking is located underneath the building as well as in a surrounding lot, offering space for about 150 vehicles.

Left:Tina Citro, vice president, WellSpan Health, and president, WellSpan Ephrata Community Hospital, and Jim Stuccio, WellSpan senior vice president for the East Region, in an operating room in the new facility. Above: An exam room in the medical office building. The historic Mayer-Hess farmhouse on Fruitville Pike is visible from the window.

Steven Fetrow-Keihl, PhD, PsyD, LMFT, leads a self-compassion training session for employees.

Health care workers are often seen as the heroes in scrubs who come to save the day for their patients and community. But just like everyone else, they face troubles and stressors under the surface. Not only has work-related stress increased for health care workers—specifically since the COVID-19 pandemic—but psychologists widely agree there is mounting evidence that society is experiencing the psychological impacts of a collective trauma, according to the most recent 2023 Stress in America study.

At Penn Medicine Lancaster General Health, a new well-being coach is now available to help staff de-stress and unload some of their mental burdens.

MEETING THE MOMENT

A 2021 employee survey showed high levels of stress and burnout due to the pandemic at Lancaster General Health. In response, a burnout taskforce was formed to address the problem. One of the strategies this team implemented was hiring a well-being coach to meet with employees to not only discuss work stress, like intense patient traumas they encounter, but also non-work-related stressors like finances, relationships, recovering from surgery—whatever could be causing them hardship.

Steven Fetrow-Keihl, PhD, PsyD, LMFT, started in November 2022 as a part-time employee well-being coach through Quest Behavioral Health, and became a full-time Penn Medicine employee with the title of advanced well-being coach in August of 2024. As a therapist with a specialization in traumas, relationships, and addictions, Keihl finds working with health care workers is a particular passion.

“Health care workers have a culture and dialogue that’s specific to them, uniquely different than the outside world, and a culture that frequently goes without,” Keihl said.

Penn Medicine fosters a culture that gives health care workers access to resources to support their well-being. PennCOBALT is an online program which holds individualized trainings, videos, and podcasts, as well as live one-on-one sessions with peers, resilience coaches, and therapists. Penn Medicine also offers eight free Employee Assistance Program (EAP) sessions per year which can be used by most mental health practitioners.

HOW THE WELL-BEING COACH WORKS WITH HEALTH CARE STAFF

The advanced well-being coach has varying levels of interaction with staff, but in every conversation the focus is not on work, metrics, or patients, but rather specifically about the employee’s well-being.

Employee interactions range from five-minute hallway check-ins to 10-minute private conversations with an employee navigating a personal or professional distress, to scheduled consultations of half an hour or more at any

LG Health location. There is the opportunity to also schedule a virtual consultation. Consultations are separate from an employee’s eight free Employee Assistance Program (EAP) sessions. There could also be a recommendation for longer, formal sessions with a mental health professional if needed.

All meetings are confidential, free of charge to employees, and no information or data is stored in the employee’s personal electronic health record.

On average, the well-being coach completes 60 check-ins and about 10 consultations on a weekly basis.

Departments may call on the well-being coach for support following a “critical incident response” after an incident such as a code blue, stroke alert, trauma code, pediatric death, or act of violence against health care workers. Partners outside of Penn Medicine affected by the incident, such as EMTs, are sometimes invited to join in these support meetings.

Michael Killinger, MSN, RN, regional director of operations, member of the LG Health Burnout Taskforce, and manager of the position, said, “We want to be asking employees, what can we do today to make tomorrow better?”

CARING FOR THE CARE PROVIDER

Physical, mental, emotional, and spiritual health are often called the pillars of well-being. Individuals need to care for all these elements to achieve balance in their lives—a well-being coach can provide the tactics needed to support this balance. Organizations can help support their employees’ well-being by creating a culture where it is a safe place to talk and take a break when needed.

Expands Treatment Options for Vascular Disease

Penn State Health’s Heart and Vascular surgery team mark the first TCAR procedure at Lancaster Medical Center in October 2024.

Patients in Lancaster County now have access to advanced care for vascular disease close to home.

Penn State Health began offering transcarotid artery revascularization (TCAR) and endovascular thrombectomy (EVT) procedures at Lancaster Medical Center in October 2024, broadening the range of treatment options available.

“We’re proud to provide a full spectrum of treatments for vascular disease,” said Dr. Faisal Aziz, chief of the Division of Vascular Surgery at Penn State Heart and Vascular Institute. “This milestone reflects our growth as a health system and our commitment to bringing advanced care closer to the communities we serve.”

New patients are welcome and can expect to see a doctor within days. Patients may be referred for appointments by their doctors or call to make an appointment themselves.

TRANSCAROTID ARTERY REVASCULARIZATION

TCAR is a minimally invasive surgical procedure that treats carotid artery disease and, in some instances, can be used as an alternative to carotid endarterectomy or carotid angioplasty and stenting. While it is not appropriate for all patients, Aziz said it’s desirable for many because it reduces the risk of stroke during treatment.

“We know that carotid artery disease is a leading cause of stroke, but traditional treatments carry a risk for stroke,” Aziz said. “TCAR significantly reduces that risk, making it a promising option for many patients.”

During a TCAR procedure, surgeons reverse blood flow through the carotid artery, rerouting it away from the brain to prevent any loose pieces of plaque from traveling to the brain and causing a stroke while a stent is being inserted.

The risk of stroke during a TCAR procedure is less than 1%, Aziz noted.

Tens of thousands of patients have undergone TCAR procedures since the treatment was approved by the U.S. Food and Drug Administration in 2015. Penn State Health completed its 300th TCAR procedure systemwide in October

2024, offering the treatment at Penn State Health Milton S. Hershey Medical Center, Holy Spirit Medical Center, and St. Joseph Medical Center, in addition to Lancaster Medical Center.

ENDOVASCULAR THROMBECTOMY

Also minimally invasive, EVT is used to remove blood clots from arteries and veins. It is frequently performed to treat ischemic stroke by removing a blood clot from a blocked artery in the brain but also is used to treat many other conditions, including heart attacks, aneurysms, and pulmonary embolisms.

Aziz said EVT is particularly effective in removing blood clots that could travel to the heart and lungs.

During the procedure, a catheter is inserted into small incisions in the groin and guided through blood vessels to the site of the blood clot using X-ray imaging. Once the catheter is in place, a stent retriever contained within captures and removes the clot.

EVT’s advantages over open surgery include small incisions, less stress on the heart, shorter recovery, less pain, and the use of local or regional anesthesia instead of general anesthesia.

Already available at other Penn State Health locations, EVT was introduced at Lancaster Medical Center in November 2024.

ADVANCEMENTS IN VASCULAR SURGERY

The field of vascular medicine, particularly surgery, has experienced rapid advancements during the past decade.

New devices and techniques, advances in stents, hybrid operations, hybrid operating rooms, and other innovations have significantly improved care for patients with vascular conditions.

Lancaster Medical Center is equipped with advanced cardiac catheterizations labs and a leading-edge hybrid operating room that features high-precision imaging technology, enabling surgeons to perform both minimally invasive and open vascular surgeries.

Aziz said that while surgical procedures have not changed, the way they are performed has changed dramatically.

“It’s a very exciting time for vascular surgeons,” he said. “I look forward to seeing how the field evolves in the future.”

Lancaster Medical Center began offering EVT to remove blood clots in November 2024.

ADDRESSING THE ISSUES, CHALLENGES, AND OPPORTUNITIES THAT IMPACT TODAY’S MEDICAL PRACTICES

Leaders Never Stop Asking, “Why?”

CHRISTOPHER MCCARTY, DO, MBA

WellSpan Family Medicine –Terre Hill

In leadership (and life in general) we should never stop asking, “Why?”

Why?

Recognizing the “why” helps us to understand ourselves, our team, and our mission. It allows us to be intentional with how we spend our time and energy, focusing more on the future (our vision) and less on the immediate (stuff that needs to get done today).

Let’s break this down into the three main “whys” you need to know as a leader.

Your “why”

I’m willing to bet that you don’t work in health care just to make a paycheck. (If you do, you should know there are way easier ways to make money.)

There is something more that drives you and that is your “why.” It’s that thing that motivates you to work long days and gracefully deal with complicated problems. When you know your “why,” you know your purpose.

So how do you figure out your “why”?

Think about what impact you want to have in your work. Next, write down that impact and the major action you need to do to accomplish that impact.

For me, I want to equip people with leadership skills (action) so they can flourish in both their personal and professional lives (impact). I know I need to help my team understand their own “why” so they can thrive, through providing support, coaching, and listening.

Your team’s “why”

It’s just as important to know the “why” of your team members.

Why?

As leaders, we want to match the “why” of our team members with the work they are doing. Think about times when your work didn’t align with your “why.” Did you feel engaged? No!

The first step to creating any change is understanding why that change is occurring.

In health care, the alignment is often there but buried because of our myopic view. Instead of seeing how the bigger picture matches up with our own “why” we are too focused on hitting certain metrics or achieving a small part of the overall goal. Taking a step back to see the alignment does wonders for team engagement. Remember, our “why” is our purpose, and it’s incredibly motivating to do work that fits in with our purpose.

Kimberly Bahata, WellSpan Health’s vice president of operations for the women and children service line and chief nursing officer for the WellSpan Medical Group, has worked to integrate “why” into her teams for decades. She regularly runs her teams through a “why” workshop where she has everyone write down their “why” and hang it up on a board for everyone to see. Kim shared several of the responses from her last workshop and the passion driving her team was so infectious! Check out this example: “I want to help people and better their lives through the power of effective communication.”

Do you know the “why” for your team members? If not, try having each member create their own “why” statements and share them.

Your mission’s “why”

At work, we are constantly on a mission (or more like missions). Yes, most organizations have a mission statement, but what I am talking about are those strategic initiatives we all constantly face. These can include improving patient safety, decreasing administrative burdens, and increasing cancer screening rates, to mention a few.

It’s imperative that we understand the “why” behind these missions.

Why?

This goes back to alignment. Our goal is to match our team members’ “why” with the “why” of the mission we need to accomplish.

These missions require us to constantly be in a state of change. Change is not often easy as it takes intentional steps to help set up new habits. (My wife just moved the trash can in our bathroom, and I keep throwing dental floss on the ground where the can used to be.)

The first step to creating any change is understanding why that change is occurring.

Dr. David Gasperack, WellSpan Health’s vice president and chief medical officer of the primary care service line and regional chief medical officer, believes that explaining the “why” prior to any new initiative is critical to a successful outcome. He has seen this help increase buy-in, reduce resistance, and ensure that everyone is moving in the right direction. It also builds trust, something essential for change management.

So, what are the initiatives that you are struggling to implement? Have you clearly defined the “why”?

GLP-1 Medicines for Treating Conditions Beyond Diabetes and Obesity

POTENTIAL HEALTH BENEFITS AND RISKS

GLP-1 medications like Ozempic® (semaglutide), Trulicity® (dulaglutide), and Wegovy® are becoming mainstays for treating type 2 diabetes and obesity. And researchers are exploring ways they might also help prevent or treat other conditions.

Lancaster Physician asked member physicians in the addiction medicine and geriatric specialties to share their insights about the potential role of GLP-1 drugs in improving patients’ health.

JON LEPLEY, DO

Penn Medicine Lancaster General Health Physicians Addiction Medicine

1. In your specialty, for what types of conditions do GLP-1 medications show promise?

In addiction medicine, GLP-1 medications show the most promise for treating tobacco use disorder and alcohol use disorder. However, it is essential to note that further studies are needed, and effective medications already exist for these conditions. Varenicline and naltrexone are examples of existing medications long proven to aid in smoking cessation and reduce heavy drinking, respectively. Both are under-utilized.

2. Are there any specific study outcomes that are noteworthy, and what have they indicated?

One well-designed study showed that a GLP-1 medication, exenatide, helped people quit smoking. All patients in the study received standard nicotine replacement therapy and counseling. It is important to note that all study participants had metabolic diseases such as obesity and prediabetes, which are valid indications for exenatide themselves. Yet, another study in patients who did not have metabolic diseases showed no improvement in smoking cessation when a GLP-1 medication was added to standard treatment.

Studies of GLP-1 agonists in patients with alcohol use disorder show similar findings. A significant reduction in heavy drinking is observed in those patients who have metabolic diseases such as obesity and elevated blood sugar. Yet, in patients with low or normal body mass index (BMI), these medications show no benefit and may even increase heavy drinking.

3. What are the potential benefits and risks for patients interested in GLP-1 medications to treat their substance use disorder?

Patients who already have an existing problem with obesity, insulin resistance, or type 2 diabetes mellitus alongside a substance use disorder (SUD) should consider utilizing a GLP-1 medication. The medication will treat their metabolic disease, and they may find it easier to quit smoking or reduce heavy drinking.

Presently, there is no reason to think that a GLP-1 medication will help treat SUD in patients who do not have metabolic disease. One study even

showed increased alcohol consumption in people with a BMI less than 25. GLP-1 medications should be reserved for treating metabolic diseases and perhaps preferentially selected for those who also have a co-existing SUD.

4. What else should patients know, and where can they get more information?

Addiction problems are common. At some point in their life, about 30% of people have problems with alcohol, and roughly 10% have problems with illicit drugs. Patients should talk to their primary care provider if they have a problem.

ALISON MERCIER, MD

Associate Program Director Lancaster General Hospital Geriatric Medicine Fellowship Geriatrician Penn Medicine Lancaster General Health Physicians Geriatrics

1. In your specialty, for what types of conditions do GLP-1 medications show promise?

In Geriatrics, it is often challenging to propose one comprehensive statement regarding the benefit of medications, as is true for GLP-1 agonists. Older adults are often excluded from clinical trials and represent a population with varying degrees of comorbidities, cognitive abilities, and function. Additionally, their life expectancy may limit the time to benefit of certain medications.

2. Are there any specific study outcomes that are noteworthy, and what have they indicated?

GLP-1 agonists show promise in treatment of T2DM in older adults. A meta-analysis reviewing several leading trials1234 evaluating the efficacy of different GLP-1 agonists for T2DM showed that the improved cardiovascular morbidity and mortality outcomes demonstrated across all age groups persist regardless of frailty.5 However, in a newer retrospective study, GLP-1 agonists increased rates of hospitalization due to severe hyperglycemia and increased progression to renal failure requiring dialysis or transplant across frail adults.6 Both of these studies excluded the most frail individuals, nor did they review

other important outcomes including risks of dehydration, falls, and institutionalization.

Mechanistically, GLP-1 agonists show promise in attenuating multiple pathways leading to Alzheimer’s and Parkinson’s disease via reduced oxidative stress, decreased neuronal inflammation, etc.7 However, these benefits have yet to show clinical efficacy in using GLP-1 agonists for those with dementia.8

3. What are the potential benefits and risks for older adult patients interested in GLP-1?

Identifying frailty in older adults can predict potential harms from medication (see eFrailty. org for frailty measurement tools). As frailty increases, physiologic reserve decreases and so too does the ability to manage stressors and maintain homeostasis. This leads to more susceptibility to medication side effects. In frailty, muscle mass is replaced by adipose tissue. Weight loss is often a desired side effect of GLP-1 agonists. In older adults, this weight loss may be from loss of muscle mass, ultimately leading to reduced function. Unintentional weight loss in frail older adults often leads to poor outcomes.9 There is currently no research focusing on obesity management with GLP-1 agonists in older adults.

4. What else should patients know, and where can they get more information?

Prior to initiating GLP-1 agonists in older adults, clinicians must be thoughtful about the risks and benefits and individualize their decision followed by close monitoring. Patients are encouraged to reach out to their primary care providers to discuss if this medication would be right for them.

1. Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, Nissen SE, Pocock S, Poulter NR, Ravn LS, Steinberg WM, Stockner M, Zinman B, Bergenstal RM, Buse JB; LEADER Steering Committee; LEADER Trial Investigators. (2016). Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 375(4):311-22.

2. Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T; SUSTAIN-6 Investigators. (2016). Semaglutide and Cardiovascular Outcomes

in Patients with Type 2 Diabetes. N Engl J Med. 375(19):1834-1844.

3. Holman RR, Bethel MA, Mentz RJ, Thompson VP, Lokhnygina Y, Buse JB, Chan JC, Choi J, Gustavson SM, Iqbal N, Maggioni AP, Marso SP, Öhman P, Pagidipati NJ, Poulter N, Ramachandran A, Zinman B, Hernandez AF; EXSCEL Study Group. Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 377(13):1228-1239.

4. Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, Probstfield J, Riesmeyer JS, Riddle MC, Rydén L, Xavier D, Atisso CM, Dyal L, Hall S, Rao-Melacini P, Wong G, Avezum A, Basile J, Chung N, Conget I, Cushman WC, Franek E, Hancu N, Hanefeld M, Holt S, Jansky P, Keltai M, Lanas F, Leiter LA, Lopez-Jaramillo P, Cardona Munoz EG, Pirags V, Pogosova N, Raubenheimer PJ, Shaw JE, Sheu WH, Temelkova-Kurktschiev T; REWIND Investigators. (2019). Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet (394:10193):121-130.

5. Strain, W.D., & Griffiths, J. (2021). A systematic review and meta-analysis of the impact of GLP-1 receptor agonists and SGLT-2 inhibitors on cardiovascular outcomes in biologically healthy adults. The British Journal of Diabetes (21:1):30-35.

6. Hsaio F., Tan E.C., Meng L., Lin Y., Chen H., Guan S., Tarng D., Wan C., & Chen L. (2024). Effect of frailty on effectiveness and safety of GLP-1 receptor agonists versus SGLT2 inhibitors in people with type 2 diabetes in Taiwan: a retrospective, nationwide, longitudinal study. The Lancet (5):1-12.

7. Du H., Meng X., & Xu J. (2022). The mechanism and efficacy of GLP-1 receptor agonists in the treatment of Alzheimer’s disease. Frontiers in Endocrinology (13).

8. Monney M., Jornayvaz F., Gariana K. GLP-1 receptor agonists effect on cognitive function in patients with and without type 2 diabetes. Diabetes & Metabolism (49:5): 1-12.

9. Jayanama K., Theou O., Godin J., Mayo A., Cahill L., & Rockewood K. (2022). Relationship of body mass index with frailty and all-cause mortality among middle-aged and older adults. BMC Medicine (20:404):1-12.

What Exactly is “Walking Pneumonia

Why Are We Seeing More of it This Year?

How Can You Stay Healthy This Winter?

JENNIFER BRUBAKER, MD, FAAP Union Community Care

The term “walking pneumonia” was introduced in the 1930s. At that time, there was a widespread realization in the medical community that a “milder” form of pneumonia existed, which didn’t develop the same lobar pattern of infection on x-ray or clinical exam but seemed instead to cause milder—albeit more diffuse—lung inflammation. Even though there were serious cases with this type of pneumonia, many people had less severe forms and were able to walk around and continue their daily lives, leading to the term “walking pneumonia.” The more medically correct term now used is “atypical pneumonia,” which contrasts with typical bacterial lobar pneumonia, most commonly caused by Streptococcus pneumoniae.

It was not until the 1940s that the organism responsible for most cases of atypical pneumonia, Mycoplasma pneumonia (M. pneumoniae), was first isolated from a patient by Dr. Eaton. Its classification as a bacterium occurred even later, not until the 1960s. M. pneumoniae is an atypical bacterium because its cell volume is much smaller (less than 5%) of other bacteria, and it lacks a cell wall, making it resistant to many antibiotics, such as beta-lactams, used to treat other types of pneumonia. We now typically use azithromycin or another macrolide antibiotic to treat M. pneumoniae. This treatment was first introduced in the late 1980s. Before then, tetracyclines were primarily used.

This year, starting in June and currently ongoing, cases of atypical pneumonia from M. pneumoniae have been greatly increased across the country, reaching10-20x last year’s levels depending on the area. In Pennsylvania, the Department of Health put out a health advisory this past October warning of the increase as well as increases in other respiratory viruses, especially rhino/enteroviruses, which can cause similar symptoms. M. pneumoniae tends to have peak increases every three to seven years, and until now, has not had one since the COVID-19 pandemic. It often peaks in school-aged children, but this year preschool children (2-4 years old and even the 0-2 year-old group) are also having more infections than usual. Previously M. pneumoniae has been uncommon in the under 4 year-old age group making this change significant. It is not an officially reportable disease, so it can be hard to get accurate data, but the CDC estimates there are likely more than 2 million infections with M. pneumoniae in the United States each year and more during peak outbreaks. Anecdotally, our practice is currently seeing increased numbers of cases.

Atypical pneumonia can be hard to diagnose because it presents similarly to many viral infections, including influenza, RSV, rhino/ enteroviruses, COVID-19, and other forms of bacterial pneumonia. It often starts out like a “common cold” with nasal congestion, cough, headache, fever, and a general feeling of fatigue and malaise. In younger children it can also present with vomiting, diarrhea, and wheezing, which are less typical in older children. In contrast to other infections, M. pneumoniae tends to be more persistent, with

the symptoms lasting longer than many of the common viral respiratory infections. Testing for M. pneumoniae is more typically found in hospital and emergency department settings and is infrequently used in outpatient settings. It is often diagnosed by a respiratory swab as part of a larger panel for diagnosing all the viruses listed above. In the office setting, it is usually diagnosed clinically with history and physical exam findings and sometimes with the help of a chest x-ray.

M. pneumoniae has a long incubation, from two to three weeks, so it can spread through a family for a long period of time, even one to two months. It is transmitted by respiratory droplets when an infected person sneezes or coughs. It can be present on hands and surfaces and be transmitted when someone else touches an infected surface and then touches their mouth or nose. It has a long clinical course, and even with antibiotic treatment, symptoms (especially cough) can last one to two months, but often in a mild form.

There is no current vaccine for M. pneumoniae, so prevention includes:

• Good handwashing habits

• Covering mouth and nose when coughing or sneezing

• Cleaning and disinfecting surfaces and toys

• Avoiding crowded places

• Maximizing immunity by eating well and getting enough sleep

Influenza, COVID-19, and respiratory syncytial virus (RSV) can also cause cough, congestion, fever, headache, and malaise and can be clinically confused with M. pneumoniae. Testing for them is available in many outpatient settings, and all these respiratory viruses have vaccines available this winter. The American Academy of Pediatrics and the CDC recommend that children 6 months of age and older receive influenza and COVID-19 vaccines for the 2024-2025 fall/winter season.

Even with the increased prevalence of M. pneumoniae this year, RSV is still the most common cause of acute respiratory infections in young children, with around 80,000 hospitalized each year. RSV causes proportionally more severe disease in infants less than 6 months of age. In the United States, RSV season typically begins in the fall and ends in the spring. This was disrupted by COVID-19 but now seems to be back to its typical seasonal pattern. People now have two options to help prevent RSV infection in their infants: a maternal vaccine (Pfizer’s Abrysvo®) given during pregnancy September through January and recommended for women who are between 32 and 36 weeks pregnant OR an RSV antibody (nirsevimab, brand name Beyfortus®) given to babies after birth. You don’t need both.

Nirsevimab was only available in limited quantities last season, but this year is more widely available in many outpatient offices. It generally is well tolerated with mild side effects in most infants. It is a one-dose passive immunization, which means the baby receives preformed antibodies that provide protection for about five months, which should get them through an RSV season. This is in contrast to a typical vaccine with the goal of inducing the baby’s own immune response. Nirsevimab is recommended for babies under 8 months of age (whose mothers did NOT receive the Abrysvo vaccine) at the start of the RSV season (November-March) or any baby born during the RSV season, administered at birth or anytime afterward during the season.

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BMC Med Imaging. 2009 Apr 29;9:7. doi: 10.1186/1471-2342-9-7

Front Microbiol. 2016 Mar 22;7:364. doi: 10.3389/fmicb.2016.00364

American Academy of Pediatrics: https://publications.aap.org/redbook/resources/25379/ AAP-Recommendations-for-the-Prevention-of-RSV Center for Disease Control: www.cdc.gov

National Institute of Health: https://www.ncbi.nlm. nih.gov/books/NBK430780/

Breast Care Navigators Support Cancer Patients Every Step of Their Journey

TRACEY WEIDNER, RT(R)(M)(BD), BHCN WellSpan Breast Care Navigator

As a WellSpan breast care navigator, I work with patients who face a breast cancer diagnosis. I meet patients when they are diagnosed and work with them during their treatment and even afterward. Put simply, I put my arm around patients, walk with them and offer resources during what can be a very challenging time.

I have a background as a radiologic technologist, working in mammography and women’s imaging for about 20 years, so I am very familiar with the diagnosis process for patients and what those early minutes, hours, and days are like for people who receive a new cancer diagnosis.

There are so many questions that patients have. Some common ones are “Will everyone be able to tell I’ve had breast surgery?” and “How will I be able to afford treatment if I have to miss work?”

My job is to be an available contact person and offer any information and support patients need. I strive to build relationships that encourage patients to feel comfortable asking me any and all questions and to always take the time to talk through and address each of their questions and concerns.

Letting patients know up front that there are resources available to them can help to alleviate some of their anxiety. Knowing that I will help them get fitted for new bras and prosthetics if needed, or that WellSpan has a Cancer Patient Help Fund to financially

assist them with everyday living expenses makes a huge difference for our patients.

Breast cancer treatment is a journey with many steps. Patients are often referred to multiple specialists, such as medical oncologists, radiation oncologists and plastic surgeons, to discuss different aspects of their treatment plan. They might meet a plastic surgeon to discuss reconstructive surgery or a physical therapist to learn about lymphedema management.

I will sometimes accompany patients on these visits to provide support. Knowing they will see a familiar face at an upcoming appointment can help relieve some anxiety. I have taken notes for patients, offered hugs, or just been a comforting presence for them at these appointments.

Breast cancer can affect men and women at many stages of life. Of course, each patient is different, and I personalize the support they need.

I closely consider cultural backgrounds. For example, when I’m working with patients from the Plain Community, I schedule times to call them and specifically discuss who will be answering the phone at the number provided because they often do not have phones in their personal homes. I want to make sure I can reach them directly, so they have all the information they need.

I also work with many patients who have moved to the United States after living for most of their lives in a different country. Understanding what health care was like for them before

coming to the U.S. helps me explain processes and procedures to them in the context of their past experiences.

It’s important to me that all patients feel that their beliefs and wishes are heard and respected. It is a privilege to work in Lancaster County and learn more every day about the diverse cultures we serve.

My relationship with patients goes on after chemotherapy or radiation treatments end.

I am at patients’ follow-up visits so they know that I am still there for them and will continue to be an available resource. We want patients to remain healthy, feel good, and thrive throughout their lives.

After breast cancer treatment, this can mean making sure patients have bras that fit and that they feel good in, that they have information about healthy eating or healthy habits as they recover from their treatment, and that they know about support groups where they can share their experiences with other survivors. Checking in with patients to ensure they have the resources they need to feel good about themselves is an important part of my job.

Being a breast care navigator allows me to help people during a scary, uncertain time in their life. I love knowing that I can provide comfort and reassurance to them when they may need it most. Every day in this position is an opportunity for me to share compassion and knowledge with others.

Family

Medicine Resident Physician, Penn Medicine Lancaster General Health

It’s our pleasure to highlight a Lancaster City & County Medical Society member’s “passion outside of practice” in each issue of Lancaster Physician. Beyond their commitment to health care, LCCMS members have many other talents, skills, and interests that might surprise you. In this issue, we’re thrilled to feature Logan Lawson, DO, MPH, and her passion outside of practice.

Nature Photography Logan Lawson, DO, MPH

Would you briefly describe your passion outside of practice for those who might be unfamiliar with it?

One of my hobbies outside of practice is nature photography. Whether I am traveling to a new location abroad, doing a short day trip, or staying in Lancaster, there are so many opportunities to capture vivid images that bring me peace.

How did you develop an interest in your passion outside of practice?

Going to undergrad in the rural town of Williamstown, MA, I was in the community’s hiking club. When I would go out and explore, I loved to take photos to remember my adventures. I continued this post-grad, but when I moved to Philadelphia for medical school, my landscapes changed. I still craved being around greenery. It was attainable, but I had to intentionally seek it. At this time, having house plants and flowers uplifted my spirit with long study hours. I then began to take photos of them and create projects such as drying as well. Now that I am in Lancaster, there is an abundance of opportunities for natural/landscape photography.

How long have you been participating in this activity? I started taking more photos of nature as an undergraduate student. It has been approximately eight years, and it evolves with each new chapter of my life.

Why is this pursuit special to you?

I intentionally try my best to live in a sustainable way to honor our planet. Taking time to appreciate surrounding environments is also extension of my respect for natural resources.

What else would you like readers to know about this passion?

I am looking forward to continuing to develop my photography skills in the future! One of my next steps is to find works of others who have a similar attraction to nature/landscapes. If I happen to cross paths with anyone reading this, I would love to hear recommendations for sites I should visit in Lancaster.

Oregon Coast 2024

Williamstown Sunrise Hike 2016

Al Lahbab Desert (near Dubai) 2024

Logan Lawson

Goals for 2025

SUSAN SHELLY Writer

Looking at trends in health care is always interesting, but perhaps especially so this year with the rapidly increasing use of artificial intelligence (AI), uncertainty regarding President-elect Donald Trump’s health care appointees and their plans, public opinion regarding the insurance industry, expansion of behavioral health care, and other developments waiting to unfold.

The health care industry is expected to face an ongoing decline in the number of people entering the workforce and will look at increased use of technology and AI to supplement the work of employees and reduce the potential for mistakes and burnout.

James Stuccio Health Care Systems Serving Lancaster County Reveal

It will deal with a predicted rise in medical cost growth, which, according to Definitive Healthcare, is set to reach its highest level in 13 years due to rising costs for supplies and labor, prescription drug spending, increasing use of behavioral health services, and other factors.

Trump appointees are expected to challenge health care initiatives such as diversity, equity, and inclusion and health equity, and analysts say trust in traditional medicine and public health could continue to erode.

Sorting through predictions and trends is interesting, indeed, and everyone in the health care industry will be watching carefully to see what happens on a national and global level.

Taking a more local approach, Lancaster Physician reached out to the health care systems serving Lancaster County to learn more about their plans and goals for 2025. Representatives of WellSpan Health, Penn State Health, and Penn Medicine Lancaster General Health responded.

WellSpan Health

WellSpan Health has wide-ranging plans in place for 2025, while continuing its long-term commitments to increasing diversity, removing barriers to access of care, and moving forward its Gene Health Project, a community health research program that offers no-cost genetic tests to help determine potential risk for certain diseases.

James Stuccio, senior vice president of WellSpan Health’s East Region, discussed the health care system’s plans for increasing its use of artificial intelligence (AI), continued expansion of services to patients

in Lancaster County, partnership agreements with Temple University and Jersey College, a significant enhancement to WellSpan York Hospital, the construction of three neighborhood hospitals in York County, and other initiatives in place for 2025.

Stuccio attributed many of the plans and initiatives as WellSpan’s responses to the COVID-19 pandemic—a ground-shifting event for nearly every health care system.

“The pandemic forced us to rethink our plans and the very way we do things,” Stuccio said. “In light of staffing shortages and other challenges, we needed to get creative and figure out how we were going to continue moving forward.”

One response was to increase its use of AI to support clinical teams and provide increased access to care for patients.

WellSpan recently partnered with Hippocratic AI, a company that developed an AI large language model that contacts patients by telephone and interacts with them in their language to remind them of appointments, schedule preventative screenings, help patients prepare for screenings, and perform other services.

The program, said Stuccio, was widely accepted by patients during a trial period and will be expanded to serve others.

“We’ve found that patients really take to this,” Stuccio said. “And we’ve found it enables us to reach those patients who might have language barriers or find it difficult to access our patient portal. We plan to use this tool more widely and will be adding languages as we move forward.”

Another AI program expected to increase in use in 2025 is Artsight’s Smart Hospital Platform, an AI system that monitors patients at high risk for falls, augmenting the work of the nursing staff by freeing them up to perform other direct-patient care.

“We trialed it in the East Region and it was so successful and highly regarded that we’ll continue expanding it throughout the whole

system,” Stuccio explained. “We’ve seen falls reduce dramatically with its use.”

WellSpan will continue to expand services to patients in Lancaster County with the openings of a 34,000-square-foot surgery center in the CityGate Corporate Center in January and a Pain & Endoscopy Center in Brownstown sometime this spring.

The surgery center will house numerous WellSpan specialty practices.

Providing additional services in Lancaster County is an effort to improve overall patient care and increase patient satisfaction.

“These are major undertakings for WellSpan, initiated with the intention of bringing care close to home, which is what our patients tell us they want,” Stuccio said.

Outside of Lancaster County, WellSpan is expanding its footprint with the construction of three neighborhood hospitals in Cumberland and York counties.

Each will house an emergency department and up to 10 inpatient beds, providing roundthe-clock care in convenient locations for patients. The hospitals, set to open in late fall 2025, are fully licensed and integrated with WellSpan systems.

“These are appealing to us in the industry because they allow us to be nimble,” Stuccio said. “And they bring care closer to people’s homes.”

The ongoing expansion and renovation of WellSpan York Hospital will be continuing throughout 2025. The centerpiece of the expansion is a new eight-story surgical and critical care tower featuring larger, state-ofthe-art surgical suites and advanced medical and robotic technology.

With a planned completion date of early 2027, the project will transform WellSpan York into one of the largest hospitals in Pennsylvania.

Addressing staffing issues in a proactive manner, WellSpan Health plans to partner with the Lewis Katz School of Medicine at

Temple University to add a regional campus for medical students. During the fall of 2024, it also collaborated with Jersey College to establish a school of nursing. Both facilities will be located in York County.

The hope, according to Stuccio, is that students who graduate from these facilities will remain and work in Central Pennsylvania.

“We know they’re more likely to remain local and we hope that will enhance our staffing efforts,” he said.

While overseeing physical and program expansions, WellSpan management is holding fast to its commitment to increasing diversity and removing barriers to access to care, Stuccio said.

It also is working to expand its Gene Health Project, which has a goal of enrolling 100,000 patients in four years and in its first year tested about 30,000 patients. That project, according to Stuccio, is a long-term investment in community health.

WellSpan’s efforts to provide the best patient experience in the safest setting possible were recognized in July when it was awarded the American Hospital Association Quest for Quality prize for hospital leadership and innovation in quality performance improvement.

The award was gratifying, Stuccio said, as it recognized the efforts of every WellSpan employee.

“We work hard to empower all team members to strive for high reliability and a commitment to quality care for our patients,” he said. “It’s nice to be recognized for that.”

Penn State Health

Just a little more than two years after opening, Penn State Health Lancaster Medical Center has outperformed in nearly every area, with plans in place to continue building on that success in 2025.

“We are exceeding our expectations,” said Joseph J. Frank, regional hospital president, Joseph J. Frank

Continued on page 22

East Region, Penn State Health. “We are looking forward to some really exciting things happening in 2025.”

He predicted that services will continue to expand in areas including general surgery, vascular services, cardiology, urology, orthopedics, oncology and pediatrics, with more procedures and options available to local patients.

Frank said much of the rapid expansion of services in Lancaster County is due to the deliberate and ongoing efforts by Penn State Health administration to recruit outstanding staff members.

“We know that a great patient experience begins with a great staff, so we went out and built a very impressive and experienced clinical team,” Frank said.

The excellence of the staff is consistent throughout, he noted, enabling outstanding treatment and care for patients throughout the county. The hospital recently received national recognition from The Leapfrog Group as one of 134 Top Hospitals within the US for quality and patient safety in 2024. Lancaster Medical Center is one of only three Top General Hospitals in Pennsylvania and the only Top Hospital in Lancaster County.

More than 65,000 patients have been treated in the Emergency Department since the hospital opened, according to Frank, a number much higher than anticipated. The number of surgeries performed in hospital operating rooms also was more than expected.

In addition, Penn State Health has brought treatment options to Lancaster County it had not previously offered, including:

• Aquablation therapy, a new, minimally invasive robot surgical procedure to treat enlarged prostate.

• Transcarotid artery revascularization procedure, an innovative treatment to treat carotid artery disease while minimizing the possibility of stroke, both during and following the procedure.

• Endovascular thrombectomy (EVT), a minimally invasive operation used to treat ischemic stroke. EVT removes a blood clot from a blocked artery in the brain, which can restore blood flow and prevent further brain damage.

“We will continue building on those services in 2025 to provide the best experience for patients in Lancaster County,” Frank said. “We’re very happy to be able to make these services more readily available.”

Plans are also in place to continue expanding access to specialized surgery for pediatric patients. Pediatric experts in plastic surgery, urological surgery and gastrointestinal surgery from Penn State Health Children’s Hospital perform non-emergent surgical procedures at Lancaster Medical Center, with follow-up care provided at Penn State Health Children’s Lancaster Pediatric Center.

“These are highly specialized pediatric physicians performing a range of surgeries right here in Lancaster County,” Frank said. “That’s an advantage of being part of an integrated academic health system.”

While Frank is optimistic about Penn State Health’s ability to continue expanding its services to Lancaster County residents in 2025, he does not overlook challenges facing health care systems nationwide.

Inadequate Medicare and Medicaid reimbursements, which account for most hospital utilization, coupled with significant increases over a wide range of expenses, are challenging hospitals in sobering ways.

“That’s not a problem that’s unique to Lancaster County or Pennsylvania, it’s a national phenomenon,” Frank said. “And it will cause us to continue to look for ways to rein in costs.”

Frank lauded Penn State Health’s partnership with Highmark, which he said has significantly contributed to improved access to health care for residents of Lancaster County. The health care system, Penn State University, and Highmark in 2017 announced they would invest $1 billion in the health and well-being of Central

Pennsylvanians, including the construction of Lancaster Medical Center.

Five years later, Frank said, the medical center is a result of that partnership, with Penn State Health recognized for providing a high level of patient care and satisfaction.

“I can tell you that Penn State University and Highmark Health are extremely proud of the great care that’s provided at Lancaster Medical Center each and every day,” Frank said.

Penn Medicine

Lancaster General Health

Penn Medicine Lancaster General Health’s focus in the new year will be on making breathtaking discoveries available to patients in settings close to home—or perhaps even at home.

John J. Herman, chief executive officer of Penn Medicine Lancaster General Health, said the health care system will continue to enhance access to services for Lancaster County patients, in part by delivering Penn Medicine’s state-ofthe-art treatments and services in ambulatory care settings.

He cited the system’s expanding infusion program, highlighting the local availability of lecanemab, a drug marketed as Leqembi, that is shown to slow cognitive decline in patients with early-stage Alzheimer’s disease.

LG Health has increased the size of its neurology team from six to 28 providers in the past five years, Herman said, enabling it to treat patients in ambulatory settings throughout the region.

“That team is bringing the lecanemab treatment to our patients in Lancaster County,” he said.

LG Health’s increased infusion capacity will complement its planned partnership with Willow Valley Communities, Herman noted. The continuing care retirement community has announced its intention to open a stateof-the-art memory care center in late 2025.

John J. Herman

Expanded infusion services also will benefit patients receiving chimeric antigen receptor (CAR) T cell therapy, a highly effective treatment for lymphoma, leukemia, and multiple myeloma. The therapy also has applications for non-cancer conditions such as lupus and rheumatoid arthritis.

Herman said LG Health has been able to greatly increase the number of CAR T therapies it offers for patients in ambulatory settings in Lancaster County and expects that trend to continue.

Lancaster County residents will have access beginning in January to a Behavioral Health Center in Lancaster General Hospital. The center will be open to people ages six and older who do not require inpatient or emergency treatment, but face conditions such as anxiety, depression, or substance abuse disorder.

Providing patients with rapid assessment, counseling, medication management, and connections to related resources, the center is meant to alleviate strain on local emergency departments.

Herman spoke about LG Health’s HealthWorks program, an employer-sponsored primary care health program that enables employees to receive care at their workplaces or virtually from their homes.

HealthWorks is currently in place at 12 locations in and around Lancaster County, Herman said, with that number expected to increase in 2025.

“It’s another way we’re making it as easy as possible for people to receive care,” he said.

LG Health is also striving to enhance work conditions for providers, Herman said, noting the importance of keeping staff members satisfied.

The system is offering flexibility for providers to choose where and how they work. Some physicians prefer traditional practices, Herman noted, while others want to treat patients at their worksites or in their homes.

“We’re working hard to meet physicians where they are and where they want to practice,” Herman said.

LG Health also is looking to help physicians by leveraging the use of artificial intelligence (AI) in various applications.

The use of ambient scribe, a technology that transcribes and summarizes conversations between clinicians and their patients, is streamlining the work loads of providers and allowing them to focus more directly on patients.

“We’ve adopted that and likely will have it available for all our physicians within six to 12 months,” Herman noted.

The system also plans to adopt augmented response technology (ART), an Epic tool that uses AI to draft a message from a clinician in response to a patient who has sought advice over a patient portal.

ART reviews the patient’s correspondence and creates a response, which is then verified by the provider. The program reduces the burden of physicians needing to respond to high volume of patient messages.

“The goal is to help our providers by giving them more time,” Herman said.

LG Health also is looking to AI to assist with radiology screenings and increasing its use of virtual appointments for residents of continuing care retirement communities.

“We’re doing everything we can to bring advanced treatment right here to Lancaster,” Herman said. “We have to be smart about using space and technology to our advantage to bring those breathtaking discoveries within reach of all our patients.”

Minnie Taw,

LEGISLATIVE UPDATES WINTER 2025

The 2023-2024 Pennsylvania Legislative Session began with the House Democrats taking a one-seat majority for the first time in over a decade. We also saw the election of Arvind Venkat, MD, the first physician elected to the State House since 1961.

The past year brought some consistency back to the Pennsylvania General Assembly’s 2023-2024 Session. While 2023 was fraught with resignations, special elections, and the constant question of who held the majority in the State House, 2024 saw more legislative functioning than what we saw in the year before.

PAMED saw movement on legislative proposals that impacted medicine, including bills that PAMED had as legislative priorities. These include, but are not necessarily limited to, the following in no order:

SCOPE OF PRACTICE

One area to highlight is PAMED’s continued vigorous opposition to bills that would expand the scope of practice to nonphysician providers throughout the Commonwealth. Senate Bill 25 (Bartolotta) and House Bill 1825 (Guenst), bills that would allow for the independent practice of nurse practitioners, were both reintroduced. At the time of this writing, Senate Bill 25 passed out of the Senate Consumer Affairs and Professional Licensure Committee and is awaiting final consideration from the PA Senate, while House Bill 1825 has received no action. House Bill 2037 (Bullock) was introduced, which would allow pharmacists to vaccinate children as young as the age of three, and we expect a Senate companion bill to be introduced soon. We have also seen a push to allow psychologists to prescribe medications in House Bill 1000 (Frankel), which we oppose. PAMED, and our physician specialty partners, will continue to advocate for physician-led team-based care.

TELEMEDICINE

The Pennsylvania Senate recently considered Senate Bill 739 (Vogel), legislation which would require health insurers to cover and pay for health care services provided via telemedicine. Senate Bill 739 passed

the PA Senate with a vote of 49-1 and then passed the PA House with a vote of 194-8. The bill was then signed by Governor Shapiro.

NONCOMPETE CLAUSES

Another advocacy priority for PAMED is restrictive covenant legislation. As directed by the PAMED House of Delegates, we continue to discuss the issue of noncompete agreements in physician contracts with several legislators. Interest in this area seems to be growing as lawmakers learn more about how these contractual agreements negatively impact patient access and continuity of care. Rep. Dan Frankel (D-Allegheny) previously introduced House Bill 1633, a proposal that would outright ban the use of noncompete agreements in all physician employment contracts.

On April 17, the Pennsylvania House of Representatives passed House Bill 1633, by a vote of 150-50. The bill had previously passed out of the House Health Committee on March 27 with a vote of 21-4. The bill was amended in the Health Committee to include a rural exemption, which PAMED had previously agreed to in previous sessions. PAMED pursued an amendment on the House floor, sponsored by Representative Torren Ecker, that would exempt private practices from the prohibition. The amendment failed with a vote of 99-102. House Bill 1633 then passed both the House and Senate and in July was signed into law by Governor Shapiro. PAMED has been at the forefront of restrictive covenant legislation and supported House Bill 1633’s advancement.

While PAMED was supportive of House Bill 1633 advancing out of the Senate HHS Committee, we strongly expressed our concerns that the bill did not go far enough. The Senate Committee amended the bill to allow noncompete clauses when the length is no more than one year, and the physician is not dismissed by their employer. House Bill 1633 also provides for a patient to be notified should their provider leave the hospital or health system the physician is employed by. The final element of House Bill 1633 provides for a study to be conducted by the Pennsylvania Health Care Cost Containment Council, three years after this legislation takes effect.

YI PIN RESTAURANT

Born and raised in China, I have a stubborn stomach for authentic Chinese food. I’ve visited many Chinese restaurants, only to find that many dishes have been altered to suit Western tastes. However, Yi Pin Restaurant is a notable exception.

reviewed by BAIHAN LI, MD

Pinnacle

Services

Nestled on Columbia Ave, Yi Pin might look unassuming and a bit aged from the outside. Once inside, however, the restaurant is clean, bright, and tidy, with an inviting warmth. The service staff are polite, hardworking, and eager to meet guests’ needs.

Yi Pin specializes in Sichuan and Hunan cuisines, both celebrated for their fiery, bold flavors. If you’re a spicy food enthusiast, this place is a culinary paradise. Personally, I gravitate towards milder flavors and often request a gentler level of spiciness in

my dishes. However, the extensive menu also features numerous non-spicy options. What truly captivates me is the unaltered authenticity of their dishes, offering flavors just like what I can expect in China.

My favorite dishes include Twice Cooked Pork, Kung Pao Chicken, Fish Fillet in Sour Soup, and Stir-fried Lotus Root. Among friends, dishes like Soup Dumplings, West Lake Beef Soup, Shredded Pork with Garlic Sauce, Scallion Pancake, Beef and Tofu in Hot Chili Sauce, Pork Shoulder in Brown Sauce, and Stir-Fried String Beans are particularly popular.

Twice Cooked Pork, a dish made from succulent pork belly, holds a special place in my heart (and stomach). The pork is first boiled to remove excess fat and then sliced thinly and stir-fried with fermented bean paste and green garlic. The result is a tantalizingly tasty dish that’s not greasy and arguably healthier. Each time I visit, I can’t resist ordering this masterpiece.

Another dish I almost always order is Lotus Root Mixed Vegetables. This dish combines thinly sliced, crunchy lotus root with vibrant carrot, snow peas, bell pepper, and green onions. After indulging in richer dishes, a bite of these fresh vegetables feels like a light and delightful intermission.

It’s best to visit a Chinese restaurant with four or more people so you can order at least four dishes. Going alone and ordering one or two dishes can be unsatisfying. Dishes are usually shared, using communal serving spoons and chopsticks to maintain hygiene.

I frequent Yi Pin because of the authentic hometown flavors it offers. The ingredients are rich and sourced from both local markets and overseas food markets in major cities like New York and Philadelphia. The restaurant owner continually introduces new dishes, adding delightful surprises to every visit. Chinese cuisine is a vibrant tapestry of flavors and textures, and its intricacies are subject to personal preference.

YI PIN RESTAURANT

1930 Columbia Ave. Lancaster, PA 17603 717-509-8988 | yipinlancaster.com

Kung Pao chicken

MEDICAL SOCIETY FOUNDATION ANNOUNCES SCHOLARSHIP WINNERS

Four County Residents Awarded Funds for Medical School

The Lancaster Medical Society Foundation, a Foundation of the Lancaster City & County Medical Society, recently awarded its 2024 scholarships to C. Veronica Ruiz and Hannah Dieterle of Lancaster, Safitaj Sindhar of Ephrata, and Hannah Ruby of Bainbridge.

Ruiz, an Elizabethtown College graduate, is a student at the Philadelphia College of Osteopathic Medicine (PCOM). Her passion for the medical field was born from a desire to be a patient advocate for the underserved. This zeal was fueled by her personal experience of becoming a caregiver at a young age, due to a lack of her family’s financial resources.

“I strongly believe that language barriers, race, gender, and socioeconomic status should not dictate the provision of essential high-quality patient care to anyone at health care institutions,” Ruiz shared. “My overarching career goal is to be a physician who will provide exemplary care and support for all persons, particularly helping patients navigate the social issues that often lead to the onset of preventable chronic diseases.”

In addition to her studies, Ruiz has also served in various student leadership positions, including working as a DO Ambassador, facilitating sessions for high school students through the Health Professions Exposure and Recruitment Program, and serving on the PCOM Advisory Council on Racial Justice and the Latino Medical Student Association board.

Ruby, a graduate of Boston College and a medical student at Drexel University College of Medicine, shared that her desire to serve others was first sparked after a near-devastating family health crisis, brought about by local health care system gaps.

Several years ago, after her brother suffered two

concussions within a short period of time, her mother pushed for him to see a specialist due to his concerning behavior. Unfortunately, due to long waiting lists he was unable to get the care he needed and ultimately attempted to take his own life.

“If my brother had gotten the medical care he needed sooner, perhaps he never would have reached that breaking point. That is when I knew I wanted to become a doctor. I realized that I could help fill those gaps and prevent others in my community from losing family members like the one I almost lost,” explained Ruby.

Ruby first explored her passion for serving others in the realm of health care with a summer internship at a local EMS agency.

“Working with both the emergent pre-hospital care term and the growing community paramedicine sector brought me into the homes of patients in a way that prior shadowing experiences did not. Working with them kindled a great motivation for me to become a provider who could advocate for patients to get manageable treatment without judgement.”

Sindhar, a student at the Pennsylvania State College of Medicine, is a graduate of Penn State Berks. She shared that her desire to pursue medicine is rooted in her experiences growing up in rural India and witnessing medical injustices that took place to her and around her.

“Stories of receiving little or no health care are not uncommon in India, which is perhaps the biggest reason I decided to become a medical professional and a health care advocate,” said Sindhar. “As a primary care physician, I have plans to practice medicine and advocate for competent health care throughout the world. Primary care doctors play a central role in

ensuring that everyone receives equitable access to quality health care.”

Sindhar ultimately aspires to become part of the international medical organization Medecins Sans Frontieres and hopes to someday contribute to opening a hospital for the underprivileged in the area of Punjab, India.

Dieterle is a Washington & Lee graduate and a current student at the Pennsylvania State College of Medicine. While pursuing her PhD, she served as a Hospitality Associate at a local hospital, which allowed her to witness the reallife effects of her research.

“I have seen how crucial the communication is between a doctor and a patient and the harmful consequences for the patient if that communication breaks down. I want to use my ethics education to create strong and trusting bonds so I can care for all areas of my patients’ health,” shared Dieterle. “The role of a physician coalesces my desire for challenge and leadership, alongside the freedom to implement compassionate care. Through every experience, it has been the patients that are the driving force behind my desire to become a physician to provide compassionate care to those who cannot care for themselves.”

Founded in 1991, the Lancaster Medical Society Foundation is a 501(c)3 nonprofit organization formed to grant scholarships to students from Lancaster County who are accepted at or continuing a medical degree at an accredited allopathic or osteopathic medical school.

Scholarship recipients exemplify good character, motivation, academic achievement and financial need. Since its inception, more than $306,000 in scholarships has been given to deserving local students.

C. Veronica Ruiz

Safitaj Sindhar

Hannah Ruby

Hannah Dieterle

2024 HOUSE OF DELEGATES WRAP UP

In October, the Pennsylvania Medical Society (PAMED) hosted its hybrid House of Delegates (HOD) meeting, where attendees participated both remotely and on-site. Delegates debated key topics of medicine to be adopted into PAMED policy. The weekend also featured networking opportunities, continuing education sessions, and entertainment.

In addition to a robust discussion and commentary online during the September Virtual Opening Session, delegates had a lively debate on many of the issues that face health care, patient care, and the practice of medicine.

The House adopted several resolutions for policy that will help to shape the depth of medicine in Pennsylvania:

Broadening Gender Identification Options on Vital Statistics Forms – Adopted as Amended. RESOLVED, that PAMED supports inclusion of an additional category for gender identification on all vital statistics forms that allows for accurate gender identification and representation of all people, including non-binary options; and be it

further RESOLVED, that PAMED supports legislative and regulatory efforts to broaden options for gender identification on all vital statistics forms to allow for more accurate gender identification and representation of all people.

Streamlining Medical Licensing for International Medical Graduates – Adopted as Amended. RESOLVED, that PAMED work closely with the State Board of Medicine to streamline the process of background checks to eliminate the request for 10 years of individual state criminal history record checks in favor of the digital FBI background check as this would allow for more timely and efficient licensing for both permanent and Locum Tenens physicians in Pennsylvania.

Harm Reduction Programs into Medical School Curricula – Adopted. RESOLVED, that PAMED will support the integration of harm reduction and SUD education in medical schools across the Commonwealth of Pennsylvania; and be it further RESOLVED, that PAMED shall encourage the expansion of Harm Reduction Programs in the Commonwealth of Pennsylvania.

Support of Efforts that Increase Caregiver Support – Adopted as Amended. RESOLVED, that PAMED encourages organizations and agencies to develop resources to better prepare and support caregivers.

Several resolutions have been referred for further study, meaning they will be sent to PAMED’s Board of Trustees for additional discussion or decision:

Resolution 24-201 - Medical Society Consortium on Climate and Health

Resolution 24-302 - Prescription Drug Affordability Boards

Resolution 24-305 - Support For Single-Payer Health Insurance

Please stay tuned for future communications on how to provide your feedback on these topics when they open for testimony in 2025.

LANCASTER CITY & COUNTY MEDICAL SOCIETY

2024 HOLIDAY SOCIAL AND FOUNDATION BENEFIT

Members, sponsors, and friends of the organization joined together to celebrate the holiday season and support the Medical Society Foundation at this year’s Holiday Social and Foundation Benefit. Held on Saturday, December 7th, at the Lancaster Country Club, the Social serves as the primary fundraising event for the Lancaster Medical Society Foundation and also as the LCCMS holiday gathering. This year’s event provided a festive environment to network and catch-up with fellow members. In addition to a short program, the evening included a cocktail hour, buffet dinner, and dancing.

Honored during the event were the 2024 scholarship recipients: C. Veronica Ruiz of Lancaster, a student at the Philadelphia College of Osteopathic Medicine (PCOM); Hannah Ruby of Bainbridge, a student at Drexel University College of Medicine; Safitaj Sindhar of Ephrata, a student at the Pennsylvania State College of Medicine; and Hannah Dieterle of Lancaster, also a student at the Pennsylvania State College of Medicine. (Learn more about this year’s scholarship winners on page 26.)

The evening featured a silent auction, with opportunities to bid on twenty-one themed baskets, offering a variety of experiences, local attractions, and area specialties. One hundred percent of the proceeds from the auction were invested directly to the Foundation scholarship fund.

Founded in 1991, the Lancaster Medical Society Foundation is a 501(c)3 nonprofit organization established to grant scholarships to students from Lancaster County who are accepted, or continuing a medical degree, at an accredited allopathic or osteopathic medical school.

Thank you to our generous sponsors and silent auction contributors!

Charles Stehman, MD

Penn Medicine Lancaster General Health Physicians Anesthesiology

Where do you practice and why did you settle in your present location or community?

I was born (at Lancaster General Hospital) and raised in Lancaster. I went to McCaskey High School and then to Drexel University for both my undergrad and medical school education. I lived in Philadelphia for 10 years and worked as a biomedical engineer before pursing medical school. Although I found biomedical engineering interesting and liked the fact that my hard work may indirectly benefit patients, I felt it wasn’t very exciting and wanted to help patients more directly. After I made the decision to pursue medicine, I knew I wanted to join the Navy via the Health Professions Scholarship Program (HPSP) and serve my country as many in my family have. I chose the Navy because I wanted to become a flight surgeon, and I liked the variety of mission and location opportunities. In the Navy, the flight surgeons train alongside the pilots and flight officers, have to pass the same physical qualifications and academic courses (which as an engineer I enjoyed), perform an abbreviated flight training syllabus for both fixed and rotatory wing aircraft, and then spend two months learning about aviation medicine as well as mishap investigation. There are many parallels between aviation and medicine, especially anesthesiology, regarding systems based approaches, safety, and team resource management.

During my first tour as a flight surgeon, I was the primary care physician for a Marine Corps helicopter squadron stationed at Miramar, CA. It was my job to perform aviation and other specialty physicals, maintain medical readiness including the vaccine program and staff our acute care clinic. We deployed to Afghanistan and performed workups for other missions including shipboard exercises. I really learned a lot outside of medicine serving as a co-pilot and aircrew member during this time. After three years with the Marine Corps, I started my residency at Naval Medical Center San Diego. I was fortunate to have a great group of residents around me as well as civilian and military mentors. I served onboard the USNS Mercy for a portion of Pacific Partnership performing humanitarian work while the ship was in Fiji. I also assisted researchers at the Scripps Institute of Oceanography, capturing and anesthetizing sea lions for diving mammal physiology research in the Channel Islands. During residency we visited clinics in northern Mexico where we provided anesthesia care for younger patients undergoing dental procedures, cleft lip and palate repair, and other surgeries.

After I completed residency, I served as a staff anesthesiologist at 29 Palms Naval Medical Center for two years before moving across the Pacific Ocean to Okinawa, Japan where I was assigned to 3rd Medical Battalion with the Marines again. Here I worked with the Marines to prepare for medical care on the battlefield and in austere environments, supported the Naval Hospital in Okinawa, and participated in military exercises in the Philippines, Thailand, and South Korea.

During this time, we had two boys, and each move seemed to be farther and farther away from family here in Lancaster. After almost 12 years on active duty and serving this great country, we decided to move back to Lancaster where I could continue service to the community where I grew up. I was very fortunate to have joined Anesthesia Associates of Lancaster in late 2019 and was looking forward to private practice. However, the economic realities of private practice, as well as COVID, resulted in the group deciding to seek employment with Penn Medicine Lancaster General about a year later. Fortunately, because of the incredible partners and the group's steady leadership over the decades, we have maintained a stable, collegial atmosphere amongst the former partners despite the volatility experienced elsewhere in the field of anesthesiology.

What do you like best about practicing medicine?

I truly enjoy caring for patients in a way that is different than other specialties. As an anesthesiologist, I am solely responsible for the patient’s care during surgery and other procedures. It truly is a hands-on profession with a nice mix of patient interaction, working as a team with the surgeons, CRNAs, and OR nurses, and being physically and mentally active. I provide anesthesia care at Lancaster General Hospital, Women and Babies Hospital, the Suburban Outpatient Pavilion, and the Physician Surgery Center, for patients of all ages, and all health conditions. Each day can be very different from the one before. Even the healthiest, ASA 1 patient, may react in a way I haven’t seen before despite having performed many thousands of anesthetics previously. Knowing that I can help guide a patient safely and comfortably through the perioperative process is a privilege and very satisfying. I also truly enjoy listening to my patients’ stories about themselves and their family and friends. Having grown up in Lancaster, I have had the opportunity to care for many people whom I have a connection with, whether that is someone who knew one of my grandparents, a friend’s parent from my childhood, or someone I went to school with whose child needs anesthesia care.

Continued on page 30

Are you involved in any community, non-profit, or professional organizations?

I am an active member of the American Society of Anesthesiology and the Uniformed Services Society of Anesthesiology. However, most of my time outside of my primary job involves continuing to serve in the United States Naval Reserves which requires one weekend per month for drill and two weeks per year serving on active duty. As you can imagine, just like in civilian medicine, the administrative burden as a physician and a Naval Officer has increased significantly over the years and most days, I am spending some time addressing these tasks for the Navy.

What are your hobbies and interests when you’re not working?

I try to spend as much time with my family as I can when I’m not working. We enjoy traveling and getting outside together. My last annual training for the Navy was June 2024, and we spent a month in Yokosuka, Japan. We traveled locally after my days working in the Yokosuka and Yokohama areas and spent one weekend in Nagano and the rest of the weekends in Tokyo. I also have a renewed interest in Tang Soo Do that I started when I was much younger and am currently working towards my black belt. Both of my boys, ages 6 and 9, have started their martial arts training as well. In addition, my wife is an avid tennis player, and the boys and I are learning to play tennis so that one day we can play together as a family.

For what reason(s) did you become a member of the Lancaster City & County Medical Society and what do you value most about your membership?

I believe physicians should be involved at all levels of their profession, local/state/national, in order to advance their specialty and advocate for what matters most to their patients. LCCMS helps foster an environment for physicians from different specialties to come together as a group and support each other as we do our best to take care of patients in these challenging times. I believe LCCMS helps physicians get to know others we may not interact with much on a regular basis. I would encourage all physicians to consider joining LCCMS so we can together make Lancaster a great place to live and practice medicine.

Avalon Primary Care

Avalon Primary Care is a fully functional primary care office. Opening in 2019 on the eve of the COVID-19 pandemic, it thrived in spite of the shutdowns and televisits. Patients of all ages enjoy the personal touches of the office combined with the ability to fully discuss their issues with a board-certified family practitioner.

An experienced family physician, Dr. Louise Butler is the Owner and Primary Care Physician at Avalon Primary Care in Lancaster, Pennsylvania. She is a graduate of New England College of Osteopathic Medicine in Biddeford, Maine and graduated from the Community Hospital of Lancaster Family Practice Residency Program. With her strong commitment to patient-focused care, Dr. Butler felt limited by the challenges imposed by conventional health care systems and insurance protocols. However, her perseverance and dedication led her to discover Direct Primary Care, a model that resonates with her vision of practicing medicine. In Direct Primary Care, she has found a platform that allows her to break free from the constraints of treating patients as mere numbers or insurance claims. Instead, she can embrace a more personalized approach, viewing each patient as an individual with unique needs and concerns. Patients pay a reasonable monthly fee and are able to have extended appointments in a relaxed, comfortable environment. Avalon Primary Care participates in Medicare, but this is the only type of insurance that is accepted.

Originally from Southern California, Dr. Butler embarked on a transformative journey at the age of 20, venturing into the wilds of Maine to pursue her education in college and medical school. The pivotal moment in her personal and professional life unfolded during her residency in Lancaster, where she not only honed her medical skills but also found the love of her life. Their union marked the beginning of a chapter that would see them traverse across North Carolina and Western Maryland for a total of eight years before an undeniable longing for home brought them back to Lancaster in 2004. She and her husband have raised three children and now have two wonderful grandsons.

In the Lancaster area, she has been a dedicated practitioner since her return. Her philosophy toward medicine is rooted in a deep understanding of the importance of listening to patients. She believes that by investing time and actively listening, patients often reveal not only their symptoms but also valuable insights into their diagnosis and the most effective treatment methods. By opening Avalon Primary Care, Dr. Butler has been able to finally achieve her lifelong dream of being a true family physician.

Dr. Louise Butler

FRONTLINE GROUPS WINTER 2025

Frontline Practice Groups have made a 100% membership commitment to LCCMS and PAMED. We thank them for their unified support of our efforts in advocating on your behalf and facilitating an environment for physicians to work collaboratively for the benefit of the profession and patients.

Argires Marotti Neurosurgical Associates of Lancaster

Avalon Primary Care

BestFit Virtual Health + Wellness PLLC

Carter MD Aesthetics

College Avenue Family Medicine

Community Services Group

Conestoga Eye

Dermasurgery Center PC

Dermatology Associates of Lancaster Ltd.

Dermatology Physicians, Inc.

DermDox Dermatology Centers PC-Leola

Eye Associates of Lancaster Ltd.

Eye Health Physicians of Lancaster

Family Eye Group

Family Practice Center PC - Elizabethtown

General Surgery of Lancaster

Glah Medical Group

The Heart Group of Lancaster General Health

Hypertension & Kidney Specialists

Lancaster Arthritis & Rheumatology Care

New Members

Sheena C. Anand, MD

Lancaster Radiology Associates Ltd.

Jordan Michael Appleyard, DO

Penn Medicine Lancaster General Health

Physicians Hospitalists

Nicole Briley, MD

Penn Medicine Lancaster General Health

Physicians Diabetes & Endocrinology

Corey T. Clyde, MD

Ryan Johnston Fischer, MD

Melissa Afton Frick, MD

Brett Hastings

Practice Administrator, WellSpan Family & Pediatric Medicine – Rothsville

Judie A. Howrylak, MD

Penn State Health Pulmonary Medicine

Jennifer Liddell Kaminstein, MD

Chance T. Kaplan, MD

Penn State Health Medical Group – Noll Drive

Ben G. Lazarus, DO

US Digestive Health-Lancaster

Roman Marchenko, MD

WellSpan Cardiology – Lancaster

Alison Lee Mercier, MD

Penn Medicine Lancaster General Health

Physicians Geriatrics

Lancaster Cancer Center, Ltd.

Lancaster Family Allergy

Lancaster Radiology Associates, Ltd.

Lancaster Skin Center PC

Manning Rommel & Thode Associates

Nemours duPont Pediatrics Lancaster

Neurology & Stroke Associates PC

Patient First – Lancaster

Penn Medicine Lancaster General Health Care Connections

Penn Medicine Lancaster General Health

Physicians Diabetes & Endocrinology

Penn Medicine Lancaster General Health

Physicians Family Medicine Lincoln

Penn Medicine Lancaster General Health

Physicians Family Medicine Manheim

Penn Medicine Lancaster General Health

Physicians Family Medicine New Holland

Penn Medicine Lancaster General Health

Physicians Family Medicine Norlanco

Penn Medicine Lancaster General Health

Physicians Family Medicine Susquehanna

Penn Medicine Lancaster General Health

Physicians Gynecologic Oncology

Sasheenie Moodley, MD, MPH, PhD

Resident, Lancaster General Hospital

Ketankumar D. Patel, MD

WellSpan Surgical Specialists – Lebanon

Robert J. Rokowski, MD

The Heart Group of Lancaster General Health

Pravesh Sangwan, MD

UPMC Neonatology Services-Harrisburg

Ashley K. Secunda, DO

Jian Shan, MD

The Heart Group of Lancaster General Health

Thomas I. Sherman, MD

Orthopedic Associates of Lancaster Ltd.

Sanjivani Shrestha, MD

Hypertension & Kidney Specialists

Nikhil Shyam, MD

Dermatology Physicians, Inc.

Ian Rutherford Smith, MD

Lancaster Emergency Associates Ltd.

Elizabeth M. Sodomin, MD

Penn State Health Milton S. Hershey Medical Center

Benjamin R. Stabler, MD

Penn Medicine Lancaster General Health

Physicians Family Medicine Manheim

Dirk Strasser, MD

WellSpan OB/Gyn – Ephrata

Penn State Health Medical Group – South Lancaster

Pennsylvania Specialty Pathology

Retina Associates of Lancaster

Shady Grove Fertility - Lancaster

Surgical Specialists—UPMC

Union Community Care – Duke Street

Union Community Care – Hershey Avenue

Union Community Care – Kinzer-Church Street

Union Community Care – New Holland Avenue

Union Community Care – Water Street

UPMC Breast Health Associates

UPMC Heart and Vascular Institute

UPMC Pinnacle Plastic & Aesthetic Surgical Associates

UPMC Lancaster Pulmonary & Sleep

WellSpan ENT & Hearing ServicesLancaster

WellSpan Ephrata Cancer Center

WellSpan Family Health – Georgetown

WellSpan Surgical Specialists – Ephrata

Lavinia M. Wainwright, MD

Resident, Lancaster General Hospital

Eli Wayman, MD

Yuchen Yang, DO Lancaster Emergency Associates Ltd

REINSTATEMENTS

Abdullateef ‘Dayo Abdulkareem, MD, MPH

Penn Medicine Lancaster General Health

Physicians Hematology & Oncology

Pamela J. Boimel, MD

Penn Medicine Lancaster General Health

Physicians Radiation Oncology

Lawrence I. Bonchek, MD

Roddy Canosa, DO

The Heart Group of Lancaster General Health

C. Anwar Chahal, MD

WellSpan Health

Rachel Claire Dever, DO

The Heart Group of Lancaster General Health

Laura M. Dipaolo, MD

Penn Medicine Lancaster General Health

Physicians Family Medicine-Manheim

Michelle Lee Fegley, MD

UPMC Obstetrics & Gynecology Specialists-Lititz

Thomas E. Fromuth, MD

UPMC Obstetrics & Gynecology Specialists-Lititz

Kenneth J. Glassford, MD

Penn State Health Lancaster Medical Center, Emergency Medicine

Prasad Krishnakurup, MD

WellSpan Radiology – Ephrata

Joseph C. Macdonald, DO

PinnacleHealth Hospitalist Services – Lititz

Paul G. Newman, MD

Penn Medicine Lancaster General Health Physicians Surgical Group

Kristina Braine Newport, MD Penn State Health Palliative Care

Kristina Y. Pao, MD

Eye Associates of Lancaster Ltd.

Lauren Parker, MD

Penn Medicine Lancaster General Health

Physicians Anesthesiology

David A. Roberts, DO

Penn Medicine Lancaster General Health

Physicians Anesthesiology

Ben Z. Roitberg, MD

WellSpan – Bartels Center

Thomas Tien, MD

Manning Rommel & Thode Associates

Paul E. Vassil, MD

WellSpan Family & Pediatric Medicine –Rothsville

Timothy V. Weaver, MD

Penn State Health Medical Group – Millersville