Orlando Medical News May 2021 by Orlando Medical News

MAY 2021

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Unique Behavioral Health Program Established in

Lake Mary Mental Health Intervention Group formed with holistic approach to care and to reduce repeated police interventions

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APRIL 2021

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APRIL 2021

CONTENTS || FEATURES PHYSICIAN SPOTLIGHT

Craig Mintzer, MD: Looking Forward

FEATURES 4

5 6

Unique Behavioral Health Program Established in Lake Mary

Alcohol, Not Cannabis, is Associated with Changes in Brain Morphology

PHYSICIAN SPOTLIGHT

The Science of Healthy Flooring

Five Reasons Why Your Website Is Not Working

Essential Work: Keeping Families Safe

Central Florida Turns Turquoise to End Lung Cancer

ORLANDO GRAND ROUNDS

NORTH CENTRAL FLORIDA GRAND ROUNDS

VOLUSIA-BREVARD GRAND ROUNDS

COVER

Craig Mintzer, MD: Looking Forward Think Offering Health Insurance in Your Small Business is Impossible? Think Again! EOCC

A Novel Therapy to Combat Post-COVID Syndrome and Heart Failure Symptoms

HEALTHCARE LEADER Their

Motivational Interviewing

Own Best Advocate

Medicare Requires 60 Percent of Your Medicare Patients Have Their Annual

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Unique Behavioral Health Program Established in Lake Mary Mental Health Intervention Group formed with holistic approach to care and to reduce repeated police interventions Often, when police are called out to respond to someone in a mental health crisis, it’s someone who has been in crisis a number of times.

seen that person before – possibly numerous times. And every time we see them, the chances increase that something tragic is going to happen,” he said. Lake Mary is a city of only 17,000 yet sees multiple hospitalizations for

Frequently it is those not receiving the kind of help that allows them stability and the ability to function without

people with suicidal ideation every

harming themselves or others.

month and the police field psych calls in various forms on a daily basis.

The Lake Mary Police Department has backed a proactive approach, and has recently launched a program

Hudson said it has become apparent

believed to be the first of its kind in the country that

that what is needed is a continuum

uses a public/private partnership to truly reimagine how

of care. It isn’t enough for people to

law enforcement officers help people suffering from

be sent to the hospital and be saved.

mental illness.

If they can't go see their psychiatrist, can’t afford their medications or don’t

The Mental Health Intervention Group developed as a 501(c)(3) non-profit organization has tremendous

have a car to get their medications,

grassroots support from local healthcare systems, business-

what happens? The police department is working in

es, faith-based organizations, and other non-profit groups.

Zach Hudson

The MHIG is designed to provide a broad range of mental

concert with the Counseling Resource

health services while striving to prevent avoidable trage-

Services (CRS), a community-based, in-home integrated

dies, ultimately reducing police interactions and minimiz-

behavioral health agency serving the aged and disabled

ing emergency room traffic.

population in Central Florida. April Boykin, LCSW, co-founder of CRS, said it is exciting to see Lake Mary

“The MHIG gives officers in the field resources they

becoming a leader in this area.

would not have even imagined a year ago,” said Zach

“Lake Mary has identified that their law enforcement

Hudson, public information officer, Lake Mary Florida Police Department and president of MHIG. “By providing

officers respond a lot to cases that are not criminal and

professional mental health counselors, medications, and

legal, but rather it's a mental health or social determi-

ancillary services at the individual’s residence, we strive

nant issue that's putting somebody in crisis,” Boykin

to break down barriers by providing treatment to those in

said. “We’ve identified two populations that can be

need of mental health and social services.”

helped. The first is those in a mental health crisis and

April Boykin

who need to be Baker Acted. The goal is, once they're

The intended goals of the program are to:

Baker Acted, we see them on the outside and we help

• Decrease repeated law enforcement facilitated Baker Acts, a Florida law that enables families and loved ones to provide emergency mental health services and temporary detention for people who are impaired because of their mental illness and who are unable to determine their needs for treatment;

figure out what's causing it. Is it lack of access to consistent medication? Is it substance use? Is it having some social determinant that is creating this ongoing crisis?” There is another population that is not Baker Actable. They're not intending to harm themselves or anybody else, and they are not delusional. But they're so stressed out that they need additional support.”

• Decrease first-time law enforcement facilitated Baker Acts;

For those people, Boykin said they find out what the person needs whether it is counseling, or access to com-

• Increase access to community resources for the vulnerable;

munity resources like a medication that can be delivered because they can't drive, food, or something else.

• Improve stability for the vulnerable;

“Florida is on the low end of providing social support,

• Reduce time spent by law enforcement on those with mental health issues.

and many workers are low wage,” she said. “People making

Hudson said when you're doing something that nobody

always going to be in crisis. So, when it comes down to,

minimum wage can't even afford an apartment. They're

else is doing, it has its own interesting set of challenges,

‘Do I get my baby's medication, or do I pay my rent?’

but begins with taking a holistic view of addressing com-

it's always going to be a crisis. Since Florida doesn't have

munity needs.

adequate supports in place, there's really nowhere for

that are so difficult for law enforcement and the individuals involved. “It's really unnecessary and keeps them from doing the work that they need to do,” Boykin said. “What we expect to see is that we will cut down on the recidivism from these calls.” Boykin said better outcomes for people with mental health challenges help build good will, create a sense of a community that cares, and reduce homelessness. CRS will bill insurance when possible but is absorbing the initial cost for the 90-day trial period. CRS doesn’t serve children but will refer people to another agency if a child is involved. “We'll still contact the family and work through any resources that they need,” she said. “And then, eventually, it will depend on how large this gets, there may be other providers to join the partnership to meet the need.”

them to turn.”

“It's been a tremendous journey. It's not just about a provider coming out,” Hudson said. “It's about barriers of

CRS’s role is working with other partners to resolve

care. When we respond to a call for service for someone

issues. They recognize they won’t be able to address every

suffering from mental illness, more than likely we have

issue, but have a goal of overcoming those multiple calls

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APRIL 2021

For more information, Hudson can be reached at 352-250-6444 or zhudson@lakemaryfl.com.

PHYSICIAN || SPOTLIGHT PRESENTED BY

Craig Mintzer, MD: Looking Forward A new orthopedic center breaking ground is groundbreaking Talk to most doctors about their specialties and they will often tell you of a new medicine or new device or diagnostic technique. And if they do, groundbreaking is an adjective that’s likely to emerge.

soccer organizing body. But it is actually for the average person that the institute holds the most promise. “There aren’t that many elite athletes quite frankly,” said Dr. Mintzer. “Orthopedic practices are based on normal people. Everybody gets up in the morning, they go to work, they exercise, they do some sports as weekend recreation and they get injured. Elite athletes go through

Talk to Craig Mintzer, MD, MBA and he wants you to

a Darwinian pyramid. You don’t get to be at that level

know that the groundbreaking news in the field of ortho-

without being different from everybody else. So even

pedics in Central Florida is that ground has literally been

though they do get injured, they tend to have fewer inju-

broken for the new Orlando Health Jewett Orthopedic

ries, or they would never make it.

Institute and that when it opens in 2023, it has the poten-

“Most ordinary people try to stay active and to be the best

tial to be transformative not only in the Orlando area but

they can. And those are the people who come to see us.”

for the Southeastern United States.

Besides treating the average person, Dr. Mintzer hopes

“The field of orthopedics is fairly advanced,” said

the new center will serve as a way to organize orthopedic

Dr. Mintzer. “We already have minimally invasive proce-

surgeons to better serve high school athletes.

dures and we have progressed to the point where a lot of

“High school athletes get injured frequently and

procedures can be done on an outpatient basis.” This new orthopedic institute will be “transformative because it will become a center of excellence in a place that

most don’t have the access to the best doctors and health

but it was hard work and intelligence that fueled

care,” he said. “I would like to see that change.”

Dr. Mintzer’s success. A product of New York City’s

Dr. Mintzer’s inspiration to go into medicine was

doesn’t have one.”

his own family’s physician.

“If you’re a city of seven to 12 million, you expect that city to have a massive center of medical knowledge and practitioners,” said Dr. Mintzer, a board-certified orthopedic surgeon who specializes in minimally invasive medicine. “But there is nothing like this in the Southeast. So, when we open the doors, we will be transforming the delivery of orthopedic health care, and for the average person that is much more significant than some new invention.”

“I grew up in New York in the Bronx and became

ed, scholarships and financial aid helped him gain entry to

interested in becoming a doctor by the third or fourth

Princeton University. And from there he went to Harvard

grade. We went to this old General Practitioner, Sam Wa-

for medical school. kid who was a smart guy” wasn’t easy. But it did pro-

you when you were sick. My parents deferred to him on

vide some early life lessons. “In the Bronx you learn fast

almost every important family decision. He practiced

that if you don’t work hard, you don’t get anywhere. You

until he was in his nineties and the amount of respect

just get left behind.”

wanted to be like him.”

ties under one roof in a 370,000 square foot complex. The access to orthopedic specialists, imaging services, radiologists and physical therapists, who are all within steps of each other. It will not only be more convenient for patients, but the complex is designed to foster research, education and collaboration among the healthcare teams and for visiting professionals. “We are trying to elevate the bar of orthopedic healthcare in the city in an organized manner,” said Dr. Mintzer. “Even if you are not affiliated with a certain health care institution, you benefit just by being around it. A rising tide lifts all boats.” It would be easy to imagine that such an advanced complex will be focused on high performing athletes. After all, Dr. Mintzer and his colleagues care for many professional and amateur athletes in the Orlando area, including the Orlando Magic basketball team, the Orlando City and Orlando Pride soccer teams, teams from the University of Central Florida and Rollins College, the Orlando Ballet and more than a dozen high school teams. And, Dr. Mintzer is unabashed in saying that one of his goals for the new institute is for it to be designated a Center of Excellence by FIFA, the world

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Dr. Mintzer is determined that when it comes to top tier orthopedics, Orlando will not be left behind.

result will be a collaborative center in which patients have

Growing up in the Bronx for a self-described “little

doctor who delivered you, took out your tonsils, and saw

my family and others had for him made me think that I

The new institute will put all of the orthopedic special-

public schools, Dr. Mintzer went to the highly selective Bronx High School of Science. When he graduat-

greich. GPs don’t exist anymore, but back then he was the

arthroscopic surgery of the knee and shoulder and sports

Dr. Wagreich might have provided the inspiration,

APRIL 2021

EAST ORLANDO CHAMBER OF COMMERCE

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Think Offering Health Insurance in Your Small Business is Impossible? Think Again!

Virtual Office Hours EVERY MONDAY | 9:00 AM – 10:00 AM MOST THURSDAY’S | 4:00 PM – 5:00 PM

Coffee Club East (1st Thursday of the month)  World Password Day

THURSDAY, MAY 6 | 8:30 – 9:30 AM  Bonefish Grill Waterford Lakes 12301 Lake Underhill Road, Orlando, FL 32838  FREE to EOCC Members | $10 for Non-Members

DOROTHY HARDEE, CHAMBER ADMINISTRATOR

Testimonial Tuesday

Margie Dodson, owner of Nailed It DIY has a small staff of 3-4. The business prepared for its Grand Opening just as the pandemic closed Central Florida.

Featuring Craig Rodrigue-CSR Benefits; Nicolas Duran – Trustco Bank; Annelizabeth Atie – ALS Association

TUESDAY, MAY 11 | 9:00 AM – 12:30 PM LIVE of Facebook

The Hybrid Member Academy: Roadmap to Member Success WEDNESDAY, MAY 12 | 8:30 AM – 10:30 AM

Determined to stay afloat, she created unique ways to offer clients Take & Make Crafts as well as virtual classes. As businesses started opening, she felt comfortable enough to bring on employees, however, she was concerned she would be unable to offer benefits that would help retain her team. We know that a smaller employer with less than 50 lives is not required to offer an ACA-described group health insurance coverage for employees. Regardless, Margie felt it was a pipe dream given the presumed cost to her business. Then she explored the Health Benefits program offered by the East Orlando Chamber of Commerce. Joe Filice (Avalon Insurance Services Inc.) & his team discussed the options and showed her how affordable it was. Margie offered her staff $25 per employee, towards payment of benefits signed up for. Plans were tailored to individuals, set up as a pre-tax contribution and showed her team how valuable they were to the business. The bonus was that Margie would also save on her payroll taxes since Joe was able to set up the program through payroll deduction. In fact, she was excited to share that one of her younger employees got three services that she needed for the $25 employer paid. Back in September, Harvard Business suggested a health insurance crisis may be looming for employees of small business that were struggling to keep their doors open, let alone meet their share of health insurance costs. Before the pandemic, 60 percent of small business offered health insurance, however the dire economic times caused many to slash employee benefits, choosing wages over health insurance premiums. Making matters worse, many business owners are confused about what they should get, costs, benefits and how it will affect their bottom line. Jennifer Englert with The Orlando Law Group added components of the Chamber plan as an option for her team. She was grateful not to have to be the expert in all thing’s insurance, relying on the excellent customer service provided by Joe and his team to ensure she had the best products available based on her teams needs. “Joe made this process easy, was thorough and readily available for questions,” said Englert. Like many in business, the pandemic shined a light on the importance of employee benefits to both the organization and employees’ members. The East Orlando Chamber’s Health Benefits plan offers three Medical Insurance options, vision, dental, supplemental offerings, MDLive and life insurance, which can be easily offered through an employee’s benefit program. It is 100 percent voluntary and does not require any financial, service, or administrative responsibilities or liabilities from the business offering the plan. Employers also can offer these coverage offerings on a

Hybrid Event - East Orlando Chamber office  12301 Lake Underhill Road, Ste. 245, Orlando, FL 32828

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Healthcare Council Collaborative Virtual Panel Discussing & Networking Three Things You Should Know: Physician Practice & Value Based Care – Is it the key to success

moving forward? Featuring Larry Jones (IIPN) and Fraser Cobbe (Cobbe Consulting)

THURSDAY, MAY 13 | 7:45 AM – 9:00 AM Virtual Event | Registration required

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Legislative Update Florida Politics Breakfast Regional Issues Sponsored by UCF and Moderated by Fred Kittinger (UCF)

THURSDAY, JUNE 8 | 7:30 AM – 9:30 AM The Celeste Hotel Orlando 4105 N Alafaya Trail, Orlando, FL 32826 Registration required.

Visit EOCC.org for a complete listing of May events

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APRIL 2021

more traditional employer platform being payroll deducted if they so desire and they may also contribute a portion or all the premium. Employers also can custom design a traditional employer benefits package designed specifically for their unique culture, demographics, and needs. EOCC is extremely proud to work with our partner Joe Filice at Avalon Insurance Services to offer the greatest value to your membership, providing employee health benefits and educational resources. Joe said, “These are unprecedent times and the EOCC is performing industry leading actions to continually meet and exceed the value of your membership.” The current plan will allow Chamber Members and their employees to take advantage of these great options: *EOCC Health Benefits being offered: Medical, Dental, Vision, Life, Accident, Critical Illness, Cancer, Hospital and Telehealth. *Customizable Employee Benefit Package Offerings: EOCC is offering employee benefits plans similar to what a traditional employer would offer and gives the member the opportunity to purchase what coverages offered best meet their unique personal and family needs. *Ease of enrollment: members can utilize a benefit administration system through an assigned website where all infor-

CONTINUED P.18

A Novel Therapy to Combat Post-COVID Syndrome and Heart Failure Symptoms BY KEVIN RYAN, MS, CCDS, CVRX BUSINESS MANAGER, FLORIDA GULF COAST

Medications were not sufficient, and due to the severity of her case, she needed customized care. Thankfully, Donna’s cardiologist introduced her to a novel therapy for the treatment of HFrEF symptoms called Barostim™ Baroflex Activation Therapy. Designated a “Breakthrough Therapy” by the FDA. Barostim uses neuromodulation - the power of the brain and nervous system - to improve the symptoms of patients with systolic HF. Unlike other devices, Barostim does not directly touch the heart, but is instead delivered by the Barostim NEO system, an implantable device that uses CVRx-patented technology to send electrical pulses to baroreceptors located in the wall of the carotid artery. The minimally invasive procedure typically takes less than 60 minutes to complete. “We were involved in the clinical studies evaluating the safety and effectiveness of this device for the past several years,” noted Dr. Lozano. “There are a significant number of patients who have no other device or drug options to help them feel better, and so we were happy to now be able to offer it to Ms. Rogers, as well as many more patients around the Orlando area who can benefit from it.” “I didn't have any other choice. It was whether I live or die, and I choose to live,” said Donna. “If you've ever been in a hospital, you'll see that everybody is coming at you like, ‘I'm doctor this, I'm doctor that,’ but the doctors engaged with me in a way that I felt comfortable. They explained how Barostim worked and assured me that their medical team would take very good care of me.”

As the COVID-19 crisis continues, many who contracted the virus are experiencing lasting effects, commonly known as postCOVID Syndrome. From the simple loss of taste to more serious issues, such as neurological problems and respiratory distress, thousands of COVID patients are facing residual symptoms. Among the most concerning of those after-effects is heart damage.

A compromised population According to the American Heart Association, nearly one-fourth of those hospitalized with COVID-19 have been diagnosed with cardiovascular complications, which, in turn, has contributed to roughly 40 percent of COVID-19-related deaths. To make matters worse, people with pre-existing heart conditions were more likely to contract the COVID-19 virus, leaving those most vulnerable in a detrimental situation. Even without the impact of COVID, there are still an estimated 6.2 million adults living with systolic heart failure (HFrEF) in the United States. For those individuals, everyday activities, such as walking up and down the stairs or playing with their grandkids, become exceedingly challenging, resulting in more hospital visits and a diagnosis that can potentially lead to death within five years. Add COVID to that, and the likelihood of survival is low.

The journey back from the brink One patient in the Orlando area knows first-hand how damaging the symptoms of HFrEF are to daily life. Having a history of minor congestive heart failure, Donna Rogers, a 50-year-old mother of three and grandmother of one, was starting to feel the effects of her condition. To combat the symptoms, she began living a healthier lifestyle and had been focused on losing weight. All was going well, until she noticed she had become increasingly nauseous and was having a hard time keeping anything down. Her daughter, concerned it was a strain of the stomach flu, convinced Donna to seek medical help and took her to the emergency room. After a few tests, the results were shocking. Donna had tested positive for COVID-19, a virus she had taken every precaution against – from sanitizing everything in sight, to wearing masks and gloves out in public. From February until September, Donna was in and out of the hospital, first battling COVID itself, and then the lasting effects of the virus. Her once minor congestive heart failure had become magnified. In September 2020, she was once again admitted to the hospital, where it became clear her condition was declining. Donna had lost a lot of blood and gained almost 60 pounds in fluid weight. As her condition worsened, she seemed on the brink of death, and had to be resuscitated twice. Just when all seemed hopeless, Donna was presented with a life-changing solution by her Orlando-based cardiologist, Dr. Hector Lozano and his colleague, vascular surgeon Dr. Manny Perez, both of AdventHealth Orlando Hospital.

A novel and effective therapy Having lost her job due to the pandemic, and in turn her insurance, her treatment options were few.

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Back to normal Barostim triggers the body’s own natural blood flow regulation system to treat HF symptoms and is designed to aid HF patients who have no proven treatment options today. Thanks to the device, patients, like Donna, are able to return to normal activities, such as spending time with loved ones, and lead healthier, more active lives. As a result of her COVID diagnosis, Donna’s recovery took slightly longer than an average patient implanted with the device. That said, she was still discharged only three days after her procedure and was given a second chance at life. Since recovery, Donna has been able to return to everyday life, and has even dropped the fluid weight gained from her hospital stay. She has regained her mobility, no longer needing the aid of a wheelchair or cane, but instead climbing flights of stairs. “Believe it or not, last month I was actually able to walk up and down the stairs from the first floor to the third floor. I had to stop and look back, like, was that me? I can move around without effort now,” said Rogers. There is still much to learn about the effects COVID-19 has on the heart, but, in cases like Donna Rogers, there is much optimism about how those suffering from post-COVID Syndrome with heart failure symptoms can regain a normal lifestyle through breakthrough therapies such as Barostim.

CONTINUED P.12

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Helping Patients Realize They are Their Own Best Advocate individual patient or managing policies that would impact entire populations.” After graduating, he left clinical medicine to serve as an International Chief Medical Officer for a health information company; later, he served the U.S. Army as a civilian, treating soldiers and veterans at Fort Polk, Louisiana. But after working in 40 countries in two years and then living in California, Edelstein and his wife — who is also a physician — decided they were ready for a change of pace from the hectic Silicon Valley lifestyle.  Together with their two daughters, they moved to Florida, where Edelstein joined the Surgical Specialty Group of Seminole. In his current role, he provides broad-spectrum care for a variety of diseases of the gastrointestinal tract, thyroid gland and abdominal wall.  Because his patients face severe and complicated conditions, Edelstein sees it as a responsibility to continuously assess and improve his methods. “Of course, technology advancements like laparoscopic surgery have been a major move forward in all gastrointestinal surgery procedures, and the addition of biologic agents has allowed us to alter our algorithms for inflammatory bowel disease. But we continue to pursue a range of new techniques — like ileal pouches for ulcerative colitis or Kono-S anastomosis for Crohn’s disease — that are shown to improve recovery. I’m also using new surgical approaches for Crohn’s disease in an attempt to prevent recurrence, which is a serious concern for our patients.”   But he’s quick to add that it’s a team effort: “Far-andaway the greatest impact on my patients’ successful recovery is our high quality post-operative nursing care.  While I greatly impact what happens to our patients in the operating room, the vast majority of post op direct patient care is provided by our nurses. The team caring for our patients following surgery is outstanding and my patient outcomes attest to that.” While treatment options continue to evolve, one thing hasn’t changed: Edelstein says he strives to be a partner in health — not just a provider. “I want to work with my patients to create individualized care plans. That’s why I encourage people to take control of their decisions. Ask questions, learn about your condition, understand your physician’s recommendations, but continue to be the one who ultimately decides your course of action. After all, it’s your body, your health, your disease and your life.” After serving the U.S. Army as a civilian, Edelstein will soon be commissioned as an officer in the U.S. Army Reserves Medical Corps. Beyond his hospital duties, he and his wife can be found outdoors, biking, hiking and fishing. Florida, he’s happy to say, has been “everything we hoped for and more.”

Peter Edelstein, MD, Surgical Specialty Group of Seminole

Whether he’s leading a talk about patient care or treating his own patients at the Surgical Specialty Group of Seminole, Dr. Peter Edelstein has one consistent message: “Own your health.” “Living with an illness can be overwhelming and as a surgeon, I see many patients whose conditions are life-threatening and seriously impact their everyday quality of life,” said Edelstein, who received board certification in both General and Colon & Rectal Surgery. “But no matter how frightening a diagnosis feels, remember: You are your own best advocate.” That philosophy is one he has pursued throughout his three decades of experience in the healthcare industry. Edelstein received his medical degree from the University of Chicago Pritzker School of Medicine and completed a general surgery residency at the University of California, San Diego. It was there that he was introduced to patients living with colorectal cancer, ulcerative colitis and Crohn’s disease — an impactful experience that led him to a colon and rectal surgery fellowship at the University of Minnesota.  “Working with patients and their families, I found a field that was both deeply challenging and immensely rewarding,” Edelstein said. “I knew I wanted to improve health in any way I could — whether by working with an

ORLANDOMEDICALNEWS.COM

APRIL 2021

Motivational Interviewing: Skills to Help Improve Patient Compliance BY APRIL BOYKIN, MSW, LCSW AND MARY-CATHERINE SEGOTA, PSY.D.

showing curiosity, and actively listening to the patient.

Empathy is essential to build a bridge between the provider and the patient to guide them to successful care. Empathy is how we express that we see and recognize the patient and his or her struggle. Building empathy starts with acknowledging how someone feels without judgment. Even if the expression is dramatic or incongruent, empathy allows the patient to feel cared about and will often reduce distress. A few examples of empathy are: "I'm sorry you are going through this. I imagine you are feeling overwhelmed." "It looks like you feel awful, and what you are doing is not making you feel any better." "That must have been frightening for you, but it looks like you were able to navigate it successfully."

One of the most challenging aspects of working in the medical field is dealing with patients who don't follow medical recommendations and end up sick, suffering, or worse off than when they originally sought care. These days the healthcare industry is expected to provide high-quality, cost-effective, patient-centered care that will improve overall health outcomes. Healthcare professionals are increasingly turning to health outcome research for the evidence-based guidance they need to improve care. Much of the research on health outcomes focuses on patient behavioral responses to changes in healthcare delivery. Additionally, research on chronic disease prevention has also focused on patient behavioral changes (e.g., smoking cessation, weight loss, increase in physical activity). Because these health behaviors are such predictors of increased compliance, improved health, and decreased risk, the ability to create a behavioral change is an essential indicator of improved health outcomes. Non-compliance is complex and is usually based on a layering of behavioral factors, including health literacy, forgetfulness, cost, misunderstanding, fear, confusion, absence of symptoms, mental illness, complicated regimen, side-effects of medications, apathy, and previous negative experiences. The healthcare industry has created protocols to overcome some of these obstacles, such as education and the well-informed diagnosis process, employing the "teach-back" model, reminders and technology, packaged medications, genetic testing, etc. But nothing is as effective as a patient being motivated to achieve the desired health outcome. Motivational Interviewing is a tool medical professionals can integrate into their everyday interactions that can help increase patient buy-in and compliance.

Discrepancy is the act of building an awareness of the difference between the patient's current behavior and desired behavior and building a plan from there. Highlighting the differences can allow the patient to assess for themselves what needs to happen. Discrepancy is accomplished by having the patient make a pro and con list or scaling their readiness, with follow-up guiding questions that can lead to the steps to make a change. "What will happen if you continue to smoke? What will happen if you stop smoking? Which reflects where you want to be? What do you think you might do from here?" "On a scale of 1 to 10, how ready are you to lose weight? What would need to be in place for you to be at a 10? What changes are you thinking about making?"

Avoid arguments and confrontation; if these worked, the change would have already happened. MI is based on the premise that providers are not there to force change but instead facilitate change.

Recognizing resistance, resistance is a normal part of change. Change can feel uncomfortable, and resistance is an indicator that the patient is not ready, and something else needs to happen to achieve the change. In a profession typically defined by “advice giving,” it is important to recognize that unwelcomed advice creates resistance. It is important to focus on the collaborative nature of the relationship when dealing with behavioral change. When resistance is considered part of the process, we more quickly identify

Motivational Interviewing (MI) is a patient-centered approach that is gathering increased use in healthcare settings. Created by William Miller in 1983 to treat substance abuse, MI has since grown into a successful model for achieving lasting behavioral change. MI provides a method of working with patients who may not seem ready to make changes that are considered necessary by the provider. MI allows patients to be active rather than passive by insisting that they choose the treatment and take responsibility for changing. The provider does not impose his or her views or goals on the patient. Motivational Interviewing's main principles include building rapport, demonstrating empathy, identifying discrepancy, avoiding arguing and confrontation, recognizing resistance as a part of the process, and supporting self-efficacy. Implementing these simple and effective principles can drastically shift interactions with patients and improve medical compliance.

Rapport creates a close, helpful relationship between the provider and the patient. Effective rapport can overcome many obstacles because the patient feels connected, which increases confidence and trust. Even in limited time together, we can build rapport by making eye contact, nodding, affirming that you are listening, getting on the patient's level (sitting instead of standing over), showing empathy,

ORLANDOMEDICALNEWS.COM

APRIL 2021

what will get in the way of identifying solutions. "Many people feel apprehensive about change. What apprehensions are you having?" "It is not uncommon to be resistant to change. What obstacle might get in the way of you making this change?"

Supporting self-efficacy is essential for the patient taking responsibility to change. Our role as providers is to remind the patient that the change is up to him (or her), but we can facilitate a sense of confidence by helping them explore past success. For example; "Tell me about a time when you were successful at (losing weight)." "What strengths do you have that will help your make this change?" “Motivation to change is not a personality trait, but is affected by interpersonal interaction.” Miller & Rollnick, 1991 When patients are facing a behavioral change, it is important to assess the stage of change they are in. Prochaska & Diclemente identified the following Stages of Change. In working with behavioral change, it is critical to understand which stage a patient is in, and that your expectation of patient change should align with what stage of the change the patient is in. 1. Precontemplation - do not intend to take action in the foreseeable future (defined as within the next 6 months) 2. Contemplation - intending to start the healthy behavior in the foreseeable future (defined as within the next 6 months), but are ambivalent, “on the fence.” 3. Preparation (Determination) - ready to take action within the next 30 days (0-3 month). start to take small steps toward the behavior change. 4. Action - have recently changed their behavior (3-6 months) and intend to keep moving forward with that behavior change. 5. Maintenance - have sustained their behavior change for a while (6+ months) and intend to maintain the behavior change going forward. 6. Relapse – the behavior returns and the re-evaluation of where process begins again.

CONTINUED P.14

Medicare Requires 60 Percent of Your Medicare Patients Have Their Annual Wellness Visits This Year! Are you Ready? BY DEREK ESTY

With the passing of the affordable care act, Medicare established a new benefit for all beneficiaries, the Annual Wellness Visit (AWV). This recent benefit visit is designed for all beneficiaries to have an opportunity to discuss their health with their providers, to build a plan of care, to help manage current medical concerns and prevent new ones from forming. AWSs are not the most profitable Medicare visit a practice can perform and have no cost to the beneficiary since all costs are covered at one hundred percent with no copay deductible to the patient. AWVs are designed for the patient to engage with their providers for an individualized long-term treatment plan of care to ensure that healthy patients stay that way, and sick patients do not worsen. Most patients and, sadly, many providers do not understand what AWVs are or how to perform them. The Centers for Disease Control (CDC) and Medicare have calculated that less than twenty percent of all Medicare beneficiaries received them last year. In fact, those same studies have shown that patients who received the visits saved Medicare over five percent in annual costs and have improved patients’ lives not only in quality, but also in longevity.

Both providers and patients confuse AWVs with a yearly physical, but the AWV is something else altogether. Yearly physicals focus on the current condition of the patient. AWVs identify ways to keep the patient healthier longer and prevent illnesses from starting or worsening. A significant focus of the annual wellness visit is to ensure that patients have access to all the services Medicare suggests, like preventive care, annual screenings (mammogram, colonoscopy, etc.), immunizations, and other missed services by busy practices. AWVs focus on lifestyle changes, understanding family history, and how the patient can have a life free from disease instead of just treating disease. Patients and providers build a plan of care to help keep that patient healthier longer and address areas that both the patient and the provider need to ensure a better health outcome.

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APRIL 2021

The requirements for an AWV set by Medicare are why the visits are underutilized. The visit requires the practice to collect and store a large quantity of data about the patient, allowing them to develop treatment plans for existing conditions and annual wellness plans to help prevent future illness. Today, many practices do not have a system to gather all the information required to complete the annual wellness visit, let alone the time needed to review the information with the patient. Most of what makes up an AWV is gathering and studying patient information and building a treatment plan for care. Still, most practices do not have the time or the staff to accomplish this goal, with medicine changing to more outcome-based versus fee-for-service. Medical practices that adapt now will provide the best care possible and ensure profitability in the future. Don’t forget that Medicare requires that practices complete AWVs on 60 percent of their Medicare patients this year. How are you doing? Derek Esty is COO for ThoughtSwift, an early-stage medical software provider of Medical Assessments to Primary Care & Internal Medicine Physicians. Esty created ThoughtSwift with a goal of helping doctors generate additional revenue while providing the highest level of care. RX2Live is a Health and Wellness Services Company positioned to advance healthcare through the BHS platform. We have been able to help our physicians open better paths of communication with their patients, limit hospital readmissions, diagnose and treat conditions that otherwise might have gone unnoticed and create an environment where the practice or facility can thrive and realize additional growth. Visit RX2Live or email John Fogarty at Jfogarty@RX2Live.com John Fogarty is regional Developer for RX2Live. He has spent 21 years in nuclear generation, transmission and distribution. He holds a master’s in International Management. He became an RX2Live developer to improve patient care and help providers and practices succeed.

Alcohol, Not Cannabis, is Associated with Changes in Brain Morphology BY MICHAEL C. PATTERSON

lectual ability is related to brain structure, including the thickness of the cerebral cortex. Investigators concluded: “No significant associations between cannabis use and thickness were observed. The lack of cannabis-specific effects is consistent with literature reviews, large sample studies, and evidence that observed cannabis effects may be accounted for by comorbid alcohol. “This study provides novel evidence that alcohol-related reductions in cortical thickness of control/salience brain networks likely represent the effects of alcohol exposure and premorbid characteristics of the genetic predisposition to misuse alcohol. The dual effects of these two alcohol-related causal influences have important and complementary implications regarding public health and prevention efforts to curb youth drinking.” The findings are consistent with those of several other studies – such as this 2017 study and this 2015 study – indicating that the use of alcohol, but not cannabis, is associated with negative changes in brain morphology. According to the findings of a literature review of 69 studies published in JAMA Psychiatry, “Associations between cannabis use and cognitive functioning in cross-sectional studies of adolescents and young adults are small and may be of questionable clinical importance for most individuals. Furthermore, abstinence of longer than 72 hours diminishes cognitive deficits associated with cannabis use. Results indicate that previous studies of cannabis youth may have overstated the magnitude and persistence of cognitive deficits associated with marijuana use.”

According to a new study published in PubMed through the US National Institutes of Health and the Journal of Biological Psychiatry, alcohol consumption, but not cannabis use, is associated with changes in brain morphology. The links to the study are below: The Effects of Alcohol and Cannabis Use on the Cortical Thickness of Cognitive Control and Salience Brain Networks in Emerging Adulthood: A Co-twin Control Study - Biological Psychiatry (biologicalpsychiatryjournal.com) https://pubmed.ncbi.nlm.nih.gov/33726938/ The theory has been impairments with inhibitory control and its underlying brain networks are associated with substance misuse. To study this theory, researchers with the University of Minnesota assessed the relationship between alcohol and cannabis exposure during young adulthood on brain morphology in a population-based sample of 436 twins aged 24 years.  Dimensional measures of cannabis use and alcohol use across emerging adulthood were measured. These dimensional measures were frequency of use, density of brain cortexes, quantity of product consumed, and number of intoxications of use. From the data, the authors reported, “Greater alcohol, but not cannabis, misuse was associated with reduced thickness of prefrontal and frontal medial cortices, as well as the temporal lobe, intraparietal sulcus, insula, parietal operculum, precuneus, and parietal medial areas.”  Neuroimaging research indicates that human’s intel-

Analysis This study destroys a strong perceived bias that legal products (alcohol, prescription drugs, etc.) are more safe than illegal products (cannabis, psychedelics, etc.). As a society, we have begun looking at cannabis through

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APRIL 2021

the “lens” of science and data, rather than ideology and political lies and theater. Through objective data, we are realizing that cannabis can be a safer alternative than alcohol for responsible adult consumption and as a prescribed or recommended medication. As cannabis becomes easier to study in the United States, we expect to see many more studies showing the efficacy of cannabis use for many medical reasons. However, we also expect to see multiple studies on cannabis related to low dose THC cannabis being used as a daily health supplement. The future of mass adoption of cannabis for wellness/health related reasons is coming. As more countries legalize cannabis and the ideology of cannabis being a “bad drug” starts to fade with more objective scientific data, more people will use cannabis and see the benefits and safety of plant-based medicine firsthand. Michael C. Patterson, founder and CEO of U.S. Cannabis Pharmaceutical Research & Development of Melbourne, is a consultant for the development of the medical marijuana industry nationwide and in Florida. He serves as a consultant to Gerson Lehrman Group, New York and helps educate GLG partners on specific investment strategies and public policy regarding Medical Marijuana in the U.S. and Internationally. He can be reached at mpatterson@uscprd.com

The Science of Healthy Flooring

PRESENTED BY

Create a healthy space beginning from the ground up with the right flooring selection BY LAUREN ODDO

because it is embedded throughout the finish. But how does it work? The antimicrobial agent in the finish stops the growth of organisms inhibiting their ability to reproduce and stopping them from spreading. Since it’s embedded throughout the wear layer and not just a thin coat on the surface of the product, the antimicrobial properties last throughout the lifetime of the wear layer.

The key to a healthy floor starts with a clean floor and the easiest way to get that is to use a product that has antimicrobial properties and is able to be easily cleaned and disinfected.

Cleanability As you can imagine, some surfaces are easier cleaned that others. When it comes to wiping something clean from general messes and dirt, a smooth product is going to make cleaning easier than something with a grit or heavy texture. That said, texture helps hide some amount of dust and dirt so it can’t be seen in the first place, as well as, providing more traction and slip-resistance. The key is to find the right amount of texture that hides just what you need it to while still wiping clean easily. Texture is not to be confused with porosity, although textured surface made of the same elements of a smooth or polished surface will always absorb and retain dirt more, just because a product has texture does not always mean the product is porous. Porosity depends more on what the material is made of. Natural stone, for example, while beautiful, is extremely porous before a sealer is applied to protect the material. Besides simply wiping clean, sometimes it’s pertinent to be able to disinfect the floors as well. There’s a multitude of ways to do this – but depending on the floor you choose, certain methods may not be applicable. The great thing about luxury vinyl is that since it, in itself, is antimicrobial, you don’t need to use harsh cleaners to clean disinfect the product. Typically a specific vinyl floor cleaner

In the next couple of sections we’ll get into some of the unique ways flooring is made to repel dirt, clean and disinfect easily. That said, the most important thing about flooring is, of course, color! Did you know there’s a science to color selection? We’ll get more into that toward the end!

Antimicrobial Flooring The easiest way to keep an environment clean and healthy is to start at the source. Since we can’t eliminate dirt and contaminates completely in most environments, this means choosing product(s) that don’t allow for bacteria to grow and spread. Hard plastic flooring products such as luxury vinyl and rubber are great options that provide the bacterial resistance you need in medical facilities, as well as at home! Cork flooring is also becoming more common in residential applications since it has naturally occurring antimicrobial properties and has the added benefit of being an extremely renewable resource. Vinyl and rubber flooring engineered for hospital, surgery centers and other commercial uses often has an antimicrobial/antibacterial additive incorporated throughout the wear layer of the product. This antibacterial property does not wear off anytime during the life of the product

is recommended for daily cleaning, and for disinfecting a solution of water and white vinegar is recommended.

Color Science This is a little bit more complex than one might think! There’s so many things that play a role in color science including individual perception, cultural influence. Have you ever noticed that red is the most common color for a dining room or fast food logo? That’s because science has proven that red activates and stimulates appetite. Using specific colors on the floors, you can engender different actions and reactions from those in the building. Want to discourage walking in a certain area? Make the floors white! There’s something about a pristine white floor that tells people not to step on it. Looking to energize your employees? Consider an orange or yellow floor! Orange and yellow are both energizing colors that stimulate the mind and encourage activity. To the contrary, if you’re looking to create a serene, peaceful break room, colors like blue and green are often associated with relaxation and would be great options to choose from! When designing a space, no matter what setting, the flooring acts as the backwash of the design canvas. To make separate sections of a large space flow together, you can use the same flooring throughout every space to create a cohesive look throughout. On the opposite end, if you’re looking to make a space pop or define it in some way, you can change the flooring to allow for visual contrast that can divide a space without using a physical barrier. Lauren Oddo has been with US Design Source for six years managing sales and specifying products. Upon graduating from the University of Central Florida with a bachelor's degree in entrepreneurship, she sought a career that would allow her to combine her love for home design and education in entrepreneurship into one passion. The owners of US Design Source, Michael and Ginny Hill, have been part of the Orlando flooring and building industry for over 50 years. As a company, we've installed hundreds of thousands of square feet of flooring throughout Central Florida.

CONTINUED ...

A Novel Therapy to Combat Post-COVID CVRx Barostim Baroflex Activation Therapy CVRx’s Barostim Baroflex Activation Therapy is the first medical technology approved by the FDA that uses neuromodulation - the power of the brain and nervous system - to improve the symptoms of patients with systolic heart failure (HFrEF). Barostim is delivered by the Barostim NEO Generator™, an implantable device that uses CVRx-patented technology to send electrical pulses to baroreceptors located in the wall of the carotid artery. Baroreceptors trigger the body’s baroreflex which in turn triggers an autonomic response to the heart. The therapy is designed to restore balance to the autonomic nervous system and thereby reduce the symptoms of HF. Barostim NEO received the FDA Breakthrough Device designation and is FDA-approved for use in HF patients in the US. It has also received the CE Mark for HF and resistant hypertension in the European Economic Area. To learn more about Barostim, watch this video.

CVRx, Inc. Headquartered in Minneapolis, MN., CVRx® is a leader in innovative medical technologies that address the unmet needs in cardiovascular diseases with safe and effective therapies that harness and harmonize the body’s natural systems. CVRx is dedicated to improving patient outcomes, quality of life, and overall cardiovascular health via novel baroreceptor neuromodulation therapies.

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APRIL 2021

Five Reasons Why Your Website Is Not Working BY JENNIFER CERNA

Having a website in this digital age is a must.

Our phones become more and more like our computers. That means surfing the web and searching Google on our mobile devices is heavily used. And as technology improves, we are only going to rely on it more. This means that making sure your website is configured to fit comfortably on mobile screens is incredibly important. If someone has to zoom into or has trouble using your website on their phone or tablet, it hurts you in more ways than one. It hurts you when it comes to SEO, to the visitor experience, and visitors don’t stay long, so it hurts your analytics and therefore your bottom line. Depending on what platform and template you use for your website, you can make your current design responsive to mobile devices.

Without a website, you lose credibility and business. So, you’ve put one together and launched it. But now it’s not working the way you thought it would. You’re either getting a good amount of traffic but not many leads, or not getting any traffic at all. Here is a list of five possible reasons why your website isn’t working.

Having an unclear or cluttered “Above the Fold”

“Above the Fold,” or ATF, derives from the newspaper days when the top story was featured in the most prominent area, which was on the front page and above the fold. It’s similar with your website. ATF in websites means the area your site visitors see without scrolling after landing on your page. It’s the few seconds you have to grab your visitor’s attention and let them know they are in the right place. Because this area makes your first impression, you need to make sure that you put your best foot forward and as concisely and clearly as possible, let visitors know what you do, and who you do it for. The biggest mistake I’ve seen is displaying too much content, making it cluttered, and not being clear about what the business does, making it unclear to the visitor if they are where they need to be to solve their problems.

Slow Loading or Broken Links

Nobody likes to stare at an empty screen waiting for the page to load. And it’s not fun to get a 404 error when clicking on a link. These are common mistakes that cause visitors to jump ship and leave your site. You get one chance to make a first impression. Make it count by making sure you keep your load speeds below 5.3 seconds and making sure that there are no broken links. You can keep your load speed down by reducing the size of images and files with compression tools. Another way to be perceived as professional and high quality is by making

Indistinctive or no Call to Actions

sure that no one gets a broken link error. This can be done by simply clicking through your website consistently on a private browser to make sure all your links still work correctly. One can be very technical and the other can be done using a few minutes a month. Both impact SEO and visitor experience and ultimately sales. These are the five main reasons why your website might not be working, but there could be many more. But most of these mistakes can be avoided by doing some research or hiring a website designer who knows the best practices for designing a website or landing page that works and converts your target audience.

Jennifer Cerna is the founder and Creative Director at Jreamit Marketing, a marketing agency that specializes in branding and website design. We have worked with doctors and other medical professionals to get better marketing results with storytelling and branded experiences. Our clients have more time to focus on growing their business as we take care of their marketing functions and processes. To learn more about website design click here. Or contact Jennifer at jenn@jreamitmarketing.com with any questions.

TechTip

A “Call to Action,” or CTA, is a wording that is used to tell your visitors what action you want them to take. For example, “Call Now.” Having someone visit your website is great, but what then? Your site visitors need to know where to go and what to do. So, tell them with a “Learn More” button under an About Us section or a “Book Now” button under your services. Keep in mind that CTAs need to be distinctive and stand out from the rest of the content around them. A big reason why you might not be converting is that you either have no CTAs or clear CTAs that move leads towards your desired action such as booking an appointment.

Not being optimized for mobile screens

Insider Tips And Secrets To Get The MOST Out Of Your Computer

The Practice Manager’s Guide To IT Support Services And Fees

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Not having a clear or easy flow

Have you ever gone onto a website that has no clear direction or where you don’t know how to get to what you want? In case you haven’t, they are extremely frustrating, and visitors don’t stay long. Many site visitors are in a hurry to get the information or solution they need, so when they can’t find it on your website, they move on to the next site. The solution is to carefully think through the structure of your website and have a clear, concise site map. A good rule of thumb to note is to make sure that your site visitors are able to find what they need in under three clicks orn less. For example, if someone wants to learn about the process you use for one of your services, they select the “Services” tab (click one). Scroll through your various services until they find the one they are looking for and select it (click two). Find it there and then click to either contact you to learn more or book an appointment (click three). Putting some thought into your target audiences’ website journey will help them navigate your site more efficiently and increase

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Essential Work: Keeping Families Safe

CONTINUED ...

Motivational Interviewing Techniques that help in the MI process include OARS. O: Open Ended Questions A: Affirming R: Reflective Listening S: Summarizing

Open ended questions can’t be answered with “yes” or “no.” Remember to ask one question at a time, and use the patient’s own words, when possible. For example: “Tell me about…..?” “Help me understand…..?”

BY AMY MONCION, LCSW-QS

I’ll be honest: It’s been a long year for social workers.

Affirming includes a combination of “reframing” and “validating” the patient. For example: “That must have been really hard for you…” (validation) “You are being really honest with yourself…” (affirming)

As advocates for child welfare, we know how to handle a full plate. In a good year, we’re busy helping families navigate financial hardship, job loss and even homelessness. When parents are struggling with mental illness or substance abuse disorder, we connect them with the resources to recover. We advocate for kids in schools, doctor’s offices, courtrooms and living rooms. 2020 brought all those issues – and some new ones – to the forefront. By May, more than 1.2 million Floridians were unemployed. Parents who still had jobs were forced to balance working hours with childcare and supervising online classes. Families that relied on school lunches and breakfasts to keep kids fed turned to food pantries. Across the board, our carefully constructed support networks were crumbling away. Was it daunting? Absolutely. But no one goes into social work expecting it to be easy. As early as March, Embrace Families – the leading nonprofit responsible for foster care and child welfare in Central Florida – was developing new strategies to navigate pandemic protocols. My team worked with more than 500 families across Orange, Osceola and Seminole counties last year, finding new ways to manage our workflow, and helping staff members process their own stresses and worries. We continued making in-person family visits when necessary and possible. When it wasn’t, we adapted to virtual visits. Of course, there’s no perfect substitute for a face-toface meeting – but going virtual had surprising advantages. Not only did it protect families from illness, but it also cut down on travel, which allowed our staff and families to meet more frequently. Meanwhile, at the Children’s Advocacy Center in

Reflective listening affirms and validates your patient’s experience. When they feel understood, they are more likely to go deeper and say more, and you are less likely to appear judgmental. For example: “It sounds like you are unsure about …” “It sounds like you have had a lot of success with…”

Summarizing - Focus on your patient’s statements regarding 1) recognizing the problem, 2) their reason for change, and 3) their optimism or confidence about the change. For example: “Let me see if I understand what you’ve told me so far…” Improving health outcomes is dependent upon many factors, including patients being willing to do their part. The Motivational Interviewing model helps patients find motivation for doing what is best for themselves. There is much more to MI than discussed here, but this is a significant first step in noticing the language we use and the process we engage in for helping our patients take steps towards better health outcomes. April Boykin is a Licensed Clinical Social Worker and cofounder of Counseling Resource Services (CRS). Established in 2013, CRS is a community-based in-home integrated behavioral health agency serving the aged and disabled population in Central Florida. As a mental health counselor, she has provided individual, family and caregiver counseling to children, teens and adults. She can be reached at april@counselingresourceservices.com With a doctorate in clinical psychology and over 20 years of experience in the field, Dr. Segota has conducted university-based behavioral medicine research, acted as a consultant to professionals and organizations, and worked with a diverse number of psychological and medical conditions. By identifying unique needs, the source of distress, and what’s perpetuating the problem, she will help develop the tools to overcome seemingly insurmountable circumstances. Visit www.CounselingResourceServices.com

Osceola, we were dealing with the medical crisis from a different perspective. As a Medical Neglect Advocate, my colleague Dan Mawhinney works with families who have children with chronic health conditions such as Type I diabetes or cystic fibrosis – all of which require ongoing care with various specialty providers, typically at a children’s hospital. Parents would often tell Dan how scared they were to take their child to the hospital, saying, “What if my child gets COVID-19? What if I get COVID-19, and bring it home to my family?” In a time of overwhelming fear and uncertainty, it’s no wonder they were worried. But thanks to his intervention – and the efforts of hundreds of social workers across Central Florida – kids got the care they needed. Dan’s team worked with families to address their concerns, keep them informed, and connect them with a compassionate team of medical providers. Another obstacle was helping families navigate the switch to telehealth services. As many as 464,000 Floridians don’t have access to high-speed internet, and others may not have the electronics or expertise to run video conferencing software. As a result, a lot of kids were missing appointments – and it was a joint effort to make sure they got online to receive the care they needed. While 2020 is now behind us, I know my job isn’t over: Across Central Florida, many families still need our support. It really does take a village to raise a healthy, happy child – not only parents and guardians, but also social workers, foster parents, doctors, tutors, donors, mentors, volunteers and community partners. And if you can help in any way – whether it’s by donating money, giving your time or opening your home to a child in need – now is the time to take that step. To learn more about child welfare in Central Florida, visit www.embracefamilies.org. Amy Moncion is a Licensed Clinical Social Worker (LCSW) and Clinical Utilization Management Manager with Embrace Families. She has worked with youth in and out of foster care for 15 years.

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Central Florida Turns Turquoise to End Lung Cancer BY JANELLE HOM

research,” said Smith. “My current wonder drug (Tagrisso) would never have been developed without this research. There are over 130 clinical trials for lung cancer research right now! At some point, I will more than likely need to be a part of a trial and Kent and I are determined to continue to raise funds for lung cancer research.”

The month of May is a symbolic one for the American Lung Association with key public health messages and activations around lung cancer awareness.

Young Woman Gets Surprise Lung Cancer Diagnosis During Pandemic

The LUNG FORCE initiative’s annual Turquoise Takeover unites men and women to raise critical awareness of lung cancer, the nation’s #1 cancer killer. Residents are encouraged to get involved by wearing turquoise, posting to social media and/or participating in one of the local activations. “The COVID-19 pandemic has been a stark reminder of the importance of lung health, especially for those with lung diseases. For many with lung cancer, the burden has become more acute, with the pandemic adding more challenges, such as increased risk of complications from COVID-19 and changes or delays in treatment,” said Janelle Hom, executive director of the Lung Association. “The pandemic also temporarily delayed access to lung cancer screening for many people at high risk. Among diverse communities who have been hardest hit by COVID-19, these difficulties may be even worse. For these reasons and many more, raising awareness and funds for lung health are more important than ever. We encourage our community to get involved in one of our many Turquoise Takeover activities this week.” Several Central Florida residents have helped to illustrate the importance of early detection, advocacy, and creating a community of support.

Orlando resident Stephanie Malecki is a 38-year-old healthy woman who has two young daughters, so when she was diagnosed with lung cancer last March, it was a complete shock. On May 8, she is participating in the LUNG FORCE Run/Walk at SeaWorld to raise awareness about lung cancer, and to make sure that anyone else diagnosed with the disease gets the resources and support they need. For nearly a year, Malecki had been short of breath, and was diagnosed with a cold, bronchitis and pneumonia. One morning in March 2020, she coughed up blood. This was the second time this had happened, so she went to the ER. They did a CT scan, which revealed a mass. “Through the height of the COVID-19 pandemic, I fought to receive care and the barrage of tests needed to figure out what exactly I was dealing with then on May 5, surgeons removed the lower lobe of my right lung. Pathology confirmed the mass was indeed a carcinoid tumor,” said Malecki. She had the surgery done robotically, so by June she was hiking in Yellowstone with her family. Because they caught the lung cancer early, Malecki didn’t have to do chemotherapy or radiation treatment. Now she has a scan every six months. “I was unbelievably lucky that I had symptoms and the ER did a CT scan. As a 37-year-old female with no history of smoking, smoke exposure, or other risk factors, I simply didn't fit what people consider the ‘typical’ lung cancer profile,” she said. “The disease is so misunderstood. I soon learned that there is a huge number of young women like me who have lung cancer.”

A Pain in the Hip That Turned Out to be Lung Cancer Three years ago, Melbourne resident and Suntree Elementary Teacher Debra Smith experienced a pain in her hip, which turned out to be stage IV lung cancer. On May 8, she will walk to raise money for life-saving lung cancer research at the American Lung Association’s LUNG FORCE Run/Walk at SeaWorld. In December 2017, Smith experienced pain in her hip. Since she was an active 55-year-old woman who had been doing Pilates for years, she thought it was a pulled hip flexor. She went to physical therapy, but the pain only got worse. She visited an orthopedic doctor, who gave her an MRI. A week later, and they found a tumor in her hip. “It was stage IV lung cancer. It was a shock because I am not a smoker and I am in decent shape,” she said. “They put a titanium rod in my hip and prescribed a targeted therapy. There are highs and lows. It is a roller coaster ride.” Smith had the tumor tested, and it revealed a genetic marker called EGFR, which means there was a targeted therapy pill called Tagrisso to help treat her lung cancer. She is still taking the medication for her lung cancer and is teaching and works out three days a week. Her type of lung cancer is treatable but not curable. After she had time to catch her breath after the diagnosis, Smith and her husband, Kent, decided that they wanted to give back. Kent created “Team Deb” for the LUNG FORCE Run/Walk and they began raising funds for research. “It is essential that ‘Team Deb’ continues to raise funds for lung cancer research as my future depends on that

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Here are 5 ways that residents can get involved in Turquoise Takeover: 1) LUNG FORCE Run/Walk at SeaWorld: On May 8, the Lung Association will host the LUNG FORCE Run/ Walk at SeaWorld. For the event, participants will run or walk a 5K through SeaWorld, where they will see all the main features of the park. Learn more and register at LUNGFORCE.org/Orlando. 2) Lung Cancer Patient Virtual Meetup: The Lung Association is hosting a free Lung Cancer Patient Virtual Meetup for patients and caregivers on May 11. At the event, AdventHealth’s Dr. Marcelo DaSilva will speak about HER2 lung cancer. The event is free and open to the public. Those interested can register at Lung.org/patient-meetup. 3) Turquoise Takeover Reception: On Friday May 14 from 5-7 p.m., the Lung Association is hosting a casual, spatially distanced reception at the Kendra Scott located at the Mall at Millennia. The event will include cocktails, light bites, a jewelry raffle, and Color Bar raffle. 20 percent of proceeds from that evening and through the weekend go back to support LUNG FORCE. More information is available on our Facebook page at https://www.facebook.com/alafcentral. 4) Lung Chat: Next week, the Lung Association will host a Lung Chat on Facebook with Dr. Cynthia Gries, a Transplant Pulmonologist from AdventHealth, to talk about LUNG FORCE, lung cancer and women’s lung health. The event is free and open to the public. Watch for it on our Facebook page at https://www.facebook.com/alafcentral 5) AdventHealth Turns Turquoise: Every year, LUNG FORCE celebrates Turquoise Takeover by turning landmarks and buildings across our nation turquoise - LUNG FORCE’s signature color - to increase education and provide hope for those living with lung cancer. In Central Florida, we are happy to have AdventHealth’s Ginsberg Tower and Women’s Hospital turning turquoise to raise awareness for lung cancer. Janelle Hom serves as the Executive Director for the American Lung Association in Florida – Central Area and has been with the organization since 2008. Janelle holds a Master of Arts in Political Policy and Analysis from UCF and a Bachelor of Arts in Government and World Affairs from the University of Tampa. She also holds her Certificate in Non-Profit Management from the Crummer Business School of Rollins College. Email her at mailto:Janelle.Hom@lung.org. Visit www.Lung.org

ORLANDO || GRAND ROUNDS

Healthcare Now

Orlando Health Pediatric Trauma Director Receives National Impact Award Orlando Health Arnold Palmer Hospital for Children’s medical director of pediatric trauma, Dr. Donald Plumley, has been awarded the 2020 Children’s Miracle Network (CMN) Hospitals Impact Award. This inaugural award recognizes one clinician or team across the country that has made a significant impact on the care provided to children in their hospital. Dr. Plumley has spent his 27-year medical career at Orlando Health, caring for some of the most injured and critically ill patients in Central Florida and across the world. He has been an ongoing champion for fundraising through CMN Hospitals partners and programs, as the dollars raised locally provide support for Orlando Health Arnold Palmer’s areas of greatest need, including purchasing life-saving medical equipment, expanding vital services, and underwriting training resources and programs that impact patients and the community. Currently serving as the chairman of the board for the

The Healthcare Now radio show has expanded and is available on both Apple Podcasts iHeart Radio Podcasts

Orlando Health St. Cloud Hospital Announces Two New Leaders Orlando Health St. Cloud Hospital announced the appointment of a new chief operating officer (COO) and chief quality officer (CQO) to strengthen clinical operations and innovation, as well as support a culture of continuous improvement. Marc Lillis assumed the role of COO on April 19. Mr. Lillis is a seasoned health care executive with over 15 years of experience in leading hospital operations. The new role is a promotion for Mr. Lillis who was previously an allied health and support services administrator at Orlando Health – Health Central Hospital. During his tenure at Orlando Health - Health Central, Mr. Lillis was responsible for overseeing the daily operations of the hospital including new construction projects. He also served as administrator of support services from 2016 to 2018 and before that director of supply chain from 2010 to 2016. Aparna Sharma, MD, will be the hospital’s new CQO beginning April 26. Dr. Sharma brings outstanding clinical expertise with internal medicine and research experience, as well as quality leadership excellence to this role. Previously, she was based at Orlando Health Dr. P. Philips Hospital where she served on the medical staff as physician advisor. She earned a Bachelor of Science from Georgetown University, and a Master of Public Health from George Washington University in Washington, D.C. Dr. Sharma earned her medical degree from New York Medical College and completed an internal medicine residency at Georgetown University Hospital. She has completed a National Cancer Institute internship on cell biology and a research fellowship at the National Institute of Neurological Disorders and Stroke in Washington, D.C. During her time in that city, she was an Americorps volunteer managing a medical clinic that served an at-risk patient population.

“No one should spend their lives in pain or discomfort,” Dr. Patel said. “For patients who are eligible, minimally invasive surgical weight loss options can truly change lives. The bariatric surgery team at Oviedo Medical Center is committed to helping each patient succeed in their weight loss journey and take charge of their health.” Immediate recovery for weight loss surgery patients is overseen by a specially trained hospital staff in a designated inpatient unit at Oviedo Medical Center. Following their hospital stay, patients have access to a network of individuals to help them stay on track, including a registered dietician, physical therapists and a monthly web-based support group. “After struggling with my weight and other medical issues for many years, I finally decided to do something about it,” said Cindy Ayer, bariatric surgery patient. “While the idea of surgery can be scary, taking control of my health – and my life – was the best decision I’ve ever made. The care team at Oviedo Medical Center helped make my recovery as comfortable and smooth as possible – and their network of professionals and other patients continues to provide priceless support along my weight loss journey.” For more information about the bariatric surgery options at Oviedo Medical Center, visit www.oviedomedicalcenter.com.

Jose Fuentes, MD, FACP, Opening

Orlando Primary Medicine Dr. Fuentes received his medical degree from the Universidad del Norte in Barranquilla, Colombia, and completed his residency in internal medicine at Hackensack Meridian Mountainside Medical Center in Montclair, New Jersey. He served as the Director of Centro Medico in Trenton, New Jersey and as the Director of Pennington Medical Group in Pennington, New Jersey and has also worked as an internist at Lehigh Valley Health Network in East Stroudsburg, Pennsylvania, and at Advanced Internal Medicine Care (AIMC) in Lakeland, Florida. Dr. Fuentes is fluent in both English and Spanish and has committed a considerable portion of his time and services toward the health and well-being of the Hispanic community. He has participated in several events and presentations to educate the Hispanic community, and his patients in general, about the importance of prevention and maintaining a healthy lifestyle through proper diet and exercise to reduce the risk of conditions such as obesity, high cholesterol, and diabetes – to address the disparities in knowledge about the prevention and treatment of illnesses and subpar health outcomes within the Hispanic community that has resulted from cultural and language barriers and a lack of nutritional education. For these reasons, Dr. Fuentes highly values effective

Oviedo Medical Center Announces Bariatric Surgery Program Oviedo Medical Center, an HCA Healthcare North Florida Division – Orlando Market hospital, recently announced the launch of its bariatric surgery program available for eligible patients looking for additional options to reach weight loss goals and improve their overall health. Led by fellowship-trained bariatric surgeons Harold D. Neyra, DO, and Chetan J. Patel, MD, the hospital’s bariatric program provides eligible patients with access to personalized care plans and minimally invasive surgery options, including sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB) – all performed via laparoscopy or robotic surgery. “Weight loss can extend both the length and quality of life,” Dr. Neyra said. “However, weight loss is not the only benefit of bariatric surgery. It can also resolve sleep apnea, hypertension, Type 2 diabetes, menstrual dysfunction and venous stasis ulcers – all of which can have a significant impact on a person’s happiness, as well as their physical and emotional health.”

ORLANDOMEDICALNEWS.COM

APRIL 2021

Greater Orlando CMN Hospitals, Dr. Plumley has been on the board of directors for 15 years. With nominations submitted by hospitals across the United States, the committee selected Dr. Plumley after careful evaluation, citing that his excellence demonstrates exceptional care supported by CMN Hospitals funds. The award announcement was made last week during a virtual ceremony in recognition of Children’s Hospitals Week, which shines a light on the importance of children’s hospitals and how charitable support of these nonprofit hospitals help care for more than 10 million children each a year.

communication with his patients. Dr. Fuentes is board-certified in internal medicine by the American Board of Internal Medicine (ABIM) and is a fellow of the American College of Physicians (ACP). With over 38 years of experience, Dr. Fuentes is regarded as a highly qualified, exceptional medical practitioner who is fully prepared to provide care to adult patients suffering from a wide range of illnesses. Furthermore, he has always upheld a passion for improving community health. Orlando Primary Medicine is at 11616 Lake Underhill Rd. Ste. 205, Orlando...phone 407.601.5308

Celebration Obstetrics & Gynecology Associates Appoints Dr. Michele Johnson as New Medical Director Celebration Obstetrics & Gynecology Associates, PA has announced the appointment of Michele Johnson, DO, FACOG as the practice’s new Medical Director. Board Certified in Obstetrics and Gynecology, Dr. Johnson attended medical school at the Ross University School of Medicine in the Dominica, West Indies after graduating with honors from the University of San Diego with a Bachelor’s degree in Biology. Following completion of residencies at Oakwood Hospital and Medical Center in Detroit, Michigan and David Grant USAF Medical Center in California , she practiced general OB/ GYN for several years before becoming an Obstetric Hospitalist. Dr. Johnson has been a member of the clinical staff at Celebration Obstetrics & Gynecology since 2018, but practicing medicine for the past 13 years.

AdventHealth Opens Palm Parkway ER in Dr. Phillips Residents of Dr. Phillips have a new option for emergency care with the opening of the AdventHealth Palm Parkway ER. The emergency room expands the health care system’s network to better serve residents in southwest Orange County, as well as the many visitors who visit the area annually. The approximately 19,000-square-foot facility has 24 patient rooms (including two pediatric-friendly rooms to make ER visits less stressful for young patients); respiratory therapy; diagnostic imaging, including CT scans, X-ray and ultrasound; and a full-service laboratory. The AdventHealth Palm Parkway ER’s design is unique in the AdventHealth network, with Old Florida architecture to complement the aesthetics of the area. The facility is staffed by a comprehensive clinical team including board-certified emergency physicians and emergency nurses. The AdventHealth Palm Parkway ER is located at the intersection of Palm Parkway and Daryl Carter Parkway.

NORTH CENTRAL FLORIDA || GRAND ROUNDS Jennifer Bizon, PhD, Named Chair of UF Department of Neuroscience BY MICHELLE KOIDIN JAFFEE

Medicine. “With Dr. Bizon’s leadership and through collaborations with others in UF’s neuroscience community, including the McKnight Brain Institute and the Norman Fixel Institute for Neurological Diseases at UF Health, the department of neuroscience has the momentum to lead the state and nation in discovery-based research and to expand educational opportunities in the neurosciences for students and trainees at all academic levels,” Koch said. A native of Burlington, North Carolina, Bizon earned a bachelor’s degree in psychology at the University of North Carolina at Chapel Hill and a doctorate in neurobiology and behavior at the University of California, Irvine. She completed a postdoctoral fellowship in the department of psychological and brain sciences at Johns Hopkins University. Prior to her arrival at UF, Bizon spent seven years as a psychology professor at Texas A&M University, where she was vice chair of the Neuroscience Executive Committee. She was recruited to UF as part of an initiative to expand the university’s research in cognitive aging,

University of Florida neuroscientist Jennifer Bizon, PhD, an expert in brain aging, has been named chair of the UF College of Medicine’s department of neuroscience. Bizon, who has served as interim chair of the department since April 2020, succeeds longtime chair Lucia Notterpek, PhD, who is now associate dean for biomedical research at the University of Nevada, Reno School of Medicine. With an annual grant portfolio of over $21 million, UF’s department of neuroscience is ranked No. 5 nationally in funding from the National Institutes of Health. “It is a true privilege to have the opportunity to lead such a talented group of faculty and students who demonstrate a clear passion for scientific discovery and quality education. I look forward to facilitating department collaborations and programmatic efforts with colleagues across our academic health center,” said Bizon, who also serves as a professor of neuroscience and co-director of UF’s Center for Cognitive Aging and Memory Clinical Translational Research, or CAM Center. “Embracing the concept of inclusive excellence, our department will further continue its efforts to recruit and advance an increasingly diverse community of neuroscientists.” Over the last 10 years, the department has greatly expanded its national visibility and scientific impact, said Colleen Koch, MD, MS, MBA, dean of the UF College of

Orlando Health Acquires FHV Health Founded almost 25 years ago, FHV Health brings together specialists in vascular surgery, primary care and cardiology to detect diseases earlier and treat them more effectively. The practice has provided access to world-renowned medical innovation and nationally recognized heart and vascular experts. FHV Health cardiologists were the first to bring procedures like cardiac catheterizations, coronary stenting as a superior alternative to traditional “clot-buster” therapy, and minimally invasive abdominal aortic aneurysm repair to the area, increasing patient options for lifesaving and diagnostic procedures. “The mission of FHV Health has always been to bring together the talents and expertise of leading physicians to our patients and this alignment with Orlando Health does just that,” said David C. Lew, MD, chairman of FHV Health. “We’re looking forward to increasing the positive health impacts we can make in our communities as we look to the future.”

Effective April 12, 2021, Orlando Health completed its acquisition of FHV Health, a multi-specialty group with locations throughout Lake, Sumter and Marion Counties. FHV Health consists of 19 physicians and 10 locations including primary care, cardiology practices and urgent care facilities. “FHV Health has provided its patients with access to distinguished physicians and providers for more than two decades,” said David Strong, Orlando Health president and chief executive officer. “We’re honored to continue that legacy while also bringing to this community the highest quality of patient care for which Orlando Health team members and physicians are recognized.” “We are excited to join the Orlando Health family, which has a strong history of providing exceptional care to the communities it serves,” said Jose R. Rosado, MD, vice chairman of FHV Health. “Joining Orlando Health allows us to further advance our ability to provide innovative and quality services.”

DOH-Marion Issues Rabies Alert After Cat in Zuber-Area Tests Positive The Florida Department of Health in Marion County has issued a rabies alert after a cat in the Zuber area tested positive for rabies. People who live or work in the Zuber area, particularly those who live south of West Highway 326, west of Northwest 44th Avenue, north of Northwest 53rd Street and east of Northwest Highway 225A, should maintain a heightened awareness that rabies is active in the area. An animal with rabies could infect other animals that have not received a rabies vaccination. Domestic animals are at risk if they are not vaccinated; rabies is always a danger in wild animal populations. Rabies is a disease of the nervous system and is fatal to humans and warm-blooded animals. The only treatment for human exposure to rabies is rabies-specific immune globulin and rabies immunization. Appropriate treatment started soon after the exposure will protect an exposed person from the disease. For more information on rabies, visit www.floridahealth.gov/diseases-and-conditions/rabies.

ORLANDOMEDICALNEWS.COM

APRIL 2021

Jennifer Bizon, PhD, reviews images with colleagues supported by the McKnight Brain Research Foundation. Bizon is a National Institute on Aging-funded principal investigator who studies brain aging and its implications for cognitive function, with a long-term goal of identifying strategies and interventions to promote cognitive resilience at advanced ages. She has published more than 80 peer-reviewed articles and been named both a UF Term Professor and a UF Research Foundation Professor.

VOLUSIA-BREVARD | | GRAND ROUNDS CONTINUED ...

Florida Dermatologists Elected President, Vice-President of American Academy of Dermatology

Think Offering Health Insurance in Your Small Business is Impossible? Think Again!

Two Florida dermatologists will be serving as president and vice-president of the American Academy of Dermatology beginning March 2023. Terrence A. Cronin, Jr., MD, FAAD, will be installed as president-elect in March 2022 and hold the office of president for one year beginning in March 2023. He earned his medical degree from Wake Forest University in Winston-Salem, North Carolina and completed his dermatology residency and served as chief resident at the University of Florida in Miami, where he is currently an assistant voluntary professor. Dr. Cronin is an advisor liaison to the AADA’s Council on Government Affairs and Health Policy and has been involved with the Academy at the leadership level since 2006. He served on the Academy’s Advisory Board Reference Committee

mation regarding the benefits offered, plan designs and rates will be housed. On this benefit administration system, the member can research all benefits offered and enroll. *Educational Resource: The benefit administration system combined with the call center and the Services from Avalon Insurance Services and the Meehan Agency will be a resource for employee benefits surpassed by no other chamber in our area. Members will now have the ability and resource to learn more about employee benefits and how they best meet their unique needs. *Industry Leading Service: members will have all benefit offering information available on the online benefit administration system and will also have a call center designed specifically for their plans. Members will have the options to go online or talk directly with a service representative assigned specifically for their group. The Federal Government Bureau of Labor Statistics indicates that while 88 percent of employers with more than 500 employees provide company health plans, only 55 percent of small business comprised of less than 100 employees, do the same. Some small business owners and entrepreneurs might feel most health insurance options are simply out of reach, like Margie. You won’t know unless you ask. We have a plan for you. The East Orlando Chamber is here to help with unique offerings to help elevate your businesses visibility and connect you with others helping your business thrive. Our upcoming W.I.S.E. (Women in Successful Endeavors) Luncheon is featuring Women in Politics, May 5th, sponsored by UCF. Dana Loncar with Consensus Communications will moderate our dynamic panel including, Orange County District 3 Commissioner Mayra Uribe, Orange County Mayor’s Chief of Staff, Roseann Harrington and OCPS Board Chair and former Orange County Mayor, Teresa Jacobs. Our next Healthcare Collaborative, May 13th will discuss Physician Practice & Value Based Care: Is it the key to success moving forward? Guest panelists, Larry Jones, Executive Director of Integrated Independent Physicians Network and Fraser Cobbe, President of Cobbe Consulting & Management will discuss this important topic for healthcare in Central Florida and beyond. For more information or to register call (407) 277-5951 or visit our website at eocc.org.  The East Orlando Chamber of Commerce everywhere East of I-4.

Dr. Harry Moulis Scholarship for Medical Excellence

Volusia County Medical Society Events and Education

To honor VCMS member Dr. Harry Moulis, his partners at Borland Groover Port Orange have established The Harry Moulis Scholarship for Medical Excellence. This scholarship will be for current medical students in their fourth year at the Daytona Beach Regional Campus where Dr. Moulis was a beloved faculty member and friend. It is their desire to create an endowed fund that will generate scholarships in perpetuity. Dr. Moulis, a local Gastroenterologist of Borland Groover, passed away on November 17, 2020 after a short battle with brain cancer. Should you wish to give, all gifts designated for this fund are tax deductible. To give online, simply click on the FSU Foundation link: http://give.fsu.edu/drmoulis

WEDNESDAY, MAY 12, 12 - 1 PM Michael Rutenberg, MD PhD Assistant Professor, University of Florida Department of Radiation Oncology, UF Health Proton Therapy Institute Virtual no-cost CME via Zoom

Home RT-PCR Saliva Test Kit

and Executive Committee, most recently as chair of the Advisory Board, and on the Academy’s Board of Directors. In addition, Dr. Cronin was named “Practitioner of the Year and Sunscreen Advocate” by the Florida Society of Dermatology and Dermatologic Surgery and maintains a private practice in Melbourne, FL. Robert S. Kirsner, MD, PhD, FAAD, will be installed as vice president-elect in March 2022 and hold the office of vice president for one year beginning in March 2023. He is chair and Harvey Blank endowed professor at the Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine. He most recently served on the Academy’s Board of Directors and previously chaired the Academy’s Council on Education.

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APRIL 2021

CLICK HERE TO REGISTER

Halifax Health – Hospice 2nd Annual Rick Zimmer Jr. Memorial Golf Tournament Hospice will be hosting the 2nd Annual Rick Zimmer Jr. Memorial Golf tournament on Saturday, May 15, at Cypress Head Golf Club in Port Orange. Proceeds from the event will support Halifax Health – Hospice’s Traumatic Loss Program. CLICK HERE FOR MORE INFORMATION.

Orlando Medical News May 2021

Articles inside

NORTH CENTRAL FLORIDA GRAND ROUNDS

VOLUSIA-BREVARD GRAND ROUNDS

Central Florida Turns Turquoise to End Lung Cancer

Five Reasons Why Your Website Is Not Working

Alcohol, Not Cannabis, is Associated with Changes in Brain Morphology

Medicare Requires 60 Percent of Your Medicare Patients Have Their Annual

Motivational Interviewing

HEALTHCARE LEADER Visionary Leadership

COVER Unique Behavioral Health Program Established in Lake Mary

A Novel Therapy to Combat Post-COVID Syndrome and Heart Failure Symptoms

EOCC Think Offering Health Insurance in Your Small Business is Impossible? Think Again

The Science of Healthy Flooring

PHYSICIAN SPOTLIGHT