table of contents | july • august 2016
20 At OurHealth, we care about helping you stay healthy, so we’ve come up with a list of ten dermatologist approved tips you can use to protect your skin.
MEDI•CABU•LARY.......................8 Local experts define health-related terms
JUST ASK!.......................................10 Healthcare questions answered by local professionals
NEW & NOTEWORTHY.............12 A listing of new physicians, providers, locations and upcoming events in the Shenandoah Valley and Charlottesville communities
HEALTH POINTS.........................16 Interesting facts and tidbits about health
THE ANATOMY CHALLENGE..................................19 Are you up for the challenge? In this issue, test your knowledge when it comes to the SKIN.
24 Even though summer is still in full swing, school will be back in session before we know it. Getting a head start on preparing kids for the new school year is always a smart idea, especially when it comes to their health.
31 Senior Living AWARDS
OurHealth presents the 2nd Annual Senior Living Awards for Charlottesville and the Shenandoah Valley!
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AWARDS 201
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
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16 BRONZE
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II RT PA
44 Part III of OurHealth’s four-part series explores healthcare careers requiring postgraduate studies, including graduate school, professional school, residency programs and fellowships.
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hello, HEALTH!.............................. 42 Capturing the spirit of those working in healthcare and of people leading healthy lives through photos.
FIT BITS!........................................ 61 Get to the 'Core' of Your Workout This article, the fourth in a yearlong OurHealth series about primary care, focuses on how you can Inspire Your Care. We’ll delve into your part of the patient-physician partnership.
Deidre Wilkes, OurHealth's resident fitness specialist, shares the many training benefits of working your 'Core'.
CLOSER LOOK..............................66 Images reflecting the landscape of healthcare in the Shenandoah Valley and Charlottesville * PLUS * a chance to win prizes!
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CARILION CLINIC ADDRESSES LEXINGTON’S NUMBER ONE HEALTH NEED
With the recent opening of VelocityCare by Carilion, Lexington and surrounding community residents now have access to a nearby urgent care. Prior to its opening, the closest urgent care was nearly an hour away.
www.OurHealthCville.com
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july • august 2016 PUBLISHER PRESIDENT/EDITOR-AT-LARGE VICE PRESIDENT OF PRODUCTION PROJECT COORDINATOR AND FITNESS EXPERT CHIEF DESIGNER GRAPHIC DESIGNER DIGITAL CONTENT MANAGER | EVENT SPECIALIST COPY EDITOR DIGITAL MEDIA STRATEGY ORIGINAL PHOTOGRAPHY ACCOUNTING MANAGER INTERN
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McClintic Media, Inc. Steve McClintic, Jr. | steve@ourhealthvirginia.com Jennifer Fields Hungate Deidre Wilkes Karrie Pridemore Tori Meador Heidi McClintic Bobbi Hoffman Dalton Holody Shawn Sprouse/ www.sdsimages.com Laura Bower Jennifer Hellier
CONTRIBUTING MEDICAL EXPERTS William Davidson, MD Joseph DiGirolamo, OD Charles Friel, MD Wendy Harper, MSOT/L Karen Klotz Kevin Lawrence, MD CONTRIBUTING PROFESSIONAL Geri Aston EXPERTS & WRITERS Lois Caliri Jennifer Hellier Tina Joyce Suzanne Ramsey Deidre Wilkes
ADVERTISING AND MARKETING Kim Wood • Vice President of Business Development 540.798.2504 • kimwood@ourhealthvirginia.com Cindy Trujillo • Senior Media Consultant 434.907.5255 • cindy@ourhealthvirginia.com
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COMMENTS/FEEDBACK/QUESTIONS We welcome your feedback. Please send all comments and/or questions to the following: U.S. Mail: McClintic Media, Inc., ATTN: Steve McClintic, Jr., President/ Publisher/Editor: 303 S. Colorado Street • Salem, VA 24153. | Email: steve@ourhealthvirginia.com | Phone: 540.387.6482 Ext. 1 Information in all print editions of OurHealth and on all OurHealth websites (websites listed below) and social media updates and emails is for informational purposes only. The information is not intended to replace medical or health advice of an individual’s physician or healthcare provider as it relates to individual situations. DO NOT UNDER ANY CIRCUMSTANCES ALTER ANY MEDICAL TREATMENT WITHOUT THE CONSENT OF YOUR DOCTOR. All matters concerning physical and mental health should be supervised by a health practitioner knowledgeable in treating that particular condition. The publisher does not directly or indirectly dispense medical advice and does not assume any responsibility for those who choose to treat themselves. The publisher has taken reasonable precaution in preparing this publication, however, the publisher does not assume any responsibility for errors or omissions. Copyright © 2016 by McClintic Media, Inc. Reproduction in whole or part without written permission is prohibited. OurHealth Charlottesville/Shenandoah Valley is published bi-monthly • Special editions are also published • McClintic Media, Inc. • 303 S. Colorado Street, Salem, VA 24153, P: 540.387.6482 F: 540.387.6483. MAIN: ourhealthvirginia.com | ourhealthswva.com | ourhealthlbss.com | ourhealthrichmond.com | ourhealthcville.com | Advertising rates upon request.
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LOCAL EXPERTS D E F I N E H E A LT H R E L AT E D T E R M S
“
What is Myringotomy? Myringotomy is simply making a cut through the eardrum. The better question is: why would we do a myringotomy?
When the eustachian tube is not functioning properly, the middle ear space will develop negative pressure or fill with fluid, which can affect hearing or cause an infection.
”
– William Davidson, MD
The middle ear is a space behind the eardrum that contains the small bones which transfer sound to the inner ear. The eustachian tube is responsible for equalizing the pressure in the middle ear. When the eustachian tube is not functioning properly, the middle ear space will develop negative pressure or fill with fluid, which can affect hearing or cause an infection. A myringotomy can be done to ventilate the middle ear when this occurs. Usually a small tube is placed in the myringotomy to maintain the opening and allow it to continue to ventilate for a longer period of time. Otherwise the myringotomy would heal up in a couple of days. This procedure is commonly done in children with recurring ear infections or middle ear fluid. (Scan the QR code to the left for a diagram of the middle ear.)
William Davidson, MD
Augusta Health Otolaryngology Charlottesville | 434.245.7010 www.augustahealth.com
What is Vestibular Therapy? Dizziness is a symptom experienced by most adults at some point in their lives, and there are many different causes. When dizziness is the result of an inner ear condition it may feel like the room is spinning, and can be triggered by movement of the head. This type of dizziness is known as vertigo. Vestibular therapy (VT) is an exercise-based program designed to reduce dizziness and vertigo. Vestibular rehabilitation clinicians are healthcare professionals with additional experience in treating vertigo. They are usually physical therapists, occupational therapists, or audiologists who have undergone specialized training. Vestibular therapy is typically an outpatient procedure. The clinician completes a thorough assessment and designs an exercise program which is customized to address the specific symptoms experienced by the patient. The success of the program depends largely upon the commitment of the patient, especially since a key component of VT is an ongoing home exercise program.
Wendy Harper, MSOT/L
SCAN HERE
to view a diagram of the middle ear.
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Restorative Therapy Manager Blue Ridge PACE Charlottesville | 434.529.1300 www.riversideonline.com/blue_ridge_pace
What is Sepsis? Sepsis is a potentially lifethreatening complication arising from an infection. It is the body’s response to the infection that defines sepsis. This response can lead to tissue damage, organ failure and even death. Signs that sepsis is present include rapid heart rate, rapid breathing, or fever in the setting of a known or suspected infection. If sepsis becomes more severe, the person typically experiences one or more signs of organ failure, such as decreased urine production or changes in mental status. Persons who progress into septic shock exhibit dangerously low blood pressure that does not respond readily to fluid replacement therapy. Treatment typically involves the use of antibiotics to fight the infection, medications to raise blood pressure and general supportive care. Supportive care may include oxygen and large amounts of intravenous fluids. In some cases, patients may require respirators or dialysis.
Kevin Lawrence, MD
Sentara Martha Jefferson Hospital Charlottesville | 434.654.7000 www.sentara.com
H E A LT H C A R E QUESTIONS ANSWERED BY LOCAL PROFESSIONALS
“
What is most disturbing is that 1 in 5 teenagers are showing some type of hearing loss. The cause stems from the use of personal listening devices streaming music into their ears through an ear piece.
”
– Karen Klotz
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How can I tell if I am at risk for colorectal cancer? Everyone is at risk for colon cancer. About 1 in 20 people will have colorectal cancer diagnosed in their lifetime, and it remains the second most common cause of cancer death. The majority of colorectal cancer is diagnosed in people over the age of 50. Therefore, everyone should have screening after age 50. While there are several options for screening, colonoscopy is the most common and has the added benefit of finding and treating colon polyps as well. Other risk factors include a family history of colon cancer and a personal history of inflammatory bowel disease. If you have either of these risk factors, your primary care physician may recommend screening prior to age 50. Finally, some people may experience symptoms that might suggest colorectal cancer. These include rectal bleeding, new-onset constipation, abdominal pain or anemia. If you have any of these symptoms, further evaluation may be appropriate no matter your age. Your doctor should help guide this evaluation. Charles Friel, MD
UVA Cancer Center Charlottesville | 434.924.9333 cancer.uvahealth.com
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
What are some signs that may indicate I need a low vision evaluation? The Vision Council defines low vision as a visual impairment which is not correctable through surgery, pharmaceuticals, glasses or contact lenses. Low vision patients often require the use of specialized optical devices. These can include hand-held magnifiers, digital magnification via computers or closed caption television, or even specialized eyeglass-mounted telescopes. Low vision can be caused by various conditions including glaucoma, macular degeneration, diabetic eye disease, or ocular injury. Since the patient usually already knows they struggle with an underlying eye condition, the low vision conversation often starts with your eye doctor. Your eye doctor will help determine when conventional eyeglasses are insufficient to meet your lifestyle needs, and will then discuss alternative solutions. Other indications of low vision can include difficulty in daily activities like reading, cooking, seeing street signs, or watching TV. Sometimes these issues can be addressed with a new pair of eyeglasses, but if not, you may be a candidate for a low vision evaluation. Joseph DiGirolamo, OD
Primary Eyecare Charlottesville | 434.977.2020 www.cvilleeyecare.com
My child has his earphones on constantly. Should I be worried about him losing his hearing? The answer is simply, yes! What is most disturbing is that 1 in 5 teenagers are showing some type of hearing loss. The cause stems from the use of personal listening devices streaming music into their ears through an ear piece. The inner ear (cochlea) is where the damage takes place. Exposure to loud sounds causes the tiny hair-like cells in this part of the ear to become damaged. These cells are what changes sound to electrical signals so that the brain may interpret it. Once these cells are damaged, they cannot be restored and the damage is permanent. Karen Klotz
Owner/Provider Virginia Hearing Group Verona | 540.248.1670 www.virginiahearinggroup.com
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NEW
NOTEWORTHY
NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS
UVA Center for Telehealth Renamed for Co-founder Karen Rheuban, MD To honor the co-founder who has helped thousands of patients across Virginia and the world better access care, the University of Virginia Center for Telehealth has been renamed the Karen S. Rheuban Center for Telehealth.
Make Sure You Don't Miss
A pediatric cardiologist by training, Dr. Rheuban says she was inspired to help create the center through the challenges she would face seeing her own patients. “We would be driving all over Virginia to see patients. But when we’re not there, we’re not there,” she says. That drive to do more for her own patients – and how technology could be harnessed to help patients with a range of conditions – led to the telehealth center’s founding more than 20 years ago. Since then, the center has facilitated more than 50,000 patient encounters, in more than 40 specialties, through secure video at more than 150 sites throughout Virginia as well as locations around the world. The center has helped patients more easily access care closer to where they live while saving them an estimated 16.1 million miles of travel to get the care they need. The care provided through the center ranges from cystic fibrosis and high-risk pregnancy clinics to psychiatry and diabetes education. Dr. Rheuban and the telehealth center have also worked to expand access to care throughout the mid-Atlantic, receiving a $1 million federal grant in 2011 to create the Mid-Atlantic Telehealth Resource Center that is based at UVA. The telehealth resource center works to expand telehealth expertise in the District of Columbia along with Virginia, Delaware, Kentucky, Maryland, North Carolina and Virginia. In addition, Dr. Rheuban serves as a trustee of the Swinfen Charitable Trust, which connects more than 300 hospitals in developing countries around the world via telemedicine with hundreds of medical specialists, including dozens at UVA. For more information, visit www.uvahealth.com.
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MLS Laser Therapy at Virginia Foot & Ankle Surgical Associates
Carilion Clinic Opens New Family Practice in Clifton Forge
Multi-wave Lock System (MLS) Laser Therapy has been used by Virginia Foot & Ankle Associates to treat over 350 patients suffering from sprains, tendonitis, and sports injuries due to arthritis, diabetic neuropathy, and other foot and ankle disorders. MLS Laser Therapy uses light energy to stimulate intercellular activity reducing pain and speeding up recovery of damaged cells.
Carilion Clinic is pleased to announce that a new family medicine practice in Clifton Forge will open in late summer 2016. The office will be located at 609 Church Street in Clifton Forge and will be staffed by six providers.
In the year since this treatment option has been offered, the results have found 83 percent of patients treated show an improvement of their condition.
The office features two exam rooms and one exam/treatment room. Providers will have access to X-ray services and a small lab, and will offer occupational medicine services to the surrounding community.
For more information on MLS Laser Therapy at Virginia Foot & Ankle Associates, visit www.vfasa.com.
To find a family provider near you, visit www.carilionclinic.org.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Vihang Bijani, DPM Virginia Foot and Ankle Surgical Associates Charlottesville 434.977.8040 www.vfasa.com
Emily Christman, MD
Charlottesville Gastroenterology Associates Charlottesville 434.817.8484 www.cvillegi.com
Faith Mercurio, MS
Augusta Pediatrics Fishersville | 540.932.0980 www.uvahealth.com
Tina Hahn, NP
Carilion Clinic Family and Community Medicine Bridgewater 540.828.2634 www.carilionclinic.org
Karen Silveira, WHNP, CNM
Augusta Health Care for Women Fishersville | 540.213.7769 www.ahcfw.netd
Arun Mannem, MD
Charlottesville Gastroenterology Associates Charlottesville 434.817.8484 www.cvillegi.com
Ines Soukoulis, MD
Meghan Little, MS, PT, Karen Martin, WHNP DPT, ATC, CMTPT, CHT Augusta Health Care for Women Fishersville | 540.213.7769 www.synergyrehabandwellness.com www.ahcfw.net Synergy Rehab and Wellness Verona | 540.416.0530
Julie-Anne Wade, MD
Pediatric Dermatology Augusta Pediatrics Charlottesville Dermatology Fishersville | 540.932.0980 Charlottesville www.uvahealth.com 434.984.2400 www.cvillederm.com
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NEW
NOTEWORTHY
NEW PHYSICIANS, P R O V I D E R S , L O C AT I O N S AND UPCOMING EVENTS
Augusta Health Employees Give Back Augusta Health employees participating in the annual campaign for the Augusta Health Foundation donated a total of $104,489. The money goes to both patient programs and funds, as well as to the Employee Emergency Fund to help colleagues in times of crisis.
PART IV of the Primary Care Series is Here!
“The most popular fund among Augusta Health employees is the Employee Emergency Fund,” says Susannah Via, employee campaign organizer and annual fund officer. “The Employee Emergency Fund was developed by employees-for employees and has provided more than $30,000 to nearly 40 employees who experienced a temporary financial hardship such as a serious illness or injury, death in the family or domestic abuse situation.” Augusta Health Foundation’s mission is to inspire community ownership through charitable giving to advance health and wellness in the region. The foundation is the charitable arm of Augusta Health and supports essential patient care programs and services including Augusta Health Hospice of the Shenandoah. “One of Augusta Health’s core values is community-centeredness, and our employees live that ideal in many ways,” says Mary N. Mannix, FACHE, President and CEO of Augusta Health. “We are ‘there to help’ in our schools, our churches and our neighborhoods. We volunteer for our highway clean-up, conduct school supply and food drives within our departments, and support our patients during Relay for Life. I’m always amazed by our continuous ability to give and to go above and beyond what is asked.” For more information about Augusta Health Foundation, please visit www.augustahealth.com/foundation.
UVA Orthopaedic Surgeons Join Culpeper Clinic University of Virginia Health System adds two orthopaedic surgeons who will work at UVA Orthopaedics Culpeper to provide care that includes spine surgery and pediatric orthopaedics.
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Hamid Hassanzadeh, MD, and Mark Romness, MD, are now seeing patients at the clinic, located on the Novant Health UVA Health System Culpeper Medical Center campus at 541 Sunset Lane, Suite 303, in Culpeper. Dr. Hassanzadeh is fellowship-trained in spine surgery and pediatric spine surgery. He will specialize in caring for patients with herniated discs, scoliosis and kyphosis as well as spinal stenosis. He will also perform minimally invasive spine surgery and revision spine surgery. Dr. Romness is fellowship-trained in pediatric orthopaedic surgery. He will specialize in caring for children with cerebral palsy and spina bifida, gait abnormalities, lower extremity problems and trauma, and Osteogenesis imperfecta. “Children who need orthopaedic care, as well as patients with spinal conditions, will have more convenient access to expert care in Culpeper with the arrival of Dr. Hassanzadeh and Dr. Romness,” says Bobby Chhabra, MD, chair of UVA’s Department of Orthopaedic Surgery. To make an appointment at UVA Orthopaedics Culpeper, call 540.321.3120.
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Norfolk Girl Receives Liver Transplant Through Partnership Between UVA Children’s Hospital and Children’s Hospital of Pittsburgh of UPMC A 13-year-old Norfolk girl is the first patient to receive a transplant in a unique pediatric liver transplant partnership between Children’s Hospital of Pittsburgh of UPMC and the University of Virginia Children’s Hospital. The partnership was established to expand UVA’s pediatric liver transplant program and increase access to care for transplant patients throughout Virginia. Children’s Hospital of Pittsburgh of UPMC transplant surgeons consult with UVA counterparts and with Virginia-based patients via teleconsult. Once organs become available, a team of nurses, surgeons and specialists from Pittsburgh travel to UVA to perform the transplant alongside UVA transplant surgeons. India and her mother, Melody Johnson, traveled to Charlottesville for evaluation with the UVA team in person and the Children’s Hospital of Pittsburgh of UPMC team via telemedicine.
PART III of the How to in Healthcare Series is Here!
“The team was so confident in what they could do, it made me confident,” Johnson says. “I was really comfortable with the facility and the people.” India received her new liver and kidney on May 17, two weeks after she was originally added to the national organ transplant waiting list. Physicians report that she is doing very well. “We’re so pleased that India received her transplant closer to home with exceptional care from UVA and Children’s Hospital of Pittsburgh of UPMC,” says Kenneth Brayman, MD, PhD, FACS, division chief of transplant surgery and director of the Charles O. Strickler Transplant Center at UVA. For more information, visit www.uvahealth.com.
PAR T
III
DSAGR Offers Services in Charlottesville The Down Syndrome Association of Greater Richmond (DSAGR) is expanding its footprint into Charlottesville. DSAGR has started a community group in Charlottesville to offer services to families of individuals with Down syndrome. The organization assists families in 28 counties, stretching from Charlottesville to Williamsburg to the Northern Neck and Fredericksburg to the Virginia/North Carolina border. “Over the past few years, we’ve heard from more and more families in the Charlottesville area looking for assistance in raising their children with Down syndrome,” says Terri Lancaster, executive director of DSGAR. “It was an easy decision to start a community group because of the passion we heard from families who share our vision of a community where individuals with Down Syndrome are fully included and valued members.” In addition, Charlottesville resident Marco Mejias of Booz Allen Hamilton has joined the DSAGR Board of Directors and is assisting the organization’s entrance into Charlottesville.
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DSAGR offers a variety of programs to ensure lifelong learning for its members and their families. It also provides numerous educational opportunities, including an annual conference at the beginning of the year that attracts educators, parents and professionals from Virginia and neighboring states. For more information, visit www.dsagr.com.
www.OurHealthCville.com
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T I P S , T I D B I T S A ND MO R E TO I NF O R M A ND ENT ERTA I N YO U
Jefferson Sprint Triathlon & Duathlon
Check out the sixth annual 2016 Jefferson Sprint Triathlon & Duathlon, newly relocated
to the triathlon-friendly Crozet YMCA. This is a family friendly, neighborhood event with two race options: Race Option 1
Jefferson Sprint Triathlon
Race Option 2
350m swim
12 mile bike
3 mile run
Jefferson Sprint Duathlon
1 mile run
12 mile bike
3 mile run
This year’s beneficiary is The Women’s Initiative, whose mission is to provide effective counseling services, social support and education to empower women to transform challenging life situations into opportunities for renewed well-being and personal growth regardless of means.
JULY
Date: Saturday, July 16, 2016 Time: 7:15 am
On average,
230 people
go to the emergency room every day with fireworks-related injuries in the month around the July 4th holiday. Source: United States Consumer Product Safety Commission
Location: Fry’s Spring Beach Club 2512 Jefferson Park Avenue | Charlottesville Registration: www.charlottesvillemultisports.com For more information about the Jefferson Sprint Triathlong & Duathlon visit www.charlottesvillemultisports.com. For more information on The Women’s Initiative, visit www.thewomensinitiative.org.
THEY SEND HOW MANY TEXTS!? According to a study by The Nielson Company, kids ages 13-17 send and receive more than 3,400 texts per month. That’s approximately seven messages every hour they are awake! Source: National Safety Council
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
HARD FACT: The enamel on teeth is the body’s HARDEST substance.
DID YOU
PLAYING IN THE POOL:
KNOW?
Don’t Forget to Hydrate! Hydration is important before, during and after swimming. Kids aged 9-12 years old should drink 3-8 fluid ounces of water
Although it is largely preventable,
TOOTH DECAY is the
NUMBER ONE chronic disease affecting children in the United States.
NOT COO L Mom
Adolescents 32-48 ounces every hour
9-12 years old 3-8 ounces every 20 minutes
every 20 minutes. For adolescents, the recommendation is 32-48 fluid ounces every hour. Source: American Academy of Pediatrics
Source: Centers for Disease Control
One or more
blistering sunburns in childhood or adolescence MORE THAN DOUBLE a person’s chances of developing MELANOMA later in life. Source: Skin Cancer Foundation
The 8th Annual
Take it
Outside! According to the American Academy of Ophthalmology, children who spend
more time outside exposed to daylight
MAY REDUCE
their risk of developing nearsightedness. Source: American Academy of Ophthalmology
SPLASH
FOR A CURE 5K
Making a Difference for Children with Cancer What is Splash for a Cure? It’s a 5K Race and Pool Party all taking place at ACAC. Come run, come to the pool, or do both! Runners will start and finish the race at ACAC and get into the waterpark with their registration, plus one additional waterpark pass. Not a runner? You may also purchase waterpark only tickets, which gives you access to all the fun, food, and to the pool ALL DAY! There will be food, games, a bounce house, raffle prize drawing, children’s activities, and music. What a fun way to end the summer and help raise money for a great cause!
ST AUGU
Date: Time: Location: Registration:
Saturday, August 27, 2016 8 -10:30 am ACAC Adventure Central 200 Four Seasons Drive | Charlottesville www.splashforacure.com
THE SECOND ANNUAL
BEST
BEDSIDE MANNER
AWA R D S IN THE
S H ENAND OAH VALLEY & CH ARLOT T ES VILLE
LO O K F O R TH E R ES U LT S I N TH E NO V E M BE R /DE CE M BE R E DI TI ON OF OU R HEA LT H CH A RL O T T ESVILLE AND SHE NANDOAH VAL L EY
F OR M ORE INF ORM AT ION SCAN HE RE OR GO TO WWW.OURHEALTHCVILLE.COM 18
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Anatomy CHALLENGE the
How much do you know about Your
Skin? Complete the word
search below. Next, match the correct word with the part of the body in the illustration.
[ Your Skin ]
WORD SEARCH basal cell carcinoma
hypodermis
basement membrane
melanocyte
basl cell
muscle layer
dermis
sweat duct
epidermis
sweat gland
hair shaft
_____________ _____________ _____________ _____________ _____________
_____________ _____________
_____________ _____________ _____________
_____________
For answers, visit OurHealth Shenandoah Valley and Charlottesville’s Facebook page at www.OurHealthCville.com
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words | JENNIFER HELLIER
As the months heat up, it’s time to make sure you’re taking care of your skin! According to the American Cancer Society, the number of skin cancer cases per year in the US has been on the rise. At OurHealth, we care about helping you stay healthy, so we’ve come up with a list of ten dermatologist-approved tips you can use to protect your skin.
2
2. Protect your skin even on cool or cloudy days.
1
1. Do Not Burn. Our first tip seems like a bit of an understatement. The Skin Cancer Foundation says that tanning alone can indicate damage to your skin, but a burn means you’ve gotten too much sun.
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While you may not be able to see the sun on cloudy days, UV rays are always present. In fact, the American Cancer Society says cloudy days are when you’re most likely to get sunburned. Be sure to protect your skin.
If you do happen to be outdoors, an umbrella or a nice, shady tree can be welcome relief from the sun’s harsh rays,
Wear long sleeved rash guards, wide-brimmed hats and other sun protective clothing. Clothing labeled “UPF+” will reflect UV rays, and is an easy and convenient way to protect broad areas
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
5
and the perfect place to relax and enjoy being outside.
4. Wear Sun Protective Clothing.
of skin from the sun.
3
3. Seek shade, especially during the sun’s peak hours.
5. Try to schedule your outdoor activities to avoid peak times a of sun. Peak times can range from 10 a.m.-3 p.m. Scheduling any activities for before and after these times can really save your skin.
6 7 CAUTION
6. Use extra caution near water, snow, and sand.
Water, snow, and sand all have a high albedo, which means these surfaces reflect harmful UV rays and increase your chances of getting sunburned while near them. Don’t forget to wear sunscreen!
7. Avoid intentional tanning and tanning beds.
While tanning can give you that skin tone you’re aiming for, lots of exposure to UV rays can really increase your chances of getting skin cancer down the road. It’s important to take care of your skin!
Vitamin D
D
D
Vi ta m in
in
m
a Vit
8
D in amVita t i min D V
Vita
min D
8. Get vitamin D safely through a healthy diet or vitamin supplements. It can be difficult to get vitamin D without getting sun damage. Luckily, there are safe, healthy alternatives. For instance, try vitamin D rich foods like fatty fish (e.g. tuna, mackerel, salmon), egg yolks and cheese. Vitamin supplements are also an easy way to get vitamin D into your diet.
Dermatology Centers In Charlottesville and the Shenandoah Valley
Advanced Dermatology of Charlottesville Board certified dermatologists offer general dermatology, laser cosmetic surgery, liposuction, and Mohs micrographic surgery. 600 Peter Jefferson Parkway Charlottesville | 434.977.0027 www.sentara.com
Albemarle Dermatology Associates Board certified dermatologists provide medical and surgical dermatology in the treatment of general skin conditions as well as advanced cosmetic dermatology services for face, eyes, and body. 3350 Berkmar Drive Charlottesville | 434.923.4651 www.albemarledermatology.com
Blue Ridge Dermatology Board certified dermatologists offer general dermatology services, and maintain consulting privileges at Augusta Health. 1151 13th Stree Waynesboro | 540.949.6934 www.blueridgedermatology.net
Charlottesville Dermatology Staff including board certified dermatologists and a physician assistant (PA-C) offer a full range of services including general dermatology in the diagnosis and treatment of general skin conditions, facial rejuvenation, general cosmetic enhancements, and aesthetic services. 600 Peter Jefferson Parkway, Suite 230 Charlottesville | 434.984.2400 www.cvillederm.com
Dermatology PLC Medical staff, including board certified dermatologists, offers a full range of medical and surgical dermatology services, covering the treatment of all skin conditions and cancer. 320 Winding River Lane, Suite 301 Charlottesville | 434.296.0113 www.dermatologyplc.com
Family Dermatology of Albemarle Medical and surgical dermatology services are available in the diagnosis and treatment of all disorders involving the skin, hair, and nails. The staff includes three board certified dermatologists. 215 Wayles Lane, Suite 150 Charlottesville | 434.964.9500 www.familydermalbemarle.com
www.OurHealthCville.com
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Dermatology Centers In Charlottesville and the Shenandoah Valley Continued...
Savola Aesthetic Dermatology Center, PLC Board certified dermatologists offer general dermatology in the diagnosis and treatment of skin, hair and nail disorders. A wide variety of aesthetic dermatology services are also available including fillers, injectables and laser treatments. 66 Parkway Lane, Suite 101A Fishersville | 540.451.2833 www.savoladermatology.com
Shenandoah Dermatology PC Private practice with a board certified dermatologist offers general and geriatric dermatology, surgery, and dermatopathology in the treatment of skin conditions including acne, eczema and psoriasis. 1600 North Coalter Street, Suite 19 Staunton | 540.885.4500 www.shenandoahdermatology.com
Signature Medical Spa – A division of Albemarle Dermatology Associates
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9. Use a broad-spectrum, water-resistant sunscreen with an SPF of at least 30. Applying sunscreen at least 15 minutes before getting wet or sweating will allow it to absorb into your skin, giving you better protection. Reapplying every two hours or so can help ensure that your skin doesn’t burn. Make sure to cover all skin that will not be covered by clothing — don’t forget the top of your head, tops of your ears and feet, and the back of your neck!
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Board certified dermatologists and licensed aestheticians offer a wide range of laser and aesthetic treatments that include laser treatments, fillers, microneedling, earlobe rejuvenation and repair, and advanced peels.
10. Carefully examine all of your skin once a month.
3350 Berkmar Drive Charlottesville | 434.923.4646 www.signaturemedspa.com
Detecting melanoma early can save your life. If you find a new or growing spot on your skin, have it examined by a professional dermatologist immediately.
UVA Dermatology The dermatology department at UVA specializes in the treatment of skin disorders, including autoimmune blistering diseases, connective tissue diseases, such as lupus, childhood skin diseases, skin infections, and common issues like aging, acne and skin damage. The staff includes several board certified dermatologists, who work with the experts in the UVA Cancer Center to treat melanoma and all types of skin cancers. 1215 Lee Street Charlottesville | 434.243.3675 www.uvahealth.com
Sources
American Cancer Society – www.cancer.org National Council on Skin Cancer Prevention – www.skincancerprevention.org The Skin Cancer Foundation – www.skincancer.org WebMD – www.webmd.com
ON THE WEB
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Health Tools words | SUZANNE RAMSEY
Even though summer is still in full swing, school will be back in session before we know it. Getting a head start on preparing kids for the new school year is always a smart idea, especially when it comes to their health. Some things on the back-to-school checklist can wait until the last minute. Three-ring binders. Pens, pencils and paper. Computers and calculators.
Reprints To order reprints of the original artwork featured on this issue’s cover, contact Deidre Wilkes at
But other things, like a young one’s annual physical, vision test or allergy assessment, require some advanced planning. The following list is a good starting point for parents to use when it comes to checking off back-to-school health needs.
Make sure shots are up to date. Before the first day of preschool or kindergarten, kids need the following vaccines: •
Diphtheria, tetanus and whooping cough/pertussis, also called “DTaP”
deidre@ourhealthvirginia.com.
•
Polio
To view additional work by our
•
Measles, mumps and rubella, also known as “MMR”
•
Chickenpox
•
Flu (the Centers for Disease Control and Prevention (CDC) recommends a flu shot every year, from preschool through adulthood.)
540.387.6482 or via email at
artist, Joe Palotas, visit www.salemartcenter.com
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What’s the difference between DTaP and Tdap? Both vaccines contain inactivated forms of the toxin produced by the bacteria that cause the three diseases [diphtheria, tetanus, pertussis]. Inactivated means the substance no longer produces disease, but does trigger the body to create antibodies that give it immunity against the toxins. DTaP is approved for children under age 7. Tdap, which has a reduced dose of the diphtheria and pertussis vaccines, is approved for adolescents starting at age 11 and adults ages 19 to 64. It is often called a booster dose because it boosts the immunity that wanes from vaccines given at ages 4 to 6. Source: WebMD.
Between ages 7 and 10, the CDC recommends children be vaccinated against Hepatitis A and pneumonia. For middle-school-age boys and girls, physicians recommend the human papillomavirus (HPV) vaccine. At that age, children also need a Tdap booster and a vaccine to protect them from meningococcal disease, more commonly known as meningitis.
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• Polio • MMR • Chickenp ox • Flu
HPV is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV (herpes). HPV is so common that nearly all sexually active men and women get it at some point in their lives. There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening. Source: CDC.
At 16, kids need a meningitis booster. The meningitis vaccine is required by colleges, where dorm and dating life puts students at increased risk for the life-threatening disease. Between 16 and 18, the CDC also recommends the serogroup B meningococcal vaccine, which protects students from another type of meningitis.
Check iron level. Have your child’s hemoglobin (iron) checked to make sure they’re not iron deficient. Being iron deficient — sometimes called “anemic” — can cause fatigue, shortness of breath, insomnia and other problems. 26
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Schedule an eye checkup. “Eye exams in kids are important. The American Academy of Ophthalmology and the American College of Pediatricians recommend eye exams at birth, 6 months of age, 3 years of age, 5 years of age, and every 1-2 years in school aged kids. The exam Marc Shields, MD EyeOne
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Schedule dental and other checkups. Get dental and other medical checkups out of the way before school starts. That way, kids won’t have to miss school for appointments. Try to schedule the year’s second dental cleaning during the winter break, if possible.
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Turn down the volume. “Using headphones is fine as long as you, the parent, teach them the pitfalls of listening too loud. 1 in 5 teenagers are now showing a hearing loss because of media players. Follow the 60/60 rule; listen to your portable media player no more than 60 minutes a day at
Karen Klotz
60 percent volume.”
Virginia Hearing Group
Schedule speech therapy, if needed. If your child is having trouble speaking or being understood by others, they might benefit from speech therapy. Not being able to communicate or be understood can lead to frustration and even bullying at school.
Make sure kids know how to find help. Teach young children how to dial 9-1-1 in case of an emergency. And Mommy’s name is not Mommy. Kids need to know their parents’ names and their address.
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ow heavy is yo ur kid’s backpack ? Doctors say a child’s backpa ck, full of book s, should weigh no more than 10 percent of th eir body weight.
the school nurse (such as food allergies, asthma, etc.) or needs to take medications at school, be sure to contact the school nurse before school starts in order to complete all necessary forms and instructions. Some of these forms will need to be completed by your child’s doctor and may take a few days to be completed. Having this arranged before the school year starts will help to make sure your child will be cared for appropriately right from the very first day of school.” Steven W. Mumbauer, MD, FAAP Valley Pediatric Group, PLC
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Set a sleep schedule. School starts early and kids are known to stay up too late, with or without parental permission. At least a week before school starts, start enforcing those bedtimes, so the first days of school aren’t spent sleepy. For younger children, doctors recommend the three Bs: Brush, Book, Bed — as in brush teeth, read a book, go to bed.
Think about back health. Scoliosis screening isn’t the only thing you need to worry about when it comes to your student’s back health. How heavy is your kid’s backpack? Doctors say a child’s backpack, full of books, should weigh no more than 10 percent of their body weight. To help prevent back problems, consider a rolling backpack.
Screen for depression. At about age 13, many pediatricians start screening their patients for depression. It’s something to think about. Middle school is tough enough.
Have “The Talk.” Before leaving for college, there needs to be a discussion about sex, drugs, alcohol and issues like date rape and depression. If you’re not comfortable talking about these things, your child’s pediatrician can have this conversation. Because Mom and Dad aren’t involved, it might even result in a more open conversation and better results.
Update contact information. Make sure the school knows how to get reach you if your child becomes ill or has a medical or other emergency.
Develop independence. Before preschool or kindergarten, work on developing your child’s independence, so being separated from you at school isn’t such a big deal. One way to do that is by taking them to your local library’s story time session. There, kids learn to be in a group setting with other kids and aren’t constantly with Mom or Dad. Story time also re-enforces reading every day and gets kids ready for school. And it’s free. Can’t beat that.
Play with your kids. Little brains need to be stimulated over the summer, too. Put down the smartphone. Play board games, read books and create things together.
ON THE WEB
Sources
www.CDC.gov www.WebMD.com
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Expert Contribu
ginia Hearing Karen Klotz with Vir ia. gin Vir a, ron Group in Ve , FA AP MD er, Steven W. Mumbau oup, PLC in Gr c tri dia Pe y lle with Va Verona, Virginia. th Eyeone in Marc Shields, MD wi ia. gin Staunton, Vir
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g n i v i L r o i Sen ARDS AW The 2nd Annual Senior Living Awards
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6 GOLD
OurHealth Charlottesville and Shenandoah Valley magazine presents the second annual Senior Living Awards which recognizes senior health communities and services who are voted on by the local community for their exceptional service and care to seniors. Please join us in congratulating this year’s second annual Senior Living Award winners. The Voting Process During April 2016, the Senior Living Awards Voting Form was available on OurHealth’s website, www.ourhealthcville.com. The form consisted of 18 categories which the public could submit the business or community name by the applicable category. If you have any questions, please contact Stephen McClintic Jr., publisher of OurHealth, at steve@ourhealthvirginia.com or 540.387.6482. www.OurHealthCville.com
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First Place Hill & Wood Funeral Service
AWARDS 201
6 GOLD
Charlottesville | 434.296.6148 www.hillandwood.com
“Our staff will give you the same care and attention that we give to our own family. ” Do unto others as you would have them do unto you” are not just words to us, but rather, the way we live.” – Hill & Wood Funeral Service
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Staunton | 540.885.7211 www.henryfuneralhome.net
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Third Place
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Coffman Funeral Home Staunton | 540.887.8111 www.coffmanfuneralhome.net
Honorable Mention Teague Funeral Home Charlottesville | 434.977.0005 www.dignitymemorial.com /teague-funeral-home
ey n r o t t aw A
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6 GOLD
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Stapleton Elder Law Firm
Charlottesville | 434.963.7673 www.rosewoodvillage.com
“RoseWood Village has been providing exceptional assisted living and memory care to the Charlottesville community since 1983. Family owned and operated, RoseWood Village is committed to creating a warm and caring environment for you or your loved ones. Come in for a tour at one of our two Charlottesville communities!”
First Place
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” The attorneys and staff at Stapleton Elder Law focus exclusively on Estate Planning and Asset Protection. We truly care about our clients and their families and work hard to ensure they are treated with sensitivity, compassion and respect. Please visit our website to learn more: www.elderlaw-va.com.”
– Old Dominion Capital Management
– Simon J. Stapleton, Principal Attorney tesv i l l e rlot h a e n a n d o a h Va l Sh
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Staunton | 877.554.8016 www.thelegacyatnorthaugusta.org
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David Barrett-Johnson
Third Place
Barrett-Johnson & Associates Charlottesville | 434.296.6611 www.teambarretjohnson.com
16 BRONZE
Doris Gelbman Charlottesville | 434.906.7022 www.gelbman-law.com
Honorable Mention Morningside Assisted Living Charlottesville | 434.971.8889 www.fivestarseniorliving.com
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6 GOLD
OurHeal th & C
OurHeal th & C
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Senior Living Awards
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The Legacy at North Augusta
Third Place
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Charlottesville | 800.784.7288 www.commonwealthal.com
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Charlottesville | 434.202.2521 www.susanwilkinsonwm.com
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Charlottesville | 434.971.3025 www.vittlaw.com
Commonwealth Assisted Living
Third Place
Wilkinson Wealth Management
Second Place
James Vitt
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Charlottesville | 434.977.1550 www.odcm.com
6 GOLD
“We work with clients to plan their financial futures, implement their financial plans, and achieve their life goals. Our goal is our clients’ success.”
– RoseWood Village
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Old Dominion Capital Management
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Charlottesville | 866.348.6375 www.elderlaw-va.com
AWARDS
First Place
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6 GOLD
“At UVA-HealthSouth the key to our patient’s success is a team approach. Our physicians and treatment teams include the patients and their families in goal planning so that together, they develop the best treatment plan for the patient’s recovery.” – Tom Cook, MBA, Chief Executive Officer
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Second Place
Verona | 540.416.0530
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www.synergyrehabandwellness.com
“Synergy Rehab and Wellness is the areas only multi-disciplinary clinic of its kind offering physical therapy, acupuncture, naturopathy, infrared sauna and medically-supervised independent exercise programs. Our mission is to offer hope, unconditional love and extraordinary care to allow us to change our patient's lives and improve their health so significantly that they can pursue the physical, emotional and spiritual growth experiences that make life worthwhile.”
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Home Instead Senior Care Charlottesville | 434.227.4726 www.homeinstead.com/532
ACAC Fitness & Wellness Centers Charlottesville | 434.978.3800 www.acac.com
Third Place
OurHeal th & C
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Charlottesville | 434.295.5501 www.interimhealthcare.com
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Charlottesville | 434.978.7815 www.charlottesvillerehab.com
6 GOLD
“Locally owned and operated with 26 years of experience caring for our patients and our employees.”
– Tobin Forbus, PT, DPT, MS, Owner
tesv i l l e rlot h a e n a n d o a h Va l Sh
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Charlottesville Health & Rehabilitation Center
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Third Place
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Shenandoah Home Therapy Services Verona | 540.324.2360
16 BRONZE
Charlottesville | 434.951.4200 www.thelaurelsofcharlottesville.com
Honorable Mention Golden LivingCenter - Charlottesville Charlottesville | 434.218.7905 www.goldenlivingcenters.com
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The Laurels of Charlottesville
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OurHeal th & C
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Charlottesville | 434.244.2000 www.uvahealthsouth.com
First Place
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UVA – HealthSouth Rehabilitation Hospital
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16 BRONZE
Pantops Physical Therapy Charlottesville | 434.245.6472 www.pantopsphysicaltherapy.com
read this edition of
Honorable Mention Bethesda Physical Therapy Staunton | 540.213.1320 www.bethesdapt.com
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on your tablet or smartphone
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Charlottesville | 434.972.2622 www.westminstercanterbury.org
– Karen Jones, RRT, RCP
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Fishersville | 540.332.4909 www.augustahealth.com/hospice
Simple Comforts
Crozet | 434.823.9100 www.lodgeatoldtrail.com
Charlottesville | 434.245.0001 www.simplecomforts.com
Honorable Mention
Honorable Mention
The Colannades
American Home Patient
Charlottesville | 434.963.4198 www.sunriseseniorliving.com/communities/ the-colonnades
Charlottesville | 434.293.8737 www.ahom.com
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Congratulations!
16 BRONZE
OurHeal th & C
Augusta Health
Third Place
AWARDS
The Lodge at Old Trail
16 BRONZE
Hospice of the Shenandoah
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Fishersville | 540.932.4000 www.augustahealth.com/care-home-medical C
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Charlottesville | 434.970.7776 www.legacy-hospice.com
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Augusta Care Home Medical
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Legacy Hospice
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Brightview Baldwin Park
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Charlottesville | 434.973.7847 www.robertshomemedical.com
6 GOLD
“Our commitment is to service, to embrace and hurdle the ever looming challenges that the durable medical equipment industry faces regarding reimbursement while always assuring that the patients’ needs are met.”
– Gary Selmeczi, President and CEO
AWARDS
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Roberts Home Medical AWARDS
“Westminster-Canterbury of the Blue Ridge, celebrating 25 years of extraordinary, is proud to be Charlottesville only accredited, not-for-profit Lifecare community. ”
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– Amy B. Gillespie EdD, MSN, RN, CHPN Interim Chief Executive Officer Hospice of the Piedmont
6 GOLD
First Place
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“Since 1980, Hospice of the Piedmont—the region’s oldest, largest, and most respected nonprofit hospice organization—has proudly provided patients, families, and communities across Virginia with compassionate, comprehensive end-of-life and grief support care.”
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Westminster Canterbury of the Blue Ridge
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6 GOLD
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First Place
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Charlottesville | 434.817.6900 www.hopva.org
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Hospice of Piedmont AWARDS
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First Place Our Lady of Peace Christopher Center Charlottesville | 434.973.1155 www.our-lady-of-peace.com
“The mission of the Christopher Center is to provide compassionate memory care by fully embracing the uniqueness of each resident in a thoughtfully designed environment that enhances security, comfort, and support .” – Sara Warden, Executive Director
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Charlottesville | 434.977.0002 www.heritageinncharlottesville.com
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Second Place
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The Heritage Inn of Charlottesville
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Third Place
16 BRONZE
RoseWood Village Charlottesville | 434.963.7673 www.rosewoodvillage.com
Honorable Mention Envoy of Staunton Charlottesville | 434.218.7905 Staunton | 540.886.2335 www.caring.com/local/nursing-homes-instaunton-virginia/envoy-of-staunton-llc
Waynesboro | 540.941.3100 www.sunnyside.com
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“A dedicated staff with a resident-centered focus is attributed to the success of Summit Square. Our signature SHINE program encourages teamwork and inspires employees to go the extra mile for our residents.” – Annie Fellers, Executive Director
– Patrick Baroco, MD, Medical Director
6 GOLD
– Tom Cook, MBA, Chief Executive Officer
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Augusta Health
Second Place
Fishersville | 540.932.4000 www.augustahealth.com
1 6 S I LV E R
UVA Palliative Care
Bridgewater | 540.828.2550 www.brc-online.org
Charlottesville | 434.243.3675 www.uvahealth.com/services/palliative-care
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OurHeal th & C
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16 BRONZE
Charlottesville Health & Rehabilitation Center
Third Place
Charlottesville | 434.978.7815 www.charlottesvillerehab.com
16 BRONZE
The Laurels of Charlottesville
Martha Jefferson Hospital
Charlottesville | 434.951.4200 www.thelaurelsofcharlottesville.com
Charlottesville | 434.654.7000 www.sentara.com
16 BRONZE
Honorable Mention
Honorable Mention
UVA Transitional Care Hospital Charlottesville | 434.924.3627
The Center for Acute Hospice Care Piedmont | 434.817.6900 www.hopva.org
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“UVA-HealthSouth is proud to be Charlottesville’s only acute rehabilitation hospital.”
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UVA - HealthSouth Rehabiltation Hospital
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“We want to be able to help our patients receive the care they want. To help them accomplish that, we will see our patients not just in the hospital or in the clinic, but in their homes. We can get to know them and their families when they are feeling well so that we are better able to help them when they are sick.”
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Summit Square Retirement Community
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Charlottesville |434.974.7756 www.seniorcenterinc.org
“We provide the opportunities and environment that support healthy aging, encouraging individuals to make choices toward lifelong engagement. By staying active and involved, we can change the way we age.” – Peter Thompson, Executive Director
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Jefferson Area Board for Aging Charlottesville | 434.817.5222 www.jabacares.org
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Staunton Senior Center Staunton | 540.886.4634 www.stauntonseniorcenter.org
Honorable Mention Waynesboro Senior Center Waynesboro | 540.942.1838 www.vpas.info/senior-centers/ waynesboro-senior-center/
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6 GOLD
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Blue Rid All-Inclusive Elderly Care
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Blue Ridge PACE (Program of All-Inclusive Care for the Elderly), a partnership between Riverside Health System, the University of Virginia Medical Center, and the Jefferson Area Board for Aging (JABA), serves seniors who live in Charlottesville and surrounding counties.
About the PACE Program PACE is a program that provides and coordinates all of the care you need, all by one team, all in one place, so you can continue living in your home and community rather than a nursing facility. Blue Ridge PACE doctors and other caregivers specialize in working with older adults and their families. PACE is focused on caring for a person's spiritual, emotional and social health, not just their combination of medical conditions. Take a look at PACE. You'll find it is unlike any other care program you've seen.
SCAN HERE
to learn more
www.blueridgepace.org
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– Tracy Wallace, Director of Operations
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Charlottesville | 434.654.7000 www.sentara.com
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Augusta Health Stroke Center Fishersville | 540.332.4000 www.augustahealth.com/stroke-care
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Charlottesville Health & Rehabilitation Center Charlottesville | 434.978.7815 www.charlottesvillerehab.com
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Charlottesville | 434.295.5501 www.interimhealthcare.com
Fishersville | 540.885.8424 www.consulatehealthcare.com
Charlottesville | 434.422.4800 www.albemarlehealthrehab.com
– UVA Stroke Center
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Albemarle Health and Rehab Center
“Nurses and physicians, pharmacists, radiology technicians, social workers, speech therapists, occupational therapists, and physical therapists all work together to provide the best possible care to our stroke patients using the latest advances in stroke interventions.”
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Honorable Mention
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Charlottesville | 434.924.3627
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Sentara Martha Jefferson Stroke Recovery Clinic ley
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“Amedisys uses extensive internal processes for ensuring great patient care beginning with timely admission, accurate coding, collaborative nursing plans, the use of technology such a telehealth, and extensive ongoing training to stay current with best practices. Amedisys uses a comprehensive approach to geriatric rehab which addresses all body systems and is able to accurately identify the source of the problem and treat effectively, including vestibular rehab when needed.”
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Charlottesville | 434.972.2622 www.westminstercanterbury.org
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Amedisys Home Health of Staunton
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Charlottesville | 434.978.7815 www.charlottesvillerehab.com
“We believe that providing the best care begins with getting to know our patients first – that’s the cornerstone of our personalized approach to rehabilitation services and skilled nursing care.”
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Photography by KG Thienemann.
OurHealth Charlottesville and Shenandoah Valley magazine’s resident photographer Keith Thienemann recently joined in on the activities at the Lexington Farmers Market while snapping some photos of locals scooping up healthy, fresh food options and more! Lexington Farmers Market vendors sell directly to consumers. Items available include fruits, vegetables, herbs, eggs, honey, baked goods, seedlings, plants and flowers, jams and jellies, fiber, meat and poultry, nuts, mushrooms, baked goods, gourmet coffee, as well as many handcrafted items created using natural materials from area farms. The Lexington Farmers Market operates in the McCrum parking lot behind the Southern Inn Restaurant (37 S Main Street, Lexington, VA 24450). It’s open on Wednesdays, 8 am – 12:30 pm, between April and November. For more information, including how to become a vendor, contact Mitch Wapner at 540.463.9234 or via email at paradoxfarm@earthlink.net.
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the
2016
OurHealth Charlottesville and Shenandoah Valley
HOW TO IN HEALTHCARE SERIES: an issue-by-issue overview
RT PA
III
words | TINA JOYCE
GRADUATING TO
GRADUATE SCHOOL OurHealth’s four-part series: How to in Healthcare, is a step-by-step guide for those interested in pursuing a career in healthcare. Imagine a career that has the potential to save lives each and every day. From emergency medical technicians and anesthesiologists to physical therapists and trauma surgeons, those who work in the healthcare field come together to save lives or improve the quality of life for their patients.
PART THREE
Entering graduate school and residency/fellowship/ clinical training.
July | August
PART FOUR
Insight on how to find the right job in your field of specialty.
September | October
OurHealth is exploring numerous healthcare employment opportunities and sharing expert advice on ways to reach career goals in healthcare. In Part I, the March/April issue, we shared tips for families of students interested in exploring collegiate opportunities with a medical focus in mind. In Part II, the May/June issue, OurHealth asked college and university representatives to share insights on certificate and degree programs that transition students directly into the healthcare workforce as well as tips to help students successfully pursue a four-year degree. In this issue, we explore healthcare careers requiring postgraduate studies, including graduate school, professional school, residency programs and fellowships. We also offer planning considerations to assist students who are currently pursuing a bachelor’s degree but looking to further their education. Previous OurHealth issues have revealed that career opportunities in healthcare are numerous, and each program of study has different requirements. Understanding the complex world of graduate school includes comprehending undergraduate requirements, entrance exams and waiting lists — a potentially overwhelming process if it is conducted without guidance.
The best plan of action is to conduct thorough research — as early as possible — about programs and colleges with specific career interests in mind. Undergraduate students who are considering an advanced degree in healthcare must begin preparing well in advance of receiving their bachelor’s degree. This includes maintaining a high GPA and taking required and advanced courses. For example, a student who wants to attend medical school is likely to be enrolled in a premed undergraduate program, taking a course load with a heavy concentration in math and science. When it comes to graduate programs in the healthcare field, students can either attend a graduate school or a professional school. Graduate schools offer master’s and doctoral degrees. Medical schools fall into a category called professional schools, which also includes dental schools, pharmacy schools, chiropractic schools, etc.
THERE ARE SEVERAL QUESTIONS
STUDENTS SHOULD CONSIDER WHEN MAKING DECISIONS ABOUT ADVANCED EDUCATION: 1. What career am I seeking? 2. What graduate degree do I need for that career? 3. Does location matter? 4. Which colleges/universities offer the program or degree I want? 5. What are my financing needs and options? 6. Is the school accredited? 7. What is the reputation of the school or program I am considering? 8. What is the school’s placement rate for graduates? 9. Do I have the needed undergraduate requirements to apply to the program? 10. Are entrance exams required for admission? 11. Is work experience required for admission? 12. When is the application deadline?
The best resource for a student beginning to look into graduate schools would typically be the institution’s website. Most, if not all, programs have extensive descriptions of the application process, entrance requirements and deadlines on their websites. Once an online search has narrowed down which colleges and universities offer the chosen graduate program of study, students can begin to dissect the steps needed to apply to their school(s) of choice. Graduate programs are usually quite competitive; therefore, it is recommended that students apply
ENTRANCE EXAM REQUIREMENTS FOR
POST-GRADUATE SCHOOLS
Applying to a graduate or professional school often requires taking a standard entrance exam. Standardized exams are designed to measure an applicant's potential to succeed in graduate or professional school. While a high grade point average (GPA) indicates success at an undergraduate college or university, standardized tests permit fair comparisons of students from a variety of universities and colleges with potentially differing grading standards. Below is an overview of the different types of graduate and professional schools entrance exams.
GRADUATE RECORD EXAMINATION (GRE)
The GRE is the general test that is used for admission into most graduate school programs. Administered by the Educational Testing Service (ETS), the GRE tests verbal reasoning, quantitative reasoning (math), and analytical writing (essay section). This computer-based test is available yearround at locations across the United States. Scores are available at the test center and you have the option of sending the scores to whichever schools you choose. There is a fee to take the GRE, and registration can be completed online.
GRADUATE MANAGEMENT ADMISSIONS TEST (GMAT)
The GMAT exam is primarily used for admissions decisions by business school graduate programs. If you’re considering a Master’s in Healthcare Administration degree, you may also be required to take the GMAT. It consists of a 30 minute analytical writing assignment, 12 integrated reasoning questions (30 minutes), 37 quantitative questions (75 minutes) and 41 verbal questions (75 minutes). These questions are designed to measure the skills needed to succeed in business school. The GMAT is given year-round and there is an average of fee of $250 to take the exam. While unofficial scores are available at the test center, your official scores will be sent to you within 20 days of completing the exam. Registration can be completed online.
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ACRONYMS RELATED TO
ADVANCED DEGREE PROGRAMS
As a reminder and to help alleviate confusion, acronyms related to advanced degrees and some licensure programs are listed below:
MSN – Master of Science in Nursing MNA – Master of Nurse Anesthesia CRNA – Certified Registered Nurse Anesthetist
NP – Nurse Practitioner DNP – Doctor of Nursing Practice PhD – in nursing, psychology and other healthcare areas
PharmD – Doctor of Pharmacy PA – Physician’s Assistant MD – Doctor of Medicine DO – Doctor of Osteopathic Medicine DPM – Doctor of Podiatric Medicine DPT – Doctor of Physical Therapy LCMHC – Licensed Clinical Mental Health Counselor
LCP – Licensed Clinical Psychologist LCPC – Licensed Clinical Professional Counselor
LCSW – Licensed Clinical Social Worker PsyD – Doctor of Psychology DC – Doctor of Chiropractic DPM – Doctor of Podiatric Medicine DrPH – Doctor of Public Health DDS – Doctor of Dental Surgery DMD – Doctor of Dental Medicine AuD – Doctor of Audiology OD – Doctor of Optometry DVM – Doctor of Veterinary Medicine 46
to more than one. Each school has its own requirements, and every program within the school has yet another set of criteria for admission. Additionally, undergraduate schools generally have pre-graduate and pre-professional advising programs that students can access, either online or in person. If there are specific questions an applicant has about a program, an email or phone call will likely prompt a helpful response from someone in the department. “I would not suggest calling professional programs with general career advising questions — they have neither the expertise nor time to answer those types of questions. But if there is a specific question to which an answer cannot be found on the website, then contact is appropriate,” explains R.J. Canterbury, MD, senior associate dean for education at the University of Virginia School of Medicine.
EXPLORING POSSIBILITIES It is important to realize there are numerous, highly sought after and lucrative healthcare opportunities besides becoming a physician. Students can explore many different facets of healthcare — both clinical and administrative — that require graduate work. For example, Virginia Tech offers a professional Master of Public Health degree. “We also offer graduate programs in biochemistry; biomedical engineering; consumer health; human nutrition, foods, and exercise; psychology; genetics; bioinformatics; and computational biology — all health sciences-related fields,” says Cathy Grimes, communications manager for Virginia Tech Graduate School. Virginia Commonwealth University offers a Master of Health Administration degree and a graduate concentration in healthcare management as part of a Master of Business Administration degree. Liberty University also offers a Master of Public Health and a Master of Science in biomedical sciences.
UNDERSTANDING THE DIFFERENCE The healthcare field is immense. Exploring careers can be overwhelming to even the most astute students. Unless students have personal experiences with a particular health professional, they might misunderstand the differences between common medical professionals. For example, the differences between psychologists and psychiatrists; optometrists and ophthalmologists; and dentists, orthodontists and periodontists. Confusion often exists between Doctor of Medicine (MD) and Doctor of Osteopathic Medicine (DO) degrees. Both degrees mean the doctor is a licensed physician, but their training and approach to healthcare differs slightly. Medical doctors generally focus on one condition or area of the body, whereas osteopathic physicians are dedicated to treating and healing the patient as a whole. Another point of clarification has to do with a specialization. An orthodontist has completed dental school and gone on to receive further training to specialize in the prevention and correction of misaligned teeth and jaw. A psychiatrist is a medical doctor who specializes in mental health. In contrast, a psychologist has earned a master’s or doctorate degree but focuses on studying and evaluating mental processes.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
It is important for students to research and learn as much as possible about the careers they are considering prior to investing time, money and energy in academic pursuit. During undergraduate studies, summer internships or part-time jobs allow students to explore careers and interview people working in the field of interest. Refer to the March/April issue of OurHealth for other recommendations.
APPLICATION & ENTRANCE EXAMS The application process varies from school to school and program to program. Sometimes there is a common application form. For example, students applying to medical school complete a national application, the American Medical College Application Service® (AMCAS®). Information about the application and medical careers can be found on the website of the Association of American Medical Colleges. The organization provides valuable information for all students seeking admission to medical schools across the country. Most clinical postgraduate programs require some type of entrance exam. For example, most graduate programs in clinical psychology require the Graduate Record Exam for application. The GRE is widely regarded as an entrance exam for many postgraduate programs, not just for medical fields. Some healthcare graduate programs require both an entrance exam and work experience.
APPLYING TO GRADUATE SCHOOL?
When planning, it’s helpful to work backward from the application deadline and follow these steps: 1. Research schools with your program of study. 2. Consider visiting the schools you are applying to and make contact with staff/professors. 3. Take a practice GRE or other entrance exam if required or recommended for admission. 4. Sign up for a GRE prep course. 5. Register for the GRE general test if necessary. 6. Begin drafting your statement of purpose for your application. 7. Complete and submit applications by deadlines. 8. Request that undergraduate transcripts be sent.
For example, if a student receives a Bachelor of Science in nursing and wants to pursue a Master of Science in nursing, the tests required to get into a school that offers an MSN vary. Christine Kueter, communications coordinator at the University of Virginia School of Nursing explains, “A year’s worth of clinical experience is required
DOCTOR OF PHILOSOPHY (PhD) A PhD is an advanced, post-graduate academic degree awarded by universities to a candidate who has submitted a thesis or dissertation that is based on extensive and original research in his/her chosen field. In general, the PhD is the highest level of degree a student can achieve, and usually follows a master’s degree. In most cases, a PhD involves three to four years of full-time study.
REQUIREMENTS FOR PhD PROGRAMS: In order to be accepted into a PhD program, a student must have a master’s degree from an accredited college or university. In addition, most universities will require several letters of recommendation, a research proposal for the thesis or dissertation, letter of motivation from the application specifying his or her objections and determination to work hard on a project, and a face-to-face interview. Some universities also require a PhD entrance exam.
DOCTOR OF HEALTH SCIENCE (DHS OR DHSc) A Doctor of Health Science (DHS or DHSc) is a post-professional academic degree for those with a master’s degree who intend to pursue or advance a professional practice career in health arts and sciences and healthcare delivery systems, to include clinical practice, education, administration and research. Individuals who complete the DHS/DHSc face the particular challenge of understanding and adapting scientific knowledge in order to achieve health gain and results. This degree leads to a career in high-level administration, teaching, applied research, or practice, where advanced analytical and conceptual capabilities are required. The Doctor of Health Science is a degree that prepares scholarly professionals in healthcare.
ENTRANCE EXAM REQUIREMENTS FOR DOCTOR OF HEALTH SCIENCE: DHS and DHSc programs require a master’s degree from an accredited college or university, as well as related work experience in a clinical or healthcare-related educational setting. An interview may also be required as part of the admission process. There are no specific entrance exams required for this program.
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for the Clinical Nurse Specialists (CNS) master’s and Nurse Practitioner (NP) master’s tracks, but the Clinical Nurse Leader (CNL) master’s program — that’s the one degree for non-nurses pivoting into the profession who have at least a bachelor’s degree in another field — has no such requirement. Students who already have a bachelor of science in nursing (BSN) and are applying to an Master of Science in Nursing (MSN) program must have passed the National Council Licensure Examination(NCLEX) and have at least a year of clinical experience, but GREs are not required for entry. All students applying to a master’s program must have completed a statistics course within the last five years.”
Cathy Grimes is the communications manager for Virginia Tech Graduate School.
Similarly, students seeking admission to a medical school might be required to take the Medical College Admissions Test (MCAT). However, not all programs require the MCAT for admission, and some require the test but do not have a minimum score to be considered for admission, according to College Admissions Partners, a college admissions counseling service provider. “The MCAT score is a very important component of all those considered by the admissions committee at the University of Virginia for several reasons. It does reflect academic abilities; it is a standard across all undergraduate schools, which may have different curricula, grading policies, etc.; and the MCAT score generally predicts performance on licensing exams and board certification examinations. An applicant who cannot be successful on the MCAT is at high risk of never being licensed to practice medicine. It is considered, though, along with many other personal and professional characteristics.”
Ronnie Martin, DO is dean and professor of family medicine at Liberty University College of Osteopathic Medicine.
— Dr. R.J. Canterbury, senior associate dean for education, University of Virginia School of Medicine For admission to Liberty University College of Osteopathic Medicine, the MCAT is a factor, as are grades, but it is not an overriding factor in the selection process. “We establish a high enough level for test scores and grades that it demonstrates with 95 percent probability they can do the work of
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medical school, but it is not a determining factor,” says Ronnie Martin, DO and professor of family medicine. “The MCAT predicts how the students will do on national boards like the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) or United States Medical Licensing Examination (USMLE) but not the type of doctor they will be or how they will perform in medical school.” Similar to deciding on an undergraduate college or university, choosing the “best fit” graduate school is extremely important for success. Expending energy to apply to schools that a student has no interest in attending or has a low probability of being admitted can be unwise. Conduct the research first and then apply to schools that are a good fit academically, socially and professionally. According to Stephen M. Workman, PhD, associate dean for admissions at Virginia Tech Carilion School of Medicine, “Generally, students should pick their home state to apply to public graduate and professional schools because a larger number of in-state students are accepted each year. Student have a better chance of being accepted outside of their state of residence if they apply to a private school.” Students shouldn’t overlook schools close to home. Virginians are fortunate to have outstanding colleges and universities within a few hours drive. Graduate schools are plentiful and diverse, while medical schools are competitive and well-respected in the state.
RESIDENCY PROGRAMS Once students have completed four years of medical school, they enter the next stage of training called “residency.” During residency, students practice medicine under the direct or indirect supervision of an attending physician in a hospital or clinic setting. Third-year medical students complete electronic applications to apply for a residency match. The residency placements are typically coordinated by the medical school’s student affairs office.
“We place an emphasis on personal statements and goals, on ethical and professional traits as much as grades or MCAT. We look for students with a strong attitude of service as reflected in their activities up to application, for example, service activities, mission trips, previous medical care experience, etc. We are partial to those with healthcare experience and those with a history of service in the military.” — Ronnie Martin, DO and professor of family medicine, Liberty University
According to the American Academy of Family Physicians, all students seeking a residency position should enroll in “The Match.” Once enrolled, students are bound to abide by the terms of the National Resident Matching Program.
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During the fourth year of medical school, students participate in residency interviews. Based on the interviews and applications, the National Resident Matching Program places applicants for postgraduate medical training positions into residency programs at teaching hospitals throughout the U.S. Match results are made public in March.
A day in March is known as National Match Day — the day medical students find out where they will complete their residency. “The state where you practice residency very often becomes where you are likely to end up residing,” Dr. Workman says. “National Match Day is a very anticipated day for medical students.”
Randolph Canterbury, MD is senior associate dean for education at the University of Virginia School of Medicine.
Graduation from medical school happens in May, and students begin their residencies in the summer. A residency is a minimum of three years. Not all students will receive a match for placement. Student who graduate at the bottom of their class or are not competitive might not receive a residency match.
FELLOWSHIP TRAINING A fellowship is post-residency education that provides training in an area of specialization, ultimately allowing students to also teach or work in a large hospital. Students gain additional knowledge and expertise in a particular area, which might or might not include a certificate of added qualification. According to the website of the American Academy of Orthopaedic Manual Physical Therapists, “A fellowship is designed for the graduate of a residency or a board-certified therapist to focus on a subspecialty area of clinical practice, education or research.”
CHANGING DIRECTION A question looming in the minds of some graduate students may be, “I feel like I might be heading in the wrong direction. What do I do now?” Some students question their program path often throughout undergraduate studies, causing a change of majors, while others have known their career choice from high school or earlier. Stephen Workman, PhD is the associate dean for admissions at Virginia Tech Carilion School of Medicine.
Several factors can contribute to a change in academic direction heading into graduate school or after a couple of semesters. Test scores, work and personal experiences, finances and advisor recommendations continue to shape a student’s career direction. For example, a student might not get accepted into the graduate or professional school of choice. “They may apply a second time or choose to go into a more research-based program,” Dr. Workman says. Dr. Canterbury recommends that “a medical student who is unhappy with his or her choice generally should not continue. Medicine is a great career and many would say a ‘calling,’ but it’s very hard work with many challenges. If a student does not find it gratifying, it will be difficult to be a good physician. There are many other wonderful careers that might make the person happier.” Continued on page 52...
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ENTRANCE EXAM REQUIREMENTS FOR PROFESSIONAL SCHOOL PROGRAMS: PROFESSIONAL DEGREE PROGRAMS A professional degree is a graduate level degree that is offered upon completion of necessary undergraduate components, followed by additional study in a specialized field. In this model, the undergraduate portion generally lasts five or more years, followed by four years at the graduate level.
CHIROPRACTIC SCHOOL The educational requirements for chiropractors specify a minimum of two years of pre-chiropractic study and four years of chiropractic school, after which the Doctor of Chiropractic degree is awarded. However, the majority of successful applicants have completed three or four years of college work before entering chiropractic school. There is no entrance exam required for admission into chiropractic school.
DENTAL SCHOOL
ability and scientific knowledge necessary for the commencement of pharmaceutical education. The PCAT is constructed specifically for colleges of pharmacy. The PCAT consists of 232 multiple-choice items and one writing topic. Candidates are given approximately four hours to complete the test (including administrative time for instructions and time for a short rest break about halfway through the test).
PHYSICIAN ASSISTANT SCHOOL
The Dental Admissions Test (DAT) is a timed multiplechoice exam conducted by the American Dental Association (ADA) that is used as part of the admissions process for dental school. The DAT measures the general academic ability, comprehension of scientific information, and perceptual ability of the prospective dental student.
Physician assistant schools may vary when it comes to which exam they require. For example, some schools require the Graduate Record Examination (GRE), which is also often required for various types of master's degree programs. Other schools will accept the Medical School Admissions Exam (MCAT) instead of the GRE.
MEDICAL SCHOOL The Medical College of Admission Test (MCAT) is a computer-based standardized exam required for prospective medical students. It is designed to assess problem solving, critical thinking, written analysis and knowledge of scientific concepts and principles.
Most physical therapy (PT) programs require applicants to complete the Graduate Record Examination (GRE). Programs may have minimum acceptable scores and last acceptable test dates. Policies regarding the consideration of multiple sets of GRE scores vary by institution.
NURSING SCHOOL
PODIATRIC MEDICAL SCHOOL
For graduate students entering nursing school, the required exams include the Graduate Record Exam (GRE), The Test of Essential Academic Skills (TEAS) and the National Council Licensure Examination (NCLEX). Exams can vary by institution, and some may require only one test.
OPTOMETRY SCHOOL All schools of optometry require the Optometry Admission Test. The OAT is a standardized examination, sponsored by the Association of Schools and Colleges of Optometry (ASCO), designed to measure general academic ability comprehension of scientific information.
PHARMACY SCHOOL The Pharmacy College Admission Test (PCAT) is a specialized test that helps identify qualified applicants to pharmacy colleges. It measures general academic
PHYSICAL THERAPY SCHOOL
Almost all podiatric medical schools require applicants to take the Medical College Admissions Test (MCAT).
SPEECH-LANGUAGE PATHOLOGY SCHOOL Applicants are required to submit scores earned within the last five years from the general test portion of the Graduate Record Examination (GRE). The general test of the GRE measures verbal reasoning, quantitative reasoning, and writing skills. The test is available year round in a computer-based format.
VETERINARY SCHOOL The Graduate Record Examination (GRE) is required by most veterinary schools, and some also require the Biology GRE. The Medical College Admission Test (MCAT) is also accepted by some schools in place of the GRE.
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51
CHARLOTTESVILLE AND SHENANDOAH VALLEY GRADUATE AND PROFESSIONAL SCHOOLS OFFERING HEALTHCARE RELATED PROGRAMS Eastern Mennonite University School of Graduate & Professional Studies
University of Virginia Graduate School of Arts & Sciences
The Eastern Mennonite University School of Graduate and Professional Studies offers master’s degrees in biomedicine, counseling, and healthcare management.
The University of Virginia Graduate School of Arts and Sciences offers programs leading to the degrees of doctor of philosophy, master’s of public health and master’s of science, as well as joint degree programs with the School of Medicine at the University of Virginia.
For more information visit www.emu.edu.
James Madison University James Madison University offers master’s degrees in kinesiology, health sciences, nursing, occupational therapy, physician assistant, psychology, and public administration. They also offer a doctor of nursing (DNP) program. For more information visit www.jmu.edu.
Murphy Deming College of Health Sciences Mary Baldwin College The Murphy Deming College of Health Sciences at Mary Baldwin College offers a doctor of physical therapy (DPT), doctor of occupational therapy (OTD), and physician assistant (MSPA) programs. For more information visit www.mbc.edu/health_sciences.
Shenandoah University Shenandoah University offers master’s degrees in nursing, occupational therapy, physician assistant, and athletic training. The Bernard J. Dunn School of Pharmacy offers the doctor of pharmacy program. The Eleanor Wade Custer School of Nursing offers the master’s of science in nursing program as well as the RN to MSN program. The school also offers the doctor of nursing practice program. For more information visit www.su.edu.
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
For more information visit gsas.virginia.edu.
University of Virginia School of Medicine The University of Virginia School of Medicine offers the doctor of medicine (MD) degree. Students interested in earning a graduate MD can choose from nearly 70 specialties. The school also offers doctor of philosophy (PhD) degrees is biochemistry, molecular biology and genetics, biomedical engineering, microbiology, immunology and infectious diseases, molecular cell and developmental biology, and molecular medicine. There are also several dual-degree programs offered between UVA School of Medicine and other UVA schools, such as the MD/PhD, MD/MPH, MD/MBA, MD/JD, and MD/MS dual degree programs. For more information visit med.virginia.edu.
University of Virginia School of Nursing The University of Virginia School of Nursing offers the master’s of science in nursing (MSN) and the doctor of nursing practice (DNP) degree programs. For more information visit www.nursing.virginia.edu.
Continued from page 50...
SOURCES
To continue down a path of rigorous academic challenge, students must be completely committed to the profession they are pursuing. Doubts and fatigue may seep into their minds, but relying on strong relationships with advisors, professors and supportive family members will provide the support necessary to finish strong. Because there are so many options in healthcare, it is possible for a student to change directions but still remain in pursuit of health-related profession. However, changes cost time and money.
Association of American Medical Colleges www.aamc.org
SEEKING BALANCE In addition to supportive relationships, diet and exercise play an important role in the mental, physical and social health of students. Inadequate sleep is common and often leads to chronic fatigue for students completing residencies and other intense work experiences. Fatigue in turn leads to illness and can have an adverse affect on course work and personal relationships. Competitive programs have very little room for error, and grades falling below a B can result in dismissal from the program. Therefore, it is vitally important for students to stay physically active, eat a healthy diet with limited use of stimulants such as energy drinks and excess caffeine and get as much rest as possible. U.S. News & World Report has reported that many medical schools are initiating wellness and social programs to help students achieve work-life balance. Last year, Psych Central recommended 12 tips for surviving graduate school, commenting that unlike college, grad school is a full-time job.
College Admissions Partners www.collegeadmissionspartners.com The National Resident Matching Program www.nrmp.org American Academy of Family Physicians, AAFP www.aafp.org American Academy of Orthopaedic Manual Physical Therapists – www.aaompt.org
EXPERT CONTRIBUTORS R.J. Canterbury, MD with University of Virginia School of Medicine. Cathy Grimes with Virginia Tech Graduate School. Christine Kueter with University of Virginia School of Nursing. Ronnie Martin, DO with Liberty University College of Osteopathic Medicine. Stephen M. Workman, PhD with Virginia Tech Carilion School of Medicine.
THE TOP SIX TIPS
FOR SURVIVING GRADUATE SCHOOL INCLUDE: 1. Know your work 2. Read smarter, not harder 3. Focus less on grades and more on learning 4. Pick opportunities wisely 5. Consult others 6. Manage your time well Also, taking study breaks every few hours optimizes the retention of information. This is a good time to take a walk, have dinner with a friend or take a nap. If these breaks are not built into their schedule, students soon find themselves working or studying 24/7 and ultimately experiencing burnout. Professional healthcare careers require planning and discipline to complete. Those with a heart to serve and a desire to continually learn will likely have the mindset for this type of career. Researching, planning, studying and finding balance will help make the student’s transition to graduate school a success.
ON THE WEB
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read this edition of
on your tablet or smartphone
the 2016 OurHealth Charlottesville and Shenandoah Valley Primary Care Series: an issue-by-issue overview
+++ january
PART
| february
KNOW YOUR CARE:
4
understanding your health and how to maintain it
+++ march
| april
DO YOUR CARE: taking action with your health
+++ may
| june
SHARE YOUR CARE: setting good examples for others to learn and live by
+++ july
| august
INSPIRE YOUR CARE: keeping creative with fresh care ideas
+++ september
| october
MEASURE YOUR CARE:
tracking your efforts to ensure you’re on the right path
+++ november
| december
CELEBRATE YOUR CARE:
rejoicing the rewards realized from taking good care of yourself
INSPIRE YOUR
care words | GERI ASTON
Keeping Creative with Fresh Care Ideas!
Primary care physicians are our partners on the road to good health. They urge us to get our vaccinations and preventive health screenings. They’re the ones reminding us to eat healthy and exercise. Getting on the road to good health often is easier than staying on it. Many people today have or are at risk of developing common chronic conditions, such as diabetes, high blood pressure, or heart disease. Oftentimes, those health concerns prompt them to visit a primary care physician. That’s a great first step. Primary care doctors work with their patients to developed a plan of action specific to their health needs and goals. “Think of any issue people have – trouble sleeping, fatigue, headaches, allergies, arthritic pain, anxiety or stress, high blood pressure or blood sugar, cholesterol levels, digestive concerns –
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
and it can be improved with lifestyle changes,” says Cara A. Goodell, MD, a family physician at Augusta Health Primary Care in Stuarts Draft. Patients often start out eager to make the lifestyle changes, such as losing weight or exercising, necessary to prevent or combat most chronic conditions. But as the months go by, many people lose steam. Sometimes they fall back into old, unhealthy habits. Sometimes people don’t see the results they expected, throw up their hands, and quit trying. Regardless of why people falter, their primary care physician can help get them back on track. This article, the fourth in a yearlong OurHealth series about primary care, will focus on “inspiring your care.” In it, primary care physicians offer ideas on how to overcome the obstacles that might sidetrack people on their path to better health.
“Remember that your primary care physician is on your side. It's never too late to get back on track.”
“The first thing patients should do if they find themselves floundering is ask their primary care doctor for help. If it’s been months and you’ve lost momentum to stick with your exercise or eating plans, it’s worth it to schedule a follow-up appointment.”
– Siobhan M. Statuta, MD
– Siobhan M. Statuta, MD
Reach for a helping hand The first thing patients should do if they find themselves floundering is ask their primary care doctor for help. If it’s been a few months and you’ve lost momentum to stick with your exercise or eating plans, it’s worth it to schedule a follow-up appointment, says Siobhan M. Statuta, MD, a family physician with the University of Virginia Health System.
Oftentimes people have bitten off more than they can chew by overestimating what they can accomplish when they first set their diet and exercise targets. They get discouraged when they don’t see the change they wanted and give up. It’s best to set realistic overall goals with your doctor’s help and then break them into smaller, more attainable pieces, Dr. Statuta says. Once you’ve reached one goal, you can set your sights on the next one. Some people cut back on their calorie intake too drastically, which may work against them because it slows down their metabolism and makes it harder to lose weight. Dr. Statuta suggests slowly increasing the amount of fruits and vegetables you eat, while decreasing the amount of processed foods. “The most successful weight loss will be the product of consistent effort,” she adds. Making lasting lifestyle changes often is harder than people think, says Kenneth S. Yew, MD, a family physician with Family Medicine of Albemarle. When they don’t reach their goals, many people experience self loathing. But, he stresses, “you have to stay positive. If you get down on yourself, you get paralyzed.” When patients falter, he wants them to make an appointment so he can work with them to identify the obstacles blocking their progress. He and the patient pick one or two doable changes the patient can make.
Siobhan M. Statuta, MD is a family physician with the University of Virginia Health System in Charlottesville. Dr. Statuta is certified by the American Board of Family Medicine.
Some patients become so discouraged that they fail to see the progress they’ve made. Dr. Yew likes to remind patients whose weight hasn’t budged or only has dropped a little that over six months people who don’t take action usually gain Continued on page 57... www.OurHealthCville.com
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THE MENTAL AND PHYSICAL HEALTH CONNECTION Many people consider their mental health as separate from their physical health, but that’s not the case. Taking care of your mental health is part of a healthy lifestyle.
“Think of any issue people have – trouble sleeping, fatigue, headaches, allergies, arthritic pain, anxiety or stress, high blood pressure or blood sugar, cholesterol levels, digestive concerns – and it can be improved with lifestyle changes” – Cara Goodell, MD
Cara Goodell, MD is a primary care physician with Augusta Health Primary Care in Stuarts Draft. Dr. Goodell is certified by the American Board of Family Medicine.
“Major life stresses of any kind can be especially difficult for anyone,” says Benjamin Pumphrey, MD, a psychiatrist at Augusta Psychological Associates. Some of these stresses, including loss of a job or the end of a significant relationship, might make people question deeply held assumptions about who they are or their place in the world. ” Sometimes these stresses lead to problematic symptoms, and sometimes they don’t,” Dr. Pumphrey says. ” If a person develops symptoms that begin to affect his or her ability to work, enjoy relationships, or enjoy life, it is time to seek a consultation.” Chronic illnesses, too, can cause mental health issues, such as anxiety or depression. For example, people with diabetes are at higher risk for depression. According to the Mayo Clinic, the difficulty of managing diabetes can be stressful and lead to depression. Also, diabetes can cause complications that may worsen depression. On the flip side, a mental health problem can make a person unmotivated to exercise, eat right or take their medicine. That can worsen or even lead to a chronic illness. Physical and mental health problems can feed off each other in a vicious cycle. For example, a person depressed about a diabetes diagnosis might lose the willpower to manage their disease, which would make their depression worse. An underlying mental health issue could be the reason for a physical problem, such as obesity. Kenneth S. Yew, MD, a family physician with Family Medicine
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of Albemarle, offers the example of an overweight person who wants to lose weight but who eats for comfort when they’re stressed or upset or who sneaks food at night. Until the reason for their unhealthy eating pattern is addressed, the person will have a hard time achieving a healthy weight. In these cases, the person should visit a behavior therapist. Opening up about the underlying reason for unhealthy eating habits can be difficult for patients, Dr. Yew says. But he emphasizes that it’s important for people to let their doctor know so they can help. He also stresses that people with eating problems, mild or severe, need to know they’re not alone. “This is not uncommon. It’s not that you’re a hard case or that you’re strange.” Statistics prove him right. In the United States, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, according to the National Eating Disorders Association. As with all other attempts to adopt a healthier lifestyle, people shouldn’t become discouraged and give up if their efforts to improve their mental health don’t work as quickly as expected. Many mental health medications don’t take full effect for several weeks or months, Dr. Pumphrey notes. Additional treatments often are necessary for a person to notice improvement, and these interventions can provide enough support during the treatment process to help prevent a person from becoming discouraged. These treatment avenues usually involve some mix of individual psychotherapy, group psychotherapy, exercise, and diet or lifestyle changes. “We must remember that seemingly small gains may still be life-changing,” Dr. Pumphrey says.
Continued from page 55...
weight, so maintaining or losing a little weight is an accomplishment. A patient who used to drink a couple of sodas a day but dropped the habit has accomplished something even if they haven’t lost weight, Dr. Yew notes. “I tell patients that these are real things they should recognize.”
Change your mindset Sometimes a person’s way of thinking can become a barrier. The words “diet” and “exercise” can sound like chores and suck away a person’s determination. “We can approach lifestyle change from the angle of just really feeling better overall, with a decrease in all of our symptoms and improvement in chronic conditions,” Goodell says. “This helps with motivation.” Looking at food choices as part of the path to health, rather than a temporary “diet” makes a big difference, Dr. Goodell says. She tells people to eat “real food” — foods that came from a tree, grew from the ground, were once alive, or came from an animal. Meanwhile, avoid foods produced in a factory. Dr. Goodell recommends people look for foods with simple ingredient labels, or better yet, no ingredient labels. “Keeping it simple helps,” she says. “When there is any question about food choices, go back to choosing real foods with real ingredients.” When exercise sounds like a dreaded chore, think instead about how to incorporate regular movement into your life as many days as possible and to remember every bit counts, Dr. Goodell says. She suggests picking activities you look forward to – walking with a friend, walking the dog or taking a dance class. When you choose activities you enjoy, you’re more likely to keep up the habit. If you have big health goals, such as losing weight or quitting smoking, it’s often helpful to turn to friends and family for support, Dr. Statuta says. “They can give you strength at moments when you naturally want to slip back into your bad habits.”
Keep tabs on yourself Life can be chaotic, so tracking results — positive and negative — and keeping them in one location can help a patient in the short term and down the road, Dr. Statuta says. She often recommends keeping a www.OurHealthCville.com
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IT'S NOT ME. IT'S YOU! Some friends and family members will embrace your determination to work toward a healthy lifestyle and may help you reach your goals, but others might ignore your efforts or even work against you. It’s good to surround yourself with people who support you and find people who share your interests in eating right and being active. At the same time, it’s important to identify people who are doing the opposite. ” If you have friends who want to smoke and eat unhealthy food, you can try to encourage them to change their habits,” says Kenneth S. Yew, MD, a family physician with Family Medicine of Albemarle. ” If that doesn’t work, you might have to take a break from them, at least until you’re strong enough to ignore their influence,” he says. Sometimes you can’t avoid the people who intentionally or unintentionally undermine your efforts. Dr. Yew mentions a patient whose work colleagues like to go out for hamburgers at lunch. Knowing that they’d tease him if they found out he was packing a healthy lunch, he made excuses to avoid outings to the burger joint, and that worked for him. Sometimes the only options are to laugh off the ribbing, Dr. Yew says. You’ll have the last laugh when you start feeling and looking better.
health file, and filing results in chronological order so that changes can be more easily noticed over time. Keeping a notebook can be helpful, Dr. Statuta says. For example, if a female patient is trying to lose weight, she can track what she is eating daily and write a comment or two about how she felt or about her stress level. When she weighs herself for the week, she can look back and see what went well or not so well. Maybe that week she wasn’t successful losing weight because she had a work project due and didn’t pack her lunch consistently. The notebook would draw her attention to what she could focus on in future stressful times. It’s important to report results to your primary care physician at your appointment. Your doctor may have some insight about why you sometimes succeed and sometimes don’t, Dr. Statuta says. Plus a review of the results may prompt the physician to order additional tests. All the feedback you give your doctor is a clue and can help guide your treatment plan on a more successful course, she says. If one approach isn’t working, your doctor likely can recommend something else. For example, a diabetic patient whose blood glucose is higher than it should be even after they’ve made recommended lifestyle changes might need medication, Dr. Statuta says.
Give yourself a pat on the back To keep up your momentum, celebrate your achievements. “A success is a success, no matter how small it is,” Dr. Statuta says. “Give yourself credit and celebrate!” Sometimes treating yourself to something small is enough, she says. For example, if you’re trying to quit smoking and have gone two weeks without a cigarette, do an activity that you enjoy, such as going to a movie. When larger goals are met, the reward may be more significant. When you recognize your achievements, you’re more likely to stay motivated.
Kenneth Yew, MD is family medicine physician at Family Medicine of Albemarle in Charlottesville. Dr. Yew is certified by the American Board of Family Medicine.
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OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
Likewise, doctors tell patients not to beat themselves up over their mistakes. Instead, use the incident to learn. Dr. Statuta brings up a hypothetical patient with a history of skin cancer who forgot sunscreen and got sunburned. The trick is to figure out why. Did the person forget to reapply sunscreen after getting out of the pool? If so, the person could leave the bottle on top of the towel the next time as a reminder. All of our doctors agree, when you stumble, don’t give up. “Even if we did not meet our goals yesterday, we
have a brand new chance today, and every step toward health matters,” Dr. Goodell says. “Eventually, a few months down the road, we’ll be able to look back and marvel at how far we have come.
Next in our series
read this edition of
on your tablet or smartphone
Part V of OurHealth magazine's six-part series "The Bridge to Better Health Starts with Primary Care" examines ways you can track your efforts to ensure you're on the right path. The ability to measure your care will make it easier to see your success. Be on the lookout for Part V in the September/ October 2016 issue!
EXPERT SOURCES Cara A. Goodell, MD, a family physician at Augusta Health Primary Care — Stuarts Draft. Benjamin Pumphrey, MD, a psychiatrist at Augusta Psychological Associates in Fishersville. Siobhan M. Statuta, MD, a family physician with the University of Virginia Health System in Charlottesville. Kenneth S. Yew, MD, a family physician with Family Medicine of Albemarle Win Charlottesville.
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www.OurHealthCville.com
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S T I B T I
F
words | DEIDRE
WILKE
GET TO
S
ND TH A HEAL N SS O FITNE O THE G
Deidre Wilkes, AFAA, ACSM Certified Personal Trainer Deidre is the resident fitness specialist for OurHealth Charlottesville & Shenandoah Valley.
THE 'C
ORE' O
F YOUR
WORK
OUT!
It’s the new buzzword – work your ‘core’. Everybody is
talking about it, there are classes devoted to it, people talk about it in the gym – ” I want to work my core.” But, where is that mysterious body part, and how exactly am I supposed to work it?
Your ‘core’ is the midsection of the body and it involves all the muscles in that area including the front, back and sides. These muscles work as stabilizers for the entire body. Core training is simply doing specific exercises to develop and strengthen these stabilizer muscles. So, why is this type of exercise getting so much attention these days? Simple—Americans are getting more and more sedentary. Prolonged sitting and no exercise weakens the muscles in your midsection. This can lead to problems like low back pain and protruding waistlines.
Okay, so that explains it, now how do I accomplish it? The good news is that core training is for EVERYONE! And, better yet, there are a variety of group core classes that take the guesswork out of selecting exercises and are fun! Plus, most classes dedicated to core workouts are generally only 30 to 45 minutes, so there isn’t a big time commitment!
FIND A CORE CLASS: Check out these local facilities that offer core classes and training: *membership and/or class fees may be required
b:core Charlottesville | 610.724.9034 www.bcoremethods.com
Gold’s Gym Charlottesville | 434.973.1307 www.goldsgym.com
ACAC Charlottesville | 434.978.3800 www.acac.com
WORKOUT STATS: MODERATE INTENSITY LOW
MODERATE
HIGH
CORE
STRENGTH
M
U SCL E S
ENDURANCE BALANCE
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CARILION CLINIC ADDRESSES LEXINGTON’S NUMBER ONE HEALTH NEED words | LOIS CALIRI original photography | KG THIENEMANN
With the opening of VelocityCare, Lexington residents no longer have to travel nearly an hour for urgent care.
Scan this QR code for the recommended adult immunization schedule provided by the Center for Disease Control.
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When a health condition requiring immediate care arises, the emergency room is often the first destination. While the emergency room is best equipped to address life-threatening issues such as heart attacks, strokes or severe injuries sustained in an automobile accident, it may not always be the most convenient and cost effective option for less serious health problems. With the recent opening of VelocityCare by Carilion, Lexington and surrounding community residents now have access to a nearby urgent care. Prior to its opening, the closest urgent care was nearly an hour away. VelocityCare by Carilion, which is located at 110 Houston Street, Suite D, is adjacent to Carilion Stonewall Jackson Hospital. Its proximity to the hospital makes it easy to transfer a patient who needs a higher level of care, says Robert Childers, MD, an urgent care specialist with VelocityCare.
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
“Carilion has responded to the number one identified need from our Community Health Needs Assessment Survey that was conducted last year,” says Chuck Carr, Vice President of Carilion Stonewall Jackson Hospital. “The number of people with minor injuries who have come into our emergency department in the past several years indicated a real need for VelocityCare in our community.”
“For patients, VelocityCare provides a lower cost alternative path for people who are seeking treatment for so-called ‘urgencies’.” – Chuck Carr
WHAT MAKES URGENT CARE DIFFERENT THAN
EMERGENCY ROOM CARE?
Put simply, urgent provides non-emergency medical care most typically referred to as urgent care services. This category of medicine includes the treatment of allergies, asthma, broken bones and sprains, burns, cold and flu symptoms, ear, sinus and respiratory infections, insect and animal bites, stomach viruses, skin rashes and most other non-life threatening injuries, illnesses and conditions (see sidebar for additional information). Additional services include a full range of immunizations such as flu and tetanus, as well as vaccinations for world-wide travel. Also offered are occupational medicine services to the region's employers for work-related injuries and annual physicals and drug testing for Department of Transportation drivers.
Urgent care centers offer convenient access to treatment for non-life threatening situations. They reduce overcrowding in emergency rooms and are less expensive. The staff at VelocityCare run x-rays and lab tests in-house, and use an integrated electronic medical records system linked to Carilion Stonewall Jackson Hospital. Because VelocityCare is part of the Carilion Clinic network, the medical histories of patients who have been previously seen by doctors within its system can be easily accessed. “Nurses navigate the patients’ care should they need to follow up with a specialist or primary care physician,” adds Dr. Childers. “And if patients do not have a primary care physician, we will help them find one.”
Photos at Right: Without the need for appointments, VelocityCare in Lexington provides walk-in medical care seven days a week and offers a less expensive option for treatment of injuries that are considered urgencies, but not emergencies. VelocityCare can treat anything from a common cold to minor breaks or fractures. They can even perform x-rays and lab work. www.OurHealthCville.com
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WHERE TO GO FOR WHAT
MEDICAL CONDITIONS: WHEN TO GO TO AN
EMERGENCY ROOM Always dial 9-1-1 or go to the closest emergency center if you experience any of the following symptoms: •
Loss of consciousness
•
Heart attack symptoms
•
Stroke symptoms
•
Difficulty breathing
•
Uncontrollable bleeding
•
Sudden, severe pain
•
Poisoning
•
Head trauma
•
Vomiting or coughing up blood
•
Severe or persistent vomiting
•
Suicidal feelings
WHEN TO GO TO AN
URGENT CARE CENTER An urgent care center is appropriate for non-life threatening issues such as: •
Minor cuts and lacerations
•
Sprains
•
Earaches
•
Colds, coughs, sore throat
•
Skin rashes
•
Insect bites / minor dog bites
•
Minor cooking burns
•
Minor infections
BRIDGING THE GAP IN PRIMARY CARE
Urgent care centers not only help alleviate overcrowding in emergency rooms, they can also serve as a back-up for primary care physicians. Nationally and locally, the need for primary care physicians continues to outpace availability. In Lexington, local primary care physicians are often booked and have to refer patients to the emergency room if they are unable to fit them in. “If you can't go to a doctor's office and you don't need to go to a hospital, an urgent care center may be a much more time and cost efficient means of getting healthcare,” explains Dr. Childers. The increase in the availability of urgent care centers has allowed primary care physicians to focus on prevention and chronic disease management. However, this doesn’t mean individuals should look to urgent care as their primary care resource. As Dr. Childers says, urgent care centers can help bridge the gap between primary care physicians and emergency and urgent care. They are not intended to serve as a replacement. Routine physicals/exams and follow-up appointments with a primary care physician are very important in the overall management of one’s health, both from a preventative and chronic disease management standpoint.
A BOOM IN
URGENT CARE CENTERS Carilion’s expansion into the urgent care center business represents a national trend. Across the country, there are 7,100 full-service urgent care centers, according to The Urgent Care Association of America (UCAOA). About 22 percent are owned by hospitals, 15 percent are part of joint ventures with a hospital system, and 19 percent are corporate-owned entities. “Many consumers understand their healthcare options, but affordability, quality and convenience are leading factors when seeking treatment,” says Steve Sellars, president of UCAOA. The Association’s recent survey found Baby Boomers prioritize experienced physicians, while Millennials look for convenience and cost-savings. The data showed: • 34 percent of those over 65 prioritize the experience of the healthcare professional they will see, compared to 19 percent of those aged 18-34 • Cost or affordability is essential to 26.5 percent of those 18-44, compared to just seven percent of those aged over 65
Chuck Carr is Vice President at Carilion Stonewall Jackson Hospital in Lexington.
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• Having a physician on-site matters the most to more than 21 percent of those aged over 45, compared to just 6 percent of those aged 18-44 • Location is most important to 17 percent of those 35-44; with wait times leading the way for 13 percent of those aged 18-34
OurHealth | The Resource for Healthy Living in the Shenandoah Valley and Charlottesville
URGENT CARE CENTERS ALLEVIATE STRAINED CAPACITY AT HOSPITAL EMERGENCY ROOMS “Prioritization of cost and convenience among younger patients is one of the reasons that the number of urgent care centers continues to grow.” – Steve Sellars
URGENT CARE CENTERS OFFER AFFORDABLE CARE
The cost of health insurance is almost as much as buying a new car every year, says Sellars. For a family of four, it is roughly $25,000 annually. While employers pick up a portion of that, employees’ contributions to their healthcare coverage have increased by about 150 percent in the last eight to 10 years. And it’s not unusual for employees to carry deductibles of $1,000 or more.
As the U.S. healthcare system grapples with strained hospital emergency room capacity in some areas, primary care physician shortages and rising healthcare costs, urgent care centers have emerged as alternative care settings. They may help improve access and contain costs, according to the Center for Studying Health System Change for the National Institute for HealthCare Reform.
The average cost for a visit to the emergency room is about seven times that of treating the same condition at an urgent care center. We’re talking about saving millions of dollars at the right level of care.” – Steve Sellars VelocityCare accepts most insurances as well as Medicaid and Medicare. Patients who do not have insurance can pay $105 before being seen. Any remaining balance will be billed to the patient. VelocityCare is open from 8 a.m. until 8 p.m. Monday through Saturday and 10 a.m. until 6 p.m. on Sunday. Holiday hours are posted on the center’s website www.velocitycarebycarilion.com. To reach VelocityCare in Lexington by phone, call 540.462.3950.
Robert Childres, MD is an urgent care specialist with VelocityCare in Lexington. Dr. Childers is certified by the American Board of Family Medicine.
EXPERT CONTRIBUTERS Chuck Carr, Vice President of Carilion Stonewall Jackson Hospital in Lexington. Robert Childres, MD with VelocityCare in Lexington. Steve Sellars, president of Urgent Care Association of America (UCAOA).
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Steve Sellars is president of Urgent Care Association of America (UCAOA).
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