Issue 118.4- Dr. Divya Shokeen and Dr. Raj Khalsa by topdoctormagazine

SPECIAL ISSUE

January 2021 Issue 118.4

Dr. Divya Shokeen and Dr. Raj Khalsa A Power Couple in the Pandemic Pg 1

Pg 12

Telemedicine: Are Physical Exams about to become Extinct? Pg 8

Pediatricians Are Concerned about More Serious Child Abuse Cases As Pandemic Continues Pg 12

CONTENTS

A POWER COUPLE IN THE PANDEMIC: AN INTERVIEW WITH DR. DIVYA SHOKEEN AND DR. RAJ KHALSA

TELEMEDICINE: ARE PHYSICAL EXAMS ABOUT TO BECOME EXTINCT?

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CHILD ABUSE PEDIATRICIANS ARE CONCERNED OF MORE SERIOUS INJURIES AS PANDEMIC CONTINUES THE CONTRAINDICATIONS OF HAND SANITIZER THESE HAND PRODUCTS COULD BE CAUSING MORE HARM THAN GOOD

ZOOM PANDEMIC: HOW COSMETIC DOCTORS ARE SEEING A 50% SURGE IN BUSINESS AND YOU CAN TOO

HOW TO BE HEALTHIER, WEALTHIER, AND HAPPIER IN 2021: AN INTERVIEW WITH DR. KERN BRAR

WORLD’S MOST FAMOUS DENTIST GIVING BACK

THE RESILIENCE OF THE MEDICAL COMMUNITY

EDNA HUDSON: A FRONTLINE HERO

JOIN OUR MARKETING SCHOOL FOR DENTISTS SO YOU WENT THROUGH MANY YEARS OF SCHOOLING AND MEDICAL INTERNSHIPS TO GET WHERE YOU ARE AND ONLY TO REALIZE NO ONE REALLY TAUGHT YOU HOW TO BUILD A SUCCESFUL PRACTICE AND ATTRACT ENVIABLE AMOUNTS OF NEW PATIENTS.

WE HAVE YOU COVERED

LET'S GROW TOGETHER

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A POWER COUPLE IN THE PANDEMIC: AN INTERVIEW WITH DR. DIVYA SHOKEEN AND DR. RAJ KHALSA By Brianna Connors

In the continuous struggle against COVID-19, doctors and medical personnel are working around the clock, often to exhaustion. These are our frontline heroes, who deserve nothing less than our utmost respect and gratitude. However, we often get a chance to gaze only at their mountainous amount of work and forget about their difficulties, their fears, and their struggles.In the hectic world we live in, some doctors find the necessary strength to rise to the challenge by looking out for the community and by giving something back as well – they truly are our modern-day heroes! That is the case of Dr. Divya Shokeen, a Board-Certified Dermatologist, and her husband, Dr. Raj Khalsa 01

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a Vascular and Interventional Radiologist, who more than joyfully agreed to talk to us about their uphill battles during the COVID-19 pandemic, which, from time to time, brought them little drops of true blessings. Let us tune in to Dr. Divya and Dr. Raj and learn more about how they made their contribution to the battle against COVID-19 while Dr. Divya opened up a second practice, launched her own skin care product company, and brought a small angel into this world!

The Challenges of COVID-19 Although the year 2020 seemed to begin under good auspices – Dr. Divya had founded the Ocean Skin and Vein Institute in May 2019 - initially, the arrival of COVID-19 has put a great strain on her practice. A complete shutdown was in effect between early March and the beginning of June. “I continued to do telemedicine so that I could be there for my patients who wanted to be seen but who unfortunately couldn’t be.” Aside from telemedicine, Dr. Divya made sure that she took care of emergency patients by keeping her practice open one day/week.

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The Challenges of COVID-19

As private practices gradually opened up at the beginning of June, Dr. Divya took every single step to protect both her patients and her employees. Constant temperature check, constant COVID-19 tests for employees, restricting the number of admitted patients to one at a time, moving the offices into larger rooms, decontaminating surfaces, hyper filters – those were the measures put in place to effectively keep the practice virus-free. “We are trying to make sure that we are as safe as possible for our patients,” Dr. Shokeen tells us. Even though the waves of fatigue and uncertainty brought by COVID-19 affected every individual, Dr. Shokeen is proud of her patients, who respected every single rule put in place. “Everyone’s been very receptive and understanding, so I think our patients have been pretty good about it.”

COVID-19 and “Zoom Time” Although the pandemic has hit numerous medical practices, in her opinion, Dr. Divya believes that people have become more receptive to cosmetic procedures, mainly because of “Zoom time.” “When people are sitting on Zoom, and they’re sitting all day, and at home, they kind of start to notice the things that they’ve been forgetting, and a lot of that has to do with self-care.” Because of “Zoom time,” patients are more more attentive to their appearance, which led to an uptick in hair loss and acne scarring treatment requests.

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Furthermore, she believes that, at least in LA, people are starting to let go of previous misconceptions about her work and begin to embrace cosmetic procedures as means of self-care. “Everyone’s coming in asking: I’ve kind of forgotten myself. I used to spend a lot of time on myself. Now, I realized I spend a lot of time on my job or my kids or on my environment, where I’m not really focusing on myself.”

COVID-19 and “Zoom Time” Dr. Shokeen admits that she often found herself in need of guidance in this hostile business environment. “There’s no guidebook to running or operating your business, and, unfortunately, they don’t teach that in medical school.” However, she tells us that the key to a successful business is not going to business school but understanding people. Whether patients, suppliers, or employees, it is people who are the foundation of a thriving business. “We’re trying to build something that is going to be a long-standing brand.” In this mission, letting people know that they can count on her is Dr. Shokeen’s secret weapon.

Skin Care during the COVID-19 Pandemic Apart from caring for their patients on-premises, Dr. Shokeen found a way to help people take better care of their skin while also giving back to the community. In September 2020, six months later than originally planned and after 1 ½ year of testing, she launched her first line of skin care products to bring a comprehensive skin treatment to the market. By launching this product, Dr. Shokeen is trying to bring something new to the skin rejuvenation field while also helping those in need. “We want to give back, especially during this time, I think, we’re trying to keep it very cost-conscious, and we’re giving percentages to two different charities every year, and the best part is that the person purchasing can choose, so it also makes you feel like you’re part of it.” She intends to improve her line of skin care with four additional products by the end of January.

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When asked about the product’s progress in terms of sales, Dr. Shokeen was happy to tell us that she has built a loyal community of patients who repurchase her product regularly. In her opinion, this has to do with women looking towards a mask-free future. “Women are really saying, You know what, I’m not spending the money to go to the hair salon as much, I’m not going to get my nails done, I’m not going on vacations, so I want to spend it on myself, I want to make sure that I feel and look better for when I do get to take the mask off.”

The Blessing of Having a Baby during the COVID-19 Pandemic Putting their careers and work aside, Dr. Divya and Dr. Raj saved their biggest blessing of the year for last – their first son, Arien, was born just a few months ago! They admitted that starting a family, as a power couple in medicine during a pandemic, was not easy. Dr. Raj was always reluctant about coming home from the hospital or bringing stuff from work. “I know this has been especially hard on my husband because every time he comes home, he has to go and decontaminate for half an hour before he can even hug his child, and that’s tough on any parent.” However, after becoming a parent, he is more sensitive about newborn children or mothers as patients - “When it’s about newborn children or mothers delivering, he doesn’t even question it, he just goes to the hospital,” Dr. Divya tells us. Besides becoming a parent during a pandemic, Dr. Divya was forced to face another stringent issue for any new parent, maternity leave.

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When asked about how many days of maternity leave she enjoyed, Dr. Divya confessed that she was happy to receive 4and-a-half weeks of maternity leave while complaining about a colleague dermatologist in FL who spent only nine days with her newborn before returning to the field. “This is what happens for all physicians,” she tells us. The short maternity leave left Dr. Divya with no choice but to find a nanny who takes COVID-19 tests regularly. However, for Dr. Divya, the joy of bringing a baby into the world surpasses all difficulties. “It tests you in a different way, for sure, but I’m incredibly blessed and graceful, and I think we both can say that because we have a wonderful, healthy, baby boy, who we couldn’t imagine our lives without, so it’s been a tough year, but this has actually been the one silver lining that we’ve had through everything, and it’s a reason to get up in the morning because we want to make sure that he is taken care of.”

Hope is in Sight With their practices coming back strong, a skin care line of products, and a healthy newborn baby, Dr. Divya and Dr. Raj are confident that the future has more sunshine in store for all of us. Their hope mainly resides in the vaccination program – Dr. Raj and Dr. Divya have already both received the vaccine. “I think that the vaccination is the light at the end of the tunnel,” Dr. Raj tells us, confident enough in the vaccine’s ability to neutralize the new COVID-19 strains that sprung up in Europe.

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As for the medical field, both of them see a future with more technologically enabled care and more light-type hospitals for COVID-19 patients in a trend towards outpatient care and procedures.

What Keeps Dr. Divya and Dr. Raj Going? “I just look at her,” Dr. Raj tells us, always impressed by his wife’s hard work and dedication. “I don’t feel like it’s work because I love what I do. I think the day that it becomes work, I’m probably going to stop doing it,” Dr. Divya tells us, with a smile on her face. They hope to keep cultivating their energy, their excitement, and their thirst for knowledge for years to come.However, spending more time with their newborn son is their true resolution for 2021. We wish them the best of luck in all of their endeavors, not only as a power couple in medicine but also as a strong, beautiful family!

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TELEMEDICINE: ARE PHYSICAL EXAMS ABOUT TO BECOME EXTINCT? By Catherine Bonandin When’s the last time you saw your doctor in person? For many people, that’s becoming a thing of the past, thanks to telemedicine services. As COVID-19 has forced all manner of gatherings from public spaces to virtual ones, it seems that medical care has not been left out.

What are telemedicine services? In short, it means meeting with your doctor or health care provider remotely, instead of in person. While some versions of telemedicine have been around since the 1950’s, new advances in technology such as video-conference apps and smartphones have made it easier for people to access. Telemedicine services can consist of interactive, real-time communication between health care professionals and patients using phone or video conferencing; recorded messages that are sent between patient and care provider; or even remote patient monitoring, that uses mobile medical devices to collect diagnostic data.

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Telemedicine and e-health services have been hailed as a boon, and also criticized, for a variety of reasons. Thanks to coronavirus risk management and physical distancing, telemedicine services are being widely expanded and used in many new ways. Doing away with physical exams in such a rapid and widespread way might be seen as highly experimental and controversial, if it weren’t for the current logistics challenges associated with the pandemic. Those who are the most at risk for severe complications of COVID-19, such as elderly and immunocompromised individuals, can especially benefit from telemedicine visits, because they allow patients to avoid the additional exposure risk of waiting in a crowded waiting room with other ill patients.

Thanks to coronavirus risk management and physical distancing, telemedicine services are being widely expanded and used in many new ways. Doing away with physical exams in such a rapid and widespread way might be seen as highly experimental and controversial, if it weren’t for the current logistics challenges associated with the pandemic. Those who are the most at risk for severe complications of COVID-19, such as elderly and immunocompromised individuals, can especially benefit from telemedicine visits, because they allow patients to avoid the additional exposure risk of waiting in a crowded waiting room with other ill patients.

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Telemedicine visits are sometimes cheaper per treatment overall. Lowering the cost of health care benefits both patients and health insurance providers. Additionally, AI diagnostics and medical streaming devices allow physicians and nurses to provide more efficient care, while reducing the possibility of errors. Telemedicine also does a great job of reducing the number of unnecessary doctor’s office visits, which saves consumers time and money. Another great benefit of telemedicine is that doctor’s visits can often be handled without the challenges of missing work, or scrambling to find childcare or eldercare in order to complete a visit. While it’s clear that telemedicine is important, it’s also worth exploring how telemedicine is changing healthcare in profound and perhaps disconcerting ways. First, there are barriers to telemedicine that we must contend with in order to continue accessing, and providing, quality health care. Not everyone has access to a personal device for telehealth visits, and new technology includes a learning curve that’s not always easy to master, especially in the elderly population. There’s also many people who are concerned over the perceived impersonalization of health care, and telemedicine services may be blamed for accelerating that trend. Some health care providers believe that an increasing trend towards telemedicine will result in missed diagnoses, which may have long-term consequences.

Is telemedicine effective? For many health care professionals, that question is at the core of their decision to offer - or forgo - telemedicine visits in their own practice. Dr. Paul Hyman, who has recently authored an essay in JAMA Internal Medicine, voices his concern that the “business of medicine has already started to devalue a doctor’s touch.” He shares that the pressure to see more patients per day results in spending less time with each of them. 10

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Dr. Hyman already feels he has little time to actively listen to their concerns and answer their questions, and with telemedicine visits, his ability to read body language and pick up on vocal cues is also inhibited. Like Dr. Hyman, many of us recognize that a major aspect of quality healthcare involves the physical touch, eye contact, and active listening that a patient and provider experience when they are fully present with one another. No AI or technology can fully replace that. Finally, it’s important to consider that technology is expensive, and the health insurance industry moves slowly when it comes to implementing changes that align with common practice. While 29 states currently have “telehealth parity laws” that require telehealth visits to be reimbursed in the same way as in-person medical treatment, this doesn’t necessarily mean that payments will be equal. The exact amount varies by insurance provider, and may only cover videoconference visits, but not other types of telemedicine services. Regardless of these potential pitfalls, telemedicine is here to stay and we are all eager to see it improve rapidly. Thankfully, as we see further advances in technology, billing and insurance standards, and medical providers integrating technology into their current practice, our experience of telemedicine services is likely to become even more positive in the near future.

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PEDIATRICIANS ARE CONCERNED ABOUT MORE SERIOUS CHILD ABUSE CASES AS PANDEMIC CONTINUES By Catherine Bonandin

As predicted by sources in the spring, child abuse rates during coronavirus lock-down are reaching disturbing highs. Hospitals are seeing more serious injuries in smaller and smaller victims. The virus has not given up and as a result, the child abuse continues to increase.

Child Abuse Facts Statistics say 1 in 4 kids are mistreated within the home at least once in their lives, and this includes physical, emotional and sexual abuse. 16% of children who are abuse experience more than one type of abuse. Rates of child abuse are 5 times higher in children with families with low income compared to high income.

Coronavirus and the Rise of Child Abuse Combine that with the impact of Coronavirus which has been more than just something health related. The effect of full worldwide lock downs has lead to mass unemployment and in general increased stress. The majority of countries are requiring people to stay home with their families. In places like the United States where toxic home life is sadly 12

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the norm, this could lead to disastrous results. “We’re seeing a surge of some kind” says Doctor Lori Frasier, Chief of Child Abuse Pediatric Division at Penn State Children’s Hospital. They report seeing “pretty serious physical abuse injuries” in patients they describe as “young to very young” since the start of the Coronavirus lock-down. In 2020, from the dates January 1st to June 15th , there have been a reported 155 dead or nearly dead children in Pennsylvania due to child abuse. In the entire year of 2019 there were 144 children who died or nearly died as a direct result of child abuse. Sadly, this has been steadily increasing for years since about 2015, with a recorded 95 children dead or nearly dead from child abuse.

Past Trends of Child Abuse “Waves of trauma” as they are called are not new however often they do seem to be linked to social or economic pressure. For example in 2008 during the economic recession there was a peak of head trauma. When talking about this situation in May, Frasier said this: “one of our big concerns is that in 2008 during economic stress, we were all seeing a lot of shaken baby syndrome”. Anyone who has looked into that knows the majority of kids that experience that do not develop normally afterwards. There was also a study done by Rachel Berger, that was launched because they realized there were more children that died from abusive head trauma than non inflicted brain injury during the 2008 recession. 13

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They did a study on 500 patients which ranged from ages 9 days to 6 years. 300 of them were hurt bad enough to be in the ICU, 100 of them died.

Past Trends of Child Abuse Child abuse is defined as “when anyone under the age of 18 is either being harmed or not properly looked after”. This includes but is not limited to: hitting, slapping, burning, suffocating, pushing, restraint, medicating, sexual abuse or emotional abuse. It also includes blatant neglect.

Where is this happening? Many of the articles found about this topic talk about the state of Pennsylvania in particular but it’s seeming that this is a nationwide problem because the lock-down is nearly nationwide. Generally stories like the ones seen about Pennsylvania are just a snapshot of what is occurring in the nation as a whole.

Signs of Child Abuse: unexplained injuries fear of physical contact depression self-mutilation personality changes being isolated or withdrawn reduced physical, mental and emotional development self deprecation “I’m stupid, ugly or worthless” neurotic behavior inappropriate response to pain.

How to Prevent Child Abuse Be a nurturing parent. Make the home a no violence zone. When you see a parent struggling, do what you can to help them. Help yourself when needed if you are the parent. If the baby is crying but safe and clean, its ok to leave the room to gather peace for a few minutes. Anything is better than shaking a baby. These are just some ways to prevent child abuse from happening in the first place. 14

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How to Report Child Abuse However the sad reality is most child abuse happens before someone has a chance to prevent it, especially in times where the majority of people are urged to spend their time home and nowhere else. Teachers were the main source of child abuse reports. With school not being in session, reports have drastically dropped while the rates of serious injury increase. In the past advocacy centers have filled the role of helping to get abused kids out of their homes in a safe space where they can tell their story and begin to heal. The bad thing is Coronavirus has shut these things down. The responsibility is left to neighbors and other passive observers to help curb the problem of these high child abuse rates. Watch the children that live around you and look for symptoms of abuse. If you hear a child being abused or see clear signs of abuse, report this to the authorities.

Because the teachers are no longer able to do so and the victims certainly can’t speak for themselves, someone has to. This can be done in a small way like just allowing your home to be a safe refuge for these children if you want and are determined to avoid involving the state. A lot face stigma for the idea of calling the authorities on their neighbors but when the safety of a kid is directly involved, sometimes exceptions can be made. Part of the spike in child abuse is attributed to the fact that neighbors are too afraid to call on each other and make their living situation difficult in times of quarantine. For those looking for guidance on how to navigate the world in times of Covid-19, click here. https://childusa.org/coronavirus/ https://www.childwelfare.gov/topics/responding/r eporting/how/

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The Contraindications of Hand Sanitizer - Hand Products That Could Be Causing More Harm than Good By Justin Miller

Working Intro Hand sanitizer is a commonplace household essential, as well as a necessity within clinics. Its purpose is to keep your hands clean and sanitized, much more so during the COVID-19 pandemic to keep you safe. However, what if repeated hand sanitizer use was poor for your health and may even lead to long term health complications? Well, prolonged hand sanitizer use can harm you and may cause serious health complications. The product designed to keep you safe is equally

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capable of hurting you if it is misused. Within this article, you will find a list of risks and advice to help you use hand sanitizer responsibly so that you may lower your risk of bodily harm.

CDC section and facts The CDC recommends the use of hand sanitizer only when soap and water are unavailable. Washing hands with soap and water may significantly reduce the number of germs and chemicals on the hands. Hand washing can kill germs, such as Cryptosporidium, norovirus, and Clostridium difficile. The hand sanitizer you use as an alternative to hand washing should contain a minimum of 60% alcohol. Anything lower than 60% is not sufficient and will not precisely kill germs. Hand sanitizer can inactivate many different microbes if used correctly. However, most do not know how to do so. User error can include not using a large enough volume or wiping it off before it has dried. Hand sanitizer also does not remove harmful chemicals from the hands. The CDC is not opposed to hand sanitizer. However, they recommend hand washing over the alcoholbased product.

Brands to avoid Due to the COVID-19 pandemic, the FDA relaxed its regulations for hand sanitizer products, placing many harmful solutions on store shelves with little to no warning to the public. To combat this, rather than tighten rules, the FDA created an online list of 75 hand sanitizers to avoid. Since hand sanitizer needs to be of a certain alcohol percentage and engineered adequately, many brands are not safe to use. These products contain high levels of methanol, which is a substance that can cause blindness and even death when ingested. You can identify methanol poisoning through its symptoms of nausea, dizziness, weakness, and visual anomalies. 17

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Brands to avoid are selling at large chains, such as Sam's Club and BJ's Wholesale Club. It is also wise to watch for hand sanitizers made in Mexico because they contain 81% toxic methanol. The fumes from these hand sanitizers are flammable, so smokers or people near candles who use these hand sanitizers are at risk of receiving severe burns. Although, hand sanitizer of any form or manufacturer may pose health risks to frequent users.

Proper use advice Proper use is all about frequency. You must limit how frequently you use hand sanitizer because it is a last resort solution. One of the less severe risks you expose yourself to is skin irritation and eczema from using too much hand sanitizer. It may cause your skin to become dry, cracked, or blistered. However, new research has suggested contraindications that sanitizers with triclosan or triclocarban as an ingredient pose a significant risk to fertility. The overuse of non-alcohol based sanitizers with antibiotic ingredients has severe risks on fertility, fetal development, and asthma rates. Triclosan in hand sanitizers can also cause hormone problems. These hormone problems could stem from antibiotic-resistant bacteria, which became resistant from the overuse of triclosan based sanitizers. Triclosan weakens the immune system, which creates a severe problem in combination with antibiotic resistant bacteria. Any hand sanitizer with too much fragrance contains harmful chemicals such as phthalates and parabens. Phthalates disrupt the endocrine system, affecting body development and reproduction. 18

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Parabens negatively impact hormone function, fertility, reproductive development, and birth outcomes. So, scented antibacterial hand sanitizers double your risks because you may expose yourself to triclosan, phthalates, and parabens all at the same time. As for alcohol-based sanitizers, they can kill off good bacteria from your hands. The removal of good bacteria could potentially put you at risk of harmful bacteria. Alcohol-based sanitizer also lowers the skin barrier function, making the skin membrane permeable to toxic chemicals. For all those that care about the way they look and their age, alcoholbased hand sanitizer can rapidly age your hands if lotion is not immediately applied after use. Another considerable risk is if you cleanse your hands with alcohol-based hand sanitizer and directly touch something with BPA on it. The hand sanitizer causes the BPA to absorb into your body up to a hundred times more. After absorption, a thin layer of BPA will stay on your hands. So, if you eat something with BPA on your hands, you are consuming a portion of that BPA with every bite. BPA is dangerous because it causes hormonal disorders, cancer, and a plethora of other body issues.

Brands to avoid Parabens negatively impact hormone function, fertility, reproductive development, and birth outcomes. So, scented antibacterial hand sanitizers double your risks because you may expose yourself to triclosan, phthalates, and parabens all at the same time. As for alcohol-based sanitizers, they can kill off good bacteria from your hands. The removal of good bacteria could potentially put you at risk of harmful bacteria. Alcohol-based sanitizer also lowers the skin barrier function, making the skin membrane permeable to toxic chemicals. For all those that care about the way they look and their age, alcoholbased hand sanitizer can rapidly age your hands if lotion is not immediately applied after use. Another considerable risk is if you cleanse your hands with alcohol-based hand sanitizer and directly touch something with BPA on it. The hand sanitizer causes the BPA to absorb into your body up to a hundred times more. After absorption, a thin layer of BPA will

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stay on your hands. So, if you eat something with BPA on your hands, you are consuming a portion of that BPA with every bite. BPA is dangerous because it causes hormonal disorders, cancer, and a plethora of other body issues.

Compare/Contrast

The risks of hand sanitizer use do not outweigh the benefits. To protect yourself from nasty germs, be sure to wash your hands first and use hand sanitizer as a last resort. It would also be smart not to recommend or personally use alcohol-free or scented sanitizers because of harmful ingredients. Hand sanitizer does kill harmful bacteria, and it is useful in defending you from serious illnesses. However, it would be best to be mindful of which sanitizer products you use.

Conclusion Hand sanitizer is a vital asset to have in a time such as this. In a world of uncertainty, being confident that you can defend yourself from harmful bacteria is a much-needed comfort. Although, as with all good and great things, there's a catch; the wrong hand sanitizers can cause more harm than good. There's no reason to buy non-alcohol-based and scented sanitizers beyond the aesthetic. Alcohol-based sanitizers with an alcohol rating of 60% or higher are the key to hygienic success and one step closer to a COVID free life.

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ZOOM PANDEMIC: HOW COSMETIC DOCTORS ARE SEEING A 50% SURGE IN BUSINESS AND YOU CAN TOO By Kayla Schleining The COVID-19 pandemic has driven almost everything online. From work, conferences, meetings, appointments, parties, gatherings, concerts, (and just about everything else), online platforms have taken the world by storm. The internet’s ability to allow people to do almost anything from the comfort of their own computer has caused some fascinating social ripples. One of these social ripples, the cosmetic surgery boom, has splashed into the medical world doubling and tripling business in cosmetic offices. So, what is the cause of this phenomenon and how can you jump in on this “unprecedented” opportunity? Let’s take a dive and find out. 21

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During in-person events, seeing oneself is usually limited to bathroom mirror stops, the occasional selfie, and other intermittent occasions. However, on Zoom, the camera is on nearly 24/7. Through these little screens, people look at their reflection almost all the time. Staring at one’s reflection for so long makes things like smile lines, lipstick wrinkles, forehead creases, and crow’s feet all the more prominent. Some people start to think everyone sees them with these flaws, regardless of whether that’s true or not. This phenomenon is now being called “Zoom Face” – and many people want to remedy their flaws so they can look better on Zoom and other forms of social media. So, they turn to cosmetic doctors.

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Facial fillers, rhinoplasties, lip fillers, face lifts, neck-lifts and other face-related procedures are booming. While the exact statistics for 2020 won’t be available until around February, the general consensus within the plastic surgery world has been that 2020 has caused a massive surge in business. While some are saying this surge is due to Zoom, others, like American Society of Plastic Surgeons spokesperson Adam Ross, mentions that there’s a possibility “this is pent-up demand from the months of shutdown when patients were not able to get their procedures.”

Regardless of exact correlation, doctors all over the United States are reporting that dozens upon dozens of their patients report that they’ve noticed things over Zoom that they’d like to get “corrected” or touched-up. Zoom isn’t the only reason why plastic surgery has skyrocketed: Instagram, TikTok, Snapchat, and YouTube is where young adults spend their time during lockdown. On these social media platforms, “influencers” set beauty and fashion trends that have encouraged young adults to seek plastic surgery to achieve their ideal beauty standard. Additionally, increasingly popular camera “filters” that slightly adjust/clear/alter one’s face mean young adults can see potential plastic surgery results through their screens. For the first time, many adults have decided to get facial fillers, lip fillers, and skin treatments in 2020 to achieve these standards, many of which are set by social media. Finally, the benefit of assured home recovery time is an additional reason people are looking towards cosmetic surgery right now. With most of the country still experiencing stay-at-home orders, many are using that increased privacy as comfortable recovery 22

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for facial procedures but also for mommy makeovers, breast enhancements, breast reductions, body sculpting, laser hair removal, and more. The appeal of not having the expectation to go anywhere means that people can rest at home while still accomplishing all their work tasks, a combination that perfectly supports bigger cosmetic procedures. Cosmetic surgery isn’t only the affect of “Zoom Face”, pent-up demand, social media influence, and added opportunity – it’s also a way people are coping with the uncertainty of 2020 and 2021. It can serve a double benefit for those struggling with the pandemic, since cosmetic surgery provides both personal pick-me-ups and a sense of control. With so many people suffering disappointment after disappointment, lockdown after lockdown, a self-confidence boost can do wonders. Whether this be in a face lift, liposuction, lip fillers, or a breast augmentation, people are using plastic surgery to splurge on themselves and provide something that gives them lasting confidence. Plus, during a time when most of the population feels helpless, being able to take control of something feels good. Cosmetic procedures provide people with something to look forward to and something they can personally control amidst a messy world. Both of these desires have contributed to the growing popularity of cosmetic surgery. What can plastic surgeons do to make the most of this opportunity? Aside from deliver excellent results, the next most important thing is to let potential patients know who you are, your service, and what you offer. Not only that, but broadcasting how your services are timely to what they’re looking for is extremely helpful in finding patients. In your marketing strategy, highlighting a few areas which are hottest right now may be the key to helping you boost your numbers for 2021. 23

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Remember that facial procedures are all the rage – including with young adults! This means emphasizing both anti-aging and preventative aging benefits is useful for today’s audiences. Face lifts and neck lifts have been increasingly popular with older audiences, while lip fillers and facial fillers are in demand with young adults. With masks being mandatory in many locations, people are also gravitating towards procedures that highlight the eyes – this includes procedures that rid crow’s feet, undereye bags, and drooping eyelids. Spotlighting these procedures while clearly showing the results is a great idea to capture the attention of those looking to do something about “Zoom face” or meet their personal goals. Also, highlighting the benefit of home recovery time is vital. Some people, particularly those who’ve never had a cosmetic procedure before, don’t think too much about recovery time when considering procedures. So, stressing that remote work and staying at home provides a perfect opportunity to recover causes people to consider the idea that now is a perfect time. Once in-person work is normal again, finding recovery time will be more difficult and less private. Bringing that attention to potential patients can be the encouragement they need to book their consultation. Additionally, underlining the safety of procedures during COVID is something patients search for. In today’s world, safety, hygiene, and cleanliness are at the top of people’s concern list. 24

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It’s critical to show patients that every safety measure is being taken to give them (and the practitioners) the safest and best experience possible. Adding online consultation, mask precautions, sanitary measures, and other precautions to websites, email lists, social media, etc. is a great way to ease the concerns of any patients who are worried about potential COVID exposure.

Finally, upping social media and online presence is a fantastic way to reach potential patients. Blogs, Instagram, Facebook, YouTube, email lists, savvy websites, and – for the most ambitious, TikTok – are great ways to capture the attention of an almostentirely online audience. The days of posters and billboards are over (for now) and the days of clickable ads and blog posts are in! In today’s time, people are seeking out cosmetic procedures, pick-me-ups, and ways to boost their confidence. They hardly need to be convinced, but they do need to know what’s available, why now is the perfect time, and what can help them achieve their goals. Today, cosmetic offices have the strange advantage of being able to make the most of the New Online World, and it’s almost certain that regardless of COVID-19, this phenomenon won’t end soon. 25

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HOW TO BE HEALTHIER, WEALTHIER, AND HAPPIER IN 2021: AN INTERVIEW WITH DR. KERN BRAR BY KAYLA SCHLEINING & BRIANNA CONNORS Oh, to be healthy, wealthy, and wise! For most people, these three concepts help drive New Year’s resolutions. Whether it be losing weight, eating healthier, tightening the budget, or curbing addictions, almost everyone hopes to be healthier, wealthier, and wiser than the year before. In 2021 especially, people are ready to bid goodbye to the 2020 slump and start thriving again.

Dr. Kern Brar, Internal Medicine Specialist from southern California who specializes in medically monitored weight loss, has witnessed the 2020 challenges first-hand from his patients: “A lot of my patients are coming in with a lot of depression, sadness, and mental health issues because of the quarantines and things that have never been seen before in US history…and unfortunately, a lot of that sadness then reflects in their personal lives with increased use of alcohol and decreased feelings of self-worth and having more of a subclinical depression almost.” 26

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In a report released in August, the CDC further underlined this problem by publishing that “over 40% of U.S. adults reported struggling with mental health or substance abuse.” With some mental challenges, such as anxiety, the CDC mentions 2020 numbers were three times those reported than the 2019 numbers. It’s a sobering fact.

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In addition to mental health struggles, many Americans are also struggling with unwanted weight gain. Dr. Brar comments, “A lot of my patients are complaining about the ‘COVID-15’ or the ‘COVID-20’, and the amount of pounds that they’ve put on because they haven’t been able to do the things they used to…we’re home more, so we spend more time at home…[so people] look at things in their life and they’re like, “oh, I’m having 3 glasses of wine every day because I don’t have a big meeting tomorrow and every day is Friday.”” This weight gain not only contributes to mental health decline, but also to the overall health decline of the American population. In a time when being healthy is of utmost importance, those unwanted pounds can be very discouraging. But with 2021’s fresh start, people are ready to begin anew. And Dr. Brar is one of the richest resources when it comes to seeking a positive lifestyle change through medically monitored weight loss. Unlike just diets, gym regiments, and cold-turkey methods, Dr. Brar’s methods encourage a lifestyle change that extrapolates on “healthy, wealthy, and wise” – that’s right, medically monitored weight loss not only creates a personalized health plan for patients, but also helps people save money by adopting a holistic view that takes finances into account. That means saving money and eating healthy at the same time, a concept Dr. Brar explains is far simpler than most would think. “You should be able to save money on fast food 27

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and realize you’re spending $10 on a fast food meal,” Dr. Brar mentions, “And most of the weight loss recommendations that we make in our office and clinic are about 50 cents to a dollar a meal, some even cheaper.” Lifestyle plans are far more effective and overall less expensive than products, making it a step above the rest. “Patients come in spending hundreds of dollars a month on supplements… sometimes they don’t even say what’s in them.” Products, on top of that, can also cost upwards of $30 a month, an expense that some people simply can’t afford. Medically monitored weight loss is both cheaper and more effective than these options, making it a far better alternative. So what exactly is medically monitored weight loss? Dr. Brar answers this question by saying, “We look at medically monitored weight loss which includes everything: what the patient is eating, what they’re drinking, what times they’re eating, what times they’re drinking, as well as exercise 2 8 | Ttheir OPDOC T O R M A G A Zregiment. INE

We use a holistic approach to look at a person’s day-to-day as well as their financial resources. Each person is different, there’s not one pill that will suddenly have you lose weight and become healthier.” This means the program is flexible and caters to each individual’s needs, goals, and financial capabilities. Additionally, he’s a world of knowledge for those with celiac disease and helping others manage other food related diseases and allergies. From athletes to computer programmers, from millionaires to those with foodstamps, Dr. Brar promises a lifestyle program that molds and grows with the patient. In 2021, this program is the perfect mix of accountability, encouragement, and personalization from a medical specialist that helps create a healthy lifestyle and get rid of those quarantine pounds. One aspect of the medically monitored weight loss program that sets Dr. Brar apart is his emphasis on behavior modification versus actual diagnosis.

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Unnecessary medications, using supplements as a substitute for healthy eating, and getting weight-loss surgery are not long-term or reliable solutions for a healthy lifestyle. “There’s a lot of things that people do need to be treated on, but a lot of things that are just behavioral modifications” Dr. Brar explains, “so we help give people tools in their arsenal to be like, “Okay, I can make that decision and I’ll feel better tomorrow about it,” and actually solidifying that mindset to help people improve and make better lifestyle decisions.” For some people, this means doing intermittent fasting 5 days a week, for others, leaner eating, and yet others, limiting alcohol intake. Or a combination of all of the above. For everyone, though, it includes being aware of what people are consuming and when. “[We encourage] a natural way of eating and documenting everything that goes into your mouth.” For those who’ve felt they’ve gained unnecessary weight, losing those pounds can make all the difference. Dr. Brar explains that shedding those excess pounds can lead to “less infection, less joint issues, less back pain, less knee surgery because you’ll have less weight on these joints.” That’s good news for everyone! Even better news, adopting a healthier lifestyle doesn’t mean eating bland foods and bidding sweets and flavors an eternal goodbye. “I’m not going to ever tell anyone, “Don’t ever eat ice cream!” I actually just had some yesterday. But at the same time, limit the amount of serving to just one serving or just a couple of bites.” Additionally, he encourages his patients to think outside of just salads and quinoa. “I love different types of food that can challenge you, whether it be Asian, Vietnamese, Indian, or anything. Even burgers or steak or barbeque, there’s an incredible amount of flavors everywhere.” Sometimes, food isn’t even the main culprit – Dr. Brar also warns his patients to be aware of food or drink crutches that contribute more to weight gain than we realize, like sodas and alcohol. Ultimately, limiting snacking, finding crutches, and managing serving sizes are often more important than only counting calories and piling on the salads.

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Despite California still being under home-order and most locations closed down, Dr. Brar doesn’t let this stop his quest to help people improve their health. Dr. Brar uses a secure online site to connect with patients and meet with them faceto-face on their phones or their computers monitors. Some patients, particularly those with hip pain and those who need joint injections, do need to come into office. Nonetheless, Dr. Brar stresses safety above all and makes certain to take precautions.

Medically monitored weight loss is an affordable, personal, holistic plan through online/in person meetings and accountability from a passionate medical specialist. Dr. Brar’s work speaks for itself, as a lot of his patients are a result of word-of-mouth recommendations. “My patients tell me, “Hey this works this is great I want to continue doing this.” I have their neighbors come, I have their golf buddies come, and they’re like, “Joe told them you helped him lose 20 pounds and he looks great, I want to do that too.”” While medically monitored weight loss can be started at any point, there’s no better time than the new year to jump into a healthier lifestyle. And 2021 is the perfect time! Dr. Brar encourages people to use their primary care physician to help them establish a medically monitored weight loss plan and not wait until they have to go to 30

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the hospital or are suffering from weightrelated pains. By using their primary care physician, people’s plans would be covered by insurance, making it a worthy investment of people’s time and resources. If someone is hoping for medically monitored weight loss from Dr. Brar, then he would love to talk with them in a consultation to see whether obesity plans or switching care physicians would work best. Overall, Dr. Brar is optimistic for the future. He has a passion for helping people find healthier, holistic lifestyles: “That’s what I base my philosophy on.” Him, and about every American is hoping for a healthier (and wealthier and wiser) future. And Dr. Brar thinks that this is just the beginning for medically monitored weight loss: “A lot of my colleagues and people that I’ve trained through residency have shown interest in collaborating and instituting similar types of weight loss systems in their practices, so we’re working on collaborating with people in California, and even the United States and eventually internationally. I think we can work together to set a better stage for the world for healthy lifestyles. It’s an exciting initiative.”

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WORLD’S MOST FAMOUS DENTIST GIVING BACK By Brianna Connors Images by Owen Duckett

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Dr. Bill Dorfman is a man of many talents, achievements, and passions whose early experiences and willingness to overcome obstacles has led him to create many projects with deep roots to his family and foundation. Driven by his belief that helping people achieve a great smile is vital in boosting their self-esteem and promoting a happy life, Dr. Dorfman has spent 40 years in the dental industry, creating some of the brightest smiles and happiest lives. Relating his decision to become a dentist back to an unfortunate accident during his childhood, Dr. Dorfman explains that it was as if the “writing was on the wall.” As a result of an accident at age 3, Dorfman lost his upper front baby teeth and required multiple surgeries to ensure the proper development of his adult teeth. During his many subsequent visits, his curiosity about the profession grew.

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Esther Williams His dental career began in 1983 after graduating from the University of the Pacific Dugoni School of Dentistry in San Francisco as one of the youngest graduates ever to receive a doctorate degree. After completing a two-year residency program at a dental hospital in Lausanne, Switzerland, Dr. Dorfman moved back to the United States and began his own aesthetic and general dentistry practice in the Beverly Hills area. At the age of 29, Dr. Dorfman had the opportunity to work with his first celebrity patient, Esther Williams, who was one of MGM's biggest silver-screen stars. Not only did this opportunity result in a lifelong friendship with Williams, but it also thrust Dr. Dorfman into the spotlight, which attracted other celebrity patients. In the following years, he worked with many celebrities, including Anthony Hopkins, Anne Hathaway, Hugh Jackman, Mark Walhberg, Kathy Bates, Eva Longoria, Katy Perry, Usher, and Paula Abdul — making him perhaps the only person who can say he has a professional relationship with Hannibal Lecter, Mia Thermopolis, and The Wolverine.

Dr. Dorfman and Paula Abdul

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Because of his distinguished career in dentistry, Dr. Dorfman has also been a featured dentist on ABC’s “Extreme Makeover” and the Emmy Winning CBS talk show “The Doctors,” where he was a recurring guest co-host. Additionally, he is the author of The Smile Guide and the New York Times bestseller Billion Dollar Smile. Dr. Dorfman also co-founded Discus Dental, Inc. through which dental products and equipment have been developed and distributed to over 100 countries. Some of these products include the groundbreaking Nite White, Day White, BreathRX, Brite Smile, and Zoom!

Dr. Dorfman and Kathy Bates Dr. Dorfman helped grow Discus Dental from zero to over $1.3 billion dollars in sales. It became the largest global tooth whitening company before being sold to Philips in 2010. But by far, his favorite passion project is founding and contributing to the LEAP Foundation (Leadership. Excellence. Accelerating Potential), a non-profit organization dedicated to building the next generation of leaders. Through LEAP, Dr. Dorfman helps bring together over 400 top student leaders from around the world to UCLA's campus for annual summer motivational programs. The LEAP Foundation, created to inspire and guide the next generation, is a week-long experience where attendees ages 15-25+ are exposed to interviews with celebrities and professionals who explain how they have built successful lives, careers, or companies. 34

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When asked what led him to founding LEAP, Dr. Dorfman replied, “I’ll go back to the beginning… There was this iconic insurance salesman from Hunt, Texas, whose nickname was Itsy Bitsy Walter Hailey. He was this little guy who was a powerhouse, and as it turned out, many of his clients were dentists.What he soon realized was that even though these guys were amazing dentists, they knew nothing about business or running a practice. It was a completely different skill set, one that was not taught in schools back then, so he started a program called Dental Boot Kamp where he and his partner, Steve Anderson taught dental teams how to work as a team, how to be productive, and how to be profitable.

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Dr. Dorfman and Anthony Hopkins [As a result of the program's success], some of the people that went to Dental Boot Kamp said, 'you know, I wish there were something like this for my high school or college kids to go to and learn these skills'. So, Walter and Steve created a program and asked different people to come as mentors.” Asked to be a mentor himself, Dr. Dorfman attended the program to talk about his dental career and experiences on ABC’s “Extreme Makeover” and being a New York Times Bestselling author. Touched by how impactful the program was for the students, he returned for numerous years before taking it over upon Walter’s passing. It was then renamed LEAP and remade into a nonprofit organization. “[LEAP] has nothing to do with dentistry. It’s about life skills and teaching things like public speaking, networking, study habits, and how to apply for a job. It’s very comprehensive, and kids who go through the program will tell you that LEAP changed their lives. It's really profound and one of the things that is so near and dear to my heart.” Dr. Dorfman and Garth Brooks

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Throughout his life, Dr. Dorfman has exemplified the key principles taught at LEAP's annual summer program. This establishes the importance of — and proven success behind — these principles and makes them extremely personal. Going back to his beginnings when he was nearing graduation from the University of the Pacific in San Francisco, Dorfman said that he began to assess his life and the next steps to be taken into a dental career. “Basically, I was in dental school about to graduate, and I'm 24 years old. I [started to think], you know, I've never traveled. I've never been anywhere or done anything except school. The idea of opening a practice and being tethered to it until I retire without ever really seeing the world scared me,” he admitted. That was until he heard about a clinic in Switzerland that accepted those with American licenses. It seemed like the perfect opportunity to practice dentistry while also traveling. The only problem was that the clinic only had one position open and somewhere near 400 applicants. Knowing that his chances of getting into the Switzerland program were slim, Dr. Dorfman began an initiative that would later become one of the founding principles taught at the LEAP Foundation.

For more information about LEAP please go to www.leapfoundation.com

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Willingness of Success “One of the things we teach at LEAP is that successful people are willing to do the things unsuccessful people are not willing to do,” said Dr. Dorfman, “So, I started sending letters of recommendation from every professor in my dental school that I was friends with, and the letters were stellar! Do you know how I know? I wrote them all!” One of the important pieces of advice he passes on to the students who attend LEAP is that asking a professor to write a letter of recommendation can take up a lot of time in their already busy schedules. An alternative request is to offer to write the letter themselves and have the professor personalize it, which Dorfman's professors chose to do. On top of sending letters of recommendation, he started to call the Director of the Switzerland program every week. “Now that doesn't sound like such a big thing, but back then, in 1983, making longdistance phone calls was not as easy as it is today and VERY expensive,” said Dorfman. Regardless, he would send in another resume at the start of each week and call to follow up, make sure it was received, and talk with the Director. Then, one day, his persistence paid off, and something different happened.

“I tell my students that you will have lifedefining moments, and sometimes you plan them, and sometimes you don't. This one was spontaneous. I don't even know where it came from, I was on the phone with [the Director], and I really felt that he wasn't interested at all, Dr. Dorfman and Michael Strahan so I said ‘can I take you to lunch?’"

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Despite the reality of being in San Francisco and having no money to travel to Switzerland, he promised the Director that he would be there. The week after graduation, having borrowed the money, he traveled to Switzerland with the hope of being hired. “It worked!” Dorfman told Top Doctor Magazine, “Apparently, I was the only one out of 400 applicants that did what I did, and he hired me. It changed the trajectory of my life; I learned how to ski, I made amazing friends, I became fluent in French, and above all, it was an amazing experience.”

Copy Genius And Build Relationships When he returned to LA from his time working in Switzerland, Dr. Dorfman recognized that the area already had many established cosmetic dentists. To build his own practice, he would need to set himself apart. As a result, he embarked on another initiative that would later become the second valuable lesson he teaches to the students who attend LEAP.

“I called five of the most successful dentists that I could find and asked if I could shadow them even though shadowing wasn't even a thing back then. They each said the same thing to me… 'You're not like other students”. While most students would sit and watch the dentist drill on teeth, Dr. Dorfman would come into the clinic early and follow the entire process. From observing patient behavior entering the practice to how they engaged with forms, listening to the receptionists at the desk, following along with the doctor as he designed a treatment plan, and taking note of office managers, Dorfman learned what he wanted to implement in his own clinic. 04

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“I took everything I learned from those five offices and put it into my office,” said Dorfman, “On top of that, I have my secret weapon, Sue Hartzler.” Upon opening his dental office, Dr. Dorfman sent out announcements to everyone in his life at the time. Following up on one of the announcements inviting her to be a patient, Sue Hartzler, a former high school classmate, came into the office one day. In their conversation, Dr. Dorfman learned that she was working as a publicist - getting PR for her clients and helping them grow their businesses. He hired her, and within a couple of months, she had him listed in the Los Angeles Magazine as The Best Dentist in L.A.

“It was one of the greatest breaks [for me],” said Dorfman, “The second biggest break was meeting my future business partner and life-long best friend, Robert Hayman, at a charity event and creating Discus Dental with him.” Through LEAP, Dr. Dorfman has communicated the importance of fostering successful business, mentoring relationships and the art of connecting in the entrepreneurial atmosphere. For example, the summer event for the program culminates on Friday with what is called the Mentor Workshop. At the Workshop, students get a chance to sit at a table with a mentor — people like doctors, lawyers, firefighters, artists, screenwriters, actors/actresses — and ask questions about their career and profession. Some of the past speakers at LEAP include Anthony Hopkins, Mark Wahlberg, Paula Abdul, Eva Longoria, Kathy Bates, Usher, Michael Strahan, Apolo Ohno, Hannah Brown, Bibop Gresta (the founder of Hyperloop), and many others.

Give Back Believing strongly in the philosophy of “paying it forward,” Dr. Dorfman lives his life under the belief that no one should go through this world without making it better. When an individual's career has taken off, that person should give back to the community — a principle he has demonstrated many times over. Dr. Dorfman's words of encouragement and advice for the next generation of dentists is that they should help people no matter the difference that help might make. The one thing that Dr. Dorfman hopes people understand from looking at his life is that he is leaving a legacy of giving back because doing so brings him feelings of joy and gratitude.

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When asked what he is most proud of, Dr. Dorfman replied, “I would say personally my 3 daughters. Professionally, the fact that together with Discus Dental, The Crown Council, and Country Singer Garth Brooks, we have raised over $44 Million for children's charities through the Smiles For Life Initiative; and finally LEAP. It's a program that teaches things that [students] don't learn in school. One of which is appreciation. We give them a pad called I Appreciate Notes, and they fill it in with things that they appreciate. Before the pandemic, out of 400 students, I would get 400 I Appreciate Notes. These notes would say things like “I really appreciate you and the team because LEAP changed my life.’ And I know that it did. It is definitely a life-changing experience, and 99% of the students say that. The reason why I say only 99% is because the 1% say 'LEAP saved my life'... LEAP isn't a one and done. We encourage the students to stay active and join mastermind groups and continue listening to our podcasts. It's a really beautiful family.”

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Looking Ahead

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When he isn’t working at Century City Aesthetic Dentistry, Dr. Dorfman spends his time working with LEAP, staying active with his strict fitness regime, skiing, and developing new products for the dental industry. He shared with Top Doctor Magazine that two new products will be launching in 2021. “I cannot tell you [specifics] about them; they are secrets! But one is what we’re going to call a category killer in take-home tooth whitening and the second is a really fun product that I’ve been working on for years that’s finally coming to fruition,” said Dorfman. Additionally, it can be expected that Dr. Dorfman will be returning to television networks as he is in talks with a TV talk show host about doing a recurring segment. If anyone would like to reach out to him, Dr. Dorfman is available on his Instagram page @drbilldorfman and responds to 100% of his direct messages.

In closing, Dr. Dorfman left us with his life mantra: “When life gives you an opportunity, don’t take it… master it.”

You earn the money. We’ll help you keep it. And grow it.

TEL 1-855-904-1047

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THE RESILIENCE OF THE MEDICAL COMMUNITY Servants in the Seasons of Storms

By Graham Shuler & Brianna Connors Resilience is described as the act of quickly recovering from difficulties to spring back into action. Commonly associated with the strong, the leading, and the pathfinders - at its etymological core, resilience is an action, a state of mind, and a character trait. Trials of health within the human experience highlight those in the medical community as one group that embodies resilience, perhaps better than many others. With the rise of the COVID-19 pandemic, the medical community faced a storm of perilous confusion that would exacerbate existing weaknesses and create opportunities for healthcare

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professionals to honor their oaths in a time of great need. This cornerstone of society answered the call to take the battle head-on. Despite many obstacles and constant attacks, the call for the medical community to stand with the People and never surrender was heard. Countless businesses have been affected that caused many practices to close. Urgent care centers and other practices lost substantial business while hospitals struggled to function with the additional load and constraints. Through acts of resilience, healthcare professionals within these entities are recovering from their difficulties and springing back into action.

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The face of resiliency is embodied by friends, neighbors, and loved ones who all serve in the medical community. The People who have looked to the medical community, those afflicted and plagued by COVID-19, have remained resilient in their pursuit of life. Resilience may have been a perceived rarity before, but the fire forges of COVID-19 have tempered resilient, brave individuals. The medical community is united by common problems that require a combination of training and discernment to overcome concerns across this society. Throughout the COVID-19 pandemic, there has been a lack of consensus of best practices and politicking that detracts from the medical community's ability to perform their duties. Despite challenges of confusion, closures, and increasing demands for service, medical professionals have faced the realities of individual patients daily. Dr. Lali Sehkon, a Neurosurgeon practicing at the Reno Orthopedic Clinic, commented to Top Doctor Magazine, saying, "Here's what we know... it's worse than the flu was with the deaths somewhere between World War I and World War II. We are now using the emergency room and hospital room as an emergency ward." He went on to caution of the lack of consistency found among medical professionals leading to further concern. 42

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"Every week, the picture seems to change," said Dr. Sehkon. This results in those same professionals relying on their abilities to research and intuitive awareness to understand the dynamics of individuals and the general welfare in real-time - both of which come at the hefty cost of increasing staff burnout. Also speaking on the irregularities of COVID-19, Dr. Max Zaslavsky, a dentist in Fort Lauderdale, Florida, continues to portray the irregularities of COVID-19 that play like a film script. Dr. Zaslavsky provides perspective on the failings of the public trust that restrict the communication of counsel from the healthcare community. He exclaimed, "Weird when there is a mask shortage, and my barber is selling masks." Healthcare professionals have been quick to understand the inversion of these times as Dr. Zaslavsky points to the strange reality that "Lysol is like a black market - really tough." Dr. Zaslavsky responded to COVID19 through a range of adaptations that include a UV Light in his HVAC system. In navigating the onslaught of patient concerns, Dr. Zaslavsky echoed the staff shortage warnings, "Do they have covid or just the sniffles? Getting hygienists has been really difficult down here (In Florida)." Lo-Wei Bruno, a nurse practitioner in the Infusion Clinic of Mountain View Hospital, told us, "COVID-19 has had an impact on everyone in every industry. The Infusion Center has been completely operational throughout the pandemic, but we had to make some adjustments, like extensive screening for symptoms of patients and their families." Entities with limited resources have struggled while other systems have been able to navigate their operations. She told us her group is "very satisfied" with the amount of protection the administration at Mountain View Hospital has provided. Dr. Josh Renk is a prosthodontist with a creative background that has empowered his practice to reconstruct and generate smiles for his patients. Sharing in the fragility of patients, he began to wipe down anything his patients' touch and implement screening practices - however, seeing one patient at a time has not changed how he runs his practice. 43

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Ranges of experiences such as Dr. Renk's graphic design training give medical professionals a storehouse of ingenuity. Another doctor who exemplifies this is Dr. Cesar Solano, who is originally from Chicago. Solano was first trained in El Salvador, where his family is from. Following his return to the United States to pursue a career in dentistry, he worked his way up from humble beginnings as an assistant to the owner of a lab. After selling the lab and going back to school to get his dental license, Dr. Solano became an associate and is now a Clinical Director in the Fresno and San Francisco areas. Dr. Solano explained that the pandemic must be addressed in two ways. First, from the perspective of running a business, and second, from a public health standpoint. Speaking directly from his experience as a dentist, Dr. Solano was quick to agree that the training dentists receive to stop diseases such as AIDS or tuberculosis from spreading made adapting to COVID-19 restrictions a little easier.

“A lot of the barriers we [already] used were the same ones we still have to use,” said Dr. Solano, “We just have to put more things on top of those… For example, we have no issue wearing masks all the time.” The range of experience for the medical community is highlighted by consistencies for Oncologists and Dentists who deal with the infection's seriousness. These subtle and drastic changes in day-to-day operations come with a consensus from these professionals to wash your hands. The challenges of how many people can be inside the offices at one time and how to bring the patients back in safely require adaptation, but perhaps one of the most challenging issues that Dr. Solano and these other professionals have to overcome by ensuring enough PPE is available. Hence, the offices remain open and functional. The chaos of PPE has yielded a search for alternatives to secure the population from COVID-19. While some doctors encourage holding out for survival to a vaccine, Dr. Renk stated, "people have a lot of mixed feelings on that (vaccine), some people are very for it, and some people are extremely hesitant to get it.

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There is no information long-term on what it is… I feel like anything is speculation at this point; it's turned into a political thing." The delicacy of hesitancy and long-term information are recurring elements for Dr. Renk, who specializes in mouth rehabs, incorrect cases, cancer cases, complicated reconstructions, and problems with implants. He told us, "Our specialty (Prosthodontist) isn't well known, and the patient is often upset by the time they get to me, so it's difficult to work on a patient who is already upset from the first one." His general practice wisdom is relevant to the healthcare community today exhausted yet encouraged, depleted yet determined, patients battle fear in the unknowns of a novel virus. Specialists like Dr. Renk have counterparts across the healthcare industry with Dr. Jason Emer, a cosmetic dermatologist known for leading usage of lasers and celebrity cosmetics. Their experience with HIV, Tuberculosis, and Oncology training reinforces the seriousness of disease spread, as Dr. Emer reminds, "Removing the negative, like removing a mirror." Dr. Emer claims the new regulations caused a shift in his patients' behavior to go to a practice they trust with protective measures in place. His patients want to do bigger procedures, come less often, do treatments at home, but come in every couple of months for big treatments. For some, COVID-19 has increased accessibility to treatment while others have been unable to receive the treatment they so desperately need. The confusion of information throughout COVID-19 has continued to tax the public trust. Consensus on guidelines and politics have retained a rift between ideals - especially the medical and scientific communities.

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The approaching tax varies across regions and administrations; as Dr. Emer highlights, "Medicare planning on cutting surgeon reimbursement 15%. 50% goes to overhead, and then the rest goes to taxes. (There is an) inflated idea of income physicians take home. "This reference connects with the massive amount of debt that most healthcare workers take on. The financial frustrations of healthcare workers do not receive due attention. "News used to be who, what, when, where, and how, the opinion pieces now occupy the same as the reality opinions… (You) can find whatever opinion you want." For those like Dr. Sehkon, who believes we will see "the worst of (COVID-19) in the next couple weeks", the mask, distance, sanitize recommendations are "the cornerstone" in their professional opinions. Cultural and personal differences have fragmented comprehension of COVID-19. Dr. Zaslavsky disclosed that he has had heavy disagreements with colleagues and friends on issues assumed to be in agreement upon. These professionals reflect on the shame of the medical industry, that we are all in this position, that this is not a political issue, and we should be ashamed that medical opinions have been put on the wayside. The arguments between elderly and comorbidity are valid, but not all of the COVID-19 deaths are these causes. "This is a scenario where every decision made was going to be a bad one." Dr. Sehkon The race to treat COVID-19 contrasts our historical health experiences with an unprecedented sense of urgency. Why did we not treat HIV like COVID-19? Dr. Zaslavsky states, "So close to a vaccine for this but can't figure out cancer for the last 50 years, 1 billion USD into the vaccine but what about cancer? The intro to every zombie movie is the government vaccine… I'm being facetious, but it's weird to me we are so close with a vaccine for this and can't figure out pancreatic cancer."

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These alternative perspectives are echoed by the alternative treatments in Mountain View Hospital, where Lo-Wei Bruno played a pivotal role in the expansion of the Infusion Center with private rooms for blood transfusions, chemotherapy, biotherapy, antibiotics, and iron treatments, using aromatherapy and music therapy to manage chemotherapy side effects like nausea, pain, and anxiety. Mountain View Hospital utilizes the first scalp cooling device in Nevada, offering cancer patients a way to reduce hair loss caused by chemotherapy. Top Doctor Magazine celebrates Bruno's wisdom,

"So many times patients complain about the wait times for a doctor's visit, if they are at home waiting for a facetime conference with the doctor, it is much less stressful as well as safer. Telemedicine is a great tool that is often used in the clinic setting and in many of our outpatient clinics, such as primary care and cardiology. However, within the hospital, options for telemedicine in our setting, and the ER setting, are limited.". Accessibility for patients unable to see a doctor has caused delays where medical providers offer preventive solutions. For Dr. Emer and his cosmetic patients, there is less "embarrassment" and the ability to see dark circles and angles through a different lens. For dentistry, Dr. Renk states dentists have to be hands-on while remote examination technology is being designed for dentists to use without patients coming in… "I don't think that's possible because a lot of things are tactile in dentistry - you have to look in person for at least what I'm doing." Dr. Emer's specialty practice provides a strong case for serious consideration as he creatively applies his skill, in person, to return smiling structure.

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Healthcare professionals come from all walks of life, but their dedication and service render a humble entry point for their character to maintain throughout their careers. This resilient medical community's response-ability is prepared for these challenges through their discipline, training, and research. Dr. Renk cautions,

"Because of how much debt people get into for dental school and residence… expecting to make more, but if you get taxed on it, then you pay such a high level of student loans back. It does create a lot of issues. People don't understand how much it takes to do what we are doing. Not just being a doctor or business owner but going into debt." These medical professionals are persistent and continue to inspire through the practice of their lives.

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Dr. Zaslavsky breathed, "I'm living my life, but if you've driven in South Florida [you know] people in South Florida are pretty crazy also, could be my last day on I-95, I'm wearing my seatbelt when I'm driving and wearing PPE when working on a patient." The return to logos is echoed with a call for pathos by Lo-Wei Bruno, "There is a certain amount of fatigue that everyone is feeling, being masked all day, and constant, meticulous hand washing, and not seeing an end to this any time soon..." The Resilience of the Medical Community is exemplified by these servants' dedication and professionalism in the storm of COVID-19. Especially, LoWei Bruno's directive:

"I can only speak in medical terms, and saving lives is the priority, and I will do my part to help ease human suffering."

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Edna Hudson: A Frontline Hero By Brianna Connors Edna Hudson grew up in the small town of Orange Bend near Leesburg, Florida, where she now lives and works. Graduating in 1982 from nursing school, Edna has thirty-eight years of experience and is currently a charge nurse at the Ambulatory Surgery Unit of Leesburg Regional Medical Center.

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Becoming a single mother at the age of 24 when her husband passed away, Edna’s two sons are now in their forties and following in her shoes. Willie Hudson is a nurse practitioner and works for a neurologist, and Tremaine Hudson, a registered nurse, is working at a rehabilitation facility.“I never said, get into nursing. I never encouraged one way or another. I just let them do what they wanted to do, and it’s amazing how they have centered their life around the medical field because never did I say go into the medical field, but for some reason, they decided to go that way,” said Edna.

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Edna shared with Top Doctor Magazine that her five-year goal is to open a private clinic together in the Leesburg area with her sons, daughter-in-law Sonia, a medical staff credentialing specialist, and soon to be daughter-in-law Lajuana, a doctorate nurse practitioner. Speaking about her school experience, Edna shared that she was going through earning her two-year degree right after the loss of her husband. Even though it was tough being a single parent and going to school at the time, she recognized the blessing of not having to work, parent, and study all at once because her husband left her financially prepared to go to school. Through school, Edna admits that it was a lot of touch and go, of wondering if she passed and could move on to the next class. 50

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Where one student might spend four hours studying, she would need closer to eight.But thanks to teachers who were attuned to her needs and her desire to succeed, Edna graduated with a two-year degree and returned several years later to earn her Bachelors of Nursing.

“It took a lot for me, but once I got it, I got it. I had an anatomy and physiology teacher who told me that basically, some people get it easy, but for some people, it comes more difficult. You just have to stick with it. And, of course, I was able to.”

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When asked what drew her to becoming a nurse, Edna explained that it is a lifelong goal. At the age of eight or nine, she remembers watching nurses running around in their white hats and uniforms, thinking, “I want to be that when I grow up.” And, 38 years later, nursing is still a passion and joy in Edna’s life. “[Nursing] is a career that I have grown to really love and is one of the things I most value and treasure. Never in my 38 years of working have I ever said I hate going into work today, and that’s how I know it’s my passion. There is nothing bad I could say about what I do because I love it so much.” In the past year, Edna has seen drastic changes in the healthcare industry due to the COVID-19 pandemic. While these changes have been quickly adapted to by the professionals on the medical frontlines, there are potential impacts that could affect healthcare for the foreseeable future if not adequately addressed. A survivor of the Coronavirus herself, Edna believes that one of the biggest concerns facing the medical community is an impending shortage of nurses.

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“I think there will be a severe shortage of nurses because a lot of the hospital personnel I see are getting out of the field. It’s the fatigue that nurses are facing. They’re thinking if I could do anything besides this, I’m going to get out of it.” In her management role at the Leesburg Regional Medical Center, Edna has talked to nurses all over the hospital and found a common complaint. They talk about the shortage of personnel, the extreme fatigue they’re working under, and the unknowns that COVID-19 presents. For many, it’s a juggling act of monitoring patients to provide the best possible care, trying to figure out how to keep themselves and their loved ones safe, or being the sole financial provider for their families. Working on the frontlines, Edna advises that the best way for nurses and other medical personnel to protect themselves and stave off a shortage of staff is to take care of themselves - this applies to physical, mental, and emotional health.

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“I think we have to take care of ourselves physically; mentally, we have to give ourselves a check-up and make sure we stay strong. We comfort others all day every day, but no one takes the time to console themselves.” Amid this year’s pandemic, one of the significant changes seen in the healthcare industry is the advancement of Telehealth and Remote Patient Monitoring (RPM) services. For many, these digital platforms were the only way to check in with their patients or were a much-needed means of protecting vulnerable populations against the spread of COVID-19. A supporter of RPM and Telehealth services, Edna believes that it will be a saving grace for patients, families, and the country as a whole.

“It’s state of the art technology to make sure we keep everyone safe, including medical professionals.” Through Telehealth, it is possible to protect the patient and their family as well. Unnecessary exposure to the Coronavirus or other illnesses is limited, while those in need of medical attention are still getting an actual assessment complete with visualization, questions and answers, and education, all from the comfort of one’s home. This is especially important for the older demographics of patients who might be in a higher risk category. In her own mother's case, Edna has found that RPM's monitoring capabilities make physical doctor visits easier and help avoid unnecessary medication. Suffering from severe white coat syndrome, Edna’s mother can experience extremely high blood pressure when in her doctor’s office.

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However, because Edna monitors her blood pressure at home throughout the week and establishes a baseline, she can inform the doctor of the actual blood pressure readings. This is just one of the many helpful monitoring tools RPM gives to patients and doctors. Because of these benefits and more, Edna is an investor for TopDocRX, an RPM company headquartered in Las Vegas, and will be utilizing Telehealth in the private practice she intends to open with her sons.

“It [TopDocRX] is very innovative and very state of the art. I’m so glad to be part of a leading company with Telehealth and RPM. I know that all my patients that come in contact with it are benefiting.” It was a privilege to speak with Edna Hudson about her life and what she sees on the medical community's frontlines. Having spoken with many of those who have dedicated their lives to helping others, it is apparent that she has a real heart for her patients and the nursing profession. In closing, she asked me to include one of the mantras by which she lives her life and career.

“Duty is a matter of the mind. Commitment is a matter of the heart.”

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MASK KILLER: THE ANSWER By: Justin Miller Now is the best time to get serious about your health. With the continuing rise of COVID-19 cases, it is imperative not only for yourself but also for your neighbors to learn what your fever number is. By identifying your fever number, you are in control of your health and can help to control the spread of infectious diseases. Medical professionals nationwide already recognize the importance of a low-grade fever. Where the problem lies, is the realization that the general public does not yet understand the need for temperature monitoring and the importance of a low-grade fever. This is why Bob Kocher of Ideal Innovations Inc. and his team have been trying to raise awareness concerning the issue (i.e., What’s Your Fever Number). It is recommended that you purchase a thermometer that you can use to track your daily temperature. The easiest way to do this is to take your temperature each morning and record the results on a notepad or device. 54

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What you must understand is that your average temperature is not the same as everyone else and is influenced by multiple factors. Such factors include age, weight, pre-existing conditions, and overall health. With this in mind, you can monitor your average temperature and respond proactively when a variation arises.

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If you find that your temperature is naturally 97.5 degrees and wake up one morning with a temperature of 99 degrees, you would know that your body is fighting something because you are actively monitoring your temperature. During the pandemic, this would be an indicator that you need to get tested and quarantine. Often, rapid COVID-19 tests give false negatives before false positives. This is why quarantining with a temperature of 99 is imperative regardless of the test results, even if your temperature is below the national fever average of 100.4. By quarantining with a temperature lower than the national fever average, you are being proactive in slowing the spread of COVID-19. However, the importance of temperature monitoring goes beyond the pandemic. Temperature monitoring is a lifelong beneficial practice that has the potential to become the most important habit of your life. Your temperature is an indispensable tool of your body. When you are ill, a fever is one of the few ways your body can warn you that something is wrong. However, your body cannot inform you of something if you are not looking to be informed. If you choose to ignore the warning signs, an illness will not simply go away. By ignoring your temperature, you are increasing the risk of becoming a carrier and spreader. Slowing the spread of infectious diseases is a group effort. If you want to see change, be the change that you want to see. Global results are only within the realm of possibility, depending on how proactive you are. This works directly into how monitoring your temperature protects your neighbor, just as much as it protects you.

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Slowing the spread of infectious diseases is a group effort. If you want to see change, be the change that you want to see. Global results are only within the realm of possibility, depending on how proactive you are. This works directly into how monitoring your temperature protects your neighbor, just as much as it protects you. As we have already covered, monitoring your temperature daily is an active preventative measure against the spread of COVID-19 and other infectious diseases. Unfortunately, temperature monitoring is only useful if everyone participates. Active monitoring could eliminate the need for masks and governor mandates. If those who feel ill and have a fever immediately get tested and quarantine, they will not be spreading the virus. This would provide an opportunity for those who have a normal temperature not to need masks or to stay at home. Although, all of this revolves around a group-effort-system of getting tested and quarantining when presenting a temperature of 99 degrees or higher.

Ultimately, the future is in your hands. If you want quarantines to end, promote thermometers, and if you want an end to mask mandates, advocate for temperature monitoring. Because, as long as low-grade fevers are being ignored, there will continue to be an influx of infections. Masks don’t seem to be working to stop the spread of COVID-19, albeit they provide some protection. However, what if a simple thermometer could be the one thing that changes the course of this pandemic? So, pick up a thermometer, start a new habit, encourage your friends to join you, and watch how you impact the world for the better.

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A Word from the Editors Top Doctor Magazine is a magazine from doctors for doctors and patients. We cover everything from cutting edge medical techniques and procedures to enterprising doctors, dentists, surgeon, naturopaths, chiropaths, orthodontists and more who are thought leaders within their own medical practice and changing the way we all experience medicine for the better. We wish to be your one-stop digest for inspiration by other professionals in your field who are making waves and setting trends and if you too are a trend-setter, reach out to us so that we can interview you for your own spotlight within an upcoming Top Doctor Magazine issue!

Brianna Connors

Justin Miller

Derek Archer

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