SPECIAL ISSUE
April 2021 - Issue 121.1
Perfecting the Lost Art of "Doctor to Door" Medicine with Clay Hall Pg 1
Why People with COVID Lose Their Sense of Smell
Pg 12
How to be Healthier, Wealthier, and Happier in 2021: An Interview with Dr. Kern Brar
Pg 15
Contents
01
05 01
Perfecting the Lost Art of
15 12
"Doctor to Door" Medicine
Why People with COVID Lose Their Sense of Smell
with Clay Hall 05
Telehealth in Medicare &
15
How to be Healthier,
Medicaid:The Hidden Hero
Wealthier, and Happier in
Keeping Us Connected to
2021: An Interview with Dr.
Our Doctors even in a
Kern Brar
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Perfecting the Lost Art of "Doctor to Door" Medicine with Clay Hall
Thirteen years ago, Clay Hall, MSN, FNP, MBA, responded to a call in Scottsdale when he was working as a paramedic. He found an older gentleman living alone in a house with no air conditioning and eating dog food for lunch on what seemed to be one of the hottest days in record history. When Clay saw how dreadful the man's living conditions were, it became a turning point in his career. He realized that when you are dealing with patients inside the hospital, you only get to see the tip of the iceberg. If you go into their homes, you get a clear-cut view of the patient's life - and this is invaluable information when it comes to providing the proper medical care. That's when he decided to move away from hospital-based setting treatments and go into home-based preventative medicine instead. Now, Clay Hall is the Vice President of Team Select Mobile Physician Services, where their mantra is, "We do everything we can to keep patients out of the hospital and keep them safe in their homes." Their primary focus is on Chronic Care Management, wherein they have full-time nurses dedicated to monitoring patients and keeping them on track with their prescriptions and directives.
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This program prevents everyday situations where patients forget to follow through with the doctor's orders from the initial check-up, which leads them to showcase more problems on the next visit. Their goal is to guide their patients on the path to wellness.
What Makes "Doctor to Door" Medicine Special Clay fondly remembers when he answered a call from a patient's daughter where she was thanking him for Dr. Porter's, one of his doctors' acts of kindness. What happened was, Dr. Porter visited a senior home to do a check-up on the caller's mother. When she got there, Dr. Porter found that the patient hadn't eaten anything in days, so she decided to cook her breakfast.
The doctor ended up spending two hours with the patient and running late for her next appointment. In usual hospital settings, Dr. Porter would have been in trouble for being an hour late to her next engagement, but Clay commended her because what she did perfectly exemplified what they do and why they do it. In hospitals, physicians are scrambling around in a hurry to see as many patients as possible. But when they are doing home preventive care, physicians focus on the quality of care they give instead of the quantity. Having the time to sit down, drink coffee, and talk comfortably in a patient's home develops an authentic connection between doctor and patient that is just not possible inside a clinic setting. However, we cannot disregard the fact that there will be times when the patient's situation calls for in-hospital treatment. Having access to 24/7 monitoring, comprehensive testing, and specialists right at your fingertips is something home care cannot provide yet. Clay clarifies that home care is not a replacement for hospital care. PAGE
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"It's not necessarily us versus them. It's more of working synergistically and using the resources we have at our disposal at the appropriate capacity," he shares with Top Doctor Magazine.
Has Covid-19 Impacted Home-Based Care At All? Because Clay and his team are running a homebased medical care system, they are fortunate that the pandemic's impact on them isn't quite as severe compared to other medical services. With telemedicine at the forefront now, he was pleasantly surprised to see that many of their older patients are now picking up smartphones.
"We are moving into a tech-savvy world for sure," he claims. His company has even partnered with QliqSoft - where patients can now fill up medical information online through an app. He thinks that this technology can increase patient compliance and enrollment, therefore enhancing patient care. However, Clay's focus is still on getting physical hands and eyes on patients, but telemedicine is a fantastic alternative, especially with this pandemic.
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A Natural and Holistic Future for Medicine Another fun fact about Clay Hall is that he is a big advocate for regenerative medicine. Even though regenerative medicine is still quite off-label due to a lack of clinical trials, he believes that it will become a massive player in medicine one day. There are already several successful reports wherein the amniotic fluid is being used to treat orthopedic injuries - and it is only a matter of time before this style of treatment will pick up in the mainstream. Meanwhile, primary care providers should continue to focus on sitting down with the patient and re-educating them on the wonders of proper nutrition, exercise, and sleeping habits. Clay sees that going back to the foundations of health and sticking with a wellness-based intervention will help with the general goal of primary care to reduce polypharmacy, which uses several different pills to treat one illness. He hopes to see medicine shuffle towards a more natural and holistic way of healing.
Clay Hall's Advice for the Masses As the world slowly starts to shift back into its pre-pandemic routine, Clay is worried that people are starting to let their guard down against COVID-19. That is why he urges the public to get the vaccine when they can, for it is a necessary act of human kindness. He says that if you don't want to get vaccinated to protect yourself, do it to protect others around you who are more susceptible to a fatal COVID-19 reaction.
Clay hopes that everyone, especially the lowincome population, will have the opportunity to get vaccinated and receive proper health care. And, to aid in making health care more accessible, Clay Hall and his team of physicians will continue to do their part in providing patients with value-based service and extensive continuous care.
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Telehealth in Medicare & Medicaid: The Hidden Hero Keeping Us Connected to Our Doctors even in a Pandemic
“The genie is not going back in the bottle!” In recent months, the Centers for Medicare and Medicaid Services (CMS) has expanded access to telehealth services under President Trump’s emergency declaration. This allows beneficiaries to receive a broader range of services from their doctors without going to a healthcare facility. These benefits are part of the larger effort put forth by CMS and the White House Task Force to ensure that all Americans - particularly those at high-risk - are aware and able to access systems that can keep them healthy. Under the 1135 waiver, Medicare can now pay for office and hospital visits - among other types of visits furnished via telehealth across the country. This is a drastic change from before the waiver when Medicare could only pay for telehealth services on a limited basis.
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As of October 14th, the CMS added eleven new services to the growing list of telehealth services that Medicare will reimburse during the COVID-19 public health emergency. Since March 2020, Medicare has added more than 135 services via telehealth that it will pay for, including emergency department visits and nursing facility visits. Seema Verma, the administrator of CMS, said of the additions: “Responding to President Trump’s Executive Order, CMS is taking action to increase telehealth adoption across the country… This revolutionary method of improving access to care is transforming healthcare delivery in America. President Trump will not let the genie go back into the bottle (CMS.gov, 2020).”
In the past three years, CMS has been working to modernize Medicare as part of the Fostering Innovation and Rethinking Rural Health strategic initiatives. It has unleashed innovation in the private sector, improving access to telecommunication technologies and services to beneficiaries. Starting in 2019, Medicare began paying for virtual check-ins where a patient can connect with doctors via phone or video chat. These check-ins were done as a preliminary way to assess whether the patient needed to come in for an in-person visit. However, in response to the COVID-19 pandemic, CMS rapidly expanded its payment for telehealth services. This allowed Medicare beneficiaries living in all parts of the country access to high-quality care from the comfort of their own home where they could avoid unnecessary exposure to the virus or other illnesses. 06
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“Before the COVID-19 pandemic, only 14,000 beneficiaries received a Medicare telehealth service in a week while over 10.1 million beneficiaries have received a Medicare telehealth service during the public health emergency from mid-March through early-July” reports CMS.gov.
TELEHEALTH IN MEDICARE: WHAT DOES IT LOOK LIKE? As the healthcare industry has had to rush to fill the gaps in coverage during the COVID-19 pandemic, CMS has made keeping people safe and avoiding unnecessary exposure to the virus a priority. Providing a fact sheet on the various telehealth services now allowed through Medicare, patients, and healthcare providers alike can seek guidance on the best options for personalized care. This historic effort has been made possible by new policies implemented in both 2019 and 2020. For a beneficiary, these services can look like an inquiry call to their doctor if they are experiencing symptoms. During this call, it can be assessed whether a physical exam is needed or merely remote monitoring to see if symptoms worsen. If the beneficiary worsens, a virtual check-in allows the doctor a chance to make recommendations without making a patient step into the office or hospital. 07
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TELEHEALTH IN MEDICARE: HERE TO STAY? Telehealth services and the technologies needed for such procedures are nothing new. They were already in progress and en route to being widely accepted before the start of this year and the COVID-19 public health emergency. However, due to the PHE, telehealth became the premier source of care - being widely accepted and, in many cases, the only avenue through which medical attention could be accessed. As we have no real way of knowing the PHE’s end, there is no approaching end date for telehealth and its services. Not to mention, with its proven track record thus far, it may very well become the preferred method of care for many patients. Medicare and Medicaid beneficiaries, especially. While telehealth will never replace the gold-standard of an in-person doctor’s visit, it serves as an important addition to access. Its rapid explosion in recent months has raised the question of whether returning to the status quo will turn back the clock on innovation and a new level of care. Remote patient monitoring (RPM) is one such innovation under question should Medicare revert to pre-pandemic telehealth service limitations.
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TELEHEALTH IN MEDICARE: WHAT IS RPM, AND WHY IS IT THE BACKBONE OF TELEHEALTH? Remote patient monitoring (RPM) is a delivery method for healthcare
that uses the most advanced technologies to gather and analyze patient data, which is then used to develop and manage a treatment plan tailormade or related to a chronic illness or health condition. RPM is about moving conventional healthcare delivery outside of the box for better patient care and outcomes. These technologies are the latest and greatest, emphasizing today’s consumer-friendly personal tech items. Leveraging Bluetooth and smartphones or tablets, these data collection devices are used specifically to make patients comfortable monitoring and aiding in their own care. As a result of this comfort, engagement levels between patients, their monitoring devices, and ultimately the doctor are increased. Naturally, higher engagement levels correlate to improving the overall quality of care. Not only is the patient incentivized to be involved in his or her own health due to the comfort of quality RPM devices, but clinicians are equally better equipped to understand and manage their patients’ health situations. This is extremely important in the prevention of deteriorating health or worsening conditions. RPM is the backbone of Telehealth because it enables clinicians to actually see what their patients are doing daily. Never before has this level of care been accessible to the public. 09
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As witnessed in recent months, without Telehealth - without RPM the mode of most healthcare delivery systems would have been cut off for weeks on end. With Telehealth services and RPM, where a patient can interact with their doctor via technology and have their situations monitored 24/7, it is possible to diagnose, treat, assess, and prevent. It is more convenient than conventional doctor or hospital visits. It is more accessible to the demographics of the public. And it is an essential part of limiting unnecessary exposure to the more vulnerable. In conclusion, without the advances of technology, especially in the medical field, the COVID-19 virus would be able to spread much faster and further like the H1N1 Influenza Pandemic of 1918 where social distancing wasn’t a thing between doctors and their patients nor even in medical wards. 50 million people are estimated to have perished just a hundred years ago from a similar virus compared to the 1.14 million people who have died from COVID-19. No one should ever die from a horrible disease and our hearts go out to all those suffering from COVID-19 (it has touched our own office as well). It is our dream at Top Doctor Magazine and among the doctors, we serve to continue the exponential growth in medical advances over the past century so that mankind can be much closer to realizing a world virtually free from lifeending diseases in the not-so-distant future.
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Citations: Gilman, M., & Stensland, J. (2013). Telehealth and Medicare: payment policy, current use, and prospects for growth. Medicare & medicaid research review, 3(4), mmrr.003.04.a04. https://doi.org/10.5600/mmrr.003.04.a04 CareInnovations. (2020). What Is Telehealth? What Is Remote Patient Monitoring? How Are They Different? Retrieved from https://news.careinnovations.com/blog/what-istelehealth-what-is-remote-patient-monitoring-how-are-they-different CMS. (2020). President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak. Retrieved from https://www.cms.gov/newsroom/pressreleases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-duringcovid-19-outbreak CMS. (2020). Proposed Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2021. Retrieved from https://www.cms.gov/newsroom/fact-sheets/proposed-policy-payment-and-qualityprovisions-changes-medicare-physician-fee-schedule-calendar-year-4 CMS. (2020). List of Telehealth Services. Retrieved from https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/TelehealthCodes Foley & Lardner, LLP. (2020). Top Ten Medicare Remote Patient Monitoring FAQs for 2021. Retrieved from https://www.foley.com/en/insights/publications/2020/08/ten-medicareremote-patient-monitoring-faqs-2021 CMS. (2020). Trump Administration Announces Historically Low Premiums and New Insulin Benefit as Medicare Open Enrollment Begins. Retrieved from https://www.cms.gov/newsroom/press-releases/trump-administration-announceshistorically-low-premiums-and-new-insulin-benefit-medicare-open CMS. (2020). Telehealth Benefits in Medicare are a Lifeline for Patients During Coronavirus Outbreak. Retrieved from https://www.cms.gov/newsroom/pressreleases/telehealth-benefits-medicare-are-lifeline-patients-during-coronavirus-outbreak
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Issue 121.1.2
Why People with COVID Lose Their Sense of Smell By Odessa Kramer There are now over 29 million coronavirus cases in the U.S. From body malaise to shortness of breath, the virus presents itself in different ways. One of the most common and interesting symptoms is anosmia or smell blindness. An NIH review studied a total of 11,054 COVID-19 patients and found that this loss of smell often precedes the other, more severe symptoms of the virus. This loss of smell can suddenly occur in people infected with COVID-19 and is often associated with loss of taste, too. Loss of smell in COVID-positive patients may happen with or without a stuffy or runny nose; in some cases, this may even be permanent. 12
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Issue 121.1.2
Even though buying a piano is a significant investment for parents with a young child, after much begging on Dr. Roy's part and seeing her dedication, she would receive her first piano at 8. For the next twenty years, she took lessons, performed in recitals, and competed across her hometown of Toronto, Canada. She would even become a student at the Royal Conservatory of Music. Her love for music and piano would continue to be a balm as she transitioned into medical school. "Fast forward to when I was doing my residency in North Carolina at Duke Medical Center. I would work 12-14 hour days. I would be exhausted when I got home, but when I got home, I would look at my piano and go 'alright Lip, just 15 minutes," said Dr. Roy. "Then I would play classical, I would play Simon and Garfunkel, whatever I wanted to, and I would just feel calm. Soon, I'd look up at the clock, and two hours would have passed."
Inflammation and Loss of Smell
C.T. scans of people with COVID-19 who have reported anosmia reveal a cleft syndrome – this happens when swollen soft tissue and mucus block the olfactory cleft, the part within the nose responsible for smelling. The novel coronavirus makes its way into the body by attaching to cells in the upper respiratory tract. Once the virus permeates these cells, with the help of the TMPRSS2 protein and replicates, the inflammatory response is then activated. Inflammation is the immune system's response when it detects foreign and possibly harmful bodies. A column by University of London consultant rhinologist and ENT surgeon, Simon Gane, and University of Reading associate professor, Jane Parker, attributes anosmia to this inflammation and swelling phenomenon. They believe that when the immune system can rid the body of the virus, the swelling subsides, and the sense of smell returns to normal. However, the loss of smell persists even after the person tests negative for the virus in numerous recorded cases. Dr. Gane and Professor Parker present a theoretical explanation based on inflammation physiology: inflammation could trigger the release of chemicals from other systems that may damage tissues and possibly olfactory neurons– the receptors of the sense of smell – in the process. Luckily, olfactory neurons are regenerative.
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Issue 121.1.2
Post-Hospitalization Care and "Smell Therapy" The onslaught of the pandemic overwhelmed the healthcare system. Patients who were lucky enough to make it out of the hospital and "recover" often don't get the necessary post-discharge care they need, as hospitals around the country don't have enough resources and staff. Those who are declared "COVID-free" but are still showing mild symptoms must stay home and wait out these symptoms. The lack of extensive and long-term recovery treatment plans for patients is by no means hospitals' fault. The pandemic nearly paralyzed the entire healthcare system, and it doesn't help that physicians and nurses have been in short supply even before this major health crisis. The spike further exacerbates this shortage in demands for COVID-19 care professionals. Fortunately, the rise of telemedicine and remote learning is helping address this need. These strategies allow healthcare workers to care for more patients through online consultations and virtual health monitoring. More importantly, they provide training to a broader population to prepare for today's healthcare workforce demands. The pandemic has also lead to a new way in which nurses can learn new skills. For qualified nurses who want to learn new skills, there are online R.N. to BSN programs that can give them the necessary abilities to provide specialized care for patients, especially in rehabilitation. These online programs have helped ensure that today's nurses can keep up with the modern demands of COVID-19, such as loss of smell, although the pandemic has made in-classroom learning very difficult. While nurses and physicians are battling the pandemic in hospitals, other organizations take the reins during recovery. Aiding them in post-discharge care are charities and other organizations offering "smell therapy" and other services to help manage lingering effects from COVID-19. These services can last up to four months per individual and can be safely done at home. 14
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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.”
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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. 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.
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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
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 their exercise regiment.
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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.
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
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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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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!
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