in good July Effect
July 2015 • Issue 9
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Buffalo & WNY’s Healthcare Newspaper
Meet ECMC’s New Boss
Real Phenomenon or Myth? The ‘July Effect’ is the belief that medical care received in teaching hospitals during the month of July bears a higher risk of complications because it’s when many experienced medical providers go on vacation and when new physicians begin their residencies. There is even a study about that — and tons of criticism of the study
Richard Cleland has been with Erie County Medical Center since the ‘80s. He is now the organization’s CEO. He talks about Obamacare, plans, accomplishments and things people don’t know about him — did he really want to become an FBI agent?
Holistic Options for Having a Baby in Buffalo
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Western New York has a wide range of holistic services available to moms-to-be
SUNSCREEN Don’t skip the lips and other spots, local experts say Page 9
Farmers Markets Across WNY Offer Community Support, Fresh Produce The Buffalo-Niagara region boasts a high number of farmers markets Page 8 that offer all sorts of locally-grown produce
Swiss chard ranks ahead of kale, the Kim Kardashian of leafy greens. Why the impressive ranking? See SmartBite inside.
Meet Your Doctor For Dr. Wajdy Haillo, head of Center for Occupational & Environmental Medicine, “the workplace is still full of risks, and workers need training to avoid those risks”
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July 2015 •
Passion for Public Health Director at UB Office of Public Health Practice, Donald Rowe, recognized for services to improve public health Page 19
Bionic Page 14 Pancreas Offers New Hope for Type 1 Diabetics
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Today, we gave comfort.
Every day at ECMC, we do something remarkable, merging the most advanced technology with the most compassionate care. Both come in many forms—from joint replacement to cancer treatment and from a reassuring whisper to a comforting hand. Today, we transplanted one kidney and healed a whole family. And tomorrow, we’ll do it all over again.
The difference between healthcare and true careTM
ecmc.edu ©2015 ECMC
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015
Americans May Be Wasting More Food Than They Think New survey on wasted food finds efforts to reduce individual waste should focus on financial costs
M
ost Americans are aware that food waste is a problem, are concerned about it, and say they work to reduce their own waste, but nearly three quarters believe that they waste less food than the national average, new research suggests. The findings, from the Johns Hopkins Center for a Livable Future (CLF) at the Johns Hopkins Bloomberg School
Health
of Public Health, are significant given that 31 to 40 percent of the American food supply goes to waste, primarily in homes, stores and restaurants. The top foods wasted, by weight, are fruits and vegetables, due in part to their perishability and bulk. Food waste costs Americans $161.6 billion annually. A report on the research was published June 10 in the journalPLOS
ONE. “Americans perceive themselves as wasting very little food, but in reality, we are wasting substantial quantities,” says study leader Roni Neff of Bloomberg School’s Department of Environmental Health Sciences. “It happens throughout the food chain, including both a lot of waste by consumers, and a lot on our behalf, when businesses think we won’t buy imperfect food. The root causes are complex.” When listing reasons why they toss food out before eating it, consumers
gave the top reasons as food safety concerns and a desire to eat only the freshest food.
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Amherst Senior Travel Club announces trips
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015
The Amherst Senior Travel Club has several fall trips planned for members. This active, nonprofit group at the Amherst Center for Senior Services has more than 440 members and takes at least one day trip per month and up to three longer trips each year — traveling by coach, train or air. Through a close partnership with Bus America Group Tours, the club has been able to provide newer model motor coaches, three-star plus hotels, full menus and more on trips. Seniors need to be members of the Amherst Center for Senior Services in order to join the Amherst Senior Travel Club. An annual fee of $7 for a
single individual and $10 per couple is required. The next trips are: • Canadian Maritimes — Nova Scotia, New Brunswick, Prince Edward Island. Aug. 3 - 12 • Lake George Balloon Festival. Sept. 17 – 20 • Calamari Sisters “Big Fat Italian Wedding” in Auburn in the Finger Lakes area. Sept. 30. • Letchworth Fall Foliage & Lunch at Glen Iris Inn. – Oc. 7. • Cabaret at SUNY Fredonia & Lunch at The White Inn. Oct. 14-15. The club meets the third Tuesday of each month at 1 p.m. at the center, 370 John James Audubon Pky., Amherst. For more information, please contact Audrey Cherry at 716-688-7059 or by email at: audreycherry@verizon.net.
July 21
Executive to discuss Yevo and food crises A representative from Yevo International, a multilevel company involved in the commerce of healthy foods, will be in Rochester to discuss the line of healthy products the Utah-based business offers and invite participants to join the organization. The representative, corporate executive Daryl Young, will discuss what he terms “the global health crisis” and “how Yevo can reverse 100 years of processed foods.” Young says Yevo is the first and only company in history to produce whole foods with all 43 essential nutrients endorsed by the World Health Organization and US Medical Institute of Health. He says the size of the food industry — one of the largest — offers Yevo and its representatives unprecedented opportunity to grow. The meeting will take place at 7 p.m., Tuesday, July 21 at Red Fedeles Brook House, 3590 W. Ridge Road, Rochester. For more information, contact Jamie or Gary at 43forsuccess@ gmail.com.
July 28
‘Golf Essentials’ clinic held in Williamsville Buffalo Spine and Sports Medicine is sponsoring a 45-minute group golf clinic tilted “Golf Essentials” from 6 – 6:45 p.m. July 28 at its headquarters, 100 College Parkway, suite 100, in Williamsville. The session will be coordinated by certified physician therapist Michael Kaminska. It is designed to help participants identify dysfunctional movements and corresponding swing faults, review common golf injuries and how to prevent them, perform golf specific warm-ups to minimize injury risk, perform golf specific exercises to improve golf game and prolong career. Seats are limited to 12. $20 per person. For more information and reservation, call 650-3101 or visit buffspine. com
Serving Western New York in good A monthly newspaper published by
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In Good Health is published 12 times a year by Local News, Inc. © 2015 by Local News, Inc. All rights reserved. 3380 Sheridan Dr., # 251 – P.O. Box 550, Amherst NY 14226 Phone: 716-332-0640 • Fax: 716-332-0779 • Email: editor@bfohealth.com Editor & Publisher: Wagner Dotto • Associate Publisher: Jamie Sandidge • Associate Editor: Lou Sorendo • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Patrick Broadwater, Tim Fenster, Ernst Lamothe, Katie Coleman, Mara Koven-Gelman, Jana Eisenberg • Advertising: Donna Kimbrell, Marsha Preston • Layout & Design: Chris Crocker • Officer Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
In Good Health is Printed Locally at Buffalo NewsPress
Recruiting the Younger Generation Local programs offer next generation a glimpse into medical professions By Patrick Broadwater
S
ometimes the only way to get a real grasp of a potential career is to try it out. Internships and volunteer programs have long been encouraged as ways for students to earn credit or cash, gain work experience and network with leaders in the field. But when it comes to exploring careers in medicine that often require intense commitments of time and money, getting as much experience as early as possible can prove to be invaluable. Hands-on work opportunities and educational programs can help shed light on the realities of a profession and help students determine whether it’s truly the right career for them. Better they have confidence — based on experience — that the job is something they will like and enjoy before they pursue it than to discover that they really don’t have a passion for the job later on, when changing majors or careers can have costly long-term consequences. There are a number of programs in Western New York that can help students decide if a career in the health professions, including medical research and veterinary medicine, is the right path for them.
D’Youville College Summer Enrichment Program
A federally funded program for disadvantaged incoming high school seniors interested in health professions, this program runs for six weeks from July to August. Participants attend academic workshops focused on college-level math and science and receive career and academic mentoring and learn more about medical careers.
Roswell Park Summer Research Program in Cancer Science
Students entering their junior year in high school can gain first-hand experience in a lab working on an independent cancer-related research project at one of the nation’s leading cancer research facilities. Students will also have the opportunity to attend educational seminars and take field trips to companies focused on the life sciences. The seven-week program runs from June to August annually.
Hauptman-Woodward Institute High School Apprentice Program
Originating from a partnership with students at City Honors High School, this program has expanded is now open to high school students
throughout Western New York. Participants study evolution and bioinformatics under scientist William L. Duax, and can work a flexible schedule that includes Fridays, after school and over summer break.
Niagara Frontier Veterinary Society Veterinary Explorer Program
High school and college students aged 14-20 interested in pursuing a career in veterinary medicine can hear from practicing veterinarians and vet techs, tour local veterinary facilities and learn about prerequisites and requirements for admission to vet school. It includes a trip each spring to see either Cornell University College of Veterinary Medicine or the Ontario Veterinary College at the University of Guelph. NFVS also offers a mini-vet school lecture series in the fall for anyone interested in animal care.
Volunteer Opportunities
Students can often gain first-hand knowledge of medical careers by shadowing or serving as a volunteer. Hospitals such as Buffalo General, DeGraff, Millard Fillmore Suburban and Women’s and Children’s Hospital and the Erie County Medical Center welcome student volunteers and shadows.
Students interested in animal care can volunteer at the Aquarium of Niagara Falls or contact their local veterinary office to inquire about shadowing opportunities.
Healthcare in a Minute By George W. Chapman Women as family “CMO” Fifty-nine percent of women say they make the healthcare decisions for their families, according to a survey of more than 9,000 people conducted by a NYC-based think tank. This jumps to 94 percent when women work and have kids under 18. However, 62 percent of these family “chief medical officers” say they lack time to research and understand healthy habits; 50 percent reported they lacked the confidence to make the right choices for healthcare; and 35 percent actually distrust their providers. The results of this survey are not new. The industry has to do a much better job of educating and engaging the family “CMO,” especially as reimbursement shifts to pay for performance and outcome. Impact of penalties on hospitals uncertain Since 2008, Medicare has penalized hospitals for preventable or avoidable injuries like patient falls, pressure sores and infections. (Hospitals are fined 1.5 percent of their Medicare payments for failure to report.) Unfortunately, there haven’t been random follow up surveys to determine if there is a cause and effect. Are there fewer avoidable incidents as a result of the penalties? If hospitals focus on reducing these particular incidents, does it come at the cost of an increase in other types of avoidable injuries? The good news for Medicare members is that preventable hospitalizations have dropped 11 percent since 2013. The reduction can be attributed to a lot of factors, including penalties for hospital readmissions
within 30 days of initial discharge, Medicare simply not paying for certain admissions anymore and better outpatient management. Drug costs unsustainable According to a study sponsored by Express Scripts, ever increasing specialty drug costs will bankrupt our healthcare system. About 576,000 of us spent more on drugs last year than the median household income (about $52,000). That number is up 63 percent over 2013. 140,000 of the 576,000 spent over $100,000. While 98 percent of these costs were borne by insurance, they are ultimately passed on to all of us in higher premiums. Specialty drugs to treat hepatitis C and cancer are primarily responsible for the drastic increases. This is not just a USA problem. Global costs for cancer drugs exceeded $100 billion last year. The AMA and the Pharmaceutical Research and Manufacturers of America are recommending that an insurer’s summary of benefits and coverage (SBC) provide more detail about what drugs are covered so consumers can make informed decisions. If this does happen, however, there must be an independent authority looking out for insurers who purposely “dump” expensive specialty drugs from their formularies, or significantly reduce coverage, in an effort to steer away at-risk-consumers who require expensive drugs. No single insurance company could survive if it had to assume all the risk for all consumers who needed an expensive specialty drug. The playing field has to be kept level.
Less choice is not worse care Insurance plans that limit consumers to specific physicians and hospitals are nothing new. These “narrow” networks are easier to manage and control and can keep costs down. Like the staff model HMOs of old, burgeoning hospital systems and accountable care organizations will ultimately control both costs and quality by offering finite provider choices for care. The question has always been does the quality of care provided by 50 cardiologists, for example, differ from that provided by 200 cardiologists? According to a study published in Health Affairs, the average quality of care in narrow/restricted networks is actually higher than that of open-ended unrestricted commercial networks. This is not surprising because there is far better communication, cooperation and familiarity among a finite or narrower panel of providers. Premiums for 2016 Depending on your plan, most NYS insurers are once again requesting double digit rate increases for 2016. The NYS Insurance Department rarely approves the full request. Commercial insurers traditionally cite increased utilization and higher drug costs as the culprits for the rate increases. Meanwhile, by comparison, Medicare premiums (for the oldest of Americans) have remained virtually unchanged the last four years at about $105 a month for Physician Part B coverage. The nation’s seven largest insurers (Aetna, Anthem, Cigna, Health Care Services Corp, Humana, Kaiser Permanente, United) July 2015 •
added 5.6 million members with profit margins over 4 percent. Health insurance stocks hit an all-time high earlier this year. Costliest conditions While the list is pretty much unchanged over the last ten years, costs, in 2012 dollars, have risen substantially. According to the Agency for Healthcare Research and Quality: heart conditions lead the way at $101 billion; trauma was second at $93 billion; at third was cancer, which increased 48 percent over the last decade to $88 billion; in fourth place is asthma at $76 billion; mental health treatments came in fifth at $84 billion. New York State Healthcare Forum Got a question concerning healthcare? Check out “Ask the Oracle” at www.Newyorkhealthcareforum.com. The site is designed to help consumers navigate the often confusing and frustrating healthcare system. It is free and anonymous. Your email address is kept in strictest confidence and is not used for any other purpose than to respond to your question.
GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
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Meet
Good News
Your Doctor
Snacking on Peanuts May Extend Your Life
P
eople who regularly eat peanuts may live longer, a new study from the Netherlands finds. But before you get too excited, peanut butter doesn’t count. In the study, people who ate at least a third of an ounce (10 grams) of peanuts or other nuts daily were 23 percent less likely to die over a 10-year period than people who didn’t eat nuts. The biggest reductions in deaths among the nut-lovers were for deaths from respiratory diseases, neurodegenerative diseases and diabetes, followed by cancer and cardiovascular diseases, the researchers said. The benefit of eating nuts topped out at 15 grams daily, which is about half a handful, and eating more than that did not bring further decreases in people’s risk of dying during the study, Piet van den Brandt, a co-author of the study and professor of epidemiology at Maastricht University, said in a statement. But “it was remarkable that substantially lower mortality was already observed” at this level of consumption, he said. Eating peanut butter, however, despite its high content of peanuts, was not associated with a lower mortality risk. Peanut butter’s salt and vegetable oils, which contain trans fatty acids, may supersede the protective nutrition in the peanuts themselves, the researchers said.
Bad News Exercising Mind and Body May Not Protect Against Alzheimer’s
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ome studies have linked doing brainy puzzles and physical exercise with a decreased risk of developing Alzheimer’s disease, or with staving off the cognitive decline associated with the disease. But now, new research suggests otherwise. The latest study on the topic found that staying physically and mentally fit may help healthy people ward off the normal mental decline that comes with aging, but it doesn’t affect the underlying causes of Alzheimer’s disease. In people with Alzheimer’s, the brain contains abnormal, fuzzy, cloudlike clusters of fragments of a protein called beta-amyloid that surround nerve cells and block their signals. This leads the person’s brain function — and, in particular, memory — to deteriorate. In the new study, researchers looked at beta-amyloid and other markers of Alzheimer’s, to see if the levels of these markers in people’s brains responded to physical and mental exercises. The results indicate that exercising “may possibly be separate from any protection against the markers of Alzheimer’s disease in the brain,” study author Keith A. Johnson, co-director of the Massachusetts Alzheimer’s Disease Research Center at Harvard Medical School, said in a statement.
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By Chris Motola
Wajdy L. Hailoo, M.D. For the head of the new Center for Occupational & Environmental Medicine, “workplace is still full of risks, and workers need training in how to identify and avoid those risks” Q: Your specialty — occupational and environmental medicine — is one we don’t come across too often. A: It’s one of the American board-certified specialties. It’s been around for a long time, but the availability of the specialists is very limited. There aren’t too many of us certified by the board of the United States. see?
Q: What kinds of patients do you
A: In general, occupational medicine deals with occupational diseases and, in some cases, occupational injuries, but often other specialties will treat occupational injuries despite not being certified as occupational specialists. Occupational medicine requires a general medicine background, but I look at and deal with it — from the work, environment and exposure aspect — and try to assess causation, because it’s important to the treatment of the patient. Then we’ll recommend removing that patient from the exposure. We’ll make a recommendation for compensation for the patient. Q: Has asbestos abatement had an effect on the incidences of asbestos-related illnesses? A: Asbestos abatement is done in a strict, controlled manner. So the exposure of the workers doing the abatement is usually not a problem. In terms of exposure to asbestos in general, it’s used in thousands of old buildings. So workers — like electricians, plumbers, construction workers who do work on the building structure — all
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015
get exposed. There are guidelines for how to handle it more safely, but a lot of it is still there. Even within the last few years people will do work but not realize they were working around it. Q: You had a prominent role in the program treating 9/11 first responders. A: There’s been a federal program to screen 9/11 first responders since 2001, 2002. It’s a yearly program to all those involved in the response and clean-up. It has a list of covered conditions that are being observed at a higher frequency within that group. Those people are scheduled for treatment — there are a number of centers around the New York City metro area to treat those patients as well as a national program for people who came from elsewhere to help with the cleanup; there are people from Western New York who were involved with that. Q: Can you talk about the Center for Occupational & Environmental Medicine at ECMC you are heading up in Buffalo now? A: That’s part of a statewide program. There are other centers, by region, in the state. There’s one in Rochester, Syracuse, Albany, New York City and Long Island. It focuses on the prevention of occupational disease in Western New York through the treatment and, of course, education of workers. We make them aware of what’s around them at work, the risks and how to avoid them. In addition to that, we have programs to help diagnose early disease and prevention complication. And we help those who already have the diseases rehabilitate and get compensation.
Wajdy L. Hailoo is one of the wellknown expert physicians specializing in occupational and environmental medicine. He is the program director at the newly-opened Center for Occupational & Environmental Medicine (COEM) at Erie County Medical Center (ECMC). COEM is a regional health facility for Western New York work force members who have work-related health needs. The center is a state-funded service supported by $3 million over five years and one of several other centers within the New York State Occupational Health Network Program. The COEM at ECMC aims to prevent work-related illnesses and injuries through increased awareness and health education, early diagnosis and treatment. “With all the major industry that operates in the area, WNY has one of the highest rates of occupational disease and injuries and is in most need for such professional medical services,” said Hailoo. Q: Are workplaces becoming safer? A: With the creation of OSHA [Occupational Safety & Health Administration] in the early ‘70s things got better, but it’s fairly limited in its resources. But the standards they put out as well as recommendations from other safety and health organizations there are health risks involved with work. But the workplace is still full of risks, and workers need training in how to identify and avoid those risks. Q: To what degree are you in an advisory role? A: A lot of work is preventive. We trained around 100 workers between December and March. I get invited myself to a lot of worker and union meetings. We try to let them know that we’re available and educate them about risks to their employment. So we do a lot of proactive education. ers?
Q: How receptive are the employ-
A: The program is still new — April of last year, so we’d been doing a lot of infrastructural work. So we haven’t had as much of a chance to do that. But we do want to get the attention of employers. When workers are safe and healthy, it’s good for the employer in the end. There’s less absence, better productivity, better morale. In my experience, when the employers were involved, they benefited from healthy and happy employees. We have an advisory board that’s helping us and serving as our arms in the community. Through them, we would like to reach out and let employers know that we can help for the benefit of both the employer and the worker.
Lifelines Name: Wajdy L. Hailoo, M.D. Position: Program director at the Center for Occupational & Environmental Medicine at ECMC Hometown: Grew up in the UK Education: Mount Sinai School of Medicine (New York City), University of Mosul (Baghdad) Affiliations: ECMC Organizations: American College of Occupational Environmental Medicine, American College of Chest Medicine, American College of Preventative Medicine Family: Married Hobbies: Reading, sports
The ‘July Effect’ — Real Phenomenon or Myth? A study states that medical errors increase 10 percent in teaching hospitals in July as a result of new doctors coming into the profession By Deborah Jeanne Sergeant
W
hen something goes wrong in a medical scenario, patients and loved ones want answers. It’s only natural to examine what went wrong to find something or someone to blame. In part, we want to understand why this happened so it can never devastate someone else’s life. Understanding also helps us gain closure about trauma. The “July Effect” is the belief that medical care received in teaching hospitals during the month of July bears a higher risk of complications because it’s when many experienced Sayers medical providers go on vacation and when new physicians begin their residencies. A study published in 2010 in Journal of General Internal Medicine stated that medical errors increased 10 percent
in teaching hospitals, but not other hospitals, during the month of July. The data spanned from 1979 to 2006. Critics of the study assert that the time span goes back to decades predating technology that helps today’s medical personnel cross-check patient care plans. Advances such as electronic medical records have lowered the chances of medical errors, especially for younger, tech-savvy residents. The earlier data from the study would skew the statistics and current-day hospital processes help reduce errors. Margaret Sayers, a private health care advocate serving clients in Buffalo, has worked for decades as a clinician, administraSomerset tor and researcher
in geriatric health care. Regarding residents’ potential for error, she said, “I have not heard the July Effect as being verified as an influence. They’re under the supervision of a university faculty member. “If you’re someone who can schedule their hospitalization, [during the summertime] hospitals are likely shorter staffed, not just because of the July Effect. Just as you wouldn’t want to schedule surgery the week of Christmas, you might have substitutes and you may not feel the care is the same as regular docs.” Although you likely won’t be surprised with a new surgeon for an elective surgery, your care team during your recovery could include members who are new. Especially for patients anticipating a lengthy post-op recovery, receiving care from new physicians may cause alarm, but it shouldn’t make a difference in the quality of care received. Though anecdotally some patients refer to the July Effect, it “has never
been a factor in medical malpractice cases to my knowledge,” said Margaret E. Somerset, attorney specializing in health care with Underberg & Kessler LLP. “But that doesn’t mean it can’t happen.” The firm maintains offices in Buffalo and other areas of Upstate New York. Somerset pointed out that courts rely upon relevant evidence on the day of a particular incident for medical malpractice suits, and the July Effect would not contribute significantly enough to become a factor in a case. Nonetheless, if you’re nervous about an upcoming hospital stay, discuss with your providers the possibility of scheduling for a different month if thoughts of the July Effect concern you.
Buffalo Medical Innovations
Buffalo Has a Long History of Medical Innovation, Discovery By Patrick Broadwater
A
tiny device that would have a profound impact on modern cardiology was born in a barn in Clarence. Wilson Greatbatch’s tinkering in the workshop behind his home in the mid-1950s led to his invention of the implantable pacemaker, preserving the lives of millions of patients with irregular or weakened heartbeats. Earlier versions of the pacemaker were big as TV sets and had to be plugged into wall sockets. Greatbatch’s patented device was as small as two cubic inches, resistant to bodily fluids, and could be installed in a 30-minute procedure that left just a thumb-length scar. “It’s been a revolutionary change for hundreds of thousands of people every year,” Georgetown University cardiologist and assistant professor Zayd Eldadah said in The Washington Post’s glowing obituary of Greatbatch. Like many great discoveries, Greatbatch’s success with the implantable pacemaker was shaped by error. Then an assistant professor of electrical engineering at the University of Buffalo, he was working on creating a heart sound monitor when he accidentally installed the wrong size transistor, which emitted a rhythmic electronic pulse that mimicked the human heartbeat. He quickly realized the potential of his discovery and set to work creating prototypes. Innovation was nothing new to Greatbatch. Disappointed with the
relatively short life (two years) of the batteries used in his pacemakers, he later acquired the rights to a lithium iodine battery design and re-engineered it to fuel them for a decade or more. He started his own company, Greatbatch Inc., to make the batteries, and the firm continues today as a leader in the medical device market. Greatbatch himself held more than 300 patents before his death in 2011. While the implantable pacemaker is perhaps the most widely known and far-reaching invention created in the Buffalo area, it is far from the only one. Western New York has a long history of medical innovation and discovery dating back to the mid-19th century. For instance, did you know that the first successful skin graft operation was performed at Sisters Hospital in 1854? Or that Buffalo’s Roswell Park Cancer Institute, opened in 1898 as the New York State Pathological Laboratory of the University of Buffalo, was the first facility in the world dedicated solely to cancer research? Aside from being the oldest such facility, Roswell Park has been an innovator in many other respects. Among the historical firsts and innovations achieved by Roswell Park doctors and researchers: • Pioneered photodynamic therapy (PDT) to treat cancers of the skin, bladder, head and neck • Pioneered the prostate-specific antigen (PSA) test • Pioneered the drug combination
Wilson Greatbatch invented the implantable pacemaker in a barn behind his home in Clarence. 5-FU and Leucovorin for colorectal cancer • Developed the PKU (phenylketonuria) screening test for newborns • Collaborated on the landmark studies of the Human Genome Project According to the former Buffalo Medical Journal, physician Frank Hastings Hamilton conducted his groundbreaking skin graft operation at Sisters in December of 1854. He was able to successfully remove skin from the left leg of a patient and transplant it to the affected area of the patient’s right leg. More recently, Buffalo was the home of Nobel Prize-winning matheJuly 2015 •
matician Herbert Hauptman. The internationally renowned scholar’s research into crystallography (determining the three-dimensional structure of molecules), first published in 1953, was accepted by the scientific community in the 1970s, earning Hauptman and fellow researchers the 1985 Nobel Prize in chemistry. Their work uncovered the structure of thousands of molecules, leading to the development of countless new drugs. Hauptman later became president of the Medical Foundation of Buffalo, which was renamed Hauptman-Woodward Medical Research Institute.
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Page 7
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Less can be more for those who live alone
L
ess is more. We’ve all heard that expression. But can less really be more when you live alone? For me, the answer is a resounding “Yes!” Here’s what I’ve discovered: When I’m pining for what I don’t or can’t have — when all I want is more, more, more — I lose my center. I get overwhelmed. In those times, I need to remind myself that less is often more, and that moderation and balance are good rules to live by. If you’ve fallen victim to the allure of “more, more, more” as I have on occasion, you may want to hop aboard my less-is-more bandwagon. Here’s what I plan to do less of this summer. Care to join me? Spend less. Have you been on a spending spree lately? I was, just last month, and now I am paying the price, literally. I just couldn’t stay away from the garden centers! For the rest of the year, I resolve to reduce my spending. How? By creating and sticking to a budget, of course, but also by following some good advice I got from a friend a few years ago. She suggested I stay out of stores (even the garden centers). Sounds obvious, right? Well, it didn’t occur to me at the time, but it works. So does throwing out direct-mail catalogs without cracking their covers.
Waste less. Wasting less goes handin-hand with spending less. I’ve been on this personal crusade for a while now, and it’s paying off. I use up what I have before I buy any replacements. No exceptions. Just this spring, I purchased some earth-friendly, lavender-infused dryer sheets. I thought it would be the “green” thing to do. I’m sorry to report that they didn’t do a very good job, but I used up the sheets anyway. I then gave myself a big high-five for doing my part to minimize waste. Eat less. It’s picnic time! Did you overdo it this weekend? Jeans a little snug? Welcome to my world. Rather than go on some fad or overly restrictive diet, I resolve to regain my waistline by cutting calories, not by cutting out major food groups. I am determined to exercise more, eat only when I’m hungry, and focus on portion control. Granted, it’s easier said than done, but I’m on a mission to get it right this summer. Are you with me? Drink less. One glass of wine, and I’m relaxed and happy. Two glasses, and I’m ready to call it a night at 8:30
p.m. (Hey, what do you expect at my age?) Besides draining me of my energy and motivation, alcohol also weakens my resolve to avoid that second helping of potato salad. If I have more than one drink, my new pledge to “eat less” bites the dust. When it comes to drinking, “twice as much ain’t twice as good,” by any standard. Let’s raise a glass to drinking less in 2015! Socialize less. Yes, socialize less — especially if your pace is frantic in an effort to avoid that dreaded “alone time.” When you slow down, you become more mindful of yourself and the things around you. This will help you appreciate what you have and make better choices. Ease into it, if you need to. It can take time, patience and practice to find comfort in your own company. Complain and blame less. Try this: For one hour, do not complain about anything or blame anyone for your troubles. If you’ve fallen silent, take heed. While chronic complaining can be a hard habit to break, I believe there is an antidote: You can choose to take responsibility for your life. When you
complain, you are declaring helplessness. When you decide to do something about what bothers you, you are declaring strength and you are taking responsibility. I have a little sign above my desk that reads, “In the face of adversity, don’t complain, just work harder.” It reminds me that I am in charge of my destiny and that complaining and blaming others will get me nowhere. Care less. That’s right. Care less about what others think of you. Care less about what your ex is up to. Care less what your kids think of your new haircut. Or what your mother thinks of how you live your life. Sure, we all need to be sensitive to other’s thoughts and feelings, but if we care too much about other’s opinions, we risk losing our own sense of self. What’s important is what you think and what you want for your life. On your own, there’s no better time to express your own independence, your own sense of style, and your own point of view. Caring less will empower you. Wanting less, doing less, and consuming less instead of more, more, more has untold benefits. It can improve your health, your relationships, and even our planet. If constantly wanting “twice as much” is sending you to your knees, I encourage you to stay down there for a moment and to say a little prayer for moderation in all things. I’m confident that better health and happiness will be your reward, nothing less. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, NY. For information about upcoming workshops or to invite Gwenn to speak, call 585-6247887 or email: gvoelckers@rochester.rr.com.
Farmers Markets Across WNY Offer Community Support, Fresh Produce By Katie Coleman
Y
ou don’t have to leave the city limits to strike up conversation with a farmer. People want to know where their food comes from, and with 20 farmers markets dotted across Buffalo and Erie County, city dwellers have seasonal access to farm-fresh produce and local products all year long. Improving local food security, supporting local farms and small businesses, and providing access to healthy food are some of the community goals farmers’ markets are reaching. And buying food locally has a lot of positive impact, according to Stewart Ritchie, farmer at Native Offerings Farm in Little Valley, Cattaraugus County. Ritchie has had a stand at the Elmwood-Bidwell Farmers’ Market for the past 12 years or so. “Almost all of our produce is picked the day before,” Ritchie said. “You can ask questions about the food, and everyone here has knowledge and stories to tell.” Instead of buying wholesale produce at grocery stores that focus on volume, all of the vendors at the market grow and sell their own food, accordPage 8
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ing to Ritchie. Community shoppers directly support the local economy and its farmers with direct producer to consumer sales. The markets also encourage farmers into cities from rural areas that may have poor economies and little job opportunities, helping farmers make a living off of small-volume sales of fresh produce. “All of the farms here have employed quite a few people in rural areas where there aren’t a lot of jobs,” Ritchie said. Another farmer at the market, Bonnie George, has been going to Elmwood to sell fresh meats and eggs for nine years from Painted Meadows Farm in Franklinville, Cattaraugus County. George said that it’s important to support local farmers markets because people need farmers to survive, so they can too. “Some people in the city wouldn’t know what to do if it wasn’t for a farmer,” George said. Farmers have knowledge that many people in the city haven’t had access to, and Bonnie is one of them,
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015
having grown up on her own farm. “It’s natural to me. If I want fresh eggs, I go out to the hen house and get eggs,” George said. Not that long ago small family farms were a main source of livelihood in Western New York. Now urban areas are well developed and a common lifestyle, but the demand for fresh, local produce is still there, and in the past few years has been on the rise. With an increase in farmers markets, family farms still surviving in WNY are able
to enter cities, and sell their produce directly to consumers at all of the farmers markets listed below.
For a complete list of area’s farmers markets, visit
www.bestofwny.com/farmers_market.
tes: None
SmartBites
By Anne Palumbo
The skinny on healthy eating
Swiss Chard Packs a Nutritional Wallop
S
ome produce just gets all the press. Kale — the Kim Kardashian of leafy greens — is one such vegetable. Sure, it’s loaded with benefits; and, yes, it’s a vitamin K and calcium hotshot; but it’s not the only nutritious green out there. Its humble cousin, Swiss chard, is also packed to the max with health benefits. A recent report published by the Centers for Disease Control that ranked 47 “powerhouse fruits and vegetables,” in fact, placed Swiss chard above kale. Why the impressive ranking? In a word, Swiss chard is an antioxidant superstar. Research has demonstrated that chard contains a rare and diverse variety of antioxidants that help reduce both inflammation and oxidative stress. Because chronic inflammation, especially when coupled with damaging free-radical stress, has been shown to increase our risk of obesity, Type 2 diabetes, high blood pressure, heart disease, certain cancers and several forms of arthritis, Swiss chard and its huge entourage of antioxidants seem primed for the limelight. Swiss chard has been called a “diabetic’s best friend”— for numerous
and unique reasons. One, multiple animal studies have shown that one of chard’s premiere antioxidants helps to steady blood sugar, especially following a meal. Two, chard’s good amount of fiber and protein also help stabilize blood sugar levels, since they help regulate the speed of digestion and keep food moving at the right pace through our system. Three, promising research has demonstrated that chard may help pancreatic cells — the cells responsible for the production of insulin — regenerate. And four, repeated studies on animals have revealed that chard may protect the liver from diabetic damage. Calling chard a “bone’s best friend” would not be out of the question either. Like other leafy greens, Swiss chard is loaded with vitamin K, with one cooked cup providing 700 percent of our daily needs. Vitamin K,
which helps blood clot properly, is a key ingredient in maintaining strong, healthy bones. And although chard does contain bone-healthy calcium, it also contains oxalates, which can bind up calcium and make it unavailable to the body. Since oxalic acid is broken down in cooking and doesn’t interfere with the absorption of calcium present in other foods, many nutritionists recommend that we cook our chard and also combine it with calcium-rich foods, like cheese, that can be easily absorbed. Last but not least, this low-calorie vegetable is a super source of vitamin A, delivering 200 percent of our daily needs in one cooked cup. This workhorse vitamin is needed for normal bone growth, healthy skin, eyesight and proper tooth development. Helpful tips: When buying Swiss chard, look for firm leaves that are vivid green, not wilted, and unblemished. Stems may be white, yellow or red, with no noticeable flavor differences between the colors. Do not wash Swiss chard before storing. Place it in a plastic storage bag, squeeze out as much air as possible, and store it in the refrigerator for up to five days.
chopped 1 tablespoon olive oil ½ teaspoon salt ¼ teaspoon black pepper 1/3 cup water ¼ cup dried cranberries (or currants) Lemon zest from 1 lemon 1 tablespoon (or more) fresh lemon juice ½ cup toasted slivered almonds 1/3 cup crumbled feta cheese Cut stems and center ribs from chard, discarding any tough parts near base, then cut stems and ribs crosswise into ¾-inch-thick slices. Coarsely chop leaves. Cook garlic in oil in large heavy pot over moderately low heat, stirring occasionally, until pale golden, about 2 minutes. Add chard stems and ribs, salt and pepper; cook, stirring occasionally, about 4 minutes. Add chard leaves and water; stir well, then increase heat to medium and cook, covered, stirring occasionally, until leaves are tender, about 5 minutes. Remove from heat and stir in cranberries, lemon zest, lemon juice, toasted almonds, and feta cheese. Makes about 4 servings.
Braised Swiss Chard with Dried Cranberries and Feta Adapted from Gourmet 1 bunch Swiss Chard 2 large garlic cloves, finely
Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Palumbo at avpalumbo@aol.com.
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 9
Meet Your Provider
Aesthetic Associates Centre Center is no ordinary medical/dental facility
Dentist Todd Shatkin has changed the lives of his patients and others locally, nationally and worldwide by providing quality care and by educating doctors from around the world with his patented F.I.R.S.T. technique for placing mini dental implants in one visit. The Aesthetic Associates Centre is no ordinary medical/ dental facility. It combines a cosmetic and reconstructive dental along with a plastic surgery practice. It is complete with state-of-the-art digital imaging and technologically advanced medical dental suites. The facility is also equipped with a fully accredited ambulatory surgery center offering IV sedation from board certified anesthesiologist Rose Berkun. Dr. Shatkin is the director of dentistry at the Aesthetic Associates Centre. He, along with his associates — dentists Diane Witczack and John Lucchese — performs all aspects of general, cosmetic and implant dentistry. Dr. Shatkin
has been in practice for 25 years. Cosmetic dentistry has been a focus of his and he has been in the forefront of new dental procedures including being one of the first dentists in WNY to do porcelain veneers. He is an expert in dental bleaching and has developed a number of bleaching products used throughout the dental industry. Besides porcelain veneers, the highly trained dentists at the center can take care of all porcelain restorations, crowns and bridges, extractions and wisdom teeth, root canals and mini dental implants “My experience at the Aesthetic Associates Centre was very pleasant. The staff was very courteous and efficient. Dr. Shatkin was wonderful”. NatalieM, Depew On June 5, Dr. Todd Shatkin was awarded the 5 Star Diamond Award by The American Academy of Hospitality Sciences and President Joseph Cinque. He is one of only
Dr. Shatkin has been three dentists in the world to receive in practice the award. for 25 Mini dental implants were brought to WNY more than 15 years years. ago by Dr. Todd and his late father, dentist and medical doctor Samuel Shatkin. Together they brought an alternative to the conventional implants which can take up to eight months to be completed. The mini implant can be immediately loaded with dentures or a fixed prosthesis to offer an immediate solution to loose dentures or one or more missing teeth. His continued research with minis and development of his patented “F.I.R.S.T. Techniques” has rocketed the Shatkin name to national and international name recognition. Who Do You Want To Place Your Mini Implant? Dr. Todd has placed over 15,000 mini implants to date with amazing results, changing the lives of his and other doctor’s patients in WNY and the world. He has also trained over 13,000 dentists world-wide on his patented
F.I.R.S.T. technics and was recently the key note speaker for The Asian Pacific Dental Conference, held in Singapore. Need a second opinion? Have you been told you need an implant? Call Dr. Todd Shatkin. Don’t have a dentist? Has it been a long time since you had a cleaning? Do you have loose dentures or missing teeth? Call Dr. Todd at the Aesthetic Associates Centre for an appointment. Dr. Todd Shatkin would like to offer you a FREE consultation with Xrays (a $500 value). Dr. Todd looks forward to meeting you and creating that winning smile for you.
Aesthetic Associates Centre • 716-839-1700 • www.gr8look.com
SummerSafety Sunscreen: Don’t Skip the Lips and Other Spots By Deborah Jeanne Sergeant
S
ummertime is sun time. Many people take a few moments to apply sunscreen to save themselves from a nasty burn and future skin damage, but some don’t apply it everywhere they should. “Anything open and exposed needs to have sunscreen, like tops of your feet, earlobes, back of the neck,” said Martha Ryan, senior director community engagement for the American Cancer Society for Upstate New York. Many people miss these areas or feel uncomfortable applying sunscreen there, though they should do so. “Wear a hat to protect your head,” Ryan said. “Its visor can shade your ears, face, and the back of your neck. Wrap-around sunglasses can protect your eyes.” Make sure they are UV-rated. Sport sunscreen tends to run less and resist stinging the eyes when its user sweats. Physician Joseph Neiman, fellow Page 10
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of the American Academy of Dermatologist and owner of Neiman Dermatology and Hair Transplantation in Buffalo, recommends that clients re-apply every two hours or after each time they towel off. Another often forgotten area is right under your nose. Lipstick typically does not contain SPF, so check the labels. Many makeup manufacturers are getting sun-smart to protect their users. Some foundation primer, liquid foundation and powder also offer varying levels of SPF; however, those containing titanium dioxide or zinc oxide offer the best protection. Apply sunscreen to your hands as you’re out and about, especially if you’re driving on a long road trip, where your hands will be prone to sun exposure on the wheel. The windshield of your car provides little sun protection. And, remember, it’s easy to wash sunscreen off when you clean your hands.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015
Beware of gaps such as at the lower back between the hem of your shirt and the waistband of your shorts if you’re bending down to garden. Areas like this, and others that are hard to reach are often ignored. Dermatologist Neiman listed the backs of the arms and legs as a couple examples. Reaching for spray sunscreen may seem an easy answer, but “spray SPF isn’t as protective as lotion,” Neiman said. Neiman prefers lotion formulas that contain titanium dioxide and zinc oxide. These physical blockers “protect against both UVA radiation, that leads to wrinkling and aging, and UVB radiation, which can cause sunburn. Both can cause skin cancer.” A day at the beach isn’t so much fun for your skin. While reapplying sunscreen after toweling and every two hours helps protect exposed skin, covering more skin makes the job of keeping it safe easier.
Many surfer-style rash guard shirts come with SPF technology as part of the fabric to help beachgoers stay protected. They also come in crew neck and long-sleeved styles. Outdoors clothing companies have also begun selling garments with SPF as a selling point. A plain, white T-shirt offers only about 7 SPF when dry and 3 when wet. In general, the darker the color and the tighter and thicker the fabric’s weave, the better protection it offers, unless it’s a high-tech fabric made to offer high SPF.
Summer Bummer
Don’t let injuries take the fun out of summertime activity By Jana Eisenberg
H
ere in Western New York and especially after the epic 201415 winter, people love to get outside and play all summer. Western New Yorkers throw themselves into summer sports and recreation — from swimming, biking, and kayaking, to baseball, boating and KanJam. Taking part in activities and sports is fun, and taking precautions to avoid injury — as well as knowing what do to in case of injury — is smart. Of course, the best preparation is to be healthy and Rauh fit already with a lifestyle that includes year-round exercise. If you don’t have a regular routine, start slowly, recommends Chelsea Bushby, a physical therapist at Sports Focus Therapy, which has offices in Buffalo and Orchard Park. “Listen to your body,” she said. “Don’t start with a 10-mile run,” said Bushby. “Start with a shorter run and see how your body reacts. If you
feel OK, begin to increase the distance. Over the course of month, assess yourself; see how you are feeling.” Michael A. Rauh of UBMD Orthopaedic & Sports Medicine said the best prevention is to be in shape. “As we get ‘less young,’ it’s important to not overdo,” he said. “It can be difficult to listen to our bodies — we don’t really want to.” When you do get ready to go outside, say the experts, use common sense. Basic recommendations for “happy campers” during the summer include: stay hydrated, wear sunscreen, and warm up muscles before starting any vigorous activity. Stay cool — sunstroke is dangerous. When appropriate, wear Bushby protective gear, like helmets, life jackets, and elbow and kneepads. Let’s say you do play hard on the ball field, the beach or even in a potato sack race, and the next day you’re hurting. How do you know when to
see someone, and when to wait it out? Where should you go to seek treatment?
Take action right away
Some injuries need immediate attention, said Rauh. “If someone has a broken arm or a low pain level, they should go to urgent care or a hospital emergency room that are staffed by primary care or emergency medical physicians who are well-versed in general musculoskeletal care. An alternative is UBMD’s Orthocare, an urgent access program for orthopedic injuries. We fully appreciate the nuances of musculoskeletal injuries.” Added Bushby, “Muscles take about three days to heal from normal discomfort or soreness after a new activity. If it lasts longer, or if the pain is on one leg or arm, and not the other, that can be a sign of a dysfunction or the predictor of an injury.” She recommends seeing a physical therapist as a first step. Changes in most insurance coverage now allow patients to seek “direct access”; they don’t need a referral any longer. What types of injuries are most common? “As a sports medicine physician
and orthopedic surgeon, we get the whole gamut,” said Rauh. “With the summertime transition to outdoor from indoor surfaces for a number of sports, we’ll have more ankle sprains and see conditions such as tennis elbow.” “People who may have been sedentary over the winter become active in the summer. We’ll see more injuries to the extremities — a lot of ankle sprains, knee or meniscus injuries,” said Bushby. Both health care providers assert that surgery is not the automatic first option. “The goal with our treatment is to educate patients with new information and new behaviors so that injuries don’t return,” said Bushby. Rauh said if you have a question or concern, see a doctor — there is no such thing as a wasted visit. “Patients are the reason we exist; we are educators — we are here to help figure out what the options are.” “Most of sport medicine is non-operative care,” he said. “Treatment may include physical therapy, injections, or a simple over-the-counter medication. Ice should not be underestimated as a tool for acute and overuse injuries.”
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Page 11
Women’s issues Holistic Options for Having a Baby in Buffalo By Mara Koven-Gelman
A
re you pregnant or thinking about it and leaning toward a less invasive, natural approach? There are several holistic options in Buffalo for prenatal (before), birthing and post-partum (after birth) care. While the Internet provides heaps of information, it can be overwhelming. Here is a brief guide on finding holistic care and meeting some of the care providers. The Birthing Center of Buffalo offers care from pregnancy to baby’s first 6 months. Professionals working at Birthing Center of Buffalo define natural birth to mean “no inductions or pain medications.” They do not offer interventions to “speed things up, rather, [they] offer natural comfort measures consistent with a reverence for the natural process.” Opened in February 2014, it is the second only free-standing birth center in New York state. Besides The Birthing Center, several midwife, doula and holistic parenting resources have emerged. “There are options in Buffalo that do not exist elsewhere,” says Katharine Morrison a physician at the Birthing Center. She is also a member of The American College of Obstetrics and Gynecology. To help guide new moms and dads through these important decisions, the Buffalo Doula Collective is offering a public “Options for Birth” event, from 6 – 8 p.m. July 8, at the Kenmore Branch Library, 160 Del-
aware Road. Representatives from Kaleida Health, Catholic Health, The Birthing Center of Buffalo, and home birth midwives are invited to be a part of a panel discussion on options for birth in their spaces. Other natural options are a hospital-based practice at Mercy Hospital (South Buffalo), which includes seasoned certified nurse midwives Sarah Worrell and Elaine Clutterbuck. “They are perfect for those who want a hospital birth but no unnecessary interventions,” said Morrison. Additionally, there are two other certified nurse midwives with independent practices who offer home birth — Khristeena Kingsley, and Eileen Stewart. They each have admitting privileges at area hospitals so can continue to care for their patients if hospital transfer is necessary. While all health care providers expect a healthy outcome, there is medical debate about perceived risks in child birth and methods to prevent these risks. Holistic birth advocates say high cost technology and invasive procedures crescendo toward high caesarean section and maternal mortality rates. Medical system proponents state that procedures and monitoring control are necessary for healthy outcomes. A measure of medical intervention is caesarean section rates. Buffalo C-section rates mirror Erie County, the state and the US ranging 38 to 42 percent. World Health Organization and
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recent studies suggest 5 to 10 percent would be optimal. There are many empowering preparations a pregnant woman can put in place in addition to choosing a midwife or doula. Rebecca J. Mercurio, a licensed massage therapist, certified doula (DONA) and prenatal yoga instructor, sees people who are more environment- and health-conscious wanting to take more control of their lives. “You can have an empowering experience with a lot of choice and ownership,” Mercurio says. “The birthing experience stays with the mom forever and can affect the relationship with the baby.” Mercurio attends births as a doula at Sisters, Millard Fillmore Suburban and Women and Children’s hos-
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015
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pitals. She says moms who take yoga have smoother deliveries because, “we teach breathing and coping methods to help prepare for this intense experience.”
Holistic Parenting Network
It was founded by parental consultant Mary Miller, who runs parenting support groups with 1,500 members on Facebook. Miller says care for having a baby is segmented: pre-birth, birthing, post-partum, breast-feeding and parenting. Her goal is to offer information and support for the whole process no matter if a mom chooses natural or medical model of care. Mercurio believes Buffalo hospitals are more willing to modify according to mother’s wishes, but the medical birthing model is too entrenched to change, she said. She — like Morrison — thinks it is women who will help change the system. “Women are now recognizing they have options and stepping up to participate in the birth process,” said Mercurio.”
Menopause & Complementary Medicine More women turning to alternative medicine for menopause without medical guidance
T
he use of complementary and alternative medicine (CAM) is increasing for the treatment of menopausal symptoms but often without the guidance of a clinician. That’s according to a new study reported online in June in Menopause, the journal of the North American Menopause Society (NAMS). As a result, the authors suggest that healthcare providers — in particular family medicine practitioners — need to be more aware of the various CAM therapies and take a more active role in guiding patients through their options to more safely and effectively coordinate their care.
Ongoing fear of the potential risks of hormone therapy is cited as a primary reason for the growing use of CAM among menopausal women (including pre-, peri- and postmenopausal) in recent decades, according to the study. CAM is a general term for healthcare practices and products not associated with the conventional medical profession. Some of the more commonly accessed CAM practitioner groups include massage therapists, naturopaths/ herbalists, chiropractors/osteopaths, and acupuncturists. The more popular self-prescribed CAM supplements/ activities include vitamins/minerals, yoga/meditation, herbal medicines,
aromatherapy oils and/or Chinese medicines. “There is still much to be learned in the CAM arena and women need to understand that just because something appears natural does not necessarily mean it is without risk, especially for certain populations,’ says NAMS Medical Director Wulf Utian, a physician. “In the meantime, this study does a good job of alerting clinicians to the growing interest in CAM alternatives and of the critical role of health providers in helping educate patients on the potential risks and benefits of all options.”
Midwives, Doulas? Understand the Difference
• Midwives are licensed care givers who care for primarily well women. They provide care that includes: gynecologic care, care during pregnancy and childbirth and the newborn following birth. They administer to a normal birthing woman in a licensed facility (hospital, birthing center) or at home. NYS licenses certified professional midwife (CPM). Nurses who also trained as a midwives can use the term, certified nurse midwife (CNM.) • Doulas from the Greek word meaning “a women who serves,” is a trained professional who assists women in pregnancy, labor and postpartum. Many doulas help the mom transition with her newborn and help with breast feeding and emotional support. While women need to check with providers, most insurers will cover NYS licensed certified midwives, certified nurse midwives prenatal and birth care at a licensed facility. Independent Health is the only insurance that contracts with The Birthing Center of Buffalo in network. Independent Health also has a managed care option that works with Medicaid recipients.
How to Find Help • Birthing Center of Buffalo www.birthingcenterofbuffalo.com/ • Buffalo Doula Collective www.buffalodoulacollective.org • Buffalo Midwifery Service buffalomidwiferyservices.coml • Holistic Parenting Network www.holisticparentingnetwork.com/ • Buffalo Birth Network www.buffalobirth.com • CenteringPregancy prenatal care centeringhealthcare.org Life Cycles Center www.lifecyclescenter.org/resources/ community/index.html New York State Midwife License and contact information: www.op.nysed. gov/prof/midwife/midwifeqa.htm
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Women’s issues Urinary Tract Infections Harder to Treat By Deborah Jeanne Sergeant
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rinary tract infections (UTIs) have become harder for physicians to treat. New strains of bacteria resistant to antibiotics have developed, especially in populations of immuno-suppressed women. These include diabetics, cancer patients receiving chemotherapy, and people receiving immunosuppressant drugs such as for rheumatoid arthritis and fibromyalgia. Jason Donovan, physician assistant at Vitalize Medical, which treats clients from Buffalo to Syracuse, said that the problem has caused physicians to up the ante and perform inter-muscular injections and IV therapy to treat and beat these infections. In addition to those who are immuno-suppressed, “the aging population as a whole is experiencing this,” Donovan said. “There’s a lot more aged women developing these infections.” Part of the reason this has become a problem is that physicians have been too eager to appease patients who demand antibiotics for treating viral infections or minor bacterial infections that should self-resolve. This causes bacteria to develop stronger strains and as a result, it’s harder to treat UTIs be-
cause the bacteria resist treatment from antibiotics. Changes in estrogen levels, such as during young adulthood and after menopause, is when many women get UTIs the most. The changes in hormone level can lower the level of good bacteria and allow the bad bacteria to multiply. Some post-menopausal women receive relief from applying vaginal estrogen cream, which helps improve the pH level so the good bacteria can thrive; however, the drawback is that vaginal estrogen cream is not indicated in women with a high risk of blood clots or a personal or family history of breast or uterine cancer. Fortunately, women have other options for preventing UTIs. Physician Teresa L. Danforth, assistant professor, department of urology, UB School of Medicine and Biomedical Sciences, who sees patients at UBMD Urology, recommends cranberry supplements. “Though cranberry is not an FDA-proven medication for UTI prevention, it has been shown to prevent a certain strain of bacterial growth in the
urine,” Danforth said. “As cranberry juice contains large amounts of sugar and can also act as a bladder irritant causing increased urinary frequency in many people, supplements in pill form are preferred. The optimal dosage of cranberry supplements has not been determined.” This therapy is not appropriate in women with a history of breast or uterine cancer and is used with caution in patients with history of blood clots. She also recommends staying hydrated with clear fluids and regular urination. “It is normal to urinate up to eight times per day,” Danforth said. “When you do urinate, take your time to empty your bladder completely. Patients should aim to keep urine light yellow to clear during the day as a sign of good hydration.” Hygiene can make a difference as well, especially for sexually active women, but “avoid using sprays, bubble baths, or douching as this causes more irritation,” Danforth said. “Taking showers over sitting in a bathtub
is preferred. Spermicidal jelly, unlubricated condoms and diaphragms have also been shown to irritate the genitals. After intercourse, it is recommended to empty your bladder.” Danforth added that loose-fitting, breathable clothing such as cotton can help keep the genitals clean and dry. In general, eating right, getting enough rest, exercising and treating any other health issues should help women resist UTIs.
Bionic Pancreas, Anyone? New Advances for Type 1 Diabetics By Deborah Jeanne Sergeant
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ew and emerging technology is helping Type 1 diabetics more easily manage their condition. About 3 million Americans have Type 1 diabetes, accounting for about 5 percent of people who have diabetes, according to the American Diabetes Association. Unlike Type 2 diabetes, in which the body doesn’t use insulin effectively and diet and exercise can help mitigate its effects, those with Type 1 diabetes have a poorly functioning pancreas. It produces too little or no insulin, the hormone that converts sugar and starch into energy for the body’s use. Since it is usually diagnosed in childhood, it had been called “juvenile diabetes” though Type 1 diabetes is incurable. Using insulin injections or automatic pumps and constant blood sugar monitoring can help diabetics manage the condition. But these methods are laborious and especially difficult for children to handle. New discoveries make coping easier. Researchers at Boston University are working with the American Diabetes Association on a bionic pancreas. “It’s so exciting for people who
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have Type 1 diabetes,” said Travis Heider, executive director for the Upstate New York region of the American Diabetes Association. Based on a closed-loop system, the device administers insulin and micro-bursts of glucagon to raise blood sugar as its sensors realize the body’s need. The “smart” technology learns the user’s eating habits and activity patterns so it can supply insulin and glucagon accurately. The equipment interfaces with a smartphone. “No more are the days of literally counting all the carbs,” Heider said. The device is proving so successful that diabetics involved with its initial testing did not want to give them up. “It was so life-changing for them, to have a taste of what it’s like to not live with diabetes,” Heider said. The anticipated date for FDA approval is 2017. This and other diabetes developments excite Manav Batra, assistant professor in the division of endocrinology at UB and endocrinologist with UBMD Physicians Group. Development of CGM (continuous glucose monitoring) has helped to im-
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015
prove the monitoring of blood sugars in patients with Type 1 diabetes avoiding hypoglycemia. “Medtronic’s...insulin pump, integrated with CGM device stops giving insulin when the sensor detects low blood sugar. That delivers insulin at the level you’ve set on it,” Batra said. “It can help people avoid low blood sugars. That is harder for children to sense.” Currently, physicians transplant pancreas along with kidney in patients with renal failure. Successful, longterm transplantation of healthy pancreatic islet cells, which make insulin, into the bodies of diabetics may become a reality someday. The procedure requires immunosuppression so that recipient doesn’t reject the transplant. That could enable diabetics to lessen their dependence on outside diabetes management. Researchers are developing beta cell outside human body in a lab setting. These cells make insulin. “The next step is, ‘Can we inject these cells in a human body and pro-
tect it from rejection?’ Batra said. “Microencapsulation technology can help the body accept the new transplant.” In essence, microencapsulation “hides” the transplanted cells from the body’s immune system which would otherwise attack the foreign cells. Anti-rejection drugs may also make transplantation more successful. Further advances for diabetics include inhaled insulin (Afrezza), though people who smoke or have chronic lung conditions cannot use it. The shelf-stable insulin pen requires no refrigeration, so diabetics can inject insulin on the go. Longer-lasting insulin concentrations reduce the number of injections necessary, so in addition to the basal insulin, the patient requires fewer injections to cope with changes in diet.
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to look at it much differently. Now, with health care, we are taking a higher responsibility to educate the public about their health. We are partnering and going to health fairs and clinics out in the community to find out what health areas they are lacking. We are doing early diagnostics and taking early, aggressive stances in making healthcare a top propriety for people. Moving away from the fee for service model is a total shift now. You have to change the habits of the consumer. That is the way you get real change to happen and it is our jobs to help move health care and education forward.
ichard C. Cleland, the interim CEO of Erie County Medical Corporation, has recently been named the organization’s CEO. He will continue providing leadership for all operations and coordinating care at ECMC and Terrace View, the skilled nursing facility on the Grider Street health campus. He recently spoke by phone with In Good Health writer, Ernst Lamothe Jr. Q: What are some of your goals as a CEO for the Erie County Medical Corporation? A: A big initiative that we are undertaking is the New York State Medicaid waiver program. ECMC is the lead in the eight-county area in helping to transform the Medicare system from fee-for-service to population health and making sure that people understand the importance of preventive health care. It is a five year, $300 million program that began this year to implement case management preventable health. We are looking to reduce emergency room visits by 25 percent and reduce acute admissions also by 25 percent. During this first year, our goal is to set up a stable infrastructure and develop relationships. We are looking to have a staff of 10 to 12 people in the first year, and then after things are set up, we can start targeting those 25 percent reduction rates. Q: What are some of the ECMC accomplishments that make you proud? A: We are an American College of Surgeons Level 1 Trauma Center, which is the highest level trauma center you can have. We have a comprehensive rehab facility certification and a regional Behavioral Health Center of Excellence. We want to make sure our service lines throughout our outpatient areas remain strong. We want to do a report of each service line in the area to make sure that they are efficient and have a quality infrastructure that puts us in position to bring patients the highest level of service. Q: How has the Patient Protection and Affordable Care Act changed healthcare? A: Whether you are an individual hospital or a hospital system, the future is quality. You are being judged on health care results, patient satisfaction and overall care. We are looking to hire a chief experience officer and a chief people officer so we can implement a Silicon Valley approach to health. Any organization that doesn’t think about strategy or creating a strategic plan is going to be in trouble. You need to put together a strong leadership structure in order to succeed. We have done a good job working on a plan to lower risk in health care and make sure our patients get the highest quality of care. Q: You mentioned population health? What is population health? A: When you look at health care over the years, it was built on having these nice buildings and a system where the population came to us when they were sick. Today, we have
Q&A with
Richard C. Cleland New CEO of Erie County Medical Corporation
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We are looking to reduce emergency room visits by 25 percent and reduce acute admissions also by 25 percent
CEO’s History with ECMC Dates Back to the late ‘80s Richard C. Cleland, appointed ECMC new CEO May 27, served as interim CEO since April 2014 when former Chief Executive Officer Jody L. Lomeo was named president/CEO of the Great Lakes Health System of WNY and Kaleida Health. Cleland served as senior vice president of operations from 2006-2014. Prior to joining ECMC, Cleland was the administrator of Brothers of Mercy Nursing and Rehabilitation Center from 2000-2006 and director of maintenance, plant operations, and environmental services at Brothers of Mercy from 1994-2000. Cleland’s history with ECMC dates back to the late’80s, when he served as director and assistant director of cleaning services from 1988-1994. Cleland holds a Master of Pub-
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lic Administration from Canisius College, has a New York State Nursing Home Administrator’s license and a certification from St Joseph’s College of Maine in long term care administration. He earned his undergraduate degree from Buffalo State College. He is a fellow of the American College of Health Care Executives. He was one of the first two ECMC executive administrators specially selected to participate in a ninemonth Harvard University leadership development program. Cleland lives in Clarence. Gym where he works out: His basement Hobbies: Running, playing guitar Things about him that few people know: Original career choice was to become FBI Agent; still loves punk rock, go Ramones! Favorite movies: “Blues Brothers,” “Caddyshack,” “Airplane.” Favorite TV series: “Green Acres.” July 2015 •
Q: Can you talk about the importance of behavioral health and substance abuse in the community? A: Mental health and substance abuse is the No. 1 costly health care segment in our community. Chemical dependency is a huge challenge in this region. About three to four years ago, ECMC became a leader in creating a center for behavioral health. The Buffalo community was struggling previously to provide quality services that benefited the community. We knew this was something that had to become a priority. We received about 675,000 outpatient encounters in mental health and chemical dependency in this area and we have a stronger program now to help people in need. Behavioral health is something that should not be ignored. As a medical community, we are proud that we have upgraded our services for people in need. Q: How do you tackle patient satisfaction? A: When it comes to improving any industry that involves customer service, it has to be customer-centric. In our case, the patient is the center and the patient is always right. You have to make the patient feel supported and that comes with nurses and physicians going to the rooms and making sure things are going well. Patients should feel they are receiving the best care. It also means making sure there are free parking options for patients when they come to the hospital. Nobody wants to walk a long way to park their cars to get to the hospital. It is making sure when they enter the hospital, they are greeted well and someone is showing them how to get around. It is listening to patients when they fill out a survey because we want to improve in areas that we need to. I know we have done a good job in culture change. Q: In Buffalo, it seems like hospitals have a good amount of collaboration. A: Collaboration is at an all time high nationwide with the Affordable Care Act. But in Buffalo this is something we have had for years. If you are going to improve your health system, you can do everything on your own within each hospital. There has to be a collaborative spirit. We are going to survive and thrive in a high level working together for the common goal and that is to offer high quality service at a low cost. Working together is how we are going to elevate the entire industry in our area. The collaboration spirit in Buffalo is one that many communities can learn a lot from.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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UB Pharmacologist’s New Book Condemns Dietary Supplements
The Social Ask Security Office
In “Optimal Aging,” author shares his knowledge about the science of aging and when drugs are — and aren’t — useful
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ou don’t need a doctorate in pharmacology to write a book about aging, but these days, when the average senior citizen takes multiple medications, it does come in handy. That’s evident in “Optimal Aging: A Guide to Your First Hundred Years,” by Jerrold Winter, PhD, a professor in the department of pharmacology and toxicology in the University at Buffalo School of Medicine and Biomedical Science. Published by CreateSpace, a self-publishing company and available through Amazon.com, the book includes plenty of non-pharmacologic information and advice on things like exercise, pain and death. Winter also focuses on providing information about “the chemWinter icals in our lives,” from over-the-counter medications to prescriptions and dietary supplements. “Aging is all about science,” said Winter. “This is true whether one is speaking of nutrition or exercise or disease or any of the other myriad factors that influence how we age. The fact that I am a professor of pharmacology and toxicology just means that when it comes to drugs, I don’t have to work as hard to understand the science.” According to Kirkus Reviews, “Winter references copious studies and incorporates a good dose of technical material, but his final product is surprisingly readable, conversational and compassionate. He consistently remains an ardent advocate for the individual, whether he’s discussing the need for opiates for pain relief or poignantly calling for the right to die with dignity.” Winter admits his own bias against supplements, discussing at one point the “fundamental idiocy” of
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the Dietary Supplement Health and Education Act. “The act permits the virtually unregulated promulgation to the American people of what, in the words of another, are largely fraudulent claims that support a $30-billiondollar-a-year industry,” he said, noting the recent television advertisements claiming that a protein supplement can improve brain function. “Any protein we eat, whether it comes from a hot dog or a supplement, is simply digested and in no way can influence specific proteins in our brains,” he said. “The ads are nonsense.” The book examines specific components of good nutrition, devoting whole sections to specific vitamins and nutrients, and he spends some time explaining why, contrary to what we’ve heard, fat and cholesterol are critical to health. Winter explains the phenomenon that too many senior citizens suffer from: They are prescribed too many medications, many of which are completely unnecessary and end up compromising, not enhancing, their health. In particular, he singles out the use of antipsychotic drugs for treating anxiety, depression, dementia, hostility and other psychiatric problems in the elderly, demonstrating how they have often done more harm than good. He also lists major drug companies that have each been fined several hundred million dollars for violating laws by prescribing anti-psychotic drugs for off-label uses, and puts those fines in the context of sales figures of the same companies. There are sections on weight loss, enhancement of performance (athletic, cognitive and sexual) and a final section on “Things we wish to avoid,” — including pain, dementia, cancer, heart disease and stroke, and on death and dignity. Winter says his goal in writing the book is to bring order and genuine understanding to the thousands of bits of information that relate to aging and to strive to attain “total perspective.”
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015
Supporting Our Youth, Protecting Our Future
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ocial Security serves a person for life — from birth, to death, and even beyond, by helping to care for surviving dependents. When a parent becomes disabled or dies, Social Security benefits help to stabilize the family’s financial future in an otherwise turbulent time. And, we pay benefits to adults and children. In July, the world celebrates World Youth Day. Social Security is no stranger to helping children in need. Every year, about 4.4 million children receive monthly benefits because one or both of their parents are disabled, retired or deceased. Those benefits help with their day-to-day needs. In addition, Social Security provides vital income for disabled children, including people disabled since childhood, through our Social Security Disability Insurance (SSDI) program and our Supplemental Security Income (SSI) program. To qualify for children’s benefits under the SSDI program, the applicant must be the child of a parent entitled to benefits and meet Social Security’s strict definition of disability. He or she must have a physical or mental condition, or a combination of disabling conditions, that seriously limits his or her daily activities and is expected to last for at least 12 months or result in death. The SSI program provides pay-
Q&A
Q: I’m 17 and eager to start my first summer job, but my mother misplaced my Social Security card. How can I get another? A: If you know your Social Security number, you may not need to obtain a replacement card to obtain employment. However, if a prospective employer requests it, in most cases you only need to provide your Social Security number, and you don’t actually need a replacement card. But if you do need the card, you can get a replacement Social Security card by following the steps below. There is no charge for a Social Security card, but you are limited to three per calendar year and 10 replacement cards during your lifetime. You will need to: • Show the required documents. We need to see different documents depending on your citizenship and the type of card you are requesting. Go to www.socialsecurity.gov/ ssnumber to find out what documents you will have to show. • Fill out and print an “Application for a Social Security Card;” and • Take or mail your application and original or certified copies of the original documents to your local Social
ments to blind or disabled children who live in households with low income and limited resources if they meet our strict definition of disability. You can find more information on eligibility requirements by visiting our website at www.socialsecurity.gov. This year marks the 25th anniversary of the Americans with Disabilities Act (ADA) of 1990. The ADA ensures equal opportunity for and equal treatment of people with disabilities at school, in work places, in commercial facilities, and through the services available from state and local government agencies. The ADA requires that government agencies communicate with Americans who have disabilities in the way that fits their needs. This legislation shows our nation’s commitment to all people, despite their physical and mental disabilities. Since the ADA’s inception, Social Security has been and continues to be at the forefront, providing accommodations for disabled beneficiaries and employees. It’s a natural part of who we are as an agency. If you think your child may qualify for children’s benefits, you can apply by calling Social Security toll-free at 1-800-772-1213 (TTY 1-800-325-0778) or by visiting your local Social Security office. You can also read our publication, “Benefits for Children,” at www. socialsecurity.gov/pubs.
Security office. For more information, read our pamphlet, “Your Social Security Number and Card” at www.socialsecurity. gov/pubs. Q: Why should I sign up for a Social Security online account? A: my Social Security gives you a personal online account you can securely use to check your Social Security information and do business with us. With a my Social Security account you can: • Keep track of your earnings and verify them every year; • Get an estimate of your future benefits if you are still working; • Get a letter with proof of your benefits if you currently receive them; and • Manage your benefits: • Change your address or telephone number; • Start or change your direct deposit; • Get a replacement Medicare card; and • Get a replacement SSA-1099 or SSA-1042S for tax season. • To find all of the services available and set up an account, go to www. socialsecurity.gov/myaccount.
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How Seniors Can Tame Pet Care Costs Dear Savvy Senior, What tips can you recommend to help senior pet owners with their veterinary bills? I have two cats and a dog that are family to me, but their vet bills have become unaffordable. Fix Income Frankie Dear Frankie, The high cost of veterinary care has become a problem for millions of pet owners today, but it can be especially difficult for seniors living on a fixed income. Routine medical care can cost hundreds of dollars, while urgent/ specialized treatments and procedures can run into the thousands. But, it is possible to reduce your pet care costs without sacrificing their health. Here are some tips that can help you save. Shop around: If you’re not attached to a particular veterinarian, call some different vet clinics in your area and compare costs. When you call, get price quotes on basic services like annual exams and vaccinations, as well as bigger-ticket items, like to repair a broken leg, so you can compare. Also, check to see if you live near a veterinary medical school (see aavmc.org for a listing). Many schools provide lowcost care provided by students who are overseen by their professors. Ask your vet for help: To help make your vet bills more manageable, see if your vet’s office accepts monthly payments so you don’t have to pay the entire cost up front. Also, find out if your vet offers discounts to senior citizens or reduces fees for annual checkups if you bring in multiple pets. Search for low-cost care: Many municipal and nonprofit animal shelters offer free or low-cost spaying and neutering programs and vaccinations, and some work with local vets who are willing to provide care at reduced prices for low-income and senior pet owners. Call your local shelter or humane society to find out what’s available in
your area. Look for financial assistance: There are a number of state and national organizations that provide financial assistance to pet owners in need. To locate these programs, the U.S. Humane Society provides a listing on their website that you can access at humanesociety.org/petfinancialaid. Buy cheaper medicine: Medicine purchased at the vet’s office is usually much more expensive than you can get from a regular pharmacy or online. Instead, get a prescription from your vet (ask for generic) so you can shop for the best price. Most pharmacies such as Walgreens, CVS, Walmart, Kmart, Rite Aid and Target fill prescriptions for pets inexpensively, so long as that same drug is also prescribed to humans. And, many pharmacies offer pet discount savings programs too. You can also save by shopping online at one of the Veterinary-Verified Internet Pharmacy Practice Sites accredited by the National Association of Boards of Pharmacy, like 1-800-PetMeds (1800petmeds.com), Drs. Foster & Smith (drsfostersmith.com), KV Supply (kvsupply.com), and PetCareRx (petcarerx.com). Consider pet insurance: If you can afford it, pet insurance is another option worth looking into. You can get a basic policy for under $10 per month, and some insurers provide discounts for insuring multiple pets. See petinsurancereview.com to compare policies. Membership discount plans like Pet Assure (petassure.com) are another way to save, but you’ll need to use a vet in their network. Look for other ways to save: In addition to cutting your veterinary bills, you can also save on pet food and other supplies depending on where you shop. Target, Walmart, Costco and the dollar stores typically offer much lower prices than supermarkets and specialty retailers like Petco and PetSmart. You can also save on treats and toys at sites like coupaw.com and doggyloot.com.
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Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. July 2015 •
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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H ealth News HealthNow recognized for management programs HealthNow New York Inc. recently announced it has earned patient and practitioner oriented accreditation from the National Committee for Quality Assurance (NCQA) for its disease management programs that help members with asthma, diabetes, cardiovascular, spine, and chronic obstructive pulmonary disease (COPD) conditions. As of June 10, HealthNow was one of only 15 organizations that maintained this level of accreditation. HealthNow’s accreditation is effective through April 2018. NCQA disease management accreditation is a voluntary review process, which recognizes organizations for comprehensive disease management programs that deliver evidence-based care, make efficient use of resources, have high levels of customer satisfaction and deliver improved health outcomes. “HealthNow is focused on empowering members with condition-specific information, so they can make decisions that improve their self-care and support their achievement of a healthier lifestyle.” said physician Thomas Schenk, senior vice president,
chief medical officer, HealthNow New York Inc. “This accreditation from a respected organization like NCQA, is validation that our programs provide our members and their physicians with the support, education, and resources necessary they need to manage their conditions.” Accreditation, certification and public reporting of measurement results help employers and consumers evaluate programs that are transparent, accountable and committed to continuous quality improvement. No comparable evaluation exists for disease management programs. “NCQA’s disease management accreditation program is thorough and rigorous. It’s designed to highlight only those programs that truly improve chronic care,” said NCQA President Margaret E. O’Kane.
Fetal Care Center opens at Children’s Hospital The division of maternal-fetal medicine at Women & Children’s Hospital of Buffalo recently held a grand opening and ribbon-cutting ceremony of Western New York’s first and only Fetal Care Center (FCC). The center is located inside the Regional Perinatal Center of WNY on the fifth floor of the hospital at 219 Bryant St. The FCC provides comprehensive,
Cleland, Quatroche Jr. Appointed at ECMC Richard C. Cleland has been recently named Erie County Medical Center Corp.’s new CEO while Thomas J. Quatroche Jr. became corporation’s new president. Cleland most recently served as interim CEO and Quatroche was senior vice president. (See story on page 15) Quatroche has worked in higher education and health care for more than 20 years in various executive roles. For the past 10 years, he was responsible for surgical services, all surgical service lines, oncology services, business development, marketing, strategic planning, and external relations. He oversaw the Cleland departments of orthopedics, neurosurgery, general surgery, oncology, head & neck/ plastic and reconstructive surgery, and oral oncology and maxillofacial prosthetics. Quatroche also served on statewide committees in education and health care for the State University of New York and the Healthcare Association of New York State. He represented ECMC on the HANYS task force on Improving New York state’s Medicaid program and allied Page 18
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executives committee and is currently serving on the Western New York Health Association Board, Trocaire College Board of Trustees, Buffalo State Foundation Board, Buffalo Renaissance Foundation Board of Directors, and Seneca Nation Economic Development Commission. A lifelong Western New Yorker, he served on the Hamburg town board from 1994-2009, was a member of the Immaculata Academy School Board from 2004 to 2009, and has been involved in other civic organizations. He is a past recipient of Buffalo Business First’s 40 Under 40 award for business and civic leadership Quatroche and has been a featured presenter at health care conferences regarding the new Federal Healthcare Reform. Quatroche received his bachelor’s degree in business administration and marketing from SUNY Fredonia, holds a master’s degree in student personnel administration from the SUNY Buffalo and earned his doctorate in higher education — educational leadership and policy — from SUNY Buffalo.
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015
OPAAnnounces Leadership Appointments Several new leaders have been appointed at Optimum Physician Alliance (OPA) as it enters its third year. OPA, a wholly owned subsidiary of Kaleida HealthNow Inc., is a network of primary care and specialist physicians who are committed to working collaboratively to improve the delivery of care to ensure patients receive the appropriate care, at the appropriGannon ate time, with the appropriate provider across the continuum of care. The new appointees are: • Suzanne M. Gannon has been appointed OPA’s executive director. She is now responsible for operational and clinical integraHughes tion strategies. She brings a combination of operating excellence and strategic vision to lead OPA to future success and has 25 years’ experience in the health insurance sector. • Physician Thomas F. Hughes III has been named OPA’s medical director. He is a family practitioner and clinical associate professor in the department of family medicine at the State University of New York at Buffalo School of Medicine and Biomultidisciplinary care for women and families whose pregnancy is complicated by fetal abnormalities. As the regional quaternary referral center for complicated pregnancies in Western New York, care is coordinated within a single site to ease the burden to families. The primary aim of the FCC is to provide advanced care of congenital or genetic fetal abnormalities, including cleft lip or palate, spina bifida, abdominal wall defects, skeletal defects such as clubbed feet and dwarfism, intestinal anomalies, congenital lung lesions, abdominal cysts and lymphatic malformations.
ECMC trauma center gets national accolade from ACS The national committee on trauma of the American College of Surgeons (ACS) recently named Erie County Medical Center a Level I Trauma Center, only the fifth in New York. The ACS committee on trauma — from which two designees visit-
medical Sciences. Hughes will lead OPA’s clinical integration strategy and initiatives to improve physician engagement, clinical outcomes, and quality of care provided to patients. • Meri G. Notaro has been appointed director of business development and communications. Notaro played an integral role in the development of OPA and the physician leadership board (PLB). Her new role focuses on day-to-day straNotaro tegic planning and strategic repositioning of OPA through tactical alignments, product development, and implementation of a marketing communications platform. • Physician Thomas Rosenthal is the new director of Rosenthal variation reduction. He is the founding director of the New York State Area Health Education Center System, and former chairman of the department of family medicine at the State University of New York at Buffalo School of Medicine and Biomedical Sciences. Rosenthal will lead multiple variation reduction projects to identify opportunities for improved care and outcomes.
ed ECMC March 10-11 for an on-site review — provides confirmation that a trauma center has demonstrated its commitment to providing the highest-quality trauma care for all injured patients. The ACS notification specifically indicated that no deficiencies were found in the review and evaluation process. Achieving verification means that the hospital voluntarily met criteria that improve the standard of care as outlined by the American College of Surgeons’ committee on trauma’s current Resources for Optimal Care of the Injured Patient manual. Established by the American College of Surgeons in 1987, the designation program promotes development of trauma centers in which participants provide not only the hospital resources necessary for trauma care, but also the entire spectrum of care to address the needs of all injured patients from the pre-hospital phase through the rehabilitation process. “Clearly, this is a confirmation of ECMC’s commitment to the highest quality trauma care,” said ECMC CEO
Donald Rowe: Passion for Public Health Director at UB Office of Public Health Practice recognized for services to improve public health By Ernst Lamothe Jr.
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here are many professions Donald Rowe could pick to meet his passion to help others. However, there was something about the medical field that drew him as he became the first person in his family to go to college. That passion and more than four decades of diligent work have positioned him to receive one of the highest honors in the medical profession. Rowe, director of the Office of Public Health Practice and faculty member in the Department of Community Health and Health Behavior at the University at Buffalo School of Public Health and Health Professions, recently won the 2015 Hermann M. Biggs Public Health Award. “I was very humbled and happy about receiving this honor,” said Rowe, of Churchville. “I looked at the list of previous award winners and this means a great deal to me because I feel they have been far more worthy of this award than I ever was.” The award is given annually by the New York State Public Health Association to an individual who is recognized for their outstanding achievement in public health. Biggs was a strong supporter of the use of laboratory identification and control of sexually transmitted diseases. “I am familiar with Dr. Bigg’s work on sexual transmitted infections and how he was the forerunner of how public health is structured in New York state,” said Rowe, who holds clinical assistant professor appointments in the department of family medicine and social and preventive medicine. Rowe’s research interest has always been in public health collaborations and partnerships, public health emergency preparedness, environmental health and children with special health care needs. Rowe also brings
his passion to the classroom where he teaches courses in public health practice and community health assessment and surveillance. “Public health is my passion,” added Rowe. “Where else do you have the opportunity to help both individuals and entire communities? I can’t imagine a more rewarding career.” Rowe’s career in public health began in 1975 as an associate scientist in the Erie County Department of Environmental Quality. He served in a variety of positions, including the public health director for the Genesee County Health Department and the public health microbiologist for the Erie County Public Health Laboratory. As the director of the Office of Public Health Practice, Rowe’s focus is on connecting the school with the practice community so that together they have an opportunity to improve the health of communities. Rowe was instrumental in the establishment of the Western New York Public Health Alliance and has been active as a member of the New York State Rural Health Council on which he currently serves as the co-chairman. He also helped in the development of the Lake Plains Community Care network. He has participated in the development of the “Physician’s Guide to Public Health- Partners in Keeping People Well”, now in its third edition. “Few people really understand the importance of public health,” he added. “Public health varies dramatically from state to state and funding is very varied from those states.” The award he received is named for Hermann M. Biggs, a physician who was an American pioneer in the field of public health and a dominant force in the New York City Department of Health for 26 years, championing the use of public health control and
Richard C. Cleland. “Today, we recognize all of the doctors, nurses and first responders who have made this trauma center system one of the best in the nation.” There are five separate categories of verification in the program. Each category has specific criteria that must be met by a facility seeking that level of verification. Each hospital has an on-site review by a team of experienced site reviewers, who use the current resources for the optimal care of the injured patient manual as a guideline in conducting the survey. “From the trauma center’s first days, ECMC continues to stand on the shoulders of great clinicians and community emergency personnel who have worked together to insist on excellence,” said physician William J. Flynn, chief of surgery, ECMC, and associate professor/chief, division of trauma/critical care, department of surgery, SUNY Buffalo. “The thousands of patient trauma survival stories are our most gratifying, living proof of success.”
Key professionals appoint at ECMC transplantation center Two physicians have been appointed to key positions at the ECMC Regional Center of Excellence for Transplantation & Kidney. Liise Kayler was selected after a national search to serve as program. In this role, Kayler will provide overall leadership of the ECMC transplant program, effective immediately. Mareena Zachariah was appointed medical director of the Regional Center of Excellence for Transplantation & Kidney Care at ECMC. She is a transplant nephrologist at ECMC and has served in this capacity since 2008.
Background
• Liise Kayler comes from a position at Montefiore Medical Center where she recently served as director of the kidney and pancreas transplant program. Kayler received her undergraduate degree from the University of Nevada and completed multi-organ transplant fellowship training at the University of Michigan.
Michael Seserman, president of New York State Public Health Association, Donald Rowe and Rosie Perez, board member at NYSPHA. enforcement measures in the fight against tuberculosis. In 1914 he became the commissioner of health for the state of New York and guided the development of public health measures in New York Biggs was also instrumental in the adoption of programs for the identification and control of venereal disease through laboratory analysis. He advocated nursing measures to combat infant mortality and he introduced, on an administrative level, the use of vaccines to prevent disease. “When the award committee reviewed not one but two separate nominations submitted for Dr. Donald Rowe, we felt that his passion for public health, his dedication to the teaching of public health students and the development of those working in the field make him a deserving recipient of the Hermann Biggs memorial medal,” said Rosie Perez, who was part of the committee. In his spare time, he also gives regular presentations on a variety of public health topics on regional, state and national levels, the most recent being at the American Public Health Association’s 142nd annual meeting
Kayler is certified by the American Board of Surgery. She practiced at the Thomas E. Starzl Transplant Institute in Pittsburgh as a clinical faculty member and later at Shands Hospital University of Florida as the director of the Living Kidney Transplant Program. While at the University of Michigan, Kayler acquired a master’s in clinical research design and statistical analysis. Her research focused on increasing opportunities for transplantation by improving utilization of deceased-donor kidneys, educational interventions to promote living kidney donor management and through kidney paired exchange. She is currently a co-investigator on an NIH-funded multicenter study to evaluate living kidney donor quality of life. • Mareena Zachariah is clinical assistant professor for the University at Buffalo, division of nephrology (2008-present) and associate director of the renal fellowship program (2013-present). July 2015 •
in November 2014 on “Cross Jurisdictional Sharing: the Rural New York experience. In 2013, he was appointed by Gov. Cuomo as chairman of the New York State Association for Rural Health, a position he still retains. “Dr. Rowe has had a long and distinguished career in public health in New York state,” added Perez. “He was selected because of his broad experience and impact on public health, public health emergency preparedness, homeland security, toxicology, environmental health, laboratory, health education and rural health. We are talking over 40 years in public health leadership positions.” Rowe has long been a leader and active in cross-border initiatives and collaborations with Canadian public health leaders, including the planning of symposia and in the development of a multi-jurisdictional guide to emergency preparedness. “Being part of a profession that helps people is truly a joy,” Rowe added. “It is such a wonderful obligation to help communities become better and healthier.”
Zachariah is an ECMC transplant nephrologist (2008-present). Prior to joining ECMC, Zachariah served as clinical assistant professor at Shands Hospital, University of Florida Kidney Transplant Program. Zachariah received her undergraduate degree from Kasturba Medical College in India and completed a nephrology fellowship at the University of Miami Miller School of Medicine (2006). She completed a transplant medicine fellowship at the University of Wisconsin (2007). Zachariah is double board-certified by the American Boards of Internal Medicine and Nephrology. The Regional Center of Excellence for Transplantation and Kidney Care at ECMC is the result of the merging of two transplant programs-from Buffalo General Hospital and ECMC — into a single streamlined, highly specialized program that offers patients world 716-332-0640 class care.
editor@buffalohealthnews.com
IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper
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Optimum Physician Alliance (OPA), a wholly owned subsidiary of Kaleida HealthNow, Inc., is a physicianled network comprised of primary care and specialist physicians who are committed to providing highquality efficient health care to ensure patients receive the appropriate care, at the appropriate time, with the appropriate provider across the continuum of care. OPA’s mission is to achieve clinical collaboration among physicians and continuously improve the quality of care provided to patients, while simultaneously controlling the costs of healthcare services provided. www.opawny.com For additional information contact Meri Nataro 716-887-7015 Page 20
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IN GOOD HEALTH – Buffalo & WNY’s Healthcare Newspaper • July 2015