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PRICELESS

New President Physician Lisa Smith was elected the new president of Monroe County Medical Society. She wants to reduce administrative burden for doctors, among other goals. See interview on page 6

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GVHEALTHNEWS.COM

JULY 2019 • ISSUE 167

Summer Fitness for Women

Do’s & Don’ts

Story on p. 12

The Top 5 Fruits to Add to Your Diet Researchers have looked at the most nutrient-dense fruits and vegetables to see which provided meaningful amounts of B vitamins including thiamin, riboflavin, niacin, folate, B6 and B12, vitamins C and K, iron, fiber and protein. Most of the top spots on their ranked list of powerhouse fruits — those most strongly associated with reducing the risk of chronic diseases — were various citrus fruits with one popular berry mixed in.

The top 5 nutrient-dense fruits • Lemons • Strawberries • Oranges • Limes • Pink and red grapefruit As terrific as blueberries are considered, blackberries were actually the next fruit on the list,

followed by white grapefruit. Now this isn’t to say that blueberries, which many studies rank very high for antioxidants and other healthful compounds, shouldn’t be on your shopping list along with raspberries. Eating fruits in a rainbow of colors gets you the widest variety of nutrients and phyto-nutrients — those hard-to-duplicate compounds that go beyond vitamins and minerals. It’s also important to pay attention to a fruit’s ripeness. Studies show that ripe fruits, including all berries, offer more antioxidants than fruits that are not quite ready. Based on that criteria, strawberries topped the list, followed by black raspberries, blackberries and red raspberries in that order. Remember that fruits have more calories than vegetables, so watch your portion sizes. P. 23

Can Italian sausage be part of a healthy diet? Story on p. 15

1,000,000

Number of new sexually transmitted infections cases every day among people aged 15-49 years, according to the World Health Organization.

Story on p. 7


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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

Come for the Art STAY FOR IT ALL! JULY 13 & 14, 2019

Join us for the 51st Annual Corn Hill Arts Festival! Featuring •

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Starting and ending at Onanda Park on the west shore of Canandaigua Lake, the 17th annual Tour de Thompson will be held Saturday, July 27. To date, this bicycle tour offering scenic views has raised more than $47,000 to help rehabilitation services patients maintain their independence at home and in the community in the “aftercare” program at UR Medicine Thompson Health. Tour de Thompson offers three options: a 15-mile route, a 30-mile route and a 62.5-mile metric century with 6,800 feet of challenging climbs. Rest stops along the way keep riders fueled up and hydrated while vehicles are on hand to help with flat tires or other mechanical issues.  All routes end with a picnic lunch, swimming, leg massages and all the amenities the park has to offer.  With check-in beginning at 7 a.m., there is a mass starting at 8 a.m. Riders have until 9 a.m. to depart.  Ride shirts are offered to the first 100 riders to sign up at www.Thompsonhealth.com/TdT. Registration fee from June 16 until July 15 is $35. After July 15, registration goes up to $40 (including the day of the ride). Online registration will close on July 24, with in-person registrations accepted the morning of the event payable by cash or check only. Follow the event’s Facebook page for updates and contact Ride Director Dudley Hallstead at 585396-6050 with any questions.  

UR Medicine’s Wilmot Cancer Institute will host its seventh annual Wilmot Warrior Walk on Sunday, Sept. 8, at the Highland Park Bowl in Rochester. Registration is now open for the annual event that features a certified 5K, certified 10K and a 1-mile walk, as well as a post-race celebration. Proceeds support cancer research and the Judy DiMarzo Cancer Survivorship Program at Wilmot Cancer Institute, but it’s not just a fundraiser. This event is meant to unite those touched by cancer.  “Cancer doesn’t just impact the person diagnosed. It impacts entire families and communities. By coming together, we can have a more meaningful impact on local cancer research for those facing cancer in the future,” said physician Jonathan W. Friedberg, director of Wilmot Cancer Institute. “Our researchers want to find better ways to treat cancer, but we can’t do it without our community’s support. I invite everyone to come out and join us for what’s always been a moving day.” Since the event began in 2013, it’s raised more than $575,000 and this year, the goal is to raise more than $200,000.  Registration for the Wilmot Warrior Walk costs $30 per person if you register online; the cost is $40 per person the day of the event. Participants can register online through Friday, Sept. 6, at Medved Running & Walking Outfitters or on the day of the event. To learn more or register, visit WarriorWalk.URMC.edu. For any questions and sponsorship opportunities, call 585-276-4717

Tour de Thompson benefit Registration opens for bike ride set for July Wilmot Warrior Walk

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 5

6/17/19 4:30 PM


Meet

Your Doctor

By Chris Motola

Lisa Smith, M.D.

New president of Monroe County Medical Society wants to reduce administrative burden for doctors, among other goals Q: You’re the new president of the Monroe County Medical Society. A: Correct, yes. Just elected last in April. Q: How is the transition going? A: It’s going very well. I was very lucky to have an excellent predecessor; he [physician Surinder Devgun] left the society in good health. Q: What aspects of his legacy do you want to pick up and where do you want to diverge? A: So I would say that, and I don’t want to speak improperly for him, but some of what he wanted to focus on was physician wellness, which is kind of a big topic, as well as communications and connections with members. Certainly advocacy was a big issue. We’re actually a local branch of the Medical Society of the State of New York, so that’s where we do more of our advocacy with the state legislature. I would say those are all initiatives that were important to him. I know he worked with the health department as well around the issue of opiates. So those are all issues that will be ongoing for us. I would say I certainly want to continue those. A big push for us right now is working on our membership and providing value to our members. We’re working on some pharmacy initiatives around electronic prescribing and safety. Anything we can do to reduce administrative the burden for physicians is also important. I would say those are just some of the initiatives. Q: On the topic of administrative burdens, is that picture getting better or worse? A: I think as far as the administrative burdens, it stays about the same overall. As soon as we make progress in one area, invariably a new program will pop up that requires increased physician time. I’m not sure if we’re winning overall, but we’re doing our best to manage new demands. We try to work on each piece at a time and try to be better advocates for physicians.

in Monroe County. Has the county been able to retain many of them after they graduate? A: I’m not sure if I’m the best one to answer that since I don’t do a lot of recruiting myself, but we have had some concerns raised at our meetings about hospital crowding and the need for beds, so that’s probably been more of where shortage issues are. But as far as physician recruiting and retention goes, we do have a very good university and draw a very high quality of trainees. I think we’re in a lot better shape than most cities our size. We really have two very good vibrant hospital systems in the city, which is remarkable. I think a fair number of people do come here to train and some of them do stay. Rochester is still highly regarded across the nation as a place where physicians work collaboratively and we’re very patient-centered. Q: What are your personal priorities for the society? A: Our stated mission is to be advocates for patients, but also one of the ways we can best help them is to be advocates for physicians and helping them to do their job as best they can. And the overall focus is on improving the health of the community.

Q: You mentioned electronic prescriptions as an area the society was working on. A: Yeah, electronic prescribing, and there’s an initiative in the community now called Cancel Rx. Up until now, the pharmacy had no way of knowing if a physician discontinued a prescription. So this initiative is in a pilot phase now, but now with electronic prescribing, physicians are able to communicate that to pharmacies. So it’s safer for patients and helps all providers know what medications patients are receiving. That started about a year ago by setting up a pharmacy committee with stakeholders from the hospitals, physicians and pharmacies in the community. Q: How does being president of the medical society affect your practice? A: I would say so far it’s mostly positive. The way our board works, I started as treasurer, then a year as secretary, then a year as president-elect, so you kind of have time to see how it all works and know what’s coming. I have been able to make some changes in my own primary care practice so I’ll have the time to dedicate to it. I’ve been on the board since 2014, so it’s been an evolution. We also have a terrific executive director, Chris Bell, who has been there about three years now. That makes a huge difference, along with all the staff. We also have a robust board of directors, so that certainly helps with my job. Interestingly, for the first time ever, all our officers are women now. We didn’t necessarily plan it that way, but that’s how it turned out.

Q: With a lot of physicians reaching retirement age, have membership levels changed? A: Good question. The organization is about the same size. In the medical society, even retired physicians can be members. They’re in a different category of membership, but they’re still members. We’ve also been increasing the number of residents and medical students who are members. So our overall membership numbers have been about the same. Q: A lot of physicians are trained Page 6

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019

In The News Lisa Smith, a Rochester-based internist and pediatrician, was elected to serve as president of Monroe County Medical Society during the 2019-2020 period. Smith completed her combined internal medicine-pediatric residency at URMC in 1999. She is dual board-certified and a fellow in the American College of Physicians. She recently joined the Primary Care Network at URMC after nearly 20 years in private practice at Ridgewood Med Peds in Greece. As a clinical instructor, she has been teaching internal medicine-pediatrics (med-peds) residents during continuity clinic and practice-based rotations throughout her career. Smith has been a member of Monroe County Medical Society since 1999 and a board member since 2014. She was a delegate to the Medical Society State of New York (MSSNY) house of delegates in 2018. She previously served on the Rochester General Physician Organization board of directors from 2007 to 2016.

Q: Have you noticed a different dynamic with it being all women? A: Not really any differences yet, though we were just seated in May. I think it will function about the same, just with different voices. Our board is also diverse in the sense that we’re all coming from different specialties; some of us are in private practice, some of us are employed. Q: How do you keep initiatives in scope? There are probably so many things you’d love to do, but are hard to implement on a local level. A: What we try to do is focus on things that will have an impact locally. Having said that, the vast majority of things that are good for our community will be good for any community. That’s why we kind of have the structure set up that we do. So in addition to the Monroe County Medical Society, we are also a part of the Medical Society of the State of New York, so we can submit proposals through them at the state level. A number of a local physicians are officers on committees at the state level, and the state in turn sends representatives nationally. So anything that we can’t get done locally can be taken up at the state level.

Lifelines Name: Lisa Smith, M.D. Position: President of the Monroe County Medical Society; Internal Medicine-Pediatric physician Hometown: Pittsburgh, Pennsylvania Education: University of Maryland at Baltimore Affiliations: Rochester Regional; University of Rochester Organizations: Monroe County Medical Society; American College of Physicians Family: Partner of 15 years (Jim Savino) Hobbies: Travel


FACT or FICTION? Gambling and Gaming are portrayed as glamorous, exciting and easy money, BUT often lead to serious financial problems, depression and substance abuse.

More Than 1 Million New Sexually Transmitted Infections Every Day

Chlamydia, gonorrhoea, trichomoniasis and syphilis lead list of most common STI cases

E

very day, there are more than 1 million new cases of curable sexually transmitted infections (STIs) among people aged 15-49 years, according to data released in June by the World Health Organization. This amounts to more than 376 million new cases annually of four infections: chlamydia, gonorrhoea, trichomoniasis and syphilis. “We’re seeing a concerning lack of progress in stopping the spread of sexually transmitted infections worldwide,” said physician Peter Salama, executive director for Universal Health Coverage and the LifeCourse at WHO. “This is a wake-up call for a concerted effort to ensure everyone, everywhere can access the services they need to prevent and treat these debilitating diseases.” Published online by the Bulletin of the World Health Organization, the research shows that among men and women aged 15–49 years, there were 127 million new cases of chlamydia in 2016, 87 million of gonorrhoea, 6.3 million of syphilis and 156 million of trichomoniasis. These STIs have a profound impact on the health of adults and children worldwide. If untreated, they can lead to serious and chronic health effects that include neurological and cardiovascular disease, infertility, ectopic pregnancy, stillbirths, and increased risk of HIV. They are also associated with significant levels of stigma and domestic violence. Syphilis alone caused an estimated 200,000 stillbirths and newborn deaths in 2016, making it one of the leading causes of baby loss globally.   STIs remain a persistent and en-

demic health threat worldwide. Since the last published data for 2012, there has been no substantive decline in either the rates of new or existing infections. On average, approximately one in 25 people globally has at least one of these STIs, according to the latest figures, with some experiencing multiple infections at the same time. STIs spread predominantly through unprotected sexual contact, including vaginal, anal and oral sex. Some — including chlamydia, gonorrhoea, and syphilis — can also be transmitted during pregnancy and childbirth, or, in the case of syphilis, through contact with infected blood or blood products, and injecting drug use. STIs are preventable through safe sexual practices, including correct and consistent condom use and sexual health education. Timely and affordable testing and treatment are crucial for reducing the burden of STIs globally, alongside efforts to encourage people who are sexually active to get screened for STIs. WHO further recommends that pregnant women should be systematically screened for syphilis as well as HIV. All bacterial STIs can be treated and cured with widely available medications. However, recent shortages in the global supply of benzathine penicillin has made it more difficult to treat syphilis. Rapidly increasing antimicrobial resistance to gonorrhoea treatments is also a growing health threat, and may lead eventually to the disease being impossible to treat.

Serving Monroe and Ontario Counties in good A monthly newspaper published

Health Rochester–GV Healthcare Newspaper

by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations.

In Good Health is published 12 times a year by Local News, Inc. © 2019 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Christine Green, Mike Costanza, Bill Ferris (DC) • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas • Office manager: Nancy Nitz 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.

July 2019 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 7


Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Friendships Can Blossom Any Time of Year: It’s Never Too Late Question from a reader:

I’ve been divorced for about a year now, and struggle with loneliness. I miss the friends we shared as a couple, but I’m just not comfortable socializing with couples anymore. I’m 56, and it feels awkward to try to make friends at my age. Any advice for me?

Answer from Gwenn:

I

t’s unfortunate, but what you are experiencing often happens in the aftermath of a separation or divorce, especially if it was acrimonious. Friends’ loyalties can be split and, just as you feel uncomfortable relating to your former “couple” friends, some couples feel uncomfortable relating to a now-single friend. So how do you meet new people and cultivate friendships as an adult? Here are a few tips: First, be your own best friend. Taking care of yourself matters. Loving yourself shows. The better you feel about yourself, the better friends you’ll attract. Positive people appreciate and gravitate to other healthy,

positive people. Do what you like doing. You won’t make friends sitting alone at home. Get out of the house and do those things you enjoy, whether it’s going to the gym, walking your dog, taking a cooking class, joining a book club, or any number of activities that are fun and active. You’ll meet people who share your interests and love of life. Friendships will likely follow! Consider a support group. It’s not uncommon for new friendships to be borne out of compassion and empathy. A divorce or grief support group will put you in touch with others facing similar challenges. A friend of mine met her second husband in a divorce support group. She shared, “We got to know each other as friends first, and have remained ‘best friends’ throughout our marriage. It’s the best thing that ever happened to me.” Say “yes” to invitations and opportunities to be with people. Circulating at parties, neighborhood meetings, work events, etc. is one of the easiest

ways to make new friends. You’ll be out and about with people with whom you share something in common. Show up and don’t be shy about extending an invitation to someone you meet. It could be a cup of coffee, drinks after work or walk in the park. Don’t overlook your family. My sister is my best friend, and she helped me re-establish a network of friends after my divorce. I had gone into the proverbial “cave” and lost contact with practically everyone. Her friends became my friends, and now, years later, I enjoy the company of her friends, as well as my own. Rekindle relationships with old friends. Sometimes friends drift away when you get married, and are therefore long gone when you may need them most. That’s not unusual. New priorities take over and establishing a new married life together requires time and focus. But now, when you’re looking to find new friendships, consider reconnecting with old friends. They were an important part of your life at one point, and may still have lots to offer. Pick up the phone. Give a “singles” event a try. Many divorced or widowed men and women find fun and friendship in community activities organized just for singles. It could be a hike, bike ride, dinner club or dance. These opportunities are often included online in community calendars or in your local newspaper. Volunteer or join a cause. Supporting an organization or cause you believe in will put you in contact with people working toward a common goal. Community gardens, political

parties, hospitals, museums, animal shelters and many other organizations often need volunteers. Strong connections can be made when you work alongside others who want to make the world a better place. Join an online community of people who share your interests. Social networking sites can be a safe and satisfying way to meet people. One popular site is www.meetup.com, which facilitates group meetings in cities and towns near and far. Meetup allows members to find and join groups unified by a common interest, such as nature, photography, hiking, books, movies, health, pets, careers, hobbies, you name it! Good friendships can make life better. The company of someone who makes you laugh, who provides a shoulder to lean on when you need one, and who is just plain fun to hang out with can provide a welcome boost to your health and happiness. So, if you feel your social network is too small, remember you can always meet new people, make new friends, and nurture existing ones. It’s never too late. Gwenn Voelckers is the founder and facilitator of “Alone & Content” empowerment boot camps for women held throughout the year in Mendon. She is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about her boot camp, to purchase her book, or invite her to speak call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com

I’m ready to live. That’s why I’m making the move—while I’m still young enough to enjoy the pool, the fitness center, the excursions, dining, entertainment and all the friendly people. Lots of people my age want to slow down. Not me, I’m just getting started.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019


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Healthcare in a Minute By George W. Chapman

‘Surprise’ Bills —Senate Health Committee to Deal with Problem

T

hese are bills sent to you by providers who, unbeknownst to you, are non-participating providers in your insurance plan. They can send you a bill for the difference between their charge and what your insurance company paid them. (Participating providers contractually agree to accept your insurance payments.) A typical example would be when you receive services from a participating hospital emergency department only to learn when the bill arrives (surprise!) that the emergency department is staffed by a national MD group that doesn’t accept nor participate in your insur-

Price Transparency

The same bill that addresses “surprise” billing also addresses price transparency. It would require providers and insurers to give patients price quotes on expected out-of-pocket expenses so consumers can shop around. It would require insurers to keep up-to-date directories so patients know what providers are in network in the first place which would virtually eliminate surprise bills. It would also ban anti- competitive language in contracts between an insurer and a healthcare system that prevent patients from seeking lower cost/higher quality providers.

JAMA and Single Payer

For the first time in a long time, JAMA (Journal of American Medical Association) published an opinion piece supporting the concept of a single payer for healthcare. Recent surveys and polls reveal half of

ance. The obvious question is, why would a participating hospital staff its ED with non-participating providers? The answer is they may not have much of a choice, especially if it’s a hard-pressed rural hospital that cannot maintain its own staff. A rare bipartisan bill coming out of the Senate health committee deals with surprise bills. It would require all providers that work for an “in network” hospital to accept a patient’s insurance. In this ED example, the national MD staffing group company must agree to become participating providers or agree to send their bill directly to the hospital vs. the patient. physician respondents now support the concept of a single payer system for healthcare. This was not nearly the case 20 years ago or so, when commercial payers paid physicians considerably more than Medicare for the exact same service. Over time, commercial insurance companies gradually lowered their fees to the equivalent of Medicare fees, or close to them, causing a lot of physicians to wonder what’s the point of the administrative hassle created by multiple payers if all are now paying about the same as Medicare. The Medicare physician fee schedule, once derided as a necessary evil by physicians, has become the “gold standard” of all physician fees. By dropping their fees to Medicare equivalents, commercial carriers have unwittingly created the case/ justification for a single payer system. Despite the rationale, physicians remain justifiably wary of a single July 2019 •

payer that would have a monopoly on their fees. To counter, the idea of a physician’s union has been floated.

Advantage Plans

Medicare Advantage (MA) plan applications were up 87% the first quarter of 2019 vs. the same period last year. MA plans are administered by commercial carriers like Aetna, Excellus, Cigna, United, etc. They typically charge a small premium more per month than regular Medicare because they offer more benefits. The typical MA “premium” decreased this year from $12 to $8 a month. Industry experts believe the price drop is due to competition, increased efficiency and tech savvy baby boomer consumers. Seniors are free to move back and forth between regular Medicare and MA plans during annual open enrollment periods. People who switched from traditional Medicare to an Advantage plan spent/cost an average of $1,253 per year less (2016 versus 2015) than those remaining on traditional Medicare.

ACA Best Year Ever

Despite more than 60 attempts to repeal the Affordable Care Act and continuing efforts to scuttle the ACA by the current administration, the insurers still offering individual plans on the exchanges are not only surviving but are thriving. They are experiencing their best year ever. As some major carriers either scaled back or completely exited the exchanges, primarily due to the uncertainty created by Washington, other carriers took advantage of the void and either newly entered the market or expanded their existing footprint. The Kaiser Family Foundation looked at insurer performances between 2011 and 2018. In 2015, there was an average loss of $9.21 per member per month

for all participating insurers. The corresponding “medical loss ratio” was 103%, meaning the insurer spent 3% more on claims than it made in premiums. In 2018, the insurers made an astounding $166.82 per member per month. The corresponding medical loss ratio was an industry enviable 70% meaning the average insurer spent 30% less on claims than it made in premiums. The ACA requires a small market insurer to refund money to its members when their medical loss ratio is under 80%. Stated another way, insurers can keep up to 20% of their premiums, but must refund anything over that. All told, insurers will refund about $800 million to members.

CVS Health Hubs

As further evidence of the expansion and encroachment of retail corporations into the provision of healthcare, CVS announced it will increase its community-based hubs by 1,500 locations over the next two years. Twenty percent of a CVS store will be dedicated to these “HealthHUBs” that will provide “new product categories, digital tools, on-demand health kiosks, trusted advice and personalized care.” CVS argues it is fulfilling unmet consumer preferences and is keeping up with competitors like Walmart.   George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 9


Cathedral Pool has no enclosure. The room itself provides darkness, quietness and warmth. This double-occupancy pool is a popular choice for those with concerns of claustrophobia. Photo provided.

Tranquility Pool does not have an enclosure. The room itself provides darkness, quietness and warmth. It features a pod-like shape, and is designed for solo floaters. Photo provided.

Want to Relax? Try ‘Floating’

Bodymind Float Center in Rochester takes relaxation to whole new level By Christine Green

I

magine being in a deep, peaceful state of meditation. Your body is weightless, your muscles relaxed and loose, your mind at ease. In the distance, soft music begins to play. As the “Adagietto” movement from Mahler’s Symphony #5 grows louder, you drift back to consciousness one music note at a time. You aren’t in a dream; you’re floating in a warm saltwater bath at Rochester’s Bodymind Float Center on Park Avenue. What is “floating?” First, 800 pounds of pharmaceutical-grade manganese sulfate (Epsom salt) is dissolved in about 10 inches of skin temperature water in a large tank. The tank is housed in a private, dark and quiet room. “Floaters” at Bodymind Float Center shower, then enter the tank and relax for 90 minutes until Mahler’s “Adagietto” begins to play, letting them know their float time has come to an end. Floaters dry off and dress after another shower to clean off the salt. But what drives people to spend over an hour in a salty tub? Floaters from around the world partake in floating sessions to help reduce stress, relieve aches and pains, aid in meditation and prayer, and to simply get away from it all in a quiet and comforting environment. Nichole Green of Brockport found her experiences at Bodymind Float Center stimulated a deep sense of peace and relaxation. “I can be pretty anxious, and I have some mild claustrophobia, so prior to my visits I was a little nervous about being in a confined space, not really knowing how confined it would actually be,” she said. “I have floated in the open tranquility pod, and the closed escape tank, and neither one posed any discomfort. I actually lost my spatial awareness rather quickly and felt that the space I was in was quite vast. When you’re Page 10

floating, you get to turn off reality for a while, and truly decompress.” Floaters can feel this decompression in the physical body as well since the sensation of weightlessness can take pressure off of overworked or tired muscles. “Most people experience quite a strong release of muscular spasm,” said David Brinkman, founder and owner of Bodymind Float Center. “In a float tank, it’s almost as though the body’s own wisdom can direct the spine to find its natural position.”

Life-changing experience

Brinkman knows first-hand how floating can relax both body and mind. A violinist, he traveled to Portland, Ore., to audition in 2012. The friend he was staying with invited him on a float, a concept totally new to Brinkman at the time. “I was just amazed by how I felt afterwards. I came out of the float tank and felt so good and so calm,” he said about his first float. As an experienced person who meditates, Brinkman was impressed that only 90 minutes of floating could induce such a sense of meditative peace. “I knew that I wanted to do it some more, and I knew instinctively other people would benefit a lot from floating,” he noted. He called his wife, Pattie Sunwoo, and told her he wanted to open a float center in Rochester and she encouraged him to go for it. By January of 2013, Brinkman and Sunwoo had installed a float tank in their basement, and by March of that year, they had insurance coverage that allowed them to bring clients into their home for float sessions. “Our basement became a little training ground for us on how to operate the machinery of a float tank, how to promote the business a little bit, how to talk about floating, and

what needed to be present in the room so that a person could do the float and be comfortable,” he said. In September of 2013 — only about one year after Brinkman’s first float experience — they opened Bodymind Float Center, the only float center in Rochester. In February of 2017, they opened a float center in Syracuse as well. Green added that, for her, floating was a great way to relax and encouraged others to give it a try. “I left feeling very physically and mentally relaxed, and it put me in a space where I was better able to handle the stresses of everyday life, and those effects last for as long as you allow them to, really,” she added.

Halotherapy

Float tanks aren’t the only service offered at Bodymind Float Center. Guests can also experience the benefits of halotherapy or the use of salt to aid in respiratory health. In the center’s “salt room,” clients relax in lounge chairs while microscopically ground sodium chloride is blown into the air. The salt is hydrophilic, meaning it attracts water to it, thus thinning mucus in the airways. The salt’s antimicrobial and anti-inflammatory properties are also said to

alleviate the symptoms of allergies, asthma, earaches, and sinus issues. Halotherapy is considered safe for most people, even children. Each session is 45 minutes long and clients can listen to music on headphones, nap, read, or simply relax while experiencing the salt room. Elaine Paratore of Webster visited the salt room for the first time recently. “I tried to do some deep breaths to inhale the salty air and didn’t notice much at first, but at the end of the session, I felt a slight tingling sensation in my chest. As a spring allergy sufferer, I did notice that the salt helped drain my sinuses,” she said. “I would go again, especially if they have another special offer. I’m definitely going to try the float room one of these days.” To learn more about floating or halotherapy, visit bodymindfloatcenter.com.

How Much Does it Cost?

Floating • Solo float: $65 • Couple’s float: $95 Salt room: • One session: $30 • 5-session package (shareable): $100

David Brinkman, founder and owner of Bodymind Float Center, and his, Pattie Sunwoo, paying violin at the float center.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019


Nurse Practitioners Stepping in for Physicians Report shows rise in number of NPs in medically underserved area as number of doctors in those place declines By Mike Costanza

M

ore and more nurse practitioners are working in medically underserved parts of the US. “The nurse practitioner workforce is growing and filling the low supply of physicians in those areas,” said Ying Xue, associate professor at the University of Rochester School of Nursing. Xue — who holds a Doctor of Nursing Science degree — is the lead author of “Primary Care Nurse Practitioners and Physicians in Low-Income and Rural Areas, 20102016,” which recently appeared in the Journal of the American Medical Association. In New York state, NPs must be registered nurses who have graduated from a New York State Education Department-approved nurse practitioner education program, or been certified by an approved national certification program. They can specialize in 14 areas, including adult health, pediatrics and psychiatry. According to the American Association of Nurse Practitioners, 89 percent of U.S. NPs are trained to provide primary care in adult, family, gerontological or pediatric medicine and women’s health. The degree of autonomy that an NP has in patient care depends upon the state in which he or she practices. In New York state, they are independently responsible for diagnosing and treating their patients as long as they satisfy certain requirements. For example, those who have less than 3,600 hours of professional experience must practice in accordance with written protocols. They must

Among primary care providers who are not physicians, NPs constitute the largest and fastest growing group in the country.

Ying Xue, associate professor at the University of Rochester School of Nursing. also have a written practice agreement with a collaborating physician, and satisfy other requirements. New York’s NPs do not need to work under a physician’s supervision. Among primary care providers who are not physicians, NPs constitute the largest and fastest growing group in the country. In 2016, that group numbered 123,316, a nearly 52% increase over 2010. While that might comfort those in need of care, a 2017 study commissioned by the American Association of Medical Colleges projected that by 2030, the U.S. could face a shortage of as many as 104,900 physicians. July 2019 •

Those trends are playing out in rural and low-income areas across the U.S. Xue and her two colleagues analyzed data on the numbers of primary care nurse practitioners and physicians who were working in those locales during 2010 through 2016, along with the communities’ economic characteristics. The researchers found that the average number of physicians working in the poorest communities fell from 52.9 to 52 per 100,000 people over that period. In rural communities, the average fell from 59.5 to 47.8 per 100,000. Losses of this kind can reduce access to medical care. “Adequate access to care is really related to health outcomes, so assuring that we have adequate clinicians serving in those areas is very, very important,” Xue explains. By contrast, the average number of nurse practitioners who were working in the poorest communities was 19.8 for every 100,000 people in 2010. By 2016, it had more than doubled, to 41.1. Among rural communities, the average number of NPs jumped to 41.3 per 100,000 in that

time, a nearly 64% increase. “It’s very assuring that we see that there’s a growing trend of NPs at this time,” Xue says. Xue suggests that growth in the number of community health centers in the U.S. might be drawing primary care nurse practitioners into underserved locales. According to the National Association of Community Health Centers, more than 11,000 community health centers serve America’s rural and urban communities. Over 28 million people turn to them for primary medical care. “Those are the infrastructure that facilitate the clinicians to serve in those areas,” she explains. Katie Sisson had other incentives. After working as a registered nurse at a Batavia hospital for a number of years, Sisson decided to become a family nurse practitioner. For about the last three years, she has practiced at Bergen Family Medicine, a primary care outpatient practice that serves about 2,400 patients in Bergen. The rural town sits about midway between Rochester and Buffalo. “We have a population in this community of older, retiring physicians, and I saw a need to be met by nurse practitioners,” Sisson said. In addition, her current job represents a kind of homecoming. Though she lives in Batavia, she’s a Bergen native. “I actually grew up and went to school across the street from my practice,” she says. “So, for me, I’m giving back to the community.” Bergen Family Medicine, which is part of the Rochester Regional Health System, has a relatively small staff — a physician, a registered nurse, two licensed practical nurses and three other employees, plus Sisson. She provides a full range of medical care for her patients. “We offer a lot of services where people can really stay in their town to receive care,” Sisson says. “You’re using a lot of your clinical judgment and clinical skills.” She relishes putting those skills to use for her patients. “What gets me up and coming to work every day is the difference you make in their lives,” Sisson says.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 11


Summer Care

Do’s & Don’ts:

Summer Fitness for Women By Deborah Jeanne Sergeant

W

arm, sun-filled days can jumpstart your fitness routine. Try these tips from area experts to make this your fittest summer yet. • “Try to work out in the morning, when it’s not as hot and there’s less sun so you won’t get as dehydrated. • “Try biking, running, swimming, even walking. • “Whatever the activity is, if you want to consider it exercise, do something above what you’re doing. If you walk the dog every day, you need to exert yourself beyond that. Get in 30-minute increments five times per week. But that doesn’t eliminate the necessity of strength training. Many women don’t strength train. • “Muscles need to be conditioned to avoid injury. Sometimes, you jump into a running program or biking program and if your body’s not conditioned to that, you’re at high risk for injury. The last thing

you want to do is injure yourself so you can’t do as much. and you get even more de-conditioned.” Kevin Silverman, certified personal trainer with Brighton Personal Training, Brighton. • “Hydration is a huge thing. Drink plenty of fluids and water, even if you’re not doing a lot of outdoor activity. Many people miss this. The outside heat factor makes a big difference. Exercising near the canal or by the lake, it’s a little cooler. • “We like to go to the park with our kids and do a workout while they’re playing. You can use the monkey bars and take advantage of things that aren’t in the gym. • “If you have a pool or can get on the lake, swimming is a good, fullbody workout and you stay cooler. “ John Nizamis, owner of Studio 22 Fitness, Hilton. • ”As a gym owner, we want people to come in the gym, but biking and activities outside are benefi-

cial to health. • “In the gym, it depends upon what type of workout they’re doing. It’s important to work with a partner if you are lifting heavy weights so you have a spotter. Working with another individual helps with motivation and for safety. • “In the heat, short blasts of working out when you’re outside is better and then cool off. Some workout all day outside, and it’s about hydration. Don’t get overheated. • “If you’re pregnant, be careful about the strenuous exercise and the heat for safety. Do what your doctor says to do and avoid overdoing it. • “You’ll see guys in the gym working on muscles and women working on step machines, treadmills and cycling. Men could do more cardio and women could do more weightlifting to stay toned. I hate walking and running, so I’m guilty of it, too. I will go for the bench press, not the treadmill. • “Many people don’t lift

weights properly. You should lift less weight and perform more repetitions. That is better for building muscle tone instead of lifting 250 pounds three times. You don’t use the muscles it’s meant for.” Matt Garver, general manager and part-owner of Atlas Body Development Center, Spencerport.

Eat Right This Summer

Picnics, parties, barbecues, ice cream stands — they’re all summer staples and all ways to derail your healthful eating plan. Three area experts offered tips on how you can eat right this summer By Deborah Jeanne Sergeant • “Plan ahead. Avoid going to a fair or festival really hungry and then end up eating a lot of unhealthy foods that are fried or high in refined sugar. • “Bring healthful snacks: things like cut up fruits and veggies, peanut butter dip, cheese and crackers. Plan on eating your favorite festival treat as well. You will want to enjoy yourself and not feel like a ‘cheat day’ is going to derail your healthy eating goals. Plan on what one or two treats you want to enjoy, you can ask for a sample portion or split the item and share with someone else so you don’t overeat. • “If you are attending a party and you don’t know what will be served, you can eat a small meal or snack before you go so you will control your portions. If there are healthy choices likes salad, fruits, vegetables and lean protein like chicken and fish, choose those items. Instead of snacking throughout a party, which makes it hard to monitor how much you are taking in. Make a plate once and commit to not eat additional servings. • “Don’t forget that beverages can also contain a lot of calories from added flavors, sweeteners, creams, etc, and watch the size of shakes, smoothies and other mixed beverages you consume. Depending on the beverage, a medium or large can be Page 12

1,500 to 2,000 calories, your recommended calories for an entire day. • “Make a point to enjoy conversations with friends and family. Take part in the activities at your summer parties so don’t find yourself mindlessly snacking the time away. Embrace summertime foods with a plan and enjoy all the season Smith has to offer.” Hannah C. Smith, registered dietitian and eastern region clinical nutrition manager at Rochester Regional Health: • “I preach moderation and balance in regard to eating right. • “Make little substitutions at a time. They can make a big difference. We can make popsicles with real fruit instead of the ones with high fructose Nizamis corn syrup.

Make fruit kebabs or turkey burgers as a healthful alternative. • “Fill up on veggie trays before chips. • “For desserts, fruit is the healthy sugar.” Maddie Nizamis , certified personal trainer, certified in fitness nutrition at Studio 22 Personal Training in East Rochester: • “It’s both a mind and body approach. That’s what I do with patients, myself and my family. Most people go into the summer and it’s the same old cycle of restrict, restrict, restrict and indulge, indulge, indulge. Being more mindful so you can enjoy life is the better approach. It’s a whole lot more than avoiding ice cream. I’d say, have it. Think about your motives and intentions. Bring mindfulness back. • “I like to experience a location based on its food. If I’m going to Germany and I’m going to choose food that bring me joy. I’ll dive in and not feel bad about it. I’ll maybe walk a little more and balance out that indulgence by other ways to stay healthy. • “At a family barbecue, it’s not really about the food. It’s the same old hot dogs and potato salad. The family is what brings me joy. Maybe I’ll steer myself toward healthier options. Remembering those intentions will gear your mind up towards

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019

what’s important. • “Find your fiber. What we often do because we’re smart about nutrients is over think it and become immobilized. Instead of thinking about magnesium or B-12, let those go by the wayside and find the fiber. Those are plant-based foods. Most of us don’t get enough nuts, whole grains, fruits and vegetables. • “Focus on the whole day of eating. Maybe for breakfast and lunch, fit in more plant-based foods. If you don’t get fiber at the barbecue you won’t have to work at it. • “My hope is that for barbecues or vacations, people should enjoy their lives. • “Stay hydrated, especially where there’s alcohol at a gathering and it’s sunny. Drinking enough water can help you get your head in the game and make better choices. Jill Chodak, registered dietitian Chodak at the Center for Community Health & Prevention of the University of Rochester Medical Center:


5

Things You Need to Know About Skin Cancer Prevention

Summer Care

By Ernst Lamothe Jr.

S

imply put, skin cancer or melanoma is one of the deadliest of skin cancers. In 2019, it is estimated that there will be 96,480 new cases of melanoma in the United States and 7,230 deaths from the disease, according to the Melanoma Foundation. In the U.S., melanoma continues to be the fifth most common cancer in men of all age groups. Rates of diagnosis for the disease have increased dramatically over the past three decades, outpacing almost all other cancers. Today, it is one of the most common cancers found among young adults in the United States. Ultraviolet rays are an invisible kind of radiation that comes from the sun, tanning beds and sunlamps. UV rays can penetrate and change skin cells. “Sun protection is important because it decreases the chances of having cancer and helps with the overall quality of your skin,” said Marc Brown, dermatologist at UR Medicine in Rochester. “People want their skin to be healthy but extensive sun damage can extensively cause issues that can’t always be reversed.”

1.

Use sunscreen

Use broad spectrum sunscreen protection every time you go outside. For the best protection, apply sunscreen generously 30 minutes before going outdoors. Reapplication of sunscreen is just as important as putting it on in the first place, so re-apply the same amount

every two hours. The term “water resistant” means that the sun protection factor (SPF) is maintained for up to 40 minutes while swimming or sweating. Very water resistant means the SPF is maintained for 80 minutes. “I have some patients that talk to me about how they were very careful not to use too much sunscreen and they didn’t even go through an entire bottle during the summer,” said Brown. “I tell people use sunscreen liberally. There is no reason to save it.”

2.

Be careful when you are outside The Centers for Disease Control and Prevention says rays from the sun can reach you on cloudy and hazy days, as well as bright and sunny days. UV rays also reflect off of surfaces like water, cement, sand and snow. UV rays are strongest and most harmful during midday. Experts say stay out of the sun when it is strongest between 10 a.m. and 2 p.m. “I like to be outdoors playing tennis, biking and hiking but I make sure that I am not outside during peak times,” said Brown. “You should revolve your activities around times when the sun is not as intense.” When possible, long-sleeved shirts and long pants and skirts can provide protection from UV rays. Clothes made from tightly woven fabric offer the best protection. A wet T-shirt offers much less UV protection than a dry one, and darker colors may offer more protection than

lighter colors.

3.

Avoid tanning booths Because tanning beds have been around for so long, many people believe using them to get a tan is a safer than exposure to sunlight. That is not true. Tanning beds radiate UVA rays, which penetrate the skin more deeply and damage collagen, the basic building block of our skin and elastin that helps us look younger, according to the Cleveland Clinic. There are studies that say you risk of skin cancer can go up 15% for every four tanning bed visits. “If it was up to me I would want every tanning booth to be closed,” said Brown. “About 30 to 40 years ago, tanning booths began and the claim was that it was safe to darken your skin but that claim is simply wrong. A suntan is evidence of damaged skin. There are some people who tan three to four days a week and that is damaging their skin long term.”

4.

Avoid smoking Smoking rates in the U.S. have declined in recent decades. However, about 15.5% of the population — or about 37.8 million adults — still smoke cigarettes, according to the latest numbers from Centers for Disease Control. And with the popularity of e-cigarettes, which are battery-operated devices that people use to inhale an aerosol that typically contains nicotine, the issue is not going away.

Marc Brown, dermatologist at UR Medicine in Rochester. “Smoking has a direct connection to aging skin. I tell people if they want better skin one of the first things they can do is quit smoking,” said Brown.

5.

Talk with a dermatologist A change in your skin is the most common sign of skin cancer. This could be a new growth, a sore that doesn’t heal, or a change in a mole. Melanoma lesions are often darkly pigmented and could have some uneven borders. They can be one-fourth inch in diameter. “We can do so much if it is detected early. If you see a change in any of your moles in asymmetry, color, diameter or the evolution of the look you should have it checked,” said Brown.

Many Sunscreens Sold in US Offer Suboptimal Protection: Report

S

unscreen is a must-have for summer, but be advised: About two-thirds of sunscreens available in the U.S. offer suboptimal protection or contain ingredients that may harm your health, according to a new report. For the report, scientists with the Environmental Working Group (EWG) reviewed 1,300 sunscreen products, including beach and sports sunscreens as well as daily moisturizers and lip balms, for the group’s annual Guide to Sunscreens, released May 22. EWG is a nonprofit advocacy organization in Washington, D.C., that focuses on environmental issues and public health. The researchers ranked sunscreens based on several criteria, including whether ingredients listed in the products are linked with health hazards and how well the products work to block ultraviolet A (UVA) and ultraviolet B (UVB) rays, both of which can damage the skin and cause skin cancer. As in prior years, EWG found that most sunscreens weren’t up to par: Only about 34 percent of the products reviewed met EWG’s strict standards. The report authors note that earlier this year, the Food and Drug Administration (FDA) proposed sweeping changes to its sun-

screen regulations aimed at improving the safety and effectiveness of the products. For example, the FDA called for additional evidence on the safety of a dozen common sunscreen ingredients for which safety testing is surprisingly lacking. Many of the FDA’s proposed changes are in line with EWG’s recommendations. However, these changes won’t apply to sunscreens on the shelves this summer, the report said.

Safety questions As part of the FDA’s proposal, the agency asked the sunscreen industry for additional evidence on the safety of 12 common sunscreen ingredients. EWG found that these 12 ingredients were used in more than 50 percent of the sunscreens reviewed for this year’s guide. EWG is particularly concerned about a sunscreen chemical called oxybenzone, and the organization doesn’t recommend sunscreens with this ingredient. This chemical may act as a hormone disruptor in humans and has been found to damage coral reefs. An FDA study published in the spring also found that oxybenzone and at least three other common sunscreen chemicals can leach into people’s blood rather July 2019 •

quickly and reach levels high enough to warrant further testing on the substances’ safety. In terms of recommended ingredients, there are two sunscreen ingredients that the FDA does consider safe and effective: Zinc oxide and titanium dioxide. These are the same two ingredients that EWG recommends for sunscreens, the report said.

Avoid sprays The FDA also proposed that all spray and powdered sunscreens undergo testing to make sure that these forms of application don’t cause sunscreen ingredients to be inhaled deep into the lungs. EWG is also concerned about this inhalation risk, and says that spray and powdered sunscreens

may also not provide a thick enough coating on the skin to be protective. Right now, the group does not recommend any spray or powdered sunscreens. EWG also recommends that people avoid sunscreens with an SPF, or sunburn protection factor, above 50. High SPF values don’t necessarily mean better protection and may give consumers a false sense of security about how long they can stay in the sun without reapplying sunscreen, the group said. And although wearing sunscreen is important, it’s only one of the recommended ways to protect yourself from the sun. People should also cover up with clothing, wear hats and sunglasses, try to stay in the shade, and avoid spending too much time in the midday sun, when its rays are most intense, EWG said.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 13


1 IN 5 AMERICANS WILL DEVELOP SKIN CANCER IN THEIR LIFETIME PROTECT YOUR SKIN! Cover exposed

skin and wear a wide-brimmed hat to shade face, head, ears and neck when outdoors. Most importantly, use sunscreen with SPF 15 or higher and UVA and UVB protection.

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SmartBites

By Anne Palumbo

The skinny on healthy eating

Can Italian Sausage Be Part of a Healthy Diet?

O

ur nation’s Italian sausage consumption skyrockets during summer months — who can blame us? The irresistible aroma of sizzling sausage sends our taste buds into overdrive! Fan the flame with some peppers and onions, and it’s no wonder many of us indulge in seconds and thirds. But as tasty as Italian sausage is — and for reasons easily imagined — it’s not the best food to eat on a regular basis. Occasionally? Yes. Daily? No. So what makes Italian sausage a “sometimes” food versus an everyday staple? In a word, most sausage tends to run fairly high in fat, calories, and sodium; most are no slouch in the cholesterol department; and, all are a processed food. Although nutritional stats vary widely for Italian sausage, a typical link of Italian pork sausage has around 200 calories, 16 grams of total fat (of which six are saturated), 50 grams of cholesterol, and 550 mg of sodium. Of course, depending on your eating habits, you may need to double (or triple) those stats. Gulp! Overconsumption of any one of the above — from the calories to the fat, the cholesterol to the sodium — can lead to serious health issues, including obesity, heart disease, diabetes and cancer. Another good reason to rein in consumption: Italian sausage is classified as a “processed meat,” meaning it’s been preserved by smoking, salting, curing or adding other

preservatives. According to the American Institute for Cancer Research, any amount of processed meat eaten regularly increases the risk of both stomach and colorectal cancers. It’s why the AICR and other health organizations recommend limited consumption of processed meats like sausage, hot dogs, bacon and deli meat. On the plus side, Italian sausage is an excellent source of complete protein and some B vitamins (especially B12). An essential nutrient for building and maintaining tissues and cells, protein also makes up the enzymes that power many chemical reactions in our body. The B vitamins play a key role in converting food to energy and in supporting nervous system function and red blood cell formation. Those monitoring carbs will be thrilled to know that Italian sausage has next to none! So, can Italian sausage be part of a healthy diet? On average and with limited consumption: yes. But for those battling health issues that may be exacerbated by eating processed meat, probably not. If you’re unsure, seek a doctor’s advice. Although my husband and I love the succulent flavor of pork sausage, we don’t love the calories, fat, and sodium and have since switched to poultry Italian sausage, shaving off half the calories, over half the fat and a modest amount of sodium. Served alongside sautéed veggies, it’s a delicious “sometime” meal.

Braised Italian Sausage with Broccoli, Garlic, and Lemon 5-6 Italian sausage links (recommend: Trader Joe’s Italian Style Chicken Sausage) 2 tablespoons olive oil, divided 1 medium yellow onion, cut into ½-inch wedges 2 cloves garlic, minced 1 teaspoon ground coriander ¼ teaspoon red pepper flakes 3 crowns broccoli, cut into 2-inch long florets with florets then halved or quartered 2 cups water 2 tablespoons lemon juice Salt and pepper

Preheat oven to 200 degrees. Place sausages in large skillet: drizzle with 1 tablespoon olive oil; add ½ inch water. Over medium-high heat, boil sausages to cook through. Once water cooks away (about 8-10 minutes), lower heat to medium and brown sausage in remaining oil. Remove from heat; transfer to foil-lined baking sheet; place in oven to keep warm. In same skillet, heat remaining olive oil over medium-high. Add onion and sauté until golden, about 6 minutes, lowering heat if needed. Add garlic, coriander, and red pepper flakes and cook for 30 seconds. Add prepared broccoli and 2 cups

Helpful tips

Read Italian sausage labels carefully. Keep in mind that claims like “natural” or “uncured” or “nitrate- and nitrite-free” do not necessarily mean the food is healthier. Some products cured with sea salt or juices such as celery juice that contain naturally occurring nitrates may end up with just as high nitrite content as meats with sodium nitrite added. Choose lower-temperature methods of cooking—such as roasting or braising—to thwart the “grilled char” that can develop harmful carcinogens. water; stir well. Bring to a boil, then reduce heat and cover. Cook until fork-tender, about 8 minutes, stirring throughout. Mix in lemon juice; season with salt and pepper. Serve sausages atop broccoli mixture.

Anne Palumbo is a lifestyle colum-

nist, 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 Anne at avpalumbo@aol.com.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 15


Submitted by Emery & Scuro DMD, PC, Rochester.

apnea is usually complaining about apnea and are struggling with CPAP snoring, dozing off during the day, equipment, there are alternative waking up feeling tired and unreoptions available to help solve your freshed and gasping for air in the dilemma. middle of the night. For more information about Traditionally sleep apnea has options to treat sleep apnea, call the been treated with a CPAP (condental office of Emery & Scuro DMD, tinuous positive airway pressure) PC, 2184 Chili Ave., Rochester, device which delivers a low flow of 585-247-7110. For more information, air through a face mask over your visit www.drsemeryandscuro.com. mouth and nose. While effective, these devices are cumbersome and require quite a bit of regular routine maintenance, making travel with them especially difficult. However, thanks to a new development in the field, there is now a much more user-friendly device that people can use in their mouth that works by keeping their airway open. This allows the free flow of breathing air while asleep, Essentially, the soft tissue in the thus maintainrear of your throat collapses and closes during sleep. Because this can ing a healthy, cause prolonged airway blockage to quiet airway. So, if you the lungs if left untreated, the results suspect a can cause serious problems, includbreathing or ing headaches, depression, weight gain, high blood pressure, cardio-vas- snoring probcular disease, memory loss, impoten- lem at night, or Dr. W. Bradford Emery, Dr. Carol A Scuro already have a cy and ADHD. and Dr. Nicholas Emery. diagnosis of sleep The first recognition of sleep

Dental Practice Offers Option to Treat Sleep Apnea M ost of us don’t think of snoring as something to be overly concerned about. However, we now know that frequent loud snoring may be a sign of a much greater problem — sleep apnea. Sleep apnea is the temporary stoppage of breathing during sleep — in some cases, people may stop breathing hundreds of times per night.

The Truth About Sciatica

Problem Gambling in the Workplace

By Bill Ferris, DC

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he term sciatica has been used, often incorrectly, to explain the pain in a person’s leg, buttock and low back. The condition is so ubiquitous that people may think they can selftreat it or just follow a friend’s advice to relieve the debilitating pain. There are many false notions about sciatica pain and patients need to fully understand some basic science, root causes and the full range of treatment options.

Sciatica Is a Symptom, Not A Diagnosis Sciatica is actually a set of symptoms rather than a diagnosis for what is causing the pain. In more severe cases, the causes of low back pain and leg pain need to be properly addressed in order to relieve the discomfort. Sciatica means that the patient’s sciatic nerve is being compressed. The million-dollar question is what exactly is causing the nerve compression, or is it more than one cause — known as multi-etiological? The most common problems that cause sciatica pain are: lumbar disc herniation, lumbar degenerative disc disease, isthmic spondylolisthesis, lumbar spinal stenosis, lumbar subluxation and

By Jennifer Faringer

A piriformis entrapment. Sometimes it is a combination of two or more of these problems, which is referred to as “double crush” syndrome. Chiropractors are particularly well-positioned to successfully treat sciatica pain because it is a mechanical problem that needs a mechanical solution. Drugs, such as painkillers (i.e. chemical solutions), often only mask the pain, leaving the patient still searching for answers. Many patients recover from sciatica within weeks if the proper treatments are administered. Treatment options include chiropractic, non-surgical spinal decompression, specific soft tissue modalities and non-surgical deep tissue laser. In severe cases, surgery is a last resort. 

Bill Ferris is a doctor of chiropractic with specialization in functional medicine. He is the president and founder of Modern Chiropractic & Pain Relief and New York Weight Loss in Victor. Call 585-398-1201 or visit www. modernchiropractic.com

Page 16

s gambling opportunities expand in our community, gambling has also made its way into the workplace. Currently approximately 5% or 668,000 adults in New York state are struggling with a serious gambling problem. Problem gambling, known as the silent addiction, causes not only financial problems, but so often also causes other addiction problems, depression, suicide and decreased productivity at work. The effects of problem gambling in the workplace environment include loss of time, loss of productivity, and sometimes more extreme effects such as theft, fraud and embezzlement. It’s important that employers and employees alike become familiar with the warning signs of problem gambling. Warning signs include: n Deterioration of performance on the job n Frequent, unexplained absences from work n Preoccupation with gambling in the workplace (sports pools, betting, etc) n Borrowing money from coworkers n Requesting pay in advance, cashing in retirement or vacation time n Mood swings or a changes in personality and interactions with co-workers

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019

n Verbalizing the toll that gambling is having on one’s life Problem gambling impacts not only the problem gambler, but also affects their loved ones. It is estimated that between eight and 10 people, including family, friends and coworkers, are affected. That equates to an additional 6.7 million people in New York who are affected by problem gambling! If you are concerned that you or a loved one or co-worker might be affected by problem gambling you can seek help from Gambler’s Anonymous meetings, outpatient treatment, counseling, and education. Resources and links may be found at https://ncadd-ra.org/ awareness-campaigns/underage-gambling. Help raise awareness about how problem gambling, the silent addiction, affects people in their workplace. Jennifer Faringer is director of DePaul’s National Councilon Alcoholism and Drug Dependence Rochester Area www.ncadd-ra.org


Career in Healthcare

Medical Billing Career: Great Entry Level Job By Deborah Jeanne Sergeant

HAVE FUN. HELP OTHERS.

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fter patients see a medical provider and before they receive a statement or bill from their health insurance company, the financial aspects of the visit go through a few different processes. One step along the way is the desk of a medical biller. If you have good math, customer service and analytical skills, you may be well suited to work as a medical biller. “There are always openings in medical billing,” said Deborah Robinson, a vice president who oversees the billing team at Rochester Regional Health. “We have a large office and there’s always turnover. We’re also growing. Right now, there aren’t a lot of people applying for these jobs. They may not know they’re available.” According to the Bureau of Labor Statistics, the mean annual wage of billers working in a hospital setting is $38,530; for those in a physician’s office, it’s $37,690; and for those in a lab, it’s $37,730. Robinson said that most people who work in medical billing take courses at a vocational school or college. “A degree is very beneficial,” Robinson said. “Most people come in with a bachelor’s or at least an associate’s, but it’s not necessarily required. Some of our best employees began years ago and have been able to learn on the job how to do it, though medical billing has become more complex.” People with entry level experience in accounting or banking may get in a medical billing office; however, health care billing knowledge is helpful. Robinson said that the big difference is understanding the world of health insurance. With hundreds of plans available, each with their own characteristics, it’s complex. Plus, coders must understand the medical terms and how billing works. “It’s different from purchasing a piece of clothing,” Robinson said. “There are multiple charges for an ER visit.” Each care provider, such as the hospital, diagnostic lab, X-ray technician and more, are billed separately. Medical billing can also involve customer service, when patients’ insurance companies refuse to cover services or they have questions about how their coverage works. Those working in medical billing also receive continuing education, provided by insurance companies and through the Health Care Financial Managers Association. Usually, employers pay for the latter. “We have good job satisfaction,” Robinson said. “Very often, they start in medical billing and want to advance into something different. There are many opportunities in healthcare. Often people use it as a stepping stone into a different area as well, like information technology that supports the revenue cycle.” Some people assume that the

Friday, September 6 6:00 – 10:00 p.m. Burgundy Basin, Pittsford ENJOY LIVE ENTERTAINMENT, MUSIC, PRIZES PROCEEDS BENEFIT HOSPICE & BEREAVEMENT SERVICES DON ALHART, EMCEE advent of electronic medical records (EMRs) has reduced the need for medical billers, as if the care providers’ input automatically generates billing. Robinson said that while EMRs have made the billing process more efficient and accurate, the health care industry still very much needs billers to verify information and provide customer service. Monroe Community College offers a program in health information technology/medical billing which could help a graduate succeed in medical billing, though Brenda Embrey, professor of health information technology, said that many people work in medical billing without a particular degree. MCC’s program focuses on the coding and classification of diseases and procedures, which prepares students for medical coding. Some medical billers perform coding work, especially in smaller offices; however, larger medical facilities have billers, coders and others handling the various aspects of medical finances. “Some go into denials management or data analysis for an organization,” Embrey said. “They look at what types of claims are being paid and more.” Professor of health information technology Lori Laco-Schiano described the idea of medical billing as “an important piece of the process, taking what the doctor decides and the coder is a person who takes the medical terminology into the alpha numeric system that’s used on claim forms.” Because of the necessity of knowing about things like anatomy, physiology and medical terms, many area hospitals won’t hire coders lacking an associate’s degree and credentialing. “One of the most frustrating things is no one knows about billing and coding and there are so many jobs in this,” Laco-Schiano said. “When I meet people in the community, they have no idea what I teach.” To get into billing, Laco-Schiano recommends at least taking a medical terminology class to get a better handle on the words with which a biller will need familiarity. July 2019 •

Call 585.214.1571 for ticket information.

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Emery and Scuro DMD, PC 2184 Chili Ave, Rochester, NY 14624 (585) 247-7110 | www.drsemeryandscuro.com Emery & Scuro DMD, PC has been recognized as one of the top Rochester Dentistry practices. Verified by Opencare.com IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 17


Women’s Health

You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org

Bone structure 3-D illustration, normal and with osteoporosis. Stock illustration.

Osteoporosis Risk Often Overlooked

Half of women 50 and older and 20% of men will break a bone because of osteoporosis at some point in their lives. By Deborah Jeanne Sergeant

WE’RE HIRING! Trillium Health is growing, and we’re looking for candidates like YOU!

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umerous health organizations state that osteoporosis is widely under-diagnosed in older adults. Among them is the National Osteoporosis Foundation, which stated recently that it is “often left undiagnosed and untreated” despite its devastating consequences. The foundation stated that breaking a hip often contributes to overall decline in health and physical condition and increases an elderly person’s risk of greater frailty, losing independence and living in a longterm care facility.

Why So Many Older Women Develop UTIs

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Page 18

Half of women 50 and older and 20% of men will break a bone because of osteoporosis at some point in their lives. Women are at greater risk for osteoporosis. Because its effects aren’t often recognized until a bone break occurs, few think to screen for it. A woman’s risk of breaking her hip equals her combined risk of breast, uterine and ovarian cancer, according to the National Osteoporosis Foundation. So why are older women more prone to osteoporosis than men?

For one thing, women’s bones tend to be smaller and thinner. For this reason, Asian women have a higher risk of osteoporosis, as do those of any race with smaller-sized frames. Lifestyle factors that disrupt nutrient absorption or weaken bones include lack of exercise, smoking, excessive alcohol and carbonated beverages. Medical issues include bulimia, anorexia, celiac disease, chemotherapy and use of medication such as steroids and anti-seizure medication. Once women hit menopause, the decline in bone-protecting estrogen declines, making them more prone to a broken bone, according to Jill Chodak, registered dietitian at the Center for Community Health & Prevention of the University of Rochester Medical Center. Fortunately, women can do quite a bit to prevent bone loss. Chodak said that many women know about calcium, found readily in dairy, spinach, broccoli, dried beans and salmon. But other key nutrients affect bone strength, including vitamin D. “Most of us are deficient living in the North,” she said. The body naturally generates vitamin D, a pre-hormone, when skin is exposed to sunlight. Just 10 to 15 minutes’ sun exposure twice a week suffices; however, Upstate New York doesn’t receive sufficient sunlight for several months of the year. That means deficiency is inevitable without supplementation. Eggs and oily fish varieties like salmon contain vitamin D. Few other foods naturally contain vitamin D, though commercially sold milk is fortified with it, as are many foods like breakfast cereal. While buying a bottle of vitamin D supplement tablets seems a good solution, Chodak said that it’s better to have vitamin D levels checked to ensure the proper amount is taken. “Phosphorus is another item that’s found in dairy and we usually consume enough,” she said.

U

rinary tract infections are one of the indignities many women face as they age. One reason why is because their bladder walls can be invaded by several species of bacteria, a new study finds. Urinary tract infections, or UTIs, are among the most common type of bacterial infections in women, accounting for nearly 25% of all infections. UTI recurrence rates can range from 16%-36% in younger women to 55% in postmenopausal women. In the new study, researchers at University of Texas Southwestern (UTSW) in Dallas analyzed bacteria in bladder biopsies from 14 postmenopausal women with recurrent UTI. The investigators found that, in these patients, several species

of bacteria can get inside the bladder’s surface area. Bacterial diversity, antibiotic resistance and immune response all play significant roles in recurrent UTIs, according to the study. “Our findings represent a step in understanding [recurrent] UTIs in postmenopausal women,” senior study author Kim Orth said in a university news release. Orth is a professor of molecular biology and biochemistry at UTSW. “We will need to use methods other than antibiotics to treat this disease, as now we observe diverse types of bacteria in the bladder wall of these patients,” Orth added. UTI is the most common reason for antibiotic prescriptions in older

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019

adults. The high rate of UTIs has a significant social impact, and treatment costs billions of dollars a year, the study authors noted. Recurrent UTI “reduces quality of life, places a significant burden on the health care system, and contributes to antimicrobial resistance,” Orth said. Other factors believed to contribute to higher UTI rates in postmenopausal women include pelvic organ prolapse, diabetes, lack of estrogen, loss of Lactobacilli in the vagina, and higher levels of E. coli in tissues surrounding the urethra, according to the researchers. The report was published online recently in the Journal of Molecular Biology.


Women’s Health

Women’s Health by Decade P

reventive health measures can help us maintain good health. As Ben Franklin stated, “A stitch in time saves nine.” While we can’t do anything to change the genetics we were born with, we can mitigate health risks by preventing some health issues decade by decade.

In your 20s:

The healthful habits established in your teens and 20s offer a lifetime of benefits. “The earlier you can start an active and healthier lifestyle, the more likely you’ll continue it as you age,” said Maddie Nizamis, certified personal trainer and certified in fitness nutrition, operates Studio 22 Personal Training in East Rochester. You greatly reduce risk of obesity, metabolic disorders, nutrient deficiencies, heart disease, cancer and more by eating right and staying active. It’s also important to drink only in moderation and abstain from tobacco use. Tobacco damages every cell of the body and represents a factor in numerous disease processes. Young women also need to get plenty of calcium to enjoy strong bones later in life. Taking care of your teeth — flossing daily, brushing after meals, avoiding sugary and starchy snacks and visiting your dentist regularly — correlates with heart health, mounting evidence states. Take care of any dental issues promptly. Prepare for pregnancy. Discuss your health with your provider before you conceive and contraception if you want to space your children or once your family is complete. Breastfeed your babies. “The fewer ovulations a woman has in her lifetime, the lower her risk of ovarian and breast cancer,” said Allison Spath, international board-certified lactation consultant with Beautiful Birth Choices in Rochester. Along with babies come sleepless nights, so moms should accept help

By Deborah Jeanne Sergeant and prioritize rest. Cullen said. “Make sure you’re able “ You don’t have to do it all your- to do pelvic floor contractions Kegels self; it won’t end well,” said Adriana correctly or get to a doctor or physiLozada, owner and post-partum cal therapist who can show you how educator and owners of Birthful in to do them.” Rochester. She added that weight-bearing activity and strength training can help prevent osteoporosis later. In your 30s: “If you wait until your 50s and In the 30s, many women become 60s, it could be too late,” she said. extremely busy with family, household and employment responsibilities, which can make it difficult to In your 50s: keep weight off. In your 50s, caring for elderly “A lot of times, that’s when parents while still working can make people notice a significant change in maintaining fitness more challenging, metabolism,” said Elizabeth Cullen, but it’s still vital for good health. Get doctorate in physical therapy and help with elderly parents as needed. owner of CNY Physical Therapy and “Balance tends to be lost as we Aquatics in the Syracuse area. age, as well as muscle tone,” Nizamis She encouraged women to ramp said. “What we naturally have in up their fitness routine and strength our 20s, we don’t naturally have into training. our 50s. Keep up with flexibility and It’s also vital to begin performing balance are essential.” self breast exams monthly if you’re Keep track of your own health not already. Report any suspicious by knowing the signs of heart attack, lumps, bumps, discharge or discolor- stroke and aneurism. At this point, ation to your provider. your risk goes up, particularly if you haven’t managed your weight and watched your diet. Take “minor” In your 40s: illnesses seriously. It will take longer The 40s can be a stressful decade to recover from the flu. Don’t push when children are middle schoolyourself when you’re sick. aged or teens with crazy schedules. Have an annual physical if you Unwind in healthful ways, such as aren’t already. Your provider can connecting with friends and family keep closer tabs on your vital numand joining in relaxing hobbies not bers like blood pressure, cholesterol with substances. and weight. Discuss any menopausal “I see people’s bodies changing symptoms; you have more options the most dramatically in this decade,” said Nizamis, certified person- than hormone replacement therapy. Get a baseline vision and hearal trainer who is certified in fitness ing exam so you can benchmark any nutrition. “What they have to do to future vision or hearing loss. maintain weigh in their 20s doesn’t work anymore. I also see people In your 60s: start to move into hormonal changWhen you reach your 60s, “make es in pre-menopause. Hormones sure you take care of yourself,” effect weight gain in the midsection. Cullen said. “Many times, people Strength training is the number one care for their significant other or the thing to do for hormones. Sugar is grandkids. Your stuff gets pushed off a culprit that doesn’t help out in the for years, sometimes, and we’re dealmidsection, either.” Also in this decade, ask your care ing with back pain that you’ve had 20 years because someone else takes provider about when you should precedent. Things are much easier to begin mammograms. handle if you deal with them right “Around this time, you start to away.” lose some urinary control function,”

Obtain a bone density scan. Even if your bones are fine, it’s good to have a benchmark so you can tell if you’re losing bone later. “Range of motion is important,” Nizamis said. “Functional training is essential and that’s something I focus on. Body weight, like a squat and a plank hold. Having control of our own bodies, being able to carry the groceries inside from the car these are very important.” Ask your doctor about colonoscopy and any other exams and screenings based upon your family health history. Speak up if you experience “embarrassing” issues like incontinence, low libido, or vaginal dryness. You won’t embarrass your care provider. You may also consider seeing a geriatrician, as their medical expertise can address the multi-faceted medical issues often accompanying older age. Ask about vaccinations, like pneumonia.

In your 70s and beyond:

In your 70s and beyond, it’s all about staying active and involved. Becoming isolated can hurt your health, since you move less and aren’t as mentally engaged when alone. Volunteers, join clubs and stay social. “If you’re capable, keep on keeping on with physical activity,” Nizamis said. If arthritis bothers you, ask your doctor what you can do. Many find that walking and swimming help their symptoms. If some chores become too much, ask for help. “A lot of times, people won’t ask for help because they don’t want to look weak, but if they fall and get hurt, they make end up in a nursing home,” Cullen said. Stay positive. By focusing on what you still have and fostering an outlook of gratitude, it’s easier to look forward instead of ruminating over the past.

Find Us on facebook @ In Good Health Rochester July 2019 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

Page 19


How to Reduce Post-Partum Depression Risks By Deborah Jeanne Sergeant

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ocial media portrays bringing home a new baby as a magical time of cuddles, snuggles and adorable baby photo ops. While some of that is true, it’s also messy, exhausting and life-changing. The changes that take place in a woman’s body, schedule and life can contribute to risk of post-partum depression, especially but not limited to women who are already at risk for depression. No woman is to blame for developing post-partum depression. The hormonal changes inherent to pregnancy can trigger it unexpectedly; however, some controllable factors

can help lower the risk for many women. Breastfeeding the baby can help moms reduce risk for post-partum depression. Alison Spath, international board-certified lactation consultant with Beautiful Birth Choices in Rochester, said that in the initial hours after breastfeeding, a mom’s body releases oxytocin, a hormone that causes the uterus to begin returning to its normal size. This helps control post-partum bleeding and kicks off the mom’s recovery. It also “is a feel-good hormone that makes you fall in love with your baby and feel attached to your baby,”

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It’s tough to remember your high blood pressure medication when you’re time-starved, stressed out and simply trying to make it through the day. B  ut if you pause for just a moment, you’ll see reminders all around you. For some, it’s family and friends. Shawn Lewis, a barber, gets reminded to take his medication every day as he is getting ready for work. Taking your medication is life-critical to preventing a heart attack or stroke. Research shows that if you take your medication regularly, you could save t housands in medical costs each year. So whatever your reminder may b  e, it’s important to never forget it.

Spath said. “It’s very empowering when it goes well and helps when a woman feels good about herself.” Breastfeeding doesn’t always go that way. For some moms, breastfeeding is painful and difficult. They may struggle with milk supply or helping baby latch on. Spath said that for many women who struggle, more breastfeeding support and education can help them nurse. “If she’s just enduring it and not getting help, she’s more likely to have post-partum depression,” Spath said. “That’s why breastfeeding support is so important and why they need help if they run into trouble.” She advises those with a history of post-partum depression or anxiety to reach out to a lactation consultant before delivery so they have an established resource ready. Adriana Lozada, owner and post-partum educator with Birthful in Rochester, said that reducing risk of post-partum depression begins with “having realistic expectations and knowing that birth is so physically enormous, a seismic shift to your identity and body. There is no going back to where things are before. It’s a new normal.” Though her outlook may seem scary to some moms-to-be, there’s also a positive side beyond the cherubic little face. Lozado views parenthood as a journey of self-discovery. “You’ll learn who you are,” she said. “It can be a great opportunity to reconnect to your body.” She encourages moms-to-be to plan for not only their delivery, but also the first three months post-partum, known colloquially as the “fourth trimester” to prevent feeling overwhelmed. Since babies don’t have a circadian rhythm for at least three months, they often awaken during the night. They also need to eat at night. “You’re at the mercy of their stomachs,” Lozada said. “You’re on around the clock. It’s a marathon and plan for it. Prioritize sleep and nutrition. Go easy on exercise.” Another way to reduce risk of post-partum depression is to allow time to recover from pregnancy. Just as babies need nurturing, new moms need nurturing for their physical and mental health benefits. Lozada said that during the nine months of gestation, every cell of the mom’s body changes. “It’s about honoring recovering,” she said. “It starts with a good fer-

tility, birth, and delivery. Every time you get pregnant, your nutrients are deprived. You need to replenish.” The adage to “rest when the baby rests” rings true. Lozada urges moms to get professional resources such as lactation consultants on speed-dial long before the birth. Add to that trusted friends and family who can pitch in with housework, laundry and errands, as needed. She tells moms to post a to-do list on the fridge. “When helpers come, they can do something on the list to get ‘baby time,’” she said. “When people ask what they can do, direct them to that list on the fridge. They can pick one. Or maybe two or three.” Some people assume that they’ll carry on like normal after baby is born and just add the baby onto whatever else they do. Lozada laughs at that notion. She likens the post-partum period to a vacation —”probably the weirdest you’ll take — where parents will sleep in, eat good food, don’t do laundry, don’t go to work and set up structures so someone else takes care of the pet and your plants. It lets you get used to being parents.” A post-partum doula can also provide light housekeeping, cooking and baby care services to help out new moms. Anyone who experiences symptoms of depression should seek medical attention and anyone with thoughts of harming herself or anyone else should seek emergency medical help.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019


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As a teacher for 20 years, I receive a pension from a school system that did not withhold Social Security taxes from my pay. After teaching, I’ve been working for a small company where I do pay Social Security taxes. Now, approaching age 65, I would like to retire and apply for my Social Security benefits. But I’ve been told that my teacher’s pension may cause me to lose some of my Social Security. Is that true?

Ready to Retire

Dear Ready, Yes, it’s true. It’s very likely that your Social Security retirement benefits will be reduced under the terms of a government rule called the Windfall Elimination Provision (or WEP). The WEP affects people who receive pensions from jobs in which they were not required to pay Social Security taxes — for example, police officers, firefighters, teachers and state and local government workers whose employers were not part of the national Social Security system. People who worked for nonprofit or religious organizations before 1984 may also be outside the system. Many of these people, like you, are also eligible for Social Security retirement or disability benefits based on other work they did over the course of their career for which Social Security taxes were paid. Because of your teacher’s pension, Social Security will use a special formula to calculate your retirement benefits, reducing them compared to what you’d otherwise get. How much they’ll be reduced depends on your work history. But one rule that generally applies is that your Social Security retirement benefits cannot be cut by more than half the size of your pension. And the WEP does not apply to survivor

benefits. If you’re married and die, your dependents can get a full Social Security payment, unless your spouse has earned his or her own government pension for which they didn’t pay Social Security taxes. If that’s the case, Social Security has another rule known as the Government Pension Offset (or GPO) that affects spouses or widows/ widowers benefits. Under the GPO, spousal and survivor benefits will be cut by twothirds of the amount of their pension. And if their pension is large enough, their Social Security spousal or survivor benefits will be zero. There are a few exceptions to these rules most of which are based on when you entered the Social Security workforce. Why Do These Rules Exist? According to the Social Security Administration, the reason Congress created the WEP (in 1983) and GPO (in 1977) was to create a more equitable system. People who get both a pension from non-Social Security work and benefits from Social Security-covered work get an unfair windfall due to the formula of how benefit amounts are calculated. These rules ensure that government employees who don’t pay Social Security taxes would end up with roughly the same income as people who work in the private sector and do pay them. For more information on the WEP visit SSA.gov/planners/retire/ wep.html, where you’ll also find a link to their WEP online calculator to help you figure out how much your Social Security benefits may be reduced. And for more information on GPO, including a GPO calculator, see SSA.gov/planners/retire/gpo. html. 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. July 2019 •

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From the Social Security District Office

Tips for Hot Summer Days By Chrisann Fennessey

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he long-awaited summer season is here, bringing with it lengthier days, warmer weather, and — hopefully — plenty of sunshine. Taking simple precautions to prevent heat-related illnesses can help you enjoy this beautiful season to its fullest. Overexertion in high temperatures can cause anyone’s body to overheat, especially someone who is 65 years of age or older, managing a chronic health problem, overweight, or physically ill. During a heat wave, it’s essential to check on vulnerable people at least twice a day to make sure they’re OK. Here are the heat illnesses and warning signs to look for: Dehydration: Loss of water in the body • Weakness • Headache • Muscle cramps • Dizziness or fainting • Confusion Heat Syncope Dizziness or fainting caused by high temperatures Heat Exhaustion: Too much heat and dehydration; can lead to heat stroke • Heavy sweating or no sweating • Muscle cramps • Tiredness • Weakness • Pale, cold, clammy skin • Dizziness or fainting • Headache • Nausea or vomiting • Fast, weak pulse Heat Stroke: Dangerous rise in body temp; can be deadly • Body temperature of ≥ 103° F • Red, hot, dry skin • Fast pulse • Headache • Dizziness or fainting • Nausea or vomiting • Confusion

These tips from St. Ann’s Community can help you protect yourself and those in your care, including your pets, from overheating: Stay Cool Wear Appropriate Clothing: Choose lightweight, light colored, loose fitting clothing, sunglasses and a wide brimmed hat. Find a Cool Place: Stay in an air Page 22

conditioned home or public place as much as possible. Take a refreshing shower or bath, sponge off with cool water or apply cool cloths to your wrists, ankles, armpits, and neck. Skip Cooking: Choose light, cold meals over hot, heavy meals to keep your body and home cooler. Schedule Outside Activities Carefully: Between 10 a.m. and 2 p.m. is the hottest time of day, so target mornings and evenings for outdoor activities. Stay in shady areas as much as possible. Pace Yourself: Work or exercise at a comfortable pace and rest when needed. Wear Sunscreen of SPF 15 or higher: Put it on 30 minutes before going out and reapply as directed. Avoid Hot Cars: Never leave people or pets in a parked car, which can heat up like an oven, even with the windows cracked open. Stay Hydrated Drink Fluids: Don’t wait until you’re thirsty. Drink plenty of fluids throughout your day, regardless of how active you are. Avoid sugary or alcoholic drinks! Keep Your Pets Hydrated: Provide plenty of fresh water for your pets, and leave the water in a shady area. Replace Salt and Minerals: Sports drinks can replace the salt and minerals your body loses when you sweat. However, talk to your doctor if you are on a salt-restricted diet, you have congestive heart failure, diabetes, or any other chronic health condition. If you are on a low salt diet, have a chronic condition such as diabetes, or take water pills or certain medicines for depression, insomnia, or poor circulation, be sure to talk with your doctor about how you can beat the heat safely. The glorious days of summer are limited, so follow these simple precautions can help prevent heatrelated illnesses from taking the fun out of your summer! Chrisann Fennessey is the director of education at St. Ann’s Community. Contact her at cfennessey@ mystanns.com or visit www. stannscommunity. com.

Social Security Can Help If You’re Young and Lose a Parent

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or young people whose parent dies, Social Security is here. Losing a parent is both emotionally painful and oftentimes devastating to a family’s finances. In the same way that Social Security helps to lift up the disabled and seniors when they need it, we support families when an income-earning parent dies. You should let Social Security know as soon as possible when a person in your family dies. Usually, the funeral director will report the person’s death to Social Security. You’ll need to give the deceased’s Social Security number to the funeral director so they can make the report. Some of the deceased’s family members may be able to receive Social Security benefits if the deceased person worked long enough in jobs covered by Social Security to qualify for benefits. Contact Social Security as soon as possible to make sure the family gets all the benefits they’re entitled to. P lease read the following information carefully to learn what benefits may be available. Your unmarried child can get benefits if they’re: • Younger than age 18; • 18-19 years old and a full-time student (no higher than grade 12); or • 18 or older with a disability that began before age 22.

Q&A

Q: I can’t seem to find my Social Security card. Do I need to get a replacement? A: In most cases, knowing your Social Security number is enough. But if you do apply for and receive a replacement card, don’t carry that card with you. Keep it with your important papers. For more information about your Social Security card and number, and for information about how to apply for a replacement, visit www. socialsecurity.gov/ssnumber. If you believe you’re the victim of identity theft, read our publication Identity Theft and Your Social Security Number, at www.socialsecurity.gov/ pubs. Q: What should I do if an employee gives me a Social Security number but cannot produce the card? A: Seeing the card is not as important as putting the correct information on the worker’s Form W-2. You can verify employee Social Security numbers by using the Social Security Number Verification Service. Just go to www.socialsecurity.gov/ bso. This online service allows registered employers to verify

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019

To get benefits, a child must have: • A parent who’s disabled or retired and entitled to Social Security benefits; or • A parent who died after having worked long enough in a job where they paid Social Security taxes. Benefits stop when your child reaches age 18 unless your child is a student in secondary school or disabled. Within a family, a child can receive up to half of the parent’s full retirement or disability benefit. If a child receives survivors benefits, he or she can get up to 75 percent of the deceased parent’s basic Social Security benefit. There is a limit to the amount of money that we can pay to a family. This family maximum is determined as part of every Social Security benefit computation. It can be from 150 to 180 percent of the parent’s full benefit amount. If the total amount payable to all family members exceeds this limit, we reduce each person’s benefit proportionately (except the parent’s) until the total equals the maximum allowable amount. Children with disabilities may also be eligible for benefits. You can read more about Benefits for Children with Disabilities at www. socialsecurity.gov/pubs/EN-0510026.pdf. employee Social Security numbers against Social Security records for wage reporting purposes. Q: I am nearing my full retirement age, but I plan to keep working after I apply for Social Security benefits. Will my benefits be reduced because of my income? A: No. If you start receiving benefits after you’ve reached your full retirement age, you can work while you receive Social Security and your current benefit will not be reduced because of the earned income. If you keep working, it could mean a higher benefit for you in the future. Higher benefits can be important to you later in life and increase the future benefit amounts your survivors could receive. If you begin receiving benefits before your full retirement age, your earnings could reduce your monthly benefit amount. After you reach full retirement age, we recalculate your benefit amount to leave out the months when we reduced or withheld benefits due to your excess earnings. Learn more about Social Security reading our publication, How Work Affects Your Benefits, at www.socialsecurity.gov/pubs/10069. html.


H ealth News Thompson Health names associate of the year, ‘shining stars’ Director of ICU and Observation Nursing Mary Kate Corey was recently named UR Medicine Thompson Health’s Associate of the Year. Corey, of Stanley, was honored during a May 14 ceremony along with more than 30 recipients of the health system’s Shining Star Award. Both Associate of the Year and Shining Star Awards are the result of nominations from peers, which then go to a secret committee consisting of representatives from throughout the health system. Each year, just 2% of the more than 1,700 staff members are chosen as Shining Stars. Receiving Shining Star Awards this year were: • Heather Antonelli of Palmyra (hospital nursing administration) • Connie Armstrong of Honeoye (nutrition services) • Jennifer Army of Canandaigua (enriched living) • Carrie Aston of Middlesex (pharmacy) • Andrew Baader of Naples (Pines Avenue in the M.M. Ewing Continuing Care Center) • Melissa Bauer of Victor (physician practice management) • Caitlin Bonanni of Shortsville (hospital 3 west nursing) • Robert Brizzee of Shortsville (environmental services) • Jessica Carey of Naples (ICU nursing) • Elyse Catlin of Victor (hospital 3 east nursing) • Kerry Clark of Canandaigua (pharmacy) • Jeremy Cole of Canandaigua (transportation services) • Lori DeRuyter of Stanley (emergency department) • Stephanie Gallo of Naples (skilled-transitional unit in the M.M. Ewing Continuing Care Center) • Stacey Gibbs of Canandaigua

Nationally renowned pediatric oncologist joins MVP MVP Health Care announced the appointment of physician Bruce Himelstein as chief medical officer. Himelstein will lead MVP’s medical management strategy by implementing policies and programs to improve outcomes for MVP’s memHimelstein bers and continue to build healthy communities. “Bruce is bringing the highest caliber of expertise to MVP through his experience as a chief medical officer and a physician,” said Denise Gonick, MVP’s chief executive officer and director. “His vision and passion

(Meadows Avenue in the M.M. Ewing Continuing Care Center) • Stephen Harrington of Avon (purchasing) • Gabriel Harvey of Canandaigua (hospital second floor nursing) • Wendy Hurley of Honeoye Falls (hospital nursing administration) • Janice Kelly of Victor (information desk) • Robert “Tony” LaBore of Farmington (respiratory therapy) • Jennifer Lawrence of Rushville (physical therapy in the M.M. Ewing Continuing Care Center) • Mindi Lewis of Lima (hospital second floor nursing) • Laurie McFetridge of Canandaigua (hospital nursing administration) • Stephanie McLoud of Prattsburgh (Pines Avenue in the M.M. Ewing Continuing Care Center) • Kristen Meyer of Canandaigua (resident services) • Marron Mooney of Webster (corporate Ccommunications) • Laura Nisbet of Wayland (interventional radiology) • Physician A David Peter of Pittsford (general surgery) • Edward Ruthven of Shortsville (facility services) • Susan Shively of Canandaigua (skilled-transitional unit in the M.M. Ewing Continuing Care Center) • Inga Simning of Pittsford (speech pathology) • Angelica Troup of Geneva (cardiopulmonary administration) • Physician Justin Weis of Geneseo (medical staff) Also during the ceremony, physician Cynthia Teerlinck of Naples Valley Family Practice received special recognition. This was for being a liaison to — and advocate for — Thompson’s medical staff during the recent implementation of a new electronic health record system, as well as for being a strong advocate of lung cancer screenings for community members who fit the criteria. to improve the lives of our members is unparalleled and we look forward to the positive impact he will have at MVP.” Himelstein joins MVP Heath Care with more than 25 years of leadership in clinical medicine, education, research and strategic program design. He most recently served as the senior executive medical director for government solutions at the Health Care Service Corporation, a privately held nonprofit BlueCross plan in Chicago. Himelstein began his career as a pediatric oncologist at the Children’s Hospital of Philadelphia and after years of clinical practice, research and accolades, he made a career change to executive roles in various managed care organizations. “Bruce is a highly accomplished, forward-thinking health care executive with a dynamic track record,” said Christopher Del Vecchio, MVP’s president and chief operating officer. “He is an innovator who will build upon our clinical strategies and programs to cultivate positive results.”  July 2019 •

Several local students received $1,000 scholarships from the Hearing Loss Association of America Rochester Chapter. They are, standing from left, Megan Minkel, Attica High School; Hunter Williams, Rochester School for the Deaf; Alyssa Kingston, Geneseo Central School; Diane Ward, RSD. Seated from left are Neriyah McPherson and Courtney Gentzke, both RSD. Absent: Jeffery Flood, Irondequoit High School.

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Hearing Loss Association Honors Students

even local high students received $1,000 scholarships at the recent dinner of Hearing Loss Association of America Rochester Chapter held at the Cobblestone Creek Country Club in Victor. The awards assist high school graduates with hearing loss in pursuing their post-secondary studies. Honored were: Jeffery Flood, Irondequoit High School; Elyssa Kingston, Geneseo Central School; Megan Minkel, Attica High School; and Courtney Gentzke, Neriyah McPherson, Diane Ward, and Hunter Williams, all of Rochester School for the Deaf. Initiated in 1996 with a grant by

the late Mr. and Mrs. J. Stuart MacDonald, the HLAA scholarships have distributed $114,500 to 130 recipients. This year’s scholarships were made possible by a donation from the MacDonald Fund at the Rochester Area Community Foundation. Hearing Loss Association of America Rochester Chapter is the local chapter of a nationwide organization which opens the world of communication to people with hearing loss through support, education, advocacy and education. For more information about HLAA visit www.hearinglossrochester.org or telephone 585 266 7890.

Himelstein earned his bachelor’s degree from Harvard University, his Doctor of Medicine from New York University School of Medicine, and his executive MBA from the University of South Florida.

“I am honored and deeply humbled to be selected for the Physician of the Year award at Highland Hospital,” said Boghani. “I am thankful to everyone for the recognition of my services to Highland patients for last 21 years and share the award with those in the Highland hospitalist program which has been the backbone of the hospital for many years.” Boghani initially received physician training in India and was a doctor there for 10 years before immigrating to the United States in 1993. He served as chief resident at Jersey City Medical Center while acquiring his credentials to practice in the United States. Advanced practice provider Jessica R. Mahoney, a physician assistant-certified (PA-C), has served as a surgical physician assistant at Highland since 2004. “I am so very honored to receive this award,” said Mahoney. “I love my job and strive to make an impact on people’s lives, even if just a small one. I couldn’t do it without the help of the great staff and my amazing

Highland honors providers of the year Highland Hospital has honored Ashish Boghani as physician of the year, and Jessica Mahoney as advanced practice provider of the year. Boghani is a Highland hospitalist who is also associate professor of clinical medicine at University of Rochester School of Medicine and Dentistry. He spearheaded the growth and development of the Highland hospitalist group and served as chief for 15 years before stepping down in 2017. The Brighton resident was nominated for the prestigious award, also called Distinguished Physician, by administrators, colleagues and other co-workers for healthcare excellence.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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H ealth News colleagues at Highland. We really are like family.” A Spencerport resident, Mahoney is a graduate of the Daemen College physician assistant program.

MVP named 24th best company to work for MVP Health Care has been honored as the 24th best company to work for by the New York State Society of Human Resources Managers and the Best Companies Group. This is the second year in a row that MVP Health Care has been named to this list among large employers in New York state.  “MVP Health Care has always placed a strong emphasis on our workplace culture because we know that our employees are the foundation of success for our company,” said Denise Gonick, MVP’s chief executive officer and director. “Making health care more personal for our members starts with our employees’ ability to work and thrive in a positive and supportive atmosphere, and we are proud that this award reflects that commitment.”  The statewide awards program, which is presented by New York State Society for Human Resources Managers (SHRM) and the Best Companies Group, is designed to identify, recognize and honor the best places of employment in New York, benefiting the state’s economy, its workforce, and businesses. Eligible organizations participated in an evaluation of their workplace policies, practices, philosophy, systems and demographics. The evaluation also involved an employee survey that measured the employee experience.

Jordan Health Foundation elects new officers The Jordan Health Foundation approved a new slate of officers at its annual meeting June 11. Elected to a term beginning June 2019, include DeLois “Kijana” Crawford, chairwoman; Stef Astheimer, vice chairman; RPD Commander (Ret.) Timothy List, secretary. William Hall, Sr., continues in his term as treasurer. Crawford presently holds the rank of professor of sociology in the sociology/anthropology department of the Rochester Institute of Technology and is chairwoman of the African American, Latino, Asian and Native American (AALANA) faculty advisory council. She is also a member of the board of directors of the Rochester Academy Charter School. Astheimer, vice president, strategy at Howe & Rusling, holds a degree in applied mathematics from Yale University. He also serves on the board of Mary’s Place Refugee Outreach and on the corporate advisory committee for the Memorial Art Gallery. Retired from the Rochester Police Department after 31 years, Com-

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Trillium Health during a ribbon-cutting event marked to open the renovated and expanded clinic at 259 Monroe Ave. at Monroe Square in Rochester.

Trillium Health Celebrates Clinic Renovations

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The newly renovated waiting room and modernized clinic serves a growing patient population

rillium Health leaders gathered May 3 for a ribbon-cutting event to celebrated the expanded and renovated clinic space at 259 Monroe Ave. at Monroe Square in Rochester. “Trillium Health is committed to ensuring extraordinary care to all who walk through our doors,” said Andrea DeMeo, president and chief executive officer of Trillium Health. “We want to ensure that everyone, including those with complex medical and social needs, members of our LGBTQ communities, and those who are considered low income or living in poverty feel welcome when they enter our clinic. Our waiting room has been

mander List currently serves on the staff of the Monroe County District Attorney. A graduate of Monroe Community College, List also attended the Leadership of Rochester program and the FBI Academy. Hall, Sr. is president of Dedwen Financial. He formerly held positions with CONEA, MassMutual and NYLife Securities. A graduate of St. John Fisher College, Hall is currently pursuing his MBA from the William E. Simon Graduate School of Business Administration at the University of Rochester. “An active board, steadfast in its commitment to Jordan Health, is more important now than ever” said Crawford. “As the political and economic climate present real challenges for the future of federally qualified health centers like Jordan, the foundation must now work harder than ever to ensure that Jordan Health can continue to be a safety net for the Rochester region’s most vulnerable citizens.”

designed for our patients to have a positive experience, where all can feel safe, comfortable, and supported by the highest quality health care.” Physician Robert Biernbaum, Trillium’s chief medical officer, said the organization cares for thousands of patients annually. “It was important to us to enhance our current clinic space and create a larger, more welcoming facility with accommodations that heighten privacy and improve patient flow.” The new waiting area includes enhanced check-in and check-out areas and a new patient-friendly selfcheck-in kiosk, as well as improved lighting, new furniture and carpet, and attractive décor elements. It

leads to Trillium Health’s community-based clinic which includes 17 exam rooms and dedicated space for patient-centered care. The clinic delivers high quality and affordable care for all, including for LGBTQ and underserved populations throughout our service region. Services include primary care and infectious disease testing and treatment. Trillium Health officials acknowledged Assemblyman Harry B. Bronson for seeking support for this project through New York State, and Rozzi Architects and DGA Builders as key partners in the project.

VA Finger Lakes has new director

care System,” said physician Joan E. McInerney, director of veterans integrated service network (VISN) 2. “His sound leadership qualities and proven experience will be a valuable asset for the health care system, the employees and volunteers, and most importantly, for the veterans we are honored to serve.” Tucker has been serving as the interim medical center director since September 2018”. Tucker joined VA more than 27 years ago and has held progressive leadership positions at the Bath and Canandaigua VA Medical Centers. Prior to serving as interim medical center director for the VA Finger Lakes Healthcare System, he served as the medical VA care line manager or chief of social work at both the Bath and Canandaigua VA Medical Centers, where he planned and managed the delivery of medical services across facilities to achieve the organization’s mission.    Tucker holds a master’s degree in social work from Marywood College and a bachelor’s degree in sociology from SUNY Cortland.  

The Department of Veterans Affairs (VA) announced the appointment of Bruce Tucker as the new director of the VA Finger Lakes Healthcare System. Tucker will oversee delivery of health care to the VA Finger Lakes Healthcare Tucker System, including five community-based outpatient clinics (CBOCs) located in Upstate New York.  He will oversee delivery of health care to more than 33,000 veterans and an operating budget of over $220 million at the VA Finger Lakes Healthcare System.  “We are excited to bring Mr. Tucker on board as the new director of the VA Finger Lakes Health-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019


Staff of Rochester General Hospital celebrating the Beacon Awards of Excellence they recently received. According to the hospital, Rochester Regional Health has earnest the most Beacon Awards in New York state.

RRH Earns 12 Beacon Awards of Excellence Rochester Regional Health’s Hospitals recently earned 12 Beacon Awards of Excellence from the American Association of Critical-Care Nurses.  The following units make up the 12 awardees:

1. Rochester General Hospital CTICU (Cardiothoracic Intensive Care Unit): Silver 2. Beacon Award 3.jpg 4400 Unit: Silver

3. Rochester General Hospital 4200 Unit: Silver 4. Rochester General Hospital 7800 Unit: Silver 5. Rochester General Hospital Labor & Delivery: Silver 6. Rochester General Hospital SICU (Surgical Intensive Care Unit): Silver 7. Rochester General Hospital 5100 Unit: Silver 8. Rochester General Hospital 6800 Unit: Silver 9. Rochester General Hospital Neonatal Intensive Care Unit: Silver 10. Rochester General Hospital

Medical Intensive Care Unit 11. Unity Hospital Intensive Nursing Care Unit: Silver 12. United Memorial Medical Center Medical Intensive Care Unit: Silver According to a news release from the hospital, Rochester Regional Health has the most Beacon Awards in New York state and is tied for the most in the nation with UNC Medical Center in North Carolina and Virginia Commonwealth University Health in Virginia. The Beacon Award of Excellence is awarded in three levels of

designation — gold, silver, and bronze. Fellow nurses across the country judge nursing units based on defined criteria in the following categories: • Leadership structures and systems • Appropriate staffing and staff engagement • Effective communication, knowledge management, learning and development • Evidence-based practice and processes • Outcome measurement  

Bob Bourg selected as HR Executive of the Year

Edie Ellis, Park Ridge Auxiliary president (from left), Janet Charles, Gloria Hamilton, Mary Stroh and Alice Knittel.

Park Ridge Auxiliary Celebrates 90 Years of Support for Unity Hospital Members of the Park Ridge Auxiliary celebrated its 90th anniversary June 11. The organization began as a group of 25 women who started volunteering and fundraising for Unity Hospital and its predecessor, the Park Avenue Hospital. Over the following decades, the auxiliary grew to more than 260 women and men. They hold fundraising events and staff the hospital gift shop using a staff of volunteers. The proceeds are directed toward facility improvements and new equipment that will improve patient care. “We are so proud to carry on the tradition started by those 25 women

90 years ago,” said Donna Sime, auxiliary coordinator for Unity Hospital. “Hospitals have changed, but our mission hasn’t. It’s heartwarming to be part of something that’s been around so long and continues to touch people’s lives today.” In its history, the Park Ridge Auxiliary has raised more than $7 million. The money has supported a myriad of projects over the years, including the creation of a mobile medical unit, the addition of a surgical robot and Unity’s 2014 expansion and modernization project. Since 2014, Unity Hospital has been part of Rochester Regional Health. To learn more about the Park Ridge Auxiliary, including how to join or support them, visit www. rochesterregional.org/about/auxiliaries/park-ridge-auxiliary.   July 2019 •

The Rochester affiliate of the National Human Resources Association presented Rochester’s sixth annual HR Executive of the Year award to Bob Bourg, senior vice president of human resources at St. Ann’s Community. Bourg began his career with St. Ann’s Community in 1999, and he has served as the senior VP of human resources since 2017. For him, what makes an exceptional HR executive is the ability to maintain perspective at all times. “It is easy to forget that everyone has different experiences and a unique perspective,” says Bourg. “They may not be the same as ours, but must be valued and respected. That’s how you build a great organization.” The HR Executive of the Year award honors human resource professionals who are innovative, and are consistently preparing their organization for the future. Award recipients make significant contributions and have a positive impact to their organization, the HR industry, and the community as a whole. They demonstrate leadership, innovation, and operational excellence, all while inspiring others to excel. “We have an HR team that cares about every single person who works

Bob Bourg, senior vice president of human resources at St. Ann’s Community. He has been with St. Ann’s since 1999. at St. Ann’s,” Bourg said. “I am extremely fortunate to be part of such a talented, engaged, and fun group. This award is truly an honor, but it is a reflection of the amazing team and caring individuals who make our organization great. Our people make all the difference.”

In Good Health

Rochester’s Healthcare Newspaper Reaching consumers, providers. For advertising information email editor@gvhealthnews.com IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019


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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • July 2019

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