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Medical Insider Professionals • Hospitals • Practices • Technology

MEET THE COVID-19 HEROES › Safe Space, Not Jail

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Telemedicine Explodes

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Putting Prevention, and You, First Patient-centered care on the rise

Life-saving stroke treatment arrives Up North Innovation in prostate care: The UroLift


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Carly Simpson Allison Jarrell Elizabeth Aseritis, Caroline Dahlquist Kim Schneider, Tim Tebeau, Andrew VanDrie Tim Hussey Theresa Burau-Baehr Rachel Watson Claire Houser


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Table of Contents

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Kara Jarvis

Emily Oakes Libby Stallman Kim Stewart

A Supplement to

MI 5 | Sparking Change in Digital Health From receiving 24-hour urgent care on your phone to high-risk pregnancy consultations for rural moms via video, COVID-19 has the region’s top healthcare innovators stepping up to meet demand for telemedicine solutions. MI 8 | COVID-19 Heroes Healthcare professionals worked tirelessly on the frontlines when the pandemic hit Northern Michigan, not knowing they would still be fighting the virus months later. These are their stories of teamwork, grit and resilience. MI 16 | Life-Saving Stroke Care Early action is critical when someone suffers a stroke. Meet the neurosurgeon who has brought life-saving expertise to Munson Healthcare. MI 20 | Holistic Health: A Whole-Body Approach to Well-Being Healthcare is moving toward prevention, and practices like Traverse City’s Table Health bring innovation along with cost-effective, transparent and patient-centered care. MI 24 | Innovation in Prostate Care: The UroLift He came North to retire—but it didn’t last long. Now, Dr. Shumaker performs an innovative non-surgical prostate procedure, increasing quality of life for men in Northern Michigan. MI 26 | With the Help of an ‘Angel’

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COVID as a catalyst for telemedicine

by Laurel Sutherland | photos by Dave Weidner

Munson Healthcare uses the telemedicine platform Perinatal Access to livestream ultrasounds during real-time video visits with prospective mothers.

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It should come as no surprise that the COVID-19 pandemic triggered a swift and unprecedented adoption of telehealth tools to help keep both patients and healthcare professionals safe. Development of products that were expected to take years happened in weeks. Connecting with healthcare professionals via phone or video call went from a convenient novelty to a necessary safety measure in short order. Necessity, along with emergency changes to HIPAA guidelines and insurance reimbursement, spurred rapid growth in the telemedicine world. Today, in Northern Michigan, patients have access to everything from 24-hour urgent care consultations to prenatal visits, all through telephone and video. Telehealth offers patients the option to enjoy access to safe, convenient and affordable care, virtually. For healthcare providers, telehealth enables specialists in more metropolitan areas to reach rural patients. Much uncertainty remains as to how changing regulations and safety measures will impact telehealth in the future, but it’s expected to have far-reaching impacts beyond the pandemic. One thing is certain: COVID-19 changed the game in healthcare technology, and healthcare leaders, as well as patients, across Northern Michigan are taking note.

Innovators Step Up to Meet Demand McLaren’s New App Provides 24/7 Care Due to the pandemic, more people are choosing to stay in Northern Michigan for a longer period. In response to this trend and safety concerns related to COVID-19, McLaren Northern Michigan piloted a telemedicine app during the early stages of the pandemic that’s now live across all McLaren hospitals. Through the app, patients can build and keep relationships with primary care doctors and specialists even when they’re not in Northern Michigan. The app, McLarenNow Virtual Visit, is accessible on smartphones, tablets or computers with a webcam. “Through the height of COVID, we say 50 percent or more of our visits were telephonic and telemedicine,” says Brad Rider, McLaren Medical Group Director of Operations. “Telehealth is a game-changer because it gives patients and providers the ability to interact no matter where they are.” The app also allows patients to connect with a board-certified physician anywhere, anytime for urgent care needs such as coronavirus screening, cold, flu, minor injuries, illness or skin conditions.

Remote Care for High-Risk Pregnancies Munson Healthcare is innovating to provide high-quality obstetrics care for high-risk pregnancies across the North through a combination of in-person and remote specialist consultations. The goal? Increase access to care while decreasing travel for prospective moms in regions without the specialists found in Traverse City. In the past, patients with high-risk pregnancies who required care from a maternal-fetal medicine specialist had to travel to Traverse City. This left patients to weigh travel costs against potential pregnancy complications. Telemedicine provides patients

access to the care they need in the comfort of their community. Munson, in partnership with Wayne State University, provides patients a questionnaire to proactively identify potentially high-risk pregnancies in need of a specialist provider. For those women in Alpena, Manistee and Cadillac, Munson leverages a telemedicine platform called Perinatal Access. The platform livestreams ultrasounds to a maternal-fetal medicine (MFM) specialist in Traverse City during a real-time video visit with the prospective mother. This saves patients travel time and increases care access because these prospective moms can “see” an MFM specialist without the drive to Traverse City. Munson has plans to expand the technology to also serve the Sault Ste. Marie and Charlevoix communities. “Our goal is to serve patients where they are, as close to home and as safely as possible,” says Nurse Manager Melanie Thompson. “We are ensuring people have access to care that perhaps they would not have had because of travel involved.” In addition to telemedicine resources for high-risk pregnancies, Munson also regularly offers on-site MFM specialist care in Cadillac and Manistee and offers 24/7 on-call coverage. Though Munson no longer delivers babies at Manistee Hospital, their OB/GYN practice does provide the full gamut of pre- and postnatal care. “With Perinatal Access, I can provide an MFM consultation on the spot so patients don’t have to have sleepless nights worrying,” says Munson Healthcare Maternal-Fetal Medicine Specialist Dr. June Murphy. “If I see something during the ultrasound, they know within a few minutes.”

Improving Rural Medicine via Digital Tools 20Fathoms’ HealthSpark initiative is launching a rural telehealth accelerator in early 2021, hoping to position Northern Michigan in the center of solving rural healthcare’s most pressing challenges via digital healthcare tools. As an accelerator, HealthSpark, located in Traverse City, offers the kind of support needed for digital healthcare startups and early-stage companies to take root and grow at a time when rural medicine is looking for innovative solutions. HealthSpark President Jack Miner is a leader in venture-stage technology startup companies and previously led the venture teams at Cleveland Clinic and the University of Michigan. Through HealthSpark, Miner sees an opportunity for Northern Michigan to become a healthcare hub, innovating and providing digital tools that can meet the increasing challenges found in rural healthcare. “We are seeing telehealth work for providers and patients,” Miner says. “There is an opportunity to use this modality to address today’s most pressing challenges, and we believe rural health systems can lead the way.”  HealthSpark’s accelerator helps digital health startups, in part, by providing experts who can help the companies be successful in working with a rural hospital system, from reimbursement and supply chain to regulatory concerns and patient safety. The accelerator helps startups that address key issues impacting rural health, including socioeconomic and social determinants of health, care access, mental health resources and broadband internet access.

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COVID-19 HEROES by Laurel Sutherland | photos by Michael Poehlman

Local healthcare professionals worked tirelessly on the frontlines when the pandemic hit Northern Michigan and the battle continues. We’re sharing some of their stories here—stories of incredible interdisciplinary teamwork, grit and resilience, long hours beyond normal responsibilities, gratitude for colleague and community support and capable task forces that remain intact. COVID-19 hit Northern Michigan, as it did the country, with a sudden urgency—the likes of which most of us have never seen. While Munson Healthcare and McLaren Northern Michigan work every day to prevent infections, secure patient and staff safety and care for patients with skill and compassion, the pandemic has put both healthcare communities to the test. Frontline healthcare professionals throughout the country, and the world, have performed heroic acts, and Northern Michigan healthcare professionals dove into the fray with commitment and vigor, remaining vigilant in the face of this virus. The following are just a handful of the many local healthcare heroes.

Kathy Stutzman, BSN, RN-BC Manager of A2 Cardiothoracic/COVID Unit Munson Healthcare As manager of Munson Hospital’s A2 cardiothoracic unit in Traverse City, Kathy Stutzman, BSN, RN-BC, is used to being flexible in high-pressure situations. But COVID-19 presents an unprecedented challenge. The reality of the pandemic hit home for Stutzman on St. Patrick’s Day 2020—when her Munson Medical Center unit was designated as the best place to care for COVID-positive patients. Knowing this meant a huge effort to relocate the unit’s patients to another part of the hospital and gear up for COVID-19 patients, Stutzman arrived home that night in tears. Her husband reminded her that she was prepared for this. Stutzman worked closely with her unit manager, Resource Nurse Clinician Tim Nastbergen, to relocate cardiothoracic patients, opening up their unit to accommodate COVID-19 patients. They worked daily from 6:30 in the morning until after 9 at night to ensure patients were transported safely—all while navigating ever-changing PPE protocols.

“On the cardiothoracic floor, we look for the positive,” Stutzman says. “It is a special group of people. It was high pressure, but we worked together to get it done. Nurses from various specialties throughout the hospital stepped up and volunteered to care for the COVID patient population.” Due to hospital restrictions, COVID patients are unable to receive visitors. This leaves Stutzman and her team to provide comfort for patients facing the prospect of death without family members present. “My motto is ‘no one should ever have to die alone.’ When we took the Nightingale Pledge, we said we would care for those who needed care,” Stutzman says. Stutzman is proud of the way Munson leadership, staff, nurses and providers have united to give outstanding care to COVID patients. She was heartened by the incredible outpouring of support from the community—from notes and banners to cowbells and cheers at shift changes. Her proudest moment to-date navigating the pandemic is sending home the first COVID patient who had been intubated. When he was discharged, everyone involved in his care, from respiratory therapists to physical therapists, nurses and others—a true cross-section of the hospital—was there to see him off with a dance while playing his favorite song, “Sweet Caroline.”

Amy Milbrandt, MLS (ASCP) Infection Preventionist McLaren Northern Michigan Amy Milbrandt is responsible for analyzing data and developing protocols to investigate and prevent infection at McLaren Northern Michigan facilities. Her job is to make sure both patients and hospital personnel are safe. COVID-19 upped the ante. In March 2020, she received a call over a weekend asking her to join McLaren’s incident command team forming to address COVID. “I was impressed by the team,” Milbrandt says. “We got together and went right to work. We focused on PPE and bed and staff availability. We made it a priority to be prepared.” Milbrandt was tasked with setting up isolation units for COVID-19 patients. Additionally, she defined protocols for “donning and doffing” (taking PPE on and off) in a sustainable manner and educated staff on CDC and state guideline changes. She is an integral team player and the primary decision-maker when it comes to reviewing whether PPE meets CDC guidelines. 4

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She works day-in and day-out to make sure all McLaren staff, providers and community members have the latest safety information. “I work closely with three infectious disease doctors and our clinical education team to make videos that loop on the floor showing providers how to don and doff PPE,” Milbrandt says. Milbrandt is proud of how her team came together and collaborated, sharing priorities and working long hours. She also appreciates how the community presented creative solutions, such as Petoskey Plastics shifting gears to make face shields and gowns for the hospitals, local distillery Gypsy Vodka making hand sanitizer and community members coming together to sew masks.

Enda McGonigle Manager of Logistics Munson Healthcare We all now know the challenges of ensuring our frontline healthcare workers have the PPE they need to provide care safely. At Munson Healthcare, that responsibility fell upon the shoulders of Enda McGonigle, Munson’s manager of logistics, who is responsible for ensuring Munson sites across all of Northern Michigan have PPE and supplies. McGonigle worked tirelessly during the initial days of the pandemic to ensure the health system was prepared to serve COVID-19 patients. However, he is quick to say that no one person is a singular hero in the success of Munson’s COVID response. “It was a team effort. No one person on this team could have made this work,” McGonigle says. “I have more than 150 team members across the Munson System and we rely on medical and non-medical staff to help us be good stewards of PPE to keep people safe and protected. Frontline staff are the heroes we are here to support.” In the face of unpredictable pandemic resource demands, McGonigle had to ask staff across all Munson hospitals and ambulatory locations to be adaptable. Early on, he was asked to be a part of Munson’s incident command team representing logistics. Logistics played a vital role in incident command, which included leadership from every hospital within the Munson system providing two daily updates, seven days a week. The crux of McGonigle’s work was developing a supply chain plan for each site to see that resource allocation considered PPE preservation and conservation needs. He also led the resource allocation committee that met daily to focus specifically on monitoring PPE preservation and conservation. They were

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responsible for devising creative solutions to keep Munson’s emergency preparedness inventory prepped—from masks and sanitizer to respirators. He credits Munson’s distribution center and the Northern Michigan Supply Alliance—a collaboration with Trinity and Spectrum Health to share supply chain knowledge—with putting Munson in a preferred position at the beginning of the pandemic. “We had space, trucks and a pretty sophisticated approach to inventory management,” McGonigle says. “The development of the resource allocation committee is really groundbreaking because it brings together the clinical team across Munson Healthcare as well as reps from nursing administration, ethicists and educators to thoughtfully operationalize change.” McGonigle is thankful for Munson’s Foundation for Charitable Giving and the at-home heroes who stepped up to supplement cloth masks for patients and visitors, as well as Iron Fish Distillery for providing hand sanitizer. He’s also impressed with the team approach and excellent integration to respond to the unprecedented crisis in the supply chain.

Karen DenBesten, M.D. Director of Infection Prevention McLaren Northern Michigan Karen DenBesten, M.D., organized McLaren Northern Michigan’s COVID-19 response. No small task. DenBesten assembled an interdisciplinary incident command team that invested thousands of hours to ensure the safety of staff, patients and the community. The team worked together to develop a respiratory isolation unit, source and access testing materials, procure PPE and create protocols for COVID-19 safety and treatment. DenBesten led the charge every step of the way, staying on top of changing CDC recommendations and updating best practices and protocols daily. There was an initial surge of cases at McLaren, which the team handled skillfully. Since then, there continue to be changes that present new challenges to DenBesten’s team. There is no letting up: The task force continues to meet daily to address ongoing changes. “I’m so incredibly proud of the hospital staff, administration and community,” DenBesten says. “We listened to science and rose to the challenge. We came together to create a safe experience.” DenBesten is proud of the safety precautions McLaren’s interdisciplinary incident command team put in place. To date, no staff members have contracted COVID-19 as a result of their work at the hospital. 4


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“We’ve saved some really sick COVID patients, making the work incredibly rewarding,” DenBesten says. “The most challenging part has not been the long hours or my concern for my safety and the safety of my family. It has been the disregard for how serious this is from some members of the public. This is a highly contagious and potentially lethal and debilitating virus that needs to be taken seriously and respected.”

Christopher Ledtke, M.D. Infectious Disease Specialist Munson Healthcare When COVID-19 arrived at Munson in March 2020, Infectious Disease Specialist Christopher Ledtke was tasked with answering some critical questions. How will we screen, test, isolate and treat COVID-19 patients? Where will we put COVID-positive patients? And, who will care for COVID-19 patients? Addressing those challenges quickly became much more than a full-time job. Throughout the pandemic, Ledtke has maintained his normal day-to-day hospital and clinic responsibilities, while adding 3-4 hours of meetings, texts and calls around the clock to ensure timely infectious disease expertise is available to every Munson facility. If there’s a question about COVID-19 protocols, it goes to Ledtke and his team. “It has become a 24/7 job. We answer questions like, ‘Can you review this protocol?’ or ‘This doctor or nurse is sick or has been exposed, what do we do?’” Ledtke says. Ledtke, along with his partner Mark Cannon, M.D., PhD., and the entire infection prevention and infectious disease team writes and reviews protocols to prevent the spread of disease throughout the nine-hospital system of Munson Healthcare. They do everything from determining the safest way to plan for surgeries to being mindful of testing resources and making sure sick patients have the resources they need. “We are trying to be as adaptable as we can,” Ledtke says. “We have a really strong group of administrators running the show here. We are dealing with limitations in supplies and a system with many locations that are all trying to get on the same plan,

which is a challenge. Our response has been excellent.” Ledtke applauds Munson’s frontline staff who have stepped up. He called out Infection Prevention Coordinator Megan Priede and VP of Quality and Patient Safety Joe Satangelo as all-stars in Munson’s response to this pandemic.

Rebecca Somerville Respiratory Therapist Grayling Hospital, Munson Healthcare Rebecca Somerville is fueled by adrenaline. Her favorite places to work in the hospital are the ever-changing intensive care unit and emergency department. She is not one to be fearful. But COVID-19 frightens even this brave respiratory therapist. “We were blindsided,” Somerville says. “We went from 0 to 100 within one day, but our department pulled together 150 percent.” Somerville says her department, the cardiopulmonary department, collaborated with the inpatient team and other ancillary services to ensure they had enough resources to provide critical care. “We would not have functioned without every single person in our department. It was a huge team effort for the hospital as a whole,” Somerville says. The team at Grayling Hospital went from wearing no masks to working in what they dubbed “battle gear” nearly overnight. In the past, the Grayling team would stabilize and transfer respiratory patients. COVID changed that. COVID-19 patients were not stabilized and transferred, they were stabilized and admitted and Sommerville’s department needed to rely on hospitalist physicians and surgical nurses for additional support to meet patient care needs. “It brought us closer as a team,” Somerville says. “Everyone was sharing ideas. We were dealing with modes of ventilation we hadn’t dealt with for a long time. We were at the forefront of treating COVID patients, and our whole team did a great job.” Somerville is thankful that her team never lacked PPE and that the Grayling community showed amazing support by making masks, providing food to employees, writing encouraging messages on the sidewalks and posting signs.

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Gary GaryB.B. Rajah, Rajah, MD MD Director, Director, Munson MunsonHealthcare Healthcare Endovascular EndovascularStroke StrokeProgram Program

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Lifesaving Stroke Care in Northern Michigan by Laurel Sutherland | photo courtesy of Munson Healthcare

Stroke touches everyone’s life; the stroke patient, their family, their caretakers. According to the Centers for Disease Control and Prevention (CDC), someone in the United States has a stroke every 40 seconds. Every 4 minutes, someone dies of a stroke. The difference between death and survival is early action, making it critical to have robust stroke resources close to home. Michigan native and neurosurgeon Dr. Gary Rajah joined Munson Healthcare in June 2020 to expand Munson Healthcare’s stroke center. Rajah is already making a difference in the lives of people impacted by a stroke in Northern Michigan by bringing endovascular stroke treatment to Munson, a lifesaving and lifechanging service not previously offered in the region. Rajah is drawn to stroke care because of the critical nature of the specialty and the chance for amazing outcomes. Prior to joining Munson Healthcare’s stroke center, Rajah completed medical school and a seven-year neurosurgery residency at Wayne State University. He then completed a vascular/endovascular/neurosurgery fellowship at the University at Buffalo Gates Vascular Institute at the Canon Stroke & Vascular Research Center. After completing his fellowship, he chose to join Munson because it was important to him to serve a Michigan stroke program that did not yet offer in-house endovascular treatment.

The stroke care processes and treatments Rajah has spearheaded at Munson enable the retrieval of blood clots from the brain via a blood vessel. The procedure, called a thrombectomy, previously required a flight downstate. The treatment wasn’t available in Traverse City before Rajah joined the team, because it requires a highly trained neurosurgeon, and recruiting that talent has been challenging due to Munson’s rural location. Munson has been a Primary Stroke Center since 2012 due to its dedicated stroke-focused program, but the addition of 24/7 endovascular services makes Munson a candidate for Comprehensive Stroke Center designation by The Joint Commission, a nonprofit that accredits healthcare organizations and programs. “Time is critical when it comes to stroke treatment, so keeping patients in Northern Michigan will save lives and improve outcomes,” Rajah says. “We are able to truly change someone’s life in a matter of minutes. Patients improve on the table during the procedure. They go from not being able to talk to talking, and not being able to move an arm to moving their arm. This procedure has been around and has been regarded as a standard of care since trials in 2015. We were glad we could finally bring it to Northern Michigan.” Shortly after the expanded stroke center opened in August 2020, the team immediately began working with interventional radiology techs, ICU nurses, anesthesia, pharmacy and the operating room to swiftly treat patients with thrombectomies and other endovascular approaches such as clipping aneurysms. An aneurysm is a balloonlike bulge that can grow in an artery, and as it does, it can leak blood into the spaces around the brain. Clipping an aneurysm is when a neurosurgeon opens the skull and places a tiny clip across the neck of the aneurysm to stop or prevent it from bleed-

ing. Aneurysms that are completely clipped have an extremely low risk of regrowth, extending patient life expectancy. Expanding the stroke program uniquely positions Munson Healthcare to offer 360 care (emergent, post-operative and rehab) to stroke patients in Munson’s entire service area in Northern Lower Michigan, but also includes bringing leading-edge stroke care closer to patients in the Upper Peninsula. Though patients from the Upper Peninsula and Munson’s locations in Grayling and Cadillac still need to be transferred to receive endovascular stroke treatment, the travel time to receive the procedure is significantly shorter than it was previous to the expansion of Munson’s stroke center. During a stroke, the brain loses, with each hour, as many neurons as it does in almost 3.6 years of normal aging. Every minute counts when it comes to saving a stroke patient’s life and making a significant impact on their ability to function post-stroke. Rajah and the Munson Stroke Center team were able to make significant progress in a short amount of time to implement new stroke care processes and achieve excellent outcomes. This work took a lot of innovation on behalf of the hospital staff to get comfortable with the process. In addition to implementing new processes, the department also became one of only seven hospitals in the U.S. with a state-ofthe-art imaging machine, the ARTIS Icono Biplane Angiography System, that enables high-precision 2D, 3D and 4D brain scans to enhance timely stroke diagnosis. Munson plans to continue to expand its stroke program through the addition of a second ARTIS Icono Biplane Angiography System and recruiting additional physicians to keep Northern Michigan’s approximately 250 annual stroke patients close to home.

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AA Continuum ofofCaring Continuum of Caring AA A Continuum AContinuum Continuum of of Caring ofCaring Caring AContinuum Continuum ofCaring Caring A Continuum of Caring Grand Traverse Pavilions is the region's first and only public, Grand Traverse Pavilions is first and only public, Grand Traverse Pavilions isTraverse theisregion's first and only public, Grand Grand Traverse Grand Traverse Pavilions Pavilions Pavilions thethe region's isregion's the is the region's first region's and first only first andpublic, and only only public, public, Grand Traverse Pavilions theis region's first and only public, nonprofit continuum of care featuring: nonprofit continuum care featuring: nonprofit continuum of care featuring: nonprofit nonprofit continuum nonprofit continuum continuum ofof care of featuring: care of care featuring: featuring: nonprofit continuum of care featuring: Grand Traverse Pavilions is the region's first and only public, • Long-term Skilled Nursing Care nonprofit continuum of care featuring: • Long-term Skilled Care Long-term Skilled Nursing CareCareCare • •Long-term • Skilled Long-term • Nursing Long-term Skilled Skilled Nursing Skilled Nursing Care Nursing • Long-term Nursing Care • Short-term Rehab • Short-term Rehab • Short-term Rehab • Short-term • Rehab Short-term • Short-term Rehab Rehab Rehab • Short-term • The •Wellness Center: Inpatient and Outpatient Therapy • Long-term Skilled Nursing Care The Wellness Center: Inpatient and Outpatient Therapy •The The Wellness Center: Inpatient and Outpatient Therapy • Wellness •Wellness The • Center: The Wellness Center: Wellness Center: Inpatient Center: Inpatient and Inpatient Outpatient andand Outpatient Outpatient Therapy Therapy Therapy • The Inpatient and Outpatient Therapy • Overnight Respite and Adult Day Services • Short-term Rehab • Overnight Respite and Adult Day Services • Overnight Respite and Adult Day Services • Overnight • Overnight • Overnight Respite Respite and Respite Adult and and Day Adult Adult Services Day Day Services Services • Overnight Respite and Adult Day Services • The •Cottages: Independent and Assisted Living • The Center: Inpatient and Outpatient Therapy The Cottages: Independent andIndependent Assisted Living •The The Cottages: Independent and Assisted Living •Wellness •Cottages: The • Independent The Cottages: Independent Cottages: Independent and Assisted and and Assisted Living Assisted Living Living • The Cottages: and Assisted Living • On-site Employee Daycare • Overnight Respite and Adult Day Services • On-site Employee Daycare • On-site Employee Daycare • On-site • On-site • Employee On-site Employee Employee Daycare Daycare Daycare • On-site Employee Daycare • The Cottages: Independent and Assisted Living With residents, participants, therapy patients, volunteers, staff, • On-site Employee Daycare With residents, participants, therapy patients, volunteers, staff,volunteers, With residents, participants, therapy patients, volunteers, staff,staff, With residents, With With residents, participants, residents, participants, participants, therapy therapy patients, therapy patients, volunteers, patients, volunteers, staff, staff, With residents, participants, therapy patients, volunteers, staff, and employee-only daycare kids, Grand Traverse Pavilions is Traverse and and employee-only daycare kids, Grand Traverse Pavilions isTraverse and employee-only daycare kids, Grand Traverse Pavilions is is is and employee-only andand employee-only employee-only daycare daycare kids, daycare Grand kids, kids, Grand Traverse Grand Pavilions is Pavilions employee-only daycare kids, Grand Traverse Pavilions isPavilions more than just amore nursing home. It's ajust ofhome. for With residents, participants, therapy patients, volunteers, staff, more than just athan nursing It's community of for more than just ajust nursing home. It's a It's community caring more just than ahome. than nursing acommunity nursing home. aaIt's nursing It's a caring community It's acaring community community ofof caring for offor caring for for more than just amore nursing home. a home. community ofa caring forof caring generations. and employee-only daycare kids, Grand Traverse Pavilions is generations. generations. generations. generations. generations. generations. more than just a nursing home. It's a community of caring for generations.

1000 Pavilions Circle | Traverse || gtpavilions.org (231) 932-3000 1000 Pavilions | 1000 Traverse City | City | gtpavilions.org (231) 932-3000 1000 Pavilions |gtpavilions.org Traverse City |City | (231) 932-3000 1000 Pavilions 1000 Pavilions Circle Pavilions |Circle Traverse Circle Traverse ||City Traverse | gtpavilions.org City | |gtpavilions.org | gtpavilions.org | (231) 932-3000 | (231) | (231) 932-3000 932-300 1000Circle Pavilions Circle | Circle Traverse City gtpavilions.org | (231) 932-3000

1000 Pavilions Circle | Traverse City | gtpavilions.org | (231) 932-3000 MyNorth Medical Insider 2021

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HOLISTIC HEALTH: WHOLE-BODY APPROACH TO WELL-BEING by Laurel Sutherland | photos courtesy of Table Health

If you long for a healthcare provider who knows you, your family and your healthcare story, you’re not alone. Both providers and patients pine for a more meaningful doctor-patient relationship. Fortunately, the healthcare system is moving toward a more patient-centered approach focused on prevention as opposed to procedures. Direct primary care and functional medicine practices like Traverse City’s Table Health are championing the movement by offering cost-effective, transparent and relationship-based care. continued on page 22

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Functional Medicine: Caring for the Whole Person The philosophy behind functional medicine is the antidote to transactional, pharmaceutical-driven medicine. It aims to keep biologic systems in balance by treating the mind, body and spirit. Driven by developing a long-term relationship between the healthcare provider and patient, functional medicine focuses on the underlying cause of disease rather than symptoms alone. For example, it may focus on stress management or diet to remedy gut dysfunction rather than prescriptions that provide short-term comfort. “We want to return to a time when the family doctor truly knew their patients and their patient’s families and incorporate modern conveniences and technology,” says Table Health Operations Manager Christine Straley.

Direct Primary Care: A Model for Flexible, Affordable Care This way of taking care of people is new in the healthcare insurance world, but it isn’t new to medicine. Table Health uses the functional medicine approach in a direct primary care (DPC) model. DPC is an alternative to traditional fee-for-service thirdparty-payer billing, and effectively allows providers to spend more time with patients and keep costs transparent. DPC patients pay their physician or practice directly with a monthly or annual fee. This fee covers most primary care services, such as clinical and lab services, care coordination and consultative services. DPC practices suggest patients keep a high-deductible policy for emergency care or procedures such as a mammogram, colonoscopy or MRI done in another facility where insurance is accepted. Meanwhile, DPC practices work to reduce the burden of healthcare costs by practicing preventative medicine and providing 24/7 access to providers to triage patient needs and reduce the use of urgent care or the emergency department when possible. “Our goal of direct primary care is to have cost-effective care that is transparent and relationship-based,” Straley says. “Because we are not bound by the regulations of insurance, we can spend more time with our patients,  meeting them on a relational, emotional and physical level.”

How it Works Functional medicine and DPC provides an alternative option to patients across the country who want more from their doctor-patient relationship. For example, someone struggling with underlying issues such as fatigue, depression and anxiety has the opportunity to learn more about lifestyle factors that impact

health status. Together, patients and providers address the root causes of ailments through diet, exercise, stress management, body treatments and supplements. “It benefits anyone from a six-month-old to a 90-year-old. It’s a whole life approach,” says Table Health Provider Meghan Sarna, FNP. “Many of our patients are in their 40s and 50s, a high-stress time of life when we are often raising children, taking care of our parents and in a demanding stage of our careers. Stress is a huge driver of our health.” At Table Health, every patient receives a one-hour first visit to establish a relationship with a primary care provider and begin setting goals. From there, the approach looks like a hybrid of what you might typically expect from a primary care doctor with added aspects that are unique to functional medicine. For example, patients may get lab work and an annual physical, but also receive regular follow-up with a health coach throughout the year. Depending on each patient’s needs, a team of licensed physicians, advanced practice clinicians, nutritionists, bodyworkers, mental health professionals, health coaches and movement specialists work together to serve each individual. “When you see how it impacts people’s health and see them get better, it's inspiring,” says Table Health Provider Andrea Stoecker, D.O. “I’m passionate about it because it’s actually helping people live better and heal rather than covering up symptoms for short-term results.”

Driving Lasting Wellness Trailblazing health centers like Table Health serve less as a conventional healthcare provider’s office and more as a hub for health. They offer more than annual physicals and urgent care by supporting patients year-round with educational resources such as webinars, lectures and classes to empower lifestyle changes that have an impact on both day-to-day wellbeing and long-term health outcomes. The trend toward patient-centered, preventative care puts patients in control of their health and aims to ensure they feel seen and heard. Innovative approaches like DPC and functional medicine practiced at Table Health meet growing patient demand for a more individualized healthcare experience. “If people leave and feel that someone was empathetic, compassionate, responsive and listened to them, then we are doing our job and we are doing something really powerful in this community,” Stoecker says.

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Innovation in Prostate Care: The UroLift McLaren doctor brings non-surgical outpatient prostate procedure to Northern Michigan, providing quicker recovery times. by Laurel Sutherland | photo by Dave Weidner

When Bryan Shumaker, M.D., retired from a large urology practice downstate in 2011, he moved Up North to his Boyne-area vacation home. In addition to practicing urology, Shumaker was an astronomy professor  and looking forward to his home’s proximity to the nearby Headlands International Dark Sky Park.  He didn’t intend to continue his urology practice in Northern Michigan. However, after visiting McLaren Hospital, he realized there was an opportunity to bring his leading-edge urology expertise to serve the greater Petoskey community. Shumaker stepped back in, and with him came the UroLift, a life-changing prostate procedure that has increased quality of life for the countless men who visit McLaren for prostate treatment. Most men will experience an enlarged prostate in their lifetime, and with it, significant urinary discomfort. Patients with enlarged prostates typically begin treat-

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ment with medication. As the prostate grows, so does the dosage needed to curb symptoms, which comes with side effects such as changes in blood pressure and dizziness. Surgery is typically the next best option for relief. For many years, the transurethral resection of the prostate (TURP) has been the gold standard of prostate care. TURP is a surgical procedure that requires a one- to two-day hospital stay, a catheter for 24 to 48 hours and four to six weeks away from strenuous activity. The UroLift offers a non-surgical, outpatient alternative to TURP that allows patients to return to physical activity sooner. The UroLift procedure takes less than an hour, and patients return home the same day without a catheter. Shumaker compared the procedure to a basic injection—minimally invasive and completed with local anesthetic.

“I like the UroLift because it’s all outpatient, and people do amazingly well with it,” Shumaker says. “Satisfaction rates with the procedure are extremely high.” After UroLift, patients can expect some immediate improvements, two to three weeks of mild urinary urgency and consistent positive progress in the weeks and months following the procedure. “Our bladders are muscles,” Shumaker says. “When we open the urinary tract up, it takes time for the bladder to rebuild strength and transition from emptying in frequent small amounts to less frequent larger amounts.” Since McLaren Northern Michigan serves patients from across the North, a minimally invasive procedure with little follow-up sets Shumaker at ease. “I can send patients home without worrying about close post-op observation, which is very important in rural medicine,” he says.


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With the Help of an 'Angel' Michigan State Police Angel Program expands to Traverse City. by Kandace Chapple | photo by Michael Poehlman

Jason DeBeck is an “Angel” for the Michigan State Police (MSP) Angel Program, and he shared one story that says it all: A man who walked—yes, walked—the nearly 30 miles from Grayling to Gaylord to turn himself into the Angel Program at the MSP Gaylord Post. “And this wasn’t during the summer,” DeBeck says. “It was cold, sometime in March or April. For me, that shows that people desperately need help and will go to any length to get it. It’s a much-needed program.” Started in 2016 at the Gaylord Post, the Angel Program allows those with a drug or substance abuse problem to turn themselves in at any MSP Post and an “Angel” will help them get the help they need for rehabilitation. The program is available at all 30 MSP Posts, and while that’s good news for towns Up North like Cadillac and Gaylord, there’s been no such program in place for much of Northern Michigan. That’s why, this year, the Traverse City Police Department is stepping in to fill a need. Within the next month, the Law Enforcement Center (851 Woodmere Ave., Traverse City) will offer the Angel Program. Anyone can walk in Monday through Friday, 8 a.m. to 4 p.m., and get the help they need, says Jordan Wieber, Crime Prevention Officer with the Traverse City Police Department. The program is traditionally offered at only MSP Posts, but a handful of city police departments are starting to come on board throughout the state. “This program is a proactive approach,” Wieber says. “For those in need, we want you to know that the police have compassion, and that we hope to change lives.” Michigan had 2,729 overdose deaths in 2017. Of those, 1,941 were opioid-related and 699 were a result of heroin use. Nationally,

since the onset of COVID-19, Wieber says overdoses are up 25 percent. Locally, they have seen an increase as well. “COVID has definitely affected opioid and narcotics usage in our area and everywhere,” he says. “We’re excited to team with the Angel Program and get people into recovery. Addiction can reach anyone.” Corey Hebner, Community Services Trooper at the Michigan State Gaylord Post, agrees. “For years, an addict was painted as a willing participant,” he says. “But is there always a choice? The truth is that it’s a sickness; it doesn’t discriminate. The problem can start with opioids prescribed by a doctor, and you think that’s safe. But then you develop a sudden addiction. A lot of times we find that these are moms who were in car accidents or a high school sports player who was injured. Those are also the faces of addiction.” Hebner adds that the same plant is used to make opioids and heroin. So once people run out of their prescription, they will then seek a different source and will find a cheaper and more lethal version of it in heroin.

How the Angel Program Works Those in need can turn themselves in at any Angel location, says Hebner. “If they come in voluntarily, there are no tricks to that,” he adds. “We know it sounds too good to be true, but the big thing is that we want to get people help. We can’t arrest our way out of this problem.” He notes that the person must come voluntarily, not as part of an intervention by the family. Also, he has seen people get pulled over for a traffic violation and when drugs are found, they claim they are on their way to the post. “It doesn’t work that way,” he says.

Once the person comes in and requests help, any drugs are taken and destroyed by the police. If a person is overdosing, they will call 911 and have the person medically treated first and foremost. Next, an Angel is called and they are brought in to help assess the needs of the person. The screening includes how long and how much the person has been using, if they have any type of insurance and the current availability at rehab programs. Typically, female Angels are called for women seeking treatment, and male Angels are called for men. Angels are volunteers and must undergo a background check. Some have personally dealt with substance abuse in the past, but must be in recovery for at least two years before becoming a volunteer. Angel Jason DeBeck, owner of Nathan's House, a recovery residence for men in Boyne City, says that he, too, has been on the dark side of addiction. It’s the reason that he decided to become an Angel and to help others when he heard about the program at the Gaylord Post. “Addicts and alcoholics understand each other,” he says. “Once you find the bottom, it’s time to find help. We call that the ‘gift of desperation.’” DeBeck has been sober for more than eight years after seeking help through the human resources department of his employer at the time. He has since found joy in helping others find hope in recovery. “There’s a tremendous reward for Angels to be a part of this program,” he says. “We get to pass on a little bit of who we are and our story, and we get to help others.” DeBeck ends with this: “I know you don’t want to see a blue uniform at a time like this, but there’s compassion and care there—and help when you’re ready.”

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As we hold our collective breath at this time, assisted living residences offer a maintenance free lifestyle, says Connie Hintsala, owner of Alliance for Senior Housing, LLC, with residents loving how staff is going above and beyond to keep them safe. Families have reported back to Connie they are thankful for the communication and information they receive from the management and staff. With technology and assistance from staff, our parents and grandparents are learning how to use Facebook, tablets, email, and the like. Calling a list of residences will not only take time but will add to your stress. Take a minute, call one agency, Alliance for Senior Housing and receive all the information you need to make a wise decision for your loved one.

Whether you’re in a crisis or planning the future, we’ll guide you through the entire process. You’re not alone. First, (for the foreseeable future) we’ll have a phone appointment, conference call or can meet virtually. If possible, we may meet face to face in your home. We’ll listen to your needs and desires and discuss your financial situation. Secondly, within that first meeting, you’ll receive information on: • Types of housing and amenities (Independent living and assisted living) • Continuum of care complexs • Cost and various funding options • Resources and attorney names if needed Connie Hintsala, Senior Housing Expert at Alliance for Senior Housing

Third, after narrowing down your choices, we’ll arrange tours (if available), email photos, arrange virtual tours, make connections and provide a spreadsheet.

Connect with Connie by calling 888-816-4040 or emailing her at connie@AllianceforSeniorHousing.com www.AllianceforSeniorHousing.com

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MyNorth Medical Insider 2021  

Meet the Covid-19 Heroes / Safe Space, Not Jail: Police offer help to substance abusers / Telemedicine Explodes: 24-hour local care on your...

MyNorth Medical Insider 2021  

Meet the Covid-19 Heroes / Safe Space, Not Jail: Police offer help to substance abusers / Telemedicine Explodes: 24-hour local care on your...

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