Summer2015

SUMMER 2015

Health LINES Penn Highlands Healthcare

Working together for a healthy community.

Inside this edition:

The Newest State-Of-The-Art Cancer Treatment for the Region

SUMMER 2015 | PENN HIGHLANDS HEALTHCARE

4

Cover Story Advanced Radiation Treatments at Hahne

QCare 3 7

Quality

8

PHH Contributes to Region’s Economy

10

New Faces

13

Complete Vision Care

14

ShortScripts

16

Advice From A Doctor

On the cover: Don and Kathy Torrey of Potter County with Cooper. Read about Don’s experience at Hahne Regional Cancer Center on page 5.

Welcome to Penn Highlands This is the first edition of our new magazine from Penn Highlands Healthcare. It will give you the most up-to-date news about services at the four Penn Highlands hospitals and what is available to help you lead a healthier life.

The Penn Highlands Healthcare system covers eight counties in western Pennsylvania with 75 miles from east to west. We hope this is a tool that will keep you informed about what is happening in healthcare throughout your region.

This magazine will always be available on our website, www.phhealthcare.org; in waiting rooms throughout our system, and for those who request, it will be available via U.S. Mail.

Thank you for taking the time to read our first edition. We hope you look forward to the next quarter’s edition in the fall.

Next time you’re online Be sure to visit www.phhealthcare.org also check us out on

HealthLines is a publication of Penn Highlands Healthcare. It is produced quarterly by the Marketing Team of Penn Highlands Healthcare which represents the four hospitals of the Penn Highlands system – Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois and Penn Highlands Elk. The HealthLines magazine will always be avaialble on our website at www.phhealthcare.org/magazine. If you wish to subscribe to HealthLines, sign up at phhealthcare.org/getmagazine. For more information please contact the Marketing Team at HealthLines@phhealthcare.org or call on weekdays from 8 a.m. to 4 p.m.

Find A Doctor

Printed copies may be found in the waiting rooms at Penn Highlands Healthcare facilities throughout the eight-county region. You may pick one up at anytime if you prefer.

Penn Highlands Healthcare wants you to know all of your healthcare providers and who is available to help you with your healthcare needs. On our website, www.phhealthcare.org, you can find a provider by name, by location, by specialty or by hospital.

You can even search by gender.

The information in this magazine does not take the place of health advice given to you by your healthcare provider. Always call 911 for any emergency.

The Penn Highlands Healthcare HealthLines Team Mary Jo Yebernetsky, Writer/Editor, 814-375-3495 Mary Jo Herzing, Graphic Design Specialist, 814-375-6539 John Brennan, Marketing/PR Director, 814-375-3494 Amy Duke, Marketing/PR Director, 814-768-2827 Karen Hazlett, Marketing/PR Specialist, 814-788-8532 Brian Musser, Community/Physician Outreach Specialist, 814-375-6508 Lori Rancik, RN, The Women’s Health Center, 814-371-9666

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Are you looking for a healthcare provider? Do you want to know a little more about who your next appointment is with?

Also, a complete listing of all our providers can be downloaded or call a Penn Highlands Healthcare marketing specialist in your area. Names and phone numbers are listed on this page.

QCARE:

Healthcare When You Need It Having a child with an autoimmune disorder can make parents anxious.

A little cold can be a big problem, and immediate help is needed if a fever rises too high.

Emergency Room trips are not fun for any parent and child, and if there is a wait, it can add to anxiety. How can that be avoided?

Dominic and Kelli Surra of St. Marys turn to QCARE. When their daughter, Sophia, 6, was 18 months old, she was diagnosed with autoimmune neutropenia, one form of neutropenia which is most common in infants and young children.

With autoimmune neutropenia, the body identifies the neutrophils, a type of white blood cell, as enemies and makes antibodies to destroy them. White blood cells help the body fight infection.

For Sophia, her body relies on other types of white cells to overcompensate and fight off germs. When she gets sick, those other white cells are outnumbered.

Sophia is at an increased risk for developing serious infections, and for her, they can also be deadly.

When Sophia has a sign of a cold that puts her white cells to work, her parents monitor her and watch her temperature.

High temperatures mean she is in a danger zone, and it could mean she needs more help through medications or hospitalization.

Sophia is monitored by having her blood checked. Dominic and Kelli or her grandparents take her to QCare in St. Marys when that is needed. “Bill (Wittman, the nurse practitioner) knows her history,” Dominic said. “It’s scary until it’s under control, again.”

“We know and trust Bill,” Kelli said.

“He is good with getting back to us. He goes the extra mile for his patients.”

QCare – short for Quick Care - allows Penn Highlands Healthcare to provide fast, convenient care for patients in an office setting. QCares are open in St. Marys, Ridgway and Cameron County, and more are opening soon in Clearfield, DuBois, Punxsutawney and Philipsburg.

The goal is to provide residents throughout the area with healthcare services they need when they need it.

Sometimes people cannot get into their primary care physician fast enough, and they may be hesitant to go to the Emergency Department at a hospital. It’s also ideal for people visiting from out-oftown.

“We stick to the simple things,” Bill Wittman, CRNP, at QCare in St. Marys, said. “We see people with colds, coughs, earaches and sprains. We do splinting and simple suturing.”

QCares offer help for rashes, minor eye problems, cuts, bladder infections, tick and insect bites, and minor animal bites.

They can do blood work and x-rays.

They can provide routine physicals for driver’s licenses and sports activities, tetanus shots and suture removal. QCares can also give routine allergy shots for patients who need them, and particular QCares, such as in St. Marys, provide various joint injections.

QCares are not for people with weakness, headaches, chest pain or complicated abdominal pain. Those are all signs of larger problems, signs that require an Emergency Department visit at a local hospital, Bill said.

Sophia is expected to grow out of her immune disorder, her parents said. This year has been better than last. And no one can tell she needs the extra care by the way she plays with her sisters, Maria, 5, and Gianna, 9. As the girls get older, Dominic and Kelli expect they will just need QCare for their girls’ softball and soccer injuries.

As a wrestling coach, Dominic sees his athletes go to QCare for check-ups to meet PIAA state sport requirements. “After practice, they can head to QCare and get the care or medicines they need immediately,” he said.

“It’s exactly what the name is,” Bill said. “It’s fast service. I can get x-rays, get basic studies and get it pretty darn fast...

People leave happy.”

Sophia Surra

QCARES ARE LOCATED: QCARE CAMERON COUNTY 416 N. Broad Street Emporium, PA 15834

QCARE RIDGWAY

104 Metoxet Street Ridgway, PA 15853

QCARE ST. MARYS New Expansion in 2015 761 Johnsonburg Road St. Marys, PA 15857

Opening 2015-2016: QCare Clearfield QCare DuBois QCare Philipsburg QCare Punxsutawney

Penn Highlands Healthcare also offers

THE CLINIC AT WALMART 100 Industrial Drive DuBois, PA 15801

It does not have x-ray or blood test capabilities.

SUMMER 2015 | 3

ADVANCED RADIATION TREATMENTS AT HAHNE Stronger and Pinpoint Accuracy for Faster Treatments The cancer-fighting arsenal at Hahne Regional Cancer Center received a major upgrade last year.

With the help of new equipment, specialists are taking local cancer treatments to the next level.

In 2014, the Hahne Regional Cancer Center installed the TruBeam linear accelerator – one of the best on the market. It delivers radiation with pinpoint accuracy and speed.

Now, that same state-of-the-art machine is being used to deliver a highly specialized form of treatment that was previously only available at larger centers. This new treatment is called stereotactic body radiation therapy, or SBRT for short.

With SBRT, a precisely targeted high dose of radiation is delivered to the tumor in 4 - 5 treatments over the course of 10 - 14 days as opposed to several weeks of treatment with conventional radiation therapy every weekday.

SBRT can be applied to certain tumors involving the lungs, the liver, pancreas and spine. SBRT requires a team of experts, including a radiation oncologist, a radiation physicist, a dosimetrist and two radiation technologists in order to plan and deliver the treatment.

To pinpoint the cancer, they rely on precise images from a CT or computed tomography scanner, which gives crosssectional pictures of the body. Lasers of

4 | SUMMER 2015

the linear accelerator line up the correct coordinates created by the team.

SBRT works in the same way as other forms of radiation treatment. It does not actually remove the tumor; rather, it damages the DNA of tumor cells. As a result, these cells lose their ability to reproduce and ultimately die.

SBRT is an important alternative to invasive surgery, especially for patients who are unable to undergo surgery and for tumors that are hard to reach or are located close to vital organs.

The initial SBRT cases treated at Hahne will be patients with lung cancer. The Lung Center of Penn Highlands DuBois has been promoting the use of low-dose CT scans at all four Penn Highlands Healthcare hospitals. This started in the fall of 2014 with the goal to identify lung cancers early when most curable.

Brent D. Murphy, president of Dade Moeller Health Group/Physics Services Integrated of South Bend, Ind., stands behind Don Torrey along with his and Hahne’s staff preparing for Don’s first SBRT treatment.

“Lung cancer is just our first step,” Grae Schuster, MD, radiation oncologist at Hahne, said. “Shortly, this treatment will be expanded to include patients whose cancer has spread to the brain. This will help preserve better brain function compared to traditional radiation treatment. In the future, we will be treating liver, spine and other areas as well.”

SBRT

SBRT treatments have advantages other than time.

Compared to traditional radiation, side effects are generally less intense. Some may get soreness in the rib cage following treatment, but there is less fatigue, less skin reaction, less effects on the appetite and smaller risk of soreness when swallowing.

Stereotactic Body Radiation Therapy - A precisely targeted high dose of radiation

SBRT will be primarily used in patients with early stage lung cancer in whom surgery would be too risky. In those patients, SBRT is just as effective as surgery in controlling the tumor.

Though shorter than conventional

therapy in the number of treatments, SBRT does take more time in a single appointment. The precise nature of the radiation requires a more exacting process with more radiation beams to set perfectly.

Staff training and education was provided by the Dade Moeller Health Group/Physics Services Integrated of South Bend, Ind. The staff had an indepth, week-long training.

Though Dr. Schuster had experience with intense radiation therapy with another type of machine, he recently visited and worked alongside Dr. Bobby Koneru, a radiation oncologist in Iowa and SBRT specialist, to perform procedures.

“We are excited to offer this at Hahne,” Dr. Schuster said. “One of the reasons the hospital invested in this accelerator was that it was designed to handle SBRT in additional to conventional treatments.

The purchase of this equipment reflects the investment and dedication to our patients and for all the communities in the Penn Highlands Healthcare region.

Our patients and their families will no longer have to travel away from home to receive this advanced type of radiation treatment.”

Our First SBRT Patient Don Torrey lives in a beautiful country area between Austin and Coudersport in Potter County. He is officially retired, but he still runs his back hoe. He and his wife of 24 years, Kathy, enjoy their time remodeling a camp in Bennezette.

Successful Experience3Complete!

Two years ago in March, Don was working in his shop and coughing up blood. Not a good sign. His primary care physician knew there was a problem, but a regular x-ray wasn’t showing much.

Don went to Dr. Sandeep Bansal at The Lung Center of Penn Highlands DuBois.

(top) Laura Adams, director of Hahne Regional Cancer Center, sits with Don Torrey before his first SBRT treatment. (bottom) Don Torrey’s radiation oncology team at Hahne Regional Cancer center. Around Don are, from left, Dr. Grae Schuster, Traci Tyger, physician assistant; James Miller, radiation therapy supervisor; Sheila Welsh, radiation therapist; Dave Good, physicist.

He was diagnosed with lung cancer. In a bad place in his lungs for an operation, he was treated with a new, stronger chemotherapy and radiation therapy to stop its growth. It worked.

He continued his routine visits with Dr. Bansal and Dr. Carmine Marchioli, medical oncologist, of Oncology Hematology Associates of Northern PA at Hahne Regional Cancer Center in DuBois.

“Hahne has its act together or I wouldn’t drive two hours to get here.”

This year, Don’s PET scan showed a new nodule growing against the chest wall. It can’t be operated on because of the size.

It’s small and too much good tissue would be damaged. His body had became use to the strong chemotherapy drugs, so it limited the choices for chemotherapy for him.

After a visit with Dr. Marchioli and Dr. Grae Schuster, radiation oncologist at Hahne Regional Cancer Center, Don is the first patient at Hahne to receive SBRT, a new, stronger radiation treatment.

SUMMER 2015 | 5

HAHNE REGIONAL CANCER CENTER

In 1984, the Frank Hahne family bestowed a gift of $1.3 million on the City of DuBois to benefit the two hospitals in the city.

As the hospitals merged to be today’s Penn Highlands DuBois, that generous donation helped create the dream of Hahne Regional Cancer Center. It became a long-awaited service for cancer treatment when it opened its doors in 1988.

Today, Hahne has the best state-of-the-art linear accelerator to provide radiation treatments. In the same building along Hospital Avenue in DuBois is the home office of Oncology Hematology Associates of Northern PA , a medical oncology group that also provides chemotherapy.

Through Oncology Hematology Associates of Northern PA, chemotherapy service has now expanded to all Penn Highlands Healthcare locations – at Penn Highlands Elk, at Penn Highlands Brookville and at Penn Highlands Clearfield through the Nathaniel D. Yingling MD Cancer Center.

And if the patients have to come a distance, and this is a barrier to receiving their treatment, transportation can be provided by Hahne van drivers. The goal then is the same goal now: patients should not have to make long trips out-of-town to get the treatments they need.

15 minutes or so with three angles for the radiation to hit a fixed spot.

(top) Don and Kathy Torrey (bottom) Dr. Sandeep Bansal of The Lung Center of Penn Highlands DuBois reviews a CT scan with Dr. Grae Schuster of Hahne Regional Cancer Center.

“He’s a good candidate,” Dr. Schuster said. It will take fewer treatments of stronger radiation – about 7 times stronger – to help Don stop this nodule from growing.

Because there is a briefer course of treatment, generally the side effects are less. Some get soreness in the rib cage following treatment, but there is less fatigue, better appetite and easier swallowing for lung patients.

“I’m really not that bad,” Don said when asked about his side-effects. He has been a little tired, but he attributes that to other medication he is taking.

Though shorter than conventional therapy in the number of treatments, SBRT takes more time in a single appointment. Conventional treatments take

6 | SUMMER 2015

SBRT takes longer because it’s a much more exacting process to perfectly line up nine individual treatment beams on three planes. And people breathe. There is a need for being more exact when the tumor moves as a patient breathes in and out.

Don said he is not much for lying still for 45 minutes, but he soon learned how far along he was in a treatment by how the machine moved.

Was Don nervous being the first SBRT patient? He wasn’t at all. “I got faith in these guys,” he said. “Hahne has its act together or I wouldn’t drive two hours to get here.”

As for his cancer, he is doing well. “The sun comes up and it’s a new day.

My wife has given me lots of support. With her, there never is a down moment.”

NATHANIEL D. YINGLING, MD, CANCER CENTER

Penn Highlands Clearfield has a long history of providing state-ofthe-art medical oncology care, dating back to the 1970s when Dr. Leonard F. Schickling established the hospital’s first Chemotherapy Clinic. In 2006, the service was relocated to the Nathaniel D. Yingling, MD Cancer Center, 815 Doctors’ Drive, Clearfield, and named in honor of the late Dr. Nathaniel D. Yingling.

The cancer center provides a comfortable environment with a choice of settings for receiving chemotherapy treatment. The design allows respect for the dignity of each patient, and family members to participate in the decision-making, treatment choices and supportive care.

Our Commitment Makes a Difference Quality. It’s what we all want in healthcare. And Penn Highlands Healthcare wants to provide the best quality healthcare for its patients.

Dr. Gary DuGan, chief medical officer for Penn Highlands Healthcare, oversees initiatives that improve quality throughout the four hospitals.

“Providing for quality care starts at the board of directors.

Our Penn Highlands board has formed a Board Quality Oversight Committee,” DuGan said.

This committee is made up of one board member from each of the four hospitals’ boards, the physicians on the board of directors and is chaired by Dr. Carmine Marchioli, chief of medicine at PH DuBois.

The committee follows the work that is being done through reports, statistics and action plans. They have approved a system-level quality assessment/performance improvement plan and have standardized all the individual hospitals plans.

Reporting to the board-level committee is the Quality Improvement Committee that meets monthly. It is comprised of the four hospitals’ Performance Improvement Department leaders: Amy Fraccola, director of Organizational Performance Improvement and patient safety officer at PH Brookville; Catherine Civiello, director of Performance Improvement/ Education at PH Clearfield; Sherry McKee, director of Performance Improvement at PH DuBois; and Christine Garner, director of Quality, Infection Control and Risk Management at PH Elk, and the hospitals’ chief nursing officers: Debra Thomas of PH Brookville; Kathy Bedger of PH Clearfield; Janice Hamscher of PH DuBois and Mary Ellen Smith of PH Elk, with Dr. DuGan as chairman.

This committee sets the stage for everybody in the field.

It defines the plans and holds staff accountable for getting the best practices into action. It sets the goals for the hospitals three sub-teams.

The first sub-team is the Patient Experience Committee.

This group reviews the Medicare website ratings that patients give at each hospital for things such as the level of noise, cleanliness and staff friendliness.

The ratings are compiled through surveys sent through a third party, Press Ganey, and results are submitted to the government with copies sent to the hospitals. The ratings are one to five stars with five being the best. “Our focus is a four star or better rating,” Dr. DuGan said.

This team started initiatives such as hourly rounding by nursing, improved communication boards in patient rooms and giving report at change of shift at bedside.

The second sub-team is the Highmark Quality Blue Committee.

Highmark, as an insurance company, offers those hospitals who accept Highmark insurance, incentives for performing well, based on Highmark’s care measures.

These Highmark initiatives encourage things that catch problems early for patients – such as mammograms, eye exams, and colonoscopies – and for prevention of in-hospital infections or reactions by following up-to-the-minute protocols for care.

“It can bring significant revenue to Penn Highlands if we do well,” Dr. DuGan said. “In the end, it’s all about providing the best care we can for our patients.”

The third sub-team is the Pay for Value Committee. This group focuses on Medicare standards. If any hospital that accepts Medicare does not meet benchmarks set by Medicare, there can be significant financial penalties.

These benchmarks measure overall care, re-admission rates for patients and healthcare-associated conditions or infections.

And those are just the committees all ready at work.

Regularly, physicians at Penn Highlands receive report cards that track how they are performing based on national qualitystandards. This report also gives them a comparison on where they stand among their peers.

Dr. DuGan is also working with several area skilled-nursing facilities to improve patient care.

“Penn Highlands Healthcare is committed to providing the best quality care in our region,” Dr. DuGan said. “In the end, all of our quality initiatives benefit our patients and our community.”

SUMMER 2015 | 7

THE HOSPITAL & HEALTHSYSTEM ASSOCIATION OF PENNSYLVANIA REPORT

Penn Highlands Healthcare Contributes $906 million to Region’s Economy Penn Highlands Healthcare annually contributes about $906 million to the region’s economy, according to a report recently released by The Hospital & Healthsystem Association of Pennsylvania, or HAP. Penn Highlands also supports 3,636 jobs in the region.

PENN HIGHLANDS HEALTHCARE is comprised of four regional hospitals – Penn Highlands Brookville, Penn Highlands Clearfield, Penn Highlands DuBois and Penn Highlands Elk. The HAP report shows both the human and financial impact of Pennsylvania’s hospitals on communities across the state, as well as on the state as a whole.

The economic impact figure reflects contributions to the economy through employment, purchased services and supplies from businesses and capital spending.

“Penn Highlands Healthcare plays a major role in the economic and social well-being of our community,” said Raymond A. Graeca, chief executive officer of Penn Highlands Healthcare. “We are a safety net for our most vulnerable citizens and are playing a critical role in population health efforts that improves quality of life.”

Penn Highlands Healthcare pays nearly $179 million in salaries. The ripple effect of

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those salaries through employment created indirectly by the hospital is an additional $158 million, for a total benefit of $337 million in salaries and wages.

Penn Highlands Healthcare’s also supports the community by providing medical care to those unable to pay, providing community services such as free health screenings and providing in-kind, volunteer and/or financial support to charitable organizations and local community programs, such as the March of Dimes, the American Cancer Society’s Relay for Life, Free Medical Clinic of DuBois and the Susquehanna Rural Free Medical Clinic.

“Penn Highlands Healthcare is not only a place for healing, but it is also vital to the region’s economic stability. Our hospitals and the people they employ support local businesses and serve as a crucial economic stimulus. As we move forward, our goal is to continue to invest in the communities we serve and strengthen healthcare and economic resources in the region,” Steven Fontaine, chief operating officer of Penn Highlands Healthcare, said.

Several initiatives are currently under way to accomplish this goal. Among those are a continued emphasis on recruiting physicians and advanced practice providers, improving access to care through new outpatient medical centers in DuBois and Philipsburg and pursuing critical access designation for Penn Highlands Elk. Adding more primary care and specialty physicians and mid-level practitioners is a top priority. Thanks to an ongoing aggressive provider recruitment program, the system has 363 physicians and 130 advanced practice providers on staff, with plans to grow.

In 2014, Penn Highlands Healthcare realized much success in recruiting a number of new physicians, including cardiovascular surgeons, family practitioners and women’s care specialists. A partnership with University Orthopedics Center of State College expanded access to additional orthopedic services such as total joint replacement and sports medicine.

Penn Highlands will also be working with

several medical schools to facilitate the rotation of medical students at all four of the system’s hospitals. By serving as a pathway for medical students, Penn Highlands hopes to encourage these students to remain and practice in the region.

Two new buildings in the region, representing a total investment of $17 million, will further improve access to care.

DuBois Community Medical Building in DuBois, slated to open later this summer, will house a retail pharmacy, walk-in clinic, sleep lab, physician offices, an infusion center and gastroenterology suites.

Opening in the fall, the Moshannon Valley Community Medical Building, located on seven acres near the intersection of North Front and Railroad streets in Rush Township, will offer primary care, surgical services, orthopedic services, outpatient diagnostic testing and ophthalmology. Among the new services planned are a QCare walk-in clinic, digital mammography and bone mineral density testing.

A

3,636 JOBS IN THE REGION

$337 MILLION IN SALARIES AND WAGES

docking area will provide the opportunity for mobile healthcare services in the future.

economic health of the Commonwealth,” said HAP President and CEO Andy Carter.

Along with the new QCare in Philipsburg, Penn Highlands Healthcare plans to open a walk-in clinic at PH Clearfield, along with enhanced outpatient services.

“Hospitals and health systems play an integral role in this effort. By example, Governor Wolf seeks to build on the ‘innate strengths of Pennsylvania’s economy.’ His goals of workforce development, attracting investments in research and strengthening our world-class healthcare system align with the hospital and health system community’s vision for the future,” he said.

The new walk-in clinics will build upon the success of others in the health system, which are located in Ridgway, St. Marys, Emporium and DuBois.

Penn Highlands Elk is in the process of obtaining the Medicare designation of a Critical Access Hospital, or CAH. The new designation will positively affect the reimbursement rate that Medicare and Medicaid will pay the hospital for its services. Instead of receiving a percentage of the bill, based on diagnoses codes, the hospital will return to a cost-based reimbursement structure. A large portion of PH Elk’s patients are Medicare or Medicaid participants, and the increased reimbursements will have a positive financial impact.

“These initiatives are among many others that will redefine Penn Highlands Healthcare’s mission, improve customer service, enhance quality and increase access to care at all of our hospitals. It is a privilege for our healthcare system $17 MILLION to not only care INVESTMENT for the region’s IN THE REGION residents, but to also serve as an economic anchor,” Fontaine noted.

Statewide, hospitals 363 PHYSICIANS contribute AND 130 $111 billion to ADVANCED the economy, PRACTICE an increase of $7 billion since 2013, PROVIDERS and support 591,000 jobs—about one in ten jobs in Pennsylvania.

“Policymakers at all levels of government are working to improve the

Carter stressed that hospitals are integrated in their communities – providing relationship-based services. “Hospitals are

integral players in improving the quality of life in the Commonwealth. They do this not only through delivery of health care services, but as top employers, creating spinoff services and providing family-sustaining jobs.”

HAP is a statewide membership services organization that advocates for nearly 240 Pennsylvania acute and specialty care, primary care, subacute care, long-term care, home health, and hospice providers, as well as the patients and communities they serve.

Additional information about HAP is available online at www.haponline.org.

Come be a part of our exciting future Fall 2015 DuBois Community Medical Building • • • • • •

Retail Pharmacy Walk-in Clinic Sleep Lab Physician Offices Infusion Center Gastroenterology Suites

Moshannon Valley Community Medical Building • Primary Care • Surgical Services • Orthopedic Services • Outpatient Diagnostic Testing • Ophthalmology • Walk-in Clinic • Digital Mammography • Bone Mineral Density Testing SUMMER 2015 | 9

Albert D. Abrams, MD, FACR Rheumatology 867 Beaver Drive DuBois, PA 814-372-0912

Amber R. Bowser, DO Family Medicine 416 North Broad Street Emporium, PA 814-486-2202

Shujayat Ali, MD Pediatrics 761 Johnsonburg Road St. Marys, PA 814-778-8015

Shae Burkett, CRNP Urology 145 Hospital Avenue DuBois, PA 814-375-9200 and 809 Turnpike Avenue Clearfield, PA 814-765-1484

Alan Arthur, MD Family Medicine 104 Metoxet Street Ridgway, PA 814-772-8122

Bradley A. Barter, DO Orthopedic (Foot and Ankle) Surgery 145 Hospital Avenue DuBois, PA 1-800-505-2101

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Chad D. Caldwell, MD General Surgicalist 145 Hospital Avenue DuBois, PA 814-375-4000

Amanda Calhoun, CRNP QCare Ridgway 104 Metoxet Street Ridgway, PA 814-788-5556

AT PENN HIGHLANDS

Kenneth L. Cherry, MD Orthopedic Surgery 145 Hospital Avenue DuBois, PA 1-800-555-2101

Anuj K. Chopra, MD Urology 809 Turnpike Avenue Clearfield, PA 814-765-1484

Wilkerson Compere, MD Internal Medicine 1049 North Front Street Philipsburg, PA 814-342-9701

Franki Crawford, PA-C Family Medicine 761 Johnsonburg Road St. Marys, PA 814-834-2850

William D. Fritz, MD Orthopedic Surgicalist 145 Hospital Avenue DuBois, PA 814-375-7797

Maofu Fu, MD, PHD Medical Oncology 815 Doctors’ Drive Clearfield, PA 814-768-2132

At PH Clearfield Pediatrician Mary Clare ManinangOcampo, MD, of the Penn Highlands Center for Children’s Care, located at Penn Highlands Clearfield, is shown with Keatin Bloom, daughter of Kristin Siwy and Corey Bloom, of Curwensville.

Mackenzie Gonder, PA-C Family Medicine 1049 N. Front Street Philipsburg, PA 814-342-9701

A. Hadi Hakki, MD Cardiovascular & Thoracic Surgery 145 Hospital Avenue DuBois, PA 814-375-2040

Grace W. Kao, DO Internal Medicine 761 Johnsonburg Road St. Marys, PA 814-834-6565

Raj R. Kaushik, MD, FACS, FACC Cardiovascular & Thoracic Surgery 145 Hospital Avenue DuBois, PA 814-375-2040

Mary Clare ManinangOcampo, MD Pediatrics 1033 Turnpike Avenue Clearfield, PA 814-768-7618 and 1049 North Front Street Philipsburg, PA 814-342-9701

Christopher S. McClellan, DO Orthopedic Surgeon 145 Hospital Avenue DuBois, PA 1-800-505-2101

Dustin P. McRae, DO Emergency Medicine 100 Hospital Avenue DuBois, PA

We’re proud to introduce the newest members of our heathcare team from July 2014 to June 2015. They look forward to being there for your healthcare needs.

Traceyan Mendez, MD Family Medicine 465 State Street Curwensville, PA 814-236-1123

Rafik D. Muawwad, MD Orthopedic Surgicalist 145 Hospital Avenue DuBois, PA 814-375-7797

John S. O’Shea, MD General Surgicalist 145 Hospital Avenue DuBois, PA 814-375-4000

SUMMER 2015 | 11

AT PENN HIGHLANDS Ryan Rice, MD Plastic, Reconstructive and Cosmetic Surgery 90 Beaver Drive DuBois, PA and St. Marys Community Medical Building 1100 Million Dollar Hwy. St. Marys, PA 814-503-8368 Anita Pandey, MD Internal Medicine 761 Johnsonburg Road St. Marys, PA 814-834-2850

Kelley R. Smith, DO General Surgery 145 Hospital Avenue DuBois, PA 814-375-4000

Lance Thompson, PA-C Behavioral Health Services 635 Maple Avenue DuBois, PA 814-375-6379

Steven Sprankle, DO Non-Invasive Cardiology 145 Hospital Avenue DuBois, PA 814-375-3722

William A. Tyndall, MD, PHD Sports Medicine 145 Hospital Avenue DuBois, PA 1-800-505-2101

Grae L. Schuster, MD Radiation Oncology 100 Hospital Avenue DuBois, PA 814-375-3535 Sanjay Ramchandani, MD, FACOG Obstetrics/Gynecology 145 Hospital Avenue DuBois, PA 814-371-6172 Paul R. Sensiba, MD Sports Medicine 145 Hospital Avenue DuBois, PA 1-800-505-2101

Melanie Riglin, PA-C Family Medicine/Qcare 761 Johnsonburg Road St. Marys, PA 814-788-8777

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Derrick P. Thomas, PA-C Family Medicine/Internal Medicine 100 Hospital Road Brookville, PA 814-849-1874 and 22 Industrial Park Road Brookville, PA 814-849-0990

At PH Brookville Dr. Steven Sprankle of DuBois Regional Cardiology Associates now sees patients in the Cardiopulmonary Department of Penn Highlands Brookville.

He is shown with Matt McCracken of Brookville.

Amy Wysocki, MD Psychiatry 635 Maple Avenue DuBois, PA 814-375-6379

What types of issues would a retina specialist see?

Retina detachment - when the retina separates from the wall of the eye, similar to wallpaper being pulled off a wall.

Diabetic retinopathy - when damage occurs to the blood vessels in the retina.

Floaters- little specks or cobwebs that float in your field of vision. If they are sudden and numerous that may be a sign of a more serious eye problem. (Most of us have floaters that occur over time and are not harmful.)

Age-Related Macular Degeneration – a common eye disease associated with aging that can destroy central vision. The retina has a small area in its very center called the macula.

This is the only part of the retina that can see with good detail, and it gives us our “straight ahead” or “central” vision. ARMD damages the macula and therefore harms our central vision.

Macular Edema - fluid and protein deposits collect on or under the macula of the eye, the central area of the retina, and causes it to thicken and swell.

The most common side effect of macular edema is blurry vision.

Waviness and distortion may also be noted. In cases where the edema is adjacent to, but not involving the central vision, e.g. in many cases of diabetic edema, there may not be any symptoms at all and the edema can only be found by routine examination.

Macular Pucker - when an abnormal membrane grows on the surface of the retina and cause wrinkling, or puckering of the retina. Macular pucker is sometimes also referred to as macular fibrosis, or epiretinal membrane.

Retinal Vein Occlusion - blockages of the blood flow through the veins that take blood away from the retina that lead to blurry vision.

Complete Vision Care at PHH Having a vision problem is scary. The eye is a small but a very complex organ.

retinal detachment, and other disorders of the retina and vitreous.

There are physicians who specialize in eye care and eye surgery that daily work with patients of our region who have cataracts, glaucoma, eye muscle problems, blocked tear ducts, and corneal or eye injuries. They also see patients with macular degenerations, double vision and all diseases of the eye.

Beginning in May, Marc Estafanous, MD, board-certified ophthalmologist and retinal surgeon began seeing patients at 529 Sunflower Drive, DuBois. This is also the DuBois office of Penn Highlands Ophthalmology.

They are Dr. John Fabre, Dr. Thomas Smith, Dr. Timothy Marra and Dr. Ryan Bisby, all of Penn Highlands Healthcare Ophthalmology with offices in Clearfield, Clarion, DuBois and Philipsburg, who perform surgeries Penn Highlands DuBois, Penn Highlands Clearfield and Clarion Hospital.

There are also Dr. Bonny Beck, ophthalmologist with an office in DuBois, who performs surgeries at PH DuBois and PH Brookville, and Dr. Brett Karlick, an ophthalmologist in St. Marys who performs surgeries at PH Elk and its surgery center.

But there are times that things are even more complex in the eye that a specialist within the specialty is called upon.

To help patients with complex eye issues, Penn Highlands Healthcare has entered into a new association with VitreoRetinal Consultants of Hermitage.

Vitreo-Retinal Consultants is a private practice of ophthalmologists who specialize in treating disorders of the vitreous and retina.

The retina is the light-sensitive layer of tissue that lines the back of the eye and acts like the film in a camera. It captures visual images and transmits that information to the brain to be seen.

The vitreous is a gel-like substance that fills the eye.

Vitreo-retinal surgeons use lasers, surgery and medicines to treat macular degeneration, diabetic eye disease,

Dr. Estafanous graduated with honors with a degree in mathematics and psychology from Johns Hopkins University in Baltimore, Maryland. He attended medical school at Georgetown University School of Medicine in Washington, D.C., and completed his residency training in ophthalmology at The Cleveland Clinic Foundation. He completed his fellowship subspecialty training in vitreo-retinal disorders at the Jules Stein Eye Institute in Los Angeles, California. He has been a valued member of the medical staff at Vitreo-Retinal Consultants since 2003.

“We are excited about the new arrangement we now have with Dr. Marc Estafanous,” said Dr. Smith on behalf of Penn Highlands Ophthalmology. “This new relationship will have a major impact on our patients as well as other patients in the community. Evaluations and injections are now possible in the DuBois office.”

“It’s great that we have a retinal specialist so close for the patients to alleviate traveling for them,” Dr. Karlik said.

“Retinal eye problems affect many people and we are delighted that we are able to provide this service to our patients,” Dr. Smith added.

Dr. Estafanous is seeing patients in DuBois every other Wednesday. For more information on the listed and other retina conditions, please visit Patient Education section of the Vitreo-Retinal Consultants website at www.vitreoretinal.com, or call 1-800-476-3129.

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ShortScripts

Penn Highlands Healthcare is making it easier to pay your bill with online bill pay.

When you log onto www.phhealthcare. org, look at the upper right corner of your screen. You will see the “Pay Bill” option.

You will be given the choice of the four PHH-system hospitals to choose from.

Click on the correct hospital to pay your bill.

You will need your access code which is located on your statement. The rest of the information is simple – the patient’s name, birth date, address along with payment information from a credit card.

We have aqua therapy! The difference between aquatic physical therapy and aquatic exercise is that aquatic physical therapy includes the specialized clinical reasoning and decision making of a physical therapist. After a thorough evaluation, a physical therapist develops an individualized treatment program addressing the patient’s specific physical needs.

The use of water can create a near zero gravity environment by varying its depths. This gravity reduction allows you to perform activities that you would be unable to perform on land.

If you would like more information about this, please feel free to contact Penn Highlands Elk at 814-788-8490 option 1, Penn Highlands DuBois at 814375-3372 or Penn Highlands Brookville at 814-849-6878.

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Looking for an easy way to make a donation to remember someone? Penn Highlands Healthcare offers online donations.

When on www.phhealthcare.org, click on the word “Donate” in the upper right corner of the screen. You may then choose the hospital you wish to support, and then possible projects or funds are listed for you to further indicate where your donation should go. If you don’t see what you are looking for, you may choose “other” or “general fund.”

If you are donating in honor or in memory of someone, please fill in the necessary information to notify the person or family.

We are truly grateful for the longstanding financial support we've received from our neighbors and friends.

Your generous gift will make a difference in the lives of our patients. One hundred percent of all contributions go directly to patient care and are used for the purposes designated by the donors. Donations are never used for salaries or other operating expenses. All contributions are tax deductible according to IRS regulations, and are acknowledged for your records.

Adults ages 55 and older can have biological and emotional changes as they age. Where do you turn? Penn Highlands Healthcare offers Behavioral Health Services at its four hospitals with three – Penn Highlands Clearfield, Penn Highlands Brookville and Penn Highlands Elk – offering in-patient treatment.

The conditions treated include: • Major depression • Excessive fears and anxiety • Suicidal thoughts and/or actions • Acting out or dangerous behaviors • Compulsive disorders • Hallucinations and delusions • Behavior problems associated with dementia For more information to help yourself or a loved one, please call the Senior Transitions Unit at Penn Highlands Brookville at 814-849-1845, Generations at Penn Highlands Elk at 814-788-8876, Bright Horizons at Penn Highlands Clearfield at 814-768-2184 or Penn Highlands DuBois Behavioral Health Unit at 814-375-6379.

It’s one of the hottest tickets around.

The Penn Highlands Brookville 1-in100 fundraiser is Saturday, September 12, at the Pinecrest Country Club, Brookville. It is sponsored by the hospital’s Development Committee.

There are only 100 tickets sold, and last year’s ticket holders have the chance to purchase tickets first. In its 14th year, a waiting list has been created for those interested. For more information on tickets, call 814-849-1832 or 814- 3753901.

Patients with diabetes have options at all four Penn Highlands Healthcare hospitals for one-onone care, and they also have the opportunity to meet with others in a support group setting, too.

Penn Highlands DuBois and Penn Highlands Elk both offer support groups for those who have diabetes that are free to attend. It’s a great way to get up-to-date information from expert speakers and talk to those who also understand living with diabetes.

The Diabetes Support Group of PH DuBois is held at 6:30 p.m. on the third Tuesday of every month in Room 107 of the Central Resource Center at PH DuBois West. It is led by a volunteer along with one of the diabetes educators from The Diabetes and Nutrition Wellness Center of PH DuBois. Call 814375-3890 for more information.

At PH Elk, the Diabetes Support Group of PH Elk meets the last Wednesday of every other month in the hospital’s Diabetes Conference Room at the hospital at 4 p.m. The group is facilitated by diabetes educators. To learn more, call 814-788-8660.

The Penn Highlands Clearfield Hospice Chili Bowl will be held September 17 from 5-9 p.m. at the Clearfield Driving Park, Expo II Building, Clearfield. The theme for this year’s event is “Game On.” There will be many different chilis to taste, a band, children’s activities and more! Admission is free.

All Chili Bowl proceeds benefit Penn Highlands Clearfield Hospice patients and their families facing end-of-life issues, as well as the bereavement program. For more information, call 814-768-2012.

Community CPR Classes Heartsaver AED and First Aid Training are held regularly throughout the year at Penn Highlands Brookville.

Cost is $25 and classes usually run from 5-8 p.m. in the PH Brookville Education Conference Center next to the hospital. Call 814-849-1870 to register.

Penn Highlands Clearfield Hospice and Community Nurses will hold their annual butterfly releases on Sunday, August 2 at 2 p.m. at the Clearfield Driving Park, Clearfield, and at 1 p.m. at The Serenity Garden at Penn Highlands Elk, respectively.

Penn Highlands DuBois will hold its first butterfly release on Saturday, August 22 at 2 p.m. in the DuBois City Park. These events are designed to remember loved ones who have passed. Hundreds of butterflies are released to honor their memories. Some butterflies flutter away immediately, while others delight the crowd by staying to rest on hands, shoulders and nearby flowers and bushes. People are invited to sponsor one or more butterflies, with proceeds going to hospice programs.

For an order form, please visit www.communitynurses.org or www.phhealthcare.org.

Come to the Penn Highlands Healthcare/ KTH Architects Golf Classic on Friday, August 21, 2015!

For the first time, we are combining all four Penn Highlands Healthcare hospital tournaments into one ultimate golf event.

Golfers may direct donations where they wish, selecting from: Penn Highlands Healthcare, where it will be shared equally among the four hospitals, PH Brookville for renovations to the post-acute rehab unit; PH Clearfield for anesthesia machine upgrades; PH DuBois for renovations to medical-surgical units; or PH Elk for enhancements to the beside reporting process.

Tee times are available at three courses at the DuBois Country Club, the Silver Course at Treasure Lake and the Gold Course at Treasure Lake, all centrally located in DuBois.

Call 814-375-3901 for more information!

It’s time to

Girls Night Out hosted by The Women’s Health Center of Penn Highlands Healthcare will be held in October.

Get an update on the latest in breast cancer screening and care available in our region at this Spirit of Women signature event.

Look for the cupcake on postcards, posters and announcements coming soon!

SUMMER 2015 | 15

Advice From A DOCTOR RYAN RICE, MD Penn Highlands Plastic, Reconstructive and Cosmetic Surgery A Service of Penn Highlands DuBois

814-503-8368

Summer Skin Safety We’ve all seen that overly-aggressive mom slathering sunscreen on her kids at the beach or the amusement park. While many of us have chuckled as she gets the SPF 50 on every square-inch of her children, healthcare professionals agree that she is correct in making sure her children are protected against the harmful rays of the sun and that the rest of us should be following her example.

More than 10,000 people in the United States die from skin cancer every year. It is the most common form of cancer and one of the most preventable. And, when detected early, it is also one of the most treatable cancers.

Ryan Rice, MD, plastic and reconstructive surgeon at Penn Highlands Healthcare, said that protecting your skin is one of the most important steps a person can take toward cancer prevention.

cancers are classified as non-melanoma, usually occurring in either basal cells or squamous cells. These cells are located in the base of the outer layer of the skin or cover the internal and external surfaces of the body.

Most non-melanoma skin cancers develop on the sun-exposed areas of the body, like the face, ear, neck, lips and the backs of the hands.

Melanoma is the most dangerous type of skin cancer. It’s a cancer that begins in the melanocytes – the cells that produce the skin coloring or pigment, know as melanin.

Melanin helps protect the deeper layers of the skin from the harmful effects of the sun.

According to the American Cancer Society, or ACS, melanoma is almost always curable when it’s detected in its early stages.

Although melanoma accounts for a small percentage of skin cancer, it’s far more dangerous than other skin cancers, and it causes the majority of skin cancer deaths.

“As with all types of cancer, early diagnosis is the key,” Dr. Rice said. “Everyone should be familiar with their skin and watch for changes. If you notice a change in a mole or your skin’s appearance, you should see your primary care physician.”

“There’s really no such thing as a healthy tan,” Dr. Rice said. “Long-term exposure causes prematurely aged skin, wrinkles, loss of skin elasticity, dark patches, precancerous skin changes and skin cancer.”

Here is what the ACS says you should look for:

There are two types of skin cancer: non-melanoma and melanoma. Most skin

•

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•

•

Any change in the skin, especially the size and color of a mole or darklypigmented growth.

Scaliness, oozing, bleeding or change in appearance of a bump or mole.

The spread of pigmentation beyond its border such as dark coloring that

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spreads past the edge of a mole or mark.

A change in sensation, itchiness or pain.

Protect yourself and your loved ones, Dr. Rice recommends. Follow the ACS guidelines: •

• •

•

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Avoid the sun between 10 a.m. and 4 p.m. The sun is typically hottest and does the most damage between noon and 2 p.m.

Seek shade.

Wear protective clothing while in the sun, such as a hat. Choose clothes made of tightly-woven fabrics that you cannot see through when held up to a light.

Use sunscreen with a sun protection factor of 15 or higher. Apply a generous amount and reapply frequently. Apply it 30 minutes before going outside to ensure it has been properly absorbed.

Use sunscreen even when it’s hazy or overcast.

Wear sunglasses with UV absorption to protect eyes.

“Enjoy the outdoors,” Dr. Rice said. “Go to the beach or enjoy the beautiful region we live in and take advantage of the summer.

However, you can never be too assertive when taking a few simple precautions to protect your skin.”