December 2020 PULSE

DECEMBER 2020

IN THIS ISSUE Clinician’s Corner by Michael Krukiel An Overview of Femoroacetabular Impingement Syndrome (FAIS)

INTRODUCING PTSMC’S PARTNER LEADERSHIP COUNCIL! I am extremely proud and thankful that eleven partners agreed to participate in an election to determine PTSMC’s first ever Partner Leadership Council (PLC). The five partners elected to serve in 2021 are: Scott Cameron, Westbrook Pete Catuccio, Watertown Rebecca Petrosino, Fairfield Brian Vo, Windsor Erin Walsh, Waterbury After the initial shock of the Covid-19 pandemic began to fade, I found myself looking for opportunities to learn from the experience personally and to improve PTSMC. In many communications I have written or spoken of “The Other Side.” Essentially, the day when the “Covid Era” ends and we go back to “normal.”

It has become increasingly clear that getting to the other side will take longer than anyone had hoped, and it will be more of a journey than a quick flip of a switch. With that in mind, and considering what we’ve learned in the past eight months, we are taking proactive steps and making changes to become a better organization along the way. One of those changes is the creation of the Partner Leadership Council.

The concept of the PLC was created in some of the pandemic’s darkest hours in March, April and May. Leadership spent many nights on two-hour plus conference calls after long and stressful days doing our “regular jobs” in order to collectively discuss and find the best way to

Virtual Organization Inservice FEEDBACK! 97% of respondents felt that given the circumstances, VOI was “good” or “great”

The Extra Mile by Kristen Forster The WOW Experience PTSMCs Orthopaedic Residency’s New Class

HR Buzz move forward through the crisis. Regardless of participants’ intentions, passion and commitment, it became clear that it was extremely difficult Wellness Program Lifebeat to be proactive and productive with 30 people on a GoTo meeting.

Wellness Incentives - Physicals Wellness Calendar I had the idea of creating a smaller, all-volunteer council of partners that would agree to meeting formally and informally through 2021. The council would be a peer elected group comprised of three tiers determined by the size of the office.

StriveHub Fab 5

“I feel safe with the telemedicine format and Amy (Demers) has been so encouraging and supportive and good humored about every part of the PT process - even when my cat hung up our video call when I was mid-exercise. Jacey (Bissell) was also super kind and I know every partner and director is focused on safely rebuilding their teams and clinics to deliver on our mission to the communities we serve. informative when I called in - she got me started and set up with ease. Thank you I am confident that will continue as we get to the other side and for everything so far!” - Branford beyond.

The intent of the PLC is: To facilitate greater connectivity to clinical leaders, Alan and admin.

To harness the talent “in the field and in admin” to move organizational challenges and opportunities forward.

To enhance problem solving, internal communication, and growth.

I am also confident that the Partner Leadership Council will be one of the positive advances PTSMC is making now and for the future.

Please stay vigilant and safe!

Alan

Patient Trends New Patients per Month

98%

of respondents felt that the Years of Service recognition was “good” or “great” while many made the excellent suggestion it would have been nice to see photos of the recipients

Visits per Month

99% of respondents felt that VOI was

informative

96%

of respondents felt that the Top Workplace Gift was “good” or “great” while some commented that they would have liked a more commemorative gift

Orange = 2019 | Blue = 2020

“The staff at Physical Therapy & Sports Medicine Centers are extremely welcoming and engaging. They are professional and up for a challenge! Even as a child in an adult setting, my son feels comfortable and enjoys attending his sessions. He has made quick and promising progress thanks to his dedicated therapist.” - Danbury “Everyone seems like they really care. The front desk staff, Randi (Gallagher), was always pleasant and ready to help. I could not recommend this place more to anyone who is looking for physical therapy.” - East Hampton “I have never been somewhere that has given such quality care and support to my injuries. I recommend this place to everyone I know that needs physical therapy or could benefit from the techniques they use.” - Middletown “Mike (McGowan) is the best physical therapist I have ever been to. He is very experienced and knowledgeable and with his help I’ve been able to to still do the sports I love pain free. Overall the facilities are very clean and all staff are very courteous and helpful. I will always recommend physical therapy and sports medicine centers to anyone who needs it.”

- Windsor

CLINICIAN’S CORNER AN OVERVIEW OF FEMOROACETABULAR IMPINGEMENT SYNDROME (FAIS)

By Michael Krukiel, PT, DPT Physical Therapist at PTSMC Simsbury & Wethersfield FAIS was popularized in the early 2000’s when Dr. Ganz developed a new arthroscopic surgical approach, however, it was not widely appreciated in research until nearly 10 years later (Figure 1). Since then arthroscopic surgery has seen a 25x increase and there has been extensive debate regarding the optimal course of care.

Figure 1 Casartelli 2015 states that 87% of athletes that underwent hip surgery for FAIS did return to sport and 82% of those returned to sport at the same level as before occurrence of symptoms.2 Reiman 2018 states that 9 out of 10 athletes returned to sport at 7 months ± 2.6 months.

However, only 74% of these returned to sport at pre-injury levels. However, 88% of professional athletes, 85% of college athletes, and 80% of adolescent athletes returned to sport at pre-injury levels. This article defined return to sport as either returning to sport or not, therefore, lacking specific criteria detailing how well the athlete is performing or if they are even getting playing time.

The 2016 Warwick agreement defined it as “FAI syndrome is a motion-related clinical disorder of the hip with a triad of symptoms, clinical signs, and imaging findings. It represents symptomatic premature contact between the proximal femur and the acetabulum”3 FAIS is commonly found in variations; the first being CAM (40%), pincer (8%), and mixed (52%) (Figure 2).7 This becomes an issue as it may lead to acetabular labral tears and early onset of hip OA. Figure 2

Ishoi 2018 published an article with clearly defined return to sport criteria.5 It was found that 57% did return to sport and only 17% of athletes have a subjective report of returning to optimal performance. This return to sport data is considerably lower than Casartelli 2015 and may reflect the use of a clear and strict return to sport definition.

Mansell 2018 recruited 80 active duty military members that were eligible for surgery.6 It was found that when comparing hip arthroscopy to 12 physical therapy sessions in a 3 week span there was not a significant difference between the two groups at 2 years. In both groups, 33% of patients in both groups were medically separated from military service at 2 years.

Lastly, Griffin 2018 compared hip arthroscopy and an individualized, supervised, and progressive physical therapy lead program.4 Hip arthroscopy and personalized hip therapy both improved hip-related quality of life for patients with FAIS. Hip arthroscopy led to a greater improvement than did personalized hip therapy, and this difference was clinically significant.

Limitations include a lack of control group, 47 different physical therapist were trained in the physical therapy lead programs that were designed prior to 2012, and only 23% of patients reported having no progression in their exercises.

The Warwick agreement by Griffin3 et al states that a patient must report subjective symptoms, clinical signs, and imaging findings to be diagnosed with FAIS. Subjective complaints are commonly deep anterior groin pain with prolonged activities, intermittent sharp deep groin pain, pain with flexion or rotation tasks, pinching or aching to the hip or groin, stiffness in the hip or groin, and pain with repeated sitting, twisting, or pivoting. Mechanical symptoms such as clicking, popping, or catching are not included as criteria for diagnosis of FAIS. On physical exam internal rotation and flexion as well as combined internal rotation and flexion are expected to be limited and painful. Demonstration of a Trendelenburg gait, significant hip flexion weakness, decreased hip muscle strength, and pain with deep squat are also helpful for the diagnosis of FAIS. Hip impingement tests such as FADIR attempt to create a symptomatic mechanical abutment and despite having a strong SN and -LR it has a poor SP and +LR, therefore performing better as a screening test and not as a test of diagnostic criteria.

Diagnostic imaging should consist of an x-ray with a Dunn Lateral view to measure Alpha angle associated with CAM morphology and an AP pelvis to measure lateral center edge angle and crossover sign associated with Pincer morphology. The etiology of FAIS isn’t agreed upon. There are many theories, however, most are based upon “excessive” loading of immature bone during adolescence that leads to CAM morphology as morphological changes are relatively static after skeletal maturation.1,8 Treatment strategies for FAIS have included conservative care, rehabilitation, and surgery. It is agreed upon that each of these may play a different role for each patient but there is very little evidence to compare their effectiveness and no high-level evidence to support a definitive treatment choice. Currently, surgery is the suggested pathway for management of FAIS according to Griffin 2016.

There is currently no agreed upon published criteria for return to sport and much of the information regarding FAIS is inconclusive since we as health care providers are in the early stages of treating it. Since this primarily occurs in the active younger population keep in mind that athletes are amazing at creating compensatory movement patterns so their patterns must be examined closely and should correlate to their reports of pain. Finally, morphology does not equal pathology and we should treat the presentation and person, not the image despite the non-binary information the patient may give us.

References 1. Agricola R, Weinans H. What causes cam deformity and femoroacetabular impingement: Still too many questions to provide clear answers. Br J Sports Med. 2016;50(5):263-264. doi:10.1136/bjsports-2015-094773 2. Casartelli NC, Leunig M, Maffiuletti NA, Bizzini M. Return to sport after hip surgery for femoroacetabular impingement: A systematic review. Br J Sports Med. 2015;49(12):819-824. doi:10.1136/bjsports-2014-094414 3. Griffin DR, Dickenson EJ, O’Donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): An international consensus statement. Br J Sports Med. 2016;50(19):1169-1176. doi:10.1136/bjsports-2016-096743 4. Griffin DR, Dickenson EJ, Wall PDH, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHIoN): a multicentre randomised controlled trial. Lancet.

2018;391(10136):2225-2235. doi:10.1016/S0140-6736(18)31202-9 5. Ishøi L, Thorborg K, Kraemer O, Hölmich P. Return to Sport and Performance After Hip Arthroscopy for Femoroacetabular Impingement in 18- to 30-Year-Old Athletes: A Cross-sectional Cohort Study of 189 Athletes. Am J Sports Med. 2018;46(11):2578-2587. doi:10.1177/0363546518789070 6. Mansell NS, Rhon DI, Meyer J, Slevin JM, Marchant BG. Arthroscopic Surgery or Physical Therapy for Patients With Femoroacetabular Impingement Syndrome: A Randomized Controlled Trial With 2-Year Follow-up. Am J Sports Med. 2018;46(6):1306-1314. doi:10.1177/0363546517751912 7. Peters S, Laing A, Emerson C, et al. Surgical criteria for femoroacetabular impingement syndrome: A scoping review.

Br J Sports Med. 2017;51(22):1605-1610. doi:10.1136/bjsports-2016-096936 8. Reiman MP, Thorborg K, Covington K, Cook CE, Hölmich P. Important clinical descriptors to include in the examination and assessment of patients with femoroacetabular impingement syndrome: an international and multi-disciplinary Delphi survey. Knee Surgery, Sport Traumatol Arthrosc. 2017;25(6):1975-1986. doi:10.1007/s00167-017-4484-z 9. Reiman MP, Peters S, Sylvain J, Hagymasi S, Mather RC, Goode AP. Femoroacetabular impingement surgery allows 74% of athletes to return to the same competitive level of sports participation but their level of performance remains unreported: A systematic review with meta-analysis. Br J Sports Med. 2018;52(15):972-981. doi:10.1136/bjsports-2017-098696

CLINICAL EXCELLENCE Upcoming Courses

Email coned@ptsmc.com to register

INTERNAL COURSES Lumbar April 2021 Location TBD

*All Internal Courses are first come first served and will be capped at 20 participants due to COVID-19 precautionary limitations.

Email Mallory at coned@ptsmc.com for all sign ups or questions.

Congratulations to the neW PTSMC Orthopaedic Residency class

2020 Top Chart Audit Scores

TOP DOCUMENTOR AWARDS

All clinicians are responsible for timely and compliant documentation standards. As a company, we perform internal audits to ensure all therapists are complying with these standards. This ensures we are compliant with insurance policies and support the treatment provided.

Congratulations to the clinicians below with the highest scores from 2020’s documentation internal audits. They received at least 97% or higher on their chart adutis.

Alyssa Griffo, East Hampton Pat Kinsella, Guilford Tom Kirsch, Avon Bailey McPherson, Wallingford Tyler Naef, East Hampton Rebecca Sauve, Naugatuck

Our next PTSMC Orthopaedic Residency cohort starts on December 1st.

They will be involved in weekly didactic coursework, monthly case discussion and journal club, weekly mentoring and assisting in our internal DOCS courses as they grow their clinical reasoning and advance their manual therapy skills!

Welcome to our new residents!

STUDENT PROGRAM UPDATE

We’re pleased to announce that two recent graduates will be part of the PTSMC clinical team!

Brian Reis has joined the New Haven office. He’s a Sacred Heart graduate who completed an affiliation at the Waterbury clinic in 2018.

Natalie Swanson is providing per diem Physical Therapist Assistant coverage at Lock Street. She’s a recent graduate of Naugatuck Valley Community College and also a current PT Aide in Middletown.

Meghan Blanusa, Naugatuck

Sam McMullen, Southington

Tom Mango, Southington

Andrew Kalach, Fairfield

Clinicians: If you haven’t yet hosted a student, we encourage you to do so! No better way to give back to the PT profession than by educating future clinicians! Reach out to Juliann Chacko, Physical Therapy Student Program Coordinator for more information: juliann.chacko@ptsmc.com

HUMAN RESOURCES

DIALOGUE FOR DEVELOPMENT (D4D) & GOALS AND OBJECTIVES TIME IS HERE WITH FILLABLE FORMS Employees* who participate in the Dialogue for Development & Personal Goals and Objective process will be contacted by your Supervisor to schedule your meeting time.

DECEMBER The December Holidays for 2020 and New Year’s Day Holiday for 2021 will be observed as follows: Friday, December 25th Christmas Closed Friday, January 1st New Year’s Day Closed Directors have the discretion to adjust clinic business hours on the following days: Thursday, December 24th Christmas Eve Thursday, December 31st New Year’s Eve On these days, all employees will be paid ONLY for hours worked. Employees shall adjust their schedule to work their expected hours.

Examples: If a director chooses to close at 1:00 pm on Christmas Eve, schedules shall be adjusted to work 7:00 am – 1:00 pm and hours short shall be made up on other days that work week.

If the director chooses to close at 4:00 pm on New Year’s Eve, a full-time employee, who works an 8 hour day, 5 days per week, hours are 10:30 am to 7:00 pm, shall adjust their workday to complete an entire day by working 7:30 am - 4:00 pm.

REVISED COMPANY POLICIES

PROFESSIONAL LICENSES: The change is to the renewal and reimbursement processes. PTSMC will reimburse annual licensure fees for all Physical Therapists, Physical Therapist Assistants, Occupational Therapists and Certified Athletic Trainers. The employee shall complete renewal before the license expiration and submit for reimbursement using an expense reimbursement form, that requires the receipt of payment and is submitted to your Director for approval.

TRANSFERS AND PROMOTIONS: The change is to the requirement for how current employees apply for posted job opportunities. PTSMC will post open positions in the PULSE (PTSMC newsletter) each month. Employees who are interested in applying for an open position must contact the Human Resources Coordinator and apply via the job posting link. Internal postings will also be advertised externally. Qualified candidates will have a telephone screening and then an interview with the Director of the clinic. Transfers or promotions will be offered to the internal or external candidate that is the best match for the position.

CONNECTICUT PAID LEAVE

Below is information from the State of CT regarding the Connecticut Paid Leave that will begin on January 1, 2021 with employee payroll deductions and January 1, 2022 eligibility for paid leave benefits. Sandra Boccialetti will be emailing additional information to all employees during the month of December.

Sandra Boccialetti will be emailing all employees the following information by position.

• Fillable D4D form to be completed • Performance considerations • Goals and Objective SMART format samples Supervisors will be emailing completed D4D’s to D4D.GO@ptsmc.com Want to review prior D4D’s and Goals and Objectives? They are located in Human Resources under Employee Documents. * PTSMC employees who work less than 20 hours may or may not participate in this process. Check with your supervisor.

ATTENTION 401(k) PARTICIPANTS, 2021 LIMITS WILL REMAIN THE SAME • Employee elective deferrals will be $19,500.

• If you are 50 years old or will be turning 50 in 2021 you are eligible for catch up contributions in the amount of $26,500. This means you can contribute the maximum of $19,500 plus the catch-up amount of $6,500.

• Contact Sandra Boccialetti if you would like a calculation done to see the “effect” to your paycheck by increasing your pretax 401(k) contributions.

Reminder: Employees who would like to make a change to their 401(k) biweekly contributions for the 1st quarter of 2021 must complete the request by Friday, December 14, 2020 to be effective with the January 13, 2021 payroll. Login to your account at https://myplan.johnhancock.com/login and click on Manage and Contributions.

ATTENTION HEALTH SAVINGS ACCOUNT (HSA) PARTICIPANTS, 2021 LIMITS HAVE INCREASED

• Individual coverage has increased to $3,600 up from $3,550.

• Family coverage has increased to $7,200 up from $7,100.

• If you are 55 years old or turning 55 in 2021 you are eligible for catch up contributions in the amount of $1,000. This means you can contribute the maximum of individual or family plus the catch up amount of $1,000; $4,600 and $8,200 respectively. Changes to your HSA contribution can be emailed to payroll@ptsmc.com. Changes can be made at any time and will go into effect the following pay period.

For covered employees in the State of Connecticut, the Connecticut Paid Leave program offers the opportunity to take time to take care of personal and family health needs without worrying about lost income while you are away from work.

ADDRESS CHANGES

KEY DATES: JANUARY 1, 2021: Employer to begin withholding employee contributions (one-half of one percent of each paycheck (0.5%) to the CT Paid Leave (CTPL) Authority trust fund.

We know during this time it may be hectic however HR should be your first contact. Your address change needs to be made in some or all of the following: Employee Navigator, John Hancock and Paychex.

JANUARY 1, 2022: Covered employees become eligible for paid leave benefits.

Have you changed your address?

So PLEASE let HR be the FIRST to know by emailing payroll@ptsmc.com. Thanks!

EMPLOYEE NEWS

NEW EMPLOYEES

Emma Anderson, Groton PT Aide

Emma Berger, Westbrook PT Aide

Stephanie Bologa, Simsbury Physical Therapist

Lexie Carroccio, New Milford Patient Services Coordinator

Heather Minue, Wallingford PT Aide

Angela Perricone New Haven Patient Services Coordinator

Sara Robinson, Middletown Patient Services Coordinator

Vladimir Smolgovskiy, West Hartford Physical Therapist

Natalie Swanson Lock Street Physical Therapist Assistant *NEW ROLE*

CURRENT JOB OPPORTUNITIES Physical Therapist Danbury Wallingford

Patient Services Coordinator Essex Guilford Waterbury

Physical Therapy Aide Groton Lock Street New Haven Westbrook

Auditor (20 hours/quarter) Admin - this is open to current PTs Customer Service Rep Lock Street

Check www.PTSMC.com/job-openings for our most up-to-date postings, and feel free to share! Call Jenn or email at Jenn.Detlefsen@ptsmc.com for PT Aide positions. Call Karen or email at karen.havlicek@ptsmc.com if you are interested in another position.

Michael Bozarth, Wallingford PT Aide

Brian Reis, New Haven Physical Therapist

Emily Tucker Windsor Patient Services Coordinator

Not Pictured

Jamie Collimore, Southington PT Aide Juliana Colonis, Branford PT Aide Julianna Zablocki, Westbrook PT Aide

The

Extra MILE

By Kristen Forster, Director of Operations

Have you ever had a “WOW” moment in customer service?

I am in the middle of redoing my bathrooms. Homeowner special style so we are doing it ALL. Shopping for all the necessary supplies has been daunting. The first store we went to, I asked for help and was told someone was coming. I waited patiently for about 15-20 minutes and went back to check in. The response was “Maybe if you were standing where you are supposed to someone would come.” Wow, seriously?

The person did not even lift their head to acknowledge me. Fast forward two weeks, and we chose another store. Immediately upon arrival we were greeted by friendly staff asking if we needed help.

(Okay, I liked this already.) I needed help locating an item and asked a staff member for help, and she spent 20 minutes finding it for me and climbed to the top of the rack to get it.

She handed it to me with a big smile. “Anything else I can help you with?” It felt genuine. This positive experience continued with EVERY single person we interacted with in the store that day. I came home STILL thinking about that experience and hopped online to fill out a review. I will be a loyal customer in this store for life.

As you can see these "WOW" moments can be both positive and negative, and leave lasting impressions on a customer. Whether it was a negative or a positive, the interaction affects the customer’s future decisions. We all have the opportunity to make the customer have that positive "WOW" moment.

We are delivering “WOW” moments all the time and it seems to happen so naturally. I am so proud to be a part of a company where I know our patients are receiving the very best of care and customer service every day. I am constantly blown away by the incredible reviews we get from our patients.

Our staff is out there improving the quality of people’s lives EVERY day. How are we continuing to deliver exceptional customer service every day amidst a global pandemic all while wearing a mask and worrying about the health and safety of ourselves and our patients? It seems impossible and we are doing it! The holiday season is upon us and we all need little joy right now. As we muscle through all the crazy let us remember we have the power to add joy to someone’s day. Keep delivering those positive WOW moments!

DECEMBER BIRTHDAYS Travis Lytle Heather Minue Ken King Alan Balavender Danielle Butsch Ashlee Smestad Nick Maltese Ted Fifield Heather Erb-Dowling Meagan Hoffman Joan Porper Kelsi McRee Maggie Thomas Mallory Mason Alison Rivera Nikki Matarazzo Jessah Doctor Jenn Fusco Alex Zablan Michelle Linicus Lexie Carroccio Rob Bass Naomi Rascati Sarah Peterson Juliann Chacko Heather Viera-Lemay Maria Grice Jenna Hancock Alyssa Griffo Tina Boccialetti Mike McGowan Bryan O'Neill Christine Raffone Scott Cameron Mary Clark

1 2 3 4 5 5 5 5 5 5 6 6 8 9 9 9 9 10 10 14 15 16 16 18 18 19 19 23 24 25 25 26 27 28 31

Avon Wallingford Westbrook President Lock Street Wethersfield Guilford Watertown West Hartford Westbrook Admin Windsor Lock Street Admin Naugatuck Wallingford Waterbury Lock Street Orange New London New Milford Middletown Wallingford Guilford Orange East Hampton Southbury New London East Hampton Admin Windsor New Milford New Haven Westbrook New Haven

DECEMBER ANNIVERSARIES Sara Gareiss

Congratulations on promotion to PSA!

Congratulations to Amy Bellone on her promotion to Patient Services Administrator in our West Hartford location. Amy started with West Hartford when they opened in May 2019. Amy brought with her five years of leadership positions in the fitness and retail space. With West Hartford’s rapid growth, they are ready for her to put her experience to work!

When West Hartford went 100% Telehealth in the spring, Amy was at the forefront in establishing effective processes for the clinic to seamlessly transition. Partner & Director Tom Kassan says that “Amy has been instrumental to West Hartford’s early success. She is a natural leader, hard worker, and always takes the initiative. She exemplifies the ‘PT for Life’ culture and I am proud to promote her to the PSA position.”

Personally, Amy is an avid reader, particularly in coaching and leadership, with heavy sprinkles of mystery and suspense.

She is also the varsity coach for the Tolland Girls basketball team. She is hoping that there will be a winter season starting in January.

In her new role, Amy cannot wait to continue to build upon the success and growth West Hartford has had so far. Always up for a new challenge, Amy is inspired by the Williams S. Burroughs quote: “When you stop growing, you start dying.”

Practice Liaison

Admin

PTSMC Happenings!

Waterbury celebrated PT Aide Carol Corbo’s 35th Anniversary with PTSMC!

Lock Street snapped a photo in their face shields. From left to right: Physical Therapist Alex Rosenberg, PT Aide Jen Fusco, and Director Danielle Butsch.

ugly sweater contest

Holiday Food Drive The Holiday Food Drives are in full force!

Four clinics have just finished up their collections in time for Thanksgiving and the rest and aiming for Christmas time deliveries.

Reminder to contact Mallory Mason for any questions and with your total number of items collected.

Let's hit that 2,020 goal!

SoCIAl Media Sensation Lauren MacDonald and Ann Hall from Essex

Guilford has won for three years straight - will this be the year a new champion is crowned? Get ready for our 4th Annual Ugly Sweater Contest! Dress in your best (or worst) holiday gear, and Facebook will decide which clinic had the best ugly sweaters! This will also be our 2020 monthly spirit theme! Your clinic will pick a day this month to sport festive attire. Voting will take place from December 24-28th.

CONGRATULATIONS! Tom Kirsch, Avon Physical Therapist, married Sara on on December 14, 2020.

Thank you to Lauren MacDonald, Essex Patient Services Coordinator, and Ann Hall (right), Essex Physical Therapist, for snapping a photo of their patient, Fay (left), all dressed up in her graduation gear and sending a brief testimonial. We love seeing fun testimonials like these, especially with photos!

PTSMC Wellness Calendar

Life Beat Savory substitues

There are many reasons to substitute ingredients in baking and cooking. They are good for allergies, “healthier” options, and even when you’re in a pinch and can’t get to the store in time. Some of these may seem pretty crazy, but they all will get the job done! Remember, substitutes are different, and your creation will not taste exactly like original ingredient recipe. That’s OK! Just curb your expectations a little and give yourself a pat on the back for trying something new.

Food

Substitute

Butter

Apple Sauce - equal

Cream or Sour Cream

Greek Yogurt - equal

Eggs - 1

Chia Seeds - 1 Tbs seed soaked in 2.5-3 tbs of water

Flour - 1 cup

Black Beans - 1 cup drained & pureed Almond Flour - equal

Pasta

Spaghetti Squash - as needed Zucchini - as needed Chickpea Pasta - equal Lentil Pasta - equal

Potatoes

Sweet Potatoes - equal Cauliflower - as needed

Vegetable Oil

Pureed Pumpkin - equal

Sugar - 1 cup

Honey - 3/4 cup Unsweetend Apple Sauce - 1 cup Banana - a cup mashed, pureed with a few tbs of water Maple Syrup - 3/4 cup Brown Sugar - 1 cup

Feelin’ like you want to give this a go? Maybe need a little holiday challenge? Check out our special insert of holiday recipes from various clinics. Then, make one original and one with substitutes! See if friends or family can guess what you swapped out!

December Social Well-Being: Community Staying Connected Challenge December 7-24 Physical Rewards & Raffle Now - February 16 January: Make your health #1 priority in 2021 Challenge Jan 4 – Jan 26 Physical Rewards & Raffle Now – Feb 16

November Gratitude Challenge Thank you to all who shared in the Gratitude Challenge. We wanted to share with everyone some of the common themes we are thankful for.And a reminder, in the words of Joan Porper (our Director of Payer Relations) "Although this year will be different, smaller gatherings for sure, maybe a few calls and a few Zoom gatherings will do the trick. It’s also a great time to check in on our family and friends and those who may be lonely, due to having lost a spouse, parent, child, sibling, close friend, or a family/friend who may be ill."

Wellness Incentive: Physicals

If you took this step for your health in 2020 or are planning to get a physical before February 16th, 2021, let us know! You will receive a $20 Amazon gift card and be entered into a $200 Amazon gift card raffle!

- What counts: Annual routine physical - Who is eligible: All employees - What you earn: $20 gift card & entry into $200 gift card raffle - How to get credit: Schedule & attend your appointment. If you participate in PTSMC’s health plan with Cigna, let us know the date and Cigna can provide the verification. If you are not a Cigna member, provide proof of receiving your annual physical from your physician and email Mallory at Wellness@ptsmc.com.

- Timeline: Physical attended between March 1, 2020 and February 16, 2021 *In order to gain credit your appointment must be for a routine appointment and cannot be diagnostic in nature. Please work with your physician to ensure that the appointment is a routine visit and is being submitted that way to your medical coverage (i.e. Cigna) in order to receive the incentive.

If you are a Cigna member and would like specific information on the preventative services that are available to you at no cost through your plan email Sandra.Boccialetti@ptsmc.com.

What Happened in DECEMBER of 2000?

Spirit day

December 12, 2000 - US Supreme Court releases its decision in Bush v. Gore, settling the recount dispute in Florida's 2000 presidential election in George W. Bush's favor and thus handing him the presidency.

December 2000 - The number one song in December 2000 was Independent Women Part I by Destiny’s Child, which was featured in the movie Charlie’s Angels.

Guilford

Newington

Wethersfield

Southington

New Haven

Simsbury

Lock Street

Waterbury

NO CLINICS OPENED IN DECEMBER

Next Month’s SPIRIT DAY THEME

Festive holiday attire Each clinic can hold this on any day before December 24th. Details of the contest are on page 7.

Admin

Holiday recipes PTSMC employees to sent their favorite holiday recipes to provide some inspiration!

Roast Fillet of Beef with Black Peppercorns

Ingredients: 1 beef fillet (3 ¼ pounds), rolled, fatted, and tied 2 cloves garlic, slivered 2 tablespoons coarsely crushed back peppercorns 1⁄2 teaspoon dried thyme leaves 1⁄2 teaspoon coarse (kosher) salt Instructions: 1. Preheat oven to 425 F 2. Using the tip of a sharp knife, cut slits all over the fillet and insert garlic slivers into them 3. Pat the pepper all over the beef, so that it is well coated. Sprinkle it with the thyme and corase salt.

4. Place the fillet in a shallow roasting pan, and cook for 15 minutes.

Reduce the heat to 350 F, and roast for an additional 20 minutes for rare meat. (To test doneness, insert an instant-reading meat thermometer in the thickest part of the roast. It should read 125 F to 130 F for rare, 135 to 140 F for medium.)

5. Let the fillet rest 10 minute before carving.

Alex Rosenberg, Lock Street PT

Pecan Pie

Ingredients: 1 cup all-purpose flour ¼ teaspoon salt 1⁄3 cup shortening 3 tablespoons cold water Filling Ingredients: 1- 1 ¼cups chopped pecans 1 cup plus 1 tablespoon light corn syrup 3 large eggs 1⁄2 cup plus 1 tablespoon sugar 1-1 1⁄2 teaspoons vanilla extract Pinch salt Instructions: 1. In a bowl, combine the flour and salt; cut in shortening until crumbly. Gradually add cold water, tossing with a fork until a ball forms.

2. Roll out dough to fit a 9-in. pie plate. Transfer crust to pie plate. Trim crust to 1⁄2 in. beyond edge of plate; flute edges. Sprinkle with pecans; set aside.

3. In a small bowl, beat the corn syrup, eggs, sugar, vanilla and salt until well blended.

Pour over pecans.

4. Bake at 350° for 45-50 minutes or until a knife inserted in the center comes our clean.

Cool on a wire rack.

Randi Gallagher, East Hampton PSC

“Cinnabon” Cinnamon Rolls with a Bread Machine

Ingredients: DOUGH 1 c warm milk (110 degrees f/45 degrees c) 2 large eggs, room temperature 1/3 c butter, melted 4 1⁄2 c bread flour 1 tsp salt 1⁄2 c white sugar 2 1⁄2 tsp bread machine yeast FILLING 1 c brown sugar (I used light) 2 1⁄2 Tbsp cinnamon (I used ceylon cinnamon) 1⁄3 c butter, softened chopped nuts, walnuts or pecans raisins or diced apples FROSTING 1 (3-ounce) package cream cheese, softened ¼ c butter, softened 1 1⁄2 c confectioner' sugar 1⁄8 tsp salt 1⁄2 tsp vanilla extract Instructions: 1.DOUGH: Place ingredients in bread pan in order they are listed. Set on 2 lb loaf and select the dough cycle.

2: Once the bread machine had done the work, turn dough out onto a floured surface. Cover with a clean dish towel and let rest for 10 minutes.

3. Meanwhile, mix brown sugar and cinnamon together, cover; set aside.

4. Once dough has rested for 10 minutes, roll out into a 16 x 21-inch rectangle. Spread dough evenly with 1⁄3 cup softened butter and sprinkle evenly with brown sugar/cinnamon mixture. If desired sprinkle with nuts and raisins (or diced apples).

5. Roll dough up (starting with long edge) tightly; slice (using sharp knife) into 12 rolls. Place rolls into a lightly greased 9 x 13-inch baking pan. Cover and let rise until nearly doubled (about 30 minutes). NOTE: You can cover and put in refrigerator over night. They will rise in the refrigerator and this will take a lot of prep time off the next morning. IF baking the next day, take rolls out of the refrigerator 30 minutes prior to baking.

6. Preheat oven to 400 degrees. Bake for 20 to 23 minutes. After 15 minutes when rolls had lightlybrowned, I tented with a piece of foil to keep from over browning. NOTE: the original recipe called for 15 minutes baking time, however, this was not long enough for the centers of rolls to cook completely in my oven. Watch and check after 15 minutes; add addtional time as needed for your oven.

7. FROSTING: mix all ingredients until creamy. Can store in the refrigerator.

Divide evenly; spread over warm rolls.

Debra Philcox, Naugatuck PSC

Holiday recipes Baked Mashed Potatoes with Parmesan Cheese and Bread Crumbs

Ingredients: 1 tablespoon butter 4 pounds russet potatoes, peeled, cut into 1-inch pieces 1 cup whole milk 1⁄2 cup (1 stick) butter, melted 1 1⁄2 cups grated mozzarella 1 cup freshly grated Parmesan Salt and freshly ground black pepper 2 tablespoons plain dry bread crumbs Instructions: 1. Preheat the oven to 400 degrees F. Coat a 13 by 9 by 2-inch baking dish with 1 tablespoon of butter and set aside.

2. Cook the potatoes in a large pot of boiling salted water until they are very tender, about 15 minutes. Drain; return the potatoes to the same pot and mash well. Mix in the milk and melted butter. Mix in the mozzarella and 3⁄4 cup of the Parmesan. Season, to taste, with salt and pepper. Transfer the potatoes to the prepared baking dish. Stir the bread crumbs and remaining ¼ cup of Parmesan in a small bowl to blend.

Sprinkle the bread crumb mixture over the mashed potatoes. Recipe can be prepared up to this point 6 hours ahead of time; cover and chill.

3. Bake, uncovered, until the topping is golden brown, about 20 minutes.

Michelle Kijewski, Wallingford Director

Cranberry Brie Bites

Ingredients: Crescent roll dough (one roll 8 oz.)

6 oz. brie cheese ¼ cup cranberry sauce (homemade or canned) ¼ cup orange marmalade Fresh rosemary (optional) Pecans (optional) Instructions: 1. Preheat oven to 375 and spray mini cupcake pan with cooking oil 2. Mix cranberry sauce and orange marmalade together in a bowl, set aside (add real cranberry’s if you want) 3. Roll out crescent roll dough onto floured counter and cut into 24 equal squares, place in the cupcake pan creating a bowl shape 4. Cut brie into equal parts totaling 24 pieces, place each in cupcake pan over dough 5. Top brie with a spoonful of the cranberry/orange sauce 6. Place pecans and fresh rosemary on top (optional) 7. Bake at 375 for 10-15 minutes until golden 8. Cool for 5-10 minutes Meghan DiPisa, New Milford PSC

Cranberry Salsa

Ingredients: 1 (12 oz) package of fresh cranberries (rinsed and sorted for any bad or soft berries) 1⁄2 to 2⁄3 cup sugar (to taste) ¼ tsp salt 1⁄2 green pepper chopped 2 tbsp. onion chopped 3 or 4 jalapeno pepper rings chopped 1 (8 oz) can crushed pineapple with its juice.

Instructions: 1. Chop the cranberries in a food processor.

2. Add the remaining ingredients and blend in the food processor.

3. Chill about 2 hours before serving.

Rebecca Petrosino, Fairfield Partner & Director

Marcella Hazan's Famous & Easy Red Pasta Sauce

Ingredients: 2 pounds fresh, ripe tomatoes, prepared as described below, or 2 cups canned imported Italian tomatoes, cut up, with their juice 5 tablespoons butter 1 medium onion, peeled and cut in half Salt to taste Sauce Instructions: 1. Put either the prepared fresh tomatoes or the canned in a saucepan, add the butter, onion, and salt, and cook uncovered at a very slow, but steady simmer for about 45 minutes, or until it is thickened to your liking and the fat floats free from the tomato.

2. Stir from time to time, mashing up any large pieces of tomato with the back of a wooden spoon.

3. Taste and correct for salt. Before tossing with pasta, you may remove the onion (as Hazan recommended) and save for another use, but many opt to leave it in. Serve with freshly grated parmigiano-reggiano cheese for the table.

Making Fresh Tomatoes Ready for Sauce 1. The blanching method: Plunge the tomatoes in boiling water for a minute or less. Drain them and, as soon as they are cool enough to handle, skin them, and cut them into coarse pieces.

2. The freezing method (from David Tanis, via The Kitchn): Freeze tomatoes on a baking sheet until hard. Thaw again, either on the counter or under running water. Skin them and cut them into coarse pieces.

3. The food mill method: Wash the tomatoes in cold water, cut them lengthwise in half, and put them in a covered saucepan. Turn on the heat to medium and cook for 10 minutes. Set a food mill fitted with the disk with the largest holes over a bowl. Transfer the tomatoes with any of their juices to the mill and puree.

Peter Decoteau, Director of Marketing