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5/29/21: Helping Our Youth and Parents
Dear PCP Community,
Pre-pandemic, in response to the assessed needs of our local communities, the Newburyport Youth Services held an excellent town hall event on the topic of the state and needs of mental health in our youth and adolescents. I found myself engaged in several conversations with various colleagues and friends post-event for weeks to come, and was convicted to continue the conversation and mission of addressing this matter.
Of course, resulting from the pandemic, this need has only magnified with time. In March, subsequent to a professional conference, where Dr. Rhea Chase from the Judge Baker Childrens Center, a Harvard Medical School affiliated program in Waltham, presented a compelling discussion on this very same topic, I contacted her and we arranged for her and her colleagues to provide a webinar to our communities.
This webinar, free of charge (financially supported by Personal Care Physicians, donations accepted but not required; co-sponsored with Riverside Pediatrics in Newburyport), will take place on Thursday evening, 7:30pm. The details are below. This is offered to anyone and everyone in our local, regional, or even distant communities, so we encourage you to pass this offering on to anyone or everyone you’d like. It’s a tough time right now for all, our youth in particular. Many of us have witnessed that the youth and adolescents have seemingly expressed greater mental health needs this spring than they did last fall, even (in context of the timing and evolution of the pandemic and it’s subsequent effects on our rhythms of life).
Peace to all, see you Thursday night on the webinar!
Mark Su, MD and the Personal Care Physicians team
Coping Skills for our Youth (Click here for larger viewing as an attachment/download!)
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5/8/21: Happy Mother’s Day!
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Dear PCP Community,
1) Happy Mother’s Day to all you mothers!
Spring seems to be in the air, and Mother’s Day 2021 is a different vibe than early-pandemic era Mother’s Day 2020. Having said that, as with any or all holidays, it’s not all rosy for everyone. Some of us experienced loving and happy childhoods with our mothers, while others of us had a strained or aggravating upbringing. Some of us experience our current relationships with our mothers as rich, supportive, or fulfilling, while others of us experience burden, guilt, conflict or regret. Whatever may be your current situation with your mother, we wish you peace. And of course, for those who are mothers, we honor you today for all your hard work with your children, especially those of you who are first time mothers this year! Furthermore, we particularly honor those of you who are single mothers. Parenthood is a very challenging responsibility in life, one without instructions or a manual, and fraught to change at any time. Single parenthood is just that much more challenging. Thanks for the work that all you mothers put forth for the sake of your children. Your time and efforts are priceless.
2) It’s tick season…
Our clinicians have experienced a “spike” in patients reaching out to us about tick bites. In response, we want to take this moment to encourage you to both prevent tick bites as much as possible, and do “tick checks” after having been in more heavily wooded or simply spent a longer amount of time outdoors, in order to do our best in preventing Lyme disease and its “co-infections”. While ticks are not exclusively found in more heavily wooded areas, the concentration of ticks are predictably greater in such areas (vs., say, in more paved or heavier people-traffic areas of a given town/community), and as the winter season is lifting, the ticks are now more present in number as well as active. Please consider rolling socks up over pant leg ends (yes, super fashionable!), wearing longer sleeved/legged clothing (when feasible, temperature dependent), wearing hats, and considering bug repellent. Some clothes are even made with embedded such repellent compounds. Upon returning home, we advocate putting the worn clothing in the wash as soon as possible, washed in hot water, as ticks are often residual on clothing brought into the home, and find themselves migrating around within the house, waiting until the opportunity avails it self to feed on us. And, of course, a skin and hair/scalp check for ticks is very prudent, as finding and removing ticks before they “bite” or embed themselves is the best form of prevention.
If you experience an embedded tick, we encourage you to talk with your practitioner here at PCP. Unfortunately, a seemingly simple tick bite warrants a much more extensive discussion about the various factors of consideration, all leading to an individualistic case decision about an action point. As we know that ticks can “transmit” pathogens to our body within 24hrs, and some ticks even within a few hours, national guidelines exist to take action regarding any given tick bite, but an individual’s health history will heavily factor into just what how simple or not-so-simple that intervention may be.
3) Some impressive feedback to report…
Pain is never wanted. Unfortunately, it’s a common problem. NSAIDs (Non-Steroidal Ant-Inflammatory Drugs) are commonly used for chronic or recurrent pain, whether it be headaches, arthritis, fibromyalgia, chronic pain from trauma, or otherwise. Unfortunately, the use of NSAIDs is also known to weaken our immune system, and especially more so if used recurrently over time. So, we’re stuck between a rock and a hard place.
Recently, our clinicians shared among each other the really impressive observational benefits we’ve seen over time, collectively, with the use of Hemp Advantage Plus, and SPM Active – two supplements that coincidentally are made by the same manufacturer, Metagenics. While Hemp Advantage Plus may be attractive to many because of it’s name, referencing CBD, it’s really about the primary ingredient, PEA (palmitoylethanolamide), which is effective in reducing nerve pains (the hemp serves to enhance the effects of the PEA). Having been told by the Metagenics folks that studies suggest about a 65% improvement in pain among legitimately diagnosed sciatica patients with nerve pain, it sounded too good to be true. But Dr. Mark now can say that he doesn’t even recall a single patient with nerve pain he’s treated with Hemp Advantage Plus who hasn’t benefited from this to date, and even those with very intense such pain, who he held low expectations for, still benefited- and with greater pain relief than his expectations… SPM Active is, on paper, arguably the “ultimate anti-inflammatory”, as reflected by it’s role in the body. SPM’s are essentially “bioidentical therapy”, as they are chemically manufactured identical compounds to what we make in our body – we just typically make much, much less than what we need or could ideally use (esp. when dealing with inflammation, esp. the chronic type). Upon first being introduced to this therapy by the Metagenics folks, we were validated about it’s potential when we immediately discovered that Dr. Mark’s wife, a PhD researcher at Harvard, in fact has indeed been part of a research group focusing specifically on SPMs. And similar to the Hemp Advantage Plus, we’ve been really impressed with the outcomes – some patients were considering knee replacements but found they no longer needed to, given their pain control with SPMs; a few who were able to stave off gout attacks; others found it beneficial for nerve pains; and some found a meaningfully better quality of life despite fibromyalgia or other similar challenging conditions…. While the cost for these two products is more than a typical nutraceutical (supplement), when it comes to chronic or meaningful pain, and having an alternative to protect/”save” our immune systems from further weakening and detriment (accelerating our “biologic clocks” and the “inflamaging” process), we’re really thrilled to have these options and excited to have observed the benefits in our patients! – so much so that we wanted to be sure others knew about these options, as no doubt many of us take ibuprofen (or Alleve, etc) on a regular basis without us as the practitioners being fully aware of such.
4/3/21: More Great News!
Dear PCP Community,
1) Yeesssss!!!
Great news! Personal Care Physicians now has phlebotomy (blood drawing) services in our office space!
Near the end of 2020, we agreed to an opportunity to have a phlebotomist in our office on a part time basis. Not only were we thrilled to have this as a benefit to our patients, but in addition, Melissa, who many of you have previously met (she has drawn blood for specialty labs 1-2x/month for the last number of years in our office), agreed to take this position, which was just icing on the cake, as she is both procedurally skilled and a very kind, wonderful human being!
The following are the take home points you’ll want to be aware of:
- This is effective immediately – Melissa began on Friday 3/26, and continue to be in our office on M/W/F from 7:30am to noon. (Note that she will be absent the week of 4/19-4/23, however.)
- Scheduling is done through our front office staff.
- There are no additional charges – drawing blood at our office will be processed just as if you were drawing elsewhere.
- She also draws blood for children and adolescents.
We will continue utilizing AJH and/or Quest labs as well, depending on your location, particular test processing needs, scheduling, and/or other factors. But where drawing in our office will be easier, simpler, and faster than going to an outside lab or hospital, this is just another offering of convenience for you, our patients. We’re excited to have Melissa join our team!
2) Last reminder!
HealCommunity will again be offering the Immune Collaborative group starting Wednesday, 4/7!
This is an insurance-covered program for those looking to improve their health through lifestyle changes, esp. for those looking to optimize their immune system (though not exclusive to this topic). It is an awesome opportunity to join a group of like-minded individuals from our practice and be led by a professionally trained and certified health coach to gain further insight into our bodies, our lifestyle routines, our strengths and weaknesses, and initiate long-lasting changes for the betterment of our health.
Take a look and sign up at www.healcommunity.com/pcp !
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3/23/21: Spread the news!
Dear PCP Community,
1) A Window of Opportunity is Open… for now
Most of us are aware that the Personal Care Physicians practice is regularly in demand, but is uncommonly available to new patients. But that window of opportunity is currently open!
Some of us have already had the pleasure of meeting Mary Ramsey, PA-c, and can no doubt attest to this wonderful opportunity for new patients to find a footing into the PCP practice. As you’ll read on her bio page, Mary is very engaging and interpersonal in nature, and a very enthusiastic learner about all things esp. functional medicine-oriented. She has attended the ILADS fundamentals course (for Lyme disease and tickborne illnesses), as well as the gut-health and hormone-health programs from the A4M certification program. Furthermore, she and Dr. Mark worked together for nearly 6 months prior to her officially beginning at PCP, to solidify practice approaches he and other PCP providers commonly implement. She started seeing patients in mid December, and has been working with both primary care patients as well as more chronic/complex illness consulting patients (Lyme disease, mold toxins, fibromyalgia, memory loss, and more).
If you have friends or family wanting more from their healthcare experiences, we invite you to introduce them to have a chat with Mary to how well of a fit they may be for each other. For those of us who have met her already, we can confidently say your friends/family will be glad that you did!
2) Reminder!
HealCommunity will again be offering the Metabolic Collaborative and Immune Collaborative groups starting Wednesday, 4/7. Take a look and sign up at www.healcommunity.com/pcp
Again, HealCommunity offers everyone the chance to participate in a small group led by a professionally trained Functional Medicine Health Coach, to improve our health in essential ways: nutrition, sleep, stress management, exercise, and more…
And, this program is covered by most insurance carriers!
Immune Collaborative: for those looking to optimize their immune health
Metabolic Collaborative: for those looking to improve their metabolism – sugar, blood pressure, weight, cholesterol, and related matters.
HealCommunity is handling all of the organization of this program, so if you call our office, we will simply refer you back to the website above – thus, we encourage you to turn your attention and questions to the website to begin with: www.healcommunity.com/pcp !
Enjoy the warmer weather! (for now!)
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3/9/21: Some Good News, Some Bad News
Dear PCP Community,
1) The Good News:
Back by popular demand! FindFunctional, now renamed to HealCommunity, is back! Those of us who have been participating in the 2 modules to date (now on week 4) have had great experiences and success to date, and I’ve enjoyed participating in the groups (jumping back and forth between one or the other week to week, as you guys have observed) to experience it with you!
We had more people interested than we had room for, last time, so now we’re creating 2 more groups. Starting Wednesday, 3/17, HealCommunity will again be offering the Metabolic Collaborative and Immune Collaborative. Take a look and sign up at www.healcommunity.com/pcp
As previously described, you’ll join a small group led by a professionally trained Functional Medicine Health Coach, focus on your health in essential ways: nutrition, sleep, creating habits that stick, stress management, movement, and more… and be part of a COMMUNITY of other Personal Care Physicians patients, on a similar mission to you to help you on your journey!
And, this group care is covered by most insurance carriers (!!!).
We had more interested participants than we had room for last time, so please register before we fill up once again.
Again, generally speaking:
Immune Collaborative: for those looking to optimize their immune health
Metabolic Collaborative: for those looking to improve their metabolism – sugar, blood pressure, weight, cholesterol, and related matters.
Reminder; HealCommunity is handling all of the organization of this program, so if you call our office, we will simply refer you back to the website above – thus, we encourage you to turn your attention and questions to the website to begin with: www.healcommunity.com/pcp !
2) COVID-19 update:
The good news:
Vaccinations are in progress, and COVID-19 cases are going down across the country. Optimism is in the air (and perhaps spring might be around the corner, hopefully as well?).
The bad news:
We’re getting a lot of questions from patients about when we will have vaccines available in our office. The answer is: we don’t know. We replied to the state’s survey last fall that we want to be available as a vaccine distributor, but have yet to hear anything back just yet. With insufficient supply, Pfizer’s vaccine needing special freezers, and state regulation due to prioritization of certain populations, we didn’t expect getting vaccines any time soon. Now, with Johnson and Johnson’s vaccines (single dose, no special freezers) and anticipated greater supply in the near future (across the board with all vaccines), we are hopeful that we will have some in hand at some point, but have no insight as to the certainty of having them, much less when that might actually happen. Of course, when we find out, we’ll let you all know!
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2/9/21: Personal Insights on Improving our Self-Care, and Health
Dear PCP Community,
We’re excited about our upcoming medical group visits, for everyone looking to improve their immune system, or metabolism!
We’ve posted a video message from Dr. Mark on our Facebook page (www.FaceBook.com/pcpnewburyport), providing greater insights as to why we’re so excited about how this group program can be of much benefit to many people – take a look!
The Metabolic Collaborative and Immune Collaborative programs next week, so if you haven’t yet taken a look or signed up, you’ll find all you need to know at www.findfunctional.com/pcp
Again: You’ll join a small group led by a professionally trained Functional Medicine Health Coach. You’ll have fun supporting and being supported by others who are like-minded as yourself. And it’s insurance covered!! (we’re even told that those of us who have deductibles won’t even have to worry about costs from whatever deductibles we may have! – be sure to call/email the Find Functional folks through the website above)
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2/4/21: Considering a Cleanse? Ready for a Reset?
Dear PCP Community,
Having experienced our first major snow storm in the last 2 winters, how’re we all feeling now?! : )
This is a brief reminder about our exciting recent announcement for our group health initiatives:
The Metabolic Collaborative and Immune Collaborative.
If you’ve been at all thinking about a “cleanse” or “reset” as we’ve started the new year, you are confident you’re going to love this program.
Take a look and sign up at www.findfunctional.com/pcp
You’ll join a small group led by a professionally trained Functional Medicine Health Coach. You’ll be motivated, you’ll motivate others (even if you don’t expect to!), and you’ll have fun. Being part of a community from within this practice to focus in on creating habits that stick regarding nutrition, stress management, sleep, movement, and more – and have it be insurance covered?? Wow… (we’re even told that those of us who have deductibles won’t even have to worry about costs from whatever deductibles we may have! – be sure to call/email the Find Functional folks through the website above)
So whether you’re looking to optimize your immune system (the Immune Collaborative), or looking to improve your metabolism (the Metabolic Collaborative), let’s do it together! www.findfunctional.com/pcp
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1/29/21: A New Year, A New Hope
Dear PCP Community,
Happy belated New Year! We have 2 very important announcements for you today, so let’s get right to them:
1) Kickstart the year with a new and proven way to improve your self care and health!
2020 was a tough year for us in many ways.
One that was most difficult for us to see was the isolation our patients felt while trying to make positive change with, or even just to maintain, their health.
We knew we needed to do something to help our patients even further.
So we’ve teamed up with an awesome resource, FindFunctional, to offer Functional Health Collaboratives to our patients.
Starting in 2 weeks, we are offering two different virtual 12-week health focus groups:
The Metabolic Collaborative and Immune Collaborative.
Take a look and sign up at www.findfunctional.com/pcp
You’ll join a small group led by a professionally trained Functional Medicine Health Coach.
You will participate in guided content to focus on your health in essential ways: nutrition, sleep, creating habits that stick, stress management, movement, and more….
Plus, you’ll be part of a COMMUNITY, on a similar mission to you to help you on your journey! A community of individuals here at Personal Care Physicians!
And, this group care is covered by most insurance carriers (!!!).
We want to keep the groups small, so they fill up quickly.
If you’d like a recommendation on which group would be best for you, ask your point practitioner, but generally speaking:
Immune Collaborative: for those looking to optimize their immune health
Metabolic Collaborative: for those looking to improve their metabolism – sugar, blood pressure, weight, cholesterol, and related matters.
We look forward to supporting you in 2021!
2) COVID-19 update:
For those who are yet unaware, we are able to provide testing in two regards: rapid testing and PCR testing. Rapid testing is a more superficial swab in the nose, and turns around in 20min per test. We swab for a little longer than the typical (for optimal sampling), but it’s superficial and less invasive. The PCR testing is more accurate esp. in those who are asymptomatic, but it’s a deeper swab. We turn around results in our office in 60min per test. We perform testing in the parking lot, weather permitting, but defer those who have outright flu-like illness symptoms to the ER or urgent care center, or treat presumptively, as warranted.
Regarding vaccines, as of this time, we have no word at all whether we will receive any for distribution/administration, much less have any right now. We are still directing individuals to the state of MA website, and receiving information on this topic real-time along with everyone else.
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12/25/20: Holiday Season Message
Dear PCP Community,
2020 has been a year like none other, and this holiday season is no different.
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5/13/20: COVID-19 Update Zoom Webinar #5
Dear PCP Community,
(To view the recorded COVID-19 Webinar #4 from 4/21/20, presented by Jess McManus PT, FAAOMPT on adapting our home workout routines, and Jessica and Mark Su, as an open Q&A forum, please go to https://youtu.be/FBW8_b9r0Ik)
In response to the number of questions we all have about reopening businesses and the application of COVID19 testing, we are going to have another COVID-19 ZOOM webinar:
COVID-19: Fact or Fiction? – and Where Do We Go From Here?
Thursday, 5/14, at 7pm
presented by:
Mark Su, MD
We all have a lot of questions and concerns about the current state of testing for COVID19: swab testing?, antibody testing?, and now, how they might help us (or not?) with decisions for re-opening businesses? How accurate are they? What do they really mean? We will do a deep dive into the science and numbers behind it all, and walk away with a much greater understanding of the tests, and discuss how this might apply to our future decision making as we try to re-establish some level of business and recreational activities.
To join the ZOOM webinar:
https://harvard.zoom.us/j/
Join by telephone (use any number to dial in)
+1 301 715 8592
+1 312 626 6799
+1 929 436 2866
+1 253 215 8782
+1 346 248 7799
+1 669 900 6833
International numbers available: https://harvard.zoom.us/u/
One tap mobile: +13017158592,,95423050584# US (Germantown)
Mark Su, MD and the PCP Team
4/17/20: COVID-19 Update Zoom Webinar #4
Dear PCP Community,
(To view the recorded COVID-19 Webinar #3 from 4/10/20, presented by Mark Su, on the topic of anti-hypertensive medications in our COVID19 pandemic context, and more broadly, critical analysis of mainstream medical recommendations, please go to https://www.youtube.com/watch?v=Hdg-jTLSWQ8&t=1s)
In response to a number of requests to hold another presentation, we are going to have another COVID-19 ZOOM webinar:
Open Q&A forum on COVID-19: You Ask, We’ll Answer (as best as we can!)
Tuesday, 4/21, at 7:30pm
presented by:
Jessica Lasky-Su, DSc
Mark Su, MD, and
Jessica McManus, PT, FAAOMPT
Jessica McManus, PT, FAAOMPT is the owner of Full Circle Physical Therapy and Wellness Coaching, and will be providing a special presentation on the topic of “Adapting Our Workouts to a New Norm of Life”. Jess is a highly skilled physical therapist who specializes in orthopaedics and pain management in unique and cutting edge approaches, while integrating whole body wellness concepts that help to accelerate healing. She is a well known, local provider with over 20 years of experience managing a range of patients from performance athletes to individuals who experience chronic pain and everyone in between.
To join the ZOOM webinar:
https://harvard.zoom.us/j/
Join by telephone (use any number to dial in)
+1 929 436 2866
+1 312 626 6799
+1 301 715 8592
+1 346 248 7799
+1 669 900 6833
+1 253 215 8782
One tap mobile: +19294362866,,97269597675# US (New York)
Join by SIP conference room system
Meeting ID: 972 6959 7675
97269597675@zoomcrc.com
As a reminder, we are regularly conducting “video visits”, or if for any reason video is not preferable or problematic, “phone visits”, in lieu of office visits – whether to address acute (illness, pain, injury) needs, or chronic (“long-term, big picture”) matters. We are very appreciative for each of you, for adapting to this format seemingly so seemlessly – we are very aware of many offices locally and across the country that are having trouble at all implementing, if not more regularly conducting, such “telehealth” formats (if even offering it at all!), and that much of that is reportedly due to patients having a hard time making such changes. So, you’re the best! Again, the links for the video visits are found below, a different link for each provider, in the 3/25/20 announcements entry.
Be well!
Mark Su, MD and the PCP Team
4/10/20: COVID-19 Update Zoom Webinar #3
Dear PCP Community,
The topic of whether ACE inhibitors or ARB medications might put hypertension patients at greater risk for disease and damage from COVID-19 has been a greatly debated topic in the scientific community and media over the last month. For an educational insight you won’t find elsewhere, explaining the details of this debate, and why we do think it matters, and why you may need to consider making a change, please feel free to go to https://www.youtube.com/watch?v=Hdg-jTLSWQ8&t=1s
4/1/20: COVID-19 Update notes – “Flattening YOUR (COVID-19) Curve”
To view the recording from Sunday night’s COVID-19 presentation, please go to: https://youtu.be/s6NpDmHvb5I
As mentioned at the end of that presentation, if you have interest in any subsequent presentations, whether as COVID-19 updates or even mixed with subtopics (such as mental health tips/recommendations, or exercising from home, or nutrition suggestions) pertinent to this COVID-19 era, please feel free to leave us feedback on our Personal Care Physicians FaceBook site, or through our website contact email address.
As well, if you are taking a blood pressure medication ending in “-pril”, please talk to your provider about any questions or concerns about continuing this.
Thank you – stay well, and be safe. We continue to be here for you, and to be able to address your healthcare needs through video visits, as previously announced.
Mark Su, MD and the PCP team
3/28/20: COVID-19 Update ZOOM Webinar #2
(Note: a recorded version of our 1st webinar, presented by Jessica Lasky-Su, DSc, on 3/25/20, can be found here: https://youtu.be/MSiKbFNspds)
Sunday 8:30-9:30pm
COVID-19 Update: Flattening YOUR (COVID-19) Curve (plus, a public health level update)
Presented by:
Dr. Jessica Lasky-Su, DSc
Dr. Mark Su, MD
Mark Su, MD will be presenting insightful and cutting edge information providing information regarding:
-What are best practices for sanitation?
-What can I do to boost or support my immune system?
-What options do I have if I contract COVID-19 (or think I may have contracted it)?
-In the end, this will be a dynamic explanation of how COVID-19 progresses from an exposure to full blown acute respiratory distress syndrome, and how we can “flatten (our individual) curves” with this process of infection and immune reactivity.
Jessica Lasky-Su, DSc will then present us with an update on COVID-19 at the public health level, both locally, regionally, and internationally, and how this translates into our ongoing need for “mitigation” vs. “suppression” (social distancing, quarantining), and projected trajectories.
Please join us by clicking on this link:
Join Zoom meeting
https://harvard.zoom.us/j/3597
Join by telephone (use any number to dial in)
+1 312 626 6799
+1 929 436 2866
+1 253 215 8782
+1 301 715 8592
+1 346 248 7799
+1 669 900 6833
International numbers available: https://harvard.zoom.us/u/ad2D
*** You do NOT need a Zoom account to attend the meeting, but if you have never used Zoom before, we recommend you download the app on your phone or computer prior to the meeting so you can link in immediately. To do so through a browser, go to here: zoom.us/download Otherwise, you can download the app on your phone.
We will try to address questions at the end, time-permitting.
3/25/20 : Links for Your Telehealth Visits
To Our Personal Care Physician Community,
In this current COVID-19 crisis, as most of you already know from the above announcement or elsewhere, we continue to be present and available as your healthcare providers – not only and especially for any COVID-19 related questions and concerns, but also for your baseline healthcare needs, which in all likelihood have remained present, even if having taken a bit of a lesser priority in the immediate moment. As you also know, Governor Baker has declared that all insurance companies be required to reimburse telehealth visits as if they were in-person visits, thus allowing for the continuation of healthcare services, as best as possible. Telehealth medicine in MA has historically been quite restricted in many ways, including the requirement for a video/visual live face-to-face encounter. While this restriction has been temporarily lifted in our crisis period, we are trying to be compliant with the usual regulations, esp. for the sake of developing “good habits” for potential telehealth changes/allowances in the state of MA in the future. As such, when your telehealth visits are scheduled during this crisis period, please refer to the following video conference links to “meet” with your provider:
Joan Delahanty https://doxy.me/joannp
Jeff Kreher https://doxy.me/drjeffk
Michele Novello https://doxy.me/novellonp
Lorelee Scipione https://doxy.me/loreleepa
Mark Su https://doxy.me/drsu1
Thank you again for your patience and ability to adjust with these changing times and responses. We continue to be here to support you and guide you in your healthcare needs.
Mark Su, MD and the Personal Care Physician team
3/24/20 : Special Community ZOOM Webinar on COVID-19
Wednesday 8:30pm
COVID-19: How did we get here, Why are we doing what we’re doing, and What’s going to happen to us?
Presented by:
Dr. Jessica Lasky-Su, DSc
Dr. George Papanicolaou, DO
Dr. Mark Su, MD
Dr. Lasky-Su will be presenting insightful, in-depth, and cutting edge information providing context and responses to commonly asked questions in our community and the public at large:
-Why are we doing what we’re doing: is this overkill?
-Is the “cure” going to be more harmful than the “illness”, in the end?
-How big of deal is it, really, to be social distancing? – how far do I really need to take this?
-Why is there such a discrepancy between what is happening elsewhere?
-Are we “Flattening the Curve” yet? When will we know when it’s being flattened enough?
-How long do we think this is really going to go on for? – what’s the prediction at this point, and who’s saying that, based on what rationale?
Drs. Papanicolaou and Su will cover clinical questions:
-what in the world is going on with the testing options and system for testing??
-what are local/regional hospitals doing to prepare or accommodate for what is happening?
-what are the recommendations at this point, with quarantines? – who, for how long, how about other family members, etc? (and how far out do the recommendations extend, with contacts?)
-what can be done, for prevention and interventions?
-who really is at more risk? – how much do our immune systems, toxin loads, environmental exposures have to do with this, both now and in the future?
Please join us by clicking on this link:
https://harvard.zoom.us/j/
or join by telephone (use any number to dial in)
+1 312 626 6799
+1 929 436 2866
+1 346 248 7799
+1 669 900 6833
+1 253 215 8782
+1 301 715 8592
International numbers available: https://harvard.zoom.us/u/
*** You do NOT need a Zoom account to attend the meeting, but if you have never used Zoom before, we recommend you download the app on your phone or computer prior to the meeting so you can link in immediately. To do so through a browser, go to here: zoom.us/download Otherwise, you can download the app on your phone.
We will try to address questions at the end, time-permitting.
If we reach ZOOM capacity and you are unable to attend, please check back on this announcement entry, on this page, within 24hrs for a recording link, if available.
3/18/20: Update on Office Procedures
Dear Personal Care Physicians community,
We continue to experience unprecedented challenges, leading to unprecedented responses.
In response to the COVID-19 pandemic, we have all been instructed to social distance, to quarantine, and to stay home when only minimally or moderately ill. Medical offices and hospitals have limited patients and family/visitors to only the most necessary, to reduce potential exposures to both patients being cared for as well as healthcare providers and staff who are caring for such patients. This has led patients to believe they need to put their non-acute, non-infection related healthcare needs on hold for the time being.
But oh, not so! For those of us not yet aware, Governor Baker announced earlier this week, in light of declaring a state of emergency here in Massachusetts, that healthcare visits, whether related to infections/illnesses or not, are encouraged and permitted to take place by telemedicine or virtual visit methods. Furthermore, health insurance plans are instructed to reimburse such visits the equivalent of an office visit. So in essence, we as patients can be reassured that all virtual visits can be conducted in lieu of office visits, with typical insurance coverage (and even minus the copays!).
We encourage everyone to be safe and smart. We encourage social distancing, quarantining, and avoiding potential exposures. We also encourage continued ongoing care of , and in the context of COVID-19, even better care of, your health. As such, we also encourage you to continue allowing us to assist you in your healthcare, including ongoing follow up of chronic fatigue, diabetes, reviewing lab results, asthma, blood pressure, heart disease, mental health, chronic pain, and/or other health conditions. We encourage you to not let your baseline health needs take an unnecessary back seat to the current COVID-19 focus, especially when many such conditions can play a crucial role in our immune health status and affect our response to both infectious or non-infectious stresses. And now, with the governor’s instructions in this time of need, our insurance plans, no matter which type it is, will be sure to cover that ongoing care, whether it takes place in the office, or from your home.
We’ve already been conducting these phone visits, and anticipate this to only become more and more the norm as we endure this COVID-19 crisis. Feel free to call us to schedule your follow up visits, or reschedule your cancelled visits, at your convenience.
Sincerely,
Mark Su, MD and the PCP team
3/16/20: COVID-19
Dear Personal Care Physicians community,
We are all well aware of the great impact and challenges in our midst as a result of the COVID-19 pandemic. We would like to take a moment to share some pragmatic prevention strategies in our office operations, as well as discuss some perspectives on this topic.
1) Office hygiene:
We have been increasingly mindful about sanitation and hygiene in the office. Per CDC recommendations, we have asked the appropriately criteria-meeting ill patients to stay home for the time being. Anti-microbial cleaning has been practiced in applicable areas immediately upon vacating of such said spaces by any other type of patients. We continue to ask any symptomatically ill patients to stay at home as much as possible (see below for more details). Thankfully, given our smaller patient community, the degree of risk by exposure based on the lower volume of potential contacts in our office should be meaningfully less than most other practices. We additionally ask that all patients make a concerted effort to wash your hands thoroughly, with soap, both while in our office (bathroom, exam room) as well as at home, on a more-than-baseline frequency basis.
2) Perspective:
We are recurrently asked about our opinions about COVID-19, along these lines: “How big of a deal is this?” While the majority of individuals who contract COVID-19 are going to be minimally ill, and fully able to self-recover, protecting those at higher risk and less able to self-recover, as well as doing our part to reduce the potential burden on the healthcare system (thus further placing those at higher risk of illness at an even higher risk of severe morbidity or even mortality) – esp. the ERs and hospitals, is our collective mission and responsibility. In essence, our job, as a collective public whole, is to “flatten the curve” (www.FlattenTheCurve.com), slowing the transmission of this pandemic, and thus allowing for healthcare resources, and research, the necessary time to treat infected patients and prevent increasing numbers of patients from becoming infected.
3) Evaluation of sick patients:
As of today, we continue to follow CDC recommendations as thus: if you are symptomatically ill, please stay at home; if you are ill enough to feel you require evaluation, please call and seek instructions about being evaluated, the location and pragmatics of which are changing on nearly a daily basis, and largely depending on your specific symptoms. Indeed, there are still many other non-COVID-19 illnesses that can be effectively and routinely addressed (strep throat, other viral illnesses, etc); and the significant majority of individuals who do contract COVID-19 will be only minimally ill and anticipated to self-resolve at home with time.
If or when you may call us with questions about your ill symptoms, please expect us to ask you about the following series of questions, aside from the proverbial questions about recent travels or COVID-19 contacts (or, you may gladly volunteer your answer to such questions, thereby expediting the triaging process!): a) do you have a fever or elevated temperature?, b) do you have muscle aches?, c) do you have asthma or emphysema or a history of more severe seasonal allergies?, and d) how long have you been ill for? Your answer to these series of questions will help us better decide whether or when you might warrant being evaluated, and where. Certainly, we would like to do our best, for multiple reasons, to avoid anyone having to go to your local ER; for this reason, please bear with us in asking these questions, which will help better serve you and others to more accurately assess whether the ER is necessary in any given individual case.
4) Quarantine questions:
-“My work place asked me to go home – do I really need to?, and for how long?” The current CDC guidelines are for non-essential services employees to remain home if s/he develops a fever, and remain home until at least 24 hours fever-free without any fever-reducing medications. The guidelines also request that all employees who are able to work from home be encouraged to do so. The dilemma is how best to respond when an employer asks employees to go home because of minimal symptoms in an individual who does not have a fever. In this case, the jurisdication is in the hands of the employer – even if the individual doesn’t meet strict CDC criteria to stay home based on illness symptoms present, the employer is, arguably, taking the more conservative and justifiable path in sending that employee home. How long that individual should stay at home is less defined on a national guideline level, but we would suggest, that short of asking your employer for their policy recommendations (ie, in case they don’t have one, or are deferring the decision to us as your primary care office), that you follow a parallel response to the case of an ill individual who does have a fever – ie, that you wait until your symptoms are resolved for 24hrs. ***Please keep in mind that this recommendation is in the context of a scenario whereby there is no high-risk COVID-19 suspicion in any individual: meaning that no one has just completed international travel to a high risk/prevalence COVID-19 country, and no one has outright been tested (+) to COVID-19. Such exposed individuals need to follow specific applicable CDC quarantine guidelines.
-“My spouse was asked to go home by her/his company – does that mean I need to stay home too, then?” This is the first of many potential extensions of contact which come into question, in regards to “how far down the chain” do the quarantine recommendations apply? To date (midnight, 3/16/20), there are no stated such recommendations from any entity that we have found. However, this response is prudent, as stated by the chief of pulmonology at Boston Childrens Hospital, who our practice has a direct relationship with and inquired for counsel: “The current protocol is to keep anyone who is sick at home (not necessary the rest of the household). This is likely going to change soon so that everyone should stay home other than for essentials.” But for now, there no official recommendations for household contacts to be quarantined, much less children of such adult household ill patients, much less friends or coworkers or extended family who are non-household contacts of such ill patients. Having said that, however, there are no doubt many cases already whereby employers are asking their employees who have had even minimal exposure to minimally ill, non-COVID 19 tested individuals, to go and stay at home. And again, this is out of our jurisdiction; and again, on a public health level, this is a conservative and justifiable recommendation by the employer. But if the question is directed toward us for counsel as to the length of recommended time to stay at home, our current response is that if you remain symptom free for 5-6 days, we are comfortable with you returning to work (this is the most recent estimated median incubation period for this virus). ***Please keep in mind that this recommendation is in the context of a scenario whereby there is no high-risk COVID-19 suspicion in any individual: meaning that no one has just completed international travel to a high risk/prevalence COVID-19 country, and no one has outright been tested (+) to COVID-19. Such exposed individuals need to follow specific applicable CDC quarantine guidelines.
5) Other FAQs:
-Where can I be tested? At this time, this topic is highly in flux, as most everyone is aware of. We are doing our best to detail how and where testing might be obtained, but for now, most people will have great difficulty obtaining testing, so if you are an individual with a low-risk health profile, we maintain the CDC recommendations to stay home at this time. If you are an individual with a higher-risk health profile (contact with a known COVID-19 or highly suspected COVID-19 individual; immunocompromised status; heart disease or lung disease; diabetes; etc), we will assess your case and direct you accordingly. To date, the state department of public health in MA is requiring authoritative assessment (by the state) for most individuals whether that patient’s test specimen, collected at an office or urgent care center or even ER/hospital, will be collected by the state and allowable for testing. Given their limited quantity of tests, we confidently believe that patients who have not just recently traveled to high-risk prevalent countries, or who are not bordering being admitted to an intensive care unit with such severity of symptoms, will not be considered qualified candidates for testing… Furthermore, Quest Diagnostics and LabCorp have both now released commercially available lab testing for COVID-19, but we have not yet seen this in operation yet; we are aware that testing is not available to be conducted at such said lab sites – specimens must be collected at a healthcare facility setting, which can be contradictory to the national recommendation for such said patients to avoid going to when they are ill, unless ill enough to be seen in an ER setting. We will keep you updated as this testing availability evolves.
-Has Personal Care Physicians considered separating well visits from sick visits at different times of the day, to stagger and separate “healthy” from “sick” patients? Yes, this was taken under consideration. But in the end, we adopted the more universal CDC recommendations, which are, more or less, being followed by most to all medical offices and other outpatient healthcare entities.
-Are you taking appropriate precautions in your office with masks, gowns, goggles, and more? Unfortunately, while such protective equipment is being recommended by the CDC in particular scenarios, such are essentially non-available, not only to our office, but to most any office, and even, unfortunately, to many urgent care centers and sometimes even ERs (the latter two of which are more apt to encounter such ill patients in question). Most people know by now that medical surgical face masks, while generally helpful to contain germs from coughing and sneezing, are not considered effective at containing COVID-19, and such N95 facemasks which are considered COVID-19 protective have long been unavailable for purchase seemingly from anywhere both in local retail stores as well as online.
-What do you recommend for immune boosting/support, or intervention if infected? We have a variety of recommendations that we have made for our patients, for both categories. Please talk to your specific provider about her/his recommendations on this topic.
We wish everyone peace of mind, and peace in health. Collectively, we will get through this. In the meanwhile, let’s be responsible, mindful of each other, and take frequent moments to express gratitude for what we can indeed be grateful for.
11/03/19:
Hello everyone!
We realized that our previous newsletter emails were not reaching everyone, so we’ve changed our delivery method to be presented through this web link instead. This is not a link that can be found through our website – it is simply an independent address that we will provide you each time we have new announcements to make (it will be the same address).
It’s been a long time since our last newsletter – we apologize for our recent absence in this regard. We’ve been working hard behind the scenes at some major changes in the practice, and we’d now like to update you on some of these evolutions:
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Some of us may still be unaware that as of January 2019, we changed our network affiliation to a group that has much greater leniency when it comes to referrals. Typically, HMO insurance plans require that referrals be maintained within a restricted network of specialists, but we have secured an unique agreement whereby such restrictions are absent. It has been more challenging than we expected to muddle through the administrative work to establish this arrangement, but we knew how much it would benefit our patients to be able to see whichever specialists, local or Boston, regardless of which network they may belong to, so we know it is worth the effort. **As always, if your plan requires referrals, please let us know as early as possible the date and name of the physician you are seeing, so we can send a referral for you in a timely manner – some specialists require a referral to be in place before they will see you for a visit.**
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WE’VE MOVED! We are now located on the 2nd floor, in the same building, on 255 Low St. in Newburyport, in Suite #202, rather than #303. Why the move? We’ve brought on new providers! They are excellent clinicians, and quality people. You can read about them here at this blog entry: https://www.pcpnewburyport.com/2019/10/31/so-why-now Most of us know that in the past, friends or family who were referred to our practice couldn’t get in as new patients, but had to be placed on a rather lengthy waiting list. But at this time, we are indeed again accepting new patients for a limited time, until our patient community is again full. So, we encourage your referrals at this time, and look forward to bringing our personalized, relational, and in-depth healthcare offerings to those in your lives who are looking for, or would appreciate, a change in their healthcare. Thank you for your support, and we look forward to caring for the treasured and loved ones in your life, no matter their ages or health needs!
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We’ve hired a few new staff, as well! This was necessary to accommodate for the growth in providers, as well as our growing administrative needs (Dr. Mark, in particular, apologizes to his patients for getting as behind as he did in the last few months, preparing for the office move and bringing on our new providers). Some of us have already met Kerrie at the front desk, who now works alongside Rachel, who was briefly away over the summertime. Some of us have also met Shaunalee, who is a very personable and proactive medical assistant. Starting this week, we will also be incorporating Betty as another excellent medical assistant – for those of you who are former patients at Cornerstone, you well know both Kerrie and Betty as individuals of extremely high quality, who are caring and attentive to patients’ needs – we are thrilled to have them join us! We will pair particular medical assistants with particular providers and their patients, so that relationships can be better fostered between patients, providers, and medical staff members, maintaining a close-knit vibe to your healthcare experience here at PCP. We are beyond thrilled to have such high quality office staff join us, to serve you in your healthcare needs!