GreenField Health’s Health Matters

December 2008

A Holiday Gift of Health

If you are looking for a great gift to give someone this holiday season, consider a gift of health. You can do this by covering a friend or loved one’s initial annual fee to GreenField. It is a perfect way to encourage someone to sign up with us.  

You can also sign someone up for GreenField’s very successful weight management program -Transformation. This could be the most healthful gift you can provide this holiday season.  Recent changes to the program, announced in last month’s Health Matters, have made the program an affordable gift to give.

Give us a call if you are interested. It is simple to arrange and we’d be happy to manage the details for you.

Save Money This Season: Pay Your Annual Fee in Advance

By now, you should have received letters and notification about our decision to increase our annual fee. Regardless of when your anniversary month is, you can save money now by pre-paying your annual fee for your next year before prices go up. Those of you who choose to pay your annual fee during the month of December will be able to pay at our current rates. Remember our annual fee does not go up until January 1^st. Pay now and save a little money for all of your other holiday wishes and needs.  

Aetna Contract Continues 

Many of our patients who have Aetna coverage received a letter from them in error stating that: “Your primary care physician (PCP) will no longer participate in the Aetna network,” which listed one of our physicians.   

This is incorrect – we will be participating in the Aetna network, and there will be no disruption in your coverage.  If you have any questions at all about this, please call and ask to speak with someone in our Billing Office.  Our apologies for any concern or confusion this may have caused. 

Welcoming Kate Griggs 

Please help us welcome Kate Griggs to her new role as administrative assistant at our Barnes Road location. Kate is a graduate of Brigham Young University. She is married and enjoys walking, running, hiking, soccer and going to the gym for a nice workout. She also enjoys coming up with new recipes for healthy meals and shopping at local farmers markets for fresh ingredients.

GreenField’s Secure Email 

At GreenField Health, we want to customize our communication to the needs of each individual. Some may wish to communicate mainly by phone, some by email. One of the many benefits of membership at GreenField is our Secure Messaging system and we’d like to remind you about the benefits of using secure email – benefits that go beyond just the confidentiality of your health information: 

-        All secure communications have the capability to go directly into your chart. At GreenField, we treat email visits like office visits. We often have a deep, thoughtful exchange of health information and personal information electronically. We believe that this information should be part of your medical record just like the items that we discuss in an office visit. We want to make sure that the information gets there in the easiest, most dependable fashion. 

-        We are notified whenever a secure message or an attachment is read and, more importantly, when it is not read. We often send important health information or instructions by secure email. It is just as important that we can verify that this information gets through to you as it is if we were transmitting it by phone. We do not leave important information on an answering machine or voice mail for this reason – we cannot be sure that the message has gotten through. With secure messaging, we are notified if the email has not been read within a certain period of time and then we can take action either by calling you, trying the email again, or sending the message by US mail. 

-        When your doctor is out of the office, we can easily cover messages that come in via secure email. Our secure email boxes are limited to messages that are patient related, whereas we can get email from a variety of different sources in our regular email boxes. At GreenField, we have a coverage policy to review patient emails in secure messaging that come in for other physicians in order to take care of our patient’s needs when their physician is out. This is most timely, as the review and coverage of the nonsecure email box includes a review of a lot of extraneous messages too. You can be sure your message will stand out if it is in the secure email box. 

-        Obviously, secure email is secure and encrypted. It is the best way to protect your health information. It is also the best way to discuss potentially sensitive subjects without concern about it being inadvertently viewed by others. 

Again, in the end our primary goal is to tailor our communication style to what works best for you. If you have tried secure messaging in the past and had problems with it, please let us know. We would love to work with you to help you through any issues you have had in using our system. We also need to know if the system has problems so that we can fix them. We want to push and advance the technology so it suits the needs of our patients and our staff. Sometimes the best way to do that is with the help of your feedback. If in the end, if you decide regular email is the way you’d like to communicate with us, we will do that with your consent. 

If you need help using our secure messaging system, please call us, we are very happy to help answer any questions that you may have.  

Rx for Better Prescriptions 

We are continuing to work on our systems to provide you with higher quality, more convenient care.  We have been working with our electronic prescribing system for over a year now, which allows your pharmacy to send us a secure message to refill your medications.  We can reply using our secure email tool, which is generally a more reliable way to communicate than using the fax machine.  While we’re pretty excited about this system enhancement, we recognize that no system is perfect.   

If for any reason, you arrive and are told that they do not have your prescription, we’d like to encourage you to give us a call from the pharmacy.  There can be many reasons for a missing prescription (although the pharmacies may well say “your doctor didn’t send it to us”). Regardless of the reason, the bottom line is that we want you to have your prescription with the least amount of hassle. If you call us from there, we’ll communicate directly with the pharmacy to be sure you can get your medication immediately. We’ve noted an increase in the number of these types of calls (which we appreciate getting so we can get the issue straightened out right away) and we’re continuing to work on improving our systems and our connection with the pharmacies so that prescriptions are reliably available when and where you need them.

More Benefit from Physical Activity  

As most GreenField Health patients know, we are big promoters of physical activity and its positive effects on health. Lifestyle factors such as diet, weight management, routine exercise, and staying intellectually engaged in life are the most important things that an individual can do for his or her health.  

From the common cold (either prevention or treatment once you have it) to dementia, exercise has been shown to be beneficial. In head-to-head trials, daily exercise has been shown to be as good as or better than medications to treat conditions such as anxiety, depression, the common cold, risk of cardiovascular disease (heart attacks or strokes), migraine prevention, emphysema, adult onset diabetes, and more.  

A recent study published in the distinguished Journal of the American Medical Association reiterates this point. The study examined the effects of physical activity on cognitive (mental) functioning in older individuals and it found that exercise provided a significant improvement in cognition in those with subjective mental impairment.  

We recommend moderate to vigorous daily exercise lasting at least 30 minutes per day on 5-6 days per week for everyone from young children (that’s called active play and sports) to older individuals. The important thing is to develop the habit of exercise – making exercise a routine in one’s life where it occurs as regularly as eating meals and sleeping. If you need coaching on this, please let us know.  

Why is this important? It’s important for your health obviously, but it is also important that you understand the challenges that US healthcare faces. One way that we look at medical interventions is to examine their “cost-effectiveness”. For example, exercise is inexpensive and delivers a large number of positive health effects, including the reduction of mental impairment. The cost-effectiveness of exercise is very high. 

On the other hand, there are several widely used “dementia” medications such as Aricept and Nemenda. They are very expensive and the data supporting their effectiveness is extremely weak – these medications have a low cost effectiveness. Many healthcare experts argue that these medications are so ineffective that they should not be used, and yet our society spends billions of dollars on them yearly.  

In our society--which is struggling so mightily with healthcare costs--we have a cultural tendency to use expensive interventions with very marginal effects over lifestyle interventions with much more profound effects and at a much lower cost. Yes, it seems a bit crazy, and it is, but this is a core part of American culture and one critical reason why US healthcare is so incredibly expensive.  

It is for these reasons that we so strongly promote healthy lifestyles – healthy diets, weight management, daily exercise, and remaining intellectually engaged in life. The cost effectiveness of these interventions are truly fantastic compared with many of the interventions that healthcare delivers to us today.  

Family Matters: Recommendations for Holiday Giving

The holiday season is a joyous and reflective time, but it can also be filled with angst and stress. The gift-giving has gotten out of control in many homes and the spirit of the season frequently seems to be lost in the materialism of our world today. This year you can do something different and create a holiday season that is a joyous and reflective time of connection with your family and friends.  

Here are our recommendations for holiday giving, which were developed by GreenField’s adolescent medicine specialist Dr. Paula Koeller and Portland’s well known Parent Coach Dr. Kathy Masarie. We believe that both parents and kids would benefit from these recommendations – the overall goal is to reduce the materialism of the holidays, and to foster positive experiences together. These same general recommendations are applicable to birthday giving as well.  

1.      Focus on spending time together: Christmas is about spending meaningful time with family and friends. Spending time together can be far more valuable than material things. One family we know stopped giving gifts altogether and simply started to take family trips over the holiday season leaving everyone with long-lasting memories. When giving gifts, consider those that foster positive family experiences such as games that the family can play together. Making gifts for each other also fosters the experience.  

2.      Reduce overall giving: We all know that the holidays have become excessive, and that really doesn’t benefit our children. In the frenzy of gift opening, our children lose the simple and grateful experience of giving and receiving. We encourage you to find ways to reduce the number of gifts. Instead of buying gifts for everyone for example, draw names or rotate names of individuals or families that your family will be buying for that particular holiday. The intent is not to take the fun out of the holidays, but in fact to reduce the excess and materialism and to replace it with high quality experiences.  

3.      Reduce the number of electronic gifts: TVs, computers, and electronic games can isolate children and families instead of fostering meaningful interactions between parents and their children. The brain is much better stimulated by reading than it is by electronics. At least one gift to each child should be a book.  

4.      Teach giving and moderate receiving: Give to them by giving to others – as a family, agree that you are going to give each other a lot less, and give time or goods to your favorite charity instead. Prepare a gift box together filled with non-perishable grocery items with special foods representative of the holidays.  

5.      Set limits on gift spending: Give children $15-25 for each sibling and parent. The parents can set their own limit on how much to spend on each child. 

You might find the book Unplug the Christmas Machine: A Complete Guide to Putting Love and Joy Back into the Season by Jo Robinson and Jean Coppock Staeheli useful.  

If you follow the guidelines above, we’re guessing that you’ll experience less stress and spend less money, yet have a more fulfilling holiday experience. At the end of this season, write down the traditions you want to keep for next year. Be patient - it may take a few years to create the traditions you want. 

Transformation: Establish a Support System in 2009 

The Transformation program at GreenField Health is a lifestyle and weight management program. There have been scores of participants over the three years of its existence and their experience has led to the development of “The Seventeen Habits of Successful Weight-Appropriate People.” Each month in Health Matters, we have been sharing one of these habits with you and discussing its benefits.

As we finish this year and look to 2009, now is a good time to put into place one more habit: establish and nurture a support system. It can be a family member, a co-worker, a neighbor or a friend. You can meet to exercise rather than eat, plan a friendly competition to see who walks more steps in a week or email challenges and successes back and forth. Anything that increases our accountability and keeps us on a healthy path is a benefit. Some of us want to keep our attempts to be healthier to ourselves, “just in case it doesn’t work out as planned”.  But those who share their attempts and enlist others’ help have a better chance of success. So, here’s to a very successful 2009! 

We would like to take a moment to remind you of exciting changes to our Transformation program. Now is the perfect time to take a moment and think about your own weight management and lifestyle choices. We recently made our Transformation program shorter and more affordable. Please call if you would like to learn more about our program (503) 292-9560.  

Office Notes: GreenField’s Holiday Hours 

-          We will be open until approximately 1:00 pm on both Christmas Eve & New Years Eve- December 24 & 31, 2008. 

-          We will be closed on December 25, 2008 and January 1, 2009 in observance of Christmas & New Years. 

-          We will have appointments available on Friday, December 26 and Friday, January 2^, 2009 – please call us if you need anything. 

-          As always, a GreenField physician is available to you by phone at all times 24/7 – just call our phone number day, night, or weekend and you’ll be put through to the person on call by our answering service.  

At this time of year, we pause to reflect on all that we are blessed with, and our thoughts turn to you. We would like to thank you for your ongoing support of GreenField, and we would like to wish all of our GreenField family and friends a wonderful holiday season and the very best for the New Year. 

Sincerely, 

Your GreenField Health Team 

             
Angie Ashburn, CMA, your Health Coordinator (email)            
Beth Davis, your Business Office Manager (email)            
Chuck Kilo, MD (email)                                                          
Cindy King, your Benefits Coordinator and Biller (email)            
Connie Turner, MA, your Health Coordinator (email)                  
Cynthia Ferrier, MD (email)                                                     
Dana Lee, MA, your Clinical Supervisor (email)                        
David Hays, MD (email)                                                         
David Shute, MD (email)                                                        
Desi Lowder, CMA, your Health Coordinator (email)
Elizabeth Hays, MD (email)
Jenna Baird, CMA, your Health Coordinator (email)
Jill Arena, your COO (email)
Joel Swartzmiller, your IT Manager (email)
Kate Griggs, your Administrative Assistant (email)
Kim Walgraeve, your Marketing Manager (email)
Kristin Walker, your Program and Executive Assistant (email)
Malcolm McAninch, MD (email)
Maria Soutavong, MA, your Health Coordinator (email)
Meena Mital, MD (email)
Pam Mockenhaupt, CMA, your Health Coordinator and Biller (email)
Paula Koeller, MD (email)
Peter Casey, your Consultant (email)
Samantha Charles, your Clinic Administrator (email)
Todd Canon, MD, (email)
Vicky Van De Walker, MA, your Health Coordinator, (email)
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GreenField Health at Barnes Road                                                  
9427 SW Barnes Road, Suite 590                                                   
Portland, OR 97225                                                                       

GreenField Health at NE Broadway
2606 NE Broadway, Suite C
Portland, OR 97232

questions, concerns, comments always appreciated:
questions@GreenFieldHealth.com

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