Please join us in welcoming Dr. Mal McAninch to GreenField Health. Dr. McAninch will be starting with GreenField on October 20. Mal will be picking up Dr. Murray’s patients. As stated in our August Health Matters, Mal is a highly respected internist who has practiced in the Portland community for over 20 years.  He has most recently been practicing and serving as a medical director at Legacy Health System. We are delighted that he is joining our GreenField Health team and we’re confident you will like him as much as we do.  

We have provided intermittent updates on our work at GreenField Health via Health Matters over the years. We believe that these updates are valuable in giving you a sense of the spectrum of work that we are engaged in. We hope that you value this work – it is all aimed at making health care better, both for you and your family, but also for our community.  

You probably view GreenField first and foremost as a medical practice – that is after all our primary focus, because caring for our patients is the core of what we do and it is our passion. However, as many of you know, we are also actively involved in local and national activities focused on health care improvement. That work makes us quite unique and hopefully it increases your commitment to us.  

Our intent is sharply focused on you ‑ our patients ‑ and the continual improvement of your care and your experience of care. Because of this, our national reputation is as a “research and development” or innovation-focused practice. We spend a fair amount of time researching and developing new methods of providing care. For example, we still do more e-mail and phone care per patient than almost any other practice in the country. And we continue to be actively involved in developing systems to improve care. This includes our long-standing strategic business partnership with Kryptiq Corporation, Portland’s well known healthcare connectivity company.  We continue our work with them to develop products to electronically connect healthcare providers and their patients. 

The development of our “Transformation” program is another example of this work. Much of this work to improve care occurs behind the scenes in our use of technology – it may not be obvious or visible to you, but the investigations are ongoing.  

We are also involved in many local and national activities focused on health care improvement. Everyone recognizes how much health care needs to change – GreenField is proud to be actively working on that transformation. In fact, GreenField derives a significant amount of revenues from paid speaking engagements and consulting. These activities make up approximately 20 percent of our revenue.  

Our consulting services focus on a wide range of topics that relate to improving health care quality. Examples of our current consulting engagements include:

• working with the Oregon Healthcare Quality Corporation to coordinate their efforts with a Robert Wood Johnson grant that spans health care quality in the Willamette Valley
• helping a local residency education program to improve physician education,
• designing and teaching a course for an association of California medical groups to help them optimize their clinical performance,
• working with the Oregon Department of Health to coordinate a grant project on chronic care quality improvements, and
• assisting one of the largest US health systems to drive innovation in their medical practices.

As we previously announced, we also had a book published in 2005 titled “Medical Practice Transformation with Information Technology”. We also published an article in the respected health care policy journal Health Affairs titled “Transforming Care: Medical Practice Design and Information Technology”.  Over the past several years, GreenField physicians and leaders were interviewed and featured in articles in many national publications focused on methods to improve health care.  

In addition to being on the advisory boards for several local technology companies, we serve on the board of directors for several organizations including:

• Outside In: a local not-for-profit that provides innovative social, mental health and medical services to homeless teens,
• The Foundation for Medical Excellence: A local not-for-profit that promotes quality health care through physician education, research and other collaborative efforts,
• Regence Blue Cross Blue Shield of Oregon: A regional health insurance company that covers many of our patients,
• TransforMED: a subsidiary of the American Academy of Family Physicians that is working to transform family physician practices to a new model of care that looks relatively similar to our GreenField model,
• Kryptiq Corporation: a Hillsboro-based health care information technology company and a local rising star,
• Cascade AIDS Project: a local not-for-profit that focuses on prevention, care, education and advocacy for our community.

For all of this work, your support is critical – we could not do it without your dedication to our team. We hope that you value this work. It demonstrates our commitment to work within healthcare, and also to work to improve health care. In turn, we are deeply appreciative of your support.  

Lastly, we have recently started a 501(c)(3) not-for-profit organization called the Trust for Healthcare Excellence (The Trust). We will be telling you more about The Trust in the near future as we are starting a capital campaign to help support The Trust’s work in leading healthcare reform.  

As you may have heard from the radio or other sources, the website Angie’s List is now making available the online ratings of physicians. Online ratings are fraught with problems, but they are happening nonetheless. Angie’s List allows consumers to rate a wider range of services, and they have recently added physicians to that list. In general, disgruntled individuals are more likely to make comments than delighted individuals which can skew the ratings.   

For those who have an Angie’s List account and are really delighted with our services at GreenField Health, we encourage you, if you are so motivated, to go to Angie’s List and rate our care. We would be appreciative. The address is www.angieslist.com/AngiesList/.   If you do not have an Angie’s List account, there is a small fee to join if you are interested.  

If you are not really delighted with our services, we hope you’ve already let us know.  If you haven’t let us know, please do, so we have an opportunity to make things right.  You can contact our Clinic Administrator, Samantha Charles at 503-384-2006 or Samantha.Charles@GreenFieldHealth.com. 

In our June/July ‘08 Health Matters we discussed biofeedback and in August we discussed hypnosis. This is the third and final part of our review of methods based on the mind-body connection. Our knowledge of each is limited, but the effectiveness of each is well validated in certain clinical situations.  

Acupuncture originated in China thousands of years ago. Its popularity has grown significantly in the US over the past two decades. Acupuncture involves the insertion of thin needles at various depths at strategic points on your body. Like biofeedback and hypnosis, we don't fully understand how or why acupuncture works but studies demonstrate that it may be beneficial in a number of medical situations ‑ from reducing pain to helping you quit smoking. 

The theory behind acupuncture as a medical treatment is very different from that of Western medicine. In traditional Chinese medicine, imbalances in the basic energy flow of life — known as qi or chi (“chee”) — are thought to cause illness. Qi is believed to flow through 20 major pathways (meridians) in your body. These meridians and the energy flow are accessible through approximately 400 different acupuncture points. By inserting extremely fine needles into these acupuncture points in various combinations, acupuncture practitioners believe that your energy flow will rebalance. This allows your body's natural healing mechanisms to take over. 

Exactly how and why acupuncture seems to improve certain conditions isn't known. Western medicine has tried to explain the positive effects of acupuncture in several ways. It is possible that acupuncture may stimulate your nervous system to release hormones that activate your body's natural healing abilities. Acupuncture might also stimulate the release of endorphins that are part of your body's natural pain-control system thereby reducing pain. These are some of the avenues of research trying to explain the mind-body connection.  

Acupuncture usually involves a series of weekly or biweekly treatments. During acupuncture treatment, the practitioner uses sterilized stainless steel needles that are used once and then thrown away.  

For what conditions is acupuncture useful?

Like hypnosis and biofeedback, acupuncture can be useful for the treatment of pain including pain related to:

• Chronic headaches including migraines
• Surgery including oral and dental surgery
• Menstruation
• Childbirth
• Tennis elbow or other forms of tendonitis
• Osteoarthritis or degenerative arthritis
• Back and neck pain

It can also be used to help treat

• Depression
• Chemotherapy-induced vomiting

How to choose an acupuncture practitioner

In the United States, a certified acupuncturist completes training and must successfully complete board exams conducted by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). If you're considering acupuncture, we would be happy to make recommendations. We suggest that you do all of the same things you'd do if you were choosing a new doctor: 

• Talk to people you trust and ask for recommendations.
• Check the individual’s training and credentials.
• Inquire about treatment costs and insurance coverage.
• Interview the practitioner.

Don’t be afraid to ask about the treatment procedures and how likely they are to help your condition. Remember that acupuncturists, hynotherapists, and biofeedback trainers differ from one another just like doctors do. A bad experience with one practitioner doesn't necessarily mean that you will not receive a more positive result with another individual. For each of these treatment modalities, the will and desire of the individual to participate positively in her or his treatment seems to be an important determinant of success – more evidence of the power of the mind-body connection! 

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.  

We want to stress this month how important it is to your overall health and to healthy weight management to get enough sleep. When we are sleep deprived, we not only lack the energy to exercise, we also tend to make very poor food choices. That combination can lead to weighty consequences!  

The amount of sleep an individual needs varies from person to person, so it is important to become aware of what your requirements are. Our busy lives commonly lead to sleep deprivation as we try to fit more things in before hitting the pillow. As we strive to make our health a priority in how we manage our schedule, don’t forget to leave enough time at the end of the day for the recovery and rest that sleep brings. You will make healthier food choices and be more successful at managing the stresses life brings.  

We are fortunate to live in an area where exercise and activity are a valued part of our community.  As the rainy season approaches it’s good to remember there are still plenty of ways that families can get good levels of exercise.  What a great idea it is to demonstrate to your children when they are young the joy and health benefits of exercise. 

Run, walk, or hike.  Throw on some rain gear and warm shoes and hit the trails!  The fall is a great time of year to enjoy the changing of the leaves and we are surrounded by hundreds of trails in our urban area and also within a short drive.  The Hoyt Arboretum is a beautiful place to explore nature in the fall.  Other good trails can be found in Forest Park, Tryon Creek State Park, Powell Butte Nature Park and other locations.  For more ideas go to www.portlandonline.com/parks  or try www.oregon.gov/OPRD/PARKS/. 

Bike around town.  The views from Terwilliger Parkway, Mt. Tabor and the Springwater Corridor are even better in the winter because many of the trees have lost their leaves.  You and your family can enjoy a bike ride along trails safe from cars in these areas.  Don’t forget your bike helmets! 

Go for a swim.  Portland Parks and Recreation operates six year-round pools where you and your family can swim and also take lessons and classes.  To find one in your area, visit www.portlandonline.com/parks. 

Lift weights.  Weight training is important to help keep your bones strong and your muscles metabolically active and is a healthy indoor activity.  Look for sales on sets of dumbbells or visit stores with used sports equipment. We are happy to help advise you on proper ways to exercise with weights and to be sure you are not setting yourself up for an injury. 

Get out on the water.  Several places in the area rent kayaks and canoes and this is a fun way to see parts of Portland you don’t often get to see.  The fall is a time when migratory birds are passing through and is a good time to go bird watching…and there’s no better way to see water fowl than gliding by on a quiet canoe. 

Check out community centers.  Many of the Portland Parks and Recreation community centers offer indoor classes in dance, gymnastics, yoga, tennis, basketball, and others.  If you live on the east side check out the Northeast Community Center at www.necommunitycenter.org for other options. 

This year’s flu shots are now available. If you get one elsewhere – for instance at work or the local grocery store – please let us know so that we can record this in your chart.

Anyone who would like to be vaccinated should be. We specifically recommend yearly vaccination for those at high risk of getting or having complications from influenza:

• Those age 65 and older
• Individuals with a chronic condition such as diabetes, chronic lung disease (asthma or emphysema), congestive heart failure, liver disease, kidney disease, significant heart disease, alcoholism and anyone with a weakened immune system such as those on steroids or those with rheumatoid arthritis
• Pregnant women
• Residents of nursing homes or long-term care facilities
• Health care workers
• Out-of-home caregivers, childcare providers, and those frequently in contact with children younger than 6 months

Vaccination is recommended for those in frequent contact with others at high risk, which is why we pretty much recommend that everyone be vaccinated.

The best time to be vaccinated against the flu is in October and November, but vaccination in December or later can still be beneficial.

Come to the Barnes Road or Broadway locations at any time. You don’t need to schedule an office visit, but if you’d like to assure that you’ll be in and out quickly, feel free to call ahead and schedule a time with one of our wonderful Health Coordinators. We promise no lines, good coffee or hot tea, and relatively painless shots.

The cost will be $40. Many insurance companies do not cover the cost of a flu shot so it is frequently an out-of-pocket expense. We will bill your insurance, and in this instance, we will collect a co-payment if you have one, as that is a large part of the total cost of the immunization.

We are happy to vaccinate your family members even if they are not patients at GreenField for the same fee of $40.  Check our website and watch for October’s Health Matters where we’ll announce dates of our flu shot clinics to be held in late October and early November.

We are delighted to bring you this monthly edition of Health Matters, and thank you as always for inviting us to walk with you on your healthcare journey.  Happy Autumn! 

Sincerely, 

Your GreenField Team

Amanda Clark, MA, your Health Coordinator (email)               
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)
Jill Arena, your COO (email)
Joel Swartzmiller, your IT Manager (email)
Kim Walgraeve, your Marketing Manager(email)
Kristin Walker, your Program and Executive Assistant (email)
Lea Robinson, your Administrative 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)
Samantha Charles, your Clinic Administrator (email)
Todd Canon, MD, (email)

GreenField Health at Barnes Road                                                   GreenField Health at NE Broadway
9427 SW Barnes Road, Suite 590                                                    2606 NE Broadway, Suite C
Portland, OR 97225                                                                        Portland, OR 97232

Phone: 503.292.9560
Fax: 503.292.9510
Web: http://www.GreenFieldHealth.com

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

© 2003-2008 GreenField Health