Monthly Matters:

• A Gift of Health
• GreenField Gives Back this Holiday Season
• GreenField's Holiday Schedule
• New Breast Cancer Screening Guidelines
• Does Exercise Boost Immunity?
• Transformation: Announcing Program Changes
• GreenField Physician Profile: Dave Hays, MD
• GreenField Physician Profile Correction: Paula Koeller, MD
• Office Notes

GreenField Health’s Health Matters

December 2009

A Gift of Health

This year as in the past, if you are looking for a great gift for someone this holiday season, consider a gift of health. You can encourage a friend or loved one to join GreenField by covering their initial Annual Fee as a holiday gift. It is a perfect way to encourage someone to get the healthcare they deserve. This could be the most healthful gift you can provide this holiday season. Give us a call if you are interested. It is simple to arrange and we’d be happy to manage the details for you.

GreenField Gives Back this Holiday Season

We continue to feel so blessed to be able to do the work that we do, and so it is especially important to us to give back to our community at this time of year. For a number of years now, we have been participating in the Annual Giving Tree at Outside In, which is a social service agency that helps homeless youth move towards improved health and self-sufficiency.

This year, the team at GreenField chose 30 names of homeless youth from the agency’s Giving Tree. Each name came with a short list of the youth’s wish list items - TriMet bus passes, warm winter coats, and gift cards are always popular items. Our gifts will be personally delivered to the agency in time for the holidays. We’re donating these in honor of our patients and clients, and we sincerely hope that they brighten the holidays for the youth who otherwise would not have much to celebrate.

For more information on this local resource or to see how you may help, please visit www.outsidein.org . They’ve posted a holiday wish list on their home page if you find yourself in a position of being able to do some extra shopping for some deserving youth this year.

GreenField's Holiday Schedule

Our holiday schedule will be as follows:

Thursday, December 24 - Open until approximately 1:00 PM
Friday, December 25 - Closed
Thursday, December 31 - Open until approximately 1:00 PM
Friday, January 1 - Closed

As always, a GreenField physician is available to you by phone at all times 24/7 – for any urgent or emergent needs. Simply call our phone number (503.292.9560) day, night, or weekend and you’ll be connected to the physician on call by our answering service.

New Breast Cancer Screening Guidelines

Several weeks ago, new guidelines were released by the U.S. Preventive Services Task Force (USPSTF) regarding the frequency with which women should get mammograms and the age at which women should begin screening. The new recommendations differed substantially from the last time they were released in 2002 and have caused confusion and concern among patient and physician groups.

The USPSTF is an independent panel of experts in primary care and preventive medicine who are convened regularly by the Department of Health and Human Services. They review all the available data on different health screening tests to determine if that data shows that the screening test is safe and effective. A significant parameter they evaluate is the cost of a test per life saved from a given disease. In this way, they can determine the cost effectiveness of a test when applied to a large population. They look at the cost of screening the US population, both the cost of the test itself, as in mammography, but also the cost of additional testing for abnormalities detected which are found on further evaluation not to be cancer (e.g. ultrasounds, MRI’s, biopsies). They also take into account the potential damaging health effects of the test itself, i.e. the radiation exposure from mammography over the years of a woman’s life.

After evaluating all these complex issues, the USPSTF determined that, for women who are not at increased risk of breast cancer, the cost-benefit analysis did not support continuing to recommend mammography beginning at age 40, but rather to begin at age 50. In addition, for women aged 50 to 65, mammography could safely be done every other year rather than yearly. Their analysis also did not support continuing to teach breast self examination as an effective means of diagnosing breast cancer, mainly because of a high “false positive rate”- abnormalities felt by women which proved not to be cancer after further evaluation.

It is important to keep in mind that these recommendations apply to screening only, not to the evaluation of a palpable abnormality found by a woman or her physician, and do not apply to women with any increased risk of breast cancer.

Several prominent physician organizations and the American Cancer Society have rejected these new recommendations, preferring to stay with the previous guidelines of advising every 1-2 year mammograms beginning at age 40 and yearly from 50-65 years of age.

The GreenField physicians have discussed this issue together and are not endorsing or rejecting the new guidelines at this point. We respect the work of the USPSTF but would like to reserve judgment on this latest recommendation until there can be more careful debate.

Decisions about breast cancer screening are complex and must be individualized. So, we are recommending that our patients discuss this with their GreenField physician at the time of their annual examination.

Does Exercise Boost Immunity?

Imagine for a moment that you are a GreenField employee, and you mention during the work day to one of your co-workers that you feel like you are catching a cold. It is likely that you’d get the following cajole from another team member – “Go for a run.” We say this only half in jest, because we believe in the potency of exercise to help heal people. We’ve addressed this many times over the years in these pages of our GreenField Health Matters newsletter.

Two recent studies reiterate the power of exercise to boost the immune system. In fact, exercise may be the most potent booster of the immune system. These studies were published in the journal Brain, Behavior, and Immunity. In each experiment, mice were divided into groups and the role of exercise and the immune system were considered.

In the first experiment, one group of mice rested comfortably while the other ran on little treadmills until they were exhausted. This continued for three days. The mice were then exposed to an influenza virus and to no surprise, more of the mice who’d exhausted themselves running came down with the flu than the control mice and they also had more severe symptoms.

In the second experiment, they first infected mice with influenza. One group then rested, a second group ran for 20 or 30 minutes, and a third group ran for a taxing two and a half hours. Each group repeated this routine for three days, until they began to show flu symptoms. The mice who exercised moderately did the best, whereas those who were either sedentary or over-exercised did poorly.

You might wonder if this is good news or bad for the effects of exercise. In fact, a good deal of recent research demonstrates what has been suspected for some time, namely that moderate exercise seems to improve immunity compared with a sedentary lifestyle, and that extreme exercise lowers immunity.

In humans, other studies do demonstrate that those who exercise seem to have less susceptibility to colds and get over them more quickly. Why and how exercise affects the immune system remains unclear.

However, the advice of “go for a run” if you feel like you are developing a cold or nasal congestion is a reasonable idea, while avoiding overly prolonged or strenuous exercise may also be advised – don’t go run a marathon, and if you are training for a particularly vigorous event, be mindful that your susceptibility to infections may in fact be higher than normal.

Transformation: Announcing Program Changes

Transformation at GreenField Health is our innovative medically-supervised lifestyle and weight management program designed and managed by GreenField’s own Cynthia Ferrier, MD. Many GreenField patients, their family members, and friends have benefitted over the years by working directly with Dr. Ferrier on their weight and lifestyle. Anyone can join; you do not have to be a GreenField patient to participate. We would like to take this opportunity to inform you of some exciting changes for 2010.

Transformation is a 3 month weight loss program that costs $495. The program is unique to the Portland area because it allows you to work directly with a physician, one-on-one, on your health, weight and lifestyle. The program includes a 90 minute initial assessment with Dr. Ferrier, followed by weekly check-ins with her in person or online. The program also includes quarterly informational group meetings that are designed to educate and motivate participants.

Program participants have the option to choose between two different food plans:

Transformation Balanced Food Plan - This plan allows participants the opportunity to develop a carbohydrate and protein balanced meal plan with Dr. Ferrier where they will buy and prepare their own foods. This option will include moderate calorie restriction incorporated into 3 meals and 3 snacks daily.

Transformation Medifast® Food Plan - This plan incorporates Medifast food items in conjunction with the web-based support program called Take Shape for Life®. As a TSFL coach, Dr. Ferrier can help participants order their food items. This option allows participants to have a lower calorie meal plan which is protein fortified in order to balance protein and carbohydrate intake to avoid muscle loss and slowing of metabolism. To learn more about the Take Shape for Life program, please visit Dr. Ferrier’s site at: www.Ferrierc.tsfl.com.

Medifast items are not included in the Transformation program cost. The cost of the Medifast food is very comparable to a typical daily food expenditure. These items are ordered individually by each participant. Dr. Ferrier does not have any personal financial interest in either Medifast or Take Shape for Life.

Many of us are often ready to begin a weight loss program in January of each New Year. Why not gather a few friends or family members and begin the Transformation journey at GreenField Health? For more information please contact Kristin.Walker@GreenFieldHealth.com or visit www.GreenFieldHealth.com.

GreenField Physician Profile: Dave Hays, MD

This month we are profiling GreenField’s Dr. Dave Hays who is a family physician at our NE Broadway Clinic. He works with patients of all ages and is currently accepting new patients. Dr. Hays enjoys caring for patients along the full spectrum of the life - from newborns to older adults.

If you know of anyone on the east side who is looking for a new personal physician, please encourage them to contact Connie.Turner@GreenFieldHealth.com and she can set up a brief meet-and-greet with Dr. Hays.

Before coming to GreenField, Dr. Hays worked in Vancouver, Washington with the Family Physicians Group. Prior to this, he was the Chief Resident in Family Medicine at OHSU from 2001-2002.

He chose to work at GreenField because trusting, respectful relationships are at the core of the care that we provide. As Dr. Hays so nicely states, “In the busy and sometimes stressful world of medicine, it is often easy to lose sight of the humanity in what we do. Instead of being treated like human beings, patients are too often seen as diseases, medications, phone calls, and appointment slots. Everyone at GreenField recognizes the importance of treating people with respect.”

All of our GreenField physicians are personal primary care physicians who focus on acute care services and the management of chronic conditions, along with a strong focus on wellness and preventive care. Dr. Hays is a family physician and the physicians at our Barnes Road Clinic are internists, with the exception of Dr. Paula Koeller who does adolescent medicine for those ages 10-30 including sports medicine and the management of eating disorders.

Family medicine grew out of the old model of the “general practitioner”- a doctor who was trained to care for all ages in the family and a community. This has always been especially important for physicians working in rural areas, but family physicians also remain very active in urban areas. A great family physician provides very comprehensive personal primary care, and that describes Dr. Dave Hays. Family physicians train primarily in adult and pediatric medicine, as well as obstetrics/ gynecology and surgery.

Dr. Dave Hays is married to GreenField’s Dr. Elizabeth Hays who is at our Barnes Road Clinic. They enjoy their five-year-old daughter Harper, and four-year-old son Thomas. According to Dave, the family “engages in a very healthy amount of silliness at home.” He enjoys biking, hiking, reading, and watching movies. Dave enjoys playing guitar and still has dreams of becoming a “rock star” although he’s not ready to give up his day job just yet.

GreenField Physician Profile- Correction: Paula Koeller, MD

Last month we profiled GreenField’s Dr. Paula Koeller and we wanted to take this opportunity to make one important correction. Dr. Koeller is not our adolescent physician - our apologies to Dr. Koeller for this reference! – but she is a pediatrician by training who specializes in working with adolescents and young adults. She enjoys working with patients ages 10-30 and is currently accepting new patients who fall into this age range. If you know of anyone in this age range looking for a new physician, please encourage them to call us at 503.292.9560 and we can set up a time for them, and perhaps their parent(s), to meet with Dr. Koeller.

Office Notes

• We would like to remind you that we will begin billing for co-payments beginning January 1, 2010. Because we are now using electronic e-statements, we will not be collecting visit co-payments at the time of your visit, but we will be billing for those payments using our electronic system. You will receive the invoice via a secure message from us which also allows for online payment. For those who don’t open the secure e-statement or those without email, a paper invoice will be generated and mailed. The amount of your co-payment should be noted on your insurance card. We appreciate your understanding about this issue. Should you have any questions, please don’t hesitate to contact us.
  

We would like to wish you and yours a wonderful holiday season, a very happy and healthy start to the New Year. We look forward to continuing our role with each and every one of you in 2010.

Sincerely,

Your GreenField Team

Alisyn Shaw, CMA, your Health Coordinator
Angie Ashburn, CMA, your Health Coordinator
Beth Davis, your Business Office Manager
Bonnie Hicks, your Billing Clerk
Carrie Destefano, CMA, your Health Coordinator
Chuck Kilo, MD
Connie Turner, MA, your Health Coordinator
Cynthia Ferrier, MD
Dana Lee, MA, your Health Coordinator
Danika Pellicano, NCMA, your Health Coordinator
David Hays, MD
David Shute, MD
Elizabeth Hays, MD
Jill Arena, your COO
Joel Swartzmiller, your IT Manager
Kate Griggs, your Administrative Assistant
Kim Walgraeve, your Marketing Manager
Kristin Walker, your Program and Executive Assistant
Malcolm McAninch, MD
Marsha Box, MA, your Health Coordinator
Meena Mital, MD
Pam Mockenhaupt, CMA, your Health Coordinator and Biller
Paula Koeller, MD
Peter Casey, your Consultant
Samantha Charles, your Clinic Administrator

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

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

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

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