Aug
31
An important message from our President and Vice President about Healthcare Reform
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Dear Patients,
As physicians we care about the welfare of people in the communities where we are privileged to live and work. This is why we have been concerned about healthcare reform for several years now. As part of this effort we have been speaking with our elected officials about ways to provide access to healthcare services and achieve good health for everyone. We recognize that this effort will not be an easy task, nor is there any simple answer. It will take all of us working together to find the best way to provide access to high quality cost effective healthcare services for everyone.
We believe that an open and honest dialogue among informed citizens is the best way to achieve a national consensus about the direction of healthcare delivery in our country. We realize that getting at the facts around healthcare reform can be challenging. In spite of (perhaps because of) the abundance of healthcare reform news coverage, it is hard to sift through the claims and counter claims and arrive at the truth. However this issue is too important to sit on the sidelines. We urge you to take the time to learn about the proposed healthcare reform measures and to voice your opinion to your Congressional Representative and our Senators. A good source of general information about healthcare legislation can be found at the Kaiser Family Foundation website, http://www.kff.org/healthreform/sidebyside.cfm. If you are looking to check a specific fact the Politifact website at http://www.politifact.com/truth-o-meter/provides an analysis of some of the common statements being made about the healthcare reform legislation.
We have also provided you with our thoughts about healthcare reform on the below document. We hope you find it informative.
Sincerely,
Paul Merrick, M.D.
President
Brian O’Leary, M.D.
Vice President
DMG Healthcare Reform Positions, 8/28/2009
Individual Mandate: DMG believes that everyone should have access to high quality medical care. However we also believe that every person has a responsibility to use the mechanisms provided for in the proposed healthcare reform legislation to obtain access to health insurance. Additionally we believe that individuals have a responsibility to adopt a healthy lifestyle to the best of their ability.
Health Insurance Exchange: DMG supports the effort to make insurance option information understandable and easily accessible for purchase through an exchange mechanism. However we are concerned that some of the exchange development provisions create an unnecessary layer of expense and bureaucracy. We encourage the Congress to focus the exchange development through already existing entities such as each state’s Department of Insurance. We believe this function would be complimentary to the responsibilities for plan review already assigned to each state’s Insurance Commissioner.
Public Health Insurance Option: DMG is concerned about any provision that mandates physician participation in public health insurance for those physicians that are currently Medicare providers. We believe that physician participation in each government health plan should be independent, in the way that provider participation is currently unlinked between Medicare and Medicaid.
Standard Benefits that include Prevention and Wellness Services: Keeping people healthy is the best healthcare cost reduction measure. Therefore DMG concurs with the emphasis on healthy behaviors and preventive services. We believe that the measures described such as removing or limiting beneficiary cost sharing for covered preventive services, providing refunds or other incentives for Medicare beneficiaries who successfully complete behavior modification programs and improving provider education and patient awareness of covered preventive services are effective measures to increase utilization of preventive services and to motivate beneficiaries to adopt healthier ways of life. DMG concurs with the Congress’s judgment to use the United States Preventive Services Task Force (USPSTF) guidelines as a basis for coverage decisions as long as coverage is provided for those preventive services deemed medically necessary by the prescribing physician. DMG believes that the covered benefits related to preventive and screening services should be standard across all public plans. This includes Medicare, Medicaid and any other public health plans implemented.
Comparative Effectiveness: DMG supports efforts to provide physicians with credible information on the medical effectiveness of medications and treatments for their patients and believes that the new federal program has the potential to promote the uniform application of such information in both the public and private sector. DMG believes that practicing physicians should be involved in the development and implementation of studies conducted through the new program to ensure that the research addresses the clinical concerns and priorities of physicians providing health care.
DMG is also concerned that the comparative effectiveness process not be seen as a replacement for the physician’s exercise of their medical judgment regarding each unique patient circumstance. The ultimate goal should be for physicians and patients to weigh comparative effectiveness information and mutually decide on the best alternatives.
Delivery System Alternatives: DMG supports the medical home delivery model and other concepts where the physician manages a team of staff providing patient-centered care. In these models nurses, case managers, patient educators and other health professionals provide vital patient care and services that enable patients to stay out of the hospital. We believe that reimbursing for specific non-physician medical care activities, such as those conducted within the medical home, will encourage more physicians to adopt these effective care models within their practices.
Aug
28
Dr. Brian O’Leary and GE Healthcare MAC 800 Technology
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Dr. Brian O’Leary, Internist and Vice President of DuPage Medical Group, recently sat down with GE Healthcare to discuss the importance that technology plays in providing access to high quality healthcare. Click here to watch a short video with Dr. Brian O’Leary discussing the GE Healthcare MAC 800 ECG!
Aug
25
Dr. Nasir Shahab, DuPage Medical Group Oncology, Featured in Recent News Report
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One of the largest reports ever published about cancer awareness was distributed within the Chicago Tribune on August 21, 2009. Leaders in Oncology, such as our own Dr. Nasir Shahab, hope to raise awareness about preventing, detecting, and treating cancer. “Finding a Cure, Your Guide to Cancer Awareness” includes almost all of the leading treatments within the world of Oncology, including preventative measures and early detection. It has become the largest report in the United States on cancer awareness in any mass publication.
Please click here to read “Finding a Cure“. “Better Results with Less Pain” is on page 8 and features Dr. Shahab.
Dr. Nasir Shahab works at our Naperville office on E. Ogden Avenue. Please call 630-364-7850 for more information or to schedule an appointment.
Aug
21
You and Your Baby - The First Few Weeks by Todd Koffler, M.D.
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Part 1; 1st day of life
Your baby’s first few weeks of life will be a time of constant transition and change. By the end of this tumultuous time of adjustment both you and your baby should end up being in a good routine. But during the first couple of weeks, do not expect any two days to be exactly the same. Knowing that change is the norm will help you to feel more at ease during this exciting time, I hope this brief outline of these changes will help as a guide of what to expect during this exciting time.
This 1st part below will focus on the first day of life. First, we will outline what to expect during the first few hours after your baby is born. Then we will go over the goals we have for your baby in its first day. These first day’s goals are basic, ensuring your baby is breathing, swallowing, urinating and passing stools normally. We will outline some common first day issues and some basic treatments and evaluations your baby will receive. Then we will talk about getting breastfeeding established. There will be an additional 2nd part to this article that will discuss our goals for the remainder of your baby’s first few weeks of life.
Keep in mind every baby is unique, and particularly in the first couple of weeks each experience will be a bit different. Your baby’s gestational age, weight, type of deliver and initial adjustment to feeding all play a part in this variability. That said, there are general trends that you can follow, and will help you and your pediatrician (or family practitioner) successfully navigate through these first few weeks and get you to the next stage where your routine will be much more regular (and likely easier too!)
Delivery Room
Every delivery is different, which is good to keep in mind when you talk to friends about their experiences. Once your baby is born medical staff will help make sure they transition well to their new environment outside the womb. During this time, your baby will receive antibiotic eye ointment to prevent infection and an injection of vitamin K to prevent bleeding problems in the newborn period. Also, your baby will be checked to see that it is breathing well and can maintain its temperature. This sometimes involves a little bit of extra support and stimulation (and if needed a neonatologist can be involved to provide additional care). As soon as possible your baby will be in your arms for bonding time and its first feeding. Often your baby’s first time at the breast goes well due to nature’s instincts.
Next your baby will go to the nursery were it will be assessed and get its first bath. Also all babies get a hearing screen while in the hospital. The hearing screen does not diagnose hearing problems nor does passing guarantee normal hearing. It simply detects which babies will need further testing to rule out significant hearing problems. It is common for babies to fail their initial hearing screening but go on to pass subsequent tests.
1st day of life and your baby’s health
Your pediatrician will thoroughly evaluate your baby during its first 24 hours of life and each day thereafter until you leave the hospital. (If your pediatrician is not on staff at the hospital another pediatrician will see your baby during this time.) Since you will be talking to your doctor once a day, it is helpful to write down any questions you have when you think of them. That way you won’t have to remember everything when we come to see you (which could be early in the morning.) Keep in mind that you don’t have to remember everything you doctor and nurses tell you the first time. We will make sure you are comfortable with the basics before you go home.
Our goals for your baby’s first day of life are pretty simple: breathing, swallowing, urinating and passing stools. A baby’s first major transition is breathing comfortably. There are times when this goes slowly and involves observation in the nursery or NICU. Because your baby is particularly vulnerable to infections and breathing issues around the time of delivery we are cautious and in some cases need to order blood tests or start an antibiotic. Because of this caution babies tend to do very well. Most babies that require testing do not end up developing any infection or serious complication. Additionally, there are routine tests performed if your baby is very small or large or if you had problems with gestational diabetes.
During the first day of life we expect to see at least one wet diaper and bowel movement. Each day after that we would like to see at least one additional wet diaper (so 2 on day 2, 3 on day 3, and eventually more than 6 wet diapers per day.) In terms of bowel movements, your baby will first pass dark tarry stools called meconium stools. These take up to 20 minutes to come out and are a bit of a challenge to clean (so you might want to wait a bit before changing if your baby has only just started passing a dark stool.) As your baby feeds more we expect the stools to transition to green and then yellow. We will discuss this more later in part 2.
Our initial goals for feeding are basic. We like to see your baby attempt feeding without swallowing difficulties. However, it is common for your baby to spit up mucous and be a bit gaggy the first day. Because of this we typically have babies feed only 4-6 times on day 1. Your baby is born with mucus and amniotic fluid in its belly and it has to be either passed with stool or spit up during the first few days. Sometimes your baby may need extra suctioning the first day to help clear these secretions- this is normal.
Breastfeeding
Getting breastfeeding established can be a challenge for many moms. We do not expect all babies to breastfeed well in the first few days of life. Some babies do great from day one, but this is often not the case. Most babies who eventually turn out to be great at breast feeding have some ups and downs over the first few days of life. It can come as a bit of a surprise to many moms that after that initial first good breastfeeding at birth, their baby struggles a bit the next several days. This is not only common, it is normal.
These struggles during the first few days do not predict problems later on with breastfeeding and typically do not represent a problem with your body or your baby. Until your milk is fully in babies often struggle with mastering the complex latch, suck and swallow needed to breastfeed effectively. Also your body needs to adapt to lactation. During the first day your milk will not be in (there will be colostrum which is still good for your baby.) Your milk will come in after day 2 or 3 (and don’t worry, you will know when it’s in).
Some moms may need to work extra with a lactation consultant. This may involve using a breast pump and sometimes even giving your baby some supplementary formula if your baby is losing too much weight. But try and remember that breastfeeding gets much easier after a few days, and typically initial struggles are only temporary. Take advantage of the support at the hospital to help you work through any initial problems with breastfeeding. Your nurses and lactation consultants are great resources. And remember that lots of babies who turn out to be great breastfeeders initially struggled to get the hang of it during their first week of life.
Recovery time
Another thing to remember during your baby’s first day is to try and let yourself recover. Just as your baby is making a major transition to the world, your body has to transition from the stress of delivery to the needs of caring for your baby. Sleep will be fragmented for a couple of weeks, so take advantage of time you have to sleep. A hospital can be chaotic at times, but remember all of these people are there to help care for you and your baby. It is good to request times to sleep and to take advantage of the help you have available. You don’t have to master everything at once, and taking care of yourself goes a long way in taking good care of your baby.
Summary
So that’s about it for the first day: breathing, swallowing, urinating and passing stools… just the basics. We don’t expect you or your baby to be any kind of settled routine after the first day. In fact each of the next few days will likely be different, with the goal of getting into a good routine by the time your baby is 2-3 weeks old. I hope this helps prepare you for what to expect immediately after your baby is born, and Part 2 will cover the remainder of your hospital stay and your babies first few days at home.
Note: This article is meant as a brief overview. You can learn a lot more by reading and talking with your doctor.
There are lots of great books and web resources out there, as well as local parenting and new mom classes at your local hospital.
Most notably books:
What to Expect the First Year, by Dr. Murkoff (I trained under Dr. Mark Widome, who wrote the forward. He remains my role model as a pediatrician.)
Your Baby’s First Year, by American Academy of Pediatrics, edited by Dr. Shelov
Heading Home with Your Newborn: From Birth to Reality, By Dr. Sears
The Baby Book: Everything You Need to Know About Your Baby from Birth to Age Two, by Drs. Jana and Shu
On the Web:
http://aap.org/parents.html (American Academy of Pediatrics)
http://www.webmd.com/parenting/baby/
Vaccination links:
The Facts About Childhood Vaccines
Also, many parents chose to meet with their pediatrician before they have their baby, this helps you learn about the office and is also helpful if you have any specific questions or concerns about your baby.
Dr. Todd Koffler is a pediatrician at West Suburban Pediatrics of DuPage Medical Group. To schedule an appointment, please call 630-620-6322.
Meet Dr. Koffler at the DuPage Women’s Fair on Wednesday, September 16 from 10:00 am to 3:00 pm at Yorktown Shopping Center.
Aug
19
DuPage Medical Group is Awarded “Best Doctor” in the Best of Naperville Awards 2009
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Naperville Magazine took an online poll for six months in various categories and DMG’s own physicians were the winners of the 2009 Best of Naperville Awards in the Best Doctor category. The first place winners received a commemorative plaque and recognition during the awards dinner on July 30th at Meson Sabika in Naperville, Illinois.
Dr. Michael Fitzgerald accepted the award on DuPage Medical Group’s behalf. In the above photo, from left to right: Dr. Feodor Ung, Otolaryngology, Head and Neck Surgery; Dr. Theresa Lee, Surgery; Dr. Michael Fitzgerald, Family Medicine; Dr. Soujanya Pulluru, Family Medicine; Dr. Shilpa Reddy-Cherukupally, Otolaryngology, Head and Neck Surgery ; and Dr. Evans Pappas, Cardiology.
Congratulations to all of our doctors!
To view the list of winners in each category, please click here. You can view our award plaque at our Rickert location at 808 Rickert Drive in Naperville, Illinois.