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New Policy Regarding COVID 19

Posted by on Mar 14, 2020 in News | 0 comments

Starting Monday, March 16th we will institute a new temporary policy. All children who are not ill and pose no exposure risk to COVID 19 will be seen exclusively in the morning from 9 AM to 1 PM. The afternoon hours will be reserved for sick patients. We will be using an algorithm to determine which patients we can safely see in the office so as not to put our staff and other patients at risk for exposure and need to be quarantined. Those that we asses to be at risk will be given instruction to stay home. If needed, will contact the DPH for guidance and possible testing. All others we will continue to see as we always...

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Coronavirus 8.0

Posted by on Mar 11, 2020 in Blog | 0 comments

I think we can successfully stem this out break by the actions we are taking now. With time we will learn more about the virus and that data can further guide policy. The ability to quickly disseminate information, find “hotspots” of activity and comply with recommendations will be the most important reasons it can work. The key interventions still are on the individual level (good hand washing, self quarantine if ill, avoiding travel and public places if at higher risk, cough covering, smart social distancing etc.). I think we need to do them within the parameters of a semblance of normalcy though. We are starting to go over that line into becoming a paralyzed, panic stricken, socially isolating, scared nation. That level of stress can have a real negative medical impact as well, especially on those with anxiety disorders....

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Coronavirus 7.0

Posted by on Mar 8, 2020 in Blog | 0 comments

As of next week there will be expanded screening ability for COVID-19 though not with unlimited capacity. The problem will be if possible but mild cases all flock to get screened they expose all those doing the screening and quickly exhaust testing kits. Most will be negative but what do you do while waiting for results? If someone is positive but well, they will be told to quarantine at home which they should be doing anyway. A better idea would be to have mildly ill people at risk stay home and quarantine there or ideally send teams to them to do the testing, fully prepared to do so. If you think about it, the people we need most if this gets bad are those in health care. Exposing them, their staff and their other patients just to get tested...

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Coronavirus 6.0

Posted by on Mar 6, 2020 in Blog | 0 comments

As the weeks roll on we are gathering more information about the virus. It seems more contagious than we thought at the outset but the spread in the US is fairly limited so far. As more testing occurs we will get a better picture of the extent of spread. Even more clear is that there are defined groups at risk. If you are not in those categories you are not at all likely to have a problem should you get infected. The data set from China is illuminating. There have been ZERO deaths in children up to age 9 and that is the case worldwide so far. Young adults up to age 40 the death rate is 0.2%, ages 40-50, 0.4%. After that the rate becomes increased to almost 21.9% if you are older than 80. This also is...

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Coronavirus 5.0

Posted by on Mar 2, 2020 in Blog | 0 comments

As predicted by the CDC there are more cases popping up around the country and the US has had our first 2 fatalities. So far though there has been only 4 cases of “community spread” where there was no known exposure that could be identified. Should that start to happen consistently then we will have a much larger outbreak. The trend of mostly mild cases is continuing and children seem to be rather under represented as an at risk group for even getting the illness. No one is sure why but my own belief is that there may be a lot more exposure to minor Coronavirus groups in their age range that serves to protect them against this one. I wanted to emphasize today that the stated mortality rate is around 3%. That seems rather alarming however we must...

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Coronavirus 4.0

Posted by on Feb 27, 2020 in Blog | 0 comments

The epidemic is evolving and following a pattern of spread similar to when the new flu virus (at the time) H1N1 hit in 2009 though so far it is nowhere near as prevalent. Also that illness started in Mexico on our own continent. The issue will be if sustained transmission occurs in communities. The first case of that type was reported yesterday. There are several factors working in our favor. First, the US is out ahead of this, second its starting late in the flu season not in October like H1N1 did. Third, they are rapidly developing treatments and vaccine strategies. There is a remote possibility though that this virus is more wide spread in the US than we think. I say that because we have had many people return to the US from zones of concern and the...

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Coronavirus Update 3.0

Posted by on Feb 15, 2020 in Blog | 0 comments

The epidemic continues though it is certainly the worst in China. It would seem it will continue there for a sustained period. The issue of course now being recognized is the spectrum of severity is vast. Many people are hardly ill at all and some have no symptoms despite testing positive. As a result, numbers are climbing quickly. In addition, the Chinese are now using different criteria for diagnosis with no confirmation testing. That makes control much more difficult but also means that the vast majority of people with the virus will be fine. This epidemic is very similar to the H1N1 swine flu and for that matter seasonal influenza, it’s just being caused by a different type of virus, now officially named CoVID-19. The amount of US cases is still amazingly low at 15 total. The CDC estimates...

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Coronavirus Update

Posted by on Jan 31, 2020 in Blog | 0 comments

Please see the previous post for background information. As predicted there are many more cases, mostly in China. There have been more fatalities as well, but all in China so far. There has been a person to person transmission here in the US in the spouse of an individual who had travelled from China where they had contracted the disease. The US now has 6 confirmed cases. That is consistent with what the feeling had been, that while the disease can be spread it likely is only in household members and very close contacts. The fear would be if casual contact creates more cases. Then the potential for spread is much more likely. The disease is creating mild illness in the majority of those infected, also encouraging news. We will try to keep updating here as the epidemic...

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Posted by on Jan 28, 2020 in Blog | 0 comments

The coronavirus has been making news and scaring people around the world. While the idea is frightening it’s important to keep perspective and avoid panic. Coronaviruses are not new but different strains have been newly identified. They come in very mild forms and some more aggressive forms. We have seen new coronaviruses in the form of SARs and MERs in past years that were also scary but wound up being relatively short lived. It is too early to tell what will happen with this one but here’s what we know so far. It can be spread from person to person though it does not seem to be as contagious as the current circulating flu. There is no evidence that the virus is mutating despite some early reports that it was. It seems to have a long incubation period (the...

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PCMH (Patient Centered Medical Home)

Posted by on Oct 21, 2019 in Blog, News | 0 comments

Over the last months we have been working hard on obtaining the distinction of being a patient centered medical home or PCMH. This is a rigorous set of documents and tasks that illustrates our commitment to serving our patients with care that centers on their needs, making sure our patients and their families have access to necessary care where and when they need it. It is adjudicated and certified by a governing body well known to those in the field called the NCQA (National Committee for Quality Assurance). We have our first virtual review on 10/22/2019 and are committed to achieving this goal. We will keep you updated as the process...

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