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GreenField’s Health Matters: January, 2005
Our GreenField Team wishes each of you a happy, healthy 2005
GreenField Welcomes New Family and Team Members - Jill Arena, GreenField's COO and a power woman around Portland, and her husband Scott, had their first child on December 18. Please join us in welcoming Isabella Ann Arena, known to her close friends as Bella. Mother and child are healthy. Bella decided to enter the world 3 weeks early. So the fact that Jill worked right up to the time of delivery was Bella's fault and not GreenField's. We wish them both well and we're delighted to have a new GreenField family member.
- We also welcome Tiana Schmitt to our team! Tiana has become a GreenField Health Coordinator along with Pam Mockenhaupt and Dia Gaede. While we all work together to help serve your health needs, Tiana will be working primarily with Drs. Elizabeth Hays and Chuck Kilo, Pam with Dr. Cynthia Ferrier, and Dia with Dr. Eric Murray.
Dr. Steve Gordon Departing GreenField
Dr. Steve Gordon will be leaving GreenField Health on January 17. His patients were informed in December. His current plans are to enter into solo practice. Over the past two years, Steve has only maintained a small group of patients at GreenField. Thus, we anticipate no substantive impact with his departure. We do appreciate Steve's initial assistance in getting GreenField started, and we wish him well in his future endeavors.
Many of you have family members that are cared for by other GreenField physicians, and many of you have already chosen to continue receiving your care from our group. Doctors Cynthia Ferrier, Elizabeth Hays, Eric Murray, and Chuck Kilo are each taking on those of Steve's patients who choose to continue on with us. As you know, we do accept Medicare. You have supported our team over the years, and the important work that we are engaged in. Our work continues to grow both locally and nationally from a health policy perspective and as a driver for health care improvement. We appreciate your support.
Concerns about Celebrex and Cardiac Disease
The pharmaceutical company Pfizer announced on Friday, December 17, that it had suspended use of its popular Celebrex medicine in a long-term cancer study because patients who used it over an extended time showed an increased cardiovascular risk (e.g., heart attacks). The company stated that it has no plans to pull the arthritis pain drug from the market.
Celebrex (celecoxib) fits into the same class of medications as Bextra (valdecoxib) and Vioxx which was recently pulled from the market by Merck due to an increase incidence of heart attacks. Bextra has been called into question as well. These medications are COX-2 Selective Inhibitors, medications similar to the very commonly used anti-inflammatory and pain medications called NSAIDs - non-steroid anti-inflammatory drugs - which are COX-2 non-selective inhibitors. Over-the-counter NSAIDs include ibuprofen (Advil and Motrin) and naproxen (Aleve). While naproxen has been available for about 20 years and is available over the counter, there are concerns about its connection to an increased risk of vascular events as well. NSAIDs available with a prescription include indomethacin (Indocin), piroxicam (Feldene), etodolac (Lodine, and others), meloxicam (Mobic), nabumetone (Relafen and others) and diclofenac (Voltaren and others). So where does this data on an increased cardiovascular risk leave us? Here is our take... - Information about the cardiovascular risk of Celebrex (celecoxib) and Bextra (valdecoxib) is evolving. Alternatives to celecoxib should be considered, based on individual patient needs and risk factors. The absolute increase in risk for any one of these medications in terms of increase in heart attack or stroke is quite small. The increase in risk occurred in those individuals who were taking these medications on a regular basis (e.g., daily for long periods of time) whereas most people who use these medications do not use them in this manner. For those who do require daily medications, it is worth questioning whether you really need a COX-2 Selective Inhibitor or if they can use a regular NSAID. If alternatives to Celebrex or Bextra are not acceptable, the lowest effective dose of the drug should be used.
- The COX-2 Selective Inhibitors - Vioxx (no longer available), Bextra, and Celebrex - are significantly overused in general. Our use at GreenField has always been very limited and selective. These medications are very expensive, they are not stronger than the regular NSAIDs, and they are only indicated when routine NSAIDs have caused stomach problems such as stomach ulcers or gastritis. In addition, the data that these medications cause fewer stomach problems is relatively weak. So, while a limited number of individuals might benefit from a COX-2 Inhibitor, most of those who are currently taking them would do fine on a regular NSAID. For more on this topic, see our October 2004 Health Matters report on Vioxx when it was removed from the market.
- Over-the-counter Aleve (naproxen) continues to be fine to use on an as needed basis for occasional aches and pains. Nonetheless, if these reports worry you, then Tylenol (acetaminophen) is a fine alternative for treatment of aches and pains, and for control of fevers when need be. Tylenol is not a NSAID.
GreenField Goes Live with our New Web Portal
Thanks to our good friends and partners at Kryptiq Corporation, GreenField is delighted to announce our new web portal aimed at serving you better. We are at www.greenfieldhealth.com.
Well, the truth is that if you've been to our web site over the past few months, you would have noticed that this web portal has been operational for about 6 months, but we have not formally announced it. Many of you have already begun to use the various functions that our web site provides. The web site has a secure center specifically for you. On our home page, click on the tab that says "My Chart". Within your secure site, you can send secure messages to us, update your demographic information, and view a summary of your medical records. Please feel free to check it out. This is another important feature of our IT system, aimed to serve you better. We were one of the first practices in the country to offer such services, and we look forward to your use of and feedback on the system. Kryptiq Corporation is a Hillsboro, Oregon-based company (www.kryptiq.com) that provides secure messaging and work flow solutions to health care. They provide a wide range of connectivity software products for health care. Kryptiq's aim is to help integrate health care by making secure connectivity and integration much easier and less costly to achieve. They have become a leader in this field over the past 3 years. We are proud to have worked with them since their inception and to continue working in close collaboration with their team to this day. They are one of several technology companies that GreenField works with in order to find ways of improving the way health care is delivered.
Health Care Videos, Wired on our Web Site
Another feature on our web site is a set of very high quality patient education video's supplied by our friends at Wired.MD, another great Portland-based company. While we have not announced these videos, they have been up on our web site also for several months and have already been viewed over 600 times! Thanks for paying attention even before we formally make the announcement.
Here is a list of videos that you can view by going to our web site www.greenfieldhealth.com and clicking on the tab that says "Resource Library" and then go to "Educational Videos". - Asthma
- Breast Cancer Screening
- Cholesterol Screening
- Colon Cancer Screening
- Colonoscopy
- Depression Screening
- EGD (Upper endoscopy - or looking down into your stomach with an endoscope)
- Meal Planning For People With Diabetes
- Metered Dose Inhaler
- Pre-Diabetes
Please feel free to check out these videos. We believe that they will help you gain a deeper knowledge of the medical condition(s) that you or a loved one may have. They are one way that we want to help make you as knowledgeable as possible about your medical conditions.
Travel Health Update
It is the time of year that many of you are scheduling travel and vacations. Some will be venturing to distant lands outside of the US. If you are going overseas, you should be aware of what infectious disease risks you face and what preventive measures are recommended.
The best place online to obtain this information is the US Centers for Disease Control web site at http://www.cdc.gov/travel/. This site is easy to use and describes the specific health risks you may encounter at different destinations. It provides information on preventive strategies such as vaccinations and prophylactic medications for things like traveler's diarrhea and malaria. While we carry basic vaccinations such as Hepatitis A and B, there are a number of travel clinics around town that specialize in providing travel advice and more specialized vaccines such as typhoid, cholera, and yellow fever. They are the best locations to get those vaccinations. Please contact us if you have any questions. In addition, if you ever get ill when you are traveling, please do not hesitate to call us at any time, from any location, so that we may be of assistance. Sincerely,
Your GreenField Health Team:
Beth Davis, your Benefits Coordinator and Biller (email)
Chuck Kilo, MD (email)
Cynthia Ferrier, MD (email)
Dia Gaede, CMA, your Health Coordinator (email)
Elizabeth Hays, MD (email)
Eric Murray, MD (email)
Jill Arena, your Clinic Administrator (email)
Joel Swartzmiller, IT Manager (email)
Pam Mockenhaupt, CMA, your Health Coordinator (email)
Ron Potrue, Clinic Management Consultant (email)
Shelly Banta, your Clinic Manager (email)
Tia Schmitt, CMA, your Health Coordinator (email) --------------------------- GreenField Health System
9427 SW Barnes Road, Suite 590
Portland, OR 97225
Phone: 503.292.9560
Fax: 503.292.9510
Web: http://www.greenfieldhealth.com questions, concerns, comments appreciated:
questions@greenfieldhealth.com
© 2003-2005 GreenField Health
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