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GreenField’s Health Matters: May, 2005
Dr. Paula Koeller joins GreenField Health
We are delighted to announce that Dr. Paula Koeller will join GreenField as of June 1. Paula will be a wonderful addition to our team. She specializes in adolescent medicine and young adult medicine, focusing on those between 10 and 30 years of age. Paula has significant expertise in adolescent and young adult health care, eating disorders (anorexia and bulimia), adolescent obesity, as well as sports medicine.
Paula graduated from Stanford University, attended medical school training at the University of Minnesota, completed her pediatric residency at Children's Hospital in Washington, DC and subsequently completed her Adolescent Medicine Fellowship at the University of Washington in Seattle. She has been in practice for over 15 years.
Please join us in welcoming Dr. Koeller, and please feel free to start enrolling your children if you would like. As noted below, we have also decided to lower our annual fee for individuals less than 30 years of age in conjunction with Paula's arrival.
Obviously, we would be delighted if you would spread the word to others you know who may be interested in these services. For those who would like to meet Dr. Koeller, please give us a call and we can schedule a brief meeting. Paula will also be present for our First Tuesday Open House on June 6th, and August 2nd which starts promptly at 5:30 PM in our office.
Dr. Koeller's schedule will be as follows: Tuesdays and Thursdays at GreenField throughout the summer as she grows her practice with the addition of Mondays as her practice grows. As usual, she will be available via email and phone throughout the week.
GreenField Adds Adolescent Medicine and Sports Medicine
With the addition of Dr. Paula Koeller to our team, GreenField now offers expertise in the following areas:
- Adult Medicine
- Women's Health
- Young Adult Medicine for those 16 to 30 years of age
- Adolescent Medicine
- Eating Disorders (including anorexia and bulimia)
- Obesity Management
- Sports Medicine for adolescents
We appreciate the ongoing support of our existing patients in referring family, friends and coworkers to us for care. While many of you have told us that you'd like for us to provide full pediatric services also, we are not quite ready yet, but it is very much on our minds.
Lower Annual Fees for Younger Individuals
In conjunction with welcoming Dr. Paula Koeller, we will be reducing our annual fee for individuals who are less than 30 years old effective June 1, 2005. Thus, our fee structure will now be:
- $295 per year for those under 30
- $395 per year for those between 30 and 59
- $495 for those 60 and older
- 10% discount when other family members also use GreenField
For current GreenField patients who are younger than 30, your fee will be lowered upon your next renewal after June 1. Likewise, if you pay monthly or quarterly, your fee will be lowered as of June 1.
We are lowering our fees for several reasons. First, because we enjoy having whole families use our practice. Second, because we want to make it more financially attractive for families to join. Third, we realize that many GreenField patients with children in the adolescent age range would like for them to receive their care at GreenField.
Biofeedback: The Power of Mind over Matter
Mind over matter... we've all heard that before, and while we have a vague sense of its promise, we are generally not sure how to capitalize on it. Wouldn't it be nice to be able to make yourself feel better by using such a mind-body connection to address certain health problems?
The mind-body connection is undoubtedly present, but modern science doesn't have a deep understanding of it yet. Despite that lack of knowledge, there are techniques that use mind-body feedback to produce positive mental and physical responses in certain situations. Biofeedback is one of those mind-body techniques.
Biofeedback is a technique that can be taught. It relies on the use of relaxation techniques and the monitoring of the body's response to those techniques using various monitoring procedures and equipment. Individuals are taught to relax while tracking things like brain activity, blood pressure, muscle tension, and heart rate. Using these techniques, you can learn to recognize and control bodily responses that cause certain problems.
Biofeedback can be used to help treat a wide range of conditions including:
- Asthma
- Back pain
- Headaches
- High blood pressure
- Hot flashes
- Incontinence
- Irritable bowel syndrome
- Migraine headaches
- Nausea and vomiting associated with chemotherapy
- Panic Attacks
- Tension Headaches
In fact, there is a decent amount of medical literature to support biofeedback's use in these conditions - in other words, there are good clinical studies that demonstrate a positive benefit when biofeedback is used in these situations. The success of biofeedback is very person dependent - different people respond differently, and some individuals are able to learn how to control their body's response to these conditions much more effectively than others.
Biofeedback Training
We talk about "training" because biofeedback is a technique that is taught to individuals who can then apply it when needed at home, at work, or when traveling. Biofeedback training is available from several different types of trainers such as physical therapists and psychologists. A typical session lasts 30 to 60 minutes and requires practicing the techniques at home.
When you begin a biofeedback session, the trainer will apply electrical sensors to different parts of your body. These sensors monitor your physiologic responses to stress--for instance, how your muscles contract when you have a tension headache. They then feed the information back to you via visual and audio cues. Given this feedback, you'll start to associate your body's unique response--pain in the case of tension headaches--with certain physical changes, such as your muscles tensing.
Once you begin to recognize that your headache, for instance, is the result of tense muscles or at least it is significantly worsened by tense muscles, you can learn how to make positive physical changes in your body to alleviate some of the pain. This may include relaxing those specific muscles when you find yourself physically or mentally stressed. Your eventual goal is to be able produce these positive responses on your own, at any time and place and without the help of the feedback technology.
There are several different techniques available for your therapist to choose from in gathering information about your body's responses. Your particular health issues and goals will help to determine which one is right for you. The options include:
- Electromyogram (EMG): An EMG uses electrodes or other types of sensors to measure muscle tension. By making you aware of muscle tension, you can learn to recognize and control the tension. EMG is normally used to promote the relaxation of muscles involved in backaches, headaches, neck pain and grinding your teeth. An EMG may also be used for patients with illnesses whose symptoms tend to worsen under stress, such as asthma.
- Temperature biofeedback: Your temperature can be monitored using sensors attached to your fingers or feet. Body temperature frequently drops when someone is under stress, so it can be monitored and used to prompt you to begin relaxation techniques as a means of responding to the stress. Temperature biofeedback can help treat certain circulatory disorders and it can help to reduce the frequency of migraines.
- Galvanic skin response training: These sensors measure the amount of perspiration on your skin, which alerts you to anxiety. This can be helpful in treating phobias, anxiety, stuttering and other emotional disorders.
- Electroencephalogram (EEG): An EEG monitors the activity of brain waves linked to different mental states, such as wakefulness, relaxation, calmness, light sleep and deep sleep.
If you decide to try biofeedback, we can help you get started by referring you for training. Additional information can be found on the Association for Applied Psychophysiology and Biofeedback (formerly the Biofeedback Society of America) website at www.aapb.org and the Biofeedback Certification Institute of America's website at www.bcia.org which can be used to search for certified trainers. You do not have to be certified to be able to train in this technique.
If you seek out such training, be sure to ask the therapist for references. Find out the therapist's other areas of professional expertise, and whether he or she has experience treating the specific problem for which you're seeking help. And, it's always a good idea to check to see whether your health insurer will cover the cost of treatment, as many plans have differing benefit levels.
In summary, biofeedback may appeal to you because it can help you respond positively to certain health problems while reducing your need for medications. We think it has value because it helps put you in greater charge of your body using measurable feedback to monitor and learn about how your body responds to certain situations.
More on the Mind-Body Connection
In upcoming issues of Health Matters, we'll explore the mind-body connection of hypnosis and we'll discuss acupuncture, an ancient and often effective Chinese technique for managing various conditions. Both modalities of treatment have shown very positive results, and yet, western medicine still cannot fully explain why these treatments are effective. As we continue to bring you the highest quality medical information we can find, we want to address all areas of interest. This prompted our look into these "alternative" therapies. Please look for the upcoming articles, and let us know what you think.
Obtaining Medication Refills
As we strive to bring you the best possible service, one of our greatest challenges is communicating refill information for your prescriptions with some of our local pharmacies. At a worst case scenario, you arrive at your pharmacy to be told that your refill information was never received, and your prescription is not ready.
Here is our approach to refills.
- We make every effort to process your request for prescription refills as quickly as they come in - generally that means the same day that we receive your request.
- We either call the pharmacy directly or fax the prescription to them, and record that we have done so in our computer.
- If clinically appropriate, we generally provide a year's worth of refills for medications that you take regularly. That is the maximum amount that we are allowed to provide.
If you arrive at your pharmacy and are told that your refill request has not yet been returned by us, please ask them to check their fax machine. If they still insist that it is not there, please ask them to call us while you wait. There are instances when we've made a mistake and have not gotten information to them. We never want to waste your time or have you make unnecessary trips the pharmacy, so we're happy to work with the pharmacy in real time while you are there, regardless of where the communication breakdown occurred.
Lastly, thanks to our partnership with Portland's Kryptiq Corporation, we will soon be testing their e-prescription process which will allow us to send prescriptions and refills directly to the pharmacy in electronic format straight from your electronic medical record. This will allow us to serve you ever more efficiently which is always our goal.
GreenField's Holiday Schedule
Our office will be closed on Monday, May 30 in observation of Memorial Day, and Monday, July 4th in observation of Independence Day. As always, one of our physicians will be on call to address any urgent needs that arise.
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)
Tiana Schmitt, MA, your Health Coordinator (email)
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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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