Monthly Matters:

• An Update on GreenField Health at NE Broadway
• GreenField Welcomes...
• Pronouncing McAninch
• GreenField and Health Policy
• Family Matters: Facts about the Sun & Sunscreen
• Office Notes

GreenField Health’s Health Matters

June 2009

An Update on GreenField Health at NE Broadway

In November, 2007, we opened the doors to our second clinic which is located at 2606 NE Broadway. We have seen steady growth since our opening, although our physicians at this location have the capacity to care for many more patients. As a reminder, Dr. Todd Canon and Dr. Dave Hays are family practice physicians who care for patients of all ages, from newborns to seniors.

Our patients are often our very best source of new patient referrals, and we would like to take this opportunity to thank you for your many referrals over the years. We would like to invite you to think about GreenField Health at NE Broadway for your friends and family who may be seeking a personal physician.

 Individuals interested in receiving care from either Dr. Canon or Dr. Hays are welcome to contact Connie.Turner@GreenFieldHealth.com.

GreenField Welcomes...

Kathy Jennings, CPA, as our new finance manager. Kathy will be in charge of accounting and financial reporting. She is a graduate of UCSB, received her CPA in California, and has worked in accounting for 16 years. Kathy and her husband have a thirteen-year-old daughter and a three-year-old son. She enjoys scrapbooking, playing Rock Band with her family, and traveling.

Bonnie Hicks as our new billing clerk. Prior to GreenField, Bonnie worked in the automobile industry for 20 years. Bonnie and her husband have 3 daughters, 9 grandchildren, 2 cats and a brand new Pomeranian puppy. Bonnie loves to work outside in her yard, read, and work on redecorating her home.

Carrie Destefano, CMA, as our newest health coordinator and will be supporting Dr. Mal McAninch. She has 15 years of experience working as a medical assistant. Carrie loves animals. She has 2 pet ducks, 2 cats and one dog. She is an avid cyclist and gym enthusiast.

Angie Ashburn, CMA, has returned to GreenField Health after a few months away, and has resumed her work as one of GreenField’s health coordinators supporting Dr. David Shute. She also has taken on a newly expanded role as GreenField’s first Patient Service Lead. In this new role, Angie will be working with our entire team to further develop our service standards and clinic workflows.

Pronouncing McAninch

Those GreenField patients who have met Dr. Mal McAninch have quickly come to appreciate him. Unfortunately, many people still can’t figure out how to pronounce that Scottish name, so we thought we’d give it to you phonetically.

You can call him Mal, Dr. Mal, or Dr. McAninch if you’d like. McAninch is pronounced “mac’ an itch” with the emphasis on the “mac”. If you continue to struggle with this, please let us know.

GreenField and Health Policy

As many of you know, several of the physicians and staff at GreenField are actively engaged in both local and national efforts to help improve healthcare. We do this by a variety of mechanisms, including working closely with healthcare IT companies, such as Kryptiq Corporation, to design products that advance our ability to provide care. Kryptiq provides our secure messaging software and other leading products for healthcare connectivity. In addition, GreenField’s Dr. David Shute serves as the medical director for a statewide initiative titled Aligning Forces for Quality, led by the Oregon Health Care Quality Corporation. We have reviewed our non-clinical work in past issues of Health Matters.

Concordant with this work, on July 1st, GreenField’s Dr. Chuck Kilo and colleague, Dr. Eric Larson, from Group Health in Seattle will have an article published in JAMA - the Journal of the American Medical Association. We wanted to bring this article to your attention.

While GreenField charges an annual fee to patients, we do so in order to allow us the time and resources necessary to form close working relationships with you - our patients. Our desire is not just to provide you with the best possible care, but with cost-effective care as well. We believe that US healthcare is far too expensive, and comprehensive primary care is a critical part of the solution to that problem. Thus, truly comprehensive, accessible primary care is what GreenField strives to provide for you.

When comprehensive primary care is available, data shows that the quality of care is higher and the cost significantly lower, potentially 20-30% less expensive. At GreenField, we engage with you in optimizing your care, and because of this, your care is generally less expensive than those who receive their care elsewhere. We engage in both the quality and cost-challenges of healthcare, acknowledging that more care is not necessarily better care. Our goal is to provide you with the right care at the right time – not too much care, and not too little care. There is a careful balance to be struck, as you well know.

In their article, Exploring the Harmful Effects of Healthcare, Drs. Kilo and Larson lay out the aggregate collective harm that healthcare risks our communities. The cost pressure that healthcare provides to employers, individuals and families has become so significant that Drs. Kilo and Larson suggest that healthcare may well be inducing aggregate harm to the health of our communities when one considers the cost shift involved in funding healthcare.

Drs. Kilo and Larson address both the direct harm from healthcare which includes adverse physical and emotional effects, and the indirect harm resulting as a collateral effect related to the opportunity cost of healthcare spending. For example, healthcare expenditures increasingly divert resources away from education, jobs, and environmental quality each of which is an important determinant of health. On balance, while it is challenging to contemplate and while the data remain imprecise, the aggregate health harm imparted by US healthcare may be significant. They conclude that formally exploring health harm will allow a more explicit consideration of the tradeoffs involved in healthcare interventions and expenditures and will help guide healthcare reform efforts.

Family Matters: Facts about the Sun & Sunscreen

Days are longer, skies are sunnier, and summer is just around the corner. Let’s get outside and enjoy that sunny weather! But wait… what about protecting your skin? Here are some sun safety tips to make your summer healthier and more fun.

Q: I have darker, more olive-toned skin. Do I need sunscreen?
A: Everyone needs to use sunscreen. Regardless of skin type, a broad spectrum sunscreen, which protects against UVA and UVB rays, with a Sun Protection Factor (SPF) of 15 or higher should be used year around.

Q: Do I need to wear sunscreen when I am driving or riding in the car?
A: Yes. Sunlight consists of two types of harmful rays- ultraviolet A (UVA) rays and ultraviolet B (UVB) rays. UVA rays, which can penetrate through window glass, cause signs of premature aging such as wrinkles and age spots. The UVB rays are the suns burning rays and are blocked by window glass. They are the primary cause of sunburn. A good way to remember it is UVA rays are the aging rays and UVB rays are the burning rays. Both types of UV rays can lead to the development of skin cancer. To avoid signs of premature aging and decrease your chances of developing skin cancer, sunscreen should be used every day, and even in the car.

Q: Where and when should I use sunscreen?
A: Sunscreen should be worn everyday and applied to all exposed skin areas. This includes face, hands, neck, and ears. Remember to put sunscreen on at least 15 minutes before going outdoors. Don’t forget that lips get sunburned too and apply a lip balm with SPF 15 or higher.

Q: Do I need to worry about sunscreen on cloudy days?
A: Yes. Even on cloudy days up to 80% of the sun’s ultraviolet rays can pass through the clouds.

Q: What type of sunscreen should I use?
A: Sunscreens are available in many forms including ointments, creams, gels, lotions, sprays and wax sticks. Creams are best if you have dry skin, but gels work better in hairy areas, such as the scalp or on a male’s chest. Sticks are good for precision application, such as around the eyes. Creams typically yield a thicker application than lotions and are best for the face. Also, there are a number of combination cosmetic products, such as moisturizers that contain sunscreen, it is important to remember that these products, like all sunscreens, need to be reapplied to achieve continued UV protection. Some of the ingredients to look for in a sunscreen to ensure broad spectrum UV coverage include: avobenzone, cinoxate, oxybenzone, titanium dioxide, zinc oxide, sulisobenzone, ecamsule, and octyl salicylate.

Q: Can I use the sunscreen I bought last summer?
A: Most likely, yes. The FDA requires that all sunscreens remain stable at their original strength for 3 years. However, if you are using adequate amounts of sunscreen, a bottle of sunscreen should not last very long. Approximately one ounce or 2 tablespoons, is considered the amount needed to cover the exposed areas of the body properly (not including chest and back).

Q: If I apply my sunscreen, am I okay for the entire day?
A: No. Re-apply sunscreen approximately every 2 hours, even on cloudy days. Re-apply after swimming or sweating, even if it’s been less than 2 hours. Also don’t forget these other sun safety tips: wear protective clothing, such as a long sleeved shirt, pants, a wide-brimmed hat and sunglasses, seek shade, especially between 10am and 4 pm, avoid tanning beds-they are just as harmful as being in the sun.

Q: Is there a safe way to tan?
A: There is no safe way to tan. A tan is the skin’s response to injury caused by UV exposure. Tanning and sunburns are outward signs of internal skin damage. This damage accumulates over time and over time can lead to skin cancer.

This summer be sun smart for your skin’s sake! If you have any additional questions about sunscreen and sun safety please talk to your GreenField physician or health coordinator.

Office Notes

• We will be open Friday, July 3rd from 8am- 1pm. Our clinics will be closing early on this day for the holiday weekend. As usual, one of our physicians will be on call and available to you for urgent and emergent needs.
  
  
• E-statements are here! A few months ago, we shared with you that we were working on e-statements, and we are pleased to announce that they are here! Within the month, we will be converting our paper statement process into an electronic one, so you can expect to receive your patient statements from us at the email address we have on file for you. You will have the option of making an on-line payment using our new credit and debit card processing service.
  
  If you would like to receive your statement on paper, please call our billing office at 503.384.2029 to opt out of this new feature, and we will mail them to you.
  
  Also, please note that our new automated system will send you a statement even if you are making regular monthly payments – this is just for informational purposes; you do not need to respond to those. If you have questions, feel free to email or call us.
  
  Thanks for your continued support as we work to make things more convenient for you, and more “green” for our environment. We anticipate reducing our paper usage by several reams a month with this one simple change.
  
  
• Automated appointment reminders. We are also getting ready to begin testing of our automated appointment reminder system, which will begin sending you email or voice mail to remind you of your upcoming appointments with us. These will be set to remind you within a day or two of your scheduled appointment, and it will give you the option to confirm or reschedule as necessary. Please let us know if you have any questions or concerns.
  
  As always we appreciate your feedback about these enhancements, and your patience as we work through the inevitable technology wrinkles to smooth sailing!

As we ease into summer, we hope you will enjoy the longer days, the sunshine (when we see it) and the bounty of fresh fruits and vegetables that this season and our region bring to us. We hope you’ll stay safe in the sun, and that you’ll call or email us if there is anything at all that we can do for you.

Sincerely,

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

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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