Family Medicine – Jason Powers http://jasonpowers.org/ Thu, 24 Nov 2022 00:41:52 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://jasonpowers.org/wp-content/uploads/2021/07/icon-1.png Family Medicine – Jason Powers http://jasonpowers.org/ 32 32 Local Division of Family Medicine launches new campaign to attract doctors to Kamloops https://jasonpowers.org/local-division-of-family-medicine-launches-new-campaign-to-attract-doctors-to-kamloops/ Thu, 24 Nov 2022 00:41:52 +0000 https://jasonpowers.org/local-division-of-family-medicine-launches-new-campaign-to-attract-doctors-to-kamloops/ Another resident, who moved from the Lower Mainland, waited a decade to finally find a doctor. “It took ten years to get one, I can tell you that,” the man said. “It’s frustrating on a scale you can’t believe.” Tim Shoults of the Thompson Area Division of Family Medicine said the organization is working to […]]]>

Another resident, who moved from the Lower Mainland, waited a decade to finally find a doctor.

“It took ten years to get one, I can tell you that,” the man said. “It’s frustrating on a scale you can’t believe.”

Tim Shoults of the Thompson Area Division of Family Medicine said the organization is working to recruit and retain doctors, but the problem is not unique to Kamloops.

“We really need to step up our game and bring more to these doctors because everyone in Canada — most communities in Canada are trying to recruit at the same time,” Shoults said. “It creates a difficult environment.”

In response, the local division is launching a new campaign, Champions for Family Medicine, aimed at recruiting and retaining doctors with financial support from local businesses.

In exchange for sponsorship, local businesses will receive exposure through the media partners of the Champions for Family Medicine campaign.

“[The campaign] Not only does it raise funds for recruitment, but it also demonstrates to our current and future physicians that Kamloops and the Thompson area are places that care about family medicine,” said Shoults.

The campaign will recognize the dedication and compassion of family physicians and showcase local physicians practicing in Kamloops.

“Most of the time the work is doctor to doctor and ultimately it’s like word of mouth, doctors come here when they hear about other doctors,” he said. declared. “Our job here in this division is to connect these potential physicians to our physicians in this community.”

Campaign ends on BC Family Doctor Day (May 19, 2023).

A magazine featuring local doctors, participating businesses and campaign progress will be distributed within the community at the end of the project.

For more information on the campaign and sponsorship, click here.

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A paradigm shift in medicine https://jasonpowers.org/a-paradigm-shift-in-medicine/ Fri, 18 Nov 2022 07:00:45 +0000 https://jasonpowers.org/a-paradigm-shift-in-medicine/ In The Myth of Normalcy: Trauma, Illness, and Healing in a Toxic Culture, family physician Gabor Maté presents a new formulation for understanding health and disease. Maybe it’s fair to call it a paradigm shift. Mate’s wording implies that those of us who work in healthcare should practice differently. What might such a healing practice […]]]>

In The Myth of Normalcy: Trauma, Illness, and Healing in a Toxic Culture, family physician Gabor Maté presents a new formulation for understanding health and disease. Maybe it’s fair to call it a paradigm shift. Mate’s wording implies that those of us who work in healthcare should practice differently. What might such a healing practice look like?

First, the healer takes the side of the patient and the family – against the toxic culture around us. One component of the toxic culture identified by Maté is capitalism, the valuing of corporate profits over human life, the relentless drive to extract private wealth while killing our ecosystem. Under capitalism, in order to remain financially solvent, pregnant women stay on the job until they go into labor. They return to their place of work a few weeks after giving birth. Work-related stress during pregnancy or the infant’s need for nurturing and attention receive little attention.

Another component of toxic culture is patriarchy, the control exercised over the bodies of women and children by men. In its ugliest form, this takes the form of sexual abuse and rape. Mate presents a number of case examples showing how such past events manifest as illness, not only psychological but also physical. Author, activist and playwright V, who wrote The Vagina Dialoguestells Mate how his biological father’s abuse led to his endometrial cancer.

Mate examines the scientific basis of how our toxic culture leads to disease. As evidenced by behaviors as seemingly insignificant as failing to pick up a crying baby for crimes such as sexual abuse, the toxic culture of contemporary capitalism, patriarchy and white supremacy leads to trauma.

What is a trauma? As I use the word, “trauma” is an inner hurt, a lasting break or split inside oneself due to difficult or hurtful events. According to this definition, trauma is primarily what happens to someone as a result of the difficult or hurtful events that happen to them; it is not the events themselves. (p.20)

This trauma then leads to somatic and psychological dysfunction that manifests in both bodily and psychiatric illnesses as well as problematic behaviors such as attention deficit and addiction. It should be noted that this disease narrative is dynamic and changes over time. Rather than an entity one possesses (e.g. “my cancer” or “my bipolar disorder”), Mate sees illness as a temporal process rooted in the toxic culture we all live in, as well as in events that might not even be subject to conscious recall.

Thus Maté seeks to transcend conventional biomedical analysis methods. The biomedical paradigm is reflected in traditional medical education. Pre-medical students must take basic science courses such as biology, physics, chemistry, and organic chemistry as prerequisites for medical school. In the conventional medicine program, medical students learn the basic sciences such as anatomy, physiology, pathology, and pharmacology before learning clinical medicine. The biomedical paradigm is reductionist in the sense that it seeks explanations at increasingly fundamental levels of analysis: Thus, the search for genes that cause such and such a disease, or deregulated neurotransmitters as explaining such and such a psychiatric disorder.

The biopsychosocial model was formulated by psychiatrist George Engel in the 1970s in opposition to the biomedical model. Engel incorporated atoms, cells, organs, cognitive and emotional factors, and social influences such as family, community, and even nation-state into the model. (See figure.) As such, the biopsychosocial model is comprehensive and potentially powerful in its explanatory scope, but the details of how it works, i.e. the underlying mechanisms, have not been sufficiently fleshed out. by Engel.

Indeed, the role of large-scale social forces on health and disease has long been the concern of social medicine. Social medicine practitioners take a step back and look at the root causes of disease. The social medicine practitioner continues to ask questions until she tackles the root cause of illness: social structure. The late Paul Farmer was a practitioner of social medicine. Howard Waitzkin, Alina Pérez and Matthew Anderson provide us with a practical manual on how to become a practitioner of social medicine in Social medicine and the transformation to come.

While Maté sees himself as working within the paradigms of biopsychosocial and social medicine, his contribution is to elucidate the epigenetic, psychological, neurological and immunological mechanisms by which the oppressive social structures and toxic culture of “hypermaterialist and consumerist capitalism” ( p. 198) manifest as disease.

Additionally, Mate criticizes the reductionist program of behavioral psychology, originally formulated by B.F. Skinner, who derived his theories of behavior modification via rewards and punishments through experiments with caged pigeons in boxes. . Mate is particularly critical of child-rearing practices based on operant conditioning principles, for example advising parents not to comfort crying infants lest they feel “rewarded” for their behavior. ” bad behaviour “.

In discussing contemporary practices relating to the treatment of young or the treatment of pregnant mothers-to-be, Maté references ethnographic accounts of the practices of cultures more in touch with nature, as well as how mammals other than humans raise their young.

Mate reviews many cases to illustrate his point, but he also references his own failures. He attributes his sensitivity to the idea of ​​his wife not picking him up from the airport to fears of abandonment stemming from being placed in the care of strangers as a child when the Nazis attacked. occupied Hungary. He regrets that his workaholic drove him away from his children’s lives when they were little. By pointing out his own flaws and sharing how he always tries to overcome them, he gives us hope to heal ourselves too.

In the Structure of scientific revolutions (1962), Thomas Kuhn described how paradigm shifts work in science. Normal science under the old paradigm, for example the Aristotelian view of the cosmos with the earth at its center, seems to work quite well, but there are just a few anomalies that cannot be explained. Over time, these anomalies and contradictions accumulate – until someone, say Copernicus, comes up with a new way to look at the data. The new way of looking at things works much better, of course, and has much better explanatory and predictive power.

When I introduce medical students to family medicine, I often refer to Chapter Five, “Philosophical and Scientific Foundations of Family Medicine,” in the 2009 edition of McWhinney’s Handbook of family medicine, the last edition before the death of Ian McWhinney in 2012. In chapter five, McWhinney discusses the paradigm shift in medicine – from the biomedical model to the biopsychosocial model – in the Kuhnian sense. Of course, the reductionist and biomedical paradigm continues to advance medicine. Take a look at the studies reported in any issue of the New England Journal of Medicine. In the clinical setting, however, we need to better understand our patients’ backgrounds, their emotional lives. Organized medicine needs to do a better job of ending the hypermaterialistic, consumerist capitalism that is making our patients sick.

I have championed the biopsychosocial model during my own medical and teaching career, although I admit (after Farmer) at times to have emphasized “structural violence” and (after Waitzkin) “social medicine at other times. (Farmer actually left out the “psycho” part and called his own approach “biosocial,” Pathologies of power, p. 19.) Mate puts the “psycho” back into the biopsychosocial.

What is the practice of biopsychosocial medicine, informed by The myth of normalcy look like? How do I envision the practice of medicine in the new paradigm?

First, I will have to examine my own flaws and shortcomings – the same way Mate submits to self-examination. In order to be an effective instrument of healing, I must first work on my own healing. Mate suggests how one might engage in “compassionate self-inquiry” (p. 431).

Second, I will pay more attention to children’s social life. Are they able to play freely? Do their parents have the means to bond with them? Do I encourage parents to respond meaningfully to their children’s emotional needs?

Third, I will work to adopt a trauma-informed attitude with patients. A first approximation will be to ask about negative childhood experiences (ACE). Many of those who share their stories of illness with Mate tell him, “None of my doctors ever asked me about it.” I hope to help patients recognize the roles their disease plays in their life trajectory. I hope to help them heal.

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Stacy Zales joins the Little League® team as a Risk Management Administrative Assistant https://jasonpowers.org/stacy-zales-joins-the-little-league-team-as-a-risk-management-administrative-assistant/ Mon, 14 Nov 2022 18:11:52 +0000 https://jasonpowers.org/stacy-zales-joins-the-little-league-team-as-a-risk-management-administrative-assistant/ little league® International is pleased to announce the addition of Stacy Zales as our new Risk Management Administrative Assistant, effective November 14, 2022. “We are thrilled to welcome Stacy to our team and are thrilled to bring her experience and local knowledge to our organization,” said Joy Reynolds McCoy, Senior Vice President and Chief Legal […]]]>

little league® International is pleased to announce the addition of Stacy Zales as our new Risk Management Administrative Assistant, effective November 14, 2022.

“We are thrilled to welcome Stacy to our team and are thrilled to bring her experience and local knowledge to our organization,” said Joy Reynolds McCoy, Senior Vice President and Chief Legal Officer of Little League. “Stacy’s background, combined with her more than a decade of customer service experience, will be a great asset to our risk management department and the Little League organization as a whole, and we look forward to to work alongside him.”

Originally from nearby Picture Rocks, Pennsylvania, Ms. Zales joins the Little League team after most recently serving as an office assistant for UPMC Family Medicine and Ear, Nose, and Throat. Prior to this role, she spent nearly a decade working for the law firm of Marshall, Parker and Weber in Williamsport as an administrative assistant and community outreach coordinator.

“As a lifelong sports enthusiast, the opportunity to be part of this historic organization is very exciting,” said Ms. Zales. “I look forward to working with the Little League team and helping support all the volunteers and local leagues that make the program so special.”

In this role, Ms. Zales will be responsible for assisting in the maintenance and development of the Little League Child Protection and Safety Awareness Program (ASAP), as well as performing administrative duties within of the risk management department.

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RSNA Margulis Prize Recognizes AI Research in X-Ray Imaging https://jasonpowers.org/rsna-margulis-prize-recognizes-ai-research-in-x-ray-imaging/ Fri, 11 Nov 2022 06:00:00 +0000 https://jasonpowers.org/rsna-margulis-prize-recognizes-ai-research-in-x-ray-imaging/ November 11, 2022 — The 2022 Alexander R. Margulis Award for Scientific Excellence from the Radiological Society of North America (RSNA) will be awarded to Ali Guermazi, MD, Ph.D., M.Sc., for the radiology paper entitled “Improving Radiographic Performance and Efficiency of Fracture Recognition Using Artificial Intelligence. Named in honor of Alexander R. Margulis, MD, a […]]]>

November 11, 2022 — The 2022 Alexander R. Margulis Award for Scientific Excellence from the Radiological Society of North America (RSNA) will be awarded to Ali Guermazi, MD, Ph.D., M.Sc., for the radiology paper entitled “Improving Radiographic Performance and Efficiency of Fracture Recognition Using Artificial Intelligence.

Named in honor of Alexander R. Margulis, MD, a distinguished researcher and inspiring visionary in the field of radiology, this annual award recognizes the best original scientific paper published in RSNA’s flagship journal, Radiology.

“This year’s Margulis Award recognizes the growing importance of artificial intelligence in our field. The authors studied fracture detection by 24 radiologists and clinicians with and without AI,” said senior editor David A. Bluemke, MD, Ph.D. “10% better fracture detection with AI, while reducing the time of radiologists. This study validates the steady increase in the use of AI tools that are becoming a common part of many clinical practices, especially in musculoskeletal radiology.

In the Food and Drug Administration (FDA) registration study, researchers retrospectively analyzed 480 X-ray exams from various US hospitals.

“AI can be a powerful tool to help radiologists and other physicians improve diagnostic performance and increase efficiency, while potentially improving the patient experience at the time of the hospital or clinic visit. clinic,” said Dr. Guermazi, director of the Quantitative Imaging Center, professor of radiology. and Medicine, and Associate Dean of the Office of Diversity at Boston University’s Chobanian & Avedisian School of Medicine and Chief of Radiology at the VA Boston Healthcare System.

The researchers included x-rays of the limbs, pelvis, spine and rib cage. The examination group included adults over the age of 21 with evidence of trauma and fracture prevalence of 50%. There were 240 patients with a total of 350 fractures and 240 patients without fractures.

The studies were reviewed twice by 24 American board-certified readers from six different specialties, including radiology, orthopedic surgery, rheumatology, emergency medicine (including physicians and physician assistants), and family medicine. .

According to Dr. Guermazi, the readings were taken with and without commercially developed software using an algorithm trained on precisely annotated X-ray images from multiple institutions, acquired on a wide variety of systems. The readers had a period of one month between the two analyses.

“The results of the study showed an absolute gain in sensitivity in detecting fractures of 10.4% with the aid of the software, with the software showing a sensitivity of 75.2% compared to 64.8% without the aid. software,” Dr. Guermazi said. The results also revealed an absolute gain in specificity – from 90.6% to 95.6% – for detecting fractures with the assistance of software.

Without being surprised by the sensitivity of the algorithm, Dr. Guermazi did not expect a gain in specificity.

“Computer-aided detection systems can be easily sensitive but usually result in a significant loss of specificity. Here, the algorithm also helped reduce false positive rates,” he said. “The time saving was a nice surprise, given that the algorithm brings additional information to look at in addition to the native images. It was not clear that the algorithm would speed up the interpretation time.

Dr. Guermazi noted that one of the biggest challenges the team faced during the study was training 24 readers from diverse backgrounds to read with AI. Despite this challenge, he said readers thought using the AI ​​algorithm was simple, user-friendly and extremely intuitive.

Clinical validation studies are underway focusing on specific parts of the body where, according to Dr. Guermazi, the gold standard is being established using CT/MRI to assess the algorithm’s ability to detect radiographically visible and occult lesions.

“Ultimately, I think my fellow radiologists will join in seeing AI as a friend rather than a foe,” Dr. Guermazi said. “As it becomes clearer that it can beat the human eye on certain specific and repetitive or tedious tasks, AI will be seen as an excellent complement to heavy clinical workflow.”

The Margulis Prize will be presented at the 108th RSNA Scientific and Annual Meeting (RSNA 2022) in Chicago, November 27-December 27. 1.

For more information: www.rsna.org

Find more RSNA22 coverage here

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Penn Highlands Healthcare shares the ABCs of RSV | Tri-County Sunday https://jasonpowers.org/penn-highlands-healthcare-shares-the-abcs-of-rsv-tri-county-sunday/ Sat, 05 Nov 2022 09:00:00 +0000 https://jasonpowers.org/penn-highlands-healthcare-shares-the-abcs-of-rsv-tri-county-sunday/ Just when parents and guardians of young children could begin to breathe a sigh of relief that the COVID-19 pandemic posed less of a threat to their children’s health, an old familiar virus began to take hold of young people. children. In hospitals from coast to coast, emergency rooms and pediatric inpatient beds are filled […]]]>

Just when parents and guardians of young children could begin to breathe a sigh of relief that the COVID-19 pandemic posed less of a threat to their children’s health, an old familiar virus began to take hold of young people. children. In hospitals from coast to coast, emergency rooms and pediatric inpatient beds are filled with children with respiratory syncytial virus infection commonly known as RSV. In fact, some regions are approaching peak seasonal levels.

What is RSV?

Respiratory syncytial virus, or RSV, is a common respiratory virus that usually causes mild cold-like symptoms. Most people usually recover within a week or two. However, RSV can be serious in infants and the elderly. It is the most common cause of bronchiolitis (inflammation of the small airways in the lungs) and pneumonia in children under 1 year old.

“We typically see an increase in RSV cases in the winter, so this increase in cases is unusual,” said Thomas Sisk, MD, family physician at Penn Highlands Family Medicine in Finleyville, Pennsylvania. “The increase in cases could be due to the way the virus is spreading. Although contracted through respiratory droplets when people cough, sneeze or talk, much like the flu, RSV can live on surfaces and objects such as toys and clothing for hours.

What are the symptoms of RSV?

RSV symptoms are usually present within four to six days of infection. Common symptoms include:

  • Runny nose
  • Decreased appetite
  • To cough
  • To sneeze
  • Fever
  • Wheezing

RSV symptoms usually appear in stages and not all at once. In very young infants with RSV, the only symptoms may be irritability, decreased activity, and difficulty breathing.

“Almost all children will have had an RSV infection by their second birthday,” Dr Sisk said. “Most children were protected against RSV and other common viruses during the pandemic when they saw fewer people, were in less public places, and when they or those around them wore masks.”

what is the treatement?

Since it is a virus, it will not respond to antibiotics. There is therefore no specific treatment. In mild cases, it’s about managing symptoms while the virus runs its course. Over-the-counter fever reducers, such as acetaminophen or ibuprofen, will help manage fever and pain. Both children and adults should drink fluids to prevent dehydration. Additionally, doctors may prescribe oral steroids or an inhaler to help with breathing.

According to the Centers for Disease Control and Prevention, healthy adults and infants infected with RSV usually do not need hospitalization. But some people infected with RSV, especially the elderly and infants under 6 months old, may need to be hospitalized if they have trouble breathing or are dehydrated. In the most severe cases, a person may need supplemental oxygen or intubation (having a breathing tube inserted through the mouth and up to the airway) with mechanical ventilation (a machine to help a person breathe ). In most of these cases, hospitalization lasts only a few days.

What can you do to help prevent RSV?

It is important to follow the practices outlined below if you or a family member has cold symptoms:

  • Cover coughs and sneezes with a tissue or use your arm – not your hands.
  • Wash your hands often with soap and water for at least 20 seconds.
  • Avoid close contact, such as kissing, handshakes, and sharing cups and cooking utensils, with others.
  • Disinfect frequently touched surfaces such as doorknobs and mobile devices.

Ideally, people with cold-like symptoms should not interact with children at high risk of severe RSV disease, including premature infants, children under 2 years of age with chronic lung or heart disease, and children whose immune system is weakened.

Whether you need an appointment for a sick child, an immunization, or an annual physical exam, the primary care physicians at Penn Highlands Family Medicine can take care of your entire family. From infants to the elderly, family physicians see patients of all ages. And they are dedicated to caring for the whole person, with an emphasis on building ongoing personal relationships with patients to help them provide the most comprehensive care possible. For more information, visit www.phhealthcare.org/familymedicine.

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RSV Treatment at Home – Cleveland Clinic https://jasonpowers.org/rsv-treatment-at-home-cleveland-clinic/ Tue, 01 Nov 2022 10:30:00 +0000 https://jasonpowers.org/rsv-treatment-at-home-cleveland-clinic/ Respiratory syncytial virus (RSV) peaks earlier than normal, worrying doctors, the elderly and parents of children who have come into contact with the respiratory virus. While anyone can get RSV, and it usually goes away on its own in less than two weeks, according to the US Centers for Disease Control and Prevention (CDC), RSV […]]]>

Respiratory syncytial virus (RSV) peaks earlier than normal, worrying doctors, the elderly and parents of children who have come into contact with the respiratory virus. While anyone can get RSV, and it usually goes away on its own in less than two weeks, according to the US Centers for Disease Control and Prevention (CDC), RSV leads to around 58,000 hospitalizations. and up to 300 deaths in children under 5 each year. . In adults 65 and older, RSV causes 177,000 hospitalizations and 14,000 deaths each year.

Cleveland Clinic is a nonprofit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

These numbers are particularly concerning when recent RSV outbreaks have led hospitals to reach or above capacity across the country with pediatric patients well before the normal winter peak.

As of mid-October, more than 7,300 tests have come back positive for RSV, according to the CDC. That’s an 83% increase since the end of August – and some doctors expect that number to double in the coming weeks. Although the direct cause of the flare-up is not known, several reasons may be at play.

COVID-19 has caused flu seasons to be disrupted over the past two years, resulting in fewer influenza and RSV cases until recent months. One of the reasons doctors think the new wave is happening is that we’ve done a great job of wearing masks, washing our hands, and isolating ourselves when sick. These practices may have diminished some of our immunity to other respiratory diseases, especially young children and infants, who would otherwise have normal interactions with RSV.

“Our youngest age group has been largely immune to viruses due to the pandemic,” says family physician Neha Vyas, MD. “Now, as they return to daycare and other pre-pandemic activities, they are exposed to these viruses and have not developed the immunity against them that normally occurs.”

As cases of RSV continue to rise, it is becoming increasingly important to keep your children home when they become ill and to treat their symptoms as they lessen the impact on children’s hospitals.

But how do you treat RSV at home and when should you take your child to the hospital for emergency medical care? Dr. Vyas explains some ways to comfort your sick child and when it’s time to seek medical assistance.

The best ways to comfort your child

Unlike influenza and COVID-19 (which have similar symptoms), there is no vaccine for RSV and there is no antiviral treatment. In most cases, RSV will go away on its own after a few days and up to two weeks after infection.

Hearing that there is no cure for RSV is totally depressing. Nobody likes to feel sick. But as a parent, you can minimize the spread of RSV by getting your child tested, keeping them home when they’re sick, and treating their symptoms as they arise. Here are some steps you can take to reassure your child while you both wait for the virus to subside:

let them rest

This may be the easiest thing your child can do when they have RSV. Put them at ease and let them rest when they feel tired. If you can, minimize their need to go up and down stairs, participate in physical activities, or do household chores. Their immune system is working to fight RSV, so the least they can do is give their body time to recover.

“Rest is important,” says Dr. Vyas. “Prioritizing sleep, especially when sick, will allow for faster recovery, so maintain a good nap and bedtime schedule.

Give them plenty of fluids

Children with RSV often lose their appetite and eat less or don’t feel like eating at all. When this happens, it is very important to keep them hydrated, especially if your child is an infant. Pedialyte® and other fluids containing electrolytes are good to have, but in most cases water is enough.

“Electrolyte solutions like Pedialyte and Gatorade® will help replenish minerals lost through sweat and sickness,” says Dr. Vyas. “Soft foods, broths and soups are also nutritious.”

Manage your fever

To reduce fever, you’ll want to maintain a comfortable room temperature. Give your child blankets when he’s cold or shivering and give him ice packs when he’s hot. In most cases, the fever will stop on its own, but you can also use over-the-counter fever reducers and pain relievers to help manage the fever and reduce the body aches they feel.

“It’s important to monitor your child’s temperature,” advises Dr. Vyas. “Temperatures above 100.4 degrees Fahrenheit (38 degrees Celsius) are cause for concern and should be brought to the attention of your healthcare professional.”

Why you should stay home if you have RSV-like symptoms

If you or your child have RSV, you could be contagious for three to eight days. Some infants and people with weakened immune systems can even spread the virus for up to four weeks, even if they have no symptoms. In the most severe cases, RSV can lead to pneumonia or bronchiolitis. That’s why it’s important that you wait to bring your child back to school or daycare until their symptoms are completely gone. And it’s also important that you stay home and avoid gathering in public.

“RSV can also occur in adults,” notes Dr. Vyas. “It usually looks like a cold, so pay particular attention to any worrying signs like difficulty breathing or dehydration.”

When to Seek Emergency Medical Care

What makes RSV so dangerous is that it has the ability to inflame and obstruct your child’s airways. The smaller or younger your child is, the more likely they are to have breathing problems. If your child is having trouble breathing or begins to wheeze, you should make an appointment with your health care provider or pediatrician and see them immediately.

“Pay attention to your child’s breathing,” insists Dr. Vyas. “If they have to use their neck or chest muscles to breathe, or if they’re breathing rapidly, or if their lips look blue, get medical help right away.”

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Food Truck Tracker: here’s what the region’s food trucks are doing https://jasonpowers.org/food-truck-tracker-heres-what-the-regions-food-trucks-are-doing/ Fri, 28 Oct 2022 09:45:53 +0000 https://jasonpowers.org/food-truck-tracker-heres-what-the-regions-food-trucks-are-doing/ (WYDaily Media) HISTORIC TRIANGLE — Several food trucks in the Historic Triangle continue to serve culinary creations throughout the community. From breweries, distilleries and wineries, here’s where you can find local food truck operators on the weekend of October 28-30. We want to hear from you! Do you have a food truck or […]]]>

(WYDaily Media)


HISTORIC TRIANGLE — Several food trucks in the Historic Triangle continue to serve culinary creations throughout the community.

From breweries, distilleries and wineries, here’s where you can find local food truck operators on the weekend of October 28-30.

We want to hear from you! Do you have a food truck or know of one in the area that you think should be included in our weekly food truck tracker? Email us at Info@WYDaily.com to let us know!

Friday: Warwick High School, 51 Copeland Lane in Newport News, 10 a.m. to 12:30 p.m.; Salem Lakes, 4052 Starwood Arch in Virginia Beach 5 p.m. to 8 p.m.
Saturday: Billsburg Brewery, 2054 Jamestown Road, 11 a.m. to 10 p.m.
Sunday: Pumpkinville Farm, 7691 Richmond Road, 9 a.m. to 7 p.m.

Saturday: Flat Iron Crossroads, 7709 Flat Iron Road in Gloucester, 6:30 p.m. to 8:30 p.m.

Friday: Sentara Norfolk General Hospital, 600 Gresham Drive in Norfolk, 11 a.m. to 1 p.m.; MoMac Brewing Company, 3228 Academy Ave. in Portsmouth, from 3 p.m. to 9 p.m.
Saturday: 757 Makerspace, 237 W 24th St. in Norfolk, 5-9 p.m.

Friday: Williamsburg Automotive, 803 Merrimac Trail, 4:30-7:30 p.m.
Sunday: Williamsburg Community Building, 401 North Boundary Street, 12 p.m. to 7 p.m.

Saturday: Yorktown Market Days Food and Artisans Market, 401 Water St. in Yorktown, 9 a.m. to 3 p.m.

Friday: Langley Air Force Base BX, 210 Sweeney Blvd. in Hampton, 11:00 a.m. to 1:00 p.m.

Friday: Langley Air Force Base BX, 210 Sweeney Blvd. in Hampton, 11:00 a.m. to 1:00 p.m.

Friday: Frothy Moon Brewery, 1826 Jamestown Road, 4 p.m. to 8 p.m.

Friday: Billsburg Brewery, 2054 Jamestown Road, 12-8 p.m.
Saturday: Billsburg Brewery, 2054 Jamestown Road, 12-8 p.m.
Sunday: Sly Clyde Ciderworks, 207 East Mellen St. in Hampton, 12-6 p.m.

Friday: Capstan Bar Brewing Company, 2036 Exploration Way in Hampton, 5-8 p.m.

Saturday: Busch Gardens Williamsburg, 1 Busch Gardens Blvd., 12 p.m. to 9 p.m.
Sunday: Busch Gardens Williamsburg, 1 Busch Gardens Blvd., 12 p.m. to 9 p.m.

Friday: Saude Creek Vineyards, 16230 Cooks Mill Road, 5-9:30 p.m.
Saturday: Capstan Bar Brewing Company, 2036 Exploration Way in Hampton, 4-8 p.m.

Sunday: Busch Gardens Williamsburg, 1 Busch Gardens Blvd., 11 a.m. to 9 p.m.

From Friday to Sunday: Billsburg Brewery, 2054 Jamestown Road, 12:00-9:30 p.m.
From Monday to Thursday: Billsburg Brewery, 2054 Jamestown Road, 12-8:30 p.m.

Friday: Alewerks Brewing Co., 189B Ewell Road, 4-8:30 p.m.

Saturday: Busch Gardens Williamsburg, 1 Busch Gardens Blvd., 12 p.m. to 9 p.m.
Sunday: Busch Gardens Williamsburg, 1 Busch Gardens Blvd., 12 p.m. to 9 p.m.

Saturday: Busch Gardens Williamsburg, 1 Busch Gardens Blvd., 5 p.m. to 10 p.m.
Sunday: Busch Gardens Williamsburg, 1 Busch Gardens Blvd., 5 p.m. to 10 p.m.

Friday: Riverside Family Medicine at Brentwood Medical Center, 10510 Jefferson Ave. #A at Newport News, 11 a.m. to 2 p.m.; 1700 Brewing, 11838 Canon Blvd. #400 in Newport News, 4-8 p.m.
Saturday: Frothy Moon Brewhouse, 1826 Jamestown Road, 11 a.m. to 2 p.m.; Coastal Fermentory, 206 23rd St. in Newport News, 4-8 p.m.
Sunday: Billsburg Brewery, 2054 Jamestown Road, 11 a.m. to 4 p.m.

Here’s what your favorite Williamsburg breweries offer:

Curbside Pickup:
Monday to Thursday, 3 p.m. to 9 p.m.
Friday to Sunday, noon to 9 p.m.

Friday: Gastronomy
Saturday: At Ray’s
Sunday: Nosh Modern Mobile Bistro

Billsburg is hosting its fifth birthday party on Saturday and a trunk or treat event on Sunday.

From Monday to Sunday : The hungry pug

Saturday: Old Town BBQ, Don Chido and Amma’s Curry in a Hurry

There will be live music at Frothy Moon on Friday.

Friday: Dominion Dogs
Saturday: Nomads Food Truck VA

Live music every day this weekend at VBC.

VBC is still offering online ordering, limited delivery, and curbside pickup services from 3 p.m. to 9 p.m. Monday through Thursday; noon to 9:30 p.m. Friday to Saturday; and from noon to 9 p.m. on Sunday.

Friday: BBQ, beers and beats with the Old Town BBQ
Saturday: Hangry’s Return
Sunday: Beers, Rhythms and Bites Feat. At Ray’s

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Scott Jensen’s unconventional views on health care have spread beyond COVID-19 https://jasonpowers.org/scott-jensens-unconventional-views-on-health-care-have-spread-beyond-covid-19/ Tue, 25 Oct 2022 11:03:56 +0000 https://jasonpowers.org/scott-jensens-unconventional-views-on-health-care-have-spread-beyond-covid-19/ Republican gubernatorial candidate Scott Jensen achieved national notoriety by sharing unconventional views on COVID-19 with right-wing radio and cable TV hosts like Laura Ingraham, who were eager to hear her play down the pandemic and attack the public health measures put in place by officials governmental. He downplayed the severity of the virus — calling […]]]>

Republican gubernatorial candidate Scott Jensen achieved national notoriety by sharing unconventional views on COVID-19 with right-wing radio and cable TV hosts like Laura Ingraham, who were eager to hear her play down the pandemic and attack the public health measures put in place by officials governmental.

He downplayed the severity of the virus — calling it a “four-day mild respiratory illness” – and decried measures to contain it, such as universal mask-wearing. Jensen compared COVID-19 public health measures against nazism and last year signed on a lawsuit to block COVID-19 vaccines for children.

A review of his public statements and published writings, however, shows that Jensen has expressed unconventional views on a wide range of health issues beyond COVID-19.

A common theme that family physician Chaska emphasizes in his writings – including two books, one of which is self-published – is skepticism toward modern medicine.

“Patients: Don’t be too willing to accept as gospel truth whatever the doctor claims,” ​​Jensen writes in his first book, “Relationship Matters: The Foundation of Medical Care is Fracturing.” published in 2015. “Trust your instincts, do your homework, and be prepared to consider alternative approaches. What do you have to lose?”

Jensen even advises an unorthodox medical research tool for patients: Google.

Jensen in his two books laments the use of electronic medical records – which much of the medical community praises because it helps providers coordinate care – and said he warns his patients that whatever ‘they tell doctors can end up in their charts and then be seen by government prying eyes.

“How could I have let my patients know that their government is constantly collecting their personal data? Jensen writes in his most recent book, “We’ve Been Played… Exposing the Triad of Tyranny.”

To amplify the government’s warnings of abuse, “We’ve Been Played” is intercut with quotes from British novelist and journalist George Orwell.

Both of Jensen’s books include his own recollections of various encounters with patients. Jensen, whose campaign did not respond to requests for comment, does not use real patient names and says he has sometimes merged various scenes for clarity and emphasis.

Her most recent book is selling at a brisk pace — in her campaign, at least. Jensen’s campaign spent $65,000 earlier this year on ‘We’ve Been Played’ to give to people who donated at least $25 to his campaign, according to campaign finance documents. He sells his first book “Relationship Matters”, which was self-published, out of his private practice.

In both books, Jensen regularly criticizes doctors who prescribe too many drugs.

“I am flabbergasted by the love affair doctors have with their prescription pads,” Jensen writes in “Relationships matter.

Jensen writes that reliance on pharmacology can ultimately be harmful.

“After four decades of caring for patients, I’ve learned an important lesson: Today’s science may be tomorrow’s madness – but that won’t stop doctors from being overly convinced that the prescriptions they write up are the “absolute best medicine” for their patients,” Jensen writes in “We’ve Been Played”.

He describes an encounter with a patient – he calls her “Abby” – who was mourning her late husband and asked Jensen if he thought she should take an antidepressant. Jensen writes that he thought “it was important that she try to go through the grieving process without medication.”

“I’ve seen people who have been prescribed antidepressants and come to rely on them to get through life. Drugs can become a barrier to the process needed to overcome grief,” Jensen writes. He said the answer for her was not prescriptions but “the power of a smile, a kind word, a listening ear, an honest compliment and the simple act of caring”.

In his books, Jensen regularly denounces pharmaceutical companies for flooding the country with drugs and implies that he thought about this trend before prescribing drugs.

Joel Wu, a medical ethicist at the University of Minnesota, said doctors need to treat patients as individuals with unique biological circumstances, even if the doctor has a problem with, say, the pharmaceutical industry. (Wu emphasized that he was talking about doctors in general, not Jensen in particular).

“You always have an obligation to the unique and individual interests and circumstances of the patient before you,” Wu said.

Despite his anti-drug musings, Jensen hasn’t been immune to using his prescription pad liberally, Gov. Tim Walz claimed during their recent televised debate. Citing 2013 data from the federal Centers for Medicare and Medicaid ServicesWalz said Jensen was a top opioid prescriber that year, by which time the addictive properties were well known.

In 2001, Jensen opened her own clinic, Catalyst Medical Clinic, where her daughter also works as a doctor. Jensen describes himself in his books as a maverick who is willing to say provocative things for the benefit of his patients.

“In We’ve Been Played“, Jensen says patients should use Google to find the best treatments, including vaccines. Despite his skepticism about vaccines, he claims the media has unfairly created an image of him as anti-vaccine, but he denies this accusation.

While he’s not against vaccines, however, he’s never had a problem appearing in public with some of the most extreme and vocal. anti-vaxx figures in the world, while also signing the lawsuit that sought to prevent young people from getting the COVID-19 vaccine.

The foreword to “We’ve Been Played” is written by Peter McCullough, an anti-vaxx figure who rose to prominence spreading COVID-19 conspiracy theories, as his request that the pandemic was planned. McCollough writes in the foreword that Jensen is “a modern-day hero” for his stance on COVID-19.

In an encounter in his latest book, Jensen describes a patient who was unsure about getting the COVID-19 vaccine. He writes that he told her he would support whatever she decides to do.

“A lot of people will tell you not to make a fuss about it and go ahead and get vaccinated. Others will say the opposite. But one thing you might not hear is the simple fact that you can’t get vaccinated,” Jensen told a patient. “Over the years involving a variety of vaccines, I’ve had many heartbreaking conversations with people who got vaccinated and then seriously thought about whether they had done the right thing.”

His agnosticism about vaccines sets Jensen apart from the medical mainstream, in which the vast majority of physicians advocate the benefits – both to individuals and to society – of widespread inoculation.

Wu said doctors had taken on a difficult responsibility during the pandemic, as misinformation surrounding COVID-19 spread rapidly and people turned to their own doctors for vaccine advice.

“I think there’s actually a problem when people who are experts and don’t want to exercise their expertise in a way that benefits both individuals and communities,” Wu said, again declining to comment. specifically address Jensen. “It’s the application of a unique power and a unique role in the community, especially when there’s so much misinformation – it’s dangerous.”

Doctors have spoken out against Jensen for his views on COVID-19. In a rare move, the political arm of the Minnesota Medical Association rejected one of their own and endorsed Walz last month. The group cited Walz’s COVID-19 policies and support for abortion rights.

Jensen says the Minnesota Board of Medical Practice has investigated him five times, most recently for his comments on COVID-19 vaccine mandates, questioning the effectiveness of masks and promoting and prescribing ivermectin as an effective treatment for COVID-19. The Board of Medical Practice has not confirmed any complaints against Jensen.

Dr. Penny Wheeler, former CEO of Allina Health, said her advice on COVID-19 has unsettled many doctors in Minnesota.

“I think Scott Jensen is out of step with science, even though he’s a doctor,” Wheeler said. “Many medical colleagues called it an embarrassment to our profession.”

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Aggregation allows independent practices to compete and grow https://jasonpowers.org/aggregation-allows-independent-practices-to-compete-and-grow/ Sat, 22 Oct 2022 18:52:21 +0000 https://jasonpowers.org/aggregation-allows-independent-practices-to-compete-and-grow/ Community oncology faces competitive headwinds, but a recent case study involving Alliance Cancer Specialists, a US Oncology Network group practice in the Philadelphia area, showed the benefits of collaboration for oncologists. The case study1 describes how independent practices individually rivaled the region’s major academic institutions. As Alliance President Allen E. Lord Terzian, MD said, his […]]]>

Community oncology faces competitive headwinds, but a recent case study involving Alliance Cancer Specialists, a US Oncology Network group practice in the Philadelphia area, showed the benefits of collaboration for oncologists.

The case study1 describes how independent practices individually rivaled the region’s major academic institutions. As Alliance President Allen E. Lord Terzian, MD said, his freelance practice was under “financial pressure.” From 2008 he was able to merge 4 independent practices into one larger practice as Alliance Cancer Specialists. Alliance then brought in The US Oncology Network as its practice management company and by 2022, the number of medical oncology providers operating under this agreement has grown to 56, across 19 care sites. . Two radiotherapy facilities were added and primary care collaborations were carried out. According to the case study, “network practices have become the preferred oncology provider to one of the largest payers in the region”.

Evidence-based oncology™ (EBO) recently spoke with Terzian about the experience. This interview is edited for length and clarity.

EBO: Can you discuss the recent case study that shared the benefits of aggregation for independent oncology practices in your area?

Terzian: We were originally a small practice of 5 or 6 doctors until 11 years ago. I realized then that we could not continue to survive in today’s market. The environment and competition for hospitals has actually deteriorated a lot since then. We met with several other practices in the Philadelphia area and eventually put together an oncology group of 23 people from 4 different practices.

Over the years, the majority of oncologists in private practice in Philadelphia have been employed by hospitals. There were only a handful of independent practices left, and 2 of them joined Alliance after we joined the US Oncology Network.

So that’s the background – we were a big practice for a long time, but now we’re much bigger after joining the US Oncology Network.

EBO: The case study describes your ability to develop efficiencies. Can you tell us about some areas where you have achieved savings or improved profitability?

Terzian: We get better drug supply and pricing as a larger group. I think it allowed us to afford things that we couldn’t have afforded as a small group, including ancillary services, a pharmacist, HR and a CEO. Everything is cheaper when you buy in bulk. So there are a lot of economies of scale.

I think we learned a lot from each other being in a big group, because we communicate. When you’re an isolated group of 5 people, instead of regularly talking to 25-30 other colleagues, you’ll learn things from both a business and clinical perspective about patient care, and that’s been a big advantage.

EBO: Over the past decade, we’ve heard a lot about the importance of data in cancer care, whether it’s precision medicine or the role of real-world evidence in drug development. Can you explain how aggregation has helped you in some of these areas?

Terzian: One of the problems with data is that it is all ICD-10 [International Classification of Diseases, 10th edition]claims data for insurance companies. The ICD-10 the codes have been very poorly developed by Medicare and have virtually no clinical relevance. So, for example, for a woman with breast cancer, the insurance companies know that the breast cancer was in the upper outer quadrant of the right breast. But that’s really all they know – they don’t know the stage, what the hormone markers are, if she’s HER2 positive; biologically, they have no idea what’s going on. This is a very diverse group of patients for breast cancer alone. Lung cancer is the same way as well as many other cancers. It is no longer a single disease, it is many, many diseases.

So to get meaningful data you need [electronic medical record] EMR data and merge it with complaints data. If you want to look at meaningful cost data, that’s very hard to do right now.

We have lots of EMR data and we can report on almost anything we want. We also have a lot of data from the US Oncology Network, because of their [national data sets]. So it helped us a lot in patient care.

EBO: Are there things you can do now with data publishing aggregation that you couldn’t have done as an independent practice, or things you can do now more efficiently?

Terzian: Obviously, the more data you have, the better. Thus, when you are a small practice, your data may be distorted by a few distant patients; the taller you are, the more accurate it is. [Joining] The US Oncology Network helped us to have better data analyses. They have analytics data on 2000 providers nationwide, so we have a baseline for comparison.

EBO: When you were looking to the future years ago and didn’t think your practice could survive, why did you think aggregation with other local oncologists was the best option? Why did you see this as a better option than being acquired by a hospital?

Terzian: First, independent physicians are generally happier. You have more control over what you do on a daily basis. Happy doctors make better doctors. Salaried doctors, I think, are generally less satisfied and subject to more stringent requirements of the hospital system. For example, I’m self-employed, so I can pick whoever I think is the best surgeon in town for a patient who needs a liver. So I have the choice between 20 different surgeons. Whereas, if you are a salaried doctor, you usually have to refer to the person who is in that facility or in that hospital system.
Care provided by independent practices costs much less than [hospital] own practices, often by a factor of 2:1. I think our care is more personalized or much more concierge-like than in a large university or even a hospital-based practice. There is a lot less bureaucracy; we get things done faster. Our employees are our employees; they are not hospital employees. We can hire the right people to do the right job without the outside influence of a hospital system. We can instill in our employees a culture of compassion for patients, and we provide a patient experience that I don’t think you can get from a hospital system.

EBO
:
In recent years, there has been a lot of focus on getting more patients into clinical trials and getting more minority patients into clinical trials. Can you discuss the landscape of patient enrollment in trials today, for example, compared to 5 or 10 years ago?

Terzian: Things have changed a lot. There have been many advances in oncology over the past 10 years; the number of new drugs coming out took off logarithmically about 10 years ago, I would say. And clinical trials at the time were mostly large group trials, like ECOG [European Cooperative Oncology Group] tests and NSABP [National Surgical Adjuvant Breast and Bowel Project]. You know, I think those trials are still important, but most trials now are pharmaceutical trials with new drugs. Most of these trials are driven by molecular defects, with more biological agents. Drug development just skyrocketed. Now a lot of clinical research is done in the community in the United States. So, with The Network, we have access to a huge number of essays; the number of trials we will have should continue to increase.

I think it is easier now to enroll patients. Decades ago, there were only a handful of group co-op trials that would interest you. Now there are many very interesting drug trials.

EBO: What does coordination with a patient’s primary care practice look like today, compared to before? Today, patients can live with cancer for a decade – patients with multiple myeloma are a good example. Being a community practice, what does care coordination with primary care look like today?

Terzian: We work closely with general practitioners. This is another difference between being in community oncology and being employed. We encourage primary care practices to refer patients to us early, even with just an abnormal CT scan. This way we can get the job done quickly and get things moving in the right direction. Patients live much longer – for patients who are actively undergoing treatment, we almost become the internist for cancer patients. Some [patients] don’t see their family doctor often while they’re having cancer treatment because they see us a lot. Meanwhile, we take care of their problems, of course [we’re] coordination with the [primary care] doctors about things that need their attention. For patients who are living much longer and on maintenance therapies that don’t have a lot of side effects, we see them less frequently, and the family doctor sees them more frequently. But communication is the key to it all.

Reference
The freedom of autonomy with strength in numbers. Case Study: Metro Philadelphia. The American Oncology Network. Accessed September 1, 2022. https://bit.ly/3UuVxWu

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PeaceHealth Oregon Encourages Flu Vaccinations https://jasonpowers.org/peacehealth-oregon-encourages-flu-vaccinations/ Wed, 19 Oct 2022 21:50:30 +0000 https://jasonpowers.org/peacehealth-oregon-encourages-flu-vaccinations/ SPRINGFIELD, Ore. — This flu season could be severe, say experts who have been tracking flu trends in the Southern Hemisphere. To protect ourselves and our community, everyone is encouraged to get their flu shot, ideally by the end of this month. “Getting vaccinated is a quick, safe and easy way to prevent getting the […]]]>

SPRINGFIELD, Ore. — This flu season could be severe, say experts who have been tracking flu trends in the Southern Hemisphere.

To protect ourselves and our community, everyone is encouraged to get their flu shot, ideally by the end of this month.

“Getting vaccinated is a quick, safe and easy way to prevent getting the flu and spreading it to others,” said Dr. Bob Pelz, PeaceHealth’s medical director for infection prevention.

“I get the flu shot every year because I have a responsibility to do everything I can to protect my patients, colleagues, friends and family as much as possible,” he said.

Who should be vaccinated and when?

Flu season usually begins in November or December and can quickly ramp up. The CDC recommends getting a flu shot before the end of October — although it’s never too late as long as the disease is still present in the community. It usually takes about two weeks after an injection for the vaccine to take full effect.

Vaccination is safe and effective for almost everyone. These particularly vulnerable groups should make the flu vaccine a priority:

  • Anyone aged 65 and over
  • People with certain medical conditions, such as asthma, diabetes, and heart disease
  • pregnant people
  • Children under 5 years old

“We encourage families to bring their children 6 months and older for their flu shots as soon as possible,” said Dr. Serena Black, pediatric hospitalist at Sacred Heart Medical Center in RiverBend and director of children’s medical services at PeaceHealth. .

“The flu is highly contagious and can easily spread among children in day care centers and schools and has the potential to make children very sick. Even if they have mild symptoms, infected children can transmit the flu to their grandparents or others at high risk of complications if they become ill.

Where are flu vaccines available?

Pediatrics: PeaceHealth Pediatrics has reserved times specifically for flu shots at the RiverBend Pavilion clinic in Springfield and the University District and Barger clinics in Eugene. Please call your pediatrician’s office to schedule an appointment.

A clinic for children 6 months to 11 years old in the Cottage Grove area will be held Saturday, October 29 from 10 a.m. to 1 p.m. at PeaceHealth Cottage Grove Community Medical Center, 1515 Village Drive. No appointment is necessary.

Visit www.peacehealth.org/flushot for dates and times of all pediatric immunization clinics.

Adults: Many PeaceHealth family practice clinics hold flu shot clinics. Please plan using MyPeaceHealth or call ahead. For more details on offerings in each community, please visit www.peacehealth.org/flushot.

Area pharmacies are also a good option.

What else can I do to protect myself against the flu?

Continue to wash your hands frequently. Cover your nose and mouth with a tissue when you cough or sneeze and throw the tissue in the trash. Avoid close contact with sick people and limit contact with others when you feel sick.

The flu shot is never a 100% guarantee that you won’t get sick, but it can significantly reduce your risk of getting sick. And even if you do catch the flu, you’ll likely experience milder symptoms if you’ve been vaccinated.

About PeaceHealth: PeaceHealth, based in Vancouver, Washington, is a nonprofit Catholic health care system that provides care to communities in Washington, Oregon, and Alaska. PeaceHealth has approximately 16,000 caregivers, a group practice with more than 900 providers, and 10 medical centers serving urban and rural communities in the Northwest. In 1890, the Sisters of St. Joseph of Peace founded what became PeaceHealth. The Sisters shared their expertise and transferred their wisdom from one medical center to another, always finding the best way to meet the unmet health care needs in their communities. Today, PeaceHealth is the legacy of the Founding Sisters and continues in a spirit of respect, stewardship, collaboration, and social justice in fulfilling its mission. Visit us online at peacehealth.org.

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