Female Athletes are More Prone to ACL Injuries

    The article Female athletes are more prone to ACL injuries was published on www.mpnnow.com and details the experience of several  Ontario, NY county female students who have torn an ACL. Specifically, this article notes that females are more likely to tear their ACLs as opposed to their male counterparts.  Dr. David C. Grimm, an orthopedic surgeon at Canandaigua Orthopedic Associates suggests that women are two to eight times more likely to sustain an ACL injury.  Grimm states that this may be due to differences between the sexes in core stability and neuromuscular control, and notes some anatomical differences; women have a wider pelvis and a different angle to the legs.  The article goes on to describe what an ACL is, treatment for an ACL tear, rehab, getting the students back on the field, and prevention.  

    As a health care provider I think it is necessary to understand the mechanism of sports related ACL tears, and that females are more susceptible to such an injury.  In addition, it is important to have knowledge regarding prevention of ACL tears.  This article notes a program called Sportsmetrics that is aimed at preventing ACL injuries using video analysis to analyze and correct an athlete's jumping mechanics.  This may be something that should be incorporated into school athletic programs.  Perhaps this program may decrease some ACL injuries, I certainly think, if I were a Medical Director at a school that this is something I should at least look into!

Finger Lakes Family Care

       Finger Lakes Family care in Canadaigua, Ontario County, NY is a patient centered medical home.  Finger Lakes Family care is part of a larger initiative called "medical home" which was launched in 2009 to serve regions surrounding Rochester, NY.  This program includes 21 doctors working in 7 different practice sites in the Rochester region, including Finger Lakes Family Care.  The medical home model utilizes technology to improve communication, coordination, and accessibility of patient care.  Specifically, the use of technological improvements allows doctors, patients, and families to have quick and easy access to not only primary care providers, but specialists as well.  Implementation of the medical home model of care allows for the elimination of unnecessary doctors visits, and streamlines the process of getting connected with the appropriate provider.
       As a Physician Assistant I hope to work in the Rochester, NY region and am looking forward to exploring the medical home model of care.  Through the utilization of abundant and ever-expanding technology it is easy to see how the medical home model, while seemingly new at this time, will begin to become a house-hold name.  I look forward to learning more about this effective form of health care.

LIFETIME CARE: Home Health Care and Hospice

     Lifetime Care is an organization that provides home care services in the following counties in New York state: Monroe, Wayne, Livingston, Cayuga, Seneca, Ontario, Yates, and Schuyler.  In addition, Lifetime Care also provides hospice services in Monroe, Wayne, and Seneca Counties.  Home health is provided for many areas of need, such as care after a hospital stay, care after surgery, care for a chronic illness and care for moms and kids.  Each of these areas employs the use of a health care team to carry out its goals of speeding up the healing process while patients maintain their independence.  Team members include: RN's and LPN's, physical therapists, occupational therapists, speech/language pathologists and medical social workers.  It is important to note that the aforementioned team groups include further subspecialties, such as a wound care RN or a home infusion RN.  Each team member has important responsibilities which contribute to the success of recovery of the patient.  For example, for care after a hospital stay the RN's are responsible for checking vital signs, administering medication or injections, wound and ostomy care, home infusion, oxygen administration, blood test and pain control.  Medical social workers are available to assist with financial issues and or setting the patient/caregivers up with information regarding available community resources. 

     I think the team approach to health care is essential in providing thorough management and treatment to patients. As a registered dietitian, I was part of a multidisciplinary hospital wide team, and more specifically a member of the Nutrition Support Team.  My experience working was a wonderful experience and I am looking forward to joining a multidisciplinary team in the future as a physician assistant. 

Ontario County Health Indicators

    For this month's blog I have reviewed specific health care indicators in Ontario County, NY and compared the results with the rest of the New York State and the Nation.
    In examining the Mortality and Morbidity indicators I found that Ontario County had 5,521 premature deaths in 2012 which falls in between the National results (5,466) and the New York State results (5,821).  With regards to morbidity, Ontario County fell between the National and State levels in all three subsets (poor physical health days, poor mental health days, and low birth weight), with National levels having a better outcome and state levels with a worse outcome that Ontario County, NY.  The exception to this trend, is that the percentage of poor or fair health was lower as compared to the Nation and New York State; 8%, 10%, and 16% respectively.
    Interestingly the aforementioned trend of Ontario County falling in between National and State indicator levels continued with regards to Social and Economic considerations. One stand out result is high school graduation, where Ontario County boasts 86% graduation rate as compared with the State result of 65%.  Of note, there were not results recorded for the National high school graduation rate. As a trend unemployment, children in poverty, inadequate social support, children in single parent homes and violent crime rate were lowest on a National level, highest at the State level and Ontario County stayed intermediate.

   Upon reviewing the Health Behaviors indicators I was surprised to see that Ontario County had not only a higher percentage of adult obesity (27%) than the National level of 25%, but it is also higher than the State level of 25%.  These levels do not follow that trend as mentioned above.

    Finally, in the area of Clinical Care indicators Ontario County has a very proportion of patients: primary care physicians (1,027:1) and compared with the Nation (631:1) and New York State (781:1); this clearly indicates that Ontario County is in need of primary care physicians!





(http://www.countyhealthrankings.org/#app/new-york/2012/rankings/outcomes/overall)). 
    

Smoke Free Fingerlakes

   The information I found for this blog comes from www.smokefreefingerlakes.com and details the work of the The Tobacco Action Coalition of the Finger Lakes (TACFL).  The TACFL works together with community leaders and the public in the Finger Lakes to reduce the prevalence of tobacco use and to promote healthy communities. Funded by the New York State Department of Health Tobacco Control Program, the TACFL works with policy makers to de-normalize tobacco use and decrease/eliminate exposure to second hand smoke. One method that the TACFL utilizes is to reduce the presence of tobacco in marketing.  In addition, TACFL is working to increase the amount of tobacco free stores, and decrease smoking in areas of public access and recreation to decrease second hand smoke exposure and ultimately improve overall air quality. The aforementioned website also provides a link to TobaccoFreeNYS.org which provides a myriad of information regarding tobacco, its effects, strategies to quit etc.... 

   As a practitioner it is important to understand that intervention programs like this exist.  In addition, if one felt very strongly about this topic it is possible to get involved with the intervention to further influence county wide policies.  Ultimately, this can improve the health of your patients, who may be inclined to pass their education on to others.

 Canandaigua Doctor Honored for Work in Family Medicine

  I found this article through the website www.mpnnow.com, which is essentially an online news source for Ontario, Monroe, and Wayne Counties in New York State.  This article pertains to the work that Dr. Robert Smith, of Thompson Hospital in Canandaigua, NY, has done to improve the practitioner-patient relationship and overall health care of those in Ontario County. Specifically, Dr. Smith operates Fingerlakes Family Care, which as the article states is a "patient-centered medical home." Dr. Smith strives to improve the health care lives of the community by offering same day appointments for sick and acute visits, management of chronic disease by an in house care manager, and secure email and electronic communication between patients and the medical staff. By combining modern technology and personalized care, Dr. Smith has improved patient care by eliminating unnecessary office visits and provided patients with the ability to get in touch quickly and easily with a health care provider that best suits their needs.
    I think the idea behind Fingerlakes Family Care is outstanding as it serves to make the patients health care experiences as seamless and accessible as possible.  From a patient perspective I know that even the simplest tasks can be daunting and confusing when faced with an illness, acute or chronic.  Thus providing an arena that minimizes patient confusion and amplifies patient comfort and clarity is clearly an important, sometimes missed, part of health care.  I look forward to learning more about Fingerlakes Family Care, specifically the work of Dr. Robert Smith, in the future.

Prescription medication abuse is rising in Ontario County

    The article I found for this blog is from MPNnow.com, which I believe is a Canandaigua, Ontario County, NY based news website.  As above, the title of the article is Prescription Medication Abuse is Rising in Ontario County.  I chose this article because I thought it dovetailed nicely with the most recent Rural Medicine lecture regarding prescription drug abuse in rural areas. 

    Per the article, prescription drugs are the 2nd most abused drugs nationwide, after marijuana.  It is evident that this national problem is also manifesting in local communities.  Lt. Brad Falkey with the Ontario County Sheriff's Office supports this claim stating that prescription drug abuse has increased over the past 5 years.  In addition, of the almost 300 drug related cases this department handles annually, approximately one half were prescription drug related.

    This article notes that prescription drugs are easily accessible, as one can procure such drugs via the internet or from pain clinics.  Prescription drug abuse is also widespread and can be seen in college campuses and the community at large involving people of all ages and backgrounds.  The most commonly abused prescription drugs include: pain relivers like vicodin, barbituates and benzodiazepines, and stimulants such as ritalin.

    Clearly, prescription drug abuse is a problem, so what is next? The Partnership for Onatrio County Inc. which is a private community based not for profit agency is actively bringing together a myriad of people in order to reduce and ultimately prevent prescription drug abuse.  Such people include those in education, public health and law enforcement.  The goal is to bring together a variety of people who can provide community outreach such as holding workshops and hosting school programs in order to efffectively attack the growing problem of prescription drug abuse.

    This is important information to be aware of as a practitioner as it is not only critical to be knowledgable about community problems, but also to be connected with the initiatives aimed at reducing such issues.