Category: News

The Psychological Cost of Stress

In September, PersonalMDs hosted an educational Zoom conference for its members discussing the psychological cost of stress.  Our host was Sarah Sarkis, a clinical psychologist and certified executive coach.  Sarah’s presentation explored the physical and emotional toll of stress, and she discussed the neurobiological underpinnings of stress, anxiety, and burnout.  The second half of the presentation focused on stress mitigation strategies including meditation, mindfulness, and behavioral techniques.

Please see the slides below from Sarah’s presentation:

 

 

Medicare Presentation: the Basics

On November 10, 2020, PersonalMDs hosted a Zoom conference on Medicare and its enrollment options. This was informative for anyone enrolling in Medicare for the first time, but also for those who were considering changes to their Medicare program.

Our host was Paula Stookey, a health insurance consultant and Medicare expert.  Paula was brought to us by Jerry Facey of Baystate Financial Services who supports PersonalMDs with our employee health insurance and retirement planning.

During our one hour Zoom conference, Paula presented an overview of Medicare coverage and fielded questions.

Please see the slides below from Paula’s presentation:

COVID-19 during the Holiday Season

Greetings,

With daylight hours shortening, colorful leaves covering the ground, and a crisp breeze chilling the morning air, our New England fall soon will transition into winter.  Many look forward to this time of year with great anticipation, knowing the holiday season will soon arrive.  This usually represents a special time to spend with close friends and family inside our homes where we enjoy food, drink, and laughter.  However, with the COVID-19 pandemic rapidly expanding here in Massachusetts, throughout the United States and elsewhere, our holidays need to be approached differently.

We’ve received many inquiries about how to safely celebrate and would like to address some of these questions.

Can I spend the holidays indoors with friends and family?

While this can be a wonderful and joyous time of year, we must be mindful of the health of our family members, friends, and loved ones.  We each have a responsibility not only to ourselves, but to our greater community at-large.  Seemingly trivial decisions about small gatherings can have much larger ramifications.  In August, a small wedding celebration in Maine led to over 175 COVID-19 cases.

What if I obtain a COVID-19 test before the holiday?

A negative COVID-19 test shortly before attending an indoor gathering is not particularly helpful.  A single nasopharyngeal PCR test often will generate a false negative test result, especially if obtained too early in the virus’ incubation period.  The rapid antigen test is even less reliable, particularly in those who are asymptomatic.

While symptoms typically develop 5-7 days following an exposure, occasionally it may take 14 days for an infected individual to become symptomatic.  Thus, if one of your guests were to be exposed to COVID-19 on the Saturday before Thanksgiving, they may have a negative test on Tuesday, celebrate Thanksgiving with you on Thursday, but then develop symptoms on Friday.  Remember that those infected with COVID-19 are contagious 1-2 days prior to symptom onset.

How can we safely get together?

We do not advise you to spend time indoors with other households.  However, if you must do so, there are precautionary measures you should implement. Since COVID-19’s incubation period can extend 14 days, the only way to safely congregate indoors is for all participants to fully quarantine for 14 days prior to the gathering.

When getting together with others, consider the following suggestions:

  • Wear a mask as much as possible.  Remove the mask briefly only for food and drink
  • Try to maintain a distance of at least 6 feet from non-household contacts
  • Do not share food, drink, cups, or utensils
  • Spend time outdoors (weather permitting)
  • Open doors and windows
  • Keep group sizes small and visits short
  • Per current Massachusetts guidelines, indoor groups must be limited to 10 people, while outdoor gatherings should be limited to 25 participants
  • Avoid shaking hands, hugging, kissing, singing, and shouting
  • Increase the spacing between guests at the dinner table.  Consider placing multiple tables in multiple rooms
  • Give each household their own table
  • Be mindful of those who may be at increased risk should they be exposed to COVID-19
  • Do not allow guests who have COVID-19 symptoms or who may have been exposed within the past 14 days

Take a look at the following guidelines from the CDC for more information:  https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays.html

We know these are challenging times, and this is not how we wish to spend the holidays.  Hopefully, a small sacrifice this year may enable us to celebrate the holidays together next year.

Wishing you good health during the holiday season,
Brad Weiner, MD

 

This blog is for informational purposes only. It does not replace medical care from a licensed physician. Please contact your doctor if you have any questions or concerns.

COVID-19 Update

Dear PersonalMDs Patients,

We hope you are well and enjoying the warmer weather.  Our physicians and staff have been busy preparing for your safe return to our office.  We would like to share with you some changes you will notice upon our reopening on Monday, June 1st.  As you know, this is not how we prefer to operate, but we must make these adjustments to keep everyone safe.  What remains unchanged is our commitment to your health.  Following the guidance of the Centers for Disease Control, the Massachusetts Medical Society, and the Commonwealth of Massachusetts, we have implemented the following measures:

  • We continue to offer telemedicine visits, but we also conduct in-person appointments when deemed necessary by your physician.
  • Office appointments are staggered to avoid overcrowding and maintain social distancing.
  • We have removed all magazines, newspapers, and snacks from the waiting room to promote a sanitary environment.
  • Our exam rooms and laboratory are disinfected before and after each patient.
  • PersonalMDs staff wear masks at all times, practice social distancing, and wash their hands with soap and water throughout each day.
  • Before an office visit, you will be asked a series of screening questions via phone or email.  You will receive a reminder phone call or email one business day before your scheduled visit at which time we will ask these questions again.
  • Please stay in your car when you arrive for your appointment.  Call our front desk (617-307-3200, select option 9) or your physician’s cell phone from the parking lot, and we will let you know when we’re ready for you to come upstairs.
  • Face masks are required for all visitors.
  • We kindly ask you to enter our office alone unless you require personal assistance.
  • When you arrive for an appointment, you will be directed to your physician’s exam room where we will ask you to wash your hands with soap and water.
  • We are unable to accommodate unscheduled visitors during the pandemic, as we must screen everyone in advance.
  • Appointments are required for laboratory testing at PersonalMDs.  Walk-ins are no longer permitted.
  • If you develop a fever, chills, sore throat, runny nose, cough, muscle aches, or sudden loss of taste or smell, please do not come into our office.  Email or call your physician and they will provide you with guidance.

Thank you for your patience, understanding and continued support.  We have missed all of you and appreciate your confidence in our care!

 

Stay safe and well,

Tania Bandak, MD, MPH
Jeffrey Bass, MD
Rachel Haims, MD
Ronald Katz, MD
Laurie Katzman, MD
Brad Weiner, MD

Advanced Care Planning: It’s Never Too Early

It’s always important to plan ahead for the future.  When we are healthy and active, it’s natural to avoid thinking about what may happen if we were to develop a significant illness or injury.  However, the best time to plan how our affairs will be managed during sickness is during times of good health.  If we become seriously ill, what type of medical care do we wish to receive?  Do we seek heroic measures, comfort care, or something in between?  Who will make these decisions for us should we become incapable of making them ourselves?  Fortunately, we have several tools at our disposal that make it easier to plan for such difficult times.

MOLST Form

The MOLST (Medical Orders for Life-Sustaining Treatment) form was implemented statewide in Massachusetts in 2012.  This form was created to help individuals document their goals of care should they develop a significant, life-altering illness.  It is a legal document that guides physicians, family members, and other providers who deliver medical care.

The MOLST form represents an important advance in planning for end-of-life care.  Until this form was adopted, health care providers relied on the DNR/DNI form which asked black and white questions about cardiopulmonary resuscitation (CPR) and intubation (breathing tube, ventilator) for life-threatening emergencies.  However, as we all know, decisions related to health care involve many areas of gray, and the MOLST form recognizes some of these nuances.

While the MOLST form does include questions regarding CPR and intubation, it also addresses other less invasive forms of medical care.  These questions include whether an individual wishes to receive intravenous fluids, artificial nutrition (feeding tube), non-invasive ventilation (bi-PAP or C-PAP), or dialysis.  There are queries regarding duration of treatment and whether a person wishes to be transferred to a hospital for medical care.

The MOLST form should be completed in consultation with your physician.  For more information, please see the following link:  http://www.molst-ma.org

Healthy Care Proxy

When healthy, we are able to make informed decisions about our own medical care.  What happens to an individual who becomes cognitively impaired and is no longer able to make such decisions? A health care proxy is someone who is given the legal authority to make medical decisions on behalf of another person.  The health care proxy is not “activated” until an individual is deemed incapable of giving informed consent to medical treatment.  When selecting a health care proxy, it is important to make sure the proxy understands a person’s wishes and goals of care should a serious illness develop.

The Commonwealth of Masssachusetts offers an easy-to-complete form by which a person may appoint two health care proxies (a primary health care proxy and a back-up).  This form may be found here:  http://www.massmed.org/healthcareproxy

Living Will

After completing the MOLST form and selecting health care proxies, some individuals choose to create a living will.  A living will is a written narrative by which a person describes their goals of care should they develop a serious illness.  It serves as a guide for the health care proxy and medical providers when an individual is no longer able to express their wishes or make informed decisions regarding their own care.

Who Should Keep These Documents?

After creating these documents, it is important that these papers be made accessible to all parties who may be involved in that person’s medical care.  This includes:

  • Health care proxies (both the primary health care proxy and the back-up)
  • Medical team (physicians, hospitals, home care providers)
  • Immediate family members or close friends
  • Estate attorney

Where Do I Get More Information?

Primary care physicians are available to guide patients with their decision-making process. Attorneys who specialize in estate planning may also provide counseling.   The following websites offer helpful information:

National Institute on Aging Information Center https://www.nia.nih.gov/health/publication/advance-care-planning

Centers for Disease Control and Prevention (CDC)     http://www.cdc.gov/aging/advancecareplanning

 

Wishing you good health,

Brad Weiner, MD

 

This blog is for informational purposes only. It does not replace medical care from a licensed physician. Please contact your doctor if you have any questions or concerns.