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Latest Patient Center Updates

February Newsletter

By editor
February 6, 2020
Image of hearts surrounded by february

Happy Heart Month!  We have some exciting news! 

At Caduceus, access is the cornerstone of our philosophy.  We have been working diligently to improve accessibility to your healthcare, including our live chat feature available on our website, and more direct access through our secure patient portal when you need to request a refill, view your lab/test results, or need to speak directly with your provider and/or staff at your chosen location.  If you do not have an active account, request an invitation.   

Another service we launched in 2019 were video visits, see the doctor from your phone or other mobile device from the comfort of your home, office, or even while you are away on vacation or work business.This option can save you a trip to the office for many sick and routine visits including prescription refills, review of test results, and much much more! 

We are happy to announce two new ways to access your healthcare in 2020.

App-

New app designs for Caduceus and PDQ Urgent Care and More were just launched this month.  We have improved your overall user experience so download our app today, available for both iOS and Android.  Any technical issues reach out to patient support anytime; we are here to help! 

Appointment booking online-
Our online appointment booking feature (you pick the time and date), currently available for most primary care, Ob-Gyn, and pediatric visits with your physician, has now expanded to include advanced care practitioners, physician assistants and nurse practitioners, an important part of our Caduceus care team.  

Its as easy as 1-2-3! From our website, you can choose the orange "appointments" tab (far left on top of home page or top tab depending on your device) and then scroll down to your office location to make an appointment with your provider. Want to skip a trip to the office? No problem!  Simply choose the orange "video visit" tab at the top of the home page (second from left or top right tab depending on your device) and request an appointment; a concierge team member will contact you to arrange! 

CMO corner logo in black and yellow

On February 3rd, 2020, the CDC (Center for Disease Control and Prevention) and APIC (Advisory Committee on Immunization Practices) announced that the Prevnar 13 pneumonia vaccine at age 65 is no longer required.  It can still be given to high risk seniors, for example, those with COPD (chronic obstructive pulmonary disease) immunocompromised, and the very elderly and frail.

At Caduceus, we recommend at the 65 year old annual CPE (complete physical exam) the time for Pneumovax 23. It is given one time without a booster.

If you have a medical question, feel free to use our MouseCalls; you can email your physician a medical question and get a response the same day!

Heart Disease: It Can Happen at Any Age

Heart disease doesn’t happen just to older adults. It is happening to younger adults more and more often. This is partly because the conditions that lead to heart disease are happening at younger ages. February is Heart Month, the perfect time to learn about your risk for heart disease and the steps you need to take now to help your heart.Heart disease—and the conditions that lead to it—can happen at any age. High rates of obesity and high blood pressure among younger people (ages 35-64) are putting them at risk for heart disease earlier in life. Half of all Americans have at least one of the top three risk factors for heart disease (high blood pressure, high cholesterol, and smoking).  

It's never too late to make changes and lifestyle modifications to improve your cardiovascular health!  Don’t smoke. Smoking is the leading cause of preventable death in the United States. If you don’t smoke, don’t start. Check with your primary care provider as there are many smoking cessation options including medication and hypnotherapy techniques.  RSVP to our next "Dinner with the Docs" zWEd. March 4th 6pm as Chief Medical Officer Gregg DeNicola MD and Chiron LMFT provider Dori Caralto will be offering dinner and dish on this very topic! Manage conditions. Work with your health care team to manage conditions such as high blood pressure, high cholesterol, and diabetes. This includes taking any medicines you have been prescribed. Make heart-healthy eating changes.  Eat food low in trans-fat, saturated fat, added sugar and sodium, the Mediterranean diet is advised.  This diet is typically high in vegetables, fruits, whole grains, beans, nuts, seeds, and olive oil. Moderate amounts of dairy, poultry, and eggs are also central to the Mediterranean Diet, as is seafood. In contrast, red meat is eaten only occasionally.  Stay active and maintain a healthy body weight and BMI (Body Mass Index) of 25 or lower. Get moving for at least 150 minutes per week. You can even break up the 30 minutes into 10-minute blocks. 

We also offer cardiology at Caduceus Specialty in Yorba Linda.  Review Dr. Weinstein's bio and reserve an appointment. 
Source: www.cdc.gov, www.mayoclinic.org 

February Event Schedule-

Yoga and Reiki RECONNECT-

What: Chiron Wellness (Yoga and Reiki RECONNECT)
When: February 13, 2020 @ 6:10 pm – 7:30 pm
Where: TLC (The Life Center) 18210 Yorba Linda Blvd Ste 404

Learn more about Chiron services

Space is limited so RSVP today to reserve your spot, 714-646-8034.  


Coronavirus PSA

By editor
January 29, 2020

An important message from our Chief Medical Officer Gregg Denicola MD

In response to hundreds of questions and visits with patient concerns at our Orange County locations regarding the coronavirus epidemic from China, Caduceus Medical Group would like to put the following alert out to our patients and community at large.

The coronavirus is not new; it has long been known to be a wintertime bug that causes symptoms similar to the common cold and possibly a walking pneumonia. It typically is not serious except in the very young and the elderly, and is not a disease for which testing is routine.

However the current strain appears to be quite aggressive with a very high percentage of cases causing pneumonia and possibly death, even in relatively young and healthy patients.

The epidemic started in Wuhan, China, and is quickly spreading over the globe. People may not realize that Wuhan is a city of 11 million people and is currently on shut down. It is now spreading across the globe with at least five documented cases here in the US. More worrisome, two are here in Southern California, with one in Orange County. She had flown in from China and is reportedly recovering in a Kaiser hospital.

The coronavirus can be spread between humans by coughing, kissing, or any contact with saliva. Symptoms frequently start as a simple common cold but can quickly settle into a serious pneumonia with severe hacking cough and high fevers.

The incubation period is relatively long for this type of virus, approximately 14 days, and the patient is infectious while they have the symptoms as well as during the incubation period. This means if a patient is exposed today they would not necessarily show symptoms for two weeks, however could spread the virus.

It is possible the high death rate in China is due to the poor medical care available. As of this writing the patient cases in the United States are all recovering and doing well. Testing of their close contacts by the CDC revealed no apparent spread.

Testing for coronavirus is complex thus it should be performed by the health department. If you would like to be tested, I advise contacting your local health department. There is no treatment for the virus. Bedrest, adequate hydration, and fever control are the main treatments. Obviously isolation would be critical.

As Chief Medical Officer at Caduceus Medical Group, please review the following recommendations:

Avoid close contact with any persons who you know or suspect has been in China during the month of January 2020.
• Seriously consider postponing all travel to China and Hong Kong until the epidemic is contained. This is sage advice even if your travels are not going to be near Wuhan.
• If you have symptoms of the common cold including cough, do not ignore them. Obviously it will be impossible to reassure via an email. Consider scheduling a video visit to discuss the case with a Caduceus provider. This will avoid spreading infections in the lobby or common areas of the office.
• For optimum protection, especially for senior patients and young children, consider wearing a face mask if you are going to an airport or train station. A face mask may also be appropriate where large crowds congregate such as at a sporting event, auditorium or theme park.
• Because we are seeing an unusually high number of influenza B cases, which can be difficult to distinguish from coronavirus on symptoms alone, consider asking for an influenza test in one of our urgent cares. If appropriate Tamiflu can be prescribed. To be prescribed Tamiflu, a provider visit, either video visit or in office will be required.

Due to the current circumstances I will take the unusual step of authorizing staff at our urgent care offices (Yorba Linda, Orange, Irvine, and Laguna Beach) to do the swab while you’re sitting in your car. This will minimize any viral spread and allow for appropriate treatments. In addition to the test itself, a level one nursing visit will be charged to your health plan if appropriate. If you do not have insurance, the cash price of the test is $25 which would include any nursing time.

To avoid tying up the phone lines and live chat features, I ask you direct all your questions via email to the general question tab on the website or email patient support at [email protected] directly from our website or Caduceus app. We commit to a same-day response.

If you are not already following us on Instagram and Facebook, I would highly recommend doing so now. These social media sites are where we will first post updates and information for our patients. They will also be posted on our website and internal office flyers.


January Newsletter

By editor
January 28, 2020

Check out the latest updates this month!

Image of doctor smiling wearing white lab coat
We are happy to announce Dr. Joseph Longnecker is Caduceus Medical Group's newest Family Practice provider and board-certified Pediatrician.  -Parents love him so much that he has seen even three generations of families. -He has a 5 STAR rating on Healthgrades.com. -He's been practicing in North Orange County for 35+ years.

Read his bio.

Dr. Longnecker's practice will be at The Life Center(TLC) and he will begin seeing patients Monday, Feb. 10th.  Reserve an appointment.  
Insurance mandate block
Uninsured Californians who think the 2017 repeal of the federal tax on people who refuse to obtain health insurance takes them off the hook could face a painful surprise when they pay their 2020 state taxes. A new California law that went into effect earlier this month resuscitates the requirement that people obtain health coverage or face tax penalties. An adult who is uninsured in 2020 face could be hit with a state tax charge of $695 or 2.5% of his or her gross income. A family of four could pay a penalty of at least $2,085. Covered California contended the new subsidies and the penalties are part of the reason sign-ups are up in an enrollment season that ends on Jan. 31.

HOW IT WORKS- Households could pay a flat fine — $695 for each uninsured adult and $347.50 for each child — or 2.5% of their income, whichever is higher. The penalties will be paid to the California Franchise Tax Board when 2020 taxes are paid in the year 2021.

WHO IS EXEMPT- People uninsured for no more than three consecutive months are exempt. People who don't make enough to file state taxes also avoid penalties as do households where coverage cost would be more than 8.24% of income.
  Other exemptions include general hardships that can range from bankruptcy to death of a loved one, membership to a group that relies solely on religious methods of healing, incarceration, and membership in a federally recognized American Indian tribe. WHAT ARE THE DEADLINES? Open enrollment for Covered California ends on Jan. 31 though late enrollment is an option for people who meet exemptions that range from being newly married to recently moving to California. 

Email patient support with any questions! 
Source: VC Star, part of USA Today 
Image of stethoscope health check reminder
Our physicians and Chief Medical Officer Gregg DeNicola MD recommend the following medical guidelines for our patients this year:

ROUTINE LAB TESTING-
Ages 21,30,35, and every other year between 40 and 50, and annually over 50. (including Lipids, A1C, PSA, Thyroid, Blood count and general chemistries). 

PAP SMEARS-
Age 21, then ACOG guidelines: Age 21-29: Pap every 3 years, HPV not recommended.
Age 30-65: Pap & HPV every five years.

MAMMOGRAMS-
Every other year starting at age 40 until age 50 and then annually. Acceptable to stop at age 75.

COLONOSCOPY-
Every 10 years beginning at age 50. Acceptable to stop at age 75.

DEXASCAN-
In females every 1-2 years after menopause or age 50, whichever is first.

SKIN CHECKS-
Annually if you are a high risk (otherwise it will be part of your annual physical exam)- History of severe atypia, personal history of skin cancer, first degree relative with melanoma, history of prolonged sun exposure or sunburns, fair skin, blonde/red hair or blue/green eyes.

Stay healthy in 2020 and reserve your visit for an annual physical, a well woman, and any screenings for your sex/age range today! 

FDA proposes rule to notify women with dense breasts about increased cancer risk and imprecise mammograms

By editor
April 2, 2019

The FDA is proposing a rule for breast cancer screenings that would require doctors to give women more information about the risks associated with dense breasts.  Read the full article here.

Caduceus Chief Medical Officer, Gregg DeNicola MD, shares his take for our patients.

“Informing women that their amount of breast density may affect results of the mammogram and their risks be outlined just makes common sense; it’s hard to imagine any body opposing this recommendation. Yes; it is more time necessary to advise patients as the physician, but it is essential women are educated on the details of their mammogram.  In California, such a requirement already exists and is enforced so it will have little impact for our patients, but to set this as a national standard is just smart medicine.”


Video Visits

By editor
March 15, 2019

Save a trip to the office and schedule a video visit with your Caduceus provider right from your mobile device, tablet, laptop or desktop. You can schedule one SAME DAY or for a future date- whatever your preference!

HOW TO REQUEST-

Schedule your future video visit.
If you prefer one SAME DAY email us at [email protected].


Hormone replacement therapy for women- Is it right for you?

By editor
February 12, 2019

There have been many recent articles and online buzz about hormone replacement therapy for women and our Chief Medical Officer and Caduceus physician Gregg DeNicola MD wanted to weigh in on the discussion.

Sign with Hormone Replacement Therapy on itTo provide some perspective, in 2002, an extensive study of over 16,000 women supported by the National Institutes of Health, was halted after discovering that the drugs, a combination of estrogen and progestin, caused small increases in breast cancer, heart attacks, strokes and blood clots. Those risks outweighed the drugs’ benefits -a small decrease in hip fractures and a decrease in colorectal cancer. A year later a comparable study was also stopped in the UK after comparable findings.

Chief Medical Officer Dr. DeNicola agrees, “The fact is a large, prospective study has never been executed proving hormone replacement therapy is indeed safe.  This is an emotional issue and the data is definitely conflicting. Both sides have ample data to support their position.  At Caduceus, we do not routinely recommend or dissuade the use of HRT. The decision is individualized after discussion between the patient and provider. Until the evidence is more definitive, it is the most prudent policy for our patients.”

More questions?  Schedule an in-office or virtual video chat with your Caduceus provider.


Millions of Americans incorrectly think they have food allergies, study finds

By editor
January 15, 2019

Sign that says food allergies surrounded by foodYou may have read the story recently that new research suggests Americans may be over-diagnosing themselves with food allergies. A study published in the medical journal JAMA Network Open estimates that nearly 19 percent of adults think they have food allergies, but less than 11 percent actually do.

Caduceus Chief Medical Officer Gregg Denicola MD adds, “I have felt this way for a long time and agree less than 10 percent of Americans have documented food allergies.  Most allergies are to fish and nuts.  (more…)


New Peanut Allergy Drug Shows ‘Lifesaving’ Potential

By editor
November 18, 2018

The word Allergy on top of peanutsResults from a new study may lead to approval of what could be the first drug that ameliorates potentially deadly reactions in children with severe peanut allergies.  Caduceus physician and Chief Medical Officer Gregg DeNicola MD weighs in, “I agree with the spirit of the article; a breakthrough and very promising, but not necessarily a cure. Peanut allergy sufferers will need to abstain until further evidence can support the findings.”

https://www.nytimes.com/2018/11/18/well/live/new-peanut-allergy-drug-shows-lifesaving-potential.html\

 


Colorectal cancer screening? To screen or not to screen before 50?

By editor
June 8, 2018

As CMO for Caduceus Medical Group, Gregg Denicola MD agrees that colon cancer is striking at a younger age than previous years.  Especially in high-risk populations, earlier screening may be beneficial.

He shares that the data that the American Cancer Society is using appears to be somewhat mixed and does not definitively show a benefit for screening prior to age 50. Also he notes, there would be increased costs in earlier screening recommendations and whether finding a cancer a few years earlier would decrease mortality has not been proven effective. (more…)


Current 2020 Caduceus Screening and Testing Guidelines

By editor
May 18, 2018

Our physicians and Chief Medical Officer Gregg DeNicola MD recommend the following medical screenings and testing for our patients this year:

ROUTINE LAB TESTING-
Ages 21,30,35, and every other year between 40 and 50, and annually over 50. (including Lipids, A1C, PSA, Thyroid, Blood count and general chemistries).

PAP SMEARS-
Age 21, then ACOG guidelines: Age 21-29: Pap every 3 years, HPV not recommended.
Age 30-65: Pap & HPV every five years.

MAMMOGRAMS-
Every other year starting at age 40 until age 50 and then annually. Acceptable to stop at age 75.

COLONOSCOPY-
Every 10 years beginning at age 50. Acceptable to stop at age 75.

DEXASCAN-
In females every 1-2 years after menopause or age 50, whichever is first.

SKIN CHECKS-
Annually if you are a high risk (otherwise it will be part of your annual physical exam)- History of severe atypia, personal history of skin cancer, first degree relative with melanoma, history of prolonged sun exposure or sunburns, fair skin, blonde/red hair or blue/green eyes.