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Doctor-Patient Relationships Promoted in Marketing Campaign By Hartley White, Vice President, People Services and Wisdom

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In an effort to promote the close doctor-patient relationships that often develop under its Total Care Model, HealthCare Partners recently implemented the “We Are HealthCare Partners” campaign, a series of television, online and print ads featuring real HealthCare Partners physicians and patients side by side. In the six videos created for television and online viewing, these patients and their doctors relay the true stories of the tight-knit relationships they have built over years of care and the positive experiences they have shared through HealthCare Partners. The print and online ads feature the same pairs of providers and patients.

HealthCare Partners pursued this new marketing campaign after experiencing positive feedback from last year’s “I Am a HealthCare Partner” campaign, which featured individual patients and providers in separate TV ads discussing their positive experiences at HealthCare Partners. It seemed a natural progression to take this idea a step further and create TV spots featuring patients and their physicians together.

In order to provide the most compelling stories for the TV segments, HealthCare Partners helped identify physicians who demonstrated very strong relationships with their patients to go on camera. A marketing agency interviewed these doctors and patients side-by-side on camera with only a few guiding questions, allowing them to take the reins on describing their experiences and convey honest answers.

Highlighting this feature in HealthCare Partners’ advertising plays an important role with informing audiences about the organization’s Total Care Model. Under this unique approach to health care, providers strive to build strong relationships with all of HealthCare Partners’ patients, spending valuable one-on-time with patients and developing a comprehensive understanding of their medical needs. Completely unscripted, the campaign’s videos convey the relatable stories of real patients and relay the fact that they have a partner in their care through HealthCare Partners.
HealthCare Partners encourages people to view the videos online at www.hcpnv.com/stories.

Living with Diabetes: Eye Care By: Dr. Chard Bubb

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Individuals diagnosed with diabetes are at an increased risk for other serious health problems. High blood sugar (glucose) can cause eye problems and even blindness in patients with diabetes. Blurry vision might signal a more serious health problem in diabetic patients. According to the National Eye Institute (NEI), diabetes is the leading cause of blindness for American adults.

The NEI defines diabetic eye disease as a group of problems that might arise as a result of complications of diabetes. Diabetic eye diseases include cataracts, glaucoma and diabetic retinopathy. These conditions can cause severe vision loss or may even lead to blindness.
A cataract is a clouding or fogging of the normally clear lens of the eye, which results in an inability to focus on light and in impaired vision. Glaucoma occurs when the fluid inside the eye does not drain properly, which can lead to excess pressure in the eye. This pressure can damage the nerves and blood vessels in the eye and cause changes in vision. Although these conditions can also occur in people without diabetes, those diagnosed with the disease are 60 percent more likely to develop cataracts and 40 percent more likely to suffer from glaucoma.

The most serious eye-related disorder caused by diabetes is diabetic retinopathy, a condition that can lead to a permanent loss of sight. Diabetes affects the blood vessels in the eye. If these blood vessels leak or experience blockage, they can cause changes in the retina and in vision. Those that have been diagnosed with diabetes for a longer period of time are more likely to develop retinopathy. Many people who have diabetic retinopathy may only experience a mild form of the condition that never progresses to vision loss. According to the Centers for Disease Control and Prevention (CDC), it is still the leading cause of blindness among American adults aged 20 to 74 years. Those who suffer from retinopathy may not notice any symptoms of eye damage until it is too late for treatment to be effective, which is why it is extremely important for patients diagnosed with diabetes to undergo regular eye exams.

All patients diagnosed with diabetes, both type 1 and type 2, are at risk for diabetic eye diseases. However, these conditions can be prevented by taking steps to control blood sugar levels and blood pressure. HealthCare Partners also recommends patients with diabetes to see their eye doctor at least once a year for a comprehensive dilated eye exam.

Remember to inform providers of symptoms such as blurry vision, red eyes that do not go away, diminished peripheral vision and eye pain. Thankfully, serious eye diseases can be prevented and treated if patients stay involved in their care and maintain regular check-ups with their HealthCare Partners provider.

Providing Essential Health Information to Emergency Responders By Dr. Reza Berjis

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Health care professionals often emphasize the importance of patients providing up-to-date information about their medical conditions. It is vital for providers to know if patients have health conditions such as pharmaceutical allergies, diabetes or cardiac issues that could be impacted by specific medications and treatments. Sometimes people are unable to provide this information when it is needed the most, however. During an emergency situation such as a stroke or heart attack, patients might be unable to relay crucial details about their personal health issues to the providers who must administer treatment.

Fortunately, there are steps people can take to prepare for such situations. August is Medic Alert Awareness Month, aimed at raising awareness of tools people can utilize to convey their personal health information when they are unable to speak to emergency responders. Medical identification tags in particular can play a key role in helping providers save a patient’s life. Emergency responders encourage individuals with unique or significant medical conditions to wear these tags relaying that the person has a medical condition that might need immediate attention or that directly affects their treatment. These identification tags, which can be worn as bracelets, necklace or on clothing, can provide important information for providers in an emergency situation, especially if the patient is incapable of speaking or too young to communicate medical needs.

Medical identification tags are available for purchase at many drug stores and pharmacies, including Wal-Mart and CVS. MedicAlert, a nonprofit dedicated to helping save lives in emergency situations, also sells medical identification tags in the form of a variety of accessories. HealthCare Partners encourages people with important medical conditions to research medical identification tags and consult their providers about the possible benefits of wearing a tag.

Ensuring the Proper Amount of Sleep for Kids By Dr. Sandeep Reddy

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Obtaining enough sleep is essential for a child’s emotional, physical and academic well-being. Studies have shown that nearly one-fourth of American children are affected in one way or another by inadequate sleep. That’s nearly 15 million children. This can impact the child in many ways from mood, to school performance or social behavior.

As adults, it’s up to us to make sure children — despite their frequent objections — get enough sleep each day. In the same way we make sure they get to and from school and have three square meals each day.

The American Academy of Pediatrics (AAP) recommends children obtain as much sleep as possible, with the amount needed decreasing as they get older. Newborns, for example, require 15 to 18 hours of sleep a day, while those from 1 to 12 months should get 14 to 15 hours. Children between the ages of 1 and 3 should get 12 to 14 hours of sleep, while children 3 to 6 need 10 to 12 hours.

As children enter school, this often means that naps are no longer part of their daily routine. Children ages 7-12 should get at least 10 to 11 hours of quality sleep each night while teens, ages 12-18, need eight to nine hours.

An AAP study showed that sleep problems have a negative relationship with daytime behavior. Specifically, children with sleep problems had more internalizing and externalizing behavior problems and poorer adaptive skill development. The study also showed that children with moderate-to-severe sleep problems had greater behavior difficulties — but not necessarily poorer adaptive functioning ¬— than children with mild to moderate sleep problems.

There are many ways to ensure children get a peaceful and restful night’s sleep. Some of these include keeping a set bedtime for both weekdays and weekends, limiting TV, playing video games or on the computer the hour prior to bedtime. Reduce the number of caffeinated drinks during the day; encourage them to sleep in their own bed each night and helping them relax by reading to them or giving them a bath prior to bedtime.

HealthCare Partners recommends keeping a semblance of regular sleep patterns. This is especially important for younger children. This way, when school resumes, getting them back into a nightly routine will be that much easier.

Unusual Diagnosis Leads to Lasting Patient-Doctor Relationship By Dr. Stephen Portz

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Ask Nick Giorgione what he has learned about his heart condition during the past 13 years, and the 26-year-old can get very specific.The Henderson resident knows walking up stairs will leave him winded. He has experienced firsthand that sprinting on a treadmill will trigger a device in his chest to administer internal electric shocks.

Nick is also certain of something else: He has a comprehensive understanding of his hypertrophic cardiomyopathy, a wide-ranging cardiac disease, thanks to cardiologist Dr. David Navratil with HealthCare Partners Cardiology.

Navratil has served as Nick’s cardiologist for 13 consecutive years, demonstrating the personalized care that serves as the crux of HealthCare Partners’ Total Care Model. “On the list of people most crucial to my life, Dr. Navratil is at the top,” Nick says.

Cardiac Issues at a Young Age
At an evening football practice in 2001, Nick noticed he felt strange. The 13-year-old suddenly saw everything suddenly grow fuzzy. He woke up still on the field to paramedics leaning over him with defibrillator paddles. It was the first cardiac arrest of his life. “I just knew I was at football practice and I wasn’t supposed to be on the ground,” Nick says.

When he was transported to Desert Springs Hospital, Nick’s father, Steven Giorgione, sought the expert opinion of Navratil, an old family friend who is board-certified in internal medicine, cardiovascular diseases and cardiac electrophysiology. Navratil quickly diagnosed Nick with hypertrophic cardiomyopathy. The condition involves the heart muscle becoming abnormally thick, making it difficult for the organ to pump blood. Symptoms can range from mild to severe, with some patients at high risk for sudden death.

Within a week, the cardiologist surgically implanted an automatic implantable cardioverter defibrillator (AICD) into the teenager’s chest. The device monitors his heart rate and administers shocks to the heart in response to any issues that arise. “I have fewer than a dozen of these cases in my practice, and none of them are as aggressive as Nick’s condition,” Navratil says.

The Total Care Model
Navratil was the clear choice to remain Nick’s cardiologist following his diagnosis, initiating a doctor-patient relationship that has lasted more than a decade. “I trust him because he’s seen everything I’ve gone through,” Nick says.

This ongoing continuum of care is an important component of the Total Care Model practiced by HealthCare Partners Nevada, a medical network serving more than 300,000 patients a year. The organization offers 290 primary care providers and more than 1,700 specialists across Southern Nevada.

HealthCare Partners has experienced many successful patient stories like Nick’s through the Total Care Model, a unique approach to health care focusing on comprehensive, patient-focused care. Under this approach, primary care providers, specialists and professional staff work as a coordinated team to manage all aspects of patients’ care and overall health.

Battling for Control
Nick initially struggled to accept his diagnosis. His case of hypertrophic cardiomyopathy involves high risk of cardiac arrest during physical activity. This was crushing news for Nick to hear at 13 years old, when, at already more than 6-feet tall, competitive sports were his passion.
Navratil offered a broad-minded prognosis, allowing Nick to follow his passion for sports while carefully monitoring his symptoms.

Nick learned the hard way he could never be as active as he wished, experiencing two heart attacks within a month when he tried playing competitive basketball. With Navratil’s support, Nick resolved to finding other avenues for success.“Navratil gave me the confidence that this condition wasn’t going to kill me,” Nick says.

Nick always felt free to discuss any questions with his cardiologist. Navratil has continued to meet with him throughout the years to review tests and consult with Nick following any additional incidents. The cardiologist conducted two more surgeries for Nick’s AICD. When Nick needed a hand operation at 18 and the doctor on duty casually mentioned turning the AICD off, Navratil responded to Nick’s concerns by visiting the hospital and ensuring that the device would stay on during the procedure. “I always know he’s the one who can handle anything related to my condition,” Nick says.

Looking Forward
Nick has since found many accomplishments outside athletics. He recently graduated from law school at the William S. Boyd School of Law, and he is currently studying for the bar exam. He still sees Navratil at least twice a year, he adds. He hopes one day to apply his personal experiences to support youths facing similar cardiac conditions.

Navratil commends his patient’s persistence with managing the condition throughout the years.“Nick has done very well living with a disease that can be challenging for many people,” Navratil says. “He can still enjoy most things in life.” Nick plans to continue doing so, with Navratil’s ongoing assistance. “You couldn’t pay me to go to a different cardiologist,” he says.

Effects of Heart Disease in Women Signs, Symptoms and Prevention By: Dr. Pamela Ivey

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Although it is traditionally thought to be more prevalent in men, heart disease is the No. 1 killer of women in the United States, out numbering the number of women who die of breast cancer. In fact, according to the American Heart Association (AHA), more women die of the disease than men, with one in three women dying of heart disease each year. Because the number of women diagnosed with heart disease each year continues to rise, there are ample opportunities to develop preventive strategies aimed at identifying and treating women with heart disease.

The most common presenting symptoms of a heart attack for both men and women can include crushing chest pain that radiates to the jaw or arms, but women don’t always experience typical heart attack symptoms . Women can experience alternative symptoms demonstrates as shortness of breath, fatigue or gastrointestinal upset.

Because heart attacks can be more difficult to diagnose in women, it is extremely important for patients to know the particular symptoms that they may experience. Although some do feel chest pain, women can experience different symptoms unrelated to chest pain, such as:

• Neck, jaw, shoulder, upper back or abdominal discomfort
• Shortness of breath
• Right arm pain
• Nausea or vomiting
• Sweating
• Lightheadedness or dizziness
• Unusual fatigue

It is especially important for women to pay close attention to their health and involve their physician when they experience any of these symptoms.

Traditional risk factors for heart disease include high cholesterol, tobacco use, hypertension and obesity and post-menopausal status. Diabetic women are at a significantly higher risk for developing a heart attack and their overall mortality is higher compared to men. New risk factors for heart disease in women are emerging and include chronic inflammatory states such as lupus and rheumatoid arthritis. Ongoing research will hopefully yield important information in the future to help guide our therapies and target women who are at the highest risk for developing heart disease.

Women can decrease their risk of heart disease by first identifying their risk factors and treating them aggressively. Annual evaluations of risk factors during a visit with your doctor can identify women who are at the highest risk for heart disease. Modifying risk factors to reduce the risk of heart disease can include treatment of hypertension, diabetes and high cholesterol.

Other lifestyle changes in diet and physical activity also play key roles in preventing heart disease. It is essential for women to take the time to develop exercise plans with their doctors’s guidance and engage in physical activity five days a week. Regular exercise can significantly improve a person’s quality of life, leading to a noticeable feeling of revitalization while strengthening physical and mental health.

As a cardiologist with HealthCare Partners Cardiology, I advise all women to remain aware of their bodies. Ask your physician about routine cholesterol and blood pressure tests. These can help identify risk factors by offering clues about your heart health. Talk to your physician if you have any developing symptoms and consider visiting a HealthCare Partners cardiologist.

Protect Your Skin for Fun in the Sun By Dr. Jasper Liu

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Spending time outdoors is always tempting on a sunny day, especially in Southern Nevada where we experience sunshine most of the year. HealthCare Partners Medical Group encourages people of all ages to take precautions when they are enjoying the outdoors for prolonged periods, as ultra-violet (UV) radiation from the sun can raise potential health risks. UV radiation directly causes damage to the DNA in skin cells. When cells can’t repair this damage, DNA can undergo mutations, heightening the risk of skin cancer.

However, spending a limited amount of time in the sun is an important component of staying healthy. Sunshine is a great source of vitamin D, which helps the body absorb calcium, increase bone density and reduce the risk of fragile bones.
Prolonged exposure to UV radiation is harmful to the skin. In addition to raising the risk of skin cancer, skin damage such as sunburns and tans also accelerate the aging process, causing wrinkles, uneven skin tones and a rough texture much earlier in life.

It is always important to take appropriate precautions before spending time outdoors. Preventing sun damage is a simple matter of applying sunscreen on any skin that isn’t covered by clothing. Health experts recommend using the highest SPF sunscreen available, as most people don’t use enough sunscreen to achieve its full protective effect. People should apply one ounce of sunscreen before any prolonged exposure to the sun, including sitting in the car for a long commute while sunshine streams through the windshield.
It is important to reapply sunscreen approximately every two hours. Sweating and swimming causes sunscreen to wear off faster, so it is beneficial to reapply sunscreen every hour in those conditions.

Indoor tanning can be more dangerous than sunbathing outdoors. Tanning beds offer the option of increasing the lamps’ intensity, escalating the amount of UV radiation an individual receives. In addition, people can utilize indoor tanning year-round, resulting in regular exposure to UV rays. Even in constantly sunny regions like Southern Nevada, most people will take a break from outdoor tanning during chilly winter temperatures and intense summer heat, reducing their exposure to the sun’s harmful rays.

For those who have already dedicated time to basking on beaches or inside tanning beds, there are simple ways to monitor for signs of skin cancer. The Skin Cancer Foundation recommends everyone practice monthly head-to-toe self-examinations to identify any new or changing lesions that might be cancerous or precancerous. Basic warning signs of skin cancer include a skin growth that increases in size, and that might appear pearly, black, brown or multicolored. People should also be on the lookout for a mole, birthmark, beauty mark or brown spot that alters in any way, including changing color, increasing in size or thickness, changing texture, becoming irregular in outline, growing larger than 6 millimeters or appearing after age 21.

Other signs can include a spot or sore that continues to itch, hurt, scab and bleed, or an open sore that doesn’t heal within three weeks. When an individual recognizes these symptoms, it is important to see a physician, preferably a dermatologist. HealthCare Partners’ physicians are always happy to answer any questions about precautions for skin health.

Back-to-School Immunizations By Dr. Blair Duddy

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With the school year quickly approaching, it is important to ensure that all students are up to date on their immunizations.

Under state law, children are only exempt from vaccination requirements if their parents or guardians have submitted a written statement to a school’s governing body indicating their religious beliefs prohibit immunizations. Medical exemptions are also permitted.

Proof of immunization is a prerequisite for enrollment in all Nevada public schools for children who are not exempt. Immunizing your child is extremely important, especially when they are preparing to enter a school environment where they will be exposed to a large population of people and face a greater risk of contracting harmful diseases that could cause serious health issues.

As your children head back to school, make an appointment with your pediatrician to ensure they receive the necessary immunizations required by our state.

A child can receive up to 24 vaccinations by the age of 2. These are targeted to ensure children are protected against as many as 14 different diseases at an early age. Although this may seem like a lot for a young child, a vast amount of experience with this regimen and scientific research supports the fact that the immune system is very capable of handling the vaccines. The human immune system is exposed to billions of organic and inorganic substances, or antigens. With this in mind, 24 vaccines in two years is not a burden to the system. These vaccines are necessary because the immune systems of young children are not fully mature, which leaves them more susceptible to infections. Immunization schedules are developed by physicians and public health experts to provide the most complete protection for children. Most immunizations are recommended until the age of 18. It is important to consult your pediatrician or family practitioner for the most current immunization schedule.

The physicians at HealthCare Partners Pediatrics recommend the following immunizations for all children up to 6 years old:

• Hepatitis B
• Rotavirus
• Diphtheria, tetanus, pertussis
• Haemophilus influenzae type B
• Pneumococcal
• Poliovirus
• Influenza
• Measles, mumps, rubella
• Varicella (chickenpox)
• Hepatitis A
• Meningococcal (for certain high-risk groups)

Immunizations serve to protect your children and the community from the spread of infectious diseases. Preventing diseases is much easier and more cost effective than treating them. This is why vaccines serve such a vital role in safeguarding public health. A recent study published by the American Academy of Pediatrics (AAP) found that immunizations prevent 42,000 early deaths and 20 million cases of disease, with a savings of $13.5 billion in direct costs and $68.8 billion in total societal costs in the U.S.

Vaccines are biological preparations that stimulate the immune system to create antibodies that fight off a particular bacterial or viral infection before it can make you sick. They contain an agent that resembles the disease-causing microbe or are made from a weakened or killed germ. Once stimulated, the antibodies circulate through the bloodstream and attack the infectious agent. Through this mechanism, immunizations are usually able to fight the onset of a disease or reduce its severity.

According to the Centers for Disease Control and Prevention (CDC), the U.S. achieved measles elimination in 2000, meaning the disease no longer spreads year-round in this country. However, this year at least 539 people across 20 states have been infected with the measles virus. The CDC found that cases have been driven by unvaccinated people who obtained the virus in other countries, brought it back to the U.S. and subsequently spread it in their communities, where many others were also not vaccinated. Pertussis, another vaccine-preventable disease, has spread widely in our neighboring state of California. As of June 27, 4,558 cases of pertussis were reported in California since the beginning of 2014.

The re-emergence of these diseases has been attributed to the anti-vaccination movement, which centers on the myth that vaccines are associated with an increased risk of autism. This myth gained popularity as a result of a medical study published in 1998. The study has since been retracted, and the physician who led the study has had his medical license revoked. However, dangerous misinformation about vaccines still persists.

A report published on July 1 in the official journal of the AAP screened more than 20,000 scientific titles and 67 papers on vaccine safety, and the report showed once again that there is no evidence that immunizations cause autism. Furthermore, the report indicated serious and harmful reactions from vaccines are extremely rare. Time and again studies have consistently shown us that vaccines are safe, and their benefits far outweigh any risks.

I am grateful that we have vaccines to prevent infections that I saw children die from 20 years ago. My children, and the children of every pediatrician I know, are fully vaccinated. As someone whose professional career is devoted to the health of children, I would never recommend something I wouldn’t do for my own children.

Although closely following the immunization schedule is essential, it is never too late to immunize children to protect them from potential outbreaks of infectious diseases. If your child’s immunizations have been delayed for any reason, it may be difficult to figure out how to catch up. The CDC has developed a useful tool to help parents create immunization schedules. Parents can access this resource by visiting https://www.vacscheduler.org/. Be sure to consult your doctor to ensure vaccines are administered on schedule.

Disease prevention is a key component of our philosophy at HealthCare Partners Pediatrics. Our mission is to ensure that our youngest and most vulnerable patients are immunized and protected. The HealthCare Partners Durango Pediatrics clinic recently received the Silver Syringe Award from the Southern Nevada Immunization and Health Coalition, an honor celebrating the clinic’s outstanding immunization rates.

HealthCare Partners also participates in the federally funded Vaccines for Children (VFC) Program. This program helps provide vaccines to children whose parents or guardians might not be able to afford them. To find out if your local HealthCare Partners provider participates in the VFC program, or to consult a pediatrician about immunizations for your child, visit http://www.hcpnv.com/lasvegaspediatrics.

Preventing Falls Among Seniors By Dr. Sunita Kalra


Many seniors experience falls throughout the year that can result in significant health issues. One in every three adults over the age of 65 falls each year, according to the U.S. Centers for Disease Control and Prevention. Of those individuals, 20 to 30 percent suffer injuries such as cuts, fractured hips or even head trauma.

HealthCare Partners Medical Group is committed to helping seniors live active, healthy lifestyles. As a family physician with HealthCare Partners, I encourage seniors to take important steps in preventing falls around the home.
Useful precautions for avoiding fall-related injuries include:

• Engage in regular exercises that strengthen the lower body muscles and improve balance, such as dancing, walking, stretching or pilates

• Closely monitor medications for drugs that can cause dizziness or sleepiness

• Install grab bars in the shower and place night lights in hallways and bathrooms

• Clear walking areas of tripping hazards such as telephone cords, rugs, papers and clothing

Prevention is a key component of the Total Care Model that HealthCare Partners practices. Under this innovative approach to health care, we provide patients with a network of primary care providers, nurses and specialists who oversee all aspects of their health care.

Firework Safety Tips for the Fourth of July

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We hope everyone has a happy and safe Fourth of July tomorrow! According to the Consumer Product Safety Commission (CPSC), 200 people will visit emergency rooms with firework-related injuries every day in July.

If you choose to set off sparks this Independence Day, taking precautions goes a long way towards keeping you and your loved ones safe. Keep these safety tips in mind:

Keep Kids and Pets Away
Children should not light or handle fireworks, even after they’ve been used. Used fireworks can still be hot and active.

Be Prepared
A spark can land somewhere it’s not supposed to. Be ready with a hose, a fire extinguisher or buckets of water; the seconds you’ll save by being prepared could be the difference between a minor burn and major destruction.

Location is Key!
Here’s what firework companies say about picking the safest location to light your fireworks:

•Light Fireworks on a Hard Surface. The best surface for lighting fireworks is one that is hard, flat and level. You want to “ensure the stability” of the firework so it doesn’t fall down and change directions.

•Don’t Light Fireworks on the Grass. Grass isn’t a stable surface. If you must light fireworks on the grass.

•You Need a Clear, Open Space. If there are buildings, vehicles, trees or other overhead obstructions nearby, it’s not a safe place to set off fireworks.