PAMF Foundation for Health Fall 2009

t h e c u r e f o r c o m m o n m e d i c i n e

Foundation for

health

HealtH Care reform: a Conversation with Hal luft, Ph.D. PanDemiC flu: What You need to Know about H1n1 tHinK outsiDe tHe lunCHbox: Healthy tips for Kids—and adults

fall 2009 | pamf.org

inside

2 Foundation for Health fall 2009

HEALTH EDUCATION PROGRAMS 3

HOW DO WE FIND OUR DOCTORS? 4

HELP WITH FALL ALLERGIES 5

H1N1 FLU VIRUS NEWS 6

A PROSTATE CANCER JOURNEY 8

Q&A ABOUT HEALTH CARE REFORM 10

TIPS FOR QUICK, HEALTHY LUNCHES 13

HEALTH FAIR FOR LOCAL SENIORS 14

HONOR YOUR “GUARDIAN ANGEL” 16

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is a not-for-profit, community-based, multispecialty health care

provider. PAMF patients are cared for by the more than 850

physicians from the three historic medical groups affiliated with

PAMF: Camino Medical Group, Palo Alto Medical Clinic and

Santa Cruz Medical Clinic. PAMF provides care to patients at its

clinics and medical centers throughout Alameda, San Mateo,

Santa Clara and Santa Cruz counties.

PAMF is a part of the Peninsula Coastal Region of Sutter Health,

one of the nation’s leading not-for-profit networks of community-

based health care providers. Sutter Health’s Peninsula Coastal

Region also includes Mills-Peninsula Health Services, based in

Burlingame and San Mateo.

the Palo alto medical foundation (Pamf) for Health Care, research and education

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At the Palo Alto Medical Foundation, we believe in empowering you to lead your healthiest life, and that’s why we offer a

wide variety of classes, lectures and other events. Are you pregnant and interested in taking a prenatal class? Do you want to learn how to better manage your diabetes? Do you want to try a new approach to lose weight? PAMF can help!

Our offerings cover health and wellness topics including:• Adult weight management • Cholesterol management• Diabetes (including pre-diabetes and

gestational diabetes)• Heart failure• High blood pressure management• Lactation consultations• Nutrition and healthy food choices• Prenatal preparation• Smoking cessation• Stress reduction

• Teen skin care• Tips for feeding your toddler

For your convenience, we offer events at many of our clinic locations throughout the Bay Area. Events are not held at every PAMF location. To find out about dates, times and locations for upcoming classes and events, or to register, visit our Web site at pamf.org/education.

You may also call us at one of the numbers listed below:➡ For events and classes at the Dublin, Fremont

or Palo Alto centers, call 650-853-2960. ➡ For events and classes at the Mountain View

Center, call 650-934-7373.➡ For events and classes at one of our clinic

locations in the Santa Cruz area, call 831-479-6628.

WANT TO LEARN HOW TO LIVE YOUR HEALTHIEST LIFE? We Can Help!

PAMF Offers Health Education Programs, Classes and More

Community HealtH ResouRCe CenteRsDo you need information about a medical condition? The registered nurse health educators and trained volunteers at PAMF’s Community Health Resource Centers in Dublin, Fremont, Mountain View and Palo Alto can help you find reliable, accurate health information in a variety of formats, including consumer-oriented health reference books, medical textbooks, health newsletters, videotapes and DVDs, and recommended Web sites, as well as community resources. Our services are free and open to the public. Visit pamf.org/education for more information.

suppoRt GRoupsDo you want to connect with others who are living with similar medical conditions or going through the same stage in life? Our support groups are held at PAMF facilities or other locations in the communities we serve. All support groups are open and free to the public. Learn more about the support groups we offer at pamf.org/education.

PAMFPULSE.ORG: Health Information for the Web 2.0 CrowdThese days, much of our lives are spent online, including time searching for health information. To save time, visit pamfpulse.org, a Web site that compiles all of PAMF’s current new media offerings, articles, information about classes and lectures, and much more.


HOW DO WE FIND

our doctors?

Despite a national shortage of doctors and other health care

professionals, the Palo Alto Medical Foundation (PAMF) still attracts

the best and brightest doctors—both new and established. Foundation

for Health asked Kimberly Ashley, PAMF’s physician recruitment

supervisor, to tell us how PAMF recruits the cream of the crop.

Q: How does PAMF recruit its doctors?

a: We use a variety of methods to find the right person. We advertise on our Web site and other sites that are connected to medical journals. Our recruiters travel to areas that have a high number of top-notch medical schools and hospitals—including Boston, Chicago, New York and Los Angeles. We also attend physician career fairs and national physician meetings and visit residency programs.

In the Bay Area, many medical students and established doctors know about PAMF’s excellent reputation and our dedication to high-quality health care, and they want to come work with us. We also have close relationships with the institutions where many of our existing doctors went to medical school or completed their residency programs, such as Stanford University and the University of California, San Francisco.

Q: What qualities and qualifications does PAMF look for in its doctors?

a: Our doctors come from top-notch medical and residency programs, but they must also embrace PAMF’s mission. We want doctors whose primary focus is the patient and who have a good bedside manner. We tell our candidates that they’re not just joining PAMF—they’re joining a family. To ensure continuity of care, we also want doctors who plan to practice at PAMF for a long time and who can build meaningful, lasting relationships with our patients.

Q: How thoroughly are new doctors screened before they’re hired?

a: Very thoroughly! Our prospective doctors go through an initial telephone screening interview, two rounds of in-person interviews (including an interview with the department chair) and evaluations by the department’s doctors. Candidates must also submit three letters of recommendation, and references are called for further information and verification. Finally, all of our doctors undergo a comprehensive background check.

Looking for a Doctor? Start Here!

Visit pamf.org to search for the right doctor for you.

Choosing a personal doctor is an important decision. One of the best ways to ensure you’re getting excellent health care is to have a primary care doctor you trust, so that you can build a long-term relationship—someone who knows your medical history and understands what’s important to you. Your primary care doctor also knows when it’s best to refer you to a specialist.

Are you looking for the right doctor? Visit our Web site at pamf.org, and click on “Find a Doctor.” You can search by medical specialty, languages spoken, location and any other criteria that are important to you.

learn How Pamf Hires the best Doctors in medicine today

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sneezin’ season: PLAN AHEAD TO REMAIN SYMPTOM FREE FROM ALLERGIES

Fall is the season for cooler air, colorful leaves—and a multitude of pollens. In Northern California, weed, grass and

tree pollens are among the most common fall allergens and cause symptoms—including runny nose, itchy and watery eyes, and congestion—that can negatively impact your energy level and trigger lower-respiratory symptoms like coughing or wheezing. Fortunately, your allergist/immunologist can help you plan ahead to prevent or control these symptoms, Robert Bocian, M.D., Ph.D., an allergist

and immunologist at the Palo Alto Medical Foundation’s (PAMF) Palo Alto Center, says.

The large variety of pollinating plants in Northern California collectively creates an outdoor pollen season that extends through most of the year. Indoor allergens also abound without regard to season, causing perennial allergies in many people.

You can prevent or combat allergic symptoms with medications and/or allergy immunotherapy vaccinations prescribed by your doctor, or by taking steps to eliminate allergens in your environment.

Sneezing on the Job: 7 Tips to Reduce Allergy Symptoms at Work

Coping with allergies at work can be a challenge. Try these tips from Steven Rubinstein, M.D., an allergist at PAMF’s Mountain View Center.

1. Wash your hands as soon as possible after being outdoors to avoid bringing pollens into your work space.

2. Avoid eating lunch outdoors to limit exposure to pollen.

3. Eliminate fabric-covered items in your work space. Don’t bring chair pillows or collectible stuffed animals into your work space—they can harbor allergens and dust mites.

4. Keep your car windows up when driving. Use the “recirculate air” setting to keep the fresh air in and pollen out of the car during your commute.

5. Use an over-the counter saline nose rinse. These rinses flush allergens and other irritants out of the nose before they can cause symptoms. Keep a supply in your desk drawer.

6. Take a non-drowsy-formula allergy medication. These medications are safe, available without a prescription, can ease allergy symptoms within an hour of taking them and won’t put you to sleep during your next meeting.

7. Ask your doctor about using a prescription cortisone nose spray. These sprays can prevent the allergic reaction that causes symptoms.

tune in to the pulse at pamfpulse.org to watch videos with our doctors’ recommendations for combating allergies.

lookinG foR an alleRGist? Our allergists/immunologists can help. We evaluate patients with sinus and nasal symptoms, including hay fever and sinus infections, bronchopulmonary conditions such as asthma, allergic skin conditions such as eczema and hives, and food and medication allergies and intolerances. We also now offer allergy and immunology services at our Mountain View and Redwood Shores centers in addition to our other clinic locations. Visit PAMF’s Web site at pamf.org/allergy to find an allergist who can help you avoid the uncomfortable symptoms of allergy season.

Q: What were the greatest miscon-ceptions about the H1N1 virus during the initial outbreak in April 2009?a: First, the news media has overstated the severity of the virus and the gravity of the outbreak, and as a result, caused unnecessary panic. The H1N1 virus is currently not more severe than the regular flu. Second, at the start of the outbreak, there was a sense that Mexico was under siege, but this is not true. In fact, the Mexican government and public health officials did a good job of responding to and managing the outbreak. Despite the contrary portrayal in the media, the vast majority of Mexican citizens were not affected by the virus. The situation in Mexico was not as chaotic as it seemed.

Q: Why did H1N1 get so much media coverage and attention?a: The international health community has known that we’re overdue for a pandemic flu and been expecting it for some time, so when the H1N1 flu began to spread and act differently than the regular seasonal flu, there was naturally some concern and speculation.

Q: How is H1N1 different from avian (“bird”) flu?a: H1N1 is transmitted from person to person, and so far (except in a few rare cases), avian flu has not. Only about 400 people worldwide have been infected with avian flu, and all but a few of these people were infected after direct contact with birds. Avian flu is also far more severe than H1N1 flu.


WHat you need to knoW about

the H1N1 Virus

Q: How is H1N1 different from the regular seasonal flu? a: Although H1N1 is not more severe than regular seasonal flu, it does have different features. Unlike seasonal flu, the pandemic H1N1 flu is capable of circulating in warm weather. It also has the capacity to affect more people, because it is caused by a virus that is new to the population (unlike seasonal flu, which is caused by viruses that are already among people). In addition, H1N1 cases do not seem to be affecting older individuals to the same degree as the regular flu typically does, which may indicate they have some immunity to H1N1 because of similar strains of the virus that circulated in years past.

Q: Is the worst of the H1N1 outbreak over? a: It is too soon to know. H1N1 has not spread as fast—or been as virulent—as more classic pandemic flu viruses. In typical pandemic flu scenarios, however, the virus may appear in two stages—the first stage in warm weather, and the second stage in colder weather and generally affecting more people. Because we’re not through the fall/winter flu season yet, we just don’t know how H1N1 will manifest. We’re hopeful, but we’re not out of the woods yet!

Q: How can I protect myself and my family?A: Don’t panic. Follow the advice of PAMF and public health officials, both of whom have pandemic plans in place and are prepared to respond to any outbreak. Practice good health habits—wash your hands frequently, cover your mouth when you cough and stay home from work or school if you have a fever.

2009-2010 upCominG flu sHot CliniC dates, times and loCations

Want to learn more about PAMF’s upcoming flu shot clinics? Visit pamf.org/flu or call one of the phone numbers listed below:

➡ For flu shot clinics in Dublin, Fremont, Los Altos, Redwood City, Redwood Shores and Palo Alto, call 650-853-2039.

➡ For flu shot clinics in Mountain View, Sunnyvale and Santa Clara, call 408-523-3029.

When the H1N1 pandemic flu virus (once known as the “swine flu”) outbreak

began this spring, media outlets around the world became harbingers of

information—and often, misinformation —about the pandemic flu. Foundation for

Health sat down with Charles Weiss, M.D., MPH, an urgent care doctor and

public health expert at PAMF, to debunk myths about the virus.

Long before the H1N1 virus made headlines around the world, PAMF had plans to respond to and care for patients during a pandemic flu outbreak. We have committees and task forces comprised of primary and specialty care doctors and administrators who are dedicated to ensuring PAMF is prepared to care for patients with flu—regardless of whether the flu is seasonal or pandemic.

Our pandemic plan outlines the actions we would take in the event of an outbreak, including monitoring viruses and responding to patients’ needs, including triaging patients and using vaccines and antiviral drugs. We are also committed to communicating regularly with our patients and the public.

We partner with local and county health officials and agencies to ensure an effective and rapid response to a flu pandemic, and receive daily updates from the World Health Organization, the U.S. Centers for Disease Control and Prevention and local health authorities with recommendations for caring for patients and preventing the spread of flu.

During the recent swine flu outbreak, pandemic planning teams throughout PAMF coordinated details to provide safe and exceptional care to patients despite the fear and confusion the outbreak caused. Kathy Korbholz, a vice president of ancillary operations at PAMF, adds that PAMF followed the incident command team structure used by law enforcement agencies and the armed forces in its pandemic planning efforts, because it provides a proven structure, action plan and defined roles for team members in managing disasters and emergencies.

“Working together and planning response efforts during the H1N1 outbreak provided us with an excellent testing ground for how we will handle future and more serious pandemic flu outbreaks,” Korbholz says. “We have a plan and are able to put it into place quickly and efficiently.”

What is PAMF Doing to Prepare?

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top tips foR stayinG HealtHy duRinG Cold and flu seasonBeyond getting a flu vaccine, there are many ways to stay healthy this cold and flu season. Visit pamf.org/flu for tips.

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NAVIGATING THE WAY THROUGH A

Prostate cancer is the second leading cause of cancer death among men. The American Cancer Society estimates that 27,360 men in the United States will

die of prostate cancer in 2009. Although there are many treatment options available—from radiation therapy to surgical removal of the prostate—all options have side effects that can significantly affect men for the rest of their lives. This makes it difficult to choose which option is best. Fortunately, PAMF has received a grant from the U.S. National Institutes of Health (NIH) to study ways to reduce the confusion and anxiety that arise before and after this decision-making process.

“We believe that if men with prostate cancer are armed with the knowledge they need to make a fully educated decision about their course of treatment and feel the benefits of their treatment outweigh any potential side effects, then they are happier and their quality of life is improved,” Nancy Brown, Ph.D., the principal investigator of the study, says. “The NIH grant will allow us to prove this and further develop

care processes and resources to ensure our patients have all of the information they need to make a decision with confidence.”

The study will examine how a nurse navigator can help prostate cancer patients make treatment decisions. A nurse navigator is a registered nurse with special training in prostate cancer who coordinates care at PAMF, answers questions and guides patients through the cancer care journey. He or she helps manage the logistics of a treatment plan and explains options to patients to help them feel more empowered and confident and less anxious in their decisions.

Beyond scheduling appointments and coordinating treatment, the nurse navigator can help patients take advantage of the myriad of cancer support services that PAMF offers. These services include assistance from nurse educators, social workers, dietitians, physical therapists and counselors. The nurse navigator also provides prostate cancer patients with a notebook of information ranging from treatment options to diet suggestions to keep them informed during their journey.

prostate cancer journeyPamf receives niH Grant to study role of nurse navigator in Cancer Care

more information about pamf’s prostate cancer program is just a click away. Visit pamf.org/prostate for information about prostate cancer, our services and care team,

clinical trials and much more.


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PAMF Santa Cruz First in County with Digital MammographyDid you know that when detected early, the chance for successful treatment of breast cancer is nearly 100 percent? Mammograms play a central role in the early detection of breast cancer because they can detect breast changes that may signal cancer, but are too small or subtle to be detected otherwise. To ensure we have the latest in detection technology, PAMF Santa Cruz has opened the first digital mammography facility in Santa Cruz County.

The recently renovated office on the first floor of PAMF’s clinic at 2025 Soquel Avenue offers full-field digital mammography, private consultation rooms, and early morning and Saturday appointments.

“We want to ensure that we have the latest technology to help women in the fight against breast cancer,” Margaret Hansen, M.D., medical director of radiology at PAMF Santa Cruz, says. “Digital mammography is more convenient for the patient and uses less radiation—and studies show that it is better at detecting cancer in younger women and in women with dense breast tissue.”

Unlike film-based mammography, digital mammograms produce images that appear on the technologist’s monitor in a matter of seconds. There is no waiting for film to develop, which means patients spend less time in the breast imaging suite. With the digital, high-resolution images, patients also receive results much more quickly. Another convenience of digital mammography over film-based systems is it can greatly reduce the need for retakes due to over- or underexposure. This saves additional time and reduces patient exposure to X-rays. Digital images can also be easily stored, transmitted and copied without any loss of information; eliminating dependence on only one set of “original” films.

prostate cancer journey

“Something drives each man’s decision about what type of treatment to have,” Brown says. “We need to understand what is most important to him and provide him with the information he needs to make a decision that will support his lifestyle and goals.”

Nurse navigators have been essential to PAMF’s prostate cancer program for several years now. The NIH grant will allow PAMF to formally document exactly how powerful having a central person coordinating care can be—especially when a patient is facing the emotionally and physically strenuous challenge of cancer.

After the two-year study is complete, Brown and her colleagues on the cancer care team will evaluate the data. If it supports the value of the nurse navigator and prostate cancer notebook—as Brown believes it will—then the program will be used as a model throughout PAMF’s Cancer Care Program.

We can’t promise our patients a certain outcome,” Tina Pierce, administrative director of PAMF’s Cancer Care Program, says. “But we can promise patients that we’ll provide them with all of the compassion and individual care they need to feel supported and the information and resources they need to feel confident that the path they’ve chosen for their cancer care journey is the right one for them.”

did you know that pamf offers digital mammography exclusively? Visit pamf.org/radiology to learn more and to find the location nearest you.

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health care reform: A CONVERSATION WITH HEALTH

ECONOMIST HAL LUFT, PH.D.

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Read a newspaper or turn on a TV these days, and you can’t avoid the alarming statistics of the number of people in the United States without health insurance—nor can you avoid hearing about the many plans and proposals currently being presented in hopes of reforming the American health care system. Foundation for Health talks to Harold “Hal” Luft, Ph.D., a nationally renowned health economist and director of PAMF’s Research Institute, about how our nation got to this point and what we need to do to overcome the barriers to affordable, quality health care for all.

health care reform:

Q: How did we arrive at the health care system we currently have?

a: Our current health care system has evolved largely by accident. Until the 1930s, health insurance did not exist. During the Great Depression, hospitals formed Blue Cross

plans to allow patients to put aside money each pay period so that when they needed care, there was money to pay for it. The hospitals supported this because it helped ensure they would get paid. Then, medical associations started the Blue Shield plans to assure that doctors would be paid.

At the end of World War II, wage and price controls were in place. Employers were competing with each other to find workers, but they weren’t allowed to raise wages. They discovered that offering health benefits to their employees would not count as a wage increase. This is how we ended up with employer-sponsored health coverage. Then in the 1970s, a law passed allowing large employers to avoid state regulation of pension benefits and to self-insure their own health plans. This resulted in widely varying coverage and benefits, yielding inconsistent and confusing incentives for physicians and hospitals. All of these events were circumstantial accidents that created a patchwork arrangement; they were not intended to create an organized health care system.

I remember looking at my uncle’s hospital bill for a heart attack he had in the 1950s. His phone charges were about one-third of the cost of his hospital room and board charge. Care wasn’t very expensive, since there wasn’t much doctors could do for people back then. Over time, we’ve learned how to do many, many

more procedures. We also have health insurance that pays for these new procedures and the technology that makes them possible (which, in turn, makes it more attractive for companies to develop new technologies). This has allowed us to dramatically improve care, but it costs money. These costs, of course, are passed on to patients.

Q: If our current health care system is an accidental patchwork, why haven’t we reformed it? Why has it been so difficult to change our current system?

a: The structure of the United States government was intentionally designed to make it difficult to affect change, which is why it’s been challenging for us to have health reform to this point. These “accidental” systems are hard to undo, especially considering that lobbyists and others who make money off of the current system walk the halls of Congress to convince legislators to maintain the status quo.

Q: The Obama administration is proposing an overhaul of the U.S. health care system. This isn’t the first time proposals have been introduced. How are things different now?

a: When the Clinton administration led the charge to reform health care in the 1990s, the argument was we ought to do it because it was “the right thing to do.” Most of the middle class, however, had some type of health insurance and was not feeling threatened. This is not the case now. Many people are losing their jobs (and thus, their employer-sponsored health insurance) because of the financial crisis on Wall Street, and even workers with access to health insurance can’t afford the premiums!

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Hal luft, pH.d.

In the 1990s, the baby boomers were further away from retirement—and from relying on Medicare—than they are today. Now, they realize that the sustainability of Medicare might be threatened if there’s not a change in the system. Consumers are not the only ones who are unhappy with rising costs of medical care and insurance; primary care doctors are also very displeased with the existing structure and are advocating change.

Finally, we now have a Democratic president and a dominant Democratic majority in Congress, so the political consensus needed to affect change is in place. The Obama administration, learning from the failures of the Clinton administration, is involving interest groups, such as health insurers and health care providers, in the discussion to ensure the major players in the health care industry support the efforts and can work with Congress to achieve real solutions. The politics are very different today. All of these factors are acting in concert like never before.

Q: What is the difference between universal health care coverage and a single-payer system?

a: Universal coverage simply implies that all Americans have coverage, whereas a single-payer system means this coverage is offered by a single source (such as states or the federal government). You can have universal health coverage without having a single-payer system. You can also have a single-payer system that doesn’t cover everyone—for example, people who are in the country illegally.

Here are some examples of how both of these models might work. In the classic single-payer model, a single entity (ie. the federal government) would enroll everyone and would finance and operate the system. Like Medicare, private contractors would still be used to administer payment and provide care to patients, but the government would set the fees and make the rules.

Under a universal coverage/multi-payer model, the government would raise taxes to pay for vouchers, allowing people to choose their own

coverage, or mandate that everyone needs to have health care coverage (just like we mandate that anyone who drives a car must have auto insurance). You would choose the coverage that you want (similar to an employer covering all employees but offering a menu of options for where they get their care), and some of the more expensive coverage options may require additional personal payments. The government would subsidize those who don’t have employer-sponsored health coverage and can’t afford to purchase coverage.

Q: What’s the best solution?

a: I believe we ought to ensure that everyone has coverage, and this is relatively easy to do—it just requires money. The more complicated and interesting question is, how do we change the way the health care delivery system works to ensure people get high quality care at a lower cost? Right now, the United States spends more on health care than any other industrialized national (16 percent of U.S. Gross Domestic Product), yet we rank at the bottom for outcomes and satisfaction. Why? It’s the way our delivery system operates. Our current delivery system pays health care providers separately for the little things—a pill here, a screening exam or procedure there. We need to coordinate medical services and educate patients.

The core of my health care reform proposal involves bundling payments so that clinicians work together with patients to treat them as appropriately as possible. This includes paying doctors, nurses and other health care providers for spending time talking to patients, something that currently doesn’t happen. Physician need to work more as coaches, and we need the reimbursement systems in place to make this possible. This will also increase patient satisfaction.


The Robert Wood Johnson Foundation recently awarded PAMF’s Research Institute a grant that will enable Dr. Luft to disseminate his ideas further. To learn more about Dr. Luft’s health care reform proposal, called SecureChoice, visit pamf.org/research, and read the latest news about his proposal and his book, Total Cure: The Antidote to the Health Care Crisis.

Health Care Reform continued from page 11

The food we put into our bodies profoundly impacts our health and well-being. Even if you make sure your children eat nutritious meals

at home, it can be challenging to pack healthy yet convenient lunches that your kids will want to eat when you’re not around.

“Supermarkets are filled with tempting, often expensive foods that are high in fats and salt and low in nutrition,” Rachel Freiberg, a registered dietitian with PAMF’s HMR Weight Management Program, says. “There are easy ways to give your child a healthy, delicious lunch that’s not too expensive. It just takes a little advance planning and creative thinking.”

Here are some tips for a packable lunch that works great for kids—and even adults—and is nutritious and delicious (as well as quick and economical):• Make sandwiches using whole-grain bread and

cut into different shapes with cookie cutters, or use whole-wheat pita bread or rolls. Pack lettuce and tomato separately to avoid sogginess.

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THINK OUTSIDE THE LUNCHBOX HEALTHY LUNCH TIPS FOR KIDS—AND ADULTS!

• Sneak in vegetables by packing baby carrots and cut-up bell peppers or broccoli.

• Include some bite-size fruits such as bananas, apples, grapes, blueberries or strawberries, and a small cup of yogurt (preferably low in sugar). Dried fruit, which contains just as many vitamins as raw fruit, is also a great addition to any lunch, especially since it doesn’t get squished like raw fruits.

• Don’t limit lunch to “lunch-type” foods. Cereal with fruit and yogurt makes a very healthy lunch.

• Cook larger meals than you need for your family’s dinner, and set aside portions of the leftovers for lunch.

• Make a healthy pizza for lunch using a bagel or English muffin for the crust, and then add tomato sauce, cheese and vegetables.

Freiberg also recommends getting your kids and other family members involved in making meals, with jobs such as chopping and prepping the foods and grocery shopping.

Want to leaRn moRe about pRepaRinG HealtHy foods and eatinG a balanCed diet? Visit ThePulse at pamfpulse.org, where you’ll find videos, podcasts, articles and classes at PAMF clinic locations that will help you learn how to eat for optimal health.

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“If your kids have an active role in preparing the family’s meals and are part of the decision-making process, they will be more likely to eat—and enjoy—the healthy foods that you’re presenting. You will be setting them up for a lifetime of healthy eating habits.”

—Rachel Freiberg, registered dietitian with PAMF’s HMR Weight Management Program

Hundreds of Santa Cruz-area seniors recently attended the 12th annual Senior Health Fair, hosted by the

Sutter Maternity & Surgery Center (SMSC) of the Palo Alto Medical Foundation (PAMF), to receive health information, screening exams and other care they might not otherwise receive.

“It is very important for seniors to maintain a healthy lifestyle and receive regular health screenings,” David Sofen, M.D., regional

medical director at PAMF Santa Cruz, says. “The Senior Health Fair has been instrumental in providing just such an opportunity for the seniors in our community for many years.”

The Senior Health Fair—which PAMF cosponsors with the Santa Cruz Parks and Recreation Department—offers multiple free health-screening exams and monitoring for diabetes, cholesterol, blood pressure, dental hygiene, skin disorders, bone

14 Foundation for Health Summer 2009

density, glaucoma, hearing and other health issues. Getting all of these services in one place is a convenience for seniors who often have a difficult time getting around to multiple medical appointments, and a real help for those living on a fixed income. Approximately 30 local organizations were represented at the event, where booths were set up for seniors to stop by and get more information about resources available to them in the community.

HEALTH FAIR PROVIDES LOCAL SENIORS WITH infoRmation, sCReeninG exams

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Did you miss this year’s Senior Health Fair? Not to worry—Minerva Navarro, M.D., a geriatric medicine doctor at PAMF’s Mountain View Center, gives seniors her top five tips on how to be your healthiest.

1. tell your doctor about any medications or supplements you’re taking. One out of five hospital admissions for elderly patients is related to an adverse drug reaction, Dr. Navarro says. Seniors are more prone to adverse drug interactions or negative effects of taking too many medications. You may not think of over-the-counter and herbal supplements as medications, but they can cause adverse effects, too—especially due to a negative interaction with another supplement or over-the-counter or prescription medication.

2. exercise. You may think that being older means being less active, but exercise is still incredibly beneficial to health, Dr. Navarro says. It improves balance, gait and flexibility, stimulates the brain, and provides cardiac and pulmonary benefits. Talk to your doctor about the intensity of exercise that is recommended for you based on your medical history.

3. eat a balanced diet. Unfortunately, malnutrition and dehydration are very common in seniors, Dr. Navarro says. Again, it is important to talk to your doctor about the best diet for you based on any medical conditions you may have, but in general, eating a diet consisting of lean meats, whole grains, and five servings of fruits and vegetables is the nutritional key to good health.

4. see your doctor for regular checkups—even if you feel well. There are “silent” medical conditions that don’t cause symptoms but have a great impact on your health and future health risks, such as hyperlipidemia, which impacts stroke and heart attack risk, and osteoporosis, which increases risk for future fractures.

5. Complete an advance health care directive. This important document specifies the care and treatment you want in the event that you are incapable of making your own health care decisions. You can appoint an agent or agents who have power of attorney to make care and treatment decisions on your behalf and give instructions about your health care wishes. Keep a copy of this directive in your personal files and give another copy to your doctor to be placed in your medical record.

Several local students with ambitions of becoming doctors are heading off to medical school and college with well-deserved financial help from the Palo Alto Medical Foundation (PAMF).

As part of our commitment to support future generations of doctors, PAMF’s Sutter Maternity & Surgery Center and the Central Coast Alliance for Health recently awarded a two-year, $5,000 scholarship ($10,000 total) to local student Brittany Guest. This award supports future doctors who have an interest in and commitment to providing primary care to the underserved in the community, including Medi-Cal and Medicare patients.

Guest is a 2009 Health Sciences graduate of the University of California, Santa Cruz who plans to become an obstetrician/gynecologist and use her Spanish-language skills to better connect with patients. She plans to return to the Central Coast after completing medical school and training.

Three local high school students—Bryan Alas from Eastside College Preparatory School, Eduardo Bent from Mountain View High School and Stephen Durdle from Menlo-Atherton High School—received PAMF’s Pre-Medical Scholarship to help pay for their undergraduate studies. The scholarship, established in 1993 and funded by PAMF physicians,

provides $5,000 a year (a total of $20,000) to students in the communities PAMF serves who attend a four-year college and plan to pursue careers as doctors.

Alas will attend the University of California, Berkeley; Bent will attend Santa Clara University; and Durdle will attend the University of California, Davis. Unlike most other scholarships, which are one-time awards, the PAMF scholarship repeats for all four years of college, providing students who might not otherwise be able to afford college with the opportunity to fulfill their dreams and give back to their communities.

Top 5 Health Tips for Seniors

Aspiring Doctors Awarded ScholarshipsaWaRds suppoRt loCal students seekinG CaReeRs in mediCine

Has a PAMF doctor, nurse or staff member provided you with exceptional care? You can now honor your PAMF doctors and other caregivers in a new way. With a $25 gift to PAMF, you can recognize a PAMF doctor or employee as a “Guardian Angel.”

The gift can be anonymous or include your name, and the person being recognized will receive a special card and Guardian Angel lapel pin.

The reasons patients give a gift and dedicate an Angel pin to a PAMF doctor or employee are varied, but all exude gratitude. Guardian Angel gifts can be made by check or credit card. For more information about the Guardian Angel program or other ways to give to PAMF, visit pamf.org/giving. You may also continue to give a philanthropic gift in someone’s name through regular donations. Donors who give $100 or more in a year will be included in PAMF’s annual report.

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Palo Alto Medical Foundation for Health Care, Research and

Education

inspiRed GiVinG: Read WoRds of GRatitude onlinePAMF is fortunate to have many grateful donors who make gifts to show their appreciation of the care they receive and their commitment to helping our communities stay healthy. Read more about their inspiring stories on our Web site at pamf.org/community/gratitude.html.

philanthropic giving:YOU CAN NAME PAMF DOCTORS, STAFF “ANGELS”

We post frequent messages that include tips on how to lead a healthy lifestyle, as well as links to educational health articles and information about our participation in local community events. We also have specialized Facebook sites for some of our popular services, such as our Laser Vision Care Department and our teen Web site, “We’re Talking.”

JOIN US ON FACEBOOK!DID YOU KNOW THAT PAMF HAS MORE THAN 1,000 FRIENDS ON FACEBOOK?

Want to beCome pamf’s fRiend on faCebook, too?Visit PAMF’s home page at pamf.org, and click on the Facebook icon at the lower right-hand side of the page.

If you do not wish to receive Foundation for Health by mail, please contact PAMF’s Public Affairs Department at [email protected] or 650-691-6471.

Foundation for Health is published quarterly by the Palo Alto Medical Foundation for Health Care, Research and Education (PAMF) for its patients and members of the community. The information provided in this publication is intended to educate readers on subjects pertinent to their health and care they receive at PAMF, and is not a substitute for a consultation with a doctor.

Director of Public Affairs: Jill Antonides, Ph.D.Managing Editor: Joelle Pauley-FineContent Advisors: Donna Cumming, Ben Drew, Cynthia Greaves, Mark Riley

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Foundation for

healthPalo Alto Medical Foundation for Health Care, Research and Education 795 El Camino Real Palo Alto, CA 94301

Documents

PAMF Foundation for Health Fall 2009