GoHealth Urgent Care News

LI stores, developers on how retail is evolving

Source: Newsday

By Aisha Al-Muslim, Maura McDermott, and Victor Ocasio

May 7, 2016

Shopping centers and malls on Long Island and in the nation are evolving as stores get smaller, landlords add non-retail tenants such as medic...

LI stores, developers on how retail is evolving

Source: Newsday

By Aisha Al-Muslim, Maura McDermott, and Victor Ocasio

May 7, 2016

Shopping centers and malls on Long Island and in the nation are evolving as stores get smaller, landlords add non-retail tenants such as medical centers and gyms, and retailers move into mixed-use developments where residents live.

Read more at :http://www.newsday.com/business/li-stores-developers-on-how-retail-is-evolving-1.11771279

Portland's war of the retail centers

Source: Portland Business Journal 

By Elizabeth Hayes

April 15, 2016

Last summer, Zoom+ helped Jody Greene get to work on time.

Greene had come down with a sinus infection and didn’t have a primary care doctor....

Portland's war of the retail centers

Source: Portland Business Journal 

By Elizabeth Hayes

April 15, 2016

Last summer, Zoom+ helped Jody Greene get to work on time.

Greene had come down with a sinus infection and didn’t have a primary care doctor. So she made an online appointment at a Zoom+ center in Portland’s Pearl District near her job and still managed to make it to her desk at the usual hour.

Zoom+, which started with a single location at Bridgeport Village a decade ago, placed a bet that tens of thousands of Jodies — or “Sarahs,” as co-founder and CEO Dr. Dave Sanders calls his customer base — are out there, demanding care where they want it, when they want it. Today Zoom+ has 25 centers in the Portland-Vancouver region and treats a quarter of a million patients a year.

Zoom+ is hardly alone in the neighborhood/retail center game. There are no fewer than 75 urgent or on-demand centers in and around Portland . Major health systems — Providence Health & Services, Legacy Health, Kaiser Permanente Northwest and Adventist Health — have jumped in enthusiastically, with a wave of new locations popping up or on the drawing board. And a handful of independent players are in the game as well.

The result is a hyper-competitive marketplace that has pitted some of the region’s biggest health care providers against one another in an all-out war for patients — or consumers, as they’re viewed these days.

“It’s definitely a concern, because we see them going up all over town, and every health care system is putting in its own solution,” said Eric Weeks, senior director of Legacy Medical Group. “We clearly have more saturation in the marketplace than we have before. But we have more people utilizing urgent care than in the past, and some of them, frankly, don’t want a primary care physician but want to get their care episodically.”

Even with demand for urgent-care services rising, it’s unlikely all these entrants will survive. With a nearly 10-year head start, Zoom+ has an established footprint and well-known brand. But Kaiser, Providence and Legacy have name recognition, hospitals and hundreds of thousands of their own insured patients they can drive to their centers.

Centers rising

The retail revolution is happening in response to changing consumer values: speed and convenience, often over long-term relationships with a family doctor, especially at a time of a nationwide shortage of primary care physicians. Whether they’re called urgent, on-demand, convenience or express care, most are open seven days a week and evenings and see patients with non-life-threatening symptoms — sore throats, earaches, rashes and sprains. They take walks-ins and same-day appointments, with wait times of 30 minutes or less.

With more people insured and more of them in high-deductible health plans, there’s also an incentive for patients to seek cheaper care alternatives than the emergency room. According to Medica Choice Network, the average ER cost for allergies, for instance, was $345 vs. $97 in an urgent care setting. For urinary tract infection, the difference was even greater: $665 vs. $112.

On-demand centers make their prices readily available, with office visits generally in the range of $125-$160 for self-pay patients, less for those who are insured.

At the same time, consumer demands, as well as regulatory changes, have impacted hospitals’ revenue mix. A decade ago, nearly 57 percent of the dollar amount Oregon hospitals charged derived from inpatient care. Now the proportion is almost equally divided between inpatient and outpatient, as more procedures have migrated to ambulatory settings and systems respond to Medicare and Medicaid incentives to lower hospitalizations.

Retail centers, with their relatively low overhead, can fill the gap, provided they achieve a high volume.

“Urgent care is very profitable,” said Bill Stinneford, senior vice president at Buxton, a Fort Worth-based consumer analytics firm working with Adventist Health to evaluate center sites. “If you’re a health system, you need that type of business to support the rest of it.”

Management consulting firm Oliver Wyman projects “at least $200 billion in current health care spend is poised to flow from traditional venues to one or more of these alternative, new front door sites,” including virtual care.

Competitive edge

In Portland, center operators are jockeying to stand out.

Zoom+ last year expanded beyond urgent care into what Chief Creative Director Steve McCallion calls a “radical redefinition of primary care,” as well as beefing up its “advanced care” offerings. For example, at the Zoom+ Performance Lab in the Pearl District, you can test your nervous system function. The company’s marketing leans heavy on catchphrases — “Sarah,” platonic ideal Zoom patient, and “twice/half/ten,” which stands for “twice the health, half the price, ten times the delight.”

It is also now in the insurance game. Greene, who was treated at Zoom+ for her sinus infection, is now on a Zoom+ group insurance plan through her employer, the tech-marketing firm Response Capture. She frequents Zoom+ centers regularly for wellness checks and to treat various maladies.

“We were in and out when my son had pink eye, and we left with a prescription and didn’t have to go elsewhere,” Greene said.

Adding insurance to its business model allows Zoom to keep patients inside the Zoom ecosystem. But, while Zoom is Portland’s most-established center operator, it’s an upstart in insurance.

On the other hand, Kaiser may be a newer entrant to the convenience center game, but it dominates Oregon’s health care landscape. The company is the largest insurer, with nearly 530,000 members. It operates two hospitals and four urgent care centers in the Portland metro area. Kaiser is piloting a new convenient care model in the Pearl District this fall, with plans to add more if the prototype center is a success.

Kaiser’s closed-loop system can steer existing members to the retail center and, conversely, entice nonmembers through the door and funnel them to its hospitals and health plan. Providence, which also owns hospitals and one of the largest health plans, enjoys a similar advantage for its Express Care centers, which it plans to expand to nearly 20 this year both within Walgreens and standalone.

Legacy, which is buying a 50 percent interest in PacificSource Health Plans, operates its own urgent care center within Legacy Good Samaritan ER. But the vast majority are in partnership with GoHealth Urgent Care, which was founded in Northern California and initially purchased five existing Portland-area centers. Since launching the joint venture last year, the footprint has grown to a dozen, with plans for eight more in 2016.

Dr. Gregory Carroll, regional president and medical director for Legacy-GoHealth, calls the company’s model “urgent care 2.0.”

“People may come to our retail site, but it’s fully connected to the Legacy system, so they get the best of both worlds,” Carroll said. “Say you need to go to (Legacy’s) Randall Children’s Hospital. The pediatric doctor pulls up your chart, and it’s already in the system. There are no redundancies or loss of communication. We’re eliminating waste over ordering tests and X-rays. You start to get efficiencies for patients.”

Even with the closed-loop advantage enjoyed by Portland’s powerhouse health systems, independent center operators see a place for themselves in the crowded marketplace. AFC/DoctorsExpress is the third-largest urgent care chain in the U.S., but is less well-known in Portland, where it has three locations and four more on the way.

Dan Reese, director of sales and marketing, said the key differentiator is this: 90 percent of patients see a doctor, not a nurse practitioner.

“It’s more about the quality and comprehensive service,” Reese said. “You go to some of these urgent care centers and you’re greeted by someone with a white lab coat, and you have no idea what their credentials are. It’s getting very gray about who’s treating a patient.”

Winners and losers

As it stands now, it’s too soon to say how much demand is really out there and which centers will flourish or flounder.

Legacy-GoHealth centers received 7,500 patients in December, slightly ahead of expectations, Weeks said.

In the short-term, those numbers may continue to rise.

Seventy percent of respondents to the business consulting firm Oliver Wyman’s national survey on on-demand centers said they are aware of retail centers, up slightly from 66 percent three years ago. And it’s not just the young and healthy that are accessing services: “Consumers have found the new front door, they like it and they’re likely going to start using it more and more,” the survey found.

For his part, Zoom+’s Sanders welcomes the competition and sounds a confident note.

“We’ve all done analytics on what we think the population base and demand is,” Sanders said. “It isn’t like they’re all equivalent, any more than all restaurants are. Some are As, Bs and Cs. Some will be successful and others less so. Probably there will be a period where folks come into the space and leave.”

He is also quick to highlight that Zoom was early to the game and that he believes that vision gives it a clear edge when it comes to market share.

“Most health care companies don’t have an original strategy or original thought about how the world is going to go,” he said. “They’re saying, ‘Who’s succeeding, who can I copy?’ For 10 years, they said, ‘That’s not going to work.’ We pointed to the light — neighborhood-based (care) — so they’re saying, ‘That’s interesting, I’ll do it too.’”

Ironically, Zoom is the one provider in these center wars that’s taking a pause, after a flurry of new locations last year. Now its focus is on serving demand for digital care.

“We’re going to focus on what we do well,” Sanders said. “We’re not in a race.”

An urgent need

On-demand centers are growing rapidly nationwide, according to Urgent Care Association of America:

  • 7,100: The number of urgent care centers nationwide.
  • 91%: The percent of urgent care centers nationwide that anticipated patient-visit growth in 2015.
  • 66%: The percent of urgent-care patients that have a primary care doctor.
  • 37%: The percent of urgent care centers that are hospital-owned or in a joint venture with a hospital.
  • 34%: The percent of urgent care centers that are located in shopping centers and strip malls.
  • 2%: The percent of urgent care center patients who required diversion to the ER/

9 Dehydrations Symptoms & Signs

Source: Self

By Amy Marturana

April 3, 2016

It may be time to make that water pitcher a permanent desk fixture.

It’s important to drink water. Over half our bodies are made up of water, and it’s necessary to keep...

9 Dehydrations Symptoms & Signs

Source: Self

By Amy Marturana

April 3, 2016

It may be time to make that water pitcher a permanent desk fixture.

It’s important to drink water. Over half our bodies are made up of water, and it’s necessary to keep us running. Whether you’re throwing back a bottle-full, or eating water-filled foods (ideally both), getting enough fluids in one way or another is essential for survival. 

Kelly Pritchett, Ph.D., exercise physiologist and assistant professor in nutrition and exercise science at Central Washington University, tells SELF that the body does a pretty good job of maintaining fluid balance under normal circumstances. You pee when you have too much water, and get thirsty when you need more. But there are actually a handful of other ways your body says “I need hydration!” that you might not recognize.

The good news is that this mild dehydration is pretty easy to reverse if you just diligently drink more water. Here are some of the signs you may be dehydrated and need to drink more H2O ASAP.

1. Your mouth and lips are dry.

When you’re dehydrated, saliva production decreases, leaving your mouth and lips feeling dry. Dry mouth can also make your breath stinky, because bacteria has the chance to linger longer when it’s not being washed away on the reg.

2. Your pee is dark.

The color of your pee can tell you a lot about your health. Healthy, hydrated pee should be light yellow or clear, a sign that it’s properly diluted. If yours is medium yellow, dark yellow, or orange, it’s likely because your body isn’t getting enough water so your urine is more concentrated, Robert Korn, M.D., medical director of GoHealth Urgent Care in the New York area, tells SELF. Less water intake also means you’ll have to go less often, too.

3. Your energy levels are low.

“The defense mechanism of the body in the face of dehydration is to shut down blood supply to ‘non-vital’ organs,” Korn explains. This means the rest of your body, and your muscles specifically, may start to operate at a slower pace, making you feel sluggish and sleepy.

4. You have a headache.

The exact way dehydration causes a headache isn’t known. But experts believe that when hydration levels drop, so does blood volume, which leads to lower blood flow to the brain. This reduces the brain’s oxygen supply and causes the blood vessels to dilate, leading to headaches and even lightheadedness. 

5. You don’t have enough tears.

Similarly to saliva, the amount of tears you have can actually decrease if your body is using every last drop of water to support its basic functions. If your eyes are dry, or just not producing much liquid when you’re crying, it could mean you’re dehydrated.

6. Your skin is dry.

Water is essential for plump, hydrated skin. When your body’s tank is low, and using all the water available for basic functions, your skin gets the short end of the stick. Over time, it can lead to dryness. 

7. You get muscle spasms or “Charley horses.”

You know those super painful muscle spasms that wake you up in the middle of the night after your whole calf seizes up? They typically occur when a muscle is overused, and exercising when your fluid levels are low can spark one. 

8. Your body is cramping.

There are lots of things that can cause cramping, and muscle fatigue is the most likely culprit. But another type of cramping has been connected to dehydration and a sodium deficit in the body. “Exertional heat cramping, or full body cramping, may be related to sodium depletion and fluid loss especially in individuals who are ‘salty sweaters,'” Pritchett says. In this case, sipping on an electrolyte sports drink can be helpful to restore the natural mineral balance in the body.

9. You feel hungry even after you just ate.

Thirst and hunger cues come from the same part of the brain, so it’s easy to confuse the two. If you feel hungry even when you know you’ve eaten enough, there’s a good chance your body’s actually telling you it needs water, not food.

Important note: The following symptoms could be a sign of severe dehydration: rapid heartbeat or breathing, sunken eyes, fever, confusion, or delirium. If you experience any of these, go to the hospital.

Legacy-GoHealth brings streamlined urgent care

Source: Portland Tribune 

By Kelsey O'Halloran 

April 1, 2016

Stepping into Southwest’s new Legacy GoHealth Urgent Care facility doesn’t feel like walking into a doctor’s office. 

The bright interior, contem...

Legacy-GoHealth brings streamlined urgent care

Source: Portland Tribune 

By Kelsey O'Halloran 

April 1, 2016

Stepping into Southwest’s new Legacy GoHealth Urgent Care facility doesn’t feel like walking into a doctor’s office. 

The bright interior, contemporary design and simple check-in system offer an experience much more like that of a retail store than of an urgent care center. 

But the facility, located at the intersection of Southwest Barbur Boulevard and Southwest Terwilliger Boulevard, does offer high-quality medical care — in an easy-to-access center that’s closely tied to Legacy Health’s larger system of hospitals across the Portland and Vancouver area. 

“There’s such a great community in this area that we think has been underserved by urgent care,” says Dr. Gregory Carroll, medical director and market president for Legacy-GoHealth’s network of urgent care facilities. He calls the new center, which opened Feb. 1, “a community access point to the full spectrum of Legacy’s care.” 

If a patient comes into the urgent care center with a broken leg, Carroll says, the center staff can provide basic treatment and bring a mobile X-ray machine right into the exam room to take a closer look. Within the same day, the patient’s Legacy Health primary care doctor could look at the X-ray and provide feedback, because the center shares Legacy Health’s medical records system. 

The center provides services for non-life-threatening illnesses and injuries — with no appointment necessary — and can also transport patients to a Legacy hospital for more extensive treatment. 

It’s the 11th such center in the Pacific Northwest as the result of a partnership between Legacy and GoHealth Urgent Care. 

Modernized care 

When patients enter the urgent care center, they’re directed to check in at a tablet station by the door. As they sit down to wait, a wall-mounted screen will show them their expected treatment time. Carroll says prospective patients can even check the Legacy-GoHealth website before coming to the center to compare the wait times at various centers around the Portland metro area and choose the one that suits their needs. 

The four exam rooms are about 108 square feet each — large and open enough to accommodate several friends or family members who may come in with a patient. While the rooms are walled in glass to provide an open and modern feel as patients come into the facility, the “smart glass” becomes opaque with the flick of a switch to provide complete privacy during the exam. 

Carroll says the facility’s design — which also includes curved architecture, “calming tones” and “healthy lighting” — is all about making patients feel comfortable and healthy so that they can heal more quickly. 

“There’s a lot of research on how environments can affect healing,” he says. “People’s sense of touch, smell, light and design can really affect their sense of wellness.” 

Southwest’s Legacy-GoHealth Urgent Care center is located at 7461 S.W. Barbur Blvd. The center is open 8 a.m.-8 p.m. on weekdays and 9 a.m.-5 p.m. on weekends. For more information, call 971-202-2099 or visit gohealthuc.com/legacy.

Creating Competition Through M&A In The Healthcare Field

Source: The Ambulatory M&A Advisor

By Richard Romero

December 2, 2016

 

Linda Fleming, partner with the law firm Carlton Fields confirms that in fact, the healthcare market is very competitive.  According to Fle...

Creating Competition Through M&A In The Healthcare Field

Source: The Ambulatory M&A Advisor

By Richard Romero

December 2, 2016

 

Linda Fleming, partner with the law firm Carlton Fields confirms that in fact, the healthcare market is very competitive.  According to Fleming, as more players enter the market, providers need to distinguish themselves to retain current patients and acquire new ones.  She explains this is also important when contracting with managed care companies.  Providers in the field need a critical mass to get their attention.

“Establishing sustainable competitive advantage and differentiation for your business is at least as important in healthcare as it would be in any other industry.  This is due in part to the fact that most healthcare service lines have multiple scaled competitors in each market and patients are presented with a greater number of options and alternatives.  Ensuring that your patients recognize and value your distinct competitive advantage is becoming more critical as patients transform themselves into educated healthcare consumers with much higher expectations for service and transparency. Creating competitive advantage can both support your growth and enable you to make longer term investments with confidence,” Todd Latz, CEO of GoHealth Urgent Care says.

Fleming adds that she believes that having a competitive advantage in the industry is not only beneficial for the physician owners, but for the patients visiting centers as well.

“If the advantage is having multiple locations, then these companies offer increased convenience to their patients.  The competitive advantage might be enhanced Electronic Health Records and participation is an health exchange, thereby allowing all of the patient’s providers to access the patient’s up-to-date medical history.  Or it could be offering a full line of services, so it makes it easy for your patients to fulfill all of their health care needs with your company and its affiliates,” Fleming says.

“At some point, size could be a disadvantage, such as when antitrust prohibitions come into play.  But size does matter, and for the most part, the more dominant you are, the better opportunities you have.”

Latz does not believe there is a dominant player in urgent care today.  However, when discussing the topic of  it being possible to be “too large” in a market, he says that is theoretically possible.

“It really depends on your operating model, competitive advantage and whether the additional locations are accretive and sustainable,” Latz says.

On the topic of patients benefiting from competition, Latz says there is no question that patients can and should benefit from this competitive advantage.

“Whether it is a unique partnership model that provides greater access to the entire healthcare continuum and a higher level of clinical quality, technical innovation that redefines convenience and access, or a patient-first focus that delivers a seamless and restorative experience – competitive advantage and differentiation must present clear value to patients and deliver on (or exceed) their expectations,” Latz says.

Latz adds that there are a number of reasons to consider an acquisition of an existing center, including:

  • Faster new market entry
  • Accelerating growth by expanding your existing network or increasing market share
  • Adding clinical or operational talent
  • Obtaining more mature operating assets and established volume
  • Tapping into new partnership and collaborative opportunities

When approaching a transaction opportunity, Fleming says the strategic plans that a company may have for the deal is critical to offer multiple entry points.

“By adding new locations, the company is likely to expand its patient base, which in turn gives it more leverage when negotiating managed care contracts.  It may also provide the opportunity to expand service lines or enhance the existing company’s reputation,” Fleming says.

On the strategic point, Latz says would-be buyers may be looking to enter a new market, increase their presence and scale in an existing market, add a new service line or simply, take advantage of synergies or enhance their presence and relevance to payors.  An acquiror’s strategic plans would be dictated by what they are looking to achieve through the transaction.

When asked on when a good time to expand is in the market, Latz shares his thoughts.

“I believe you simply have to be opportunistic, as perfectly timing your growth can be tricky.  De novo growth is certainly easier to manage from a timing perspective, but growth through acquisition is much harder to manage, since the market may present a unique opportunity at a different time than you might have hoped for or projected.  You should also consider the cultural implications and amount of work it may take to transform or align an acquired business with your own unique model,” Latz says.

Fleming says that in her belief, growth for growth’s sake is rarely advisable.  Rather it should be part of a comprehensive strategic plan and should be done when the Company has the necessary resources to do so.

“This would include management and financial resources.  However, sometimes opportunities present themselves.  If the opportunity fits into your strategic plan, you might need to react immediately, even if you planned to do it a year or two later,” Fleming says.

Another way that M&A can create competition directly through the sales process is through an auction.

Lisa Taylor, partner with Webster, Wyciskala, and Taylor says that she is certainly seeing an increased trend in auctions throughout the healthcare industry that are increasing competition via M&A.

“If you would have asked me about an auction a year ago, I would have thought of an auction in a completely different context, like selling art work.  What I am really seeing is that they are increasingly being used where a substantial portion of the value of the selling organization is franchised to provide services; particularly in areas where for regulatory reasons, you can’t get into the market anymore,” Taylor says.

“That’s really the big thing.  CMS has put into place a number of moritoriums for a number of services like durable medical equipment, home health, and other services in various places across the country.  There are increasingly tight barriers to entry for services and to facilities that may not previously have had barriers to entry.

The only access to the market is by acquiring an existing organization, or in some cases, approval for an organization that has not been developed yet.  That license is what is really most valuable.  The selling organization wants to maximize the value for the current owners so an auction makes a lot of sense in terms of trying to maximize that value.  In some cases it is a good way to be able to entertain perspective bidders and to try and get offers, competition, and get purchasers to try to turn around a deal pretty quickly.”

Customer Loyalty Is Spelled N-P-S

Source: Entrepreneur Online

By Todd Latz

July 8, 2016

Superior customer loyalty is critically important for any successful business. However, many leaders struggle with how to effectively measure it. How loyal are your custom...

Customer Loyalty Is Spelled N-P-S

Source: Entrepreneur Online

By Todd Latz

July 8, 2016

Superior customer loyalty is critically important for any successful business. However, many leaders struggle with how to effectively measure it. How loyal are your customers? What are they saying about your products or services to others? Do they promote you to others and provide an incredibly valuable word-of-mouth endorsement? To answer these questions, we look to Net Promoter Scores (NPS). NPS is a relatively simple measurement tool that helps businesses gauge how likely their customers are to refer family members and friends to their products or services. NPS is also a leading indicator, and when used optimally, it can be a predictor of future customer engagement and growth. Since NPS allows for real-time measurement of customer satisfaction, it allows management to take immediate action to improve operations based on customer feedback.

Related: Analyzing the Science Behind Customer Loyalty

How NPS works.

After purchasing your product or service, your customers are asked one question: “how likely are you to recommend our company/product/service to a friend or family member?” The customer responds on a scale from 0-10. Scores of 9 or 10 are considered “Promoters” -- satisfied customers who are more likely to continue buying your products or services and to recommend you to their friends and family. Scores of 0-6 are considered “Detractors” -- unsatisfied customers who are more likely to complain about a negative experience or speak poorly of your brand. Scores of 7 or 8 are considered “Passives” -- satisfied customers who are not enthusiastic enough to actively promote, and may try a competing offering next time. To calculate a NPS rating, you subtract the percentage of Detractors from the percentage of Promoters. Passives are part of the denominator and thus do not help your score.

A NPS of 50+ is excellent, and leading consumer brands, such as Costco, USAA insurance and Nordstrom routinely score in the high 70s and enjoy fierce customer loyalty. Healthcare companies typically have been slower to adopt NPS as a measure of patient loyalty, and when they have, their NPS ratings have often been poor. National NPS averages for the healthcare industry are as low as just 17 and are often the result of access issues, long wait times, and a focus on their own, rather than their customer’s convenience. However, there are exceptions, especially where there is an intense focus on customer experience. At GoHealth Urgent Care, by making our patients and the quality of their care our highest priority, we have routinely achieved NPS ratings of 90. 

Related: 25 Tips for Earning Customer Loyalty

What to know before implementing NPS.

Most companies want to understand their customers better, but many are reluctant to open the door to negative feedback. You need to embrace the feedback -- if your customers have a bad experience, they are going to tell others about it, and it is imperative for you to hear this feedback so that you can set the course for positive change.

How to implement NPS.

You can implement NPS through phone, email or internet. Our GoHealth Urgent Care patients receive an NPS query via text message shortly after visiting a center. Our patients can then respond and have the option to leave a comment for their clinician. This simplicity ensures a higher response rate and supports an effortless patient experience.

How to boost NPS ratings.

Excellent customer service begins with your team. When your team is passionate, energetic and focused on a singular purpose or customer promise (for GoHealth Urgent Care it’s “we put you first”), that positivity permeates your customers.

Look for ways to make customers’ experiences more personal. We have found that introducing yourself every time better connects patients to their clinical team, makes them more likely to express any concerns during their visit (instead of after they leave on social media) and results in high NPS ratings. The lasting impression made during a customer’s final few minutes at your store/center is incredibly important.

Related: 3 Ways to Increase Customer Loyalty

A leading indicator for future success.

Utilizing NPS to measure your effectiveness from your customer’s perspective can be invaluable. NPS ratings can be broken down by department, product, store or even individual team member to gauge what is working, and what needs improvement. NPS also helps set clear goals for improving the customer experience. Our industry-leading NPS ratings have given us concrete, real-time, actionable data to measure and confirm that we are delivering on the promises we make every day to our patients. Positive NPS ratings indicate satisfied, loyal customers who are much more likely to tell their friends, neighbors and family about their exemplary experiences -- the best possible endorsement for any brand. 

8 Signs You Might Not Be Spending Enough Time Outside

Source: Bustle

By Carina Wolff

July 19, 2016

Most of us spend the majority of our days cooped up at our desks, and we don't get to spend much time outside. However, spending time in nature can have profound health effects, an...

8 Signs You Might Not Be Spending Enough Time Outside

Source: Bustle

By Carina Wolff

July 19, 2016

Most of us spend the majority of our days cooped up at our desks, and we don't get to spend much time outside. However, spending time in nature can have profound health effects, and if you're inside too often, you may be exhibiting some signs that you aren't spending enough time outside. Not only does spending time outdoors usually include a little bit of exercise, but it can help calm our minds and even improve our physical health.

"Spending time outside is important as it produces natural Vitamin D and mood-enhancing hormones," says Dr. Nikki Martinez, Psy.D., LCPC over email. "Spending time outside gets us active, involved, one with our surroundings, and with others, compared to staying holed up in the house."

Getting outside doesn't always have to mean spending a whole day at the beach, as even just 15 to 20 minutes outside can have invigorating effects on the mind and body. And if you are outside, you want to make sure you're taking the proper care to protect your skin from the sun.

That being said, it's definitely not healthy to keep yourself holed up all day in fear of seeing the light. If you suspect you are staying indoors too often, consider these eight signs that you need to get outside more.

1. Your Vitamin D Is Low

If you get blood work done and your vitamin D levels are low, it's time to get outside. "Vitamin D is manufactured in your skin when exposed to sunlight," says Dr. Debra Brooks, Physician at Northwell Health—GoHealth Urgent Care. "You do not need to bake in the sun and risk cancer, but 15 minutes a day outside is a healthy way to keep your levels up, and you can't develop toxicity this way like you can from ingesting too much."

2. You're Pale Compared To Those Around You

No one's saying you need to have a tan (hello, sun protection!), but if you are particularly pasty compared to your peers, you may want to spend just 10 minutes or so outside — with sunscreen, of course. "Some amount of sun exposure can be healthy, including increased levels of vitamin D," says Dr. Larry Burchett over email.

3. You're Spending Too Much Time In Bed

We all need a TV binge-watching day here and there, but if this is becoming a regular habit, it's time to consider heading out the door. "If you would rather watch a Netflix marathon than enjoy a night out with friends, you may want to check your priorities and your healthy choices," says Martinez. "Think about what is best for you and your well being."

4. You're Anxious

If you're feeling stressed or anxious, you may want to spend a little more time in nature. "We know that sunlight has a positive effect on the serotonin neurotransmitters that restore healthy moods," says psychologist Jeanette Raymond, Ph.D. over email.

5. You Feel Socially Isolated

It's easy to feel alone when you aren't getting any social interaction besides your roommates. "Being outside puts you in touch with your neighbors, dog walkers, trees, and grass," says Brooks. "We spend so much time planning ahead or looking at our pasts, both of which can produce significant anxiety. Being outside facilitates our ability to be in the present moment."

6. You Have Joint Pain

"If you are noticing more pains in general, and you have been less active, you may be able to feel better by exercising and releasing some endorphins into your bloodstream," says Burchett. Adequate vitamin D is also needed for bone health, so a lack in the nutrient can cause achiness and stiffness.

7. You Have Stomach Issues

That stomach ache may come from being too sedentary. "Gastric troubles like constipation, bloating, cramping etc. are all eased by walking in natural surroundings," says Raymond. "Nature takes your eye off the discomfort, and by synchronizing your bowel movements to that in nature, you will feel lighter, and restored to better gastric functioning."

8. You're Fatigued

"Pay attention to energy levels, both at the end of the day, and day to day," says Burchett. A series of studies from the Journal of Environmental Psychology found that being outside in nature makes people feel more alive and energetic.

Just like with other aspects of our health, there should be a healthy balance of spending time inside and outside.

Zika Virus: What Families Need to Know

Source: Six Degrees of Mom

By Dr. Neal Shipley

June 16, 2016

 Expert Advice from Dr. Neal Shipley, Regional Medical Director, Northwell Health-GoHealth Urgent Care

What we know about ZikaThe most common way ...

Zika Virus: What Families Need to Know

Source: Six Degrees of Mom

By Dr. Neal Shipley

June 16, 2016

 
Expert Advice from Dr. Neal Shipley, Regional Medical Director, Northwell Health-GoHealth Urgent Care

What we know about Zika
The most common way for people to contract Zika is through bug bites from infected mosquitos. Partners can also give one another Zika if intimately involved, so be sure to get a screening if a spouse or partner has recently traveled to a high-risk area. To date, there are no reports of infants contracting the Zika virus through breastfeeding. Because of the benefits of breastfeeding, mothers are encouraged to breastfeed even in areas where Zika virus is found.Most people who contract Zika virus do not show any out-of-the-ordinary symptoms and are unaware that they have been infected. Zika usually remains in the blood of an infected person for about a week to 10 days. Once a person has been infected, he or she is unlikely to get Zika again.

What we don’t yet know about Zika
There is no vaccine or medicine to effectively eliminate Zika and the medical community still has a lot of learning to do about the virus. Unfortunately, there are still many uncertainties in terms of exactly how and when the virus passes from mother to baby, its impact on the developing infant in the womb and long-term health outcomes for those who have been infected. We do not yet have statistics on how common it is for a pregnant woman who has contracted Zika to pass Zika on to her unborn baby or how common it is for a new mother to pass the virus on to her newborn baby at the time of delivery. We’re also not yet sure whether the severity of a woman’s symptoms will affect her pregnancy. Last, we’re still not sure what the long-term health outcomes are for infants and children who have contracted Zika.

What are the symptoms of Zika?
Most people who are infected with Zika do not even know they have the virus because they don’t have any symptoms or the symptoms are very mild. In other words, people usually don’t feel sick enough to go to the hospital when they first contract the virus. The most common symptoms of Zika are fever, rash, joint pain and red eyes (conjunctivitis). Other common symptoms include headache and muscle pains. These symptoms usually go away within a few days to one week.

The exact incubation period (the time from exposure to symptoms) for Zika is not known, but we estimate that this is likely to be a few days to a week. See your doctor or other healthcare provider immediately if you are pregnant and develop a fever, rash, joint pain, or red eyes within two weeks of traveling to a place where Zika has been reported.

What if I am pregnant or might get pregnant?
Zika can be passed from a woman to her unborn child during pregnancy or around the time of birth. Cases of pregnancy loss and other pregnancy-related complications have been reported in women infected with Zika during pregnancy.

Babies born to women infected with Zika during pregnancy have been reported to have birth defects as well as other problems. Recently, the CDC concluded that Zika virus infection during pregnancy is a cause of microcephaly – a birth defect which causes a baby’s head to be smaller than expected when compared to babies of the same sex and age.

Zika has been linked with other birth defects as well, including eye defects, hearing loss, and impaired growth. However, it is important to note that not all babies whose mothers had Zika during pregnancy are born with health problems. Women who are infected with Zika virus later during pregnancy, in the third trimester and around the time of birth, are less likely to have a baby born with microcephaly.

Are there risks for future pregnancies?
Based on the available evidence, the CDC does not think that women who contract Zika before becoming pregnant are at risk for future pregnancy complications, as long as the virus has cleared from the bloodstream before conception. Nor do they think that babies born to mothers who once had Zika are at risk for Zika-related birth defects. From what we know about similar infections, once a person has been infected with Zika, he or she will most likely be protected from a future Zika infection.

Do I have to worry about traveling in the U.S. this summer?
There have been no reported cases of anyone getting Zika from a mosquito in the U.S. (except Puerto Rico) but there have been cases which people who contracted the virus while traveling abroad came back to the New York City area with the virus. No local mosquito-borne Zika cases have yet been reported in U.S. However, given the recent outbreak of Zika, the number of Zika cases among travelers visiting or returning to the U.S. will likely increase. These imported cases could result in local spread of the virus in some areas of the U.S.

What can I do to protect my family against Zika?
Prevent mosquito bites.

  • Use Environmental Protection Agency (EPA)-registered insect repellants with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol. Choosing an EPA-registered repellent ensures the EPA has evaluated the product for effectiveness. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breast-feeding women.
  • Dress your child in clothing that covers his/her arms and legs.
  • Cover your crib, stroller, and baby carrier with mosquito netting.
  • Do not use insect repellent on babies under 3 months of age.
  • Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years old.
  • In children older than 3 months, do not apply insect repellent onto a child’s hands, eyes, mouth, or to irritated or broken skin.
  • Never spray insect repellent directly on a child’s face. Instead, spray it on your hands and then apply sparingly, taking care to avoid the eyes and mouth.
  • Treat clothing and gear with the insecticide permethrin or purchase permethrin-treated items.
  • Treated clothing remains protective after multiple washings. See product information to learn how long the protection will last.
  • If you are treating items such as clothing or gear yourself, follow the product instructions carefully.
  • Do NOT use permethrin products directly on skin. They are intended to treat clothing.
  • Control mosquitoes inside and outside your home.

What should I do if my child has symptoms?If your child has symptoms, take him or her to see a doctor or other healthcare provider.
If you or a loved one starts displaying Zika symptoms after traveling to an affected area, such as fever, rash, joint pain, or red eyes please contact a health care provider immediately and describe where you have traveled. Fever (more than 100.4° F) in a baby less than 3 months old always requires evaluation by a medical professional. If your baby is less than 3 months old and has a fever, call your health care provider or immediately seek medical care.

The CDC provides updates on Zika regularly, as does the NYS Department of Health (DOH). Please check the Center for Disease Control and Prevention (CDC) or the DOHhttps://www.health.ny.gov/diseases/zika_virus/ for more information. 
The DOH also has a Zika hotline: 1-888-364-4723, available Monday – Friday (9 a.m. to 5 p.m.)

About Dr. Neal Shipley
An emergency physician for more than 20 years, Dr. Shipley is board certified in Emergency Medicine and practices medicine in Northwell Health-GoHealth Urgent Care centers. He has served as chairman of the Department of Emergency Medicine at New York City’s North General Hospital and the Jersey City Medical Center. He was assistant professor of Emergency Medicine at the Mt. Sinai School of Medicine and director of quality and patient safety for the Department of Emergency Medicine at New York Presbyterian Hospital. He is a graduate of Princeton University and the Albert Einstein College of Medicine. A father of three boys, Dr. Shipley understands the need for urgent care without the long wait and high cost of emergency rooms.

About Northwell Health-GoHealth
At Northwell Health-GoHealth Urgent Care, we place the needs of our patients first – by providing an effortless patient experience, a welcoming culture of care and seamless integration with Northwell Health’s electronic medical records. Northwell Health-GoHealth Urgent Care’s network has developed new urgent care centers across the greater New York area, spanning Long Island, Queens, Westchester, Staten Island and Manhattan. Northwell Health-GoHealth Urgent Care network currently includes 23 centers, with plans to open 15 more by the end of 2016. The centers combine GoHealth Urgent Care’s award-winning and inviting facility design with Northwell Health’s best-in-class, quality providers. All of Northwell Health-GoHealth Urgent Care’s centers operate seven days a week with extended evening hours and welcome walk-in patients, with the opportunity to “save your spot” by checking-in online. Each center features x-ray equipment and a lab, combined with an integrated electronic medical record system that can be accessed by caregivers across Northwell Health. To learn more, please visit: www.gohealthuc.com/northwell

Why You Should Avoid Taking Ibuprofen When You’re Drinking

Source: SELF Online

By Amy Marturana

June 22, 2016

Pain relievers like Advil (ibuprofen) and Tylenol (acetaminophen) can have some dicey effects when mixed with alcohol.

Lots of medications come with the warning to av...

Why You Should Avoid Taking Ibuprofen When You’re Drinking

Source: SELF Online

By Amy Marturana

June 22, 2016

Pain relievers like Advil (ibuprofen) and Tylenol (acetaminophen) can have some dicey effects when mixed with alcohol.

Lots of medications come with the warning to avoid alcohol when you’re taking them. Antibiotics are a tough one to accept, especially if you’re not feeling particularly sick from what ails you. But reading the labels on pain relievers like Advil (ibuprofen) and Tylenol (acetaminophen) and learning that severe side effects are more likely when you mix them with booze feels downright torturous—especially when your head is pounding and popping a few pills promises sweet relief.

The warnings aren’t there just to taunt you, though. In fact, ibuprofen, acetaminophen, and even aspirin, come with potential dangers if you make a habit of taking them with alcohol. “All have risks if you take them, period, as do all medications, but the risks for all three increase if you take them when you drink,” Debra E. Brooks, M.D., an urgent care physician at GoHealth Urgent Care, tells SELF. This goes for immediately post-imbibing, too, when you’re trying to preemptively treat the hangover-induced headache you know will hit in the A.M.

Ibuprofen is a NSAID, or non-steroidal anti-inflammatory drug. It works as a pain reducer and, you guessed it, also reduces inflammation. The most concerning side effect is that ibuprofen can cause irritation in the lining of the stomach that can lead to ulcers and bleeding, sometimes without warning. Alcohol on its own is a known irritant to the stomach lining and can cause ulcers in heavy drinkers, so and adding ibuprofen into the mix can compound the effects. Ibuprofen can also be toxic to the liver and kidneys, and though it isn’t a blood thinner, may alter how blood coagulates, either to form clots more easily or to cause easier bleeding, Brooks says.

Your other go-to option is probably acetaminophen, or Tylenol. “It’s completely different, and its analgesic effects have a different mechanism,” Brooks says. It doesn’t affect your blood’s clotting abilities nor does it hurt your stomach lining. But acetaminophen is more toxic to the liver and more often associated with liver failure—often and without warning, Brooks notes—than NSAIDs. When you’re drinking, you’re already sending a toxic substance to your liver and making it work overtime to filter it out. Adding acetaminophen puts additional, overwhelming stress on the organ, increasing the risk of damage.

Aspirin is also a NSAID, and additionally, works as a blood-thinner. “It is an anti-platelet medicine, which means it makes it harder for blood to clot,” Brooks says. That’s why it’s sometimes recommended as preventive medication for those at high risk of heart disease. Its effects on the liver and kidneys are similar to ibuprofen, and it can also cause bleeding in the GI tract. “Alcohol multiplies the blood-thinner effects of aspirin, and heavy drinkers are already at risk of bleeds due to previous damage to the stomach and liver, so they are at far greater risk of bleeding.”

There is some good news: If you’re relatively healthy, and have no existing problems like gastritis or ulcers, or issues with your kidneys or liver, “taking any of these if you are going out to dinner and having one drink is most likely safe,” Brooks reassures. If you have a choice, you probably want to reach for NSAIDs over acetaminophen, which is the worst for your liver. Food also buffers the effects of both alcohol and NSAIDs, so eating something at the same time can help mitigate potential side effects. But if you’re drinking heavily, it might not be so safe. “Again, this depends on the genetic make up and the prior history of the person imbibing. In a certain way, it’s Russian roulette. It’s not a problem, until one day it is,” Brooks says.

When it comes to the morning after, it’s unclear how much of a risk remains because it’s dependent on so many factors including how much the person drinks in general, and how much alcohol is still in their body.

If you have to take pain medication during or after imbibing, curb your drinking to be safe. If you’re popping pills in anticipation of the morning after, it’s best to prevent a hangover the old-fashioned way: by chugging lots of water. Or just don’t drink enough to be hungover in the first place. 

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