Author Archives: Trudy

Small Doses of Nature Can Lead to Big Health Benefits

Many people believe that being outdoors in nature is good for them, and research backs that up. But what “dosage” of nature is needed for good health?

Two recent studies show that just ten minutes of exposure to nature, two to three times per week, provides real health benefits. And you don’t have to visit the wilderness to get the good effects; short nature “time-outs” can happen in small, urban green spaces or even your backyard.

The studies were conducted by Mary Carol Hunter at the University of Michigan and Marc Berman of the University of Chicago. The studies are part of a larger body of research supported by the TKF Foundation, which funds projects across the country integrating the design of urban green spaces with research on user benefits. TKF has funded the creation of more than 130 publicly accessible, urban green spaces, and seeks to prove that green spaces provide health benefits through contemplation and restoration, with the goal of influencing city planning and design.

Hunter’s study had subjects immerse themselves in nature and answer questions before and after about their mental well-being on a mobile app. The digital entries were correlated with participants’ cortisol levels in saliva, an indicator of stress. After being exposed to nature for just ten minutes, two to three times a week, participants reported having significantly less stress, improved ability to focus, and increased satisfaction with their mood and energy levels. Also, benefits were greater in residential landscapes or small parks.

In Berman’s study, subjects were asked to take a 2.5 mile, 50-minute walk through either a dense urban environment or an arboretum. Afterward, they were given memory tests to measure their ability to concentrate or focus. Those who walked through the arboretum had a 20 percent improvement in working memory over the other group.

The two researchers are still working to answer questions such as how senses other than sight might influence health benefits, and which features of nature create a sense of well-being and improve one’s ability to concentrate. However, their studies make a strong case that exposure to nature, even in small doses and in urban settings, makes you feel better. And that’s an important part of good health.

Dr. Ashbeck is an MPCP partner and sees patients in the Pasadena office. Certified by the American Board of Family Medicine, he received his medical degree from Georgetown University School of Medicine and completed his residency program in Family Practice at Memorial Medical Center.

Is Zika coming to Maryland?

A Q & A by: Jerry Levine, M.D., FACP, MPCP Medical Director

Q: What is Zika?

A: Zika is a virus spread mainly by Aedes aegypti mosquitoes, a species found in Maryland and many other states. These mosquitoes, when they bite people infected with Zika virus, become disease carriers and spread the virus by biting other people. In some cases, Zika can also be transmitted between sexual partners.

Q: Where does Zika come from?

A: Before 2015, Zika virus outbreaks occurred in areas of Africa, Southeast Asia, and the Pacific Islands. Since then, Zika has spread to parts of South and Central America, Mexico and the Caribbean.

See which countries have reported Zika: http://1.usa.gov/1Qq5Iow

Q: Is Zika in Maryland?

A: At the time this article was written, there were dozens of confirmed cases of Zika virus in Maryland, but all of those people were infected while traveling overseas. So far, no one has gotten Zika in Maryland, but the imported cases may result in local spread of the virus.

See Zika cases in the U.S.: http://1.usa.gov/1PiUIcc

Q: Are people with Zika contagious?

A: At this time, the Zika virus is not believed to be airborne and is not primarily spread from person to person, which means there’s little to no risk of becoming infected with the virus from simply being near an infected person. However, Zika can be transmitted sexually.

Q: How dangerous is Zika?

A: Most people infected with Zika virus won’t experience any symptoms or will only have mild symptoms. Common symptoms include fever, rash, joint pain, muscle pain, headache or conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week. Hospitalization is rarely needed, and so far there have been only two deaths from Zika reported in the U.S. – an elderly man with other health issues and a baby born infected with the virus.

The main danger from Zika is that pregnant women can pass it to their unborn children. The CDC has confirmed that the virus can cause severe defects in unborn children, including microcephaly, which leaves babies with abnormally small heads and often with brains that do not develop properly. The CDC strongly advises that women who are pregnant or plan to become pregnant soon don’t travel to Zika-infected areas.

Q: If Zika comes to Maryland, what can I do?

A: There is no medicine or vaccine to prevent or treat Zika virus disease, so prevention is key. If Zika is reported in Maryland, take these steps to protect yourself and your family:

Use insect repellents containing DEET, picaridin, IR3535, para-menthane-diol, and lemon eucalyptus oil.
When weather permits, wear long-sleeved shirts and long pants.
Use air conditioning or window/door screens to keep mosquitoes outside.
Aedes mosquitoes typically lay eggs in standing water, so empty water from containers outside your home such as buckets, bowls, bird baths, flower pots, old tires and vases.

Q: What should I do if I think I have Zika?

A: The risk of getting Zika is presently very low in Maryland. However, if you travel to an area with Zika and develop a fever, rash, joint pain, or red eyes within two weeks of returning, see your doctor. Be sure to tell your doctor where you traveled. Zika can’t be cured, but your symptoms can be treated to make you more comfortable.

Dr. Levine is an MPCP partner and sees patients in the Columbia office. He received his medical degree from New York Medical College, completed his residency program in Internal Medicine at University of Maryland Medical Center, and is certified by the American Board of Internal Medicine. Dr. Levine currently serves as MPCP’s Medical Director and Vice President.

HealthWise – Spring 2016 Emergency Room, E-cigarettes & Exercise For Disease

Welcome to the spring edition of HealthWise In this issue of the Maryland Primary Care Physicians e-newsletter, our providers discuss when you should go to the emergency room (and when you shouldn’t), new concerns about e-cigarettes, and treating disease with exercise. Please read on and feel free to share these health tips with friends and family.

In this issue: Emergency Room | E-cigarettes | Exercise for disease

What to do? ED vs. urgent care vs. doctor’s office
By: Jamie Harms, M.D.

Having an illness or injury often results in a good deal of anxiety and worry. You want medical attention and relief from your symptoms as quickly as possible. But where should you go to get the best, most appropriate and cost-effective care? The following are the most widely used treatment options and suggestions about when each might be best suited to meet your particular medical needs.

Not so safe: New evidence on e-cigs

By: Patricia P. Jett, M.D.

When e-cigarettes were introduced in the U.S. in 2006, they were promoted as a safer alternative to smoking. Users inhale nicotine-infused vapor, without the mix of carcinogenic chemicals found in regular cigarettes.E-cigarettes and vaporizers (which produce large, fluffy clouds of vapor) have gained popularity among current and former smokers, as well as those who have never smoked, including teenagers…

Rx: Treating disease with exercise
By: Harriett Neverdon, FNP-C

The next time your doctor reaches for his prescription pad, don’t be surprised if he recommends exercise instead of medication. A growing number of healthcare providers are encouraging patients to think of physical activity as their new medication.A study published in the British Medical Journal found that exercise affects outcomes for some serious medical conditions about equally as well as prescription drugs…

MPCP News:

Did you know MPCP offers:

DOT exams: The U.S. Dept. of Transportation (DOT) requires drivers of commercial motor vehicles to get physical examinations. MPCP has NRCME-certified clinicians in our Arnold, Arundel Mills and Pasadena locations, so if you need a DOT exam, please contact us to schedule it.

Medicare Part B (medical insurance) ‘wellness’ visits: If you’ve had Medicare Part B for longer than 12 months, you are entitled to an “Annual Wellness” screening visit. Your MPCP provider will help you develop or update a personalized prevention health plan. This visit is covered once every 12 months (11 full months must have passed since the last visit), so contact your MPCP office to schedule an appointment.

Botox cosmetic and migraine services: Reduce facial lines, frowns and wrinkles the non-surgical way. Also, MPCP offers Botox injections to treat chronic migraine. Call our Pasadena office for more information, 410-255-2700.

Patient Portal

Our Patient Portal is a secure website that allows our patients 24/7 access to their personal health information. Through the Patient Portal, you can schedule appointments and request prescription refills, and receive information to your portal account, including clinical summaries of your visit, patient education, lab letters and referral requests. If you’d like to sign up, please contact your doctor’s office.

Additional Reading

What To Do? Emergency Department vs. Urgent Care vs. Your Doctor’s Office

By: Jamie Harms, M.D.

The emergency department: Most emergency departments are part of hospitals, although there are free-standing emergency departments in Bowie and Queenstown. The ED is designed and equipped to handle serious or life-threatening emergencies. It is always open, including nights, weekends and holidays. Patients are seen according to how sick or injured they are. The most serious cases jump to the front of the line, even if they arrive later than everyone else. Physicians in the ED are trained to look for life-threatening conditions, and the tests you will receive in the ED will help them decide if you have any of these.

The Emergency Department is the right place to go if you have a serious or potentially life-threatening illness or injury: chest pain, sudden weakness on one side of your body, a new seizure, severe headache, persistent heavy bleeding, poisoning, or a large broken bone.

The Emergency Department is probably not the right place to go if you have a milder illness or a longstanding issue. You are likely to wait longer for treatment. The Emergency Department doctors do not have access to your medical records. Your visit will be much more expensive-as much as 4-6 times as expensive! Remember, they have to keep all that life-saving equipment available all the time. That’s great if you need it, but it’s just an extra charge if you don’t.

Urgent care centers: There are lots of these in our area. They often have extended hours, including evenings and some weekend hours. They are designed and equipped to handle medical problems that need attention the same day, but are not life-threatening. Patients are usually seen in the order they arrive, so your wait will depend on how many other people go to the Urgent Care Center at the same time you do. Many Urgent Care Centers have X-ray and blood testing equipment.

An Urgent Care Center is the right place to go if you have a new illness or injury that occurs when your doctor’s office is closed: sprains and strains, painful urination, ear pain, severe cough or wheezing.

An Urgent Care Center is probably not the right place to go if your doctor’s office is open or if you have a serious or life-threatening condition. A visit to an Urgent Care Center is more expensive than a visit for the same condition at your doctor’s office. The provider in the Urgent Care Center does not know you and will not have access to your medical records. Urgent Care Centers are not equipped with life-saving equipment or providers trained to treat life-threatening illnesses or injuries.

Your doctor’s office: No one knows you like your own doctor. Your doctor is equipped to treat many illnesses and injuries, and can arrange any testing you may need. Your primary care doctor has your medical records and knows your medical history. Patients are seen by appointment. Maryland Primary Care Physician offices reserve appointments for patients who need same-day treatment. Many MPCP offices have evening and/or Saturday hours for your convenience. Call or check our website, www.mpcp.com, for a list of hours at your doctor’s office.

Your doctor’s is the right place to go if you have a new problem, such as sinus pain, ear pain or flu, cuts or other wounds, sprains or strains, cough, or a flare up of an old problem, such as back pain or migraine headache, or an ongoing problem that may require more testing or treatment, such as persistent stomach problems or joint issues. You will pay the lowest copay at your primary care doctor’s office, and most times, you will be able to get an appointment the same day you call.

Your doctor’s office is the wrong place to go if you have a serious or life-threatening condition. If you need care in the next hour, go to the Emergency Department.

Don’t forget: Good communication is important to make sure you get good care. If you’re not sure what to do, call your primary care provider. Even when the office is closed, there is always someone on call who can direct you to the care you need. If you ever need to go to the Emergency Department or an Urgent Care center, take a list of all your medications and allergies with you. Let the staff know who your primary care provider is, and schedule a follow up appointment if needed.

Primary care quicker, less costly than the ER

A study by a New York health insurer claims 90% of conditions commonly seen in emergency rooms ─ like sinus infections, sprains and sore throats – could be treated faster and at a lower cost elsewhere. Excellus BlueCross BlueShield reports that in 2013 emergency room visits in the state for these conditions were nearly 8 times more expensive than a primary care office, 3.5 times higher than an urgent care center, and 15 times costlier than telemedicine. Patients in ERs also had the longest wait times for treatment. The report concludes: “the best method of care for nearly all of these cases is for patients to see their primary care doctors.”