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CN Guidance & Counseling Services is setting up shop at Horizons Counseling & Education Center on Main Street in Smithtown. Photo by Jared Cantor

The fight against drug abuse has a new home in Smithtown.

In response to a multiyear surge of heroin and opiate pill use across the North Shore and greater Long Island, CN Guidance & Counseling Services, which works on addressing substance use and mental health disorders, has launched outpatient detoxification and withdrawal support services to residents of Smithtown.

Two new sites — one at Horizons Counseling & Education Center at 161 East Main St. in Smithtown and the other at CN Guidance’s main office at 950 S. Oyster Bay Road in Hicksville — have begun delivering a combination of services to local residents addicted to opiates. The services, supported by funds from both county governments, include assessment, detoxification, symptom relief with addiction medications, monitoring of vital signs and instant connection to longer-term treatment and relapse prevention.

Heroin killed a record-high 144 people on Long Island in 2013, a death toll increasing 91 percent in Nassau County and 163 percent in Suffolk County since just 2010, CN said in a statement. Opioid pills, including oxycodone, were linked to 343 additional deaths on Long Island in 2012 and 2013.

“We are filling a critical gap,” said Jeffrey Friedman, chief executive officer of CN Guidance. “The havoc connected to untreated opiate addiction on Long Island has been slicing through our Long Island families and communities. These new outpatient detoxification and support services are enabling opiate-addicted individuals — and their families — to receive the help they need immediately, with no lag in connection to the longer-term treatment and recovery services they need after detoxification. If you know someone in need, please call us.”

During a studied nine-month period in 2013, 4,409 individuals requested detoxification services in Nassau County, but only 26 percent, or 1,157, were actually admitted, according to Nassau County’s Department of Human Services, Office of Mental Health, Chemical Dependency and Developmental Disabilities Services. Suffolk County struggles analogously.

Data from the New York State Office of Alcoholism and Substance Abuse Services show that 85 percent of detoxification in New York State is done in hospitals, often with long waits, at high costs and lacking results, whereas other states use such hospital-based detoxification primarily for medically or psychiatrically complicated cases. The new outpatient programs offer an alternative for the many residents who face mild to moderate severity of withdrawal from opiates, rather than severe withdrawal most commonly associated with emergency-level crises.

Because CN Guidance is a comprehensive behavioral health services provider that offers full-service care coordination, it is able to link clients in the new outpatient programs immediately to a whole array of often- needed services ranging from mental health counseling and treatment to long-term substance use treatment.

Residents and other service providers in either county may call 516-822-6111 to accesDs the program.

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Medical experts offer ways to stay on top of mental health

By Lisa Steuer

While the holidays are typically viewed as a happy time, the season can also bring many challenges and stresses that aren’t as common during the rest of the year.

When it comes to the holidays, the combined influence of lack of sunlight as well as the stresses of the holiday season can result in poor mental and emotional health, said Dr. Laura Kunkel, clinical assistant professor of psychiatry at Stony Brook University School of Medicine.

“The media makes it seem like a very happy time … and then people wind up feeling guilty if they’re not happy,” said Kunkel.

One stress that people face during the holidays is getting together with family members with whom they may be estranged from or not get along.

“It’s important for people to be mindful of when they’re going overboard to please others, and the holidays particularly puts people at risk for this if they have a pattern of wanting to please others,” said Kunkel. “People should kind of step back and be mindful to their own physical needs and take care of their health during this time and recognize when they might be giving too much.”

A particular challenge that some people may face during the holidays is how to deal with family members with addiction. “Sometimes I recommend that people go to a public place to have a holiday dinner, rather than in someone’s home, and obviously make sure that the person with addiction has transportation.”

When it comes to the holidays, the combined influence of lack of sunlight as well as the stresses of the holiday season can result in poor mental and emotional health. — Dr. Laura Kunkel, clinical assistant professor of psychiatry at Stony Brook University School of Medicine

People who have lost a relative or someone close to them can find the holidays particularly painful.

“One way to kind of let the grieving process go quickly is to talk about the person and to talk about the memories, and even though it may bring up tears, it’s part of the healing process,” said Kunkel.

For someone who has lost a child, however, it can be quite different. “Old customs may be too painful, and there might need to be some changes,” said Kunkel, adding that some people suffering such a loss choose to travel during the holidays, for instance.

And in the age of social media, try to focus on the moment at hand instead of constantly checking your phone and looking at what everyone else is doing.  “Put the media down and enjoy with the people who are there,” said Kunkel.

In addition, after the hubbub of the holidays, people tend to feel empty and bored in January, Kunkel added. “January is a good time to make sure your social calendar has things set up.”

Seasonal Affective Disorder

It is estimated that 10 million Americans are affected with seasonal affective disorder (SAD) and that another 10 to 20 percent may have a mild case of SAD, which is a type of depression that is related to the change in seasons and lack of light. Anyone can be affected — those with a history of depression and even those without. Here are five tips from Ramin Parsey M.D., Ph.D., chair, Department of Psychiatry at Stony Brook University School of Medicine.

  1. Get plenty of exercise.  Exercise and other types of physical activity help relieve stress and anxiety, both of which can increase SAD symptoms. Being more fit can make you feel better about yourself, too, which can lift your mood.
  2. Keep up with social activities. When you’re feeling down, it can be hard to be social, but making an effort to connect with people that you enjoy being around can give you a boost. Staying connected to friends and loved ones can offer support and give you something else to think about other than the weather.
  3. Keep on the bright lights. Light therapy is often used to treat SAD, and those lights mimic the natural outdoor light, which appears to cause a change in brain chemicals linked to mood. Also think about opening the blinds or sitting closer to bright windows while at home or in the office.
  4. Try to keep a regular sleep schedule. Melatonin, a hormone that controls the natural cycle of sleeping and waking hours, could fluctuate during the shorter winter days, causing disruptions to sleep patterns and mood.
  5. Speak to your health care provider. Your doctor can make the proper assessment and give you an accurate diagnosis. He or she can also recommend the right form of treatment.

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Your guide to a healthy winter

By Lisa Steuer

It’s easy to become sedentary and gain a little extra weight during the winter. After all, the frigid temperatures tend to keep us indoors, there are holiday parties with goodies that tempt us and an extra weight gain can simply be hidden under a few more layers of clothing.

But if you take a few steps toward your health and fitness this winter, you can lose or maintain your weight and then be prepared to be in your best shape when the warmer months hit yet again. Here are some tips to keep you on track this winter.

Plan it out
Each Sunday, take the time to look at what you’re doing the week ahead. Plan out what days you’ll work out and what the workout will be. Scheduling them in like appointments may just become habit and make you less likely to miss them. Plus, prepare your healthy meals for the week on Sunday to save time and make it easier to stay on track during the week. For a simple guide to food prep, visit www.fitnessrxwomen.com and search for the article “10 Tips for a Quicker and Easier Food Prep.”

Work out — no excuses
Living a fit lifestyle doesn’t mean you have to miss out on sweet treats at holiday parties and other gatherings. If you know you’re going to be indulging in a few extra calories one day, be absolutely sure to get in a workout that morning so you don’t feel too guilty about it.

Eat beforehand
Before a party or gathering, have a satisfying but healthy snack like a protein shake or fruit like a banana so that you don’t attend the party starving and end up making poor food choices due to being so hungry.

Fill up on veggies
When you go to a party, go right to the veggie tray and fill up.

Stay away from eggnog and other high-calorie drinks
If having alcohol at a party, try a glass of dry red wine or vodka with cranberry. Liquid calories can add up extremely fast. If you do drink alcohol, make sure you’re also drinking plenty of water.

Experiment with healthy baking and cooking
A lot of times, with a few simple substitutions, it’s easy to cook and bake healthier without sacrificing taste. For example, you probably won’t be able to tell the difference if you use Greek yogurt in place of sour cream on lean chicken tacos. Visit www.fitnessrxwomen.com for tons of healthy, easy and delicious meals and desserts that won’t leave you feeling like you’re missing out on your favorite foods.

Fitness classes
Taking fitness classes can help keep you motivated, and you may even meet new friends who can help inspire you to get to class. The instructor running the class can help, too. Let him or her know your fitness goals for the winter, and they can probably help give you that extra push and also offer suggestions to help you meet those goals.

Work out at home
When it’s cold and snowy, you may be more likely to make excuses to stay home and avoid the gym. Instead, invest in a few simple items that don’t take up a lot of space but allow you to get a good workout in right in your living room — dumbbells, a medicine ball, exercise bands, etc. Try fitness DVDs and free on-demand fitness videos (if you have cable, go to the on-demand menu, select Free On Demand, then Sports then Exercise Sportskool).

Have an incentive
Check out www.dietbet.com and the app, which has games where players bet as little as $30 to meet a specific weight loss or fitness challenge within a specific time frame, and the winners split the pot. You can even start your own game and challenge your friends.

Sign up for a 5K
This will force you to get up and moving! Plus, meeting a challenge you never thought you could do is an indescribable feeling.

Don’t be so hard on yourself
If you overindulge a little bit over the holidays, don’t beat yourself up too much. The good news about getting fit and healthy is that you can always get back on track. Put it behind you, recommit yourself, have a goal and then get to work getting it done.

Lisa Steuer is the managing editor of FitnessRx for Women and FitnessRx for Men magazines. For more fitness tips, recipes, training videos and print-and-go workouts that you can take with you to the gym, visit www.fitnessrxformen.com and www.fitnessrxwomen.com.

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SCCC Biology Professor Peter Smith demonstrates the Anatomage Table. Photo by Victoria Pendzik, SCCC

It’s the most technologically advanced anatomy visualization system in the world, according to its manufacturer, and Suffolk County Community College’s Selden campus is the only college in New York State to have one. Welcome to teaching and learning in the 21st century.

The Anatomage virtual dissection table is being adopted at leading medical schools and institutions to allow lifelike and never-before-available interaction and visualization of the human body and its systems.

The table — about the size of a hospital bed, with a touchscreen surface — uses three-dimensional imagery from digitally scanned specimens to allow students to perform a lifesize, virtual dissection via touchscreen interface. The table can render limitless views of the human body in flawless detail.

Students can zoom in on or rotate different structures and virtually remove individual organs, according to SCCC Professor of Biology Dr. Peter Smith.

“The table is a remarkable technological tool that provides students with a 360-degree view of anatomical structures and their relationship to one another,” said Smith.

“We can look at the body through three dimensional visualization and all of the body’s structures can be annotated. This is what teaching anatomy in the 21st century is all about,” he added.

“The Anatomage Table is a true 21st century teaching tool. It permits Biology students not only to study Human anatomy, but it is a good addition to general biology classes that include animal anatomy. It includes, in its programming, the possibility of virtual dissection of cats and dogs. The table will help to reduce the use of preserved specimens, a more humane and sustainable approach to the study of vertebrate anatomy,” said Suffolk County Community College Biology Department Chair Dr. Rosa Gambier.

The technology allows students to visualize skeletal tissues, muscles, organs and soft tissue, and further customize the interaction by virtually slicing, layering and segmenting the anatomy. The selections can be rotated or flipped to accommodate any viewpoint.

Work with an actual cadaver requires many chemicals, there needs to be a facility to house them (SCCC was the only community college in New York with a cadaver lab), there is a great deal of regulation in working with cadavers, and there are recurring costs associated with them.

With the Anatomage Table, countless students have the ability to work with a body, enlarge or rotate systems and bisect and remove parts.

“The table,” explained Suffolk County Community College President Dr. Shaun L. McKay, “while advanced, is also a natural extension of what students are familiar with because it functions much like a tablet computer. We are extremely proud to bring this new tool to our college and to our students while fulfilling our mission of incorporating innovative teaching and learning strategies into our classrooms.”

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Convenient, cost-efficient medical care offers today’s patients flexibility

It’s midnight and you wake up with a stabbing earache. Or you’re suffering an indescribable stomach pain. It’s not so bad that you need to see a doctor now, but you’re still worried about it.

Twenty years ago, the next logical step would have been to trek out to the local emergency room —a feat both time-consuming and costly. Today’s patient, though, is likely turn to an urgent care center for medical attention.

A convenient middle ground between the ER and scheduling a visit with your primary doctor — where wait times for an appointment only seem to grow — more and more people are frequenting urgent care centers, where patients can be treated for anything ranging from sore throats to minor lacerations requiring stitches. And on Long Island, business is booming.

“There has definitely been an increase in the number of urgent care centers that have been opening up around the area,” said Dr. Gerard Brogan, executive director of Huntington Hospital.

North Shore-LIJ Health System, of which Huntington Hospital is a member, has jumped into the business of urgent care centers themselves. The system announced last November that it was opening 50 GoHealth Urgent Care centers in the New York-metropolitan area over the next three years.

The centers, which are open on nights and weekends, serve as a “portal of entry” into the health system’s 18 hospitals and more than 400 outpatient physician practices throughout New York City, Long Island and Westchester County, according to a news release announcing the initiative last year.

“People are busy. They really don’t want to wait a long time to be seen and cared for. As long as the care is of high quality — whether it’s in urgent care centers or the ER fast track — it really doesn’t matter, as long as they’re getting the right care at the right time and it’s part of a coordinated comprehensive primary care program.” — Dr. Gerard Brogan, executive director of Huntington Hospital

Brogan said the rise of urgent care is a “recent phenomena” on Long Island, as much of the country has already seen this boom. At Huntington Hospital, the facility’s “fast track” area in the ER serves as an urgent care center, offering the same convenient hours centers do, but with the backup of an entire hospital. The hospital added this service to its medical repertoire about seven years ago, he said.

“The patients want that,” Brogan said. “People are busy. They really don’t want to wait a long time to be seen and cared for. As long as the care is of high quality — whether it’s in urgent care centers or the ER fast track — it really doesn’t matter, as long as they’re getting the right care at the right time and it’s part of a coordinated comprehensive primary care program.”

Convenience and an increased need in the marketplace is why urgent care centers have grown nationally, according to Dr. William Gluckman, of FastER Urgent Care in Morris Plains, New Jersey. Urgent care isn’t a new thing, though — the concept has been around for 20 years, and many of these facilities are mom-and-pop operated. “I would say we’ve certainly seen a large boom in growth nationally and locally in the northeast over the last five years,” he said.

A downside Brogan said he could see with the proliferation of urgent care centers is when patients use them in lieu of primary care, missing out on important health screenings, for example, “that would be very important to maintaining high quality, cost effective care,” Brogan said.

At GoHealth, patients of the North Shore-LIJ Health System stay within their network, meaning the various hospitals and doctors all communicate with one another, no matter where the patient goes for service, Brogan said.

Urgent care centers aren’t looking to be the next primary doctor, though. Calvin Hwang, of CityMD, which operates 16 urgent care centers on Long Island, said the company would be at 54 locations by this year, which include the five boroughs and New Jersey. Hwang, who is the first non-physician executive of CityMD, said the urgent care company urges patients to find a “medical home” in a primary care physician.

“We’re not trying to take over primary care groups,” he said. “They do feel that we’re taking their patients away and they’re threatened by us. We’re actually trying to make them more efficient. And the same thing with ERs. We’re trying to make them more efficient. We believe that urgent care has a role in the overall medical care system.”

Urgent care isn’t going away anytime soon — the market is growing, especially on Long Island, he said. CityMD will see more than one million patients this year, he said.

Asked how he sees urgent care transforming in the future, Hwang said he felt even the word “urgent” would get redefined, conforming to the needs of the customer. It could mean video chatting via cell phone with a doctor to see if something’s okay.

“The way the millenials [are] consuming health care is completely changing,” he said. “It’s going to evolve.”

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A view of the front entrance to Huntington Hospital on Park Avenue in Huntington. File photo

Hospitals across the North Shore and the country have been adapting to an entirely new set of medical codes over the last two months, completely changing the system in which a patient’s diagnosis is detailed.

As of October, all hospitals across the United States switched to the ICD-10 system, which allows for more than 14,000 different codes and permits the tracking of many new diagnoses. ICD-10, an international medical classification system by the World Health Organization, requires more specificity than the previous code system. Doctors at North Shore facilities said they agreed that although it’s time-consuming and has slowed productivity, it is more beneficial to patients in the end.

Dr. Michael Grosso, chairman of medicine at Huntington Hospital said these new codes should help make it easier for symptoms of various diseases to be tracked.

According to Gross, preparation for the new code started two years ago with a required education program for all physicians that described what all the new codes meant.

“Physicians are being called upon to provide more specificity and detail,” Grosso said in a phone interview. He described the codes as a “vast extension” to what the hospital was previously using and said it should “improve the quality of medical records and increase the amount of information that researchers can obtain and make for the best care for patients.”

Grosso also said that understanding and learning the codes was an important first step, but ongoing feedback on how the codes are being adopted is equally important. A feedback program has been created at each hospital.

John T. Mather Memorial Hospital in Port Jefferson. File photo
John T. Mather Memorial Hospital in Port Jefferson. File photo

John Ruth, director of revenue integrity and interim chief compliance officer at Stony Brook University Hospital, said Stony Brook used outside resource companies with online courses to teach the new code to their physicians and coding staff.

Ruth said that a new code system was necessary, as the previous system, ICD-9, was created by WHO in the 1970s. He called ICD-10 a natural progression.

“There are a lot more codes for specific organ systems, muscles, muscle tendons and nerves than were required with ICD-9,” he said in a phone interview.

Ruth also said that ICD-9 was mostly comprised of three- and four-digit codes, and ICD-10 is up to seven digits in length, which makes the new coding more challenging but more valuable.

“If a patient has PTSD, we can assign a code from where he got it from, not just that he has it, which is important for planning his future and ongoing care,” Ruth said.

Stacie Colonna, associate director of inpatient coding at Stony Brook University Hospital, said there has been approximately a 30 percent decrease in staff productivity with the changeover to ICD-10 and a shortage of trained staff.

“I get 10 questions a day just from internal staff,” Colonna said. But she also noted that staff frequently asked daily questions about the old system as well. She said she expects productivity to improve in the near future.

At John T. Mather Memorial Hospital in Port Jefferson, Chief Medical Information Officer Dr. Joseph Ng said the staff went through web training, too. One-on-one training was also available if a clinician requested it.

Ng agreed specificity is both the pro and con of ICD-10. “Because it’s so specific, it really allows clinicians to hone in on what’s really going on with patients and be able to communicate better with one another,” Ng said in an email. “But because it’s so specific, sometimes it’s hard to find the right code, especially when it comes to procedures. The codes are not all inclusive.”

Looking forward, Grosso said the new system had a lot to offer for hospitals across the country because of the amount of information people could potentially learn from it.

“A number of private and government parties will benefit from the ability to look at more detailed hospital data,” Grosso said.

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People at an anti-drug forum stay afterward to learn how to use the anti-overdose medication Narcan. Above, someone practices spraying into a dummy’s nostrils. Photo by Elana Glowatz

The Suffolk County Police Department handed out dozens of overdose rescue kits in the Port Jefferson high school on Monday night, at the conclusion of a crowded drug abuse prevention forum geared toward educating parents.

“We have to double-down on prevention,” said Tim Sini, a deputy county commissioner for public safety who has recently been nominated for police commissioner.

People at an anti-drug forum stay afterward to learn how to use the anti-overdose medication Narcan. Above, Jim Laffey assembles a syringe. Photo by Elana Glowatz
People at an anti-drug forum stay afterward to learn how to use the anti-overdose medication Narcan. Above, Jim Laffey assembles a syringe. Photo by Elana Glowatz

He and other officials from the police department, medical examiner’s office and community spoke at the forum to inform parents about the dangers of drug abuse, including how kids get introduced to and hooked on drugs in the first place. Much of the discussion focused on opioid drugs, which include heroin as well as prescription painkillers like Vicodin and Percocet, and on the lifesaving Narcan, an anti-overdose medication that blocks opioid receptors in the brain and can stop an overdose of those types of drugs.

According to Dr. Scott Coyne, the SCPD’s chief surgeon and medical director, in the three years since Suffolk officers have been trained to administer Narcan — the well-known brand name for naloxone — they have used it successfully 435 times.

Attendees who stayed after the forum were able to register in the police department’s public Narcan program and receive a kit with two doses of the medication, which can be sprayed into an overdose victim’s nostrils.

Narcan training classes are coming up
Want to learn how to use Narcan, the medication that stops an opioid overdose in its tracks? Training courses are taking place across Suffolk County over the next couple of months, including in Port Jefferson and in neighboring Centereach.

Narcan, the brand name of naloxone, blocks receptors in the brain to stop overdoses of drugs like heroin, Vicodin, Percocet, OxyContin or Demerol, among others. It can be administered through a nasal spray and will not cause harm if mistakenly given to someone who is not suffering an opioid overdose.

The local training sessions meet state health requirements, according to the Suffolk County Department of Health Services, and will teach trainees to recognize opioid overdoses, to administer Narcan and to take other steps until emergency medical personnel arrive on the scene. All participants will receive a certificate of completion and an emergency kit that includes Narcan.

The first course will be held on Monday, Dec. 14, from 6 to 7:30 p.m. at the county’s Office of Health Education in Hauppauge, at 725 Veterans Highway, Building C928. RSVP to 631-853-4017 or [email protected].

In Centereach, a course will take place on Friday, Jan. 15, from 6:30 to 7:30 p.m. in the Middle Country library at 101 Eastwood Blvd. RSVP before Jan. 11 at [email protected] or at 631-585-9393 ext. 213.

Later that month, Hope House Ministries will host another Narcan training session in its facility at 1 High St. in Port Jefferson, in the Sister Aimee Room. That event, held in conjunction with the Port Jefferson ambulance company, will take place on Thursday, Jan. 28, at 10 a.m. Call 631-928-2377 for more information or register at https://pjvac.enrollware.com/enroll?id=952865.

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By Dr. Matthew Kearns

Nothing makes a better gift for the family than a little bundle of barking fur. The expectation is that this is not only the perfect surprise, but also a relationship and responsibility builder for your children. How do we choose a puppy that is friendly and safe?

As with human development, a puppy’s temperament (personality) is determined by both genetics and environment. Purebred dogs will generally have different temperaments: retrieving, herding, hunting/guarding, etc, and come in different sizes. The type of dog chosen should match with your family’s activity levels, number and age of children, etc.

If you have younger children it is good to choose a breed that is big enough to not be injured by your child, but not too big as to knock your child into next Tuesday as the puppy develops into an adult dog. Also take into account that certain breeds may be very good with you and your children but may see your children’s friends as unwanted intruders. This not only becomes dangerous to guests, but also a potential financial liability for you.

Good breeders will match their dogs to appropriate families but poor breeding (puppy mills) can be dangerous. When purchasing a puppy from a breeder, the puppy is usually somewhere between 8-10 weeks old. This is a key time for the puppy to bond with your family (including younger family members) and quickly consider everyone part of their new “pack.”

Adopting from a shelter or rescue group is a noble but uncertain endeavor. The actual genetics is somewhat of a guessing game, and many of these puppies have traveled great distances with other dogs under stressful circumstances. When first introduced these puppies may appear calm (even timid) but it can take many days to weeks for their true personality to emerge. That does not mean that every dog from a shelter has a “Jekyll and Hyde” personality. However, make sure that the shelter or rescue has a clear (and timely) return policy if things aren’t working out.

Your own family dynamic plays a role. Children younger than school age can pose a problem. Toddlers are curious, but also are grabby and impulsive. What seems harmless (pulling at hair, stealing toys/food) could become a potentially dangerous point of conflict. This is very true as the puppy matures into a young adult dog.

What was once tolerable a few months ago as a puppy is now taken as an act of aggression or challenge. Therefore, many experts that recommend only adopting adult dogs with a proven temperament from a shelter if you have children or children under school age (6-7 years). An added benefit of an adult dog is that many times they are already housebroken (especially if spayed or neutered) and far less destructive than a puppy.

I hope this information is helpful in choosing the right dog for your home this holiday season. I want to wish all of the readers of this column both a safe and joyous holiday season and happy 2016. I also want to thank both Heidi Sutton, editor of the Arts and Lifestyles section, as well as all the staff of the Times Beacon Record and affiliates for another great year.

Dr. Kearns has been in practice for 16 years.

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Business employs other local disabled individuals

Pictured, Brittney (left) and Logan (right) Wohl, co-owners of Our Coffee with a Cause, with their mother Stacey Wohl (center), company founder/president. Photo from PRMG New York

The sister-and-brother team, Brittney, age 18, and Logan Wohl, age 16, of Northport, are the newly appointed co-owners of Our Coffee with a Cause Inc., a business that employs individuals with cognitive and developmental disabilities and funds local charities that support them. These siblings with autism have dedicated their time to helping other special-needs teens and adults by providing gainful employment opportunities in a supportive business setting.

Our Coffee with a Cause was founded in 2012 by Stacey Wohl, mother of Brittney and Logan, in response to the growing concern for special-needs individuals on Long Island who are aging out of schools to find job opportunities and a learning environment to acquire real-life skills. The employees package coffee, apply labels to the bags and coordinate shipments. Additional opportunities are available during Our Coffee with a Cause’s sales and informational events, during which employees work with an assistant to sell coffee and products using a custom-designed iPad app and interacting with customers.

A portion of the business proceeds benefit Our Own Place, a non-profit organization that Stacey Wohl founded to provide unique opportunities to special-needs children and their single parents. The organization’s ultimate mission is to open a weekend respite home for families of children with cognitive disabilities that will provide job training and socialization skills to its residents and will feature a café at which Our Coffee products will be brewed and sold.

Stacey Wohl and her mother and business partner, Susan Schultz, bring to the company a combined 50 years of business experience, along with the knowledge of addressing the unique needs of teens and adults with disabilities.

“Our Coffee with a Cause is dedicated to employing special-needs adults and showing that there is ability in disability,” says Stacey Wohl. “I am proud to name Brittney and Logan as the owners of this business, which provides careers to people with disabilities who may not otherwise have the opportunity.”

Although 53 million adults in the United States are living with a disability, as many as 70 percent of this working-age population are currently unemployed. For many, the current systems in place to support both young adults and their families disappear once the teen “ages out” of the education system, typically when they turn 21. In 2016, nearly 500,000 autistic persons will enter this category, in addition to adults with Down Syndrome and other cognitive conditions.

For more information, visit www.ourcoffeewithacause.net.

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By Melissa Arnold

Imagine this: You’re out with friends at a barbecue and wake up the next day with an unusual rash. On top of that, you’re just not feeling well.

Most people would head to a nearby urgent care center, emergency department or doctor’s office to get checked out. In all of these situations, though, you’re probably in for a wait of several hours. And in the case of a doctor’s office, you might have to wait a few days or even longer to be seen.

But what if you could take a picture of that rash with your cellphone and text it to a doctor, who responds right away with advice before calling in a prescription? Even better, what if you could do that at any time, seven days a week?

Such direct access to a doctor isn’t just a fantasy anymore. It’s a type of care called concierge medicine, and it’s spreading rapidly across the country.

Concierge practices come in several different forms, but in all cases, patients pay an annual or semi-annual fee to their physician, even if they don’t visit the office. In exchange, patients are guaranteed shorter wait times, longer, unrushed appointments and 24/7 access if a problem arises.

The fee varies widely depending on the location of the practice and the services they offer. Some physicians will also charge based on a patient’s age or medical status.

Dr. Bruce Feldman works independently, traveling throughout Long Island and occasionally elsewhere to meet his patients at their workplace, home or another location.

“My preferred population is an executive or professional who is too busy to go to the doctor. I go directly to them,” said Feldman, who also has offices in Melville and Port Washington. “If a guy is making a fair living, the idea of driving to the doctor and having to spend time waiting usually doesn’t sit well. And yet they want to be successful at their jobs and function at an optimal level.”

Feldman does have patients come in for an initial physical, but as he gets to know them, care becomes less about face-to-face contact and more about communicating by phone or email as needed.

The biggest difference between concierge and traditional medical care, Feldman said, is the focus on preventing future health issues instead of attempting to resolve existing problems.

Both Feldman and Dr. Vasilios Kalonaros of Northport agreed that preventative care is lacking in traditional medicine, and patients are suffering for it.

“When you’re only given 15 minutes with a patient, it’s like putting your finger in a dam — you can’t always take the time to treat every issue,” Kalonaros says.

Small practices are a hallmark in concierge medicine. Most doctors limit themselves to a few hundred patients, allowing for longer visits.

Before Kalonaros made the switch to concierge medicine eight years ago, he was seeing up to 40 patients a day. Now, it varies between eight and 12. Feldman sees about four patients each day, with only 60 patients total.

And statistics show that a doctor with time to spare makes a difference for patients. According to MDVIP, a private network of physicians that includes Kalonaros, concierge patients are hospitalized 72 percent less than those seeing a traditional doctor. In addition, the American Journal of Managed Care reports that concierge medicine ultimately saves the health care system more than $300 million in Medicare expenses.

Its popularity appears to be growing, too. There are now hundreds of concierge doctors throughout the country, and more than 20 on Long Island alone.

Before choosing a concierge doctor, it’s best to determine exactly what you want. Are you looking for a doctor who takes your insurance, does house calls or has inexpensive fees? Answering these questions will help narrow the field.

Then, ask for a consultation. Use that time to get to know them, learn about their services and determine if he or she is a good fit for your needs.

Fees vary widely in the concierge world, from under $2,000 annually to more than $20,000.

Concierge medicine is familiar to some, thanks to the USA Network’s medical drama series “Royal Pains.” The show follows a cardiac surgeon who becomes a private physician for the wealthiest residents of the Hamptons.

While some of the show’s themes are accurate, its sole focus on upper-class patients is just a stereotype.

“Most of my patients are not wealthy — they are middle and lower-middle class,” Kalonaros said. He added that a concierge doctor can be a great option for those with minimal or no insurance, because his $1,650 fee guarantees access to him at any time.

And Feldman argues that when you don’t get sick in the first place, this model will save you money that would be otherwise spent on medication or more extensive treatment.

But both doctors are quick to admit it’s not the best option for everyone.

“If you have a good relationship with your existing doctor, you don’t need a concierge doctor. But if you’re frustrated or not getting the care you need and are willing to pay more, a concierge doctor might be for you,” Feldman says. “It’s about having a partner in your wellness.”

For those interested, contact Dr. Bruce Feldman at (646) 801-7541, www.mypersonaldocny.com, and contact Dr. Vasilios Kalonaros at (631) 239-1677. Or visit www.mdvip.com to learn more about concierge medicine on Long Island.

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