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Medicine

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Sechrist model chamber for hyperbaric oxygen therapy. Photo courtesy Renee Novelle

Port Jefferson’s St. Charles Hospital will open its new Center for Hyperbaric Medicine & Wound Healing on July 18, as the hospital seeks to help people with chronic, nonhealing wounds.

The center, which will be located on the second floor of the hospital, will include two hyperbaric chambers that provide 100% pure oxygen under pressurized conditions and will have four examining rooms.

The chamber “provides patients with the opportunity to properly oxygenate their blood, which will increase wound healing and wound-healing time,” said Jason Foeppel, a registered nurse and program director for this new service.

Potential patients will be eligible for this treatment when they have wounds that fail to heal after other treatments for 30 days or more.

Residents with circulatory challenges or who have diabetes can struggle with a wound that not only doesn’t heal, but can cause other health problems as well.

More oxygen in people’s red blood cells promotes wound healing and prevents infection.

The treatment “goes hand in hand to deliver aid to the body’s immune system and to promote a healing environment,” Foeppel said.

Nicholas Dominici, RestorixHealth regional director of Clinical Operations; Ronald Weingartner, chief operating officer, St. Charles Hospital; Jim O’Connor, president, St. Charles Hospital; and Jason Foeppel, program director. Photo courtesy Renee Novelle

St. Charles is partnering with RestorixHealth in this wound healing effort. A national chain, RestorixHealth has created similar wound healing partnerships with other health care facilities in all 50 states.

The new wound healing center at St. Charles is one of several others on Long Island, amid an increased demand for these kinds of services.

Partnering with Healogics, Huntington Hospital opened a hyperbaric chamber and wound healing center in May 2021. Stony Brook Southampton Hospital also has a wound care center.

“There’s a great need for this in our community,” said John Kutzma, program director at the Huntington Hospital center. “We know that there are 7 million Americans living with chronic wounds,” many of whom did not receive necessary medical attention during the worst of the pandemic, as people avoided doctors and hospitals.

Concerns about contracting COVID-19 not only kept people from receiving necessary treatment, but also may have caused nonhealing wounds to deteriorate for people who contracted the virus.

Although Kutzma hasn’t read any scientific studies, he said that, anecdotally, “We’ve had patients that had COVID whose wounds haven’t healed as quickly as non-COVID patients.”

Patients at the Huntington Hospital center range in age from 15 to 100, Kutzma said. People with diabetes constitute about one-third of the patients.

Treatment plan

For the hyperbaric chamber to have the greatest chance of success, patients typically need daily treatments that last between one and a half to two hours, five days a week for four to six weeks. While the time commitment is significant, Foeppel said it has proven effective in wound healing studies.

“We pitch it as an antibiotic treatment,” he said. “You want to complete that full cycle to ensure the body has enough time to complete the healing process.”

Kutzma said Huntington Hospital reviews the treatment plan with new patients.

In following the extensive treatment protocol to its conclusion, he said, “The alternative is to live with this very painful, chronic wound that may lead to amputation.” Given the potential dire alternative, Huntington Hospital doesn’t “have a problem getting that kind of commitment.”

While the treatment has proven effective for many patients, not everyone is medically eligible for the hyperbaric chamber.

Colin Martin, safety director. Photo courtesy Renee Novelle

Some chemotherapy drugs are contraindicators for hyperbaric oxygen treatments. Those patients may have other options, such as skin grafts, extra antibiotics or additional visits with physicians for debridement, which involves removing dead, damaged or infected tissue.

“We invite patients to come in, go through the checklist and see what their plan of attack” includes, Foeppel said.

The cost of the hyperbaric treatment for eligible conditions is generally covered by most health insurance plans, including Medicaid and Medicare, he said. 

The two hyperbaric chambers at St. Charles can treat eight to 10 patients in a day.

Aside from the cost and eligibility, patients who have this treatment frequently ask what they can do during their treatments. The center has a TV that can play movies or people can listen to music.

“We don’t expect you to sit there like in an MRI,” Foeppel said.

As for complaints, patients sometimes say they have pressure in their ears, the way they would if they ascend or descend in an airplane. The center urges people to hold their nose and blow or to do other things to relieve that pressure.

Foeppel encourages patients to use the restroom before the treatment, which is more effective when people don’t interrupt their time in the chamber.

Prospective patients don’t need a referral and can call the St. Charles center at 631-465-2950 to schedule an appointment.

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It is disconcerting when the medical community reverses course. They seem to do that every decade or so, as with the purported value of vitamin C, estrogen and so forth. The latest about face, in case you haven’t yet heard, is on the matter of taking baby aspirin. For years we have been urged to take a baby aspirin each day to ward off all sorts of ills: heart attacks, strokes, dementia, colorectal cancers and who knows what else. Those tiny pills that can dissolve in seconds against the roof of one’s mouth, or be popped into it, seemed capable of miracles.

Now, with a shot heard truly around the world, an Australian research team at Monash University in Melbourne concluded that not only may aspirin not help, it may in some cases actually harm. The results of their study, which included more than 19,000 people over 4.7 years, were published in three articles this past Sunday in the prestigious New England Journal of Medicine and summarized by The New York Times on Monday, and by just about all other major media.

The study included whites 70 and older, and blacks and Hispanics 65 and older. Each took 100 milligrams — slightly more than the 81 milligrams of a baby aspirin — or a placebo each day. While doing so did not lower their risks of diseases, it did increase “the risk of significant bleeding in the digestive tract, brain or other sites that required transfusions or admission to the hospital,” according to The Times.

So what does all that mean, especially for those already at risk for the conditions aspirin was supposed to protect against?

I am going to quote from The Times very carefully here because this can get confusing due to mixed messages. “Although there is good evidence that aspirin can help people who have already had heart attacks or strokes, or who have a high risk that they will occur, the drug’s value is actually not so clear for people with less risk, especially older ones,” wrote reporter Denise Grady.

So can aspirin prevent cardiovascular events in people with diabetes, for example, or is the benefit outweighed by the risk of major bleeding? Does dose matter in that heavier people might require more aspirin to be prophylactive?

Here’s what the study tells us: Healthy older people should not begin taking aspirin. This will no doubt disappoint Bayer, St. Joseph and others who manufacture the drug. But those who have already been using it regularly should not quit based on these findings, according to Dr. John McNeil, leader of the Australian study. Rather they should talk with their doctors first because the new findings do not apply to those who have already had heart attacks or strokes, which involve blood clots. Aspirin is known to inhibit clotting.

The name of this study is Aspree and it was funded by the National Institute on Aging, along with the National Cancer Institute, Monash University and the Australian government. Bayer supplied the aspirin and placebos but had no other role, according to The Times.

The study focuses on preventive medicine, especially how to keep older people healthy longer. It included 16,703 people from Australia and 2,411 from the United States, starting in 2010. Serious bleeding occurred in 3.8 percent of the aspirin group as opposed to 2.7 percent in the placebo group.

McNeil does suggest the possibility that aspirin’s protective effect against colorectal cancers might still exist but not show up for a longer time span than the study. The Times article does go on to say that the good doctor, who is 71 and specializes in epidemiology and preventive medicine, does not himself take aspirin.

Don’t know what to do? As they say in the commercials, consult your doctor.

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North Shore resident Ivan Kalina is remembered by many as a man of adventure. Photo from Yvette Panno

By Yvette Panno

Ivan Kalina, 84, of Setauket died peacefully the morning of May 27 following a brief illness.

Originally born in Kosice, Czechoslovakia, in 1932 to beloved parents Geza and Ilonka, Kalina’s life was defined by courage, strength and resilience. First as a European Jewish Holocaust survivor, later as an escaped refugee from Communism to America, his story shaped not only his life, but also the history of a generation.

During World War II, Kalina was a young child who managed to survive the Nazis’ early invasion of Czechoslovakia and the deportation of the Jews to concentration camps through the help of Christian friends and false papers.

In the final years of the war, he separated from his mother and father and went to Budapest, Hungary, to hide in an apartment with relatives just blocks from Gestapo headquarters that was bombed day and night by American, Russian and British forces.

Returning to Kosice, his was among the few Jewish families to survive.

Although his education was delayed for years by the war, as a testimony to his determination, in 1956 he graduated as the valedictorian of his medical school class from Charles University in Prague, as a pediatrician. That same year, he married his beautiful wife Vera Atlas, a histopathologist, in Kosice.

With the onslaught of Communist persecution of both Jews and democratic sympathizers, Ivan and Vera realized they could never be free in their oppressive homeland.

In 1965, they left their close families and planned a daring escape through the Yugoslavia border into Austria, until they could manage a flight to New York City with their two young children, Peter and Yvette. They came to this country with two suitcases and $200. With prison sentences awaiting them if they returned to Czechoslovakia, they dedicated themselves to making new lives. Ivan and Vera worked long hours at Bellevue Hospital and New York University while he took his medical board exams in English – his fifth fluent language.

Ivan’s favorite expression – said with characteristic humor and positive spirit – was “that’s why I came to America.”

To this country, Kalina brought with him the grit, charm and fun-loving outlook to be successful. His career spanned a private practice in pediatrics in Rocky Point as well as medical director of Little Flower Orphanage in Wading River, associate professor at Stony Brook University, and attending physician at both St. Charles Hospital and John T. Mather Memorial Hospital in Port Jefferson.

Always athletic and tanned, he was a fiercely competitive, daily tennis player and longtime member of the Harbor Hills Country Club near his original home in Port Jefferson. A perfect day was sitting in the sun near the backyard pool reading a newspaper. A remarkable skier until the age of 70, he loved to travel and took multiple trips out to his condo in Vail, Colorado, and traveled several times a year around the world.

His love of children was no greater than that for his five grandchildren, who called him Papi and of whom he was most proud: Olivia, Mia, Sydney, Jake and Sam.

He is also survived by his children, Dr. Peter Kalina and Yvette Kalina Panno; daughter-in-law, Michelle Kalina; and long-loved partner, Carolyn Van Helden.

As he would say in Hungarian: Sok Szeretet, Servuse Tatulko.

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Mather Hospital changed its visitation policies Nov. 23. File photo by Alex Petroski

In the National Football League, it is widely believed that team success can be traced back to a long, stable relationship between head coach and quarterback. The longer those two have been working together and in perfect harmony, the likelihood for success usually goes up.

The board of directors at John T. Mather Memorial Hospital have followed a similar blueprint, and they couldn’t be happier with the results. Mather’s board chairman is Kenneth Jacoppi,  and he has held that position for about 10 years, though he began serving on the board in May 1977. Konrad Kuhn joined the board a year later. One year after that, Harold Tranchon joined. All three remain on the board of directors to this day.

“Honestly, when you have board members who have been there for a long length of time they have institutional memory and a long understanding of [the] changing field of medical care,” hospital President Kenneth Roberts said in a phone interview.

He has a long tenure as well: This June marks the 30th anniversary of when Roberts took over that post. Prior to becoming president he served four years as the vice president.

Jacoppi, 78, who was the president of his senior class at Port Jefferson High School and later went on to become a lawyer, reflected on his near 40 years at Mather and his lifetime in the community in a phone interview.

“Never in my wildest dreams did I think I would serve this long,” he said.

Jacoppi referred to others on the board as his “Mather family,” and said that his fondness and pride for his community have contributed to keeping him in the position for so long.

During the decades under the current leadership team, Mather has earned a Magnet designation for nursing excellence, achieved the highest patient experience scores in Suffolk County, been recognized as the only hospital in New York State to earn nine consecutive A ratings for patient safety and quality from the Leapfrog Group and established a new graduate medical education program, among many other accomplishments.

“You have a stability you don’t have in most organizations,” Jacoppi said. “We obviously want to provide the best possible care to people in the area.”

‘Never in my wildest dreams did I think I would serve this long.’
—Kenneth Jacoppi

Jacoppi added one of the things he’s picked up in his experience over the years is to be “a bit more laid back and patient.” He referred to himself when he started as a “hard-charging young lawyer” who had to learn to listen to other viewpoints and think about the effect decisions would have on doctors and the community.

Clearly Jacoppi and the rest of the board have figured out a way to stay on top of their game in what he and Roberts both referred to as an extremely challenging time for health care.

“In the old days, the volunteers held grand card parties under the huge old tree on the Mather lawn that helped raise money to provide exceptional health care for the community,” Jacoppi said in a statement from the hospital.

Times may have changed, but the Mather board of directors has not.

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By Susan Risoli

People coping with illnesses such as osteoporosis and rheumatoid arthritis — or those who have undergone a mastectomy — may also contend with pain, disability and a swirl of emotions.

hand_health_wThe best treatment plan is a multifaceted approach, said Marco Palmieri, D.O. Palmieri is medical director of the Center for Pain Management at Stony Brook Medicine. “A pretty high percentage” of post-mastectomy patients experience pain, he said. He and his colleagues recommend a well-structured regimen that could include medications, interventional approaches, physical therapy, acupuncture, massage therapy, diet, exercise and, in some cases, treatment by a pain psychologist, Palmieri said.

Interventional approaches may include ablation and nerve blocks. “We block the nerves that supply the area of the chest wall,” Palmieri explained. For postmastectomy patients, he said, pain management specialists would choose neuropathic pain medications first, before turning to opioid drugs, in what Palmieri called “an opioid-sparing strategy.”

A pain psychologist may be called in for postmastectomy patients “who experience mood effects or have trouble coping,” Palmieri said.

Most important is to remember that postmastectomy patients need more than a cookie-cutter pain management plan, Palmieri said. “Not every patient is going to fit into the same treatment paradigm. Some things may be more appropriate for some patients than others.”

An individualized treatment plan can also aid people with rheumatoid arthritis, a disease that is “more of an inflammatory syndrome from other body structures than from a nerve,” Palmieri said. RA treatments at SBU’s Center for Pain Management could include joint injections guided by imaging (x-ray or ultrasound), nerve blocks and ablations, non-steroidal anti-inflammatory medications, “and, sometimes, anti-depressant medications,” he said. Low-impact exercise, acupuncture, physical therapy and speaking with a pain psychologist can also help, he said.

He urges patients with acute or chronic pain from arthritis or mastectomy to understand that “there are options for them. If you come to pain management, it does not mean you’re going to be placed on narcotics.”

For information on the Center for Pain Management, visit www.stonybrookmedicine.edu or call 631-689-8333.

Those who have become all-too-familiar with the effects of osteoporosis and rheumatoid arthritis, and people who have undergone mastectomy can find relief and renewed health through the regular practice of yoga, said Danielle Goldstein. Yoga helps mastectomy patients “rebuild their upper body strength and work through the scar tissue that forms as a result of the mastectomy,” said Goldstein, owner/director of Mindful Turtle Yoga and Wellness in East Setauket. After a mastectomy, the breath work that is part of doing yoga helps people “worry less, because they’re able to be in the present moment. They develop the ability to not think about the past or the future — even if it’s just for that hour-long yoga practice,” Goldstein said.

 “The practice of yoga is the effort towards steadiness of mind,” she explained. And the physical side of it “will help people feel better, so they can enjoy their life more.” To get started, consult your physician and an experienced yoga instructor who has worked with mastectomy patients, she advised.

Keep moving — that’s Goldstein’s advice for people with osteoporosis and rheumatoid arthritis. Yoga will develop strength, she said, “and in combination with diet, the physical practice could help get body fluids moving so they’re not so stuck.” For osteoporosis, yoga postures (asanas) that are weight-bearing — planks, arm balances, bent-knee poses — will maintain bone density, Goldstein pointed out, “and these asanas can be modified for any age level.” Yoga is also great as a combination approach with acupuncture, nutrition, and Western medical treatment, she added.

People being treated or recovering from illnesses can still turn to yoga, Goldstein said. “It is believed that if you can breathe, you can practice yoga,” she said. “Yoga’s for everybody.” She recommended new students get started by calling the studio, speaking to her, and being guided to the best instructor for their needs.

“A yoga practice is sustainable over the course of a lifetime,” Goldstein said. “The practice may change, it may look different, but it’s still there.” And above all, she said, “It should make you joyful and happy.”

Goldstein can be reached at the Mindful Turtle Yoga and Wellness, 631-721-1881.

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By Javed Butler, MD

February means heart health awareness, but taking care of your heart requires a year-round commitment that has lifelong benefits. What will you do differently to take better care of your heart?

Heart disease can affect anyone, regardless of gender, age or background. That’s why all of our cardiac care experts at Stony Brook University Heart Institute remain focused on how to best prevent heart disease and heal the heart.

We fight cardiovascular disease from every angle, using the best that cardiovascular medicine can offer: risk factor prevention; state-of-the-art diagnostics, such as 3D cardiovascular imaging; advanced minimally invasive procedures with robotic assistance; and transcatheter aortic valve replacement (TAVR) for inoperable aortic stenosis. In the hands of our cardiac experts, these and other cardiac advancements are used to address each patient’s unique situation.

Our ventricular assist device (VAD) program is the most experienced program on Long Island and the first to achieve national accreditation. It offers patients who are ineligible for a heart transplant a way to temporarily or permanently support heart function and heart flow. Patients who are eligible for a heart transplant but are too sick to wait for a suitable donor can also be helped by a VAD device.

The Heart Institute also features both a Valve Center and an Aortic Center where patients are evaluated by multiple cardiac specialists who create individualized treatment plans. Our Chest Pain Center is one of the few accredited centers in New York State. Our Endovascular Rapid Response Team is available 24/7 to treat aortic dissections/ruptures. Stony Brook is consistently recognized by the American Heart Association/American Stroke Association’s Get With The Guidelines® Heart Failure Gold Quality Performance Achievement Award.

Do something good for your heart by getting involved in your own heart health. On Feb. 24, join us at Smith Haven Mall food court for blood pressure screenings at 8 a.m. and a heart health lecture at 9 a.m.

Our popular spring event, Keeping Your Heart Healthy at Any Age dinner and panel discussion will be held on Wednesday, May 11, at 5:30 p.m. at Stony Brook University. Register now at www.stonybookmedicine.edu/hearthealthy.

Have a question about heart disease prevention? Seeking a solution to a cardiac problem? Call us at 631-44-HEART (444-3278). We’re ready to help.

Dr. Javed Butler is co-director of the Heart Institute and chief of the Division of Cardiology at Stony Brook Medicine.

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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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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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Uerda Zena and mom Barbara are all smiles while in the U.S. to repair the girl's heart defect Photo from Joe DeVincent

Simple but necessary medical procedures we receive in the United States are often something we take for granted, but they are miracles to many people around the globe.

Take, for instance, the case of 4-year-old Uerda Zena, a girl born in Kosovo with a heart defect. Rotary volunteers across Suffolk County and the North Shore recently brought her to this country through their Gift of Life program so she could receive a lifesaving heart operation. Uerda had a hole in her heart the size of a nickel, but the procedure to repair it was not available in her home country because the hospitals there do not have the resources to train their staff.

Uerda’s case is not an isolated one. Young children from developing and disadvantaged nations around the world, including in Eastern Europe, much of Africa and South America, do not have access in their home countries to medicine and surgical procedures they desperately need.

Several global organizations have made it their mission to provide procedures like the one performed on Uerda, but Americans tend to forget that those organizations are necessary at all. If an American child is born with a cleft lip or a detectable heart defect, it is fixed as soon as possible and without the child needing to trek hundreds of miles — or thousands, in the case of Uerda.

We should be grateful for all the lifesaving procedures we have at our fingertips. And maybe instead of spending some of our money on a discounted plasma screen television on Black Friday, we should donate to causes like Gift of Life.

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