Millions of people struggle every day with extra pounds that take their toll on self-esteem and physical stamina. While there are no shortage of diets and exercise routines to try, it’s not unusual for those who are extremely overweight to lose hope of ever making it to their healthy goal weight.
Bariatric surgery has been a lifesaver for countless Americans who desperately want to lose weight and regain the quality of life that comes with improved mobility and fewer health complications. Every year, the number of bariatric options increase as new technologies are introduced to this growing sub-specialty.
Dr. Seun Sowemimo, MD, FACS, is a board-certified, fellowship trained bariatric surgeon.At his center, Prime Surgicare in Freehold, he routinely counsels patients about the benefits of losing weight with the help of minimally invasive laparoscopic weight loss surgery, including the gastric sleeve.
This surgery does not alter the anatomy (the way a full gastric bypass does) and usually requires no more than a one night stay in the hospital after surgery. The gastric sleeve works best for people who are considered morbidly obese,meaning they have a BMI (body mass index) of40 (or 35 with a comorbidity such as diabetes)and are ready to live a healthy lifestyle.
“It’s a wonderful procedure that has very good results as long as the patient understands that they must participate in changing their lifestyle,” Dr. Sowemimo said. “To be successful long-term, which is what I think counts, you need to understand that you need to stop eating high calorie foods and really exercise. If you aren’t willing to make the changes, the gastric sleeve won’t work nor will any other bariatric changes.”
Ragui Sadek, MD, FACS, director of bariatric surgery at Robert Wood Johnson University Hospital, views the gastric sleeve procedure asa metabolic solution for weight loss. He routinely performs this bariatric procedure as well as others to help patients regain their quality of life.
Additionally, he is one of the only bariatric surgeons in the entire United States who performs the gastric sleeve procedure endoscopically (endoscopic sleeve gastroplasty) as opposed to laparoscopically.
Endobariatrics, he said, is very popular in Europe and Latin America. By conducting the gastric sleeve procedure through the mouth endoscopically, Dr. Sadek says downtime and recovery are completely reduced. The entire operation is completed in less than an hour,there are no incisions and there is usually no need for an overnight hospital stay.
“This operation restricts the amount of calories the person can consume, by reducing the size of the stomach and removing the part where the hunger hormone, ghrelin, resides.This reduces food cravings making it easier to stick with a healthy food plan.
“After a gastric sleeve procedure, patients report a natural sense of satiety with small meals,” he said, making it ideal for patients who feel a constant sense of hunger or never feel full.”
Both physicians agree that aftercare is paramount when it comes to success of any bariatric surgery.
At Prime Surgicare, Dr. Sowemimo said bariatric surgery is not a magic bullet; it can be a very a successful weight loss tool. Other tools that are equally as important include regular exercise and emotional support groups. To that end, Dr. Sowemimo invites patients to participate in regularly scheduled support groups, exercise groups with personal trainers and outdoor activities monthly.
“We follow patients for life,” Dr. Sadek said.“We want to see a patient once or twice a year for life. That way, if there is a problem, we can pinpoint it and solve it before weight is regained.”
Prime Surgicare • www.primesurgicare.com Advanced Surgical & Bariatrics of NJ, PA • www.bariatricsurgerynewjersey.com
Say the word “menopause” and a look of understanding…even frustration…comes across the face of many women (and men!) within earshot. For women, mood swings, hot flashes and loss of libido can make menopause an uncomfortable beginning to the next stage of life.
While men do not experience classic menopause for obvious physiological reasons, they do experience a change of life of their own. Andropause, or male menopause, can be quite debilitating for men especially because it’s often misunderstood and under diagnosed.
A man’s testosterone levels decline naturally with age. “Low T” is characterized by the loss of the male hormone and often occurs in mid 40s to mid 50s. Men as young as early 30s can begin to experience symptoms of low testosterone.
Andropause causes many uncomfortable and even debilitating symptoms including fatigue, irritability, anxiety, depression, loss of focus and memory, erectile dysfunction, reduced libido and more.
Mukaram Gazi, MD, FACS, a board-certified urologist, Fellow of the American College of Surgeons, and the founding member of University Urology Associates of New Jersey, urges patients to come in and speak very candidly about their low T symptoms. In fact, UUANJ has a program titled Men’sHealth@UUANJ designed exclusively to deal with male issues.
“When it comes to men’s health, there are very few things I haven’t heard before,” Dr. Gazi says. “Embarrassment should not be a reason to suffer through symptoms.”
When a man appears to be experiencing symptoms of possible andropause, Dr. Gazi runs a full panel of tests to check not only for low T, but also the levels of other hormones.“Testosterone must be prescribed carefully after thorough investigation of all symptoms and possible causes and after considering the risk factors,” he says. “We want to appropriately diagnose and evaluate every patient before prescribing any treatment.”
Once diagnosed, there is help and hope. Testosterone replacement can truly put an end to many symptoms of andropause.
George Trim, MD, FACOG, FACS, NCMP, is a board-certified OB/GYN and age management physician in the Monmouth and Ocean County areas who has been actively treating andropause in men for many years.
“The number one misconception about andropause has to do with the treatment. For decades it was believed that testosterone replacement therapy either increased the risks for prostate cancer or, if a man had an undiagnosed prostate cancer, it would make it more aggressive,” says Dr. Trim. “We now know, thanks to Dr. Abraham Morgantaler at Harvard Medical School, these beliefs were based on a study in the 1940s with erroneous findings.”
In fact, testosterone replacement is safe and efficacious, Dr. Trim says. In addition to proper diet and exercise, testosterone can be increased “by administering testosterone via the many different delivery systems available or,possibly, supplementing with medicines that will, in turn, raise a man’s own level.”
However, both doctors warned there are no over the counter (OTC) solutions for low testosterone or andropause. There are pros and cons to each method and they should be discussed with a knowledgeable physician.
If there is a silver lining of being diagnosed with low T, it’s this: “Men who receive testosterone replacement report that they feel sexier,stronger and healthier,” Dr. Trim says. “They state that it makes them feel as they did when they were in their prime.”
Bob Garrett displays an inner cool that some might say seems surprising for a man at the center of many complex and exciting initiatives that are bringing dramatic improvement to the health care landscape here in New Jersey and beyond. As Co-CEO of the state’s largest, most comprehensive, and most integrated health network, Bob takes his transformation mission in stride.
Bob and his team at Hackensack Meridian Health, led with Co-CEO John K. Lloyd, former head of Meridian Health, are maestros when it comes to doing their due diligence, nailing the right strategy, and then executing against plan. From cementing a ten-year vision to creating a new private medical school – from scratch, mind you– to taking conventional disease treatment and re-imagining how to better connect health and care to keep people and communities well, Bob is a virtuoso.
It took one internship, at Mercy Hospital in Rockville Center, for this Connecticut native and political science major to know he had found his calling. “I loved what I saw,” he recalls, “and I thought, I really want to be involved with this.” The numbers speak for themselves: 33,000 team members; 6,500 credentialed physicians; 16 hospitals; 180 locations.
With a worldview informed by connecting with global leaders and rising entrepreneurs at the World Economic Forum in Davos, hosting health care panels at Vatican conferences, and working closely with Governor Murphy’s office on important issues like behavioral health care solutions and New Jersey’s innovation economy, Bob Garrett has his head up and his eyes on the health care horizon.
HumanizeMD thanks Bob Garrett for taking the time to talk with us about the important changes going on in health care today, and the future of health care he is helping to lead.
HMD: For an outside observer, it’s hard to keep up with the pace of advancement at Hackensack Meridian Health. There’s breakthrough news happening at HMH on almost every major health care front. Bob, before we delve into specific initiatives, can you explain your role in leading the organization to set so many precedents for the future state of health care, not just in New Jersey but at a national level?
RCG: My job, in essence, is to orchestrate excellence so that wecan be sure that our health network is providing top quality care,giving people in our communities the best possible patient experience, and keeping health care affordable. All three are equally important and, as Co-CEO, I want to live up to our mission to transform health care.
There are a lot of people in the industry who are pessimistic about the future of health care. I know there’s a lot of disruption,a lot of uncertainty, but I’ve never been more optimistic than I am now. There are great opportunities to do more, to do better –we just need to take advantage of them.
It’s my role to help us be focused, be agile. I think we are an agile organization, even as large as we are, with 6,500 credentialed physicians and 33,000 team members. I’ve learned a lotof lessons over the years about perseverance, so whether I’m opening a hospital or spending ten years to pioneer our own medical school, I know how to keep focused on a positive future and spread that optimism.
HMD: In July, 60 students in the inaugural class of the Hackensack Meridian School of Medicine at Seton Hall University launched their medical careers with a traditional White Coat ceremony,symbolizing the compassion and duty inherent in the medical profession. Why was this ceremony especially meaningful for you?
RCG: It was special for many reasons, but one of the great things about starting a new school of medicine from scratch – and I’ve been working on this project for a decade is that you can truly innovate.
Immersion is key to an innovative curriculum at Hackensack Meridian School of Medicine where our students team up with families in stressed areas such as Asbury Park, learning first hand the health challenges that families can have and their role in keeping entire communities well, based on an approach that focuses equally on maintaining health and curing illness.
As we have come to recognize the importance of social factors on health outcomes, we better understand that health and wellness occur in the community, not in the hospital. I’m proud to see this vision reach fruition and to deliver on our goal to change medical education to better prepare physicians of the future.
For me, the White Coat ceremony launched this inaugural class and our new innovative school of medicine.
HMD: How will this new medical school help resolve the growing physician shortage in New Jersey and meet new challenges in health care delivery?
RCG: I see this as an alternative for the current “brain drain” where many young people from New Jersey are going to medical schools outside of the state. Research shows that physicians often practice where they train, so the Hackensack Meridian School of Medicine is a solution which will help the state ease a shortage of an estimated 3,000 doctors by 2020. We will ramp up to 150 students next year, so ultimately it will be a medical school of 600 students.
Along with the opening of this state-of-theart medical school,Seton Hall University has relocated its College of Nursing and School of Health and Medical Sciences to create an Interprofessional Health Sciences (IHS) campus spread across Nutley and Clifton, helping to revitalize this major economic hub on the site of the former Hoffman La Roche campus. Students benefit from a three-year program, so they can save on a fourth year of tuition and start their residencies a year early at one of HMH’s 16hospitals, or stay on and obtain a graduate degree. Our Board of Trusteeshas established a $100 million endowment fund for scholarships, ensuring top students will be able to afford a medical education.
More than 2,100 students applied for the 60 spots. Diversity is well represented in the class, with students speaking a total of 25 languages. We wantour physicians to mirror the communities they serve. Women make up half of our class. Many of the students overcame their own challenges to get to where they are, which again, made the White Coat ceremony very special.
HMD: In 2017, you and your wife Laura donated $2.65 million to create the Robert C. and Laura C. Garrett Endowed Chair for the School of Medicine Dean. You were the first donors to make a gift of this magnitude to the new medical school.
RCG: Laura and I were thrilled to create this endowment to recognize the highest standards required in a leader of our medical school. The gift honored Dr. Bonita Stanton, founding dean of the Hackensack Meridian School of Medicine at Seton Hall University, who has practiced globally with distinction as a physician academician and will continue to bring the highest standards in medical education to the next generation of physicians.
Endowed chairs are among the highest honors conferred in academia and the $15 million donated in support of endowments at Hackensack University Medical Center reinforce its role as one of the top ranked academic medical centers in the country.
My wife and I wanted to make sure the school kicked off in the right way,and we’re very proud to have been able to endow this Chair. This school will be part of our legacy of improved health care for future generations.
HMD: Let’s talk about how the new Memorial Sloan Kettering–Hackensack Meridian Health partnership will transform patient care through collaboration, innovation and advanced technologies.
RCG: This is a time of unprecedented change in cancer care. The goal of this partnership is simple – to find more treatments for cancer faster while ensuring that residents have access to the highest quality, most individualized cancer care, where and when they need it.
Combining industry leading expertise and deep local roots is helping our new organization to accelerate research and discovery, advance the continuum of care for cancer patients and their families, and create new hope for cancer patients.
Our future outpatient cancer centers will be jointly owned and operated,a first for Memorial Sloan Kettering, and guided by exceptionally uniform standards. Clinicians on both sides have developed one hundred clinical standards that will define how cancer care is administered at these jointly owned centers across the state. So, if you are a patient in South Jersey or North Jersey or Central Jersey, you’ll receive the same world class standard of care,close to home.
Patients will benefit from precision medicine, immuno therapy, cell-based therapies, earlier cancer diagnosis, and an unmatched continuum of care that will support them throughout active treatment and beyond into survivorship. Equally as exciting, our communities will have greater access to hundreds of clinical trials to improve care for many types of cancer.
HMD: In August, HMH and Carrier Clinic, a leader in behavioral health with a 100-year history in New Jersey, announced plans to merge with a goal to deliver unsurpassed behavioral health care to the tri-state region. Why did you see a need to focus on behavioral health care?
RCG: The state of behavioral health care in New Jersey can be applied across the country. It’s fragmented at best and broken at worst. We see behavioral health issues growing as a significant problem in our society. Plus, there’s so much linkage between medical disease and behavioral health diseases. Almost 50 percent of people that have a primary medical diagnosis have a secondary behavioral health diagnosis, and in our emergency departments,about a third of patients have behavioral health issues.
We felt we needed a first class partner to help us take the lead as we did with Memorial Sloan Kettering in cancer care. Carrier is nationally recognized; they have great outcomes. We partnered on a couple of projects to get to know one another and were very impressed with their leadership and their clinical community, so we felt this collaboration could be a good fit. We plan to open an addiction treatment center next year in New Jersey.
HMD: What are you doing to make a difference through this new alliance?
RCG: Our primary goal is to expand access dramatically. Far too many people are waiting too long for care.We want to do some things differently in this area. We already have a massive ambulatory care network in place and plan to add a behavioral health component. We’ll open behavioral health urgent care centers because patients having an acute episode shouldn’t have to sit in an emergency department waiting for treatment.
Our goal is to create more addiction treatment centers in New Jersey. Too many residents are leaving New Jersey to go out of state for treatment.Florida, California and North Carolina are common destinations. This causes a burden to families, as a lot of these patients are younger, even adolescents.
The merger with Carrier will enhance research to improve behavioral health care and provide additional opportunities for our medical students pursuing psychiatry residencies and fellowship programs. We want to create world class addiction treatment centers right here in New Jersey, and we believe Carrier Clinic is going to help us to accomplish that.
HMD: What other types of care transformation initiatives are taking place,and how can value based “bundled” payments mean cost savings for patients?
RCG: What we’re doing is taking our top disease entities and approaching them in a very different way to achieve better results. Teams have been established around cardiovascular health, diabetes, different types of cancer and other diseases and conditions, and we’re looking through a new lens of improving quality, improving patient experience and ultimately making health care more affordable.
We’ve taken evolutionary actions such as creating bundles of care with insurers. This is the next threshold in value based health care, or patient centric practice – a new direction that is making the traditional fee based mode lless prevalent.
At the beginning of this year, Dr. Andrew Pecora, our chief innovation officer, oversaw the creation of an upfront payment model for breast cancer patients at HMH’s John Theurer Cancer Center,in partnership with Horizon Blue Cross Blue Shield of New Jersey, and now we have added bundled care for knee, hip and spine procedures.
With bundled care, hospitals receive an upfront payment from insurance companies for an agreed upon price for treatment. We accept 100 percent of the risk for all the care we provide. So, it provides an incentive for us – and all providers to make sure the patient receives high quality, cost effective care for every step of treatment, such as pre-surgical and postoperative care. It ultimately makes health care more affordable.
This program is one example of the ways we are reshaping how health care is delivered, helping enhance care coordination, improving outcomes and delivering greater value.
HMD: You believe that innovation is in your DNA at HMH. How is innovation creating a new foundation for innovative care at Hackensack Meridian Health?
RCG: We are eager to connect with individuals and companies at the forefront of enhancing care transformation, and so we have created an ideation center in partnership with the New Jersey Institute of Technology. The Agile Strategies Lab is the first incubator of its kind for health care advances in New Jersey. The Lab, located in Newark, is designed to help create and launch the next wave of problem solving in health care through better devices, improved technology and more efficient services to provide high quality of care, lower costs and an enhanced patient experience.We intend to leverage the combined skills of entrepreneurs,major corporations, research scientists, students and NJIT faculty to solve our challenges with novel strategies and products.
Our Board of Trustees also had a lot of great foresight when they committed $25 million to create an Innovation Center, helping companies develop trailblazing products and services. Seed money from the Innovation Center is helping to launch ideas to the point where they can become viable and receive financing from venture capitalists.
HMD: What kind of progress have you made with new product development?
RCG: We’ve already had 10 companies pitch us their ideas. We call it the Bear’s Den because we can’t say Shark Tank but the strategy is similar. The Bear’s Den is led by Dr. Andrew Pecora, president of physician enterprise and chief innovation officer at HMH, and our judges include a patent attorney, medical and financial experts, and Co-CEO John Lloyd. If we like you, we might invest in you.
In June, we invested in a new product created by Pillo Health,a leading in-home digital care management company. Pillo leverages voice first technology and artificial intelligence. Sitting on a countertop, Pillo uses voice and video technology to remind people to take medication at the appropriate time. It dispenses their medications, digitally coordinates prescription refills and connects individuals in their homes with physicians,caregivers and loved ones.
For example, Pillo can alert a family member if an elderly relative misses a medication dose. Pillo can also connect a patient or family member with a physician via video conference and provide an on-screen display of essential medical data as obtained from the patient’s electronic medical record.
HMD: A little over two and a half years ago, you and John Lloyd,who was CEO of Meridian Health prior to the merger, became Co-CEOs of Hackensack Meridian Health. Some people said it wouldn’t work for two strong, longtime CEOs to co-partner. Can you tell me why it has been successful?
RCG: It’s worked in our case for a couple of reasons, First, John and I have very complementary strengths and that’s how we divided up the organization. My background and my strengths have been in a more traditional hospital setting, and Hackensack University Medical Center was a major, nationally recognized medical center with a big emphasis on academics and research.Work began on the medical school years ago. Meridian excelled in their plan to create a major health care system with a broad ambulatory care network but were less evolved on the research and academics, so we each had something that the other needed.
It’s a true story that we challenged each other over dinner one night to write down on a piece of paper what areas we each thought we should be responsible for. “You know, John, what do you want to do and Bob, what do you want to do?” We exchanged our pieces of paper right there and we agreed about 90, 95 percent on what we felt our roles should be.
Another reason that this partnership works is that we had a succession plan in place from the beginning because, no matter how well you know and respect each other, no matter how complementary your strengths,if you don’t have a succession plan it’s going to be like the Wild West.Now John will retire at the end of the year and I’ll take over as the sole CEO, as we had always planned.
As much as we have been friends for a long time, we also worked hard to make this work and I think we are roles models as well and I think we’ve done really well together.
HMD: What do you see as John Lloyd’s legacy after so many years as a leader in health care, and as Co-CEO at HMH?
RCG: There’s no doubt that John is leaving an indelible mark on healthcare in New Jersey and beyond.
John was a visionary when it came to seeing the need to develop a full continuum of care to deliver comprehensive health services to communities. Now,everybody wants that full continuum of care and you hear about different health systems developing ambulatory care and post-acute care services. John saw the need for that early on and did it very well.
In addition to understanding the right strategy, John could get so much done because of his personality and his ability to connect with people. Whether you’re in a board room with John or at a community event or rounding on the floor with front-line team members, it’s the same John Lloyd. He’s just real and authentic and he connects with people. He’s an excellent leader and people want to follow him.
HMD: That infectious enthusiasm and ability to lead is an important quality in an organization with 33,000 team members and 6,500 physicians.How did you and John manage to build a new culture when you combined your organizations?
RCG: When we envisioned HMH we had some great initiatives and some great strategies but we knew that if we didn’t develop a unified culture over time, none of it was going to work. We focused on it and I think that the way you do that with 33,000 team members at all levels of the organization is to make it really simple.
We wanted to develop core messages in such a way that everybody,at any level or corner of the organization, would be able to relate. And we took this into consideration in developing our mission statement, our vision and our core beliefs. Our mission statement basically states that we’re all here to transform health care. All 33,000 team members can relate to our vision, which is that innovation is in our DNA.
HMD: How have you used your core beliefs to enhance employee engagement?
RCG: Collaborative, courageous, creative and compassionate are the four C’s that form our core beliefs. Each team member takes a test to see which C they score highest in, and they love it! John and I have been going around doing these pop culture events, with tent cards illustrating the four core beliefs. Team members who attend want us to sign their side of the card. “Oh I’m creative, could you please sign it?”
It’s providing people with a simple, universal way to relate, so whether you’re a world class bone marrow physician or a person who ensures that our patient environment is clean and safe, there’s something that every single person can hold in their hand and whatever decisions they need to make throughout the day, they can just check back to our core beliefs.
We developed the four C’s earlier this year and we’ve been rolling them out at Town Hall meetings and popup events across the organization. We even had a pep rally at Met Life Stadium, where I got to do my first zip line across the stadium. I loved it. I’d do it again in a minute.
HMD: Speaking of zip lining, how do you manage to stay above it all in terms of work/life balance?
RCG: A long time ago someone told me it’s a lifestyle and not a job. That’s true. I try to spend as much time as I can with family and friends, and many of our close friends are Hackensack Meridian Health people as well.
We get away, but often it’s no further than from our home in Morristown to our beach house in Spring Lake, where I love to walk on the boardwalk. I thrive on running into team members, people I know and people I don’t know and talking with them about what’s going on. This takes a certain personality type that I have, and it has helped me keep a lot of balls in the air and be successful at it.
Aside from people, my other great passion is travel. Seeing what’s different,seeing what’s going on. I’m fortunate to have twice been invited to participate on a panel as part of the Unite To Cure Conference at the Vatican.This year’s conference was themed How Science, Technology and 21stCentury Medicine Will Impact Culture and Society.I’ve also been fortunate to host a panel on the global transition of health care delivery at the World Economic Forum in Davos, Switzerland.
I work out four days a week, play some racquetball, and I do actually sleep pretty well, although I often say sleep is overrated!
Carpal Tunnel Syndrome is one of the most common conditions treated by Sports Medicine and Orthopedic physicians. It affects more than 12 million people per year in the US and carpal tunnel release is the second most common surgery performed, with over 230,000 performed annually.
Carpal tunnel syndrome is caused by compression of the median nerve, as it passes through a narrow space in the wrist called the carpal tunnel. Compression of this nerve typically causes numbness, tingling and weakness in the hand, specifically the thumb, index, middle and inside part of the ring finger. If left untreated, this condition may worsen over time and can even cause burning pain, muscle atrophy or muscle wasting.
The most common cause of carpal tunnel syndrome is repetitive motion of the wrist, like when using the computer or doing repetitive movements at work. Underactive thyroid, obesity, rheumatoid arthritis, diabetes and pregnancy can also increase the risk for carpal tunnel syndrome.
If conservative treatments like bracing, ice, NSAID’s (ibuprofen, naproxen), physical therapy or injections fail to relieve the symptoms, the last step is surgical release of the carpal tunnel. Traditionally, carpal tunnel release was performed as an open surgery. A 2 inch incision is made in the palm and wrist and the transverse carpal ligament is exposed and cut. This open surgery often requires a long recovery period, has a high rate of scar tissue formation which can also prolong the recovery period, and as with any surgery, a risk for infection.
Endoscopic carpal tunnel release has a much smaller incision than open carpal tunnel, 1 or 2 incisions around a ½ inch each. A camera is then inserted to visualize the ligament, nerves and artery while the ligament is cut. This method has a faster recovery but also has a slightly higher risk of nerve injury.
Sonex SX-One Microknife is the latest evolution of carpal tunnel release. Developed in the Mayo Clinic, the Sonex procedure was created to provide patients with a safe and effective treatment, with a low risk for infection or scar formation. In the Sonex procedure, a very small incision is made – the incision is so small, a patient won’t even need a single stitch after the surgery. Sonex is performed with ultrasound guidance which allows the physician to visualize all the nerves and blood vessels, whereas with an endoscopic surgery, the physician can only see what is at the end of the camera. Since very little tissue is disturbed, and there is complete visualization, the likelihood of complications such as scar tissue, infection and nerve or vascular damage is extremely low. Because Sonex is minimally invasive, most people can return to their usual activities in a couple of days, unlike in an open surgery which can take weeks to months.
In order to perform the procedure, the physician must be very skilled at musculoskeletal ultrasound. Because of this there are only a couple dozen doctors performing this procedure in the entire country. Dr. Daniel Savarino at Apex Sports and Regenerative Medicine in Tinton Falls is one of these few, select doctors. Dr. Savarino is certified in musculoskeletal ultrasound, and has extensive knowledge in the field.
To recap, Sonex for carpal tunnel provides the smallest incision, the least likelihood of complications and the fastest recovery of any method of carpal tunnel release. To learn more about this cutting edge procedure, please visit Apex Sports and Regenerative Medicine’s website -www.ApexSportsNJ.com or call 732-385-APEX (2739) to see if Sonex is right for you.
Amy B. Mansue covers a lot of geography behind the wheel of her car as she crisscrosses large chunks of New Jersey daily for her demanding work as an executive in healthcare delivery for Monmouth, Ocean, Mercer, Middlesex, and Somerset counties. In March 2016, Mansue accepted the position of President of the Southern Region of RWJBarnabas Health, the parent organization formed by the 2016 merger of Barnabas Health and Robert Wood Johnson Health System. As a person who is passionate about learning, she uses her driving time to listen to audio books and think creatively about the healthcare challenges that affect the communities she serves.
Mansue is accustomed to traveling from place to place, since as a child her family would vacation for a week camping in Maine, then visit family in Massachusetts or Florida. She grew up in a house that her parents built on two acres of a spinach field in Plainsboro. She planted trees, examined worms, and took violin lessons. As an only child, she has a close relationship with her parents, who were both educators.
Her mother was enrolled in one of the first classes at Douglass College, which encouraged women to enter college after they had children. She did this when Mansue was four years of age and shared duties with her father who oversaw care for young Amy at night. There were visits to the candy store and visits to family members. “It took a village,” Mansue observes, a concept that forms her own people-centered approach as a leading healthcare executive.
Mansue sees her job at RWJBarnabas Health as a chance to develop relationships, see people in different ways and learn from them. She applies the same principles of the village running through daily life, “whether you pick up a cup, or help somebody in a grocery store or transform healthcare in multiple counties.” She believes that we each play a role in helping others and from the small to large scales of action, that we can do it better when we do it together.
Mansue was born and raised in Plainsboro and is now a Hightstown resident who also owns a condo in Bradley Beach. Though she went south for her college years at University of Alabama, Mansue is a true New Jerseyan who has along the way fallen in love with the Shore. She draws her considerable drive and inspiration from every town and community she visits, however, as they form the roots of her faith in positive outcomes.
“I think you have to be purposeful about finding the goodness in every day, because there’s so much getting thrown at us about what is wrong or what we don’t have or what we should be aspiring to, that I think we can lose sight of what we have, and most importantly what can be done.”
A favorite book that she likes to keep close is “The Power of Moments” by Chip Heath, Dan Heath. It teaches how to focus on how to make an ordinary moment memorable. Mansue ordered 15 of the books to give to co-workers, encouraging them to find those opportunities. She also has a favorite “business” book, Five Dysfunctions of a Team by Patrick Lencioni, which presents in narrative form insights about how to tackle management issues. She turns to music – from classical to country rock to Bruce – to provide comfort in her very busy and challenging life.
As a child growing up in a household with two educator-parents, Mansue was allowed to watch only the news with Walter Cronkite and one half-hour TV show daily. It’s entirely probable that her big smile and ready laugh were inspired by nightly doses of her show of choice, I Love Lucy. Thankfully for us, that enduring sense of humor, coupled with intelligence and a wicked work ethic have this Jersey Girl in good stead as she tackles complex healthcare – and other issues – on the frontlines in New Jersey.
Living In Monmouth thanks Amy Mansue for taking the time to chat with us about her important role in shaping the present and future of healthcare in New Jersey.
LIM: The merger of Barnabas Health and Robert Wood Johnson Health System happened in 2016. How difficult was the merger process for these two major institutions?
AM: Change is always a hard thing, so any merger is difficult. But I think for the most part we’ve had a really smooth transition. We’ve had a steady opportunity to hit our goals, and that’s the first key of any merger.
We knew there would be synergies arising from strategic alignment, and there certainly have been. The need to share best practices has been wonderful throughout the system. I watched how suddenly all these people who were fierce competitors back in the community hospital days had to sit down together and share. It was definitely a process.
LIM: What institutions fall under your purview?
AM: I am responsible for the system’s service areas from the Raritan River south, including RWJ Somerset, RWJ Hamilton, Community Medical Center, Monmouth Medical Center, Monmouth Medical Center Southern Campus, and Children’s Specialized Hospital. Beyond hospitals, I have responsibility for those outpatient sites and physician practice locations in this region that work together to provide accessible service to patients.
LIM: Can you describe your main strategy for accomplishing healthcare services goals?
AM: There are established collaboratives around each of our service lines that provide the opportunity to share best practices. Using Ob/Gyn as an example, every hospital that has a program can come together and say, these are the issues we’re working on. How did you solve something similar? We pilot things and test them. There’s such dynamic energy in these systems, and it’s been really exciting to see how people love coming together.
LIM: You were CEO and president of Children’s Specialized Hospital in Mountainside from 2003 to 2016. Can you talk a little about the legacy you established there?
AM: I was very excited to have been there and have a chance to work with the team to create really powerful things, such as the expansion of our services to 11 sites and the move of the inpatient hospital from Mountainside to the RWJUH academic campus in New Brunswick. We tried to serve as many kids as we possibly could, and so we invested in telemedicine and all sorts of other approaches to try to meet the need, because the need was so great. By the time I left, we were taking care of 28,000 kids, but we knew that the need was more like 300,000.
LIM: What was it like for you to leave?
AM: I don’t think anybody really leaves Children’s Specialized. I think your heart always stays there. But when the merger came, it was a wonderful opportunity to channel my skills into a whole different set of challenges.
LIM: What knowledge did you bring to your new job as President of the Southern Region of RWJBarnabas Health?
AM: The thing that I learned early on in my education in social work is that the experts are the patients and families who are on the forefront of what we do. These are the people in our communities receiving the services, living in poverty or struggling with some of the changes. They know how the system can better serve them. They know this much better than we do. And I think that’s really true for healthcare in general. I think that we’re still very driven by everyone’s needs but those of our customers. Medicare, the State, the Joint Commission have requirements for us, but we need to learn how you listen and how you respond to the people we care for as much as our regulatory structure.
LIM: What do you think is the most important metric in assessing health needs for the Southern Region?
AM: I think it’s really about the number of people we can touch. There are nine million people in the state of New Jersey, and five and a half million of them live in our service area. So, we have the chance to improve the lives of those people with our programs and our services. How we are going to help people live better lives today, and in the future, is the key issue for me.
LIM: Why are we seeing a growing number of partnerships and mergers between competing healthcare organizations?
AM: I’ll use Monmouth and Ocean counties as an example. Hackensack Meridian and RWJBarnabas, we’re well-matched competitors on the healthcare playing field. But there are places where we can and do come together around opioid addiction, health screenings, ways to improve access and quality of care that we must tackle together because the issues for people in New Jersey are too big to tackle alone.
LIM: What are some of the biggest challenges for healthcare in our area?
AM: We know that the opioid epidemic is just horrific. We go to too many funerals and see too much loss. There must be a marriage between behavioral health and physical health if we are ever going to address the most perplexing health issues of our time – such as this opioid epidemic. The drugs really are about filling holes and cravings, and we must figure out how to deal with those in a forward-thinking basis, like we would do if we found out you were diagnosed with cancer. There has to be that same understanding, and so much of it is still stuck in the stigma against raising your hand and saying I need help – and then being able to access care.
LIM: How can healthcare services help bridge this divide between behavioral and physical health?
AM: I feel like things are not where they need to be in reaching kids and families sooner, or younger. And also making it okay to say, I need to talk to somebody. Many of us were raised that you just tough those things out. Nobody would ever say to somebody with a cancer diagnosis, just “suck it up”, but for some reason you need to tough it out when you’re depressed, right? But that is still the message when there is a behavioral health issue. The challenge that I think we all have to overcome in the healthcare field is to figure out how to de-stigmatize a program, a set of services that is critical, not just for those people with mental illness, but those people who have chronic health conditions, because those chronic health conditions make you depressed. You need to be able to have the ability to move in and out of those systems and access that care. And we as a healthcare system need to make that easier.
LIM: Have you seen progress in access to care?
AM: A really important instance of a team approach to improving access is in Central Jersey, where The Robert Wood Johnson Foundation and Middlesex County funded the work that St. Peter’s University Hospital in New Brunswick and RWJ New Brunswick are doing together. We have these two super hospitals three blocks from each other, and through this partnership we’re seeing improved access to cancer screenings and behavioral health services, for example. We have been making great strides and are looking at those boots on the ground to figure out how to do that work better in Monmouth and other counties.
LIM: In January 2018, you were named chair of the Board of the New Jersey Hospital Association, the state’s oldest and largest hospital and healthcare advocacy organization. Do you feel this is a good fit for you?
AM: I am grateful for this opportunity to continue to improve wellness for both individuals and local communities. Our 2018 mission statement is to improve the health of the people across the state, and as Board Chair of NJHA I look forward to collaborating with other leaders and organizations to concentrate on the societal challenges that impact health in our communities throughout New Jersey.
LIM: Are you looking to community partners outside the healthcare arena?
AM: I’m seeing that RWJBarnabas has really moved outside of the traditional healthcare realm very successfully. We view ourselves broadly in the social service business, not solely in the healthcare business. Whether you’re talking about developing jobs and work opportunities or looking at food insecurity and safe housing, you know, you’re really looking at these holes that need to be plugged to really have total wellness for people in a community.
LIM: Can you give an example of a community-outreach initiative?
AM: One of our major initiatives in Ocean County was the partnership with the schools and the naming of the RWJBarnabas Health Arena, which is in Toms River. It’s right on the campus of the high school. The school uses it for all of its activities, and it’s also the center for the community.
A primary driver for that naming opportunity was partnering with families and educators and really looking at creating those healthy lifestyles right up front because, you know, the older we get, the harder it is to change our behaviors, right? We want to look at how to start those healthy behaviors early, and also identify this next generation of healthcare leaders.
We’ve also started aligning RWJBarnabas Health with Rutgers’ education, research and clinical activities, including those at the Rutgers Cancer Institute of New Jersey and Rutgers University Behavioral Health Care.
This summer we will mark the first Rutgers Robert Wood Johnson Medical School class that will begin at Monmouth Medical Center in Long Branch. We’re very excited about that opportunity.
LIM: Can you identify any major shifts in our healthcare services model?
AM: We know we’re moving from a fee for service, inpatient model to an outpatient model, a value- based model that really looks at health outcomes. A priority is making sure that we use our universities and our health professionals to help ensure that we’re protecting people as we move to that value- based model. That is going to be critical. LIM: You seem to take a boots-on-the-ground approach to community healthcare. Why?
AM: The responsibility of ensuring the public good is one that you don’t always understand until you’re inside of Federal and State government.
I could never tell you the hours and challenges and things that I saw from the DYFS worker who would go into the most difficult situations, to the individual who’s making, you know, just barely minimum wage caring for our most fragile elderly and children. Those are really important jobs and we need to make sure that there is talent to be able to do them. When you’ve been privileged to see that whole range of challenges people face, it forms who you are. When you see the dedication of people who are passionate about helping their neighbors, it’s humbling. What matters is what you’re doing on the ground every single day for each person. And I think that it’s easy in this time of great competition to lose sight of that.
LIM: Does healthcare advocacy necessarily involve politics?
AM: I’ve always been interested in how laws get made and in how they impact people on the frontline, but I don’t see healthcare as a partisan issue. At the end of the day, whether you’re a Democrat or Republican or Independent, you want to make sure that when a patient walks into a facility, they receive the highest quality of care, a relationship with the practitioner that is respectful, and the ability to make important decisions together.
LIM: You’ve had experience in the public sector at both the federal and state level. Can you give us some highlights?
AM I had two tours of duty in State government under Governor Florio and then again under Governor McGreevey. My most memorable experiences came from the dedicated staff, advocates and families I got to meet along the way. Caring for the most vulnerable among us is both a huge responsibility and a tremendous honor. We must strive to find the best in each other and the institutions that help us provide these critical services.
LIM: You served as Co-Chair of the Budget Transition Advisory Committee for current Governor Phil Murphy. Do you think his administration will be proactive on healthcare issues?
AM: The thing that I like most about Governor Murphy is that he’s not afraid to take on a tough issue. He has been very clear about his desire to address the major issues we have in New Jersey, and it doesn’t matter whether it’s healthcare or education or transportation. They are all important issues that are going to require critical partnerships. I think we’re in for a very dramatic time in New Jersey as one of the states that has been on the forefront of Medicaid expansion, ensuring that people have access to services. There is no calculation under any federal block grant proposal or any entitlement reform that doesn’t end up hurting New Jersey. I think Governor Murphy has a clear vision about that. He’s been out front in reference to the out-of-network legislation, saying that people should not have surprise medical bills. He looks for a partnership between the hospitals and the doctors to really address those issues.
LIM: Any chance you might run for public office yourself?
AM: I never say never, except I know I won’t ever run for office. I can say never to that! Mr. Ostrowsky [Barry H. Ostrowsky, President and Chief Executive Officer at RWJBarnabas Health] has given me more work than I could even imagine. I can’t be thinking about another job right now. I’ve got to do well with the one I have.
Atlantic Eye – Providing a full continuum of care for your eyes
Our vision plays such a crucial role in everyday life, and that’s why the doctors at Atlantic Eye Physicians offer a full continuum of the most up-to-date procedures for restoring and maintaining eye health and function for their patients. They are dedicated to providing comprehensive, high-quality, personalized eye care, from routine eye examinations to cosmetic improvements to state-of-the-art eye surgery. The guiding principle of their team of physicians and nursing staff is always to provide the highest standards of patient care and service.
Their services include advanced custom cataract surgery, laser vision correction, corneal transplant surgery and DSEK, and they are also sought out for expertise in glaucoma evaluations, laser therapy, retinal care for diabetes and macular degeneration. They perform eyelid rejuvenation, Botox and Restylane procedures in the office, too. No matter what procedure you choose, the knowledgeable and friendly staff is committed to providing you with all of the information you need to feel comfortable with the process.
Atlantic Eye Physicians has four convenient locations in Monmouth County: Long Branch, Little Silver, Holmdel, and Manasquan. Each office is equipped with state-of-the-art diagnostic equipment: digital imaging, corneal topography, anterior & posterior segment OCT.
Many doctors now refer patients to ambulatory surgery centers because they know that ambulatory surgery is a quality, cost-effective alternative to hospitalization for many procedures. At Atlantic Eye Physicians, your surgery will be performed on an outpatient basis by your own doctor in the privacy of their comfortable Center. Their mission is to provide first-class surgical services in a safe, welcoming environment with compassionate care, integrity and the highest ethical standards, one in which they would be happy to treat their own families. Best of all, no overnight stay is necessary.
Atlantic Eye Physicians is also here to help you with any eye injuries and emergencies. They have the expertise, the experience and the facilities to take care of you and your family members should an eye-related emergency arise. In addition, they have an Optical center offering a wide selection of frames, and the newest lens technology for each specific prescription.
Visit www.atlanticeyephysicians.com to schedule a Free LASIK consultation or Custom Cataract consultation. At Atlantic Eye Physicians, taking good care of your eyes is their highest professional priority.
Sal Cannizzaro, CEO
SFC Enterprises, Inc.
Immediate Care Medical Walk-In
Marlboro Medical Arts Building
479 Route 520, Suite A103
Marlboro, NJ 07746 (732) 218.7550
OVERVIEW: The Immediate Care vision is to be the emblem for superior quality, patient centered care in the communities they serve. They are creating a new standard for urgent care services, one that combines a personalized, caring environment with a commitment to providing compassionate and convenient healthcare services.
With your background not originally being in the medical field, what made you want to move into urgent care centers in NJ?
My vision of building and opening a medical complex came from wanting a place where I myself could go for emergency services, X-rays, and lab work as well as my primary doctor. While plans for the Marlboro Medical Arts Building were on hold, I was introduced to the concept of urgent care centers, from which Immediate Care Medical Walk-In was started. We were finally able to break ground on this facility in August 2016.
How many medical facilities have you opened thus far?
The Marlboro Medical Arts Building houses the ninth urgent care center for Immediate Care Medical Walk-In.
What were the most important factors you considered when choosing the location for the Marlboro Medical Arts Building?
When looking for the ideal property for this facility, I considered the population of the community and surrounding towns, visibility and accessibility for patients. I also looked for a location that I could add to in the future.
Do you plan to expand the Marlboro Medical Arts Building? If so, what do you plan to include?
Yes, we have already begun plans for an additional 24,000 square foot, two-story building that will house a surgery center and medical offices for pain management and sports medicine.
What are some of the surprises or challenges you encountered when building your own medical arts building?
I initially started this project in 2005, but a huge challenge was the recession that the economy encountered shortly after plans were started. However, this challenge brought with it my discovery of the urgent care business from which Immediate Care Medical Walk-In developed.
What other practices are located on premises?
Within the facility is Immediate Care Medical Walk-In of Marlboro, CentraState Physical Therapy and Primary Care, Dr. Gostovich, Marlboro Medical Arts Pharmacy, and Dr. Sadek of Advanced Surgical and Bariatrics.
With so many projects and responsibilities, is it difficult to create a work/life balance?
I am very lucky to have a family that is so understanding and supportive of my work. I truly enjoy what I do, which makes them very happy for me. I also have the privilege of working with my son, Frank, who is the Vice President of Construction for SFC Enterprises Inc.
Can you tell us a bit about your involvement in the community?
We make every effort to be involved with all the communities that we are a part of whether that is sponsoring the local schools, participating in town events or hosting blood drives. We are in the business of helping people and that continues outside our urgent care centers.
What’s next for Immediate Care?
Immediate Care is always looking for a new way to make medical treatment more accessible, convenient and cost effective. We plan to continue to implement additional healthcare services and expand to new communities.
Mary Brighton, MS, RDN
Hackensack Meridian Health Integrative Health & Medicine (732) 263-7999
BIO: Mary Brighton is a Registered Dietitian and French trained Culinary Nutritionist. As an Integrative Nutritionist with Hackensack Meridian Integrative Health & Medicine, she works with the Integrative team on a Five Pillars of Health and Well-Being (Sleep, Activity, Purpose, Nutrition, and Resilience) approach, with the ‘food as medicine’ philosophy as the basis of her nutrition counseling and classes with patients and the community. Mary strives to see every person, young to less young, optimize their health and live a longer more productive life.
I’ve noticed that when I have a cold, food doesn’t taste as good. Can you tell me why?
Smell is the most important sense in how we perceive the flavor of the food we eat. When there is a physical problem with processing odors, the pleasure in relation to our diet is diminished. Taste is mostly odor detection, so if food has lost its flavor, the problem is usually a smell issue. Our taste sense, which is a sensory system, is similar to sight and audio senses. The tongue’s taste buds perceive chemical signals from the food we eat and work together with the aromas in food, our memory, temperature and even the texture of the food to bring the final ‘yum!’ picture to the person eating.
Are there any disorders that affect our sense of smell?
Smell disorders are a common problem with several million Americans suffering either temporarily or chronically from this condition. Half of all diabetic persons have a diminished sense of smell and taste and almost all those with Alzheimer’s disease have lowered smell capacity. Viral infections like colds and flu, certain medications, smoking, alcohol abuse and other brain related disorders are linked with smell disorders. As we age, over a quarter of persons over 55 years old and about two-thirds over 80 years old have a lowered sense of smell.
Why should health professionals know about the taste and smell sense?
Unlike our sense of sight and hearing, which are apparent to the health professional, our loss of smell sensitivity is not detected as well, and this problem can have devastating effects on a person’s lifestyle and food enjoyment. Appetite and food intake can go up or down, and because the flavor of foods is linked to emotion and memory, a person with a smell disorder can feel isolated and even depressed. Genes also play a role in taste perception and certain genetic variations can affect how we perceive flavor. This is why cilantro tastes delicious for some of us but tastes like soap to others! By knowing how important smell is to food pleasure, we can guide a person to the different options available, some of which are related to food preparation and nutrient availability.
If we have a smell disorder, what can we do to help food be more flavorful?
In the aging population we see people trying to make food ‘taste’ better by adding more salt to their meals. Rather than adding table salt, we emphasize textures and temperatures, spices and herbs that help the mouth taste food but don’t involve the olfactory sense.
How can we keep our sense of taste and smell as we get older?
There are certain trace mineral deficiencies that are related to taste and smell, in particular zinc. Good oral hygiene and nutritious diet with adequate zinc are important to support our sense of smell and food enjoyment. In our practice, I talk to people about the taste of food and look for any underlying factors on why their appetite for flavorful food is down.
The terms ‘aneurysm’ and ‘stroke’ are sometimes used interchangeably. Factors such as obesity, smoking, high blood pressure, cardiovascular disease, alcoholism, and diabetes can lead to aneurysm and stroke. Diagnosis includes a thorough medical exam as well as tests such as MRI and CAT scans. Additional diagnostic tools for stroke include carotid ultrasound, cerebral angiograms and echocardiograms.
Most Aneurysms Develop After Age 40
“An aneurysm occurs when the walls of an artery weaken and a bulge forms,” says Dr. Ciro G. Randazzo, a board-certified neurosurgeon and neuro-endovascular specialist. “If the aneurysm continues to grow, it can eventually burst, which can lead to severe and even fatal consequences (hemorrhagic stroke).”
Symptoms can vary depending on where the aneurysm is located, from pain and swelling in the abdomen to vision problems, slurred speech and severe headaches.
“Fortunately, state-of-the-art treatments exist that permanently seal the bulging blood vessel and redirect blood flow,” says Dr. Randazzo.
Stroke: A Leading Cause Of Long-Term Disability
“Stroke is the fifth leading cause of death in the US and a leading cause of disability,’ says Dr. Randazzo. “By understanding the risk factors and with proper diagnosis and treatment, most strokes can be avoided.”
Stroke, also known as a cerebrovascular accident (CVA), occurs when the blood supply to the brain is interrupted or reduced. Stroke is a medical emergency. Treatments include the blood clot buster tPA, thrombectomy, and angioplasty procedures. “Fortunately, by partnering with comprehensive stroke centers throughout New Jersey, skilled stroke teams at local hospitals are helping New Jersey residents survive the devastating effects of stroke,” concludes Dr. Randazzo.
Spinal Disc Degeneration
Degenerative disc disease (DDD) is a condition that results from aging and normal wear and tear on the spinal discs, which act as shock absorbers between the vertebrae. “With age, the discs lose fluid, making them less flexible and more compressed,” says Pinakin R. Jethwa, MD, a board-certified neurosurgeon. “The discs can also develop tiny tears, which cause pressure on the spinal cord and nerves. The most common symptoms of DDD are deep lower back pain or neck pain, and stiffness.”
Smoking, obesity, heavy lifting and hereditary factors also lead to disc degeneration.
Artificial Spinal Disc Replacement
“Conservative therapies such as over-the-counter medications, physical therapy and injections are the first course of treatment,” says Dr. Jethwa. “When these no longer bring relief, it may be time to consider surgical intervention.”
“Spinal fusion or replacing the disc with a metal cage or other stabilizing materials were the conventional approaches to degenerative disc disease,” says Dr. Jethwa. “The gamechanger today is using a device that allows normal motion of the spine – bending, pivoting – to continue. Disc replacement patients can return to normal routines, such as playing tennis and picking up grandchildren.”
Spinal surgery is not a procedure to be taken lightly. Take the time to consult with a skilled spinal surgeon experienced in newer procedures such as artificial disc replacement.
Ciro G. Randazzo, MD, MPH, FAANS
From performing regular exams to full-mouth reconstruction, your dentist plays a key role in maintaining your overall health. Good oral and dental hygiene can help prevent bad breath, tooth decay and gum disease, and can help you maintain or replace your teeth as you get older. Researchers have discovered that good oral health can help ward off serious medical disorders such as heart disease, stroke, diabetes and even preterm labor.
Establish an Oral Health Baseline
“Adults should have a dental exam and cleaning twice yearly,” says Dr. Joseph P. Prasad D.M.D., M.A.G.D. “It is very important to establish your oral health baseline,” he explains. “Your dentist should perform a complete oral examination, including an oral cancer screening, a periodontal evaluation, an analysis of
your bite, and a thorough examination of your teeth, their supporting structures, and of the oral anatomy.”
“Regular cleanings by a dental hygienist will help prevent new cavities, preserve teeth that have been restored, and manage periodontal disease,” says Dr. Prasad. “If you haven’t visited the dentist in a while,” he adds, “schedule an appointment soon.”
Technology-Driven Patient Care
Technology is contributing to more beautiful smiles for patients of all ages. “Orthodontic practice is embracing the future of technology in dentistry,” says orthodontist Dr. Patrick Cuozzo. “One great advance is using 3-D printing to create in minutes customized orthodontic models for clear aligners, precise surgical guides and more, which can be done right in the orthodontist’s office.”
After a digital impression has been made, the data is fed into a computer program and a 3-D printer produces a model on the spot. “State-of-the-art 3-D printing is just one of the technologies available to streamline patient care without sacrificing accuracy and precision,” says Dr. Cuozzo.
Accelerated Orthodontics: Faster Orthodontic Treatment with Less Discomfort
“For anyone considering orthodontic treatment, the first question is always ‘How long will treatment take?’” says Dr. Tara Gostovich.
“The goal of an emerging school of treatment called “Accelerated Orthodontics” is to shorten the time in orthodontic appliances and treat the patient with less discomfort,” says Dr. Gostovich. “Almost anyone is a candidate for accelerated treatment, but it is perfect for those who have a special event in mind, such as a wedding or the start of a new job.”
“Today’s surgical and non-surgical accelerated orthodontic treatment options painlessly stimulate the movement of teeth into proper alignment in less time,” says Dr. Gostovich. “These accelerated treatment options can be used in combination with current orthodontic treatments such as braces or clear aligners to reduce treatment time by as much as 50 percent.”
Prosthodontists: Architects of the Smile
Not all dental care is preventative. Some conditions require the advanced care of a prosthodontic specialist. Sometimes called the “architects of the smile,” prosthodontists are primarily concerned with the restoration and replacement of lost or damaged teeth with implants, dentures, bridges, crowns and other restorations.
After graduating from college and completing four years of dental school, prosthodontists receive an additional four years of advanced graduate training recognized by the American Dental Academy. These specialists are highly familiar with all the elements that go into a beautiful, functional and naturallooking smile—not just the teeth, but also the gums, lips, and facial features.
“Dental reconstruction because of trauma, disease and congenital disorders can sometimes require several steps, including bone grafts, implants and orthodontic therapy,” says prosthodontist Dr. James Courey. “The prosthodontist puts the plan together and sequences other dental specialists. By collaborating with dental professionals in other specialty areas, we can ensure the best possible outcomes for the patients we serve.”