Charlotte Family Health Center
 
    
Charlotte Family Health Center

News

Office Closed on Wednesdays in fall, 2015

Our office family is expanding - one of our providers is expecting a baby due in September. As a result of this, please note the office will be closed on Wednesdays approximately between September 28th and December 2nd. During this time, we will continue to have 2 providers in the office on Mondays, Tuesdays, Thursdays and Fridays. Our phone lines will remain open on Wednesdays. Thank you for your understanding.

FLU UPDATE October 2014

As we begin to prepare for the upcoming flu season, we wanted to review a few ways you can help protect yourself and your family from acquiring the flu this winter.                           
Overview:
“The flu” is the term generally used to describe infection with the influenza virus, which is usually spread through water droplets from sneezing, coughing, breathing, and hand to mouth contamination.  Flu symptoms can be very similar to the common cold (sore throat, muscle aches, cough, nasal congestion), though symptoms are usually come on more quickly and are typically more severe. Flu activity generally begins to increase in Oct-Nov and peaks between Jan and March. People at highest risk for serious complications from the flu are infants and toddlers less than 2 years old, adults over 65 years old, and those with other medical problems (asthma, diabetes, and chronic diseases of the lungs, heart, liver, kidney or immune system). You can read more about symptoms, etc by reading Dr. Gieg’s original flu update article below.
Prevention:
The best protection from the influenza virus is the flu vaccine.  This is usually available from early fall through to the end of the flu season in March or April, and takes about 2 weeks to achieve full effectiveness following administration.  It is currently recommended annually by the CDC (Center for Disease Control) for everyone over the age of 6 months, with particular emphasis on those at high risk as mentioned above.  The reason that the vaccine must be given annually is because there are many different strains of the influenza virus, and each year new mutations tend to be the dominant ones causing infection in humans; the CDC researchers try to predict the most likely strains to cause widespread disease in any given year, and the vaccines are usually developed to the 3-4 most prevalent strains.
We recommend flu vaccination after Oct 1st and will have vaccines available in our office at that time. The CDC has not acknowledged preference of quadrivalent (4 flu strains in one vaccine)  vs trivalent (3 flu strains in one vaccine) vaccines at this time but as of this year does recommend that healthy children between the ages of 2-8 years old receive the nasal spray instead of the injectable vaccine.
Treatment:
Treatment of the flu is generally supportive as antibiotics are not effective against viral infections. Supportive treatment includes staying home, getting plenty of rest and fluids, and using acetaminophen and/or ibuprofen for fever, headaches, and muscle/body aches.  For typical flu cases further medical treatment is not usually necessary, however there are medications such as Tamiflu and Zanamivir which may shorten the length and severity of symptoms. Influenza has the potential to also become a much more serious, even life-threatening illness in some cases and it is important to seek medical attention early, particularly for those at increased risk for complications.
Further information regarding influenza may be found at http://www.cdc.gov/flu/ and http://healthvermont.gov/prevent/flu/index.aspx .

Thank you for visiting our site, and please let us know if this information has been helpful, and there is further information about the flu, or other topics which you would like to see addressed through this forum.

Dr. Bernstein Announces his Retirement from the Charlotte Family Health Center 8/1/13
To all my patients:

I am writing to let you know that I will be retiring from the practice of medicine in August. Having been associated with the Charlotte Family Health Center since its founding in 1975, I wish to thank all those who have relied on me and entrusted to me their most precious possessions: their health and the health of their families.

Over the years, I have come to realize that the art of medicine is not simply the wise application of scientific principles and advances. In essence, the practice of medicine is the communication between two people—one a good listener, the other sharing his or her deepest concerns and fears. The art of medicine, as I have come to understand it, is the ability to truly hear these concerns and to address them in a way that promotes overall well-being. To the extent I have realized this ability, I will say the past 38 years have been extremely satisfying to me. I am grateful to the past and present members of the Health Center staff; they have helped me to develop and practice my art throughout my career.

The hardest part of leaving, of course, is that I will miss the associations I have developed—some extending back decades, some with children and grandchildren of my early patients. I’ll miss knowing how it all turns out.

I am confident, however, that the Charlotte Family Health Center will continue to be what it has become: a place where everyone is known personally and respected, a place where our patients know they can be seen quickly when there is a problem, and a place where caring staff practice family medicine in an expert fashion.

I am pleased to be leaving the Health Center in capable hands. Dr. Andrea Regan, Dr. Gordon Gieg, and our newest staff member, Nurse Practitioner Jennifer Allaire, will be able to continue your care and are looking forward to getting to know you if they haven’t met you already.

Your records will remain at the Charlotte Family Health Center unless you request we move them. If you are taking a medication regularly, please call the office to schedule a visit with a new practitioner when your prescription is near time for renewal.

Thank you again for your confidence in me. I wish you the best health and success in the future.
Dr. Richard H. Bernstein 8/1/2013

Changes in Medicine 1970-present. A Retiring Physician Looks Back.

The anxious woman and her family are in the hospital waiting room, smoking, occasionally pacing. The door opens. A doctor, dressed in surgical scrubs, enters. With sincere concern, he finds the woman’s eyes, then looks down and says, “We went in to have a look. But we found a cancer. It has spread all over. There was nothing we could do. We closed him back up.”

This is a scene from a movie. But it’s an old movie. You can’t smoke in hospitals any more. Exploratory surgery, which was fairly common in 1972 when I started to practice medicine, was superseded by the CAT scan by the end of the decade. This technology, as well as advanced ultrasound techniques and the MRI, have allowed physicians to see into the patient without the need for exploratory surgery.

There have been many more medical advances since 1975, the founding year of the Charlotte Family Health Center. Coronary bypass surgery, new at the time, resulted in a two-week stay hospital stay, often with several days in intensive care. Now patients are back home within five days. Hernia surgery is done as an outpatient. Gallbladder surgery, done laparoscopically, means an overnight stay, while repair of a ruptured disc likewise requires but a brief hospitalization.

There have been advances in non-surgical treatment as well. Quicker diagnosis of heart attack, advanced techniques in the cardiac care units, and anti-cholesterol drugs have sent cardiovascular death rates down by 40% since 1970. In addition to these advances, patients are more aware of the role of exercise and healthy eating, and smoking rates are half what they were in 1970. With improved screening and better drugs, cancer death rates have declined 20% since 1991, and drugs to reduce stomach acid have made peptic ulcers and ulcer surgery a rarity.

On the other side of the coin, average life expectancy has increased from 70.81 years in 1970 to 78.6 years today, and growing challenges have come from an aging population that suffers more chronic diseases such as arthritis, memory loss, and strokes. There is also more obesity, which is causing an increase in diabetes with all its complications.

Advances in the practice of medicine have been supported by a huge increase in medical research. Though the growth of funding has slowed significantly in the past two years, support for biomedical research doubled in the decade before 2003 and increased 30% between then and 2007. Pharmaceutical and other biotech companies have provided an increased percentage of the total in recent years.

Medical research is increasingly guiding treatment. Evidence-based medicine requires proof that a drug or procedure works. The best evidence comes from double-blind trials where one group of patients is given a placebo treatment, another the proposed treatment, and neither the patient nor the physician knows who is getting what until the end of the study. Anecdotal evidence ("Well, it worked for a few people, so it must be effective.") is given little credence in modern medicine.

However, there are limitations to the so called evidence-based approach. First and foremost, as most research is supported by organizations with a financial stake in the outcome, wise physicians must evaluate the evidence carefully and with healthy skepticism. Moreover, results are expressed statistically, and it is unlikely that we all react the same, differing in ways we may not understand yet. In a system that increasingly encourages physicians to believe in statistics and the law of averages, there must still be room for the treatment of the individual.

Biomedical research and medical advances have contributed significantly to the growing cost of medical care. According to a 2012 study by the Kaiser Foundation, health care accounted for 7.2% of the US economy in 1972 and 18% in 2010, increasing from $75 billion to $2.6 trillion during that time. A dollar spent on healthcare is another nurse or hospital worker or lab tech employed, and health care accounted for nearly 12 million jobs in 2011. Health care employment is growing faster than the national average.

There is another factor that is a large contributor to the rising cost of health care. New York public health expert, Dr. David Himmelstein, found that between 1968 and 1993, the number of medical personnel (doctors, nurses, assistants, technical workers) increased from 480,000 to 750,000, while the number of managers and administrators grew from 600,000 to 2,800,000. In other words, the number of health-care providers grew by less 50%, and the number of administrators more than quadrupled. This trend continues.

Administrators are those insurance company representatives who tell you that the medication you’ve been taking for the last 10 years is no longer covered because they negotiated a cheaper deal on a similar pill, or that the MRI your doctor believes you need is denied. They are the medical billers and clinic supervisors. And they are growing in number way faster than the number of physicians.

Meanwhile, medical care is becoming increasingly centralized into larger organizations. Over the past decade, medical administrators have increasingly inserted themselves between doctors and their patients. These administrators use numbers and statistics to determine “quality” of health care. Keeping up with their demands requires extra staff and more technology, which places a burden on small, local health centers.

As a physician about to retire, I wrote this in a letter to my patients: “Over the years, I have come to realize that the art of medicine is not simply the wise application of scientific principles and advances. In essence, the practice of medicine is the communication between two people—one a good listener and the other sharing his or her deepest concerns and fears. The art of medicine, as I have come to understand it, is the ability to truly hear these concerns and to address them in a way that promotes overall well-being.”

We live in a time when the ability and opportunity to communicate with each other is increasingly challenged by cell phones, texting, computers, and the general pace of our lives. All these things place barriers to the deep, personal, face-to-face communication between two people. Yet the ability to know someone as an individual, to interpret medical research and recommendations for that unique person, to forget the numbers and demands of the central clinic bureaucrats, and to do what is best for the patient is still the essence of good medical practice.

With all the wondrous medical advances, the leaps in research, the costs and questions of funding, and the invasion of the health administrators, the fundamental opportunity to communicate with another and thereby to change the course of an illness remains the physician's most important tool.

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