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Quality &In addition to milk, bread andfresh produce, North County residentscan now add some new items to theirshopping list, like diabetes testing,school physical exams and treatment fora sprained ankle, to name a few.Palomar Pomerado Health’s “PPHexpresscare” walk-in health centers arenow open inside of Albertsons/Sav-onPharmacy stores in Escondido and Rancho Penasquitos. While stilla relatively new concept in Southern California, retail health centershave opened across the country and are generally located within grocerystores, drug stores, large discount stores and strip malls.From 9 a.m. to 9 p.m. Monday through Friday, 9 a.m. to 5 p.m. onSaturday, and 10 a.m. to 6 p.m. on Sunday, PPH expresscare is opento treat patients on a first-come, first-served basis, with no appointmentThe PPH expresscare team of physicians,necessary. As an added convenience, patients are offered pagers sofamily nurse practitioners and administrators.that they may complete their grocery shopping, visit Starbucks or tendto their banking needs while waiting to be seen by a PPH expresscarecertified family nurse practitioner. The pager is similar to those used by “We work under the direct supervision of the medical directors,” saysSprague, who works at the PPH expresscare location in Escondido.restaurants to let you know your table is ready.“This means we can prescribe medications for routine illnesses and orderDuring a visit that might last about 20 minutes, certified family nurse lab tests and X-rays. We cannot refill medications prescribed by otherpractitioners examine and treat patients, age two years and older. They clinicians for chronic illnesses.”address many common medical conditions such as strep throat, seasonalallergies, pink eye, ear infections, skin conditions, coughs and colds or “At PPH expresscare, I am able to treat medical problems while they areminor injuries. Additionally, the PPH expresscare nurse practitioners still relatively minor and connect patients to needed follow-up care,”administer select vaccines, provide health education, conduct school Kerrigan says. “If they don’t have a primary care physician, we will referpatients to a PPH affiliated doctor or community clinic and provideand sports physical exams and make referrals for follow-up care.appropriate information about other community resources.”Improved Access“I am passionate about improving access to health care,” says KimberlyKerrigan, APRN-C, MSN, FNP, a certified family nurse practitioner whoworks part-time at both locations. “PPH expresscare retail health centersremove some barriers by making health-care services quick, accessible,affordable and convenient.”Kerrigan, Monica Sprague, Tania Marek, Cristina Shoukry and DorisAsombrado are the regular family nurse practitioners who work incollaboration with the program’s three PPH affiliated board-certifiedfamily practice physicians: Donald Herip, M.D., MPH; Alejandro Paz,M.D., MPH; and Lawrence Koenig, M.D. All of the nurse practitionersare nationally certified in their advanced practice specialty as familynurse practitioners and all hold master’s degrees in armacyAlbertsons/Sav-onPharmacy1509 East Valley ParkwayEscondido, CA 9202714340 Penasquitos DriveSan Diego, CA 92129 Patients receive a visit summary report, which includes the diagnosis,directions for follow-up care as needed and any medication information.The visit summary report will be sent to the patient’s physician,provided consent has been given. The report is sent within 24 hoursof the patient’s visit to help assure that follow-up care is effectivelycoordinated with the primary care physician.Continuity of Care“Ensuring continuity of care is one of PPH expresscare’s primary goals,”says Stonish Pierce, M.H.A., manager for Clinical Outreach Services.Pierce, along with Sheila Brown, R.N., MBA, PPH chief clinical outreachofficer; and Bob Hemker, PPH chief finance officer; worked to build arelationship with Albertsons/Sav-on Pharmacy and bring the expresscareconcept to reality. “Through our deployment of an electronic medicalrecord we currently have about 700 community-based physicians in theexpresscare database, which enhances our ability to inform them in atimely manner,” added Pierce.PPH expresscare serves everyone regardless of where they receiveregular medical treatment or insurance status. The average charge formost services is 59. PPH expresscare accepts cash and major creditcards and is working with several health plans for network inclusion.Patients who are members of one of the contracted health plans will payonly the required co-pay at time of service.may – A u g u s t 2 0 0 8w w w. p p h . o r g

Convenience You Can Depend On“Our prices are transparent, which issomething not regularly experienced inhealth care,” says Pierce. “When yougo to a restaurant, the prices are listedon the menu so that you know exactlyhow much it will cost for your meal.Likewise, at PPH expresscare our pricesare posted in the store, on our website,in informational brochures and furtheradvised by the expresscare clinicians sothat there are no surprises.”“PPH has an excellent reputation as a top quality health-care providerand understands that good customer service is the key to success today,”says Sprague. “PPH expresscare is just one more way that PPH canprovide outstanding service to the residents of our community.”“This is an exciting new venture for Palomar Pomerado Health,” saysSheila Brown, R.N., MBA, chief clinical outreach officer. “We are thefirst health system in the state of California to be licensed as a hospitalbased outpatient service center. This achievement further illustratesour ongoing commitment to improving access for basic health-careservices, enhancing patient relationships with our affiliated physicians,and strengthening the continuum of care in North County.”Think PPH expresscarefor Prompt Care“There is a transformation occurring in health care, in that threelevels of care are emerging for hospitals and health systems:expresscare, urgent care and emergency care,” says Stonish Pierce,M.H.A., Manager for Clinical Outreach Services at PPH. “Patientsare quickly learning which level of care best suits their needs.”“PPH expresscare is intended to provide episodic care for situationsthat require immediate attention, like when a child is sick witha sore throat on a school night, someone sprains an ankle whileplaying softball, or you are suffering from allergies and can’t affordto miss work,” adds Pierce.“The retail health center is not an urgent care center and is notmeant to replace a patient’s primary care physician,” says DonaldHerip, M.D., MPH.To learn more, visit www.pphexpresscare.org or call The HealthSource at800.628.2880.Patients who have a more severe illness or injury should call theirphysician or go to urgent care.To learn more, visit www.pphexpresscare.org or callThe HealthSource at 800.628.2880PrICIng menuCommon IllnessesBronchitisColds and FluConjunctivitis (Pink Eye) and StyesEar InfectionsLaryngitisPharyngitis (Strep Throat)Seasonal AllergiesSinusitis (Sinus Infections)Urinary Tract InfectionskIn CondItIons 59 59 59 59 59 59 59 59 59musCles and JoIntsAnkle SprainMild Musculoskeletal ProblemsMinor InjuriesMinor Knee InjuriesMinor Pain (Neck, Back) 59 59 59 59 59PreventIve medICIneSchool Physical ExamsSports/Camp Physical Exams 59 59sCreenIngsBlood Sugar/Diabetes TestingBody Mass Index (BMI)CholesterolHypertension (Blood Pressure)Pregnancy Confirmation 25 25 39 25 39Acne 59Animal Bites 59Athlete’s Foot 59Cold Sores 59Contact Dermatitis (Poison Oak/Ivy) 59Impetigo (Minor Bacterial Infections) 59Insect Bites or Stings (Including Tick Bites) 59Lice/Scabies 59Minor Burns 59Minor Skin Infections and Rashes 59Minor Sunburn 59Ringworm 59vaC C I n at I o n sDiptheria, Tetanus & Pertussis (DTaP)Hepatitis AHepatitis BHPV (Gardasil)InfluenzaMeningitisMeasles, Mumps, Rubella (MMR)PneumococcalTetanus, Diphtheria (Td)Td Pertussis (Tdap)For a physician referral, or to register for a class, call The HealthSource at 800.628.2880. 59 69 59 169 29 110 65 49 39 59

ClassesCheck out the latest programs available and register today!Heart HealthCardiac RehabilitationPalomar Medical CenterCall 760.739.3566 for dates, times and fees.Medically supervised program for anyone recovering from acardiac event.Diabetes HealthSigns of Stroke? ActDid you know that stroke is the third leading cause of death inAmerica and the number one cause of adult disability? Thegood news is that 80 percent of strokes are preventable, if youact F.A.S.T.!A stroke or “brain attack” occurs when a blood clot blocks an arteryor a blood vessel breaks, interrupting blood flow to an area of thebrain. When either of these things occur, brain cells begin to die andbrain damage occurs.Diabetes Related NeuropathyOASISWednesday, August 2010:30 a.m. – NoonIndividuals with diabetes are at risk for developing chroniccomplications like nerve damage called neuropathy. Controllingblood sugar levels can delay or even prevent complications. JoinHalle Elbling, M.S., R.D., Diabetes Educator, as she explains thesymptoms of diabetic neuropathy, how to prevent it, and the areasof the body that are affected by this condition. To register, callOASIS at 760.432.0635.FEE: 3 / participantDiabetes EducationThe HealthSource, San MarcosClasses offered weekly.Call 760.510.7377 for dates, times and fees.DiabetesHealth education classes are designed to help individualswith diabetes improve their health status and quality of life.Classes range from a core education series to specific needs thatfocus on self-blood glucose monitoring, nutritional meal planning,carbohydrate counting, oral medications and gestational diabetes.DiabetesHealth is certified by the American Diabetes Associationand accredited by California’s “Sweet Success” program forgestational diabetes.Lung Health“When brain cells die during a stroke, abilities controlled by thatarea of the brain are lost,” says Barbara Buesch, R.N., district strokecoordinator at Palomar Pomerado Health. “These abilities includespeech, movement and memory. How a stroke patient is affecteddepends on where the stroke occurs in the brain and how much thebrain is damaged.”Someone who has a small stroke may experience only minorproblems such as weakness of an arm or leg. People who have largerstrokes may be paralyzed on one side or lose their ability to speak.Some people recover completely from strokes, but more than 2/3 ofsurvivors will have some type of disability.The stroke units at Palomar Medical Center and Pomerado Hospitalare well equipped to care for stroke patients. A stroke team isimmediately summoned to care for suspected stroke patientsarriving to the Emergency Department (ED). They are then evaluatedby an ED physician and neurologist for appropriate treatment suchas thrombolytic therapy (TPA). Nurses have received expandededucation to care for the special needs of stroke patients, andextensive inpatient and outpatient rehabilitation services areavailable for the best possible recovery. For more information onstroke care at Palomar Pomerado Health, call The HealthSource at800.628.2880.May is National Stroke Awareness Month,a time to educate the nation and spread awarenessabout stroke prevention, symptom recognition andrecovery. In recent years stroke deaths have declinedby 10,000 Americans. This year, the National StrokeAssociation hopes to continue to reduce strokedeaths by educating the public to recognize strokesymptoms, and to act F.A.S.T.Kick the Habit: Smoking CessationPalomar Medical Center, Education ClassroomEight-week seriesWednesdays, May 14 – July 2PPH’s smoking cessation class, led by oncology nurse Kay Kimball,RN, MSN, OCN, explores the challenges of “quitting” and providesthe tools and support necessary to help you kick the habit. Includescomprehensive workbook.FEE: 125 / participant – Register with a friend for just 100 each!Pulmonary RehabilitationPalomar Medical CenterPomerado HospitalCall 760.739.3685 for dates, times and fees.Education and physical conditioning for those suffering from anyform of pulmonary disease. F. A.S.T.!may – A u g u s t 2 0 0 8F FaceAsk the person to smile. Does one side of the facedroop?A ArmAsk the person to raise both arms. Does one armdrift downward?S SpeechAsk the person to repeat a simple phrase. Does thespeech sound slurred or strange?T TimeIf you observe any of these signs, it’s time to call9-1-1.w w w. p p h . o r g

Women’s Center2Extends Warm Welcome to the CommunityThe new Jean McLaughlin Women’s Center for Health and Healingopened its doors for business in January and commemorated theoccasion with a dedication ceremony on January 16, followed by acommunity open house on February 9. More than 600 area residentsstopped by to enjoy the festivities. Free tours of the new facility arestill available. Please call 858.613.6120 for more information.1345A perfect fit for women.6Slip into a health-care experience that’s as comfortable as yourfavorite pair of jeans. The new Jean McLaughlin Women’s Centerfor Health and Healing combines the most advanced technologiesfor diagnosis and treatment, with personalized, compassionatecare provided in a peaceful, healingenvironment. Our physicians and healthcare professionals specialize in a widerange of services for women of all stagesof life, including: Comprehensive Breast Center Heart, Bone and Bladder Health Stroke Prevention Diabetes Prevention Perinatal Testing Center Women’s Health Connection Boutiqueand Resource CenterLadies, schedule yourroutine screeningmammogram today!Our comprehensivebreast center featuresdigital mammographyfor highest resolutionimages.To learn more, visit www.pph.org/womenor call 800.628.2880.Call 858.613.6120for an appointment. Lactation Consultation Wellness Center Nutrition & Weight Management Women’s Health EducationFor a physician referral, or to register for a class, call The HealthSource at 800.628.2880.

Robotic Hysterectomy:Back to Work in Two WeeksDr. Ghosh’s patients have ranged in age from 32 to 94year-old Catherine Estes, who had endometrial cancerremoved in a two-hour procedure. “I can’t get overthe three little incisions that were fastened withband aids and how there was absolutely no pain,”she says.Casaus had surgery at PMC on January 15. “The daVinci is big and looks like a huge tarantula with thesearms sticking out,” Casaus says. While the surgical teamsurrounded her during the half-hour surgery, Dr. Ghoshwas positioned at a nearby console where he directed themovement of the state-of-the-art instruments that are attachedto the arms. (See photos to left.)“When I heard about this brand new way of doing ahysterectomy and that I would be back at work intwo weeks, I was all for it,” says Yvette Casaus ofSpring Valley.Dr. Ghosh made five dime-sized incisions into her abdomen. Operatingcomputerized controls, he carefully directed a camera and surgicalinstruments through those openings. Sitting at the console, he hada birds-eye view of the surgical area that can be magnified 10 timesand was able to move the instruments a full 360 degrees arounddelicate tissue.“With the robotic technology there is far less tissue damage and,therefore, less blood loss which leads to quicker recovery, less pain andother important patient benefits,” Dr. Ghosh says.Casaus was discharged two days later and says she felt like herself“I was first told I needed this surgery about five years ago, but I waited within a few days. She returned to work as a coordinator for a generalbecause I couldn’t be away from work for six weeks,” Casaus says. “I contractor two weeks later.wasn’t crazy about the surgery until Dr. Ghosh told me about the da “If I had been given the choice of laparoscopic surgery at a hospital nearVinci way of doing it.”Spring Valley or the robotic surgery I had at Palomar Medical Center, IKris Ghosh, M.D., is a board-certified obstetrician/gynecologist and would choose Palomar even though it is further from my home,” Casausgynecologic oncologist, and a specialist in treating women’s cancer and says. “The distance is nothing compared to the benefits of this type oflaparoscopic surgery. Since last fall, Dr. Ghosh has used the newest surgery.”generation da Vinci S HD Surgical System to perform hysterectomies “If a woman has been told she needs a hysterectomy, I hope she willand other gynecologic surgeries at Palomar Medical Center (PMC).take the time to become fully informed of the advantages of da Vinci“We have the best da Vinci available anywhere, with the clearest and compared to laparoscopic surgery and especially conventional openclosest view of the surgical area,” says Dr. Ghosh, director of robotic surgery,” Dr. Ghosh says. “Ask lots of questions and choose the bestsurgery at Palomar Medical Center. “I can see much better than with option for your personal health.”traditional laparoscopic surgery due to the excellent magnification and To learn more about robotic surgery at PPH, visit www.pph.org/davinci orhigh definition capabilities of da Vinci.”call The HealthSource at 800.628.2880.M e e t S eym o u r!The da Vinci surgical robot at PalomarMedical Center (PMC) has a new name.“Seymour” was the winning namesubmitted by John Carver of Escondidoduring our online “Name the Robot”contest. Carver is pictured here withSeymour and members of the OperatingRoom team at PMC. “This robot helps thesurgeon to “see more” so I thought thename was very appropriate,” says Carver.“I am honored that it was selected.” may – A u g u s t 2 0 0 8w w w. p p h . o r gFor most women, da Vinci Surgeryoffers numerous potential benefits overtraditional surgical approaches, including: Shorter hospital staySmaller incisionsLess painLess risk of infectionLess blood lossLess scarringFaster recoveryQuicker return to normal activities

Cancer ClassesKris Ghosh, M.D., FACOG, is the medicaldirector of robotic surgery at PalomarMedical Center. Dr. Ghosh uses the daVincisystem for various gynecologic surgeriesincluding hysterectomy, myomectomy andpelvic floor prolapse repair.I Can CopePalomar Medical Center, Education ClassroomSix-week seriesTuesdays, Sept. 16, 23, 30, Oct. 7, 14, 212 – 4 p.m.Oncology nurse Cathy Blazek leads this FREE series of educationalclasses for people confronting a cancer diagnosis. Open to patientsand families through the collaborative efforts of the AmericanCancer Society and PPH Cancer Resource Centers. To register, call760.739.3943.FEE: FreeLook Good, Feel BetterPalomar Medical Center, Education Classroom (Bilingual)Monday, July 285 – 7:30 p.m.Jean McLaughlin Women’s Center, Education ClassroomMonday, June 231 – 3:30 p.m.Monday, Aug. 251 – 3:30 p.m.da VinciGynecologic Surgery ProceduresIn addition to the following gynecologic procedures, the da Vincirobotic surgical system is also being used for general and urologicsurgeries at Palomar Medical Center.HysterectomyWhile hysterectomy may offer a life-saving treatment for seriousconditions such as cancer or uncontrollable bleeding, it is often anelective procedure used to relieve chronic pain or bleeding.Uterine fibroids (noncancerous masses) are the leading reasonfor hysterectomy (removal of the uterus) in the United States.Not all women with fibroids experience symptoms, which includeexcessive menstrual bleeding, pelvic pain and infertility. Anestimated 600,000 hysterectomies are performed in the UnitedStates annually, and at least one-third are for fibroids.MyomectomyThis procedure removes uterine fibroids while leaving the uterusintact. About 65,000 myomectomies are performed annually in theUnited States.Pelvic Floor Prolapse RepairMore than 120,000 cases of uterine and vaginal vault prolapseare surgically corrected annually in the U.S. Prolapse or fallingof the vagina, uterus, bladder or rectum is caused by weakenedconnective tissues that accelerates with age or occurs after childbirth, with weight gain and strenuous physical labor. Pelvic organprolapse may cause urinary incontinence, vaginal ulceration, sexualdysfunction and/or difficulty having a bowel movement.Sacrocolpopexy is the surgical procedure that corrects vaginalvault prolapse. In this procedure, surgical mesh is used to hold thevagina in the correct anatomical position.A class designed to help women cope with the appearance-relatedeffects of cancer treatment. All cosmetics and skin care productsare complimentary. To register, call the American Cancer Society at800.227.2345.FEE: FreeWomen’s Recurrent Cancer Support GroupJean McLaughlin Women’s Center, Education Classroom2nd and 4th Thursdays of each month2 – 3 p.m.The issues of women confronting recurrent or metastatic cancerare often different than the concerns of the newly diagnosed. BejaiHiggins, MS, MFT, is a specialist in psychosocial oncology andleads this valuable support group.Registration is REQUIRED. To register, or for more information,please call 858.229.5373.FEE: FreeRebound: Renewing Healthy Living after Breast CancerJean McLaughlin Women’s Center, Education ClassroomSeven-week seriesTuesdays, Aug. 26; Sept. 2, 9, 16, 23, 30; Oct. 710 a.m. – NoonA new FREE series of classes for women who have been diagnosedwith breast cancer. Topics include breast cancer and treatment,nutrition, fitness, stress reduction, cosmetic options followingmastectomy/chemotherapy, sexuality following treatment and more.Open to patients, female family members and friends. To register,call 858.613.6044.FEE: FreeWigs & Wig ProductsWigs and wig products are available at competitiveprices from the PPH Cancer Resource Centers andthe Women’s Health Connection Boutique.PPH Cancer ResourceWomen’s HealthCenters:Connection Boutique:858.613.4044 (Poway)858.613.6110 (Poway)760.739.3943 (Escondido)For a physician referral, or to register for a class, call The HealthSource at 800.628.2880.

Finding the Right Doctor is Easy at PPHLooking for a physician and don’t know where tostart? At Palomar Pomerado Health, we make it easyto find the doctor that’s right for you. Just call TheHealthSource at 800.628.2880, and one of our friendlyrepresentatives will help you to select the doctor whob

Escondido Palomar Medical Center 555 East Valley Parkway Escondido, cA 92025 760.739.3000 OAsIs Westfield shoppingtown formerly Robinson's May South** 280 East Via Rancho Parkway Escondido, cA 92025 760.432.0635 *off-site classes are also available for groups, businesses and other organizations that would like instruction on a particular