For teens and young adults facing long, difficult battles with cancer, and their families, little things such as a private room, fridge, bathroom, shower, large flat-screen television, mood lighting and expansive views make a big difference. And they’re all in the mix at the country’s first dedicated cancer unit for teens and young adults on the eighth floor of the new building at Seattle Children’s Hospital.
We’re all obsessed with iPhone photography (Instagram, Hipstamatic, etc.) but how about rocking it old school and exploring the world of tintype photography this weekend at The Aviary in Ballard? San Fran-based photographer Michael Shindler is really into tintype, a style that he centers his popular Photobooth company around, and has just recently built a 14 by 17 inch camera, which will create the largest images he has ever produced.
Seattle magazine thanks the members of its Top Doctors advisory panel, who agreed to share their insights and advice on medical trends and issues as we compiled this year’s Top Doctors issue. They also helped with nominations and the review of nominees for our Community Service Awards. Panel members do not review or influence the choice of doctors on the final list, and so they are eligible to be included on the list. Our advisory members are:
The body’s blood-brain barrier is a wonderful thing, allowing essential nutrients into the brain, but keeping dangerous bacteria out. Unfortunately, it also blocks some of the drugs that have the potential to treat or cure central nervous system disorders, such as Alzheimer’s, Parkinson’s, multiple sclerosis and epilepsy. Seattle-based Impel Neuropharma is developing a noninvasive intranasal technology—a pressurized aerosol, far beyond the capabilities of a nasal spray—that delivers biologics for otherwise difficult-to-treat brain diseases.
If you’ve ever fractured a rib, you know one thing: It hurts. A lot. And with every single breath. That’s because you can’t immobilize your ribs, like you would a wrist, arm, ankle or leg, while the bones knit back together. Which also means, insult to injury, that recovery can take longer—sometimes six months. And that’s not all. Breathing with broken ribs risks puncturing lungs, spleen, liver or kidneys. • For the first time, there is an alternative to simply waiting and managing the pain; it’s called rib plating, which was recently approved by the FDA.
1. The Too-Busy-to-Talk Doc There are lots of reasons it may seem like your doctor wants to bolt: shortage of time, poor bedside manner, or the real desire to be elsewhere. But wanting a doctor to demonstrate he or she has time and interest in your well-being isn’t about your self-esteem, it’s actually a matter of good health. Studies show that patients who are satisfied with a doctor visit are more likely to follow that doctor’s advice.
When orthopedic surgeon Sean Adelman, M.D., served as a member of an Air Force surgical team in the Middle East following 9/11, he didn’t have access to high-end imaging options, such as MRIs. So he and his fellow surgeons used handheld ultrasound devices instead. Years later, this experience would be called on in a different sort of battle—the one against runaway health care costs.Overuse of expensive imaging is a key factor in the high price of health care. Some national studies estimate at least 15 percent of high-end imaging tests are unnecessary and drive costs higher.
Must RockCapitol Hill Block Party(7/26 to 7/28, times vary) — It’s the sweatiest, loudest, most rockin’ party of the summer, when local musicians and the hipsters who love them swarm Capitol Hill’s Pike/Pine corridor. With more than 60 bands (including The Flaming Lips!) performing over three days, this is musical mayhem you don’t want to miss. The three-day pass has already sold out, but single-day tickets are there for the taking.
There have been oodles of ceiling references swirling about the Internets this morning ("the ceiling did hold them after all!"), due to Macklemore et al filming a video on top of Dick's Drive-In in Capitol Hill. (Underneath rock-dwellers: His song "Can't Hold Us" mentions that, in fact, a ceiling perhaps may not hold them.)
This would be the weekend to avoid (most of) Capitol Hill if you aren't into crowds. The crazy, three-day hipster-filled bash that is the Capitol Hill Block Party begins tomorrow, so expect the Pike/Pine corridor to be teeming with swarms of sweaty, music-loving revelers. (If you do need a ticket, go here. Single-day passes are still up for grabs.)
The Puget Sound region is home to some of the most dedicated and knowledgeable health care practitioners in the world. But all of these resources can only make a difference in the life of an individual when he or she has access to them. This year as part of Top Doctors, we’re singling out for praise just a few of the many local health care practitioners and researchers—and their associated clinics and hospital outreach programs—who are making a difference in underserved, disenfranchised communities.
Kathryn is in her early 50s and lives on the shore of Lake Washington with her husband, Bill, in an elegant contemporary home filled with sunlight and exquisite art. Bill, a successful entrepreneur, retired in his mid-50s. Bill and Kathryn* are too young for Medicare, but felt well protected since they had purchased one of the best health insurance plans on the market. She thought the Affordable Care Act a good thing—for other people who need help. As politicians argued about the merits and costs of “Obama Care,” Kathryn was aware of the debate raging in Congress, but thought neither she nor Bill would ever need it. She was wrong.
Bill developed a rare and aggressive form of cancer. With surgery, multiple rounds of chemotherapy and radiation treatments, and numerous hospital visits, Bill’s medical expenses totaled more than $1 million in under 12 months. The costs surpassed his policy’s annual cap for expenditures, as well as the lifetime cap. His health insurance was canceled. It was impossible to obtain new insurance. Not eligible for Medicare or Medicaid, Bill and Kathryn were on the brink of bankruptcy.In a very up-close and personal way, Kathryn gets it now: Without the Affordable Care Act, preexisting conditions mean no access to health insurance—for some of the people who need it most. Health care reform affects everyone (or will at some point in live) from prominent executives with company-paid medical plans loaded with benefits to employees who lose their insurance along with their jobs. Ditto for seniors, children, adults with preexisting conditions, those with serious illnesses, working moms and young adults. Some of its most important provisions, such as expanded coverage for children and young adults, are already in place, while the most significant changes are coming, beginning with open enrollment in a state-run health insurance exchange this fall and implementation in January of the “individual mandate” requiring everyone who can afford it to have health care insurance. While other states hesitate to embrace reforms, Washington state is a leader in national reform efforts and has been experimenting with new approaches to health care for years—even before the passage of the Affordable Care Act—making Washington better prepared than most states to meet the challenges of implementing health care reform. More than 10 years ago, Virginia Mason Medical Center became the first in the nation to adapt the lean principles of the Toyota Production System for health care. Called the Virginia Mason Production System, it enables the medical center to identify and eliminate waste, improve quality of care and patient safety, and lower the cost of care. In 2008, the Virginia Mason Institute was established to teach other hospitals and health organizations how to implement the lean principles. Virginia Mason chair and CEO Gary S. Kaplan, M.D., has testified before Congress and was ranked number six on the 2013 list of the “50 Most Influential Physician Executives in Healthcare” by Modern Physician and Modern Healthcare magazines.Other local health care executives, such as Group Health Cooperative president and CEO Scott Armstrong and Everett Clinic CEO Rick Cooper also feature prominently in the national discourse on health care reform with their efforts to address challenges in primary care. And under the leadership of its executive director/CEO, Lloyd David, The Polyclinic, Seattle’s largest multispecialty, physician-owned practice, became the state’s first Medicare-approved accountable care organization in July 2012. Accountable care ties provider reimbursements to quality metrics and reductions in the total cost of care. The Polyclinic has experimented with accountable care models with health insurance companies such as Premera Blue Cross for several years. Washington even “developed its own state-based health insurance marketplace to better meet the unique needs of the uninsured in our state,” says Richard Onizuka, chief executive officer of Washington Healthplanfinder.
At a Glance: Washington HealthplanfinderWashington was one of the first states to receive conditional approval of its health plan exchange by the U.S. Department of Health and Human Services. “The exchange will be a one-stop shop, allowing consumers to make apples-to-apples comparisons between plans, determine eligibility for tax credits or less expensive copays and deductibles, and receive personal assistance in finding, selecting and enrolling in the right health plan,” says Richard Onizuka, chief executive officer of Washington Healthplanfinder (wahbexchange.org).Key dates to remember:September 1, 2013: Washington Healthplanfinder call center opens, providing detailed information about state exchanges to individuals, families and small businesses. October 1, 2013: Open enrollment begins for coverage that starts January 1, 2014. The plans offered specifically for the exchange will only be available through open enrollment in the fall. March 31, 2014: Enrollment period for 2014 closes. The next open enrollment period kicks off October 15, 2014. —S.M.
Specialty: Urogynecology Hospital affiliation: Virginia Mason Medical CenterWhy did you choose to specialize in urogynecology? I’ve always had a big interest in women’s health issues and learned in medical school that I loved surgery—urogynecology is the perfect blend of those two interests. I’ve read that 30 percent of women ages 65 and older suffer from pelvic floor disorders (most commonly urinary incontinence and pelvic organ prolapse), yet many won’t talk about it or seek treatment.
Specialty: Medical oncology, head, neck and lung cancerHospital affiliation: Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, UW MedicineAs a native of Brazil, what drew you to pursue your career here in Seattle?