The Latterman Letter
Ed ito r:
J ani ce
Ch an ,
M D
August 2012 Volume 11, Issue 2
A WORD FROM THE NEW RESIDENCY DIRECTOR
Change! It is an action word. It is defined as a verb meaning to become different; to
become altered or modified; to become transformed or converted; to pass gradually into,
or a noun meaning the act or fact of changing; a variation or deviation; to substitute one
thing for another. Change is inevitable and whether we accept it or not; whether we
embrace it or not; change will happen.
As we transition from summer to fall, we are faced with getting our kids back to school.
There is an article about this transition in this issue. We are also changing how we provide
care for our families during the first two years of life. See the piece on interconception
care. We have also seen changes in the healthcare system and many more patients do not
have insurance, inhibiting their access to care. With that in mind, Dr. Markle has provided
us with information regarding the 9th Street Clinic.
We are experiencing a lot of change at Latterman as well. In June we said goodbye to the
third year residents as they graduated and moved on to the next phase of their careers. Our
new residents joined us in July and you can see their pictures on the next page. Please join
me in welcoming them to the community. There was also a change in leadership, with my
appointment as the Director of the Residency Program, Dr. Markle’s transition to the
position of Senior Associate Director and the appointment of Dr. Johns as the Associate
Director. We view all of these changes as positive and continue to strive for excellence in
our program and the health center. We look forward to your continued support and
involvement as we navigate the days ahead. With each new transition comes new
challenges and new opportunities for growth. As we press forward, let us be mindful not
only of the inevitability of change but to how our individual and collective responses to
change dictate the impact of that change.
Dr. Tracey Conti
The 9th Street Clinic for the Uninsured
The 9th Street Clinic is a free clinic for the uninsured established in 2007 at 410 Ninth St.
to help with the large number of people with medical problems who have difficulty
accessing care because of the lack of medical insurance. Dr. Markle is the Medical
Director and Dr. Conti and Susan Kramer serve on the Board of Directors. Many of the
residency faculty continue to volunteer at the clinic. Residents can work at the clinic as
part of an elective in the Care of the Underserved. The clinic offers primary care and basic
lab services for the patients enrolled there. It is open from 1-8PM on Thursdays and is
usually very busy with about 50 patients seen every week. A pharmacy is on site to
provide medications and help patients enroll in programs to get medications directly from
free pharmaceutical programs. Although not officially part of UPMC, the McKeesport
Hospital Foundation has given generous support to the clinic and grants have been received from the State Department of Health among others. Any patient without insurance
is welcome however no appointments are taken and it does get crowded at times.
If we could change
ourselves, the
tendencies in the
world would also
change. As a man
changes his own
nature, so does the
attitude of the world
change towards
him.”
-Mahatma Gandhi
Page 2
The Latterman Letter
RESIDENT SPOTLIGHT
Tamar Carmel, MD is a 4th year Family Medicine and Psychiatry resident returning to
Latterman this academic year after obtaining some training in psychiatry at the Western
Psychiatric Institute and Clinic in Pittsburgh. He was born and raised in South Florida and moved
to Chicago, Illinois for undergraduate and medical school. Tamar has a passion for the care of the
underserved with a particular focus on folks with severe or persistent mental health issues, as well
as folks who identify within the LGBTQ community. Tamar’s approach to patient care combines
evidence-based medicine and person-centered care. He likes to use patient education,
collaboration and humor as integral parts of patient care. You may recognize him by his
infectious laugh.
Ereny Eskarous, MD is originally from Egypt. Her passion has always been to be a successful
doctor and she has worked hard all her life to reach that goal. She graduated from the Cairo
Medical School but felt the need for more education and training. That is why she decided to
come to the USA for more learning experiences. “I enjoy my residency in McKeesport and enjoy
working with the patients here a lot. I especially like it when we have spent some time together
and get to know each other well. For me, patients are my second family. My first family is my
husband and my daughter, who is now six years old and an adorable kid, whom I love a ton.”
“I would say I am very fortunate to join this residency and be a part of the Latterman FHC. I can
imagine myself, after training, working with patients and raising my daughter so that she also can
fulfill her dreams.”
NEW RESIDENTS 2012
Christina Alimin, MD
Universitas Trisakti
Indonesia
Family Medicine
Steven Petrinac, MD
St. George’s University
Grenada
Family Medicine
Oliver Lee, MD
Saba University School of
Medicine
Netherlands Antilles
Family Medicine
Swetha Subbareddy, MD
Sri Devaraj Urs Medical College
India
Family Medicine
Gordon Liu, MD
St. George’s University
Grenada
Family Medicine
Michael Taylor, DO
Lake Erie College of Osteopathic
Medicine
Erie, PA
Osteopathic Family Medicine
Bo Ra Nam, MD
University of Santo Tomas
Philippines
Family Medicine
Heena Panchal, MD
University of California, Davis
Davis, CA
Psychiatry/Family Medicine
August 2012
Volume 11, Issue 2
Page 3
Back to School Health Tips
As the school year begins, it is vital for parents and caregivers to establish healthy habits to make
a child’s transition back to the classroom a smooth one. Here is a list of tips for keeping school
age children healthy.
Instruct your kids to:
Eat breakfast. It sustains a child’s energy and has been shown to improve
performance at school. Fruits and unsweetened cereal with milk are good
choices for the morning meal.
Choose water or low-fat milk over sugary drinks. Parents should offer
children older than 2 years of age low-fat milk, which still has the calcium they
need without the fat of whole milk. Children between 12 and 24 months of age
generally should drink whole cow’s milk, however the decision should be made
on a case-by-case basis by the parents and pediatric healthcare provider.
Wash their hands as a simple and the most effective way to ward off colds and the flu. Teach your
children to wash their hands with warm, soapy water before eating meals, after using the bathroom,
after handling the classroom pet and when they return home after school. Children should wash for at
least 20 seconds (about the time it takes to sing “Happy Birthday” twice). If allowed, encourage
children to carry hand sanitizer or wipes in the their backpacks for use when soap and water are not
available.
Avoid touching the eyes, nose and mouth when hands are not clean.
Germs spread this way.
Use proper cough and sneeze etiquette. Show your children how to cough
or sneeze into tissue or the inside of the elbow instead of their hands, which
can spread germs when they touch another surface. Throw the tissue in the
trash after you use it.
Not share food or drink. While kids may be tempted to try a friend’s drink or take a bite of his/her
lunch, it isn’t a good idea. Talk about safe ways to sample food, such as pouring liquids into another
cup or breaking off a piece of cookie from an area that has not been bitten.
Not share clothing, hats, hair brushes, combs or hair clips and avoid head
contact with other children. This will minimize the opportunities for the spread of
head lice, another pesky classroom nuisance.
Remember to:
Schedule a well child visit annually. The wellness exams should include vision and
hearing tests, which are critical to detect early problems with vision and hearing.
Keep your children at home if they are sick. When your children are sick, keep them home from school
to avoid spreading germs to other healthy children.
Stay up-to-date on childhood vaccines and get the flu shot.
Make time for team sports and regular exercise. Group activities, such as
soccer, tend to be very healthy habits. They should also help motivate a child
to exercise more to keep up with other team members.
Keep copies of medical records on hand. These records should include a
description of any allergies children have to medications as well as their
immunization records.
-Adapted from the Alliance for Consumer Education website
The Latterman Letter
The Latterman Family Health Center—UPMC
2347 Fifth Avenue
McKeesport, PA 15132
Phone: 412-673-5504
Inter-Conception Care Kicks Off at Latterman Family Health Center
On July 13, 2012 Latterman began the interconception care (ICC) initiative, designed to identify maternal heath risks at
well child visits. The ICC initiative is part of a larger collaborative of Family Medicine residencies in the Northeastern US
called IMPLICIT (Interventions to Minimize Preterm Birth and Low Birth Weight Infants through Continuous
Improvement Techniques). For the past nine years, family medicine residencies, including Latterman, have focused on
providing pregnant women with evidence-based health interventions to reduce the number of preterm and low birth
weight births. While the quality of prenatal care at Latterman has improved as a result of these interventions, reducing
the number of preterm and low birth weight births has remained a challenge. By the time a woman enters prenatal care, it may
often be too late to significantly affect birth outcomes. Therefore the goal of the ICC initiative is to identify and address maternal
health risks before the next pregnancy occurs, and as a result, improve future birth outcomes.
Providing care to women during the interconception period (the time between pregnancies) can be a challenge. During this time,
maternal focus shifts to care for her infant, often to the exclusion of her own healthcare needs. Also following pregnancy, some
women revert to behaviors that can put them, their children and their future pregnancies at risk (i.e. smoking). Although mothers
may not seek care for themselves after pregnancy, they do seek care for their new babies and often accompany them to the healthcare appointments. Thus, when mothers accompany their children to any of the child’s 1-2 year well child visits,
physicians will now screen mothers for four health risks that can affect them, their family and future pregnancies:
1. Smoking cessation, 2. Depression management, 3. Contraceptive use, and 4. Multivitamin
intake.
The ICC initiative provides women with a previously underutilized avenue back into well woman
care by using the well child visit as a maternal checkpoint where mothers can gain access to information and
resources to improve their health. Without this initiative, healthcare needs of new mothers could be left
unaddressed, putting the health of mothers, families and future pregnancies at risk. In combination with the
health interventions offered to pregnant women, Latterman Family Health Center’s ICC initiative seeks
Tirzah Creel
to encourage healthy mothers and healthy families at all stages—before, during and after pregnancy.
ICC Project Coordinator