Quitting smoking

No one can deny that tobacco use is one of our biggest public-health issues and that healthcare practitioners need to do all they can to help cut it down.

“I tell our physicians that discussing smoking cessation with their patients may be the most important conversation of their patients’ lives,” said Dr. Walter Woodley, who practices at the Kingston Family Health Center and is regional medical director for the Institute for Family Health (IFH). The IFH, along with Hudson River Health Care (HRHC), which serves residents of Ulster, Dutchess and Sullivan counties, plus Peekskill and parts of Long Island, are local centers that offer health care — primary and preventive care with access to pharmacy, dental and mental-health services — to low-income and underserved New Yorkers of any insurance status, whether they are able to pay or not.

Tobacco use is much higher in low-income and underserved communities than in the general population, according to the state health department’s Bureau of Tobacco Control, with 26.7 percent of Medicaid recipients and 21.8 percent of uninsured adults being smokers compared to 12.1 percent of adults with private insurance.
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photo by Sardinelly
photo by Sardinelly

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The local health centers address this priority when they interface with patients. The IFH, established in 1979 to address a shortage in the mid-Hudson region, now trains 30 physicians a year in a residency training program in family medicine, Dr. Woodley said. Integrating smoking cessation into the primary-care visit when needed is key.

Though a state smoking ban in restaurants and bars a decade ago and other measures have helped bring numbers of smokers down by 28 percent, more than 25,000 state residents still die each year because of smoking. The leading cause of death for New Yorkers is cardiovascular disease, and smoking contributes to much of that.

Healthy and happy old age

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Dr. Jodi Friedman.
Dr. Jodi Friedman.

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People no longer experience life as a succession of roles which shift like clockwork purely on the basis on their age. What it means to be 40, 50 and 60 has changed. People are living longer than ever before, and as the first wave of baby boomers enters retirement the process of aging is evolving, beset by unique challenges as well as opportunities.

Many new types of facilities are sprouting up that not only treat seniors medically, but also help them maintain quality of life in extreme old age. The Center for Healthy Aging, a facility on the grounds of Northern Dutchess Hospital, in Rhinebeck, is an example. It offers geriatric assessments and works collaboratively with patients, caregivers and primary-care providers to deliver inpatient, outpatient, and transitional care to people age 65 and older.

The center opened in 2011 with a full-time medical director, Dr. Jodi Friedman. A year later she was joined by part-time social worker Allison Gould. The center caters to seniors in several counties, providing assistance in developing a customized, comprehensive wellness plan.

Friedman treats “mostly the oldest and most complicated medically patients,” usually referrals from other doctors. Gould sees younger seniors as well — people in their mid-seventies — who are dealing with emotional issues related to aging, such as bereavement or fears about dementia.

To further reach out to the growing community of retirees, the center has begun partnering with [email protected], a not-for-profit networking organization that’s located in the same building and dedicated to helping its 56 members stay at home and maintain their independence.

The center, which accepts private insurance and Medicare, can refer its clients to community services such as [email protected] It can come up with a program of therapy, including alternative modalities such as massage and acupuncture. It offers use of a medically based fitness center and educational programs. In the fall and spring, it hosts a lecture series, in which past topics have included financial wellness, relaxation and meditation workshops, and aging gracefully.

Isn’t “healthy aging” a bit of an oxymoron? “There’s more chronic illnesses, and people are on a lot of medications,” said Friedman, who has a background in family practice. “We try to look at their medications in the context of different medical problems. Part of being a healthy older person is managing these multiple problems.”

Holistically yours

[wide]holistic[/wide]They say there’s no such thing as a free lunch, but there is such a thing as free care. Dozens of local practitioners of holistic and alternative treatment methods have been giving it away for years, under the name Health Care is a Human Right.

Each month, the collective of healers holds clinics in a number of places — the Darmstadt Shelter and Kirkland Hotel in Kingston, the Parish Hall on Main Street in Phoenicia and the Woodstock Community Center. (The Darmstadt clinics are open only to shelter and Family Inn residents and staff; all others are open to the public. The next one at the Kirkland, 2 Main St. Uptown, will be next Thursday, Aug. 8, from 4-7 p.m.)

According to Susan Weeks, RPA-C, who co-founded the group 10 years ago and now serves as its director, the group’s mission is “to provide holistic health care to all regardless of ability to pay.”

The providers, or “faculty” of Health Care is a Human Right cover a broad span of disciplines: acupuncture, nutrition, homeopathy, massage therapy, reiki, energy work, hypnosis and more. All told, there are about 60, who all work pro bono, and more are being interviewed all the time, said Weeks.

Money truly is no object: insured or not, anyone seeking holistic care will be helped, for free. A triage procedure which involves the filling out of some forms and releases is done on each client but that’s about it. Which is not a bad deal at all, considering holistic and alternative care is not always covered by insurance or if covered, not very well, and can be expensive. “It gives people an opportunity to experience modalities that they normally wouldn’t be able to,” said acupuncturist and group managing director Julia Rose of Phoenicia.

The idea, said Weeks, is to bring healing back to its true basics: helping someone who needs help. “I think we have an amazing faculty of healers who are an example of what healing should be — people who are experts in their field and give of themselves selflessly to help others,” Weeks said, noting that it includes some of the most experienced practitioners in the area. “I’m really proud of them and I think they deserve a tremendous amount of credit.”

Last month’s clinic at the Kirkland featured a number of these providers treating a steady stream of people who appeared to be from numerous walks of life. Every nook and cranny of the hotel’s public interior space seemed to be in use — one room hosted massage, while a hypnotist set up in the landing between flights of stairs.