April 2024 | Vol. 4 | Issue 16 | |
EXCELLENCE • COMPASSION • BELONGING • DIVERSITY • PROFESSIONALISM • INNOVATION | |
RECENT NEWS & ANNOUNCEMENTS | |
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Welcome, Madeline Salyer, MMS, PA-C, to TPMG Orthopedics in Newport News and Williamsburg.
Madeline's work is driven by compassion and empathy, which remains at the heart of all that she does. She sees patients 18 years of age and older for a variety of joint-related conditions including osteoarthritis, rheumatoid arthritis, avascular necrosis, and fractures, among other ailments. In collaboration with Joint and Arthritis Specialist, Dr. Kalain Workman, she is dedicated to building trust and confidence among patients ensuring to tailor treatment plans to their individual needs.
Visit Madeline's provider page to learn more.
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TPMG Denbigh Family Medicine welcomes Deanna C. Kubik, FNP-C to the practice.
Deanna previously worked as a Registered Nurse in the emergency room department prior to joining TPMG. Over the course of her career, she has always been drawn to the idea of helping others live healthier lives. She strives to provide compassionate care, empowering patients to make informed decisions about their health. She takes a holistic approach to care, attentively listening to each patient's concerns and goals in order to provide a comprehensive treatment plan. She sees patients from birth to advanced age for a variety of acute and chronic conditions.
Discover more about Deanna here on her provider page.
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Lights, Camera, Action!
Chris Reckling from WAVY-TV’s Hampton Roads Show joined TPMG Urologists Dr. Eric Darby and Dr. Ifeanyi Ani to delve into the exciting developments in prostate health. During the segment, our doctors shed light on Aquablation, a cutting-edge procedure used to treat patients suffering from benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate. Aquablation can be performed on any shape and size prostate. TPMG Urology – Newport News is proud to be among the first in the Hampton Roads area to offer this advanced, minimally invasive treatment.
Watch the segment from WAVY-TV 10 here or click on the above image.
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All three locations which can be reached by calling (757) 659-6288.
Newport News office: 860 Omni Blvd., Suite 301 | Newport News, VA 23606
Virginia Beach office: 4421 Virginia Beach Blvd., Suite 112 |Virginia Beach, VA 23462
Suffolk office: 1540 Breezeport Way, Suite 100 | Suffolk, VA 23435
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We are happy to announce that the 2024 Coastal Virginia Magazine Top Doctors nominations and voting have officially begun. These awards, which rely on peer-to-peer recognition, are a significant way to show appreciation and respect towards fellow colleagues, making them a highly esteemed feature for the magazine's audience. | |
Physicians can nominate now through April 29, 2024. Results of the Top Doctors will be published in the September/October issue of Coastal Virginia Magazine. Please share with your fellow physicians to ensure everyone has the opportunity to cast their vote. | | |
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TPMG recently hosted a provider Winter Social at the Newport News Marriot in City Center, bringing together physicians and ACPs after years of social distancing. It was a wonderful evening where they could reconnect, share ideas, and begin the new year with a fresh outlook. The event saw an impressive turnout of more than 175 attendees, providing a fantastic opportunity for providers to mingle with their peers and colleagues.
Our providers also met the following day for TPMG's CME (Continuing Medical Education) event. Events like this allow physicians and ACPs to maintain, develop, and increase their knowledge, skills, and professional performance to better serve our patients and ensure that we continue to be at the forefront of innovative medical practice.
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Going Back to Basics with Our Communication Skills
Seeking healthcare services can often be a daunting and overwhelming experience for patients. We can help to minimize additional stress by implementing the following six fundamental tips to enhance the patient experience and improve overall outcomes.
Remember these communication BASICS:
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At TPMG, we have integrated our exceptional customer service into the framework of how we practice and deliver care. Through our actions, we have the ability to heal, motivate, and restore patients to live the fulfilling life they deserve. | |
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TPMG has a Laboratory Collection Center in Virginia Beach located in the TPMG Town Center Hub. Lab specimen collection services are open to all TPMG patients with lab orders for the Central Laboratory.
If you have a patient who needs to have a lab specimen collected, please schedule any available appointments in NextGen.
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Hours of operation are:
Monday - Friday | 8:00 am - 3:30 pm
All patients are required to have a scheduled appointment and a valid order.
Please consider your patients if they work, live, or see a provider on the Southside. Staff will gladly assist your patients in a timely manner!
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Patient Experience Cards
Did you know that aside from receiving valuable feedback from our patients, our Patient Experience cards also serve as a way to collect reviews? We can then display these reviews on our website, social channels, and on providers' biography pages with the patient's permission.
These comment cards can also help deter negative comments from being publicized online. When we come across a negative comment, this allows us to handle the matter in the office and directly with the patient, while giving the patient an outlet to vent and feel reassured the matter is being handled.
These reviews can be submitted to the Marketing team. Contact the Marketing Helpdesk with any questions or concerns, and thank you for helping to promote our providers!
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Have you weighed your retirement options lately?
Create your financial foundation with a Retirement Blueprint from CAPTRUST during the month of April and receive a free smart body scale from Human Resources, while supplies last!
CAPTRUST is available to provide you with individual, unbiased investment advice, and to assist you with your Retirement Plan investment decisions. This service is available at no additional cost as part of your Retirement Plan benefits.
Schedule an appointment here during TPMG's dedicated virtual consultations on April 10th or 23rd. Or call 800-967-9948 for a date and time that is convenient for you.
Learn more about the Retirement Blueprint here.
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STRIVE FITNESS & SPORTS PERFORMANCE | |
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A Focus on Group Exercise Classes
Exercise is important for anyone’s weekly routine and, as we age, it becomes even more important to maintain an active and healthy lifestyle. Strive's fitness classes can help you achieve your health and wellness goals with our highly qualified and experienced training professionals, who offer support and motivation every step of the way.
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Bootcamp is an exercise class geared towards the active individual who wishes to gain and/or maintain strength, cardio, and overall flexibility. We incorporate all mediums of workout equipment, from resistance bands to weight machines to free weights and cardio equipment. It’s a great way to start or end your day, as this class is offered Mondays and Thursdays at 5:30pm as well as Wednesdays and Fridays at 6am or 9:30am.
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Balance and Strength class is for anyone wishing to improve and gain strength in everyday life, as well as improve balance and coordination for day-to-day activities. This class is perfect for someone who may have a walker or cane, or who has just finished physical therapy and wants to continue to build upon their achievements. Classes are offered on Tuesdays at 10am. With this class, you also get access to the open gym.
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Silver Power Hour is a group class for active older adults looking to improve flexibility, balance, strength, and bone health. We utilize light free weights, machines, and resistance bands, while a trained professional assists with movement modifications. The Silver Power Hour class is offered on Tuesdays/Thursdays at 12pm as well as Wednesdays/Fridays at 10:30am.
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For many of us, the return of spring means more than enjoying the beauty of blooming flowers and warmer weather. For many, it also signals the start of seasonal allergies, which can bring a world of discomfort such as a runny nose, itchy eyes, and endless sneezing. Fortunately, there are effective ways to combat the allergy season. Read more here from board certified allergist, Christina Ortiz, MD, as she explains how to find much-needed relief from your seasonal allergy symptoms.
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April Wellness Challenge
30 Days to Build Healthy Habits
Working in the healthcare field requires a special set of skills. To give the best care to our patients, it's crucial that we prioritize our own well-being!
In April, the Culture Committee is presenting TPMG staff with a 30-day wellness challenge to build healthy habits. Participation is optional and can be done individually or on teams.
Look for these colorful cards arriving in offices soon. Completed cards can be turned in to be entered into a drawing, where 3 lucky participants can win a health and wellness gift package!
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What Should We Eat to Support Our Immune System? | |
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The same diet that can help your immune system function at its best will also promote your overall health. Fill your plate with fruits, vegetables, lean proteins like chicken and fish, and whole grains. You also want to be sure you are getting enough nutrients by eating three balanced meals a day. Try not to snack in between meals. Find healthy portions of your favorite foods and limit your consumption of processed foods. It all comes down to balance.
Read more here about how our nutrition is connected to our immune health.
Take control of your health with the guidance of a trained dietitian. For more information, contact TPMG Nutrition Services at (757) 232-8768.
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Prothrombin Time Test and INR
Obtaining an ideal drop of blood is imperative to ensure accurate PT/INR results. Below are some techniques, tips, and tricks to keep in mind.
Obtaining an optimal drop of blood during fingerstick:
- Your package insert is the best reference.
- Only place the lancet on the lateral sides of the tip of the finger to fingerstick.
- Use a glove filled with warm water for the patient to hold before the fingerstick.
- Have the patient hold hands under their arms before wiping with an alcohol pad.
- Have the patient hang their arm down to the side so that the hand is below the waist for good blood flow.
- Have the patient run their hand under warm water or have them wash their hands in warm water.
- Immediately after lancing the finger, massage from the base of the finger, but do not go past the first knuckle.
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Things to avoid doing after lancing the finger:
- Do not press or squeeze the finger.
- Do not excessively milk the finger.
- Do not try to add more blood to the test strip after the original drop has been applied.
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All SST tubes must sit a minimum of 15-20 minutes, but no longer than 2 hours to allow for complete clotting.
Please be aware, if the patient is on any anticoagulant therapy, their blood will take longer to clot in the SST. Please account for this in your pre-centrifugation phase.
If the sample is spun before complete clotting has occurred, the gel separator in the tube will not effectively separate the cells from the serum. Since cells in the serum can impact various test results (most notably Potassium), samples without complete separation may be rejected at the laboratory.
Never rush the process, even if preparing for a courier’s imminent arrival. The patient does not benefit by sending a specimen that will be rejected.
If you have questions about how to handle specimens, please contact the laboratory at (757) 873-0952 or the POC department at (757) 232-8814.
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Hypertension and Chronic Kidney Disease
- Assume a cause-and-effect relationship -
Under ICD-10-CM, coders are instructed to assume a cause-and-effect relationship between hypertension and chronic kidney disease and code them together unless the rendering provider’s documentation specifically states they aren’t related. In my experience, such a non-relationship is rarely specifically documented.
The correct way to code hypertension with chronic kidney disease is to assign I12.9 for a patient with hypertension and chronic kidney disease stages 1-4 or unspecified chronic kidney disease.
If a patient has hypertension and stage 4 chronic kidney disease, the correct coding is to code I12.9, followed by N18.4. When the patient has stage 5 chronic kidney disease, code I12.0, followed by N18.5. If the patient has ESRD, code I12.0 followed by N18.6.
Learn more here from the National Alliance of Medical Auditing Specialists.
For questions about the coding of these visits, please email the TPMG Coding Team.
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During the month of April, we recognize National Cancer Control Month. Here are some guidelines to help with documenting cancer-related information:
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- If the patient is receiving active treatment for a malignancy, document the malignancy as active. Active treatment includes surgery, chemotherapy, radiation, and long-term hormone therapy.
- Document if a patient is undergoing "watchful waiting" (active surveillance) or monitoring for recurrence (routine surveillance).
- If the diagnosis has been confirmed, but treatment has not yet started, document the malignancy as active.
- When all forms of treatment have been completed and the malignancy is no longer considered active, document the malignancy as history of.
- If the patient’s malignancy has metastasized, document both the primary and secondary site.
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DSP Documentation Example:
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Bad: Patient has prostate cancer
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Good: Patient has a past medical history of prostate cancer that resolved in 2006.
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Excellent: Patient has a past medical history of prostate cancer that resolved in 2006. Diagnosed in 2023 with metastasized liver cancer. Currently undergoing chemotherapy.
Please contact RAF@upstream.care with any questions.
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Can I Access NextGen from Anywhere?
The short answer is yes - you can access NextGen over the entire world with the changes in our infrastructure. While this is meant to be a way to empower physicians and employees when they travel, there are considerations one should take when connecting to Citrix/Nextgen.
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Are you using Public Wi-Fi?
The answer to this one is generally yes while you are traveling. Unless you are staying with relatives who may live in another country, you are likely using a hotel wireless network, which is considered “public.” The reason this is important to make this distinction is that public Wi-Fi is generally unsecured with little to no encryption. While the connection to Citrix is encrypted, there are still potential ways for someone wishing to steal your credentials - and thus, access NextGen and access PII/PHI - to perform what is called a "man-in-the-middle" attack. In a scenario where you are using the aforementioned public Wi-Fi, it's important to consider the safety of doing so.
Are you using a Virtual Private Network (VPN)?
While you do not necessarily have to use a VPN, it is HIGHLY recommended that you do so in scenarios of using public Wi-Fi. The reasons are multifaceted, both for personal and work usage. More information is available by contacting IT through the below link.
Is your computer a TPMG-managed device or personal?
The importance of this question can not be understated. Per HIPAA technical compliances, anything that can access PII/PHI must be centrally managed, kept up to date with the latest security patches both in regards to the applications - Chrome, Safari, Edge, Firefox, Outlook, etcetera - as well as the underlying operating system (Windows, Mac, Linux). This is both to keep the device secure as well as to ensure its performance is the best it can possibly be.
Please do not hesitate to email the TPMG cybersecurity team with any questions you may have. They are more than happy to provide in-depth explanations about the necessity of this, as well as provide additional solutions or assistance to ensure you are following best practices for the accomplishment of patient care.
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Anterior Approach Hip Replacement
For many Americans, hip replacement surgery is a revolutionary procedure that can relieve pain, restore mobility, and repair damaged joints. On average, over 450,000 hip replacement surgeries are performed annually in the United States, according to the American College of Rheumatology. One favored technique for total hip replacement surgery is the anterior approach hip replacement.
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Kalain Workman, DO delves into greater detail about this procedure, shedding light on its benefits, associated risks, and how to assess your candidacy. Continue reading here to learn more.
Dr. Workman is a board certified surgeon with TPMG Orthopedics in Newport News, Gloucester, and Williamsburg. He treats patients 18 years and older for a variety of joint-related conditions including osteoarthritis, rheumatoid arthritis, avascular necrosis, and fractures. He has a particular focus on osteoarthritis of the hip and knee.
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Dr. Patel is board certified in Internal Medicine and has over
20 years of experience as a primary care physician. Treating
adults ages 18 and up for a variety of conditions, she
specializes in the treatment of diabetes, hypertension,
hyperlipidemia, thyroid problems, anemia, gout, migraine,
women’s health issues, well-woman exams, preventative
care, and more. By viewing her patients as people first,
rather than a health history or set of symptoms, Dr. Patel
strives to guarantee each of her patients feels valued.
View Dr. Patel's provider page to learn more.
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As a board certified family nurse practitioner, Nikki provides a
range of primary care services for adults including disease
management across the lifespan, chronic and acute illnesses, and health promotion. With a particular emphasis on prevention,
diagnosis, and treatment, she cares for older adults who may have complex medical conditions, such as Alzheimer’s and dementia, among other age-related conditions. Nikki values the importance of open dialogue between patients and providers, actively listening to patients and offering comprehensive education tailored to their unique needs.
Learn more about Nikki here on her provider page.
| TPMG Peninsula Internal & Geriatric Medicine has been providing healthcare services to patients in Newport News since 2008. Please contact the office at (757) 243-8550. | |
Congratulations to Houston Scott with our IT Department | |
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Houston's expertise as a seasoned EHR developer has greatly benefited TPMG, especially during our recent upgrade to the latest major version of NextGen. Thanks to his exceptional knowledge, he was able to provide accurate projections for the months-long project of migrating our customizations to the latest version. Not only did he deliver on time, but the quality of his work was also remarkable. In addition to his demanding duties, Houston also dedicates himself to training new staff members, all while maintaining his friendly and humorous nature. Keep up the outstanding work, Houston!
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Congratulations to Tiffany Gills-Godley with TPMG City Center Family Medicine | |
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Tiffany consistently surpasses expectations in her support for colleagues. She upholds a high standard of professionalism in her work and introduces innovative ideas that positively influence the team. Her unwavering compassion and dedication are evident at all times, as she consistently prioritizes the well-being of patients and demonstrates an exceptional level of care and commitment. Tiffany's proactive attitude and genuine commitment to helping others exemplify an extraordinary dedication to both colleagues and patients. Her empathetic approach builds trust and comfort, establishing her as an invaluable asset to our team.
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Congratulations to Ashley Manning with TPMG Cardiovascular Specialists in Virginia Beach | |
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Ashley is consistently ready to assist in any clinic department without delay. As the lead MA and device manager, she carries out her responsibilities diligently, making sure her team is supported. She willingly takes on extra tasks and aids her colleagues with their workloads. Additionally, she steps in to cover and support nuclear studies when necessary. Ashley is recognized by her coworkers, healthcare providers, and staff for her exceptional dedication to patients and team members. She is undeniably a highly valued asset to the team!
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Congratulations to Practice Support Specialist, Siera Peeples | |
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Siera was recognized for her exceptional level of professionalism. Her proactive and approachable nature, along with her willingness to assist others, exemplify her dedication to supporting both new hires and existing staff. She dedicates her time and effort to promptly address any inquiries or issues that arise, and her positive outlook, compassion, and unwavering commitment play a key role in fostering a strong sense of family within TPMG. We thank Siera for her remarkable work!
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If you would like to nominate a fellow employee for the Beacon Award, fill out a nomination form here. Be sure to include in your nomination how the staff person models our core values of Excellence, Compassion, Belonging, Diversity, Professionalism, and Innovation. | |
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As a part of the TPMG team, you have the opportunity to provide care to patients in the Hampton Roads area and beyond. Our mission is to deliver exceptional medical care to every patient at a competitive cost, to improve the health of our communities, and to provide a premier work experience for our employees and physicians.
Visit our career page for clinical and non-clinical job opportunities!
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Good things happen when you read your Vital Signs! | |
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Stephanie Chappell-Nicholson (pictured right) with TPMG Rheumatology and Jessica Johnson, DNP, WHNP-BC of TPMG Obstetrics and Gynecology answered the trivia question correctly from last month's issue of Vital Signs and won these prizes! (Names were drawn at random.)
Answer the following question correctly and your name will be entered to win a prize.
What are three ways you can prepare for seasonal allergies?
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- Follow TPMG for fun facts, pictures, and positive engagement - | | | | |
