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BIDMC Named a Center of Excellence for Urogynecology

Beth Israel Deaconess Medical Center has been designed a Center of Excellence: Continence Care by the National Association for Continence (NAFC).

The multidisciplinary team is led by Anurag K. Das, MD; Roger Lefevre, MD; Janet Li, MD; and Deborah A. Nagle, MD, representing the Roberta and Stephen R. Weiner Department of Surgery and the Department of Obstetrics and Gynecology.

NAFC sealNAFC’s COE initiative was established to offer patients, seeking solutions to their bladder and bowel control problems and related pelvic floor dysfunction (PFD), a reliable, trustworthy means of finding an experienced and well-trained interdisciplinary team of experts. Health care institutions seeking to apply for this designation must first meet pre-qualification requirements set by NAFC and its COE Governance Board.

The designation process is entirely patient-centered and includes a patient satisfaction survey as well as an extensive site visit. A complete list of the requirements can be found on NAFC’s website.

BIDMC is consistently ranked by U.S. News and World Report as a “Best Hospital” in multiple categories, and has also been ranked as top-in-category for urology and gynecology.

The Division of Urogynecology/Female Pelvic Medicine and Reconstructive Surgery was formally designated a specialty service within the Department of Obstetrics and Gynecology in 2010 with the recruitment of Li as program director. She holds an academic appointment as Instructor in Obstetrics, Gynecology Reproductive Biology at Harvard Medical School.

The Division of Urogynecology/Female Pelvic Medicine and Reconstructive Surgery utilizes expert physicians and nurses, advanced care systems, administrative leadership, diagnostic and support personnel in order to provide consistently high level of clinical excellence and patient-centered care.

Under Li’s leadership, the program is able to leverage Das’ skills in urology, Lefevre’s in gynecological surgery, and Nagle’s in colon and rectal surgery. 

"Advanced" Urgent Care Center Opens in Norwood

Dedham Medical Associates, an affiliate of Atrius Health, has teamed up with Beth Israel Deaconess Medical Center to create a unique, high quality urgent care center in Norwood.

The Dedham Medical Urgent Care Center, affiliated with BIDMC, opened on February 28 and is now providing walk-in care for a variety of non-life-threatening illnesses and injuries. Every patient is seen by a board-certified emergency medicine physician from Harvard Medical Faculty Physicians at BIDMC, offering a level of expertise not seen in most urgent care settings.

The Center, located on Route 1 South in Norwood, will treat anyone three months and older with no need for a referral.

The service provides urgent care for a range of medical problems that may be too complex for a primary care office, or that occur after hours or on weekends. Among the conditions that can be treated: accidents and falls; lacerations that require stitches; sprains and broken bones; migraines; back problems; breathing difficulties, including asthma; severe abdominal pain; high fever; vomiting/diarrhea /dehydration; sunburn/heat stroke/frostbite; cellulitis, urinary tract infections, and severe sore throat or cough.

Imaging and a full lab are available on site for quick access when needed. All major insurance plans are accepted and typically the co-pay for urgent care is lower than that of an emergency room visit. Wait time is also expected to be less than that of an emergency room.

“Our affiliation with Beth Israel Deaconess Medical Center for the Urgent Care Center will offer residents of Norwood and other towns in our region quick and convenient access to excellent care and services,” says Roberta Zysman, CEO of Dedham Medical Associates. “We have more than 75 years of offering the best care to patients of Dedham Medical Associates and now we can extend that high level of care to others in the area with this Urgent Care Center.”

“We are thrilled to be working with Dedham Medical Associates. Their experience providing high quality, award-winning care to the community and Beth Israel Deaconess Medical Center’s respected reputation are a perfect combination that will benefit area residents,” says Jayne Carvelli Sheehan, Senior Vice President of Ambulatory and Emergency at BIDMC.

The Center is open to the public Monday through Friday from 12 p.m. to 10 p.m.; Saturdays, Sundays and most holidays from 8 a.m. to 6 p.m.

Parking is free with easy access to the first floor.

While the Center will welcome walk-ins, patients of Dedham Medical Associates, the other Atrius Health affiliates (Granite Medical Group, Harvard Vanguard Medical Associates, Reliant Medical Group, South Shore Medical Center and Southboro Medical Group), and Beth Israel Deaconess will have an added benefit.

“Medical record keeping and information will be shared between physicians at the urgent care center and BIDMC-affiliated providers,” says Larry Markson, BIDMC’s Vice President of Clinical Information Systems. “BIDMC providers will receive a discharge summary when one of their patients is seen, and Atrius Health providers will also be notified via the Epic system when one of their patients is seen.”

“As an experienced emergency medicine physician, I know this blending of two great organizations with great reputations into one great facility will be a real service to the community here,” says Paul Paganelli, MD, Director of the Urgent Care Center.

“While there are other urgent care centers around, our combination of certified emergency medicine physicians, skilled ancillary staff, Dedham Medical Associates’ state-of-the-art lab and X-ray services and the new, well-equipped facility here in Norwood, should encourage everyone to come to us as their first choice when care is needed urgently.”

Learn more about Dedham Medical Urgent Care Center »

Study: Heart Attack Risk Increases after Angry Outburst

Call it what you will — getting red in the face, hot under the collar, losing your cool, blowing your top — we all experience anger. And while we know that anger is a normal, sometimes even beneficial emotion, we‘re also aware of the often harmful connection between anger and health.

New research from Beth Israel Deaconess Medical Center shows an even more compelling reason to think about getting anger in check — a nearly fivefold increase in risk for heart attack in the two hours following outbursts of anger.

“There has been a lot of research on anger; we already know it can be unhealthy, but we wanted to quantify the risk, not just for heart attack, but for other potentially lethal cardiovascular events as well,” says lead author Elizabeth Mostofsky, MPH, ScD, a post-doctoral fellow in the cardiovascular epidemiological unit at BIDMC and an instructor at the Harvard School of Public Health. “The hope is this might help patients think about how they manage anger in their everyday lives and prompt physicians to discuss medications and psychosocial supports with their patients for whom anger is an issue, especially patients with known cardiovascular risk factors.”

In the study published Tuesday in the European Heart Journal, Mostofsky and colleagues performed a systematic review of studies published between 1966 and 2013. They identified nine case crossover studies where patients who had experienced cardiovascular events answered questions about anger. They were asked about their level of anger immediately prior to the cardiovascular event compared with other times, using terms like very angry, furious or enraged.

The researchers found that despite differences between the studies, there was “consistent evidence of a higher risk of cardiovascular events immediately following outbursts of anger.”

The study results showed that the risk of heart attack or acute coronary syndrome — the symptoms like chest pain, shortness of breath or sweating related to a blocked artery — was 4.7 times higher in the two hours following an angry outburst than at any other time. And the risk for stroke caused by a blocked artery in the brain was 3.6 times higher than at other times. One study indicated a 6.3 fold increased risk for brain aneurysm in the hour following an outburst of anger compared with other times.

Mostofsky and colleagues also examined two studies that looked at arrhythmia and anger. Analysis of these studies showed that patients with implanted cardiac defibrillators (ICD) were nearly twice as likely to experience an abnormal heart rate requiring a shock from the ICD in the 15 minutes following an angry outburst than at other times.

“It’s important to bear in mind that while these results show a significantly higher risk of a cardiovascular event associated with an angry outburst, the overall risk for people without other risk factors like smoking or high blood pressure is relatively small, about one extra heart attack per 10,000 people each year,” says senior author Murray Mittleman, MD, DrPH, a physician in the CardioVascular Institute at Beth Israel Deaconess Medical Center, an Associate Professor of Medicine at Harvard Medical School and director of BIDMC’s cardiovascular epidemiological research program. “However, the risk is cumulative, so the more angry outbursts, the higher the risk, which means we should be concerned about the occurrence of angry outbursts with our higher risk patients as well as our patients who have frequent outbursts of anger.”

While it’s possible that medications and other interventions that may lower the frequency of angry outbursts or the risk associated with anger, Mostofsky says “more research including clinical trials are needed to identify which drugs or behavioral therapies will be most effective.”

This study was supported by grants T32-HL098048 and F32-HL120505 from the National Heart, Lung, and Blood Institute at the National Institutes of Health. Elizabeth Anne Penner from the Department of Internal Medicine, New York Presbyterian Hospital and Weill Cornell Medical Center is a co-author on the study. 

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted March 2014

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