What is a DO?

Throughout my training and career, this question has certainly come up more than once. Now, more than ever, with the topic of DO physicians making news and headlines (all press is good press, right? Not necessarily…) are we presented with the opportunity to educate and share exactly what “DOing” is.

DO stands for Doctor of Osteopathic Medicine whereas MD stands for Doctor of Medicine.  Like MDs, Doctors of Osteopathic Medicine are fully licensed physicians who can practice in all areas and specialties of medicine.  We practice evidence-based medicine, using the latest science and technology.  During our medical school training, like MD students, the first two years are centered around classroom learning, and the last two gaining clinical experience in various specialties during clinical rotations.

Many DOs sit for the same licensing exams as MDs (USMLE) during medical school in addition to their osteopathic licensing exams (COMLEX).  The field has grown 300% (wow!) in the last three decades, currently making up 11% of the physician population.  In addition, 42% of actively practicing DOs are female!

In many circumstances, patients may not even notice a difference between their DO or MD physicians.  Where DOs differ is the underlying philosophy that is incorporated in our medical school training.

The hallmark of Osteopathy emphasizes a “whole person” approach (a person is a unit of “body, mind and spirit”).  We are trained that the person and body is whole and interconnected, and each body system affects the other.  DOs have an additional 200 hours on top of general medical school curriculum that focuses on Osteopathic Manipulative Treatment (OMT).  OMT is a hands-on approach, where we learn in depth musculoskeletal exam and treatment of musculoskeletal dysfunction, which may be related to visceral (other body systems/organs) or somatic (musculoskeletal) causes.  While not every DO uses OMT in their day to day practice, this inherent philosophy of treating the person as a whole is how osteopaths are trained to approach each and every patient.  Many of my MD colleagues approach their patients with a similar view due to their compassionate personality, but this philosophy is not part a focus their medical school curriculum.

One of the best parts of being a DO, like all differences, is being able to bring a different perspective to the table.  I am proud of my training and where it has led me (here at BCOG!)!

Flu Vaccine – coming to Bedford Commons OBGYN October 1, 2020!

“Ouch, that hurt!  Why did you do that?!?” — that’s what my 5 year old daughter yelled at the nurse giving her the flu vaccine last year.

In the midst of the current COVID-19 pandemic, it’s easy to forget the flu season is just around the corner.  Or maybe you haven’t forgotten because you have seen signs advertising the flu vaccine at many national pharmacy chains.  I think I saw my first flu vaccine advertisement at the end of July, more than 2 months before the onset of the flu season!

The Center for Disease Control (CDC) recommends the flu vaccine every year for everyone 6 months of age and older.  It is especially important this year given the overlap of symptoms caused by COVID-19 and the flu.  Getting your flu vaccine is one of the best ways to protect against the flu.  Although the flu vaccine is currently available at many pharmacies, the CDC recommends waiting until late September to get vaccinated because getting the vaccine too early may cause reduced protection against the flu later in the flu season.

As we have been so focused on COVID-19, I think it is important to remember that last year, more than 410,000 Americans were hospitalized due to the flu and more than 24,000 people died from the flu.  Although wearing a mask can help prevent the flu, the best way to protect yourself is to get the vaccine.

At Bedford Commons OB-GYN, we will begin to offer the flu vaccine to our pregnant patients starting October 1, 2020.  We recommend the vaccine for all of our patients but due to a limited supply, we are only able to offer the vaccine in our office to our obstetric patients.  For our non-obstetric patients, we would recommend heading to your primary care or a local pharmacy to get vaccinated.

Click here for more information from the CDC about this year’s flu vaccine.


Unexpected Medical Bills Don’t Make Good Surprises

Understanding your high deductible health insurance plan

Remember the days of paying a $25 copay for every office visit and that was all you were personally responsible for?  With the increasing number of high deductible health insurance plans out there, it has become increasingly more confusing for patients to figure out what they will be responsible for in regards to healthcare costs.  We hear words like “subject to your deductible”, “preventative care”, “100% covered” with no clear understanding with what to expect when the bill ultimately comes in the mail.  I think the key is in understanding preventative care versus diagnostic care.

Preventative Care

Preventative care in gynecology includes the annual examination physical, lab tests, screenings and other services intended to prevent illness or detect problems before you notice any symptoms.  Because of the Affordable Care Act (passed in March 2010), most health insurance plans cover preventative care at 100% and often you won’t have to pay a cent.  It’s important to check with your health insurance plan to find out what services are included in preventative care as well as to make sure you are visiting an in-network provider.

Diagnostic Care

Diagnostic care involves treating a problem you already have, checking out new symptoms, or following up on abnormal lab tests.  When you receive diagnostic care, you may have to pay out-of-pocket with your plan until you have met your deductible and your co-insurance requirements.

Insurance in Action

That all sounds good, but in practice it can seem a little more confusing.  Let’s look at two patients’ examples to help to clarify.

Sue – During her yearly annual gynecology exam, Sue’s provider orders some lab tests, including a pap test to screen for cervical cancer.  Sue has never had an abnormal pap test.  The pap test is considered to be preventative.  Sue’s pap test comes back abnormal and requires additional testing for HPV through the laboratory.  Although the pap test is a preventative test, the additional testing for HPV is considered to be diagnostic because it’s being done because something was abnormal.  Sue’s visit would still be considered to be preventative care but the additional testing is diagnostic.

Julie – During Julie’s annual gynecology visit, Julie is asked about her periods.  Julie talks to her provider about her abnormal bleeding patterns.  Her periods are becoming heavier and sometimes she bleeds in between periods.  Julie’s provider is concerned about what might be causing the change in bleeding patterns.  To further investigate what is going on, Julie’s provider orders some lab tests and an ultrasound.  Because these tests are being done to follow-up on symptoms that Julie is having, these tests are considered to be diagnostic.  Part of Julie’s visit to her provider is considered to be preventative and part of her visit is considered to be diagnostic because of the symptoms she is reporting.

There are a million (probably more) health insurance plans out there and all plans have different coverage.  Please understand that 100% covered is not the same as 100% free of charge.  If you have specific questions regarding your healthcare plan, please call the number on the back of your insurance card to get more information.

For more information on health insurance in general, click here to watch a quick video.

Upcoming visit?

As we all have experienced, the current COVID19 pandemic has changed the way we do even life’s simplest things.  Going to the grocery store, although it’s never been one of my favorite things, is now like finding my way through a maze of one-way aisles.

Like most places, things are a little different at Bedford Commons OB-GYN right now.  We are still the same awesome team and we really are excited to see you but there are a few things that you should know before you come for your visit:

  1. Visitors – It’s awesome to meet your partner, parent, and children but right now, we need to limit the number of people in our office to keep our environment safe for all of our patients and team.  Because of this, unless you are under the age of 18, or require assistance, or are coming in for an obstetric ultrasound, no visitors will be permitted to accompany you to your visit.  We know this can be difficult, especially with childcare challenges.  However, we are committed to keeping everyone healthy which is why we cannot make any exceptions to this rule.  We are happy to FaceTime or do a phone call during your visit so someone else can be a part of your care.
  2. Pre-visit check-in – You will receive a text message and email 1 day before you appointment from Phreesia asking you to “Check-in”.  This is not actually checking you in but is our way of having you verify all of your information is correct and complete any paperwork we would have had you do at your visit.  This process takes between 1-4 minutes.  Completing it ahead of your appointment prevents you from having to fill out actual paperwork when you come in.
  3. Let us know you’re here! – For appointments in our Bedford location ONLY, let us know when you arrive by texting us at 603-668-4646.  We will ask you a few questions about signs and symptoms of COVID19 and recent travel.  As long as you completed the pre-visit paperwork from Phreesia, you’ll wait in your car until a room is ready.  For our Derry and Windham locations, because we can get you quickly in a room, come on in and check in and we will bring you right back to an exam room.
  4. Recent travel?  If you have recently traveled outside of New England, we may ask you to reschedule your visit.  Traveling to any areas with a >5% positivity rate increases the possibility that you may be exposed to COVID19.  Please call us if you have traveled in the past 14 days and we will let you know if we need to reschedule your appointment.

Questions?  This is all a little confusing so if you have any questions, just give us a call.  We would love to help!

The “Heart & Soul” of Dr. Katlyn Viglianco

While Dr. Katlyn Viglianco has been with the practice for a couple months now it recently came to our attention that a fabulous article was written about her “Heart and Soul” by her previous “family”: the CAMC Health System.

Before she left, Viglianco was recognized for her constant care and leading by example, every day. The person nominating Viglianco said she consistently went above and beyond during her residency. Below are some examples from the nomination:

  • Whenever there was an emergency situation on the unit, she did everything she could to help not only the patient, but the nursing staff as well.
  • She stayed at bedside with nursing staff waiting on patients to be transferred to an ICU.

To read the full article, click here.

This Month’s Super Food: Luscious Mango

It’s late summer, and mango is everywhere. In fact, mango may be the most widely-consumed fruit in the world. A stone fruit (as peaches are), it has been cultivated for over 4,000 years overseas, but is a relative newcomer to North America.  Low in calories (one cup is just 100 calories), it is packed with Vitamin C, has great antioxidant properties and may help boost immunity because of its relatively high level of Vitamin A. Mangos also contain a group of digestive enzymes (amylases) that help aid in the breakdown of food for easier absorption by the digestive system.

Did we also mention mango is delicious? Instead of ice cream this week, why not try this quick and healthy mango dessert alternative?

Mango Ginger Parfaits

Compliments of myrecipes.com  |  4 servings (serving size: 1 parfait)

2 cups plain 2% reduced-fat Greek yogurt
2 tablespoons mascarpone cheese
2 tablespoons brown sugar
2 tablespoons fresh lime juice
2 ripe mangos, peeled and chopped
1/4 cup gingersnap crumbs (about 4 cookies, finely crushed)
2 tablespoons flaked sweetened coconut, toasted

Combine yogurt and mascarpone in a small bowl.
Combine sugar, lime juice, and mango in a small bowl; toss to coat.
Combine gingersnaps and coconut in a small bowl.
Place 1/4 cup yogurt mixture into each of 4 parfait glasses. Top yogurt with 1/4 cup mango mixture and 1 1/2 teaspoons gingersnap mixture. Repeat layers with remaining ingredients.