This Newsletter Brought to You by the Physicians and Staff of The Center for Primary Care

Immunizations An Important Step

In Preventing Childhood Illnesses

It may still feel like summer outside, but for all practical purposes, vacation is history and its time for parents and children to turn their attention to school. With the abundance of TV, radio and newspaper back-to-school ads, it would be hard to forget about items like school supplies and fall clothes, but what about your childs health? Is your childs immunization history up to date? Have you met the health requirements set by the school system your child will be attending?

There are some health requirements that must be met prior to enrollment in a school for the first time, says Rebecca Talley, MD, of the Center for Primary Care in Evans. Parents of children initially enrolling in a Georgia school, for instance, must supply an up-to-date immunization record at the time of enrollment, showing that the child has received the required vaccines. These typically include the DPT (diphtheria, pertussis, and tetanus vaccine, given at age 2,4, 6, and 12-18 months and age 4-6 years, with boosters at age 11-12 years and every 10 years afterward); the MMR (measles, mumps, and rubella vaccine, given at age 12-15 months and again at age 4-6 years); and vaccines for polio (given at ages 2,4, and 6-18 months with a booster at age 4-6 years) hepatitis B (given three times in the first 6 months of life, each dose separated by appropriate intervals),

and varicella (chickenpox). Chickenpox vaccination is a new requirement for new Georgia students. Any student entering a Georgia school for the first time who has already had the infection will be asked when (month/year) it occurred. It must have occurred after the child reached one year of age and have been a clear-cut case of chickenpox If the childs chickenpox history is not known or uncertain, he/she should be vaccinated. Students who are new to Georgia schools must also present proof of a three-point medical screening test for vision, hearing and dental health.

Since immunization and other health requirements can vary among school systems, it is best to find out directly from your childs school exactly what is needed. While some school systems notify parents ahead of time about health requirements, it is ultimately the parents responsibility to know what immunizations are needed at what ages and to have an accurate and current immunization record on hand.In a step toward standardizing childhood immunization practices nationwide, several medical organizations* have collaborated to establish a harmonized immunization schedule. This schedule includes recommended vaccines and corresponding age ranges and intervals at which they should be administered. These recommendations are based on safety, risk and cost-benefit profiles of the individual vaccines and are intended to serve as a guide for physicians in clinical decision-making.

Colleges sometimes suggest the bacterial meningitis vaccine for students living in dormitories because, while it is a rare disease, it is extremely dangerous and highly contagious. The vaccine is not universally recommended because it is costly and the risk of disease is so low, but parents and students who are concerned about the risk should discuss their concerns with their family physician.Generally, vaccines are safe and effective in preventing diseases. Vaccines are the crux of preventive medicine. Along with better hygiene (hand-washing, in particular) and clean drinking water, vaccines are among the most effective and safest means available for preventing disease , she says. The potential problems associated with diseases far outweigh the problems that can occur with vaccines.The cost of vaccines varies widely, as does the amount, if any, covered by health insurance policies. The best way to determine what is covered is to carefully review your policy. Local health departments offer immunizations, often at reduced rates based on the patients ability to pay. Another program is being developed to address the immunization needs of people who are financially unable to pay.If your insurance does not cover immunizations and you cannot otherwise afford them, Dr. Talley recommends talking with your physician or contacting your local health department for assistance. Immunizations are so important, we dont want there to be any disincentive for getting them, she says.For patients convenience, CPC does not require an appointment for immunization.CPC Physician Profile: Dr. Jay Tomeo of CPC Central

Medical school was always in the long-range plan for Dr. Jay Tomeo, but when he graduated in 1978 from Loyola Marymount University in Los Angeles, California, with a degree in science, he took a detour South. Instead of heading straight for medical school, he was recruited by nuns in Mexico to teach science at a girls boarding school. Thinking this offer might be a interesting departure from his California upbringing, he accepted the challenge and embarked on a journey that would become a culturally enriching and treasured experience.

Located approximately one hour southeast of Mexico City in Cuerna Vaca, the school for sixth- to twelfth-grade girls was staffed primarily by the nuns and was housed in an imposing structure that had served as a fort during the revolution. Although Jay learned to speak quite a bit of Spanish during his year and a half there, he was allowed to teach in English, as most of his students were bilingual or multilingual. Some were even fluent enough and had a broad enough cultural background to serve as diplomatic translators.

Young Jay lived off campus with a Mexican family who had a large home. Every night at dinner, there were different faces around the table. The house was close to a language school attended by British diplomats, scientists from Sweden, and others, he recalls. There was a medical school nearby as well, so medical students also frequented the home. This diversity added an international flair to his experience as a teacher in Mexico.

Jay grew up in Los Angeles with his parents, Maurice and Betty, two younger brothers, Michael and Todd, and a sister, Gail. During what he describes as a happy childhood, Jay says he was a bit of a bookworm and a loner but was also athletic and competitive. He always enjoyed and was involved in sports: football in high school, and later, handball and racquetball.

After college and his stint as a teacher, Jay enrolled in a graduate program in genetics at California State University at Northridge, until he was accepted in 1980 to Loyola University Medical School in Chicago. This school was a natural fit for Jay since he had graduated from Loyola in California and his mother was originally from Chicago. I had visited there as a child, and it was nice to have some family nearby, he says.

As a new medical student, Jay had a keen interest in primary care, even though it was at a time when there was a greater push toward other medical specialties. This was particularly true at Loyola, which had a prominent heart program. Many students were urged to pursue other specialties, he says.

Despite the trend, Jay stayed with his early area of interest. Following graduation in 1985, he entered a family practice residency at McNeill Hospital in Berwyn, a suburb of Chicago. The philosophy at McNeill was that there was great value in being an all-round doctor, he explains. While that still holds true, he has seen family practice evolve to include a gatekeeper function, wherein patients consult first with their family physician, who provides referrals to other specialists when needed. Our place as family physicians is still evolving, he says, especially with respect to more coordinated care, which he believes is being enhanced by the trend toward computerized medical charts and hospital records.

After completing his residency in 1988, Dr. Tomeo moonlighted at several urgent care centers in and around Chicago while also attending a geriatric fellowship at LaGrange Hospital. With geriatric fellowships just beginning to emerge as a medical specialty, Dr. Tomeo followed his family practice director to the new program at LaGrange Hospital. Dr. Tomeo participated in the fellowship for a year and a half until he left for a group practice in Florida. Dr. Tomeo explains: Most fellowships turn out teachers, and I wanted to enter private practice.

During that time, Dr. Tomeo married. Because he and his new wife, a nurse, wanted to live near the beach, they explored employment opportunities in Florida. They settled on a small hospital near Cape Coral, located two hours south of Tampa along the Gulf coast. Jay was happy during his three years in this community, in part because of its unique characteristics. Cape Coral is a canal community that was created out of swampland. At the time Dr. Tomeo lived there, it was populated predominantly by elderly residents and fluctuated in size seasonally because of its popularity as a winter retreat. All of the doctors were from up North, 70 percent of the residents were on Medicare, and the population almost doubled in winter, he says. It was an interesting place to live and work.

Dr. Tomeos next move was in 1993 to Augusta, where he went into private practice affiliated with Doctors Hospital. He enjoyed the next five years in private practice but found there are considerable drawbacks to working solo. I enjoyed private practice but there were too many administrative headaches, he says. I started to recognize the benefits of being in a group practice, and so he began looking.

At the same time, the Center for Primary Care was growing and planning to establish a presence at Doctors Hospital. Dr. Paul Fischer approached Dr. Tomeo in 1998 about joining his growing practice group. He also recruited Drs. Phillip and Denise Kennedy, fresh out of the Medical College of Georgia. And thus, the third office of CPC was established at its present location at the medical office complex adjacent to the hospital. Everything worked out perfectly, he says. Since joining the staff of the Center for Primary Care, Dr. Tomeo has grown his practice and expanded his role as a leader in the medical community. He was recently elected chairman of the Department of Family Medicine at Doctors Hospital.

When Dr. Tomeo is not busy caring for patients, he spends time with his Augusta family, Sherry Peck and Ryan, her 12-year-old son. In the seven years they have known one another, Dr. Tomeo has learned a great deal from Ryan, who has struggled with the difficulties of having muscles that do not adequately support his skeletal frame. In part from being close to Sherry and Ryan, Dr. Tomeo has developed an interest in caring for children with special needs. He is also involved in programs designed for young people with physical disabilities: Special Olympics activities and Ryans wheelchair soccer team, the Fireballs.

As for his personal pursuits, Dr. Tomeo is a rocket fan. His interest in rockets began with building models, but the hobby has evolved to include building and launching functioning rockets. Most recently, he was able to hobnob with others who share his interest at the National Rocket Shoot in Orangeburg, SC, held over the July 4th weekend.

Computers are perhaps Dr. Tomeos biggest interest away from work. He likes to build them, play with local area networks, and find ways to improve voice dictation and make programs run better and faster. As such, he has become CPCs computer guru. Dr. Tomeos computer know-how is one of the contributions he feels he makes to CPC. When it comes to technical matters, he says, I have good knowledge.

Dr. Tomeo is proud of what he has accomplished, most notably following his dreams and having done so on his own. The road so far has taken him in many directions and given him enriching experiences that complement his work at CPC. His current goals include being the best physician he can be. I want to be a good doctor and to do good work, he says, and CPC is all the better for his devotion to learning, growing, and serving others.

Dr. Priya Deshpande To Join Staff of CPCThe Center for Primary Care is pleased to welcome Priya S. Deshpande, MD, to the physician staff of CPC . Dr. Deshpande is board-certified in family medicine.Dr. Deshpande completed her family practice residency at the University of Massachusetts Medical Center in 1995. Following her residency, she was an assistant professor of Family Medicine at the University of Massachusetts for two years. For the past four years, she has been in private practice in Massachusetts and New York, while her husband, Sharad Ghamande, MD, completed his medical fellowship training in gynecological oncology.Dr. Deshpande has a special interest in womens health and pediatrics. She and her husband have a three-year-old son and are looking forward to not moving anymore and settling permanently in Augusta.She will begin seeing patients on September 5, 2000 call CPC Central at (706) 868-7380 for an appointment.Automated Rx Refill, Test Results Service Offers Convenience

• Have you ever meant to call the Center for Primary Care for a prescription refill during business hours but realized too late that it had closed for the day and youd have to wait until tomorrow?
• Are you occasionally frustrated by phone tag when your doctor is trying to contact you about test results and you keep missing the call?
• How often have you looked at your calendar at the end of the day and realized youd forgotten about your doctors appointment scheduled for earlier that day?

When youre trying to fit 24 hours of daily tasks into a 9-to-5 slot, things are bound to fall through the cracks. Realizing this is a fairly common problem, CPC has attempted to make your life a little easier by offering an automated method of retrieving test results and requesting prescription refills around the clock. We also provide a telephone reminder service for next-day appointments.CPCs automated phone service offers an additional advantage for patients and staff alike: it helps keep CPCs main phone line open for appointments and other patient needs during regular office hours.How does the automated service work?To request refills or to obtain test results, all you have to do is call one of the two dedicated phone lines (650-9458 or 650-8421) and follow the recorded instructions.

These phone lines are available 7 days a week around the clock except from 6-9 p.m., when new information is being entered.If you are requesting a refill prescription, you will be asked to supply the following information: your name and phone number, your doctors name, the name and phone number of your pharmacy, and the name of your medication, dosage and directions for taking it.If you are calling to obtain test results, you will be asked to supply your social security number. Your doctor records your test results in the system as soon as they become available, so that when you call the service for this purpose, you will hear your own doctors voice. Depending on the type of test, the result may be available to you within several hours or it may take several days. You will be advised at the time of your appointment approximately when this information will be available by phone.The reminder service is a courtesy call for patients, but it also helps CPC by reducing the number of missed appointments.

Does this mean I cant speak directly with my doctor or the office personnel anymore?Absolutely not! The automated service is intended only as a convenience. You may still call and speak with one of our doctors or staff members regarding test results, prescription refills, or questions you have about either. Additionally, if your test result is anything other than routine, your doctor or a staff member will contact you personally rather than using the automated service.The automated telephone service has been in operation for more than a year now, but it is taking everyone a while to become accustomed to using it. According to Jim Larson, CPC Vice President for Operations, most patients who use the automated service like the flexibility and convenience it offers.The automated refill and test result service might be new and different, but it is designed to be easy to use and self-explanatory, he says. The recorded message walks you through the process step-by-step. Then if you have any problem using the service or have any questions, you can always call the office during regular business hours.Next time you need a prescription refill or want to find out your test results, give our automated phone service a try. You may be pleasantly surprised to find out how convenient and easy it is to use.

Center for Primary Care

Family Medicine

Recommended vaccines include all of those mentioned earlier for Georgia schools (DPT, MMR, hepatitis B, polio, and chickenpox) as well as those for hepatitis A (in some areas only; not routinely recommended locally), and haemophilus influenzae Type b (Hib or flu). There are always some exceptions to general recommendations, and not all physicians agree on the appropriateness of all standard recommendations. Therefore, it is important to discuss with your physician the pros and cons of vaccines you have concerns and questions about.Sometimes it is obvious when a vaccine should be given, as for polio, explains Dr. Talley. The benefits of others are less well established. The vaccine for bacterial meningitis, for example, is not universally recommended but is available for those who wish to receive it.Dr. Rebecca Talley Administers Tetanus Booster Vaccine to Lindsey Heier, Age 14

The Center for Primary Care offices are staffed by 11 board-certified family physicians who provide care at three convenient locations:

CPC South

2011 Windsor Spring Rd.,

 Augusta, GA 30906

(706) 798-1700

Tracy Barefield, MD

Riaz Rassekh, MD

Edwin Scott, MD

CPC Evans

363 N. Belair Rd.

Evans, GA 30809

(706) 650-7563

Robert Clark, DO

Paul Fischer, MD

James Mobley, MD

Rebecca Talley, MD

CPC Central

3614-D J. Dewey Gray Cir.

Augusta, GA 30909

(706) 868-7380

Denise Kennedy, MD

Priya Deshpande, MD

Phillip Kennedy, MD

Jay Tomeo, MD