Category: 2025

Bassett Cancer Institute: Advanced Healthcare in a Patient-Focused, Community Setting

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By Elizabeth Landry

Providing premiere, patient centered care for patients of all types of adult cancers, Bassett Cancer Institute is a major highlight within the larger Bassett Healthcare Network, a health system that spans eight counties and 5,600 square miles in Central New York. With cancer treatment centers in Cooperstown, Oneonta, Herkimer and Cobleskill, Bassett Cancer Institute welcomes patients from both nearby and far beyond the footprint of its rural communities.

A growing healthcare organization, Bassett provided over 14,000 cancer treatments in 2024 alone, offering care to almost 1,000 cancer patients. From oncology and hematology to more specialized care including gynecologic cancer treatments, radiopharmaceutical treatments and clinical trials, the multidisciplinary team at Bassett aims to achieve high patient satisfaction for adults with varying diagnoses and treatment needs, as Alfred Tinger, MD, Chief and Medical Director at Bassett Cancer Institute, emphasized. 

“The cancer center routinely gets excellent marks for patient satisfaction – no one’s perfect, but we’re well above 90% consistently for patient satisfaction. That makes Bassett a great place to work because we’re doing what we’re called to do: get rid of cancer and take care of patients with cancer,” said Dr. Tinger. 

Breakthrough Treatments and Clinical Trials

The radiation oncology team at Bassett, led by Timothy Korytko, MD, Radiation Oncologist-in-Chief, provides treatment technologies that offer patients the most effective cancer treatments available. 

Dr. Korytko said that in the last five years, the radiation oncology field has seen a big increase in the types of radiopharmaceutical drugs available for cancer treatment. He highlighted two drugs specifically that are available at Bassett: Lutathera, a special treatment for neuroendocrine cancer, and Pluvicto, a radioactive IV treatment used for prostate cancer. Dr. Korytko shared that patients come to Bassett for these kinds of treatment options, and he said the rural setting helps the team provide the best care for patients.

“We’re giving novel therapies, which sets us apart from just being a rural hospital that provides the basics. We were one of the earliest sites giving Lutathera and Pluvicto. We have a team that’s very committed to bringing the best care we can to our patients. And we treat them in a place that’s a comfortable, community based treatment location. You could go to a larger, metropolitan center and get lost in the traffic and crowds, or you can come here and get treated a little bit more like family. To be able to offer this type of care here is really a testament to our investment in doing the right thing,” said Dr. Korytko.

“The technology allows us to deliver radiation much more precisely to maximize killing the cancer and minimize side effects on other organs,” explained Dr. Tinger. “Dr. Korytko pioneered bringing this technology here to Bassett, and he’s grown the program immensely, so it’s basically become a regional referral center for all of Upstate New York.” 

Bassett also offers additional treatments through 11 clinical cancer trials. Dr. Korytko noted that the team has collaborated with a company called Alpha Tau Medical to investigate a new implanted radiation treatment, which may lead to novel approaches for treating cancer in the future. Alpha DaRT™ (Diffusing Alpha-emitters Radiation Therapy) is the first localized anticancer therapy to leverage the specific therapeutic properties of alpha particles to treat solid tumors.

“We’re involved in radiation clinical trials using an investigational radiation implant to treat skin cancer,” Dr. Korytko stated. “We’ve been enrolling patients in a study for recurrent skin cancer who have limited treatment options. We’re one of the first sites in the country to be involved in this clinical trial and are the first in the U.S. to open a clinical trial investigating this device in treating pancreatic cancer.”

Patient-Focused, Multidisciplinary Team 

Treating a wide array of adult cancers, the multidisciplinary team at Bassett Cancer Institute works together to provide specialized care and treatments that are personalized to each unique patient. Dr. Korytko explained how patients benefit from collaboration among the healthcare providers at Bassett.

“Each patient and each circumstance is unique. A lot of times we make decisions as a team. One of the nice things about Bassett and one of the reasons I wanted to join the team here is because we really focus on caring for the patient collaboratively. We discuss and make individualized decisions for patients based on what makes sense for their specific circumstances,” said Dr. Korytko.

The team of over 100 diverse staff members at Bassett Cancer Institute is comprised of nurses (including clinic nurses, infusion nurses, and nurse navigators), support staff (including social workers, financial counselors, nutritionists, and administrative staff) and radiation therapists. Anush Patel, MD, Chief of Medical Oncology and Hematology, shared how patients recognize the high-quality care offered by this multidisciplinary team.

“Our patients are appreciative of what we do. They really value Bassett being in their neighborhood and they value the quality of care we provide. Specific to the cancer center, I think we have extremely collaborative networks here that include our extensive, patient focused support system. We’re a very small oncology group and we know each other quite well. We’re accessible to each other almost all the time. I think that really makes care much more seamless than you would otherwise find in a fragmented system. It makes us stand out in the area, and even at the national level, that we are providing fantastic care in a rural setting,” said Dr. Patel, who also highlighted the unique transportation support system offered at Bassett, which helps ensure patients who face transportation challenges across the  health system’s rural communities can come from their homes to the cancer center for appointments and treatments.

Specialized, Seamless Cancer Care

Within the multidisciplinary team at Bassett Cancer Institute are highly specialized healthcare providers who care for patients with specific types of cancer and other disorders. As the Chief of Hematology and Oncology, Dr. Patel provides treatment for patients with leukemia, lymphoma and non cancerous disorders like blood clots or hemophilia.

“We are trained especially in noncancerous blood disorders, along with malignant hematology, which is leukemia and lymphoma, as well as medical oncology, which involves solid tumors. It’s quite seamless because someone who gets chemotherapy might have a complication of low blood count, so we need to be quite well trained and comfortable with dealing with the anticipated complications,” explained Dr. Patel. 

Another highly specialized and trained physician at Bassett Cancer Institute is Elizabeth Pelkofski, MD, Gynecologic Oncologist, who joined the Bassett team in 2023.

With extensive experience in gynecologic oncology, Dr. Pelkofski provides diagnosis  and treatment for a wide array of cancers, including cancers of the cervix, ovaries, uterus, fallopian tubes, vagina, vulva and peritoneum, as well as cancers associated with pregnancy. Treatment options she offers are complex pelvic surgery, chemotherapy, immunotherapy, radiation therapy, hormone therapy and assistance with clinical trials, depending on specific patient needs.

“Gynecologic oncology is a very specialized surgical subspecialty, so patients in rural areas can be very underserved and must travel very far for care. It’s rare to have a local, full-service, specially trained gynecologic oncologist practice here in Cooperstown and in the surrounding communities. With all the therapies we provide, between surgery visits, chemotherapy, radiation and more, our relationship with patients isn’t a one-time point of care. That’s a big reason why it’s such a benefit to have localized care in a smaller center with more focus on patients and their needs,” said Dr. Pelkofski.

Although a referral is needed for patients to see Dr. Pelkofski, she offers rapid appointment access for patients with complex gynecologic conditions and cancers. Practitioners who wish to refer a patient should contact Bassett Cancer Institute at 607-547-3336.

“I think all oncologists work hard to see patients as quickly as possible, not only because it’s so stressful to have a cancer diagnosis or a potential diagnosis, but also because patients often experience debilitating symptoms. They may have bleeding or be in a lot of pain because of their cancer,” shared Dr. Pelkofski. “It’s not unheard of, depending on the condition and the patient, to be seen the same day or the next day, and with invasive cancer almost always within a week. We try to be fast.”

Expanding the Network of Dedicated Providers

Despite being a multidisciplinary team serving and treating patients with many different types of cancer, the physicians at Bassett Cancer Institute seem to have an important thing in common with each other: a passion for the team of people they work with, especially regarding how each provides a high level of care for patients.

“After I was trained at Bassett, I went out to a  larger institution, and the reason I came back to Bassett is the people. The people that we work with every day genuinely want to make a difference in patients’ lives. We’re very patient focused and we truly take pride in providing exceptional cancer care to our community,” said Dr. Patel.

Dr. Pelkofski echoed Dr. Patel’s sentiments, highlighting the elevated culture at Bassett that allows patients to stay at the center of the team’s focus.

“It’s a really wonderful culture. Everyone goes above and beyond, and the focus is on work and taking care of patients. I think culture can be the hardest thing for a company to create, and we just have it here,” she said.

Dr. Korytko highlighted the autonomy providers have within Bassett’s network of more than 525 practitioners, explaining how opportunities arise not only for providers to grow their careers but also for the expansion of treatment technologies at the facility.

“One of the reasons I came to Bassett was because of the opportunities. The way the leadership is structured,  there’s a focus on each physician’s unique skills. Physicians really drive the direction of patient care. Subsequently, when new technologies become available, the hospital tries to help us get those new technologies here as much as they can. To be in a place that is so supportive of these endeavors has always been really important to me,” Dr. Korytko said.

As new team members are added at Bassett Cancer Institute, and as they care for more patients across Central New York, plans are being made for exciting facility expansions. Funding is currently being raised to expand and modernize Bassett Cancer Institute’s oncology unit at FoxCare Center in Oneonta, one of the network’s most utilized cancer treatment centers in a university town with a larger population. The goal is to provide an enhanced environment for patients and practitioners alike.

“We’re kind of outgrowing our space, so we’re investing in a new cancer center by building out and expanding the oncology unit inside FoxCare Center,” stated Dr. Tinger. “The plan is to expand the space, so we’ll have more room for offices and exam rooms, including private rooms for infusions.  We have pending plans for expansion in our other offices, as well.”

As the teams and the locations grow, however, the mission of Bassett Cancer Institute, as described by Dr. Tinger, will remain the same: “Our mission is to take great care of patients with cancer. Hearing you have a cancer diagnosis puts someone in a very vulnerable position. We exist to remove the vulnerabilities and give people hope.” 

Learn more about Bassett Cancer Institute by visiting bassett.org/cancer. Call 607-547-3336 to make a patient referral or inquire about Bassett’s clinical trials.

 

Mental Health Access

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By: Kathryn Ruscitto, Advisor

Recent conversations with families seeking mental health resources have highlighted the severe challenges in accessing psychiatric care in our community. What began as routine inquiries have exposed a healthcare system stretched beyond capacity, with primary care physicians increasingly unable to connect patients with psychiatric specialists. The backlog, initially attributed to COVID-19 disruptions and workforce shortages, has reached critical levels that demand innovative solutions.

In consultation with Ann Rooney, Deputy County Executive for Human Services in Onondaga County, the scope of this challenge became clear. The County is actively responding through the Department of Children and Family Services, implementing triage systems designed to prioritize the most vulnerable patients and ensure they receive timely care. Ann also shared a tool the County recommends for physicians to consider called Clinicom (https://clinicom.com/). This algorithm helps providers assess mental health conditions in a timely manner to consider treatment options. Other counties in upstate New York, along with major health foundations from Buffalo to Albany, cite mental health and substance abuse among their top priorities for focus in the next year.

For families with private insurance and financial resources, online mental health platforms offer promising alternatives. Services like Talkiatry and BetterHelp provide access to licensed providers when traditional pathways fail, though they typically operate on a private pay basis. Online services must be licensed in your state to provide care. While often requiring private payment, they can help individuals navigate next steps and access immediate support. 

The mental health system is adapting through tiered care approaches. Psychiatrists focus on the most acute cases, while psychologists and therapists provide ongoing counseling and support for longer-term cases. This model maximizes specialist availability while ensuring comprehensive care. Primary care physicians have become frontline mental health providers by necessity. Many report managing mental health concerns, including substance abuse issues, while patients await specialist access. This reality requires staying current with available resources and access points. 

The range of inpatient beds in local health systems are critical parts of the mental health care system when individuals and families face crisis. These beds are also under severe stress from increasing demand. This adds to the crisis in access when immediate care is needed. Multiple barriers continue to impact access including rural geography limitations, insurance coverage gaps, and evolving telehealth regulations. Staying informed about available resources remains crucial for reducing patient frustration and improving care coordination. 

Thank you for all you do in supporting families facing mental health crisis.

Advances In Cardiac Technology:Diagnosis, Treatment, And Monitoring

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Data from the World Health Organization indicates that cardiovascular diseases (CVDs) are responsible for approximately 17.9 million or 32% of deaths worldwide, necessitating continuous innovation in diagnostic and therapeutic technologies. Recent advances in cardiac technology have significantly improved patient outcomes, with breakthroughs spanning early detection, minimally invasive treatments, and personalized care.

Advancements in Cardiac Imaging: Enhancing Diagnostic Accuracy and Treatment Planning

One of the most significant advancements is the use of Cardiac Magnetic Resonance Imaging (MRI). Cardiac MRI is an essential tool for assessing myocardial viability, scar tissue, and heart chamber functionality. A breakthrough in MRI technology, Late Gadolinium Enhancement (LGE) imaging allows for highly accurate detection of myocardial infarction and fibrosis. This non-invasive imaging modality provides details on heart tissue structure, enabling clinicians to better predict patient outcomes and guide therapy decisions.

Another notable advancement is 3D Echocardiography. Unlike two-dimensional echocardiograms, 3D imagining allows for a more precise evaluation of cardiac morphology, valve function, and hemodynamics. This is especially beneficial when assessing mitral valve diseases and congenital heart defects, facilitating improved surgical planning and postoperative care.

Minimally Invasive Cardiac Interventions: Revolutionizing Treatment, Reducing Recovery Time, and Improving Outcomes

One of the most significant developments in recent years is the evolution of Transcatheter Aortic Valve Replacement (TAVR). TAVR, a procedure in which a catheter replaces a damaged aortic valve without open-heart surgery, has gained widespread acceptance for the treatment of aortic stenosis, particularly in elderly and high-risk patients. Advances in valve design and catheter technology have significantly improved the success rate and reduced the risk of complications, making TAVR an increasingly preferred option over traditional valve replacement surgery.

Similarly, left atrial appendage closure (LAAC) devices, such as the WATCHMAN™ device, offer a minimally invasive solution for stroke prevention in patients with atrial fibrillation. By occluding the left atrial appendage,  thrombus formation is prevented and reduces the risk of stroke, eliminating the need for long-term anticoagulation therapy in certain patients.

The Rise of Digital Health: Wearable Technology and Remote Monitoring

 Wearable devices have become integral to the management of cardiovascular diseases. Technologies such as smartwatches with built-in electrocardiograms (ECGs) can detect arrhythmias, including atrial fibrillation (AF), in real time. Devices like the Apple Watch® and KardiaMobile® capture high-quality ECG readings that can be instantly transmitted to healthcare providers for analysis, allowing for earlier detection of cardiac abnormalities and timely interventions.

Additionally, remote monitoring systems are improving the management of heart failure. Implantable devices, such as Cardiac Resynchronization Therapy CRT) devices and implantable cardioverter-defibrillators (ICDs), can continuously monitor heart function and send data to clinicians for analysis. This allows for personalized adjustments to treatment regimens and early intervention when abnormalities are detected. The use of artificial intelligence (AI) to analyze large datasets from these devices further enhances clinical decision making, making care more proactive and individualized.

The Landscape of the Future

Cardiac technology continues to make tremendous strides, improving the ability to diagnose, treat, and monitor cardiovascular diseases. Advances in imaging techniques along with minimally invasive procedures have revolutionized management of heart disease. Furthermore, wearable technologies and remote monitoring systems are ushering in an era of personalized, continuous care, enabling better management of chronic conditions like heart failure and atrial fibrillation. As technology continues to evolve, these innovations promise to further transform cardiovascular care, improving patient outcomes and quality of life.

Claims-made vs. Occurrence Insurance Policies:Understanding the Differences, Benefits, and Drawbacks

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By: Jenn Negley, Vice President, Risk Strategies Company

When it comes to liability insurance for professionals such as doctors, choosing the right type of policy is crucial. Two of the most common forms of coverage for professionals, such as doctors, lawyers, and business owners, are claims made and occurrence  policies. While they both offer liability protection, the way coverage is triggered and how long it lasts differs significantly. Understanding these differences is crucial for individuals and organizations to avoid costly coverage gaps and ensure they are adequately protected.

What is a Claims-Made Policy?
A claims-made policy provides coverage only if the claim is made during the policy period and the incident occurred on or after the policy’s retroactive date. The retroactive date is usually the date the insured first purchased a claims made policy and continuously maintained it. For example, suppose a doctor has a claims-made malpractice policy that starts on January 1, 2022, with a retroactive date of January 1, 2020. A patient filed a lawsuit on March 1, 2023, for something that happened in 2021. Because the policy is still active when the claim is made and the incident occurred after the retroactive date, the lawsuit is covered.

Benefits of Claims-Made Policies:

Lower initial premiums:
These policies are often cheaper in the early years because the insurer is only covering claims reported during the policy period, not the full history of a professional’s work.

Customizable tail coverage:
If you retire, take a break from your career, or switch insurers, tail coverage can extend your protection beyond the end of the policy. This helps cover claims that arise later from work you did while the policy was active.

Adaptability:
Claims-made policies are a good fit for professionals whose situations may change, such as a growing practice or changing insurers. However, continuity is key to avoiding coverage lapses.

Drawbacks of Claims-Made Policies:

Tail coverage can be expensive:
If the policyholder retires or switches carriers, they may need to buy tail coverage, which can cost up to 200% of the final year’s premium.

Coverage gaps: If there’s a lapse in policy renewal or the retroactive date changes, claims may be denied.

Complexity:
The nuances of retroactive dates and tail coverage can confuse policyholders unfamiliar with insurance jargon.

What is an Occurrence Policy?
An occurrence policy provides coverage for incidents that occur during the policy period, regardless of when the claim is filed. This means even if a claim is filed years after the policy expires, the insurer will still cover it if the incident occurred during the time the policy was active. For example, if a contractor has an occurrence policy from 2018 to 2020, and a claim is  filed in 2024 for a job completed in 2019, the claim will still be covered.

Benefits of Occurrence Policies:

Long-term peace of mind:
Once the policy is in place, the policyholder is protected for incidents that occurred during the coverage period, even if the claim arises years later.

No need for tail coverage:
This makes occurrence policies especially attractive for professionals who don’t want to worry about coverage after retiring or changing jobs.

Simplicity:
Easier to understand and manage over time, since there’s no concern over retroactive dates or claim reporting timelines.

Drawbacks of Occurrence Policies:

Higher premiums:
These policies usually cost more upfront than claims made policies, reflecting the broader protection they offer.

Limited availability:
Some insurers offer only claims-made policies for specific professions or high-risk fields.

Harder to budget long-term:
Because the insurer assumes longterm liability, the policy’s true cost can be challenging to estimate or predict.

How Do You Decide Which Policy Is Right for You?
Choosing between claims made and occurrence policies often depends on your financial situation, career stage, and risk preferences.

• Early career professionals may prefer claims-made policies for their lower initial cost.

• Established professionals or those nearing retirement might lean toward occurrence policies for their lasting protection.

• Those who switch jobs or insurers frequently must carefully manage claims made coverage to avoid gaps.

Both policy types have their place, and the best choice depends on your specific situation. Consulting with an experienced insurance broker can help ensure your coverage aligns with your needs, career plans, and financial goals.

For more information, please contact Jenn Negley, Vice President, Risk Strategies, at 267-251-2233 or JNegley@RiskStrategies.com.

Renowned Cardiothoracic Surgeon Dr. Soon J. Park Joins The Albany Med Health System

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Soon J. Park, MD, renowned both locally and internationally for his expertise and scientific contributions to cardiothoracic surgery, has joined the Albany Med Health System. He will serve as surgical director of cardiovascular services at Albany Medical Center, and he will collaborate with colleagues across the System to elevate a coordinated, regional approach to cardiovascular care.

“The level of expertise Dr. Park brings to the Albany Med Health System’s cardiovascular services is unmatched in the region,” said Alan S. Boulos, MD, The Lynne and Mark D. Groban ’67 Distinguished Dean of Albany Medical College. “His surgical talent and decades of experience and insight will benefit patient care, medical education, and surgical training for years to come.”

Dr. Park is an expert in all aspects of adult cardiothoracic surgery, including ischemic heart disease, mitral valve repair, aortic aneurysm repair, and septic myectomy for hypertrophic cardiomyopathy.

Through partnerships between hospitals and the implementation of a unified electronic medical record, the Albany Med Health System has expanded access to heart and vascular care for more patients in more places. Referrals to higher levels of care are also made easier with more resources in one network. According to Dr. Park, those connections provide the framework to reinforce a comprehensive team approach to care.

“Albany Medical Center, Columbia Memorial Health, Glens Falls Hospital, and Saratoga Hospital each hold a critical role in their communities,” Dr. Park said. “Their collective strength sets our System apart. There are tremendous opportunities to deepen our
commitment to collaborative, patient centered care that positions the Albany Med Health System as the premier cardiovascular program in the region.”

A respected educator, scientist, and advisor, Dr. Park also said he is glad to return to academic medicine. He has mentored dozens of residents and fellows and has led several National Institutes of Health (NIH) trials. The intersection of patient care, research, and education, Dr. Park said, is where patients can find
the most contemporary and innovative care available.

“As a tertiary medical center, Albany Medical Center provides the research infrastructure, community resources, and missions to care, teach, and discover,” Dr. Park said. “It’s a privilege to teach the future generation better ways to deliver care based on research and education, and to be among fresh minds.”

Dr. Park will also serve on a newly created System-wide cardiovascular steering committee comprised of cardiac leadership throughout the System, as well as care partners at Capital Cardiology Associates, aimed at guiding and overseeing resources, data, and quality, and fostering opportunities for collaboration and enhanced efficiency in cardiac care.

An advisor or a member of the editorial boards of several prestigious journals throughout his career, Dr. Park has published nearly 200 peer reviewed articles or book chapters. He also is credited for pioneering a procedure used to close an aortic valve to prevent leaking during placement of a left ventricular assist device (LVAD) implant, aptly called the Park Stitch. 

Dr. Park’s experience has taken him across the country. He has held leadership positions at the Mayo Clinic College of Medicine in Rochester, Minn.; the University of Minnesota; California Pacific Medical Center in San Francisco; Rochester General Hospital in Rochester, N.Y.; and University Hospitals Case Medical Center and Case Western Reserve University School of Medicine in Cleveland. In the Capital Region, Dr. Park was the chief of cardiac surgery at St. Peter’s Health Partners and a member of Albany Cardiothoracic Surgeons. He completed residencies in thoracic surgery at the University of Minnesota and general surgery at the University of Washington. He earned his medical degree from the University of Chicago.

The Albany Med Health System provides heart care using the latest techniques and leading-edge surgical procedures to address routine and complex medical issues. Because the System is an academic health system, all System patients have access to the most advanced care, clinical trials for new treatments and devices, and they benefit from the ongoing research conducted at Albany Medical College. 

Cardiothoracic surgeons at Albany Medical Center perform a wide range of cardiac procedures on patients of all ages. They have led the way in heart care for decades and have performed many of the region’s first heart procedures, including the first open heart surgery on an infant. They also teach at Albany Medical College. Albany Medical Center cares for more cardiology patients, performs more cardiovascular and vascular surgeries, and has the largest coronary care unit than any other health care provider in the Capital Region. 

St. Peter’s Bariatric and Metabolic Care: An Integrated Weight Loss Team Working Together for Patient Success

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By: Elizabeth Landry

Obesity is a major chronic disease affecting many adults in the United States. At St. Peter’s Health Partners, the St. Peter’s Bariatric and Metabolic Care team treat obese and overweight patients in the greater Albany area, from Saratoga County, to Vermont, Western Massachusetts and even as far South as Poughkeepsie. Working out of both Samaritan Hospital and St. Peter’s Hospital, the multidisciplinary team includes providers specializing in bariatric surgery, internal and bariatric medicine, nutrition, and behavioral health to support a full range of individualized care for bariatric patients.

Samuel Hykin, MD, FACS, Director of Bariatric Surgery for St. Peter’s Health Partners, has been leading the team since 2021 and has spent over seven years performing bariatric surgery. Once patients have attended an informational seminar about bariatric medicinal options and chosen to pursue care with the team, the providers put together a weight loss plan that looks different depending on each patient’s needs and goals, as Dr. Hykin described.

“We really focus on individualizing strategies and procedures for patients, meeting them where they are in their journey. We look at the patient as a whole, determining what other medical comorbidities they have and what their goals are in terms of how much weight they want to lose. Whether patients decide bariatric surgery is right for them, or if they prefer to go the non-surgical route, our integrated team approach helps support them in reaching their goals,” said Dr. Hykin.

Minimally Invasive Bariatric Surgery Options

For many patients experiencing obesity, bariatric surgery is selected as the best strategy to help them reach their targeted weight loss. At St. Peter’s Bariatric and Metabolic Care, patients are required to receive several clearances to qualify for surgery, which helps to ensure patients are ready and can be as successful as possible. Prior to receiving a date for surgery, patients must achieve 5% weight loss, receive clearances from nutrition, behavioral health, and cardiology, have an endoscopy and possibly also a sleep study. To be considered for surgery, patients need to have a BMI (body mass index) of 35-40 or higher and may need to have at least one of the comorbidities associated with obesity, including diabetes, high blood pressure, sleep apnea and high cholesterol.

There are two main surgical options offered at St. Peter’s, a sleeve gastrectomy and gastric bypass, both minimizing parts of patients’ digestive systems, which can result in a loss of between 50-75% of excess body weight. Dr. Hykin explained how these surgeries have become significantly less invasive over the years, with most patients now able to go home the day after surgery.

“About ten years ago, medical society made a shift toward minimally invasive surgery and shorter hospital stays which have dramatically improved patient outcomes,” said Dr. Hykin. “Right now, I complete a gastric sleeve surgery in three to five small incisions, and a gastric bypass is done in four to five small incisions. Patients can be in and out relatively quickly and get back to their everyday lives without much interruption.”

Importantly, improved patient outcomes are tied to lower complication rates. Dr. Hykin has consistently achieved a 

complication rate at or below the national average while performing bariatric surgery at St. Peter’s, and the patient success rate at the bariatric care center has remained strong at about 85-90% even while seeing a high volume of patients.

In fact, the bariatric surgery center located at St. Peter’s Hospital has received the Bariatric Center of Excellence designation from the American Society for Metabolic and Bariatric Surgery (ASMBS), 

which requires a stringent certification process in addition to high patient success rates and low complication rates.

“The process is about patient safety, protocolizing your approach, low complication rates, quality follow-up care – all of that combined. If you meet the bar, you’re granted Center of Excellence status, and you must recertify every three years. During those next three years you need to continue to meet the standards you were originally qualified by, and the ASMBS reviews 

that time to ensure the standards were achieved. It’s a very rigorous process but it 

ensures excellence in bariatric care, which is what makes it so 

important,” stated Dr. Hykin.

Multidisciplinary Approach to Metabolic Medicine

Whether patients opt for bariatric surgery or if they choose to work toward weight loss using non-surgical strategies, the integrated, multidisciplinary team at St. 

Peter’s offers cohesive support to help patients overcome obesity. Leading the way in non-surgical bariatric medicine at St. Peter’s is Priyangika Pathirana, MD, board-certified bariatric medicine and internal medicine physician, who’s been with St. Peter’s Health Partners for about 17 years.

Dr. Pathirana’s approach to bariatric medicine involves four main strategies: changes in diet and nutrition, changes in exercise, behavioral modification, and medications, when appropriate. Her strategy for patients is highly customized based on each patient’s individual needs, and she explained how the process and the goals are about much more than reaching a target weight.

“My goal for each patient is to help them become a healthier person, medically and psychologically. It’s not just about appearance – it’s about much more than the weight. Patient goals are very individualized, and so we receive a full patient history and create an individualized plan for how to change their eating and exercise habits. For example, some people cannot do regular exercises so we may teach them how to do chair exercises. It’s certainly not a ‘cookie-cutter’ type of approach,” said Dr. Pathirana.

Working with Dr. Pathirana to provide customized plans for weight loss through diet and exercise is a team of three registered dieticians including Lauren Zielinski, RD. Seeing non-surgical metabolic patients as well as surgical patients both pre- and post-operatively, Zielinski and the team help guide patients in balancing out their meals, focusing on a low-carbohydrate and higher-protein diet to achieve weight loss goals.

Zielinski aims to provide realistic strategies for patients that help them be more likely to achieve success. “I like to meet patients wherever they’re ready to make changes. I’m all about sustainability and being realistic with where the patient currently is and what changes they want to make,” she said.

Rounding out the integrated medical weight loss team is Alyssa Kontoh, licensed mental health counselor and board-certified bariatric counselor. She completes psychological assessments for patients pursuing surgery and offers support for any patient needing mental health guidance, including non-surgical patients seeing Dr. Pathirana, as well. Many patients have been struggling with obesity and weight issues since childhood, and Kontoh works with patients regarding their family history of eating habits, including food rules or messaging they may have carried over into adulthood.

Kontoh emphasized how the integrated team approach at St. Peter’s, as well as the support groups she offers, set the team apart from other bariatric medicine centers.

“Our office is truly based in a multidisciplinary approach,” Kontoh said. “We’re a very close office and we have very good communication with each other. We make sure we’re letting each of the other providers know if a patient may have a higher need for enhanced support as they work toward their goals. I also think the support groups we offer are a major highlight of our office – we cover topics ranging from binge eating to navigating change to the stress of the holiday season. The number of resources we offer is often surprising to patients.”

Helping Patients Attain Long-Term Success

With all the medical weight loss providers working together, the team at St. Peter’s helps set bariatric patients up for success on the rest of their journey. Once weight loss goals are reached, patients can choose to remain engaged with the office as often as they like, and surgical patients are seen regularly post-operatively at one week, one month, three months, six months, one year and yearly thereafter.

Although each provider or team of specialists at St. Peter’s approaches bariatric medicine through a different lens, a common thread that connects them all is how rewarding they each find it when they can celebrate their patients’ successes alongside them. For each, overcoming obesity is less about the number on the scale and more about the unique and often seemingly simple achievements that affect each patient’s life in different ways.

“My goal for patients is to give them their lives back,” said Dr. Hykin. “My favorite story is about a gentleman who came to me for bariatric surgery, and I asked him the true reason for why he came to our office. He told me he had been at the Great Escape over the summer and couldn’t fit into the rollercoaster with his son. He remembered riding the rollercoasters with his father when he was young and it being the best time they had together. When he couldn’t create that memory with his own son, he said that was the moment he knew he needed help. He was very motivated, completed the program, and when he came back for his six-month follow-up, he said, ‘Doc, you’re going to like this. We went back to the Great Escape, and I was able to ride that rollercoaster with my son. It was a blast.’ You can’t put a price tag on that. It was one of those moments that just sticks with you.”

Certainly, as the practice expands and grows to help support more patients in reaching their weight loss goals, the motivation for each provider at St. Peter’s will remain focused on finding strategies that work for each individual patient, as Dr. Pathirana emphasized.

“It’s the patient’s weight loss journey and I’m here to help them and offer support as needed for each individual,” she said. “It’s the simple things that really do matter, which show how their progress really affects their life. It’s a very rewarding job. This is my happy job. I so enjoy working with my patients.”

Who’s Taking Care Of The Physicians?

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By: Bari Faye Dean

MSSNY’s Peer Coaching Program Combats Stigma, Offers ‘Safe Space’ for Docs Battling Demons

It’s no secret that physicians live in a pressure cooker of stressors. They want to provide the highest quality care to patients, give the most of themselves to their families and personal life and, all the while, find themselves buried in paperwork and the inexplicable frustrations brought on by the technology required to balance healthcare regulations and insurance red tape.

“Doctors aren’t weak. We are strong and resourceful,” said Frank Dowling, MD, a psychiatrist in private practice on Long Island. “But even steel has a breaking point.”

Without intervention, stress and burnout can lead to severe health issues, including depression, PTSD, substance abuse and even suicide. No question about it: something has to give – before a practitioner gives in to stress, burnout or a personal challenge that has been threatening to sideline them. The bottom line, wonders Bonnie Litvack, MD, a Mount Kisco, NY-based radiologist who specializes in breast imaging, is this: “Who’s taking care of the physicians while physicians take care of everyone around them?”

Confidential Assistance from Trained Peer Coaches
The Medical Society of the State of New York’s (MSSNY) Physician Wellness and Resilience Committee launched a Peer 2 Peer (P2P) program. This program offers a vital lifeline to physicians, residents and medical students who are having emotional difficulties but have decided not to seek help because they are afraid of the stigma attached to mental healthcare – especially for physicians who are “supposed to be able to handle everything,” Dr. Litvak said.

When a participant reaches out for help, they are connected with a P2P Program peer supporter, a fellow medical professional, who has been trained to actively listen and offer feedback during one or two phone calls or video chats.

“We are providing psychological first aid,” said Dr. Dowling, who has been a peer supporter since the inception of the MSSNY program. “It’s therapeutic because it provides support and empathy, but it’s not treatment. If the participant needs a clinical referral and agrees to take one, they will be connected with the help they need.”

To date, almost 100 physicians have been successfully trained in crisis management by MSSNY’s P2P Program. During three-hours of training, peer supporters are trained to know what resources are available and how to guide a physician to get the help they need moving forward. If you would like to learn more about becoming a peer supporter, contact Emily Rento, Program Coordinator, at erento@mssny.org.

“Too many doctors are suffering in silence because they fear that if people knew what was going on in their heads, others would look at them differently,” Dr. Dowling said. “The P2P Program allows doctors to help our peers manage their battles confidentially.”

Indeed, the entire program is 100 percent confidential. There is no paper trail. There is no reason to fear retribution at work. If you need help, reach out now. You can get connected with a peer supporter by emailing P2P@mssny.org or by calling 844-P2P-PEER (844-727-7337).

P2P Provides a Safe, Judgment-Free Space
“There is a real need for this program. Many other fields have these types Physicians are human beings and they need a safe space, where they can be validated and talk about their feelings without judgment,” explained P2P Program peer supporter Dr. Litvack.

Dr. Litvack was president of MSSNY in 2020 2021 during the height of the COVID-19 pandemic, when the P2P Program was launched. “COVID exacerbated everything physicians are dealing with at work and in their personal lives. I am proud we were able to start the P2P Program then, Dr. Litvack said. “But it’s a few years later and we see those life stressors haven’t gone away. Physicians faced them long before COVID and we will be facing them long after.”

Take It From Someone Who’s Been There
Janine L. Fogarty, MD, a diagnostic radiologist in Rochester, NY, is not only a trained peer supporter, but she knows first-hand how a career in medicine can cause a level of stress that can engulf a physician. She has been there and retired from that.

“I retired from a long medical career in 2022 because I was burned out beyond repair,” Dr. Fogarty said. “At work, I had all the responsibility and no control. I couldn’t affect change for my patients. I couldn’t do it anymore. I was so emotionally isolated. No one around me knew I was struggling. My work environment wasn’t healthy for me so I couldn’t reach out there. I could talk with friends but they didn’t really understand because they are not physicians.”

Dr. Fogarty remembers the days of the physicians’ lounge, when a step away, a cup of coffee and a quick chat with a colleague could do wonders to calm a stressed doctor down. Those days are long gone, she said. “You put your head down and move forward. You don’t want to disappoint patients or coworkers.”

This combination, she said, is a recipe for disaster in a physician community where shortages are rising at record rates. Bringing back a sense of comradery could be a real solution for physicians who are struggling and need connection, she said.


At the same time, physicians don’t reach out for help because of the stigma they believe is alive and well throughout the medical community.

“Every day, doctors choose to suck it up and don’t get the help they need,” Dr. Dowling said. “If doctors can get help earlier, without anyone knowing, it can make all the difference. The P2P Program has done this for many physicians all around New York.”

If you need someone to talk with or a physician you know is struggling, MSSNY’s P2P Program is here to help. For more information, email P2P@mssny.org or call 844-P2P-PEER (844-727-7337).

Changing Weather Patterns and the Potential Impaction Environments and People

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By Kathryn Ruscitto, Advisor

This week I had the opportunity to talk to two science experts who I have asked to be part of a panel on restoration of parks and landscapes after two recent hurricanes. The Garden Club I belong to in Florida works to raise money to restore pollinator gardens and native plantings, and we will be sponsoring a panel to help people plan for the future.

The scientists listened and observed and said, be sad for what is lost but move on. Our weather patterns are changing, and what worked in the past needs rethinking. What survived, and what didn’t, and how do you use resources and time to plan for the future.

Sobering but great advice.

Health experts are beginning to look at the issue of changing weather patterns and its impact on health as well. Research suggests more respiratory and cardiac- related chronic conditions, spread of parasites and pathogens, as suggested by increases in tick-borne diseases, West Nile and Dengue, and more foodborne illness, as suggested by the recalls we are experiencing due to outbreaks from food across the country.

For those patients who work outside, the exposure is leading to more risks related to heat and cold. Many clinicians were trained in a period where climate impact on patients was not part of anyone’s curriculum. That has changed.

The American Medical Association in November issued stronger statements on this topic:

“Climate change has adversely affected people’s physical and mental health. Climate- related risks are not distributed equally. The AMA recognizes that minoritized and marginalized populations, children, pregnant people, the elderly, rural communities, and those who are economically disadvantaged will suffer disproportionate harm from climate change.”

The American Hospital Association has developed tools for organizations to look at their behaviors and policies to promote sustainable practices and reduce environmental impacts.

It’s a broad topic that leads us to consider both personal and professional implications. How do I adjust my behaviors and even my investments of time and resources in renewable technology and research.

Sobering issues, but we should focus on what we can do individually to improve our education and actions.

Resources:
Climate Doctors: https://www.youtube.com/ watch?v=bgvMYCMy57w

•AHA Survey on Climate Change: https://
www.aha.org/news/headline/2024-01-24 survey- most-clinicians-support-hospital efforts-address- climate-change

AMA Advocacy on Climate Effects: https:// www.ama-assn.org/delivering-care/ public-health/advocacy-action-combatting- health-effects-climate-change

Kathryn Ruscitto, Advisor, can be reached at linkedin.com/in/kathrynruscitto or at krusct@gmail.com

Physician Burnout: Seeing Improvement but Still a FixableCause for Medical Errors

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By: Jenn Negley, Vice President, Risk Strategies Company

Physician burnout is not a new phenomenon, but its prevalence has recently reached alarming levels. According to a 2021 survey by Mayo Clinic and Stanford Medicine, 62.8% of physicians reported experiencing burnout. While the numbers have improved, with a more recent AMA study showing that 50% of physicians are now struggling with burnout, the issue remains far from solved. The lingering effects of the COVID-19 pandemic, growing mistrust in medical science, and misinformation continue to place added stress on healthcare providers, making burnout a critical issue that affects both physicians and patients.

The Lasting Impact of Administrative Challenges

A key factor fueling burnout in physicians is the increasing administrative burden they face. Constantly changing regulations, including the often-onerous prior authorization (PA) processes, have been cited by physicians as major contributors to job dissatisfaction. The American Medical Association (AMA) has voiced concerns about PAs, describing them as a “barrier between patients and necessary care under the guise of controlling costs.” According to the AMA’s latest survey, 95% of physicians reported that the PA process either somewhat or significantly increased their burnout.

While administrative tasks are a challenge in many professions, in healthcare, the stakes are much higher. When physicians are overwhelmed by paperwork, their ability to provide optimal patient care is compromised, which directly impacts patient safety. Medical errors, which are already a significant concern, are further exacerbated by burnout.

Physician Burnout and Its Link to Medical Errors

The relationship between physician burnout and medical errors is well documented. In a study led by Daniel Tawfik and published in Mayo Clinic Proceedings, it was revealed that rates of medical errors tripled in work units where physicians reported high levels of burnout—even in units with top safety ratings. This data makes it clear: burnout doesn’t just affect physician well-being—it directly impacts the quality of care they provide.

Though healthcare systems have made progress in improving patient safety through system-level interventions, we cannot overlook the role of the physician’s mental health. If physicians are experiencing burnout, even the most well-designed systems will fail to prevent medical errors. In fact, burnout could undo many of the safety gains achieved through system-level changes. To reduce errors and improve care, we must address the root cause of burnout.

Addressing the Root Causes of Burnout

There are clear steps that can be taken to reduce burnout and improve both physician well-being and patient care. First and foremost, healthcare organizations must create a culture where mental health is prioritized. This begins by fostering an open dialogue about burnout, encouraging physicians to seek help when needed, and ensuring they have access to mental health resources.

While individual support is crucial, systemic changes are just as important. The administrative burden physicians face must be reduced by streamlining processes such as prior authorizations and cutting down on redundant tasks. Physicians should be allowed to focus on patient care, rather than spending countless hours on paperwork. Furthermore, healthcare leaders must listen to the needs and concerns of their staff, ensuring that burnout is addressed not just as a personal issue but as an organizational one.

• To make a lasting impact, addressing burnout requires collaboration among all stakeholders, including healthcare systems, insurance companies, the government, and technology providers. Solutions should include adjusting workflows, improving reimbursement rates, and eliminating unnecessary administrative barriers. If we tackle these issues, we can create an environment that supports physicians and, in turn, improves the quality-of-care patients receive.

Conclusion: Physician Burnout Is a Fixable Problem

While physician burnout rates have improved, they remain alarmingly high and continue to contribute to medical errors. This is a crisis that cannot be ignored. The good news is that burnout is a fixable problem—one that requires the collective effort of healthcare leaders, administrators, policymakers, and the broader healthcare system. By addressing the root causes of burnout, such as administrative burdens, and fostering a culture of mental health support, we can reduce medical errors and ensure that physicians are able to provide the best possible care to their patients.

For more information, please contact Jenn Negley, Vice President, Risk Strategies Company at 267-251-2233 or JNegley@Risk Strategies.com.

Tackling Drug Costs In New York State

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New York Governor Kathy Hochul signed legislation amending subdivision five of Section 280-a of the New York Public Health Law (“PHL”) and announced new regulations that aim to protect New Yorkers from the rising cost of prescription medications. Both target the operations of Pharmacy Benefit Managers (“PBMs”) by prohibiting business practices that raise the cost of prescription drugs and by increasing opportunities for independent pharmacies to compete with large, PBM-affiliated pharmacies. 

What are Pharmacy Benefit Managers?

PBMs are third-party ‘‘intermediaries’ that help negotiate costs and payment of prescription drugs between the major players in the prescription drug supply chain: health insurance providers, drug manufacturers, wholesalers, and pharmacies. PBMs determine which drugs are accessible to consumers, at what cost, and often by what pharmacies. 

PBMs contract with health insurance providers to manage prescription drug benefits for insured beneficiaries. PBMs do this by creating and maintaining formularies, which are lists of prescription drugs covered by health insurance plans. Each insurance plan has a unique formulary. When creating a formulary, PBMs negotiate discounts and rebates with drug manufacturers. That determines the prices insurance plans pay for prescription drugs and payments pharmacies receive for distributing drugs to consumers insured by the plan. 

When PBMs negotiate rebates with drug manufacturers, they typically retain a percentage of the rebate as profit, rather than passing the full amount to consumers. Because prescription drugs with higher prices often have higher rebates, PBMs are incentivized to include higher priced drugs on their formularies.

PBMs also play an administrative role for insurance providers by directly reimbursing pharmacies for dispensing drugs. PBMs receive administrative fees for these services from insurance providers and profit from ‘spread pricing.’ When a PBM receives a higher payment from an insurance provider than the amount the PBM pays to pharmacies, the PBM retains the difference. Legislators have identified spread pricing as a factor in increasing costs of prescription drugs for consumers.

The Federal Trade Commission reports that only three PBMs manage approximately 80% of all prescriptions filled in the U.S and that pharmacies affiliated with those PBMs account for nearly 70% of all specialty drug revenue. Critics argue that the tightly controlled marketplace has led to increased costs to patients and the closure or sale of independent pharmacies. 

PBM Regulation in New York 

In January 2022, Governor Hochul signed a first-of-its kind law in New York, providing for licensure and registration of PBMs. The law also set new standards that PBMs are required to comply with when operating in the State. In addition to reducing costs for consumers, Governor Hochul cited increased transparency regarding PBMs’ operations as a chief goal of the law.

The State Department of Financial Services is empowered to enforce the law and can receive complaints of violations of the law by PMBs from New Yorkers, pharmacies, and health care providers.

Impact of Amended PHL and New Regulations 

On September 27, 2024, the Governor signed legislation that eliminated the ‘gag clause’ that had prohibited pharmacists from telling consumers about negative reimbursements charged to pharmacies for prescription drugs. Negative reimbursements cause pharmacies not to stock certain drugs, limiting access to essential prescription drugs for consumers. By lifting the gag clause, pharmacists can explain why they cannot stock certain drugs, and consumers can use that information to petition their health insurance provider to increase access. 

The Governor recently announced new regulations governing market conduct for PBMs that:

• allow home delivery of prescription drugs by in network pharmacies;

• mandate PBMs to publish formularies and pharmacy directories;

• require PBMs to establish customer service lines;

• prohibit PBMs from steering patients to affiliated pharmacies;

• prevent PBMs from passing losses onto pharmacies when the PBM mistakenly approves a dispensed drug;

• permit small pharmacies to submit and receive electronic communications from PBMs; and

• require PBMs to apply the same audit standards to all in network pharmacies, helping small pharmacies compete with PBM affiliate pharmacies.

The regulations, supported by the Pharmacist Society of the State of New York, are anticipated to empower consumers, increase access to prescription drugs, level the playing field for small pharmacies and lower costs of prescription drugs across the State. 

For questions, contact Lippes Mathias attorney Sarah E. Steinmann by phone at 315-477-6232 or by email at ssteinmann@lippes.com.