City of Health

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At one point in his 25-year career, cardiologist Edwin Palileo was on staff of more than a dozen different hospitals in the Chicago area. "There were days when I’d drive to three and four hospitals a day seeing patients," he says. Not surprisingly, a typical workday lasted as long as 16 hours. "That takes a toll on a physician," he remembers. "And your car."

The exhausting schedule eventually led Palileo to seek an academic position in teaching and research-and ultimately, to private practice here in Sarasota.

Palileo is one of many physicians who have come to Sarasota from major metropolitan areas. They’re here for the same reasons most of us are-quality of life, but also because the city has a wealth of resources available to them. And that benefits all our residents.

A recent study by the University of South Florida ranked Sarasota County second in the state (behind Charlotte County) in overall health status. In counties with populations between 50,000 and 399,000, Sarasota was rated "much better than average" in adult mortality and community capacity and resources, and "better than average" in screening prevention and primary care. That puts it higher than similar counties in the Tampa Bay area such as Lee, Pasco, Volusia and Seminole.

Part of our high ranking derives from our supply of medical professionals. More than 1,300 medical doctors practice here. Sarasota has 2,808 licensed practical nurses and more than 6,000 registered nurses. Three hundred twenty-four dentists attend to our teeth, 51 podiatrists care for our feet and 452 pharmacists dole out our prescriptions every day.

Nearly 200 mental health counselors ease our minds; for serious emotional turbulence, 106 psychologists are available. Four licensed marriage and family therapists can help provide solutions to family tumult, and the city is filled with free support groups for every ailment, medical condition or emotional problem imaginable.

Lifestyle remains a major attraction for these professionals. Dr. Stella King, who practices family medicine at Intracoastal Medical Group, grew up in Naples, but received her medical training in New Jersey. After graduating, she and her husband (also a doctor) interviewed along the Southeast coast but chose Sarasota because it offered a place where both she and her husband could practice. She says their group includes most major specialties and affords them more opportunities for personal autonomy than they might receive in a larger city.

"Often, (doctors) in an urban setting may have to go to multiple hospitals," says King. "In Philadelphia, you may have as many as four, five or six hospitals where you have to see patients every day. That can definitely adversely affect your quality of life. Here, a physician only has to deal with two hospitals that are about 20 minutes apart."

In fact, the bi-county area that includes Sarasota and Manatee enjoys the resources of six hospitals, all conveniently spread throughout the region. With 845 beds, downtown’s Sarasota Memorial is the second-largest public hospital in Florida. It is among the top 25 hospitals in the United States in the number of open-heart surgeries performed annually and has the second-largest cardiac program in Florida. It was also ranked among the top 100 cardiovascular and stroke hospitals in the country.

The cancer program at Sarasota Memorial has been fully accredited by the American College of Surgeons Commission on Cancer since 1986, and last year began an affiliation with Tampa-based H. Lee Moffitt Cancer Center to provide patients greater access to the center’s clinical research programs and treatment for complex cancers.

Near the interstate is the 168-bed Doctor’s Hospital, where patient surveys reveal a 98-percent satisfaction rate and recent changes have reduced waiting times at the emergency rooms by 75 percent. The hospital recently added an in-house, state-of-the-art MRI that reduces scan times, and residents can check its monthly full-page advertisement in the Sarasota Herald-Tribune for details of health screenings, lectures and support groups, most of them free.

South County is home to Bon-Secours Venice Hospital and Englewood Hospital, and Bradenton has Manatee Memorial Hospital and Blake Medical Center, which has been a "Top 100" hospital for the past five years. Blake was the first hospital in Florida and the third in the nation to receive an OSHA voluntary protection merit award and has one of the top 100 ICU departments in the country.

"The biggest surprise is how large the hospitals and staffs are and how advanced the medical community is, in terms of up-to-date technology. You usually don’t find that except in larger urban areas," says Palileo, a Filipino native who had job offers from New Orleans, St. Petersburg and Venice before selecting Sarasota. "I think you can find almost anything you need right here," he says.

He’s right. Besides general practitioners, Sarasota has what King describes as "an incredibly large number of doctors and quite a few different kinds of programs available."

For example, we can boast of 137 opticians and 70 optometrists. At the Sarasota Cataract & Laser Institute, Dr. Harry Grabow participates in leading-edge research, including FDA studies of new products and techniques. This state-of-the-art facility hosts numerous surgeons each year who travel from around the world to learn techniques from Grabow, who founded the institute. At Center for Sight, Dr. David Shoemaker, an acknowledged leader in his field, is a regular featured speaker at national and international ophthalmology conferences. He is among a select group of physicians chosen to serve as FDA investigators for new ophthalmic technologies, including the foldable intraocular implant and the implantable contact lens. And the Sarasota Retina Institute participates in FDA trials for macular degeneration treatments.

The Silverstein Institute is a nationally recognized center for hearing research. Its founder, Dr. Herbert Silverstein, was instrumental in bringing cochlear implants to the American public and is considered a leading authority on Meniere’s disease. Now the area has 45 licensed audiologists and 87 hearing aid specialists.

Sarasota has three licensed midwives, five licensed doulas (who provide support and comfort to laboring women) and a hospital obstetrics unit at Sarasota Memorial Hospital to serve women’s health issues. The hospital is unique for its neonatal intensive care unit, lactation consultants and a maternal-infant staff available by phone 24 hours a day to answer questions from new mothers. It’s also recruiting candidates for a gynecological oncology program.

Men fare just as well, thanks to Sarasota’s array of services to treat cancer patients. The Dattoli Cancer Center has pioneered many of the innovations associated with modern prostate brachytherapy. It now has the largest brachytherapy program in the country, and patients come from all over the world to use its services. Dr. Alan Porter of Radiation Oncology Centers offered the first prostate seed implantation here in 1978, and his offices participate in numerous clinical trials in the research and development of cancer treatments.

Sarasota is also home to The Wellness Community, one of only 25 centers in the country dedicated to psychological and emotional support for all cancer patients and their loved ones. It offers one-on-one and group counseling, nutrition counseling, relaxation, yoga and tai chi-all free of charge.

Meanwhile, important clinical research flourishes here. Reproductive endocrinologist Dr. Julio Pabon is one of a handful of fertility specialists in Florida participating in trials for MicroSort, a technique that screens for desired gender in children. Since its inception, MicroSort has garnered an 88-percent success rate for producing girls and a 73-percent rate for boys. At least three couples have tried the procedure at Pabon’s office in Naples. Pabon is also the only doctor on the entire West Coast performing a technique called pre-implantation genetic diagnosis (PGD), where individual embryos can be sampled for gender selection after a mere three days before they are implanted using in-vitro fertilization.

At Sarasota Memorial, Hemolink, an oxygen carrier that may eliminate or reduce the need for blood transfusions during open heart surgery, is under investigation. Its main advantage is that it can be used in any patient, so doctors hope to use it in severe trauma cases where a patient can die in the time it takes to identify blood type. The hospital is also on the forefront of a minimally invasive heart bypass procedure called endoscopic vein harvesting that allows surgeons to graft a vein through a single three-centimeter incision near the knee. Traditional methods involve an incision of 40 centimeters or longer.

This Florida resort destination also has a firm foundation of services for the elderly. Nearly 32 percent of Sarasota’s population is aged 65 and over, and for those who need them, assisted living facilities, nursing homes and centers that treat advanced cases of Alzheimer’s and dementia are plentiful and of high quality. The Senior Friendship Center offers adult day services, nutrition programs and a Center for Healthy Aging that provides medical and dental care for seniors on limited incomes. Last year the center provided more than a half-million dollars in free care, along with exercise classes, dancing, live bands, crafts and many other activities.

For the estimated 20 percent of Sarasota’s population who are physically or developmentally disabled, organizations like Easter Seals and United Cerebral Palsy assist those with cerebral palsy, spina bifida, muscular dystrophy, mental retardation, epilepsy, Down syndrome, blindness, deafness and other risk factors.

"As a state, Florida struggles to provide government funding to people with disabilities, so we look to the community to pick up the gap," says Mary Hitchcock, president and CEO of Easter Seals in Sarasota. They compensate with organizations like Manasota Lighthouse and its services for the blind; Children’s Haven & Adult Center, Manasota ARC and Loveland Center, which support residents with mental retardation; and Child Development Center, which assists at-risk children.

The alternative healing arts thrive here as well. In addition to 211 chiropractors, Sarasota has 123 acupuncturists and 101 osteopaths. Spa services abound, with more than 1,400 massage therapists to soothe our muscles, 16 electrologists to remove unwanted hair, 33 licensed athletic trainers to whip our bodies into shape and 118 nutritionists and nutrition counselors to make sure they stay fit. After injuries, 274 occupational therapists and 407 physical therapists can get you back on your feet again. We also enjoy a wealth of board-certified plastic and reconstructive surgeons.

The abundance of care surprises new residents like Palileo and King, who says, "There’s a perception that hospitals that are not tertiary [teaching] centers are not as good, and that’s just not true here." King says Sarasota enjoys most of the same services as Tampa, Gainesville, Jacksonville and Miami. When you consider that we also enjoy dazzling beaches, spectacular climate and a superior cultural atmosphere, Sarasota truly is a city of physical, emotional and mental good health.

All figures from the Florida Department of Health Web site, http://www.doh.state.fl.us/IRM00PRAES/PRASLIST.ASP

CLOCKING IN AND OUT

Most of us already know that we’re either a "morning" person or a "vampire," someone who prowls the night only to cringe at the sun’s first rays. But few people are aware of the science that has occurred regarding these instincts.

Enter Dr. Matthew Edlund, head of the Center for Circadian Medicine and director of the Gulf Coast Sleep Institute. Edlund, a Sarasota resident, has trained in sleep medicine, occupational health and internal medicine at Brown University, Harvard and the University of California. He is also one of the first physicians in the United States to clinically practice body clock medicine and recently published his first book on the subject, The Body Clock Advantage.

The book is based on Edlund’s assertion that each of us falls into one of two groups: "owls," who rage late into the night, and "larks," who spring out of bed at dawn but are crawling by midnight.

Edlund maintains that understanding what kind of "clock" your body runs on can improve every area of your life, from athletics to health, romance and creativity. He also believes that all humans are ruled by "circadian rhythms" that impact how we behave.

Did you know, for example, that most industrial accidents happen between the hours of midnight and 6 a.m.? According to Edlund, many major mishaps, from the Exxon Valdez oil spill to the nuclear accidents at Chernobyl and Three Mile Island, occurred during these hours. He even declares in his book, that, "Unless you are a night person, your performance will decline from midnight on."

The good news is that, regardless of your internal rhythms, you can learn from them, and even change them to work for you instead of against you. Recently, Edlund spoke with us about his book and his research.

Q. What exactly is a human body clock?

A. Everyone is born with a particular type of body clock that tells them when to sleep. An exquisite set of genes controls the biological clock. But all of terrestrial biology is based on a daily cycle. If you go into the Pacific Basin, where there is no light, you’ll still see organisms existing under a 24-hour system.

Q. How does this clock affect humans?

A. In humans, it means that some people genetically prefer to stay up late while others can’t go past 10 at night. Many people select their jobs based on their clock. The trouble starts if you don’t know or won’t acknowledge what type of body clock you have. Then it becomes difficult to find areas that it doesn’t affect.

Q. What do you mean?

A. Take shift work. Humans certainly did not evolve for nighttime shifts. Studies show that people who work overnight have higher rates of hypertension and other health problems, even miscarriage. We have to recognize how to use the body in the way it was built. We seem to want to use our bodies as if they were machines, instead of making sleep patterns more regular so that we stay in sync with our own body clock.

Q. Is that just because larks are trying to work at "owl" jobs?

A. Partially, but the amount of sleep we get has enormous influence over us. And the body clock regulates certain things for everyone. For example, histamine release in humans tends to be greatest between 11 a.m. and 3 p.m., so most people have trouble with allergies during those hours.

Q. How else can your body clock affect your health?

A. It can make you gain or lose weight depending upon when you eat meals. It can affect work or sports performance-sports injuries are highest in the morning, and most athletes perform their best in the late afternoon or early evening. If you want to set a world record, do it between 5 p.m. and 6 p.m.

Q. How do body clocks affect us here in Florida?

A. For humans, light and day set the cycle of life. A lot of people come to Florida during vacation and decide to stay because of the weather. But in many cases, they’re really coming for the light. One quarter to 50 percent of people who live in Northern climates have major mood shifts during winter. Here, there’s less depression because people have more access to light.

Q. Do owls and larks have anything in common?

A. Yes (laughing). They marry each other. Seriously, many couples are like that, and after a certain number of years, they just end up living with it instead of trying to fight it.

Q. What can you do to change your body clock?

A. You can shift your clock both long-term and short-term, but it takes exercise and sunlight. Owls who want to rise earlier would begin by walking in early morning. Sunlight itself is the main time-giver. Larks can stay up later by avoiding sunlight during the day.

Q. How long does it take to change your internal clock?

A. Depending upon the goal, it can take just a few days, but for long-lasting effects, you’ll need to sustain a disciplined system. Humans are profoundly cyclical, but there are ways to use your body clock to its best advantage.

Still not sure whether you’re an owl or a lark? Then pick up a copy of The Body Clock Advantage. It contains a handy test to evaluate your "morning-ness" and "evening-ness" abilities and gives a pretty good indication of where you fall in that scale. It also has a sleep table that can help you get a better handle on how much rest you really need, and explains a variety of methods that can help you readjust your own body clock.

(in italic) Matthew Edlund will be discussing his book and signing copies at 7 p.m., March 18 at Barnes and Noble, 4010 S. Tamiami Trail.

Sarasota health at a glance.

1,283 Medical Doctors

2,808 Licensed Practical Nurses

6,313 Registered Nurses

324 Dentists

70 Optometrists

211 Chiropractors

51 Podiatrists

452 Pharmacists

Numbers to know.

Sarasota Memorial Hospital (941) 917-9000

H. Lee Moffitt Cancer Center (888) MOFFITT

Doctor’s Hospital (941) 342-1100

Bon Secours Venice Hospital (941) 485-7711

Manatee Memorial Hospital (941) 746-5111

Blake Medical Center (941) 792-6611

The Wellness Community (941) 921-5539

Senior Friendship Center (941) 955-2122

On the Internet.

Sarasota Memorial Hospital www.smh.com

H. Lee Moffitt Cancer Center www.moffitt.usf.edu

Doctor’s Hospital www.doctorsofsarasota.com

Bon Secours Venice Hospital www.bonsecours.org/venice/

Manatee Memorial Hospital www.manateememorial.com

Blake Medical Center www.blakemedicalcenter.com

The Wellness Community

www.wellness-swf.org

Senior Friendship Center www.SeniorFriendship.com