Attention Blue Shield HMO Members:

Please be advised that starting May 1, 2012, Blue Shield will no longer have an HMO contract with our local IPA carrier, Monarch Healthcare. This change in status is causing significant concerns to patients, parents, providers and brokers. These contract issues are completely out of our control. The quality of care to our patients is very important to us, as is the continuity of care. Please refer to the information listed below for answers to common questions, and what you can do to AVOID any delay in care to your child. As always, we are here to help you. If you still have questions, please contact our office directly, so we can be of further assistance in this time of transition from one plan to another. We are hopeful that you will be able to remain a member of our SOCPA family, and this event will not affect the care of your child.

How will this affect our SOCPA patients?
Unfortunately, this decision will no longer allow you to choose one of our SOCPA providers as an “in network” primary care physician for your child; which could include care to other network specialists. This will not affect patients that carry a Blue Shield PPO contract. This decision ONLY affects the Blue Shield HMO members. Our contract remains in effect for all other HMO plans contracted with Monarch Healthcare, and most major PPO carriers.

What are the options available to our Blue Shield HMO Members?
As far as we know, the Blue Shield HMO contract with Monarch Healthcare will remain in effect until April 30, 2012. Up until this date, we will continue seeing our Blue Shield HMO patients. We will do our best to notify all of our parents/patients of these changes, so each member can take corrective action to retain our physicians as the primary care physician for the care of the patient. Each patient will be asked to sign a waiver form at the time of check in, should any coverage issues present themselves in the future. After May 1, 2012, SOCPA would gladly continue to provide care for your child with coverage through other HMO carriers (Aetna, Blue Cross, Caloptima, Cigna, Health Net and United Healthcare) along with most major PPO plans. Blue Shield HMO members seen after May 1, 2012 will be considered a “cash patient.”

As a parent/patient, what can you do?
SOCPA has been providing “great care to great kids” since 1977. With our 10 board-certified pediatricians and 4 nurse practitioners, 4 convenient offices, available after hours care, access to the online patient portal, and 24/7 on-call service, our top concern is the compassionate care of your children. Continuity of care is an important component of this journey, and we encourage you to seek other options for coverage that would allow you to stay with your child’s primary care physician. Contact your human resource department or broker and VOICE YOUR CONCERNS. Most importantly, don’t be afraid to contact Blue Shield directly. Monarch Healthcare is also proactively assisting members with other options. For more information on high-quality plans that will guarantee access to your providers of choice, please visit DontLoseYourDoc.com.

You may also contact the California Department of Managed Health Care (DMHC) at (888) 466-2219 to voice your concerns about abruptly losing your primary care physician. The job of the DMHC is to make certain all health plan members receive the right care at the right time.

We are anxiously awaiting a contractual resolution between the two parties (Blue Shield and Monarch Healthcare) but, until then, we want you to be informed. We look forward to providing uninterrupted care to the patients of our community.

If you would like to express your concerns about the changes with Blue Shield HMO, feel free to download the pre-drafted letters below to mail to the appropriate parties.

Blue Shield HMO Member Letter
Letter to the Department of Managed Health Care

Please click here for a printable version of this insurance update.

“Mothers hold their children’s hands for a short while, but their hearts forever.” ~Author Unknown

Wishing all moms a wonderful Mother’s Day weekend surrounded by those you cherish and hold dear. May your special day be filled with lots of relaxation and love!

“Nurses dispense comfort, compassion, and caring without even a prescription” ~ Val Saintsbury

This week is National Nurses Week, which is held every year from May 6th (Florence Nightingale’s birthday) to May 12th. The purpose of this week long celebration is to raise awareness of the value of nursing and to help educate the public about the role nurses play in meeting the health care needs of the American people.

To our wonderful SOCPA nursing staff and to nurses nationwide–In honor of your dedication, commitment, and tireless efforts, we salute you this week and every week.  You make a difference!

by Terence Chu, M.D.
May 2012

It was just about 5 years ago when I had written an article for SOCPA that included information about a new vaccine for girls and young women called Gardasil. Gardasil is a vaccine against a virus called Human Papilloma Virus (HPV). HPV is the most common sexually transmitted viral infection and causes genital warts, cervical cancer, vaginal cancer, oropharyngeal cancer, anal cancer, and penile cancer. Initially it was tested in girls and women and was found to be very effective in the prevention of genital warts and the anogenital cancers in females. Of most benefit was and is the prevention of cervical cancer. We have been giving the vaccine to our adolescent female patients since 2007.

However, during this past year, it was finally recommended by the ACIP (Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention) and the AAP (American Academy of Pediatrics) to routinely vaccinate all boys starting at age 11 or 12 and to catch them up with the vaccination at ages 13 through 21 if they have not been vaccinated yet. We as doctors expected that this would eventually be recommended and were waiting for it. Why vaccinate the boys? There a few reasons. 1) The vaccine has been shown to prevent genital warts in both boys and girls. The vaccine protects against the strains of HPV that cause 90% of the genital warts. 2) The vaccine also has been shown to help prevent anal cancer in boys. While it is likely that it will also provide protection against oropharyngeal cancers and penile cancers in boys, these are not clinically proven indications for the vaccine yet. 3) We want to develop as much “herd immunity” as possible. In other words, the more kids/adolescents/young adults that are immunized, the less HPV will be spread and in turn, the less HPV related diseases will occur. Even though the vaccine has been recommended for females since 2007, there are still large numbers of unvaccinated teenage females (more than 60% have not been vaccinated). So by giving the vaccine to the boys, we can help ensure that the unvaccinated girls will not be infected.

Why vaccinate at age 11 or 12? Well the vaccine is actually approved down to age 9, so it can be given even earlier safely. Also earlier vaccination means earlier protection. The majority of HPV infections occur in adolescence and young adulthood. While we as doctors and parents want and teach our children to be abstinent for a long, long time and if not abstinent then to use condoms; we know that does not always happen. Therefore it is in our young people’s best interest to get them vaccinated early before the onset of sexual activity (which unfortunately sometimes occurs early in adolescence). Even if your child has no sex before marriage, that does not mean his/her marriage partner did the same. Additionally, higher antibody levels are obtained when the vaccine is given between 9 and 15 years of age. This higher antibody level may give a longer time of protection in adulthood. Therefore protect your child/adolescent now to prevent disease in him/her now.

Of note, Gardasil is a 3 dose series. It is given at time 0, then at 1-2 months after time 0, and then again 6 months after time 0. If a dose is missed, the series does not have to be restarted. There is another HPV vaccine called Cervarix, however this vaccine is only approved for females and does not include the strains that cause genital warts.

We encourage you to talk to your child’s doctor about the vaccine at your next appointment.

The contents of this web site are provided as an informational tool. This is not intended to replace medical advice or care administered by a healthcare professional. Common sense should always be used when referencing this site. If, at any time, you feel your child is experiencing a medical emergency, call 911 immediately.

On Saturday, March 31st,  SOCPA will host a prize wheel booth at the 2012 Ladera Ranch Spring Celebration, sponsored by LARCS.   This event will be held at Founders Park located in Ladera Ranch from 11am to 2pm. The celebration will feature Egg Scambles for kids 4-10, photos with Mr. and Mrs. Peter Rabbit, games and activities, food and beverages for sale, and much more for the families of Ladera Ranch and the surrounding communities. Be sure to bring the family by if you are in the area, and of course don’t forget to stop by the SOCPA booth!  Dr. Eric Ball and nurse practitioner Melody Mitchel will be be there along with SOCPA staff to greet our booth visitors.

For more information regarding this event, visit the Ladera Life website. For a map and driving directions, please click here.

Come visit us at the “Good To Go From Head To Toe” Family Fun and Wellness Fair this Saturday, March 17th at Pretend City Children’s Museum in Irvine. Southern Orange County Pediatric Associates will be on hand providing car seat safety information, and of course we’ll bring along our prize wheel!

The event will run from 9am to 2pm (rain or shine), and will feature free health screenings and information.  The health fair is open to the general public at no cost and is located at 29 Hubble, Irvine, CA.  Click here to learn more about the Family Fun and Wellness Fair. We hope to see you there!

Located in our Ladera Ranch office is Sharon “Sam” Randlett Major, a board certified lactation consultant.

Sam earned her bachelor’s degree in business management from the University of Phoenix and her IBCLC from the University of California, San Diego. She has worked with mothers, babies, and families as a registered nurse for over 3 decades. Sam has been an International Board Certified Lactation Consultant since 2003. The core of her nursing experience has included working as a hospital lactation consultant, providing inpatient family centered care, specialized care for sick/premature infants and their families, teaching breastfeeding and infant care classes, telephone consulting and follow-up care in an outpatient clinic.

Sam was a former chair of the Orange County Breast Feeding Coalition and a former secretary for the Orange County Lactation Consultants Association. She and her husband live in Dana Point and have two adult children (who were breastfed of course).

An in-office lactation visit includes:

• A detailed history of mother/infant
• An assessment of maternal/infant anatomy
• Observation of a feeding for evaluation of technique and effectiveness
• Recommendations for management to improve and/or resolve breastfeeding related issues
• A written and/or oral care plan to improve breastfeeding concerns
• A written medical report is sent to your health care provider

Sam may be contacted at (949) 422-1577, or you may reach her via email at mlc.rnsam@gmail.com.

Please click here to view the Major Lactation Consulting website.

by Eric Ball, M.D.
March 2012

A common concern amongst both parents and pediatricians is the growing rate of obesity in our children. According to a recent study, the rate of obesity in six through ten-year-olds has doubled since 1980, and the rate in adolescents has nearly tripled! This epidemic of obesity is concerning for our future as obese children have a 70% chance of becoming obese adults. Some estimates place the cost of obesity and its related disorders at nearly $100 billion in the United States alone (and rising!). It is critical that we deal with the obesity epidemic now and encourage healthier eating habits in our children.

Most of us parents are busy with the day-to-day craziness of life as a parent. Between work, school, sports practices, and play dates, there is often little time to prepare a healthy meal, let alone to all sit down and eat together. I have therefore compiled some practical tips that I use in my family to ensure that we eat healthy foods as often as possible:

TIP 1: Be a smart shopper.
Nutrition begins at the grocery store. Once a food crosses into your home, your child will either eat it or there will be a big battle between you and him. If there are foods that you do not want your children to eat, don’t buy them. Until your child gets a car and a job, you are in 100% control of which foods he is offered.

It is best to shop in the periphery of the grocery store. The middle aisles are stocked with processed and frozen foods that are generally much higher in sugars, fats, and salts. Try to buy whole foods as much as possible. In other words, it is better to serve your kids apples than apple juice or apple sauce or (heaven-forbid) Apple Jacks.

TIP 2: Try make-ahead and 30-minute meals.
Try to make food ahead of time or learn a few quick recipes that you can whip together between soccer practices on a weeknight. In my house, two indispensable cookbooks are Cook’s Illustrated Best Make-Ahead Recipes and Cook’s Illustrated Best 30-Minute Recipes. In our family we try to meal plan on the weekend; we buy groceries for the week and make a few make-ahead dishes that we can freeze or store and use later in the week. Often, putting together a 30-minute meal in your kitchen takes less time than going to the fast food drive-in for unhealthy take-out.

TIP 3: Use smaller plates and fill them with fruits and vegetables.
A study in 2011 showed that serving food on an 8-10 inch plate instead of a standard 12 inch plate led to a 22% reduction in calorie consumption with the same feelings of satisfaction and fullness. Eating and fullness is not only biologic; there is a strong psychological impact as well. Using smaller plates will ‘trick’ your body into thinking you’ve eaten a full meal, even though you have eaten less.

In a similar way, filling your plate with healthy foods will help to fill you up with good stuff, leaving less room for unhealthy food. The government’s new nutritional guidelines (http://www.choosemyplate.gov/) recommend that you fill up at least half of your plate with fruits and vegetables.

TIP 4: Do not use food as a reward.
Many of us make the mistake of using food (and especially junk food) as a reward for good behavior. Every day, several of my patients are taken to the ice cream shop across the street from the office as a reward for getting shots or acting well-behaved in the doctor’s office. Although this is a nice gesture, it subconsciously causes the children to equate fatty, calorie-rich, nutrient-poor foods with good behavior. These same children are often ‘forced’ to eat their vegetables and learn that healthy foods are more of a punishment. This cycle of food rewards leads to a dysfunctional view of foods that we take into adulthood. Most people continue to ‘reward themselves’ in adulthood with fatty foods because they “deserve it”. Try using stickers, books, or toys as rewards and incentives and leave the food for mealtime.

TIP 5: Encourage your children to eat when they are hungry and stop when they are full.
It is important to respect your children when they are not hungry. Everyone in the family should be served the same foods (you are not a short-order cook!) but it is the child’s responsibility to eat his food. When they chose not to eat their meal, they are often telling you that they are not hungry at that moment. It is best to excuse them from the table, save the food, and offer it to them later if they are hungry. The more you argue, fight, bribe, or bargain, the less likely they are to eat. Hunger is actually a better motivator.

One of the big risk factors for obesity is eating in the absence of hunger. Over the years, many people learn to eat for reasons other than hunger: they eat because they are socializing, they are mindlessly eating while watching TV, they are depressed, they are bored, etc. Infants will usually eat only when hungry but over time they can learn to eat without being hungry, which puts them at risk for obesity. When children eat to please their parents or because they are forced to eat or because there is a reward (usually more food!) for eating, their risk for poor eating behaviors goes up.

TIP 6: Lead by example.
Your child learns healthy behaviors from you. Make sure that you are eating healthy foods as well. Your child is much more likely to eat vegetables if he sees you eating vegetables as well. Try to sit down as a family as much as possible to eat together. Make that time stress and distraction free. Even those of us with the most hectic schedules can spare 15-30 minutes a day to sit down as a family, eat and talk. Studies consistently show that frequent family meals lead to lower rates of obesity.

The earlier you address poor eating habits, the easier they will be to fix. When making changes in the family, remember to do so gradually and involve all family members. If you are worried about your child’s weight or eating habits, please make an appointment to discuss this issue further with one of our providers.

The contents of this web site are provided as an informational tool. This is not intended to replace medical advice or care administered by a healthcare professional. Common sense should always be used when referencing this site. If, at any time, you feel your child is experiencing a medical emergency, call 911 immediately.

It is with great pleasure that we announce the newest addition to the Southern Orange County Pediatric Associates family of providers–Katherine Roberts, M.D.!  Dr. Roberts will officially join SOCPA in March 2012 and will make our Ladera Ranch location her home office.

Dr. Roberts received her medical degree from the University of California, San Francisco, School of Medicine, and completed her pediatric residency at Children’s Hospital of Orange County (CHOC). She has been an active member and advocate for the American Academy of Pediatrics and is a passionate pediatrician who will provide great care to our SOCPA kids.

Please join us in welcoming Dr. Roberts to SOCPA– we are excited to have her as the newest member of our team!

To schedule an appointment with Dr. Roberts, please call our future appointment scheduling line at (949) 770-4242. To learn more about Dr. Roberts, please click here.

All SOCPA offices will be closed for regular and after hours care on Monday, February 20th, in observance of the President’s Day holiday. Should your child require care, please refer to our holiday after hours schedule.

We hope you enjoy a happy and safe President’s Day weekend!