May Your Holidays Be Happy, Healthy & Safe!

Happy holidays!

For many of us, the holiday season really is the most wonderful time of the year.  It’s an opportunity to spend time with family, give thanks, watch football, exchange gifts, enjoy holiday parties and marvel at the magical effect Christmas has on children.

All of this activity can be a lot of fun – it can also be exhausting and stressful.  Privia Medical Group North Texas physicians want you and your family to have a special and memorable holiday season, and that starts with looking out for your health and safety first.  Here’s our seven keys to staying safe and healthy this holiday season.

  1. Get Your Flu Shot

If you haven’t already had your flu shot, do it now! Flu season started in October and flu cases begin to spike in December.

“The last thing you want in the middle of the holiday season is to be down for a week or two with the flu,” says Dr. James Parker, an internal medicine physician.  “Everyone six months and older should receive an annual flu vaccine, which are available at most Privia Medical Group primary care offices, as well as most pharmacies.”

  1. Wash Your Hands Often

Just as flu season picks up around the holidays, so does the likelihood of an upper respiratory infection, such as the common cold.  “The best safeguard against colds and other illnesses is frequent and proper hand-washing,” advises Dr. Parker.  “When we touch anything that others have touched, such as money, a handrail on a staircase or a credit card machine at a retail checkout, we’re putting ourselves at risk of a cold.”

The U.S. Centers for Disease Control and Prevention (CDC) provides the following instructions for proper hand-washing:

  • “Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
    • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
    • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
    • Rinse your hands well under clean, running water.
    • Dry your hands using a clean towel or air dry them.”

Hand-washing is always preferable, but it’s a good idea to keep a bottle of hand sanitizer that has at least a 60 percent alcohol content nearby.  This is a good fallback you when you can’t use soap and water right away.

  1. Safety First

Holiday decorating should be fun, not dangerous.  Here are a few important holiday safety tips:

If you’re putting up a live Christmas tree, always keep the water basin full.  If the tree dries out, it can become a fire hazard.

When putting up Christmas lights, take a few safety precautions.  First, check your lights carefully to see that the wires are not frayed or damaged and that the bulbs are not broken.  If lights are damaged in any way, they are a fire and electrocution hazard – throw them away.  Follow instructions on how many strands you can safely connect and take care not to create a circuit overload.

One of the most common household injuries involves ladders.  If you’re hanging outside lights and it involves a ladder, it is best to hire an insured professional to do the job.  Falling off a ladder is one of the more common household injuries and can be quite dangerous.  “Breaking your leg or suffering a head injury isn’t a risk worth taking,” says Dr. Robert Reddix, Jr., an orthopedic surgeon.  “We’ve seen too many of these types of injuries from ladder falls.”

Safety extends to meal preparation, as well. If you prefer your holiday turkey to be fried, order it from a restaurant, ready to serve.  Every year, there are reports of home fires as a result of a turkey-frying project gone awry.  In some cases, this method of turkey preparation has caused explosions and severe, life-threatening burns.  “Our advice on deep-frying a turkey at home: don’t,” says Dr. Uzoma Ben Gbulie, a plastic surgeon.

  1. Enjoy the Food – Just Not Too Much of It

Undoubtedly, one of the best parts of the holiday season is the great meals we get to enjoy.  While Thanksgiving dinners and other holiday foods may tend to be on the rich side, much of the traditional holiday food is not terrible for you, in and of itself.

“The problem with holiday dining is that we tend to simply eat too much fat, sugar and salt,” explains Dr. Errol Bryce, an internal medicine physician.  “Having some turkey, mashed potatoes with gravy and a reasonably-sized slice of pumpkin pie isn’t going to cause devastating weight gain.  The problem tends to be that we simply eat too much of all this good food.  We load an excessive amount of food on our plates and maybe go back for seconds, also.”

If you have a chronic health condition, such as diabetes or high blood pressure, there are some simple things you can do to ensure the holiday season doesn’t mean an unhealthy intake of sugar or salt.  If you’re doing the cooking, it’s easier to know the foods you’re serving aren’t loaded with ingredients that adversely affect your health.  If you’ll be dining at a relative’s or friend’s home, it’s best to let them know of any dietary restrictions before you come (and if you’re a host, it’s always a good idea to ask your guests this question beforehand).  You can also always bring your own side or desert to a holiday gathering – you’ll help out the host, while ensuring you’ve got something healthy to eat.

  1. Easy on the bubbly

For people who drink alcohol, moderate consumption is an important part of staying healthy.  That means no more than one drink per day for women and two for men.  It’s especially important to remain mindful of this around the holidays, when people can have a tendency to over-indulge.

Just as eating too much will result in an unhealthy calorie intake, so will drinking too much – all alcoholic drinks contain calories that can lead to weight gain and they provide none of the nutrients that food contains.

The dangers of drinking too much alcohol go far beyond the calories.  “Drinking in excess can lead to intoxication and will leave you dehydrated and possibly nauseous for several hours after you stop drinking,” says Dr. Joseph Milne, an orthopedic surgeon.  “The most dangerous part of drinking to intoxication is that your judgement and motor skills become impaired. You might lose your balance and fall, suffering a broken bone or head injury.”

And of course, drinking too much and then getting behind the wheel can lead to a lethal outcome.  The National Institutes of Health reports that two to three times as many people die in alcohol-related traffic accidents over Christmas and New Year’s, compared to the rest of the year.  Additionally, 40 percent of traffic fatalities over Christmas and New Year’s involve a driver who is alcohol-impaired, compared to 28 percent for the rest of December.

If you’ve been drinking, don’t drive, ever.

  1. Keep Moving

It’s important for our overall health that we get at least 30 minutes of physical activity a day, five to seven days a week.  That’s true year-round and it’s important to keep up an exercise routine around the holidays, when it’s especially needed to burn those extra calories.

“Given how hectic the holiday season can be, some may be tempted to put their exercise routine on hold – promise yourself you won’t do that,” advises Dr. Lindsay Breedlove Tate, an obstetrician and gynecologist.  “You need to stay with your exercise routine to burn calories and also help clear your head from your endless holiday to-do list.”

If your holiday plans include travel, pack your walking or running shoes and make time to get in some exercise when you’re on the road.

  1. Find Your Stress Reliever

While the holiday season is supposed to be joyful and fun, the reality for many people is that it can be stressful.  Between the decorating, cooking, baking, shopping, travel and entertaining, some try to cram too much into a few short weeks.

“If you find yourself feeling overwhelmed, that’s a key sign you need to ease up on yourself,” says Dr. John Briscoe, an internal medicine physician.  “Make time for yourself and do something that relieves your stress – read a book, watch a movie or go for a walk.  Remind yourself that everything does not have to be ‘perfect’ – you, your family and friends will enjoy the holidays the most when you’re relaxed, rested and at ease.”

Having a happy and joyous holiday season starts with putting your health and safety first.  By taking time to ensure you’re protecting your health, minimizing stress and getting rest, you’ll better enjoy this special time of year and your family and friends will enjoy their time with you.  So slow down, give thanks for what you have and take care of yourself!

From all of us at Privia Medical Group North Texas, we wish you

Happy Holidays and a healthy and safe New Year!

Healthy Holiday Gift Guide

Are you making your list and checking it twice?  If your holiday shopping list includes family or friends who spend a lot of time in the kitchen, enjoy exercise and fitness or love the latest high-tech gadget, there are a lot of clever, health-oriented gift ideas for you to consider.  And if you fall into one of those categories yourself, maybe you can use this gift guide to drop some hints to your family and friends!  Here are some of our favorite gift ideas for those who are interested in focusing on health, wellness and fitness.

Kitchen Gadgets

For people who enjoy cooking, a new kitchen gadget or tool is often the perfect gift.  Many food-oriented gifts can also serve a healthy purpose.

Blenders: Blenders are hardly a new item, but there are now a greater variety of sizes and price points on the market than ever before.  For someone who may be interested in blending healthy smoothies or shakes to start their day or for a post-workout meal, consider a small blender/smoothie-maker that yields an individual-size smoothie in no time at all.

“Not only is making a smoothie or shake at home much cheaper than buying one on your way to work, you can also ensure that your smoothie isn’t loaded with sugar or fat,” explains Dr. Scott Ewing, a cardiologist.

Think about what types of produce you’ll be blending and buy one that is up to job.  For example, if someone likes a smoothie made from hard produce, such as apples or carrots, make sure the blender is rated well for pureeing that type of food.

Kitchen scales: for an inexpensive, yet useful gift, consider a kitchen scale.  Not only is this helpful to the cook who has to figure out how much of an ingredient to put in a recipe, it’s especially beneficial for those interested in cutting back how much food they are preparing and eating.  If someone is trying to get their meat portions down to the recommended four ounces per serving, a kitchen scale is a foolproof way of getting there.

Air Fryers: Deep-fried food may taste good, but it can be rough on your waistline and cholesterol levels.  Air fryers are designed to create crunchy food as though it has been fried, but they don’t use the frying oil that can be so unhealthy.  In fact, air fryers don’t really fry food at all.  They circulate heat around the food, similar to a convection oven.  This helps to crisp the food without frying it.

Healthy Cookbooks: “A cook never minds getting a new cookbook,” says Dr. Timothy Jones, an obstetrician and gynecologist.  “There are plenty of cookbooks for sale that emphasize healthier eating and have creative recipes that taste good and are good for you.”

Fitness Trackers & Smart Watches

Smart watches and activity trackers have become all the rage over the last few years.  These smart devices can do a lot – they keep track of the steps you’ve walked, how fast you have run, how many flights of stairs you climbed, your heart rate and how much sleep you’re getting.

“We should all get at least 30 minutes of physical activity a day, 5-7 days per week,” says Dr. Katherine Kane, a vascular surgeon.  “Many activity trackers and smart watches will keep track of your steps and other movements, so you can see if you are meeting that 30-minute goal.”

If you’re thinking of buying a fitness tracker for someone on your shopping list, consider what they will use it for.  If it’s someone who has a moderate exercise routine, a device that tracks steps will probably be sufficient.

But some trackers and smart watches will do much more.  If you are shopping for an avid runner, swimmer or triathlete, consider a training tracker that does it all.  Many include a GPS function, enabling the user to can easily track the route and distance walked, run or biked.

Some trackers contain a gyroscope that can tell if you’re sitting or standing – with periodic reminders to stand or move about.  They can also determine if you are running, swimming or on a bike.

Others will also monitor your heart rate, so you can track it throughout the day and know if you’re hitting your target heart rate during workouts.  Even others can track your perspiration and breathing.

“Virtually all fitness trackers and smart watches will sync data with an app on your smartphone, which makes it easy to check how many steps you have taken or what your heart rate got up to on the last run,” says Dr. Ronald Blair, a pediatrician.  “These apps can also sync with smart bathroom scales, so that your body weight is automatically transmitted into the app.  However, our professional medical advice is that you don’t buy anyone a bathroom scale as a gift!”

Other Fitness Gifts

There are plenty of other good gift ideas for the fitness-oriented person on your list, at a variety of price points.

“If you have someone who goes to the gym or runs regularly, you can never go wrong with new exercise shorts, running shoes or other workout attire,” says Dr. Caren Reaves, an obstetrician and gynecologist.  “I know I always appreciate getting new gear for my workout routine.”

For those who like to listen to music while they exercise, consider upgrading their headphones.  Many people enjoy having wireless headphones or ear buds that connect with their phone via Bluetooth – this frees them from having a wire extending to their phone and makes movement during exercise easier.

And if they need some new material to listen to while running or hitting the weights, you could always buy them a subscription to a digital music service or some audio books.

For those who travel frequently, you might buy them some low-tech exercise equipment they can take on the road.  “Resistance bands make a great gift for someone who travels a lot – they’re compact, lightweight and easily fit into a suitcase,” says Dr. Emil Tajzoy, an obstetrician and gynecologist.  “Resistance bands help facilitate an easy strength training workout in a hotel room. Jump ropes and yoga mats are also good gifts for the road warrior.”

Expand Their Fitness Horizons

A good fitness-oriented gift doesn’t necessarily have to come in a box.  If you have someone on your list who is looking for a new exercise routine or workout challenge, consider buying them a membership for a Pilates studio, a dance studio or a gym.  If you’re not sure they’ll stick with it, look for short-term or trial membership options.

Finding a new activity does not have to involve a pricey membership, however.  Community colleges, including Tarrant County College and the Dallas County Community College District, offer inexpensive, non-credit fitness classes, available to any resident of the county.  These include cycling, kickboxing, yoga, swimming and a variety of sports.  If you have someone on your list who is interested in a new challenge, one of these classes may be the perfect gift for them or for both of you to take together.

And for someone who enjoys spending time in the great outdoors, consider a Texas State Parks Pass, available for $70 from the Texas Parks and Wildlife Department.  This pass grants entry for one year to the pass holder and anyone else in their vehicle to any one of Texas’ 90 state parks, including several convenient North Texas locations.  The Parks Pass provides limitless opportunities for hiking and other outdoor activity.

Don’t Forget the Stocking Stuffers!

“If your family’s tradition includes stuffing stockings, cut back on the candy canes this year and throw in some useful items such as hand sanitizer, a personal first aid kit and sunscreen,” suggests Dr. Isha Mannering, a pediatrician.

Good luck with your shopping and gift-giving!

From all of us at Privia Medical Group North Texas, have a safe and happy holiday season!

This article contains information sourced from:

Consumer Reports


OPEN ENROLLMENT FOR EMPLOYEES WILL BEGIN 11/01/2018 through Close of Business day 11/30/2018
There will be four open enrollment benefits meetings for PMG NTX -THC staff and two meetings for PMG NTX Dallas clinics.
(Privia clinical offices in Dallas should check with their office managers for participation and dates.)

This is the only time of year that full time eligible staff can update (change, enroll or terminate) coverage for an eligible benefit for yourself and/or family members. Please review the dates and times listed below to find the meeting you would like to attend. Then you may click the link to sign up.


Location 1 – 11/06/2018 Tuesday -Hilton Inn – Garden Center, 912 Northton Street, Fort Worth, Texas 76106, 6:00 – 7:00 PM

Location 2 – 11/08/2018 Thursday – Hulen Movie Tavern, Hulen Mall, 4920 South Hulen, Fort Worth, Texas 76132, 6:00- 7:00 PM

Location 3 – 11/12/2018 Monday -Hilton Inn – Garden Center, 912 Northton Street, Fort Worth, Texas 76106, 6:00 – 7:00 PM

Location 4 – 11/13/2018 Tuesday – Hulen Movie Tavern, Hulen Mall, 4920 South Hulen, Fort Worth, Texas 76132, 6:00- 7:00 PM

Higginbotham and Associates will conduct the 2019 Benefits Overview providing our New Employee Benefits Guide and provide online Enrollment Instructions for our new web based benefits platform “Benefits in Hand”*. You will be paid for the one hour company paid event(s). — Employee Benefits Guide will also be available upon conclusion of the 11/13th meeting and made available on the company’s Google Drive (PMGNTX THC Benefits Open Enrollment)

Contact Cindy Wooley or Sara Funchess at 817/740-8400 for meeting registration assistance.

*Open Enrollment will close 11/30/2018

Open Enrollment OPENS 11/01/2018

Last day for online enrollment will be 11/30/2018

All requested changes will be effective 01/01/2019.




Is it Time for a Health Insurance Check-up?

With the end of the calendar year approaching, this is the time for many people to take a look at their health insurance coverage and determine if any changes or updates are in order.  Health insurance plans provide what’s known as an “open enrollment” period, during which time people can change plans.  For many people who have employer-based coverage, Medicare or Health Insurance Marketplace coverage, this period occurs toward the end of the calendar year.  However, some employer-based plans will offer an open enrollment period during another part of the year, so be sure to check with your human resources office to find out when your open enrollment period takes place.

Why Have Health Insurance?

No one ever wants or plans for a tornado to hit their home, but we have a homeowner’s insurance policy so that we can repair or rebuild, if needed.  We need health insurance for the same reason: because we never know when we will need it.  People don’t plan on a gallbladder removal, open heart surgery or cancer treatment – but at some point in our lives, we may have to confront a significant medical event.  And when that day comes, we don’t want it to bankrupt us – that’s why it’s important to have health insurance.

Just as with homeowners or auto insurance, the premise behind health insurance is one of “spreading risk.” By having many customers, insurance companies collect premiums from a broad base and then use a portion of those funds to pay policyholders’ claims.  For many people, those claims aren’t any more expensive than a routine check-up or physical once a year.  However, other medical needs are much more expensive, such as delivering a baby, treatment for cancer or various types of surgery.  Commonly-used diagnosis and screening tools, such as an MRI or a CT scan, can also be costly.

“Not all health insurance plans are created equal,” says Dr. Yevgeniy Ostrinsky, a gastroenterologist.   “Understanding the various pros and cons of different types of health plans is important to ensuring you and your family have the right coverage to get the health care you need.”

The ABCs of Health Insurance

The world of health insurance seems to have its own language.  Here’s a look at some of the common health insurance terms and acronyms every consumer should familiarize themselves with:

  • HMO: Health Maintenance Organization. HMOs are insurance plans in which enrollees can only see providers who are part of the HMO’s network.  A visit to an out-of-network provider will not be covered, except in cases of medical emergency or if the insurer has agreed in advance that it is a medical necessity.
  • PPO: Preferred Provider Organization. This type of health insurance plan allows enrollees to see out-of-network providers, though usually at a greater out-of-pocket cost.  There are also fewer restrictions on seeing specialists without a referral from a primary care provider.
  • EPO: Exclusive Provider Network.  This plan has some characteristics of both HMOs and PPOs.  As with an HMO, there is generally no coverage for out-of-network providers.  But like PPOs, EPOs do not require you to first get a referral from a primary care doctor before seeing a specialist.
  • In-network: Insurance plans have a group of health care providers they refer to as a “network.”  These are providers, such as physicians, hospitals and labs, with which the insurer has a contract that stipulates what the provider will be paid by the insurance company.  The bottom line for the patient is that it’s cheaper to see a doctor or go to a hospital that is in-network.  Sometimes, however, it is not always practical.
  • Out-of-network: This refers to providers who are not in your insurer’s plan.  You may pay more to see providers who are out-of-network.  Some patients will choose to see a provider out-of-network if they believe that’s the best health care available for their situation.  In other instances, such as a medical emergency, it may not be practical to get to an in-network provider in a timely manner.
  • Premium: This is the amount you pay each month to maintain your health insurance coverage.
  • Deductible: This is the sum you pay out-of-pocket before your insurance company begins to pay your claims. It is generally a fixed dollar amount each year.
  • Co-pay/co-insurance: This is the amount you pay at each visit to a health care provider. This is a fixed dollar amount, or in some cases, a percentage of the total bill.  There are co-pays for visiting a doctor, a specialist, getting an x-ray, having lab work done, filling a prescription, getting hearing aids, using an ambulance and going to an urgent care clinic or emergency room.
  • PCP: This is the abbreviation for primary care provider, often a doctor of family medicine, internal medicine or obstetrician/gynecologist. PCP is an important term for insurance purposes; your insurance company will want to make sure you have one and will sometimes require a referral from your PCP before you can see a specialist.
  • EOB: This is the “explanation of benefits” your insurer will send you after you’ve used your health insurance. The EOB will explain what the total charges were, how much your insurance covered and what amount, if any, you may still owe to the provider.  The EOB is not a bill.
  • Prior Authorization: In some cases, you or your physician may need to obtain prior authorization for a medical procedure, screening or prescription drug. In these cases, the procedure or prescription in question may not automatically be covered and your provider (or you) has to explain to the insurance company why it is medically necessary and why it should be covered.
  • Preventative Services: This is a category of health care services that are available to consumers and do not require a co-pay or co-insurance; they are fully covered by the insurance plan. This includes services such as flu vaccines, some screening tests and wellness visits.

Where do you get health insurance?

People obtain health insurance in a variety of ways:

  • Your employer: This is the traditional way most non-seniors in America have health insurance.  You select a plan offered by your employer and you pay a premium that is deducted from your paycheck, before taxes.  Generally, the employer pays a share of the employee’s coverage and in some cases, a share of the employee’s family members’ coverage.
  • The Health Insurance Marketplace: The Marketplace was established by the Affordable Care Act and is an option for American citizens under 65 to purchase health insurance.  People generally use this option if coverage is not available through their employer.  Some plans have low premiums and high deductibles, which could make sense for younger, healthy people who don’t have a lot of medical needs.  Other plans are more expensive but cover more, which make sense the older you get.  Some enrollees may qualify for a federal income tax credit when they enroll, depending on income. Open enrollment in the Marketplace runs from November 1 to December 15, 2018. Visit for more information.
  • Association Health Plans: AHPs may be an option for small businesses to band together and offer coverage to their employees as an employer group or business association. They are generally formed when businesses in a like industry or geographical area work together to offer coverage.  The U.S. Department of Labor issued new guidelines in 2018 intended to expand the availability of AHPs.
  • Medicare: This is the federal health insurance program for American citizens age 65 and older.  People who are approaching the age of 65 should visit gov for enrollment information.  Some people are automatically enrolled at age 65, while others need to enroll themselves.  There are three main components of Medicare:
    • Medicare Part A is known as hospital insurance, covering hospital stays and some long-term care needs.
    • Medicare Part B is medical insurance, covering physician visits and medical screenings and labs.
    • Medicare Part D is a prescription drug insurance program.

Some people choose to delay enrollment in Medicare Parts B and D if they have health insurance through an employer that they prefer to keep while they are still working.  However, a late enrollment penalty may apply.

  • Medicare Advantage: These are private plans that some seniors choose to purchase to supplement the coverage provided by Medicare.  Medicare Advantage plans are offered by private companies but must be approved by Medicare.  Those with a Medicare Advantage plan still have Medicare coverage, but they receive their benefits through the plan directly, not traditional Medicare.


The purpose of Medicare Advantage plans is to provide additional coverage beyond that provided by traditional Medicare.  These added benefits may include dental, hearing and vision coverage.  Out-of-pocket expenses vary between Medicare Advantage plans, as do the provider networks they offer. For these reasons, it is important to compare Medicare Advantage plans just as you would employer-based plans, taking into account a variety of factors.

Important Note: For Medicare Part D and Medicare Advantage, you can make changes to your plans and switch plans during an open enrollment period that runs from October 15 – December 7, 2018.  You can also disenroll from a Medicare Advantage plan between January 1 – February 14, 2019.  

  • Veterans Administration: Veterans of the United States Armed Forces may be eligible for varying degrees of health benefits through the VA, depending on a variety of factors, including length of time served, discharge circumstances, income and service-connected disability. For more information, visit gov.
  • Tricare: Tricare is health insurance for active-duty military personnel, as well as some military retirees. For more information, visit mil.
  • Medicaid and CHIP: Medicaid and the Children’s Health Insurance Program (CHIP) primarily serve lower-income families.  In Texas, Medicaid eligibility is usually limited to children and women who are pregnant.  CHIP is available for some families who earn too much to qualify for Medicaid.  Visit or the Texas Health & Human Services Commission.

Selecting a Plan

If you have employer-based health insurance or will be shopping for insurance in the Health Insurance Marketplace, you will likely have a few options to choose from.  You may have a choice between an HMO, a PPO or an EPO.  Carefully evaluate the differences between these options.  An HMO may be less expensive but may also provide fewer benefits or not allow you as many provider options.  On the other hand, if you are relatively young and healthy, a less-expensive plan may be right for you.  Similarly, on the Health Insurance Marketplace, you will find a variety of plans at varying costs.  These plans are named after metals – bronze, silver, gold and platinum.  You’ll pay the least for bronze and also get the fewest benefits; at the other end of the scale, platinum is the most expensive but provides the most comprehensive overall coverage.

When comparing costs on any plan, be sure to consider three separate cost factors:

    • Premium: the amount you pay each month to maintain coverage.
    • Co-pay/co-insurance: the amount you will pay each time you visit a provider or get a prescription filled.
    • Deductible: the amount you must pay out-of-pocket each year before your health plan begins to cover the cost of medical services.

You may find an inexpensive plan but later discover you have to meet a high deductible before you benefit from any coverage from the plan.  You may also find that your co-pay for each visit, procedure or prescription is higher than you expected.  For some people, these low premium/high-deductible plans work just fine; just make sure you have all the facts before making a decision.

An additional tool some employers offer for people who opt to enroll in a high-deductible plan is a health savings account (HSA).  This is essentially a medical savings account that people can contribute pre-tax income to and then spend later to cover deductibles and other out-of-pocket costs.

Understanding Networks

Understanding an insurer’s network is critical to making a decision about a health insurance plan.  No matter what type of plan you select, you will pay higher out-of-pocket costs to see a provider who is not in your plan’s network.  Whenever possible, you want to stay within your network to keep costs down and you certainly want to ensure that your primary care provider and any specialists you see are in your plan’s network.  Privia Medical Group North Texas providers are in-network for most major insurance plans in North Texas.

All insurance plans, including HMOs, PPOs and EPOs, are required to maintain adequate networks for their customers.  Network adequacy in Texas is regulated by the Texas Department of Insurance (TDI).

There are several requirements that insurers must meet, according to TDI:

      • “These plans must provide a network with enough qualified doctors and hospitals to make sure that covered services are reasonably available and that you have choice, access, and quality care.
      • General doctor and hospital care must be available within 30 miles (within 60 miles in rural areas for PPOs and EPOs).
      • Network specialty doctors and hospitals must be available within 75 miles.
      • Emergency hospital care (including general, specialty, and psychiatric hospitals) must be available 24 hours a day, seven days a week.
      • Nonemergency urgent care must be available within 24 hours for medical and behavioral health conditions.”

If you believe your insurance provider is not meeting these or other requirements, you can file a complaint with TDI.   (Note: TDI regulates the private health insurance market in Texas and does not have jurisdiction over Medicare, VA, Tricare or most aspects of the Health Insurance Marketplace).

At the Doctor’s Office

When you make an appointment to see a doctor, you will give the office staff your insurance card and they will verify your coverage is active.   You may also have filled out an information sheet before your visit.  The doctor’s office will collect any co-pay you owe for the visit.  After your visit, the physician’s office will bill your health insurance provider directly.  You will later receive the EOB from your insurer, explaining what they covered for the visit.  If there is an amount that you still owe the provider, you will receive a bill directly from the provider later.

“Health insurance can be extremely confusing, even for those of us who deal with it every day,” says Dr. Larry Tatum, CEO of Privia Medical Group North Texas.  “Our providers have experienced administrative staff who work hard to facilitate insurance benefits on behalf of our patients.  To better serve our patients, we have in-network agreements with most of the major health plans in North Texas.  That’s a big advantage for both our patients and our physician members.”

Ovarian Cancer Awareness – September 2018

September is Ovarian Cancer Awareness Month, a time to shed light on the eighth-most common cancer affecting women in the United States.  Ovarian cancer is a type of gynecological cancer, cancers that originate in a woman’s reproductive system.  Other types of gynecological cancer include cervical, uterine, vaginal and vulvar.

Each year in the United States, roughly 21,000 women are diagnosed with ovarian cancer.  While the disease is relatively rare, it is serious.  Ovarian cancer can be treated effectively in its early stages; however, it is challenging to screen for and diagnose.  In addition, it generally produces no symptoms early on, so is often diagnosed at later stages.

“Regular exams by your physician and immediately reporting any symptoms or changes in your body are the keys to the early detection of ovarian cancer, and early detection is the key to beating this cancer,” says Dr. Lindsay Breedlove Tate, an obstetrician and gynecologist.

Risk Factors

While it is not known exactly what causes ovarian cancer, there are some known risk factors for the disease.  These include:

  • Age: women who are 50-60 years old are more at risk
  • Heredity: a relative such as a mother, sister, aunt, grandmother having had ovarian cancer increases risk
  • Having ever had certain other types of cancer, such as breast, colon or uterine
  • Having never given birth
  • Having had endometriosis, a condition that causes tissue from the lining of the uterus to grow elsewhere in the body
  • Mutations in the BCRA1 or BCRA2 genes – these are inherited gene characteristics that are known as breast cancer genes. They also increase the risk of ovarian cancer. 

In addition, the following are known risk-reducing strategies:  taking birth control pills for five years or longer, breastfeeding, tubal ligation and complete removal of the ovaries and/or fallopian tubes.


While ovarian cancer does not typically cause symptoms in early stages, the following may be indicative of the disease:

  • Vaginal bleeding
  • Pain in the pelvic or abdominal area
  • Back pain
  • Bloating or feeling full; difficulty eating
  • Urgent or frequent need to urinate
  • Constipation

All of these symptoms can be caused by conditions other than ovarian cancer, but any one of them is reason to see your doctor for examination.

Diagnosis and Treatment

“While there is no standard screening test for ovarian cancer, all women should see their physician for an annual pelvic exam,” says Dr. Taylor Bradley, an obstetrician and gynecologist.  “The earlier ovarian cancer is diagnosed, the greater the likelihood that treatment will be effective.  In fact, if the cancer has not spread beyond the ovaries when treatment begins, the five-year survival rate is improved.”

Treatment for ovarian cancer typically includes a combination of surgery and chemotherapy.  A surgeon will remove the cancerous ovaries, and depending at what stage the cancer is, may also remove the fallopian tubes, uterus and lymph nodes located near the reproductive system.  Chemotherapy is then used to treat remaining cancerous cells.

“Even though ovarian cancer is relatively rare, it is quite serious,” says Dr. Bradley.  “If you have any of the known risk factors for ovarian cancer, such as a family history of the disease or other cancers, you should visit with your doctor about your risk.”

This article contains information sourced from:

The U.S. Centers for Disease Control & Prevention

The American College of Obstetricians and Gynecologists



Flu Season: What You Need to Know

The flu.  If you’ve ever had it, you know there are few things that can make a person feel so miserable.  Body aches. Fever. Chills.  Exhaustion.  All of these symptoms appear when you get the flu, and they don’t go away quickly – many people can be in bed for a week or two with the flu.  And for some, the flu can lead to even more serious problems, such as pneumonia and in especially severe cases, death.

The good news is that you can dramatically reduce your chances of getting the flu with one simple step: getting an annual flu vaccine. It’s fast, easy and cheap – and it could well save you from experiencing a serious illness this fall and winter.

Flu season runs from October to May and typically peaks December through February. Privia Medical Group North Texas physicians recommend everyone get a flu shot in September, because it takes a couple of weeks for the vaccine to be completely effective.  A September vaccine provides the best protection by the time flu season arrives in October.

Get Vaccinated!

“Getting a flu shot each year is one of the best things you can do for your health,” says Dr. Charles Cook, a primary care physician.  “Many of our Privia Medical Group North Texas primary care physicians and pediatricians have flu shots available in their offices and vaccines are also readily available at most pharmacies.”

The U.S. Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics and Privia Medical Group recommend that everyone age 6 months or older receive an annual flu vaccine. While everyone should get a flu vaccine, it is especially critical that people who are at high risk for getting the flu and/or at high risk for serious flu-related complications do so, including:

  • Children younger than 5 years
  • Adults age 65 and older
  • Women who are pregnant
  • People who live in nursing homes or long-term care facilities
  • Health care workers

In addition, people with certain health conditions are especially at risk, including those with asthma, heart disease, kidney or liver disorders, a compromised immune system and those who are morbidly obese.  People with these conditions are more susceptible to flu-related complications, including pneumonia, bronchitis and sinus infections.  In addition, the flu can worsen pre-existing conditions, triggering hospitalization.

Additionally, since infants younger than 6 months are too young to receive the flu vaccine, it is imperative that anyone who will be around an infant has been vaccinated.

Is the Flu Vaccine Really Effective?

Yes. While it is not a 100 percent guarantee that you will not get the flu, the flu vaccine lowers your chances of doing so.  In addition, people who receive a vaccination and do get the flu experience less severe symptoms and a shorter duration of the illness compared to people who do not receive the vaccine.  The effectiveness of the vaccine varies from year to year. There are several strands of the flu and the vaccine includes viruses scientists believe are most likely to be prevalent in the upcoming flu season.

In addition to getting a flu vaccine, you should always take other precautions, such as washing your hands frequently with soap and water. Always cover your mouth when you sneeze or cough to prevent the spread of germs.

But Can the Vaccine Cause the Flu?

No. It’s a myth that the flu vaccine can give you the flu. The vaccine does not contain an active virus, so it is not possible for it to cause the flu.

What If I Get the Flu?

If you begin to experience flu-like symptoms, such as a high fever (100 degrees Fahrenheit or higher), body aches and chills, headache, fatigue, nasal congestion and sore throat, see your doctor right away.  Your physician can test for the flu and if you have it, prescribe antiviral medication that may help you recover more quickly. These medications can help lessen and shorten the symptoms, but they generally work best within 48 hours of the onset of the flu, so it’s important to see the doctor quickly if you suspect you have the flu.

“In addition to antivirals, the best thing you can do is get plenty of bed rest and drink lots of fluids,” says Dr. Raymond Blair, a primary care physician.  “Resting your body completely gives it the best chance to fight the flu virus and get better. Plus, if you have the flu, you are highly contagious – so it’s important you stay at home!”

Keep in mind that the best way to greatly decrease the odds of a miserable week or two in bed is to get your flu shot. The sooner you get vaccinated, the better – but as long as flu season is underway, it’s never too late!


This article contains information sourced from:

The U.S. Centers for Disease Control and Prevention


Prostate Health Awareness – September 2018

September is National Prostate Health Awareness Month, a time to think about men’s health issues involving the prostate.  This includes prostate cancer, as well as other conditions.  The prostate is a walnut-sized gland that sits below the bladder and wraps around the urethra.  The prostate is a part of the male reproductive system, as it produces fluid for the semen that carries sperm.

Prostate Cancer

Cancer of the prostate is the second-most common cancer that affects men, after cancers of the skin.  Many prostate cancers are slow-growing and will not lead to death.  However, some are more aggressive and can lead to serious problems.

Risk factors

There are a few known risk factors for prostate cancer:

  • Age is the greatest risk factor – the older you are, the greater the chances of getting prostate cancer
  • African-American men have a significantly elevated risk
  • Men who smoke have a higher risk
  • Men who have a family member, such as a father or brother who had the disease, are at higher risk


Prostate cancer does not always produce symptoms.  When it does, symptoms can be very similar to other prostate concerns, such as an enlarged prostate.  These possible symptoms include:

  • Difficulty beginning urination or experiencing a weak or interrupted urine flow
  • Frequent urination and urge to urinate during the night
  • Difficulty completely emptying the bladder
  • Painful urination
  • Blood in semen or urine
  • Painful ejaculation
  • Pain in the back, hips or pelvis

“These symptoms could be the result of another condition altogether, so the presence of these conditions does not necessarily indicate prostate cancer,” says Dr. Keith Livingstone, a family medicine physician.  “You should visit with your doctor if you are experiencing any of these symptoms.”

Screening & Diagnosis

There are two primary ways to screen for prostate cancer: a digital rectal exam (DRE) and the prostate-specific antigen (PSA) blood test.

For a DRE, the physician will insert a gloved, lubricated finger into the patient’s rectum to feel for abnormalities in the prostate.  While this method can detect potential problems with the prostate, it cannot, by itself, indicate if cancer is present or not.

The PSA screening is a blood test.  Essentially, a low level of PSA in the blood indicates a healthy prostate, while an elevated level could indicate cancer.  However, an elevated level may also be indicative of another, unrelated prostate issue, such as enlarged prostate or an infection of the prostate.

There is considerable debate within the medical community about the appropriateness of PSA testing.  While the test can have value in detecting cancer, it is also known that the test can result in both false-positives (indicating cancer when none is present) and false-negatives (indicating no cancer when the disease actually is present).

In addition, due to the fact that many forms of prostate cancer are slow-growing and do not pose an immediate risk to a man’s health, a diagnosis may result in unnecessary surgery to remove the cancer, as well as elevated apprehension and stress for the patient.

“Privia Medical Group North Texas supports the shared recommendations of the U.S. Centers for Disease Control and Prevention and the American Urological Association,” says Dr. Louis Zegarelli, a family medicine physician.  “Our guidance is that men over 50 should discuss the pros and cons of a prostate cancer screening with their health care provider and, taking into account medical history and other factors, make a decision together as to whether or not a PSA test is in order.”


The only way to know for sure if prostate cancer is present is to biopsy the prostate. A biopsy is a surgical procedure in which a portion of the prostate is removed so it can be analyzed for the presence of cancerous cells.  Cancer of the prostate can be treated in three main ways: surveillance, surgery and radiation treatment.

With surveillance, the prostate is checked every few months to determine if the cancer is spreading.  If it is not, your physician may advise simply continuing to monitor the prostate.  If a determination is made that the cancer is spreading, surgery may be performed to remove the prostate altogether.  Alternately, radiation therapy may be employed to kill the cancerous cells.

Both surgery and radiation therapy can produce lasting side effects, including sexual health issues.  That’s why physicians are cautious about rushing to diagnose and treat prostate cancer, as the odds of dying from this condition are quite low.

“All men are different, and there is not a one-size-fits-all approach when it comes to PSA screening for prostate cancer, nor is there a singular approach to treating this cancer,” says Dr. Andrew Hoover, a family medicine physician.  “It is definitely something to talk over with your physician, taking into account any risk factors or symptoms you may be experiencing so that you can make the most informed decision together.”

Enlarged Prostate

An enlarged prostate – Benign Prostatic Hyperplasia (BPH) – is a very common condition in men over age 50; roughly half of men between ages 51 and 60 have BPH and 90 percent of men over age 80 do.

Since the prostate is located next to the bladder, enlargement can cause urinary complications, such as having to urinate more frequently and difficulty fully emptying the bladder.  Men experiencing these symptoms should visit with their physician to determine if there are steps that can be taken to improve the situation.

There is some evidence that a healthy diet can reduce the likelihood of BPH, including eating more fruits and vegetables.  Obesity and lack of physical activity may also play a role in developing BPH.  It is important to note that BPH is neither a cause or a result of prostate cancer; however, it is possible to have both conditions at the same time.


Another prostate condition – one that primarily affects men under the age of 50 – is prostatitis.  Prostatitis is a bacterial infection of the prostate, which can lead to painful urination, difficulty urinating and pain in the lower back, groin area or testicles.  Note these symptoms are very similar to those associated with prostate cancer, so it’s important to consult with your physician.  Prostatitis can be treated effectively with antibiotics.  Like BPH, prostatitis has not been shown to cause or be a result of prostate cancer.

This article contains information sourced from:

The U.S. Centers for Disease Control and Prevention

Urology Care Foundation



August 2nd, 2018

Privia Sponsors 2018 Tarrant County Heart Walk

On Saturday, September 8, Privia Medical Group North Texas physicians and staff members will join with thousands of others at Will Rogers Memorial Center in Fort Worth to walk for a good cause – fighting heart disease and stroke.  The 2018 Tarrant County Heart Walk, a project of the American Heart Association, is one of more than 300 similar events across the country.

Heart Walks raise money to fight heart disease, the leading cause of death and disability in the United States.  The American Heart Association sponsors research to prevent and treat various forms of heart disease.  The goal for this year’s Tarrant County Heart Walk is $1,330,000, some of which will also go to training North Texas high school students on CPR.

“Sense of Community”

Privia Medical Group North Texas is one of the companies sponsoring the Heart Walk – with nine teams in place, Privia’s goal is to recruit 100 participants for the walk.  Dr. Triwanna Fisher-Wikoff, a primary care physician, is leading the effort for Privia, along with administrative staff members Tami Foster and Corey Harriman.

The proposal to sponsor the Heart Walk came from Dr. Scott Ewing, a cardiologist who participated in the 2017 event.  Privia’s Practice Development Committee agreed it was a good opportunity to promote “a sense of community within our organization,” according to Dr. Fisher-Wikoff.  After all, she says, “everyone recognizes the Heart Walk.”

As the physician leader for the effort, Dr. Fisher-Wikoff has several responsibilities: “My role is to make sure we are staying on target in terms of recruitment for the teams, getting all of our information submitted to the American Heart Association for registration, overseeing logistics and working with our practice consultants to make sure each team is organized and ready to walk.”

Fighting Heart Disease

Dr. Fisher-Wikoff believes it is important for Privia to support and participate in the Heart Walk because “heart disease is the number-one killer of Americans and many of these deaths are preventable.   Things like high blood pressure, poor diet, obesity and tobacco use are some of the most common causes of heart disease. When we walk, we are bringing light to the subject matter and showing how important it is to everyone.”

As a primary care physician, Dr. Fisher-Wikoff treats patients who have heart disease or are at heightened risk for getting it.  “I encourage my patients to start with the habits first. Even though it is difficult to change habits, I find that patients are often willing to change, especially if the behavior is leading to heart disease. Tobacco use, weight loss, increasing exercise, a better diet – these are the most common areas we focus on.”

A Team-Building Opportunity

With more than 200 providers serving patients in offices across seven North Texas counties, Privia physicians and staff members don’t always get the opportunity to interact with their colleagues outside their own practices.

“I think this will be a fun opportunity for Privia physicians and staff members, as it will give us a chance to know each other better on a personal level,” Dr. Fisher-Wikoff says.  “We want it to be personnel-friendly, so physicians get to know each other better and staff gets to know each other, as well.”

“We’re encouraging all of our walkers to bring their families, friends and even their dogs if they want to!”  Dr. Fisher-Wikoff continues. “We want as many people to participate as possible, so please register early so we can order enough t-shirts and other fun things.  Once our teams are set, we will have a competition to see who can raise the most money and recruit the biggest team.”

Walk for a Cause!

When it comes to an event like the Heart Walk, the more the merrier.  For those interested in participating, you can join a team, start a team or participate as an individual.  To join a Privia team, click here.

The opening ceremony begins at 8:30 am and the walk commences at 9:00 am.  The Heart Walk is a 1 to 3-mile, non-competitive walk around the Will Rogers Center.  Kids are encouraged to participate, as are dogs, provided they are on a leash. There will be water stations along the route and light refreshments will be available, as well.  For parking and additional information, visit the Heart Walk information page.



August 2nd, 2018

Back to School: Get an A+ on Immunizations

As August arrives, parents and children across North Texas begin to focus on the new school year ahead.  That means the final few weeks of summer vacation fun, as well as shopping for school supplies and new clothes.  It should also mean a check-in with your child’s doctor to ensure all immunizations are up-to-date.

Texas law requires that school children who attend public, charter or private schools be current on a number of vaccines.  In addition to these mandatory immunizations, there are a few more that are strongly recommended by the U.S. Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists and the health care providers of Privia Medical Group North Texas.

“Immunizations are essential to our health because they build our body’s immunity to serious diseases,” says Dr. Jeffrey Tessier, an infectious disease specialist.  “When parents ensure that their children receive all recommended immunizations, they are giving them a wonderful gift of protection from many dangerous infections.”

Debunking Vaccine Myths

Over the last twenty years, there has been a rash of misinformation about vaccines.  The genesis of these dangerous falsehoods is a report – one that has been completely discredited by the medical and scientific community – that vaccines can increase the likelihood of autism in children.  This is simply not true.

“Anyone who says vaccines are unsafe is peddling junk science – period,” says Dr. Mark Bernhard, a primary care physician.  “Vaccines save lives and discouraging immunizations puts lives at risk.  Anyone who has not received required immunizations is at a much-higher risk of contracting a serious, preventable and potentially deadly disease, such as whooping cough or measles.”

While the overall number of parents opting out of vaccines for their children is small, it has increased over the last several years, no doubt fueled by internet rumors and debunked theories. And as the number of vaccine opt-outs has crept up, so has the incidence of measles and pertussis outbreaks.  For example, in the first six months of 2018, there have been 93 confirmed measles cases in the U.S., including in Texas.  In 2014, there were 667 measles cases, the highest number since 2000, the year in which the disease was declared to have been eradicated in this country.

“We can’t afford to backslide on all the progress that has been made in combatting these completely preventable and serious diseases,” says Dr. Carolyn Evans, a pediatrician.  “Vaccines have done more to prevent death and disability in children than anything else we do in the field of medicine. If you have questions about a vaccine, please do speak with your child’s doctor about any concerns you have – we are here to answer your questions so that you can keep your child healthy.”

Immunization Schedule

Children begin receiving immunizations shortly after birth and continue to do so throughout childhood.  However, immunizations are not just for babies and young children.  People of all ages need periodic immunizations to protect against various diseases.  Here is a look at the most commonly-administered immunizations, the diseases they help prevent and standard guidelines on who should get them and when.

Please note that these are standard guidelines developed and issued by the U.S. Centers for Disease Control and Prevention, the American Academy of Family Physicians, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.  If you or your child have an underlying health condition, your physician may recommend forgoing a vaccine or receiving additional vaccines.  It is very important to consult with your physician on immunizations

Printable, color-coded charts showing recommended vaccinations by age can be found on the CDC’s website:

The information in these charts and below has been updated for 2018.

Required Immunizations for Children

Hepatitis B (HepB)
When Children Need It Birth AND

1-2 months AND

6-18 months

Why It’s Important Hepatitis B is a virus that attacks the liver.  It is spread through the blood and other bodily fluids.


Rotavirus (RV, RV1, RV5)
When Children Need It 2 months AND

4 months

6 months (depending on type of vaccine)

Why It’s Important Rotavirus causes gastroenteritis, which is inflammation of the digestive system.  It can cause severe diarrhea, vomiting, fever and pain.


Diphtheria, tetanus & acellular pertussis (DTaP)
When Children Need It 2 months AND

4 months AND

6 months AND

15-18 months AND

4-6 years

Why It’s Important Diphtheria, tetanus and pertussis are serious diseases caused by bacteria.  Diphtheria causes a thick covering in the throat and can lead to cardiovascular and breathing problems, paralysis and death.

Tetanus, also called “lockjaw,” causes tightening of muscles throughout the body.  In the event the jaw locks, a person may be unable to swallow.

Pertussis is commonly referred to as whooping cough.  This disease causes intense coughing fits for infants and young children, leaving them unable to eat or drink.

“Whooping cough is exhibit A in demonstrating why vaccines are so important.  This is a disease that was essentially eradicated a few years ago, but now we are seeing it make a comeback as more people have opted out of vaccines.  Pertussis is not simply a bad cough.  It is a terrible – and sometimes deadly – illness that children are defenseless against if not vaccinated.”

Dr. Lynne Tilkin, Primary Care


Haemophilus influenzae type b (Hib)
When Children Need It  2 months AND

4 months AND

6 months AND

12-15 months

Why It’s Important Hib disease is a bacterial disease that can lead to meningitis, pneumonia and death.  Before the Hib vaccine, Hib disease was the leading cause of bacterial meningitis infections in children under the age of 5.


Pneumococcal conjugate (PCV13)
When Children Need It  2 months AND

4 months AND

6 months AND

12-15 months

Why It’s Important Pneumococcal disease can cause ear infections, bloodstream infections, meningitis and pneumonia.  The very young and older people are especially vulnerable to pneumonia.


Inactivated poliovirus (IPV)
When Children Need It  2 months AND

4 months AND

6-18 months AND

4-6 years

Why It’s Important “As recently as 65 years ago, parents lived in fear that their children would contract polio – a devastating disease that can cause paralysis and even death.  But when Dr. Jonas Salk developed a polio vaccine in 1955, the world changed – and by 1979, polio was considered eradicated in the United States.  There are still parts of the world in which polio cases continue to be reported, so until the disease is completely eradicated, immunizations remain absolutely necessary.”

Dr. Jason Ledbetter, Internal Medicine


Influenza (IIV)
When Children Need It  6 months AND

Every year thereafter

Why It’s Important The flu causes serious symptoms such as fever, muscle pain, extreme fatigue and headache.  Young children and older adults are especially susceptible to complications, such as pneumonia and even death.

The flu vaccine is updated each year to be as effective as possible against the flu viruses expected to be most common.  Annual flu vaccines are generally available beginning in September.


Measles, mumps, rubella (MMR)
When Children Need It 12-15 months AND

4-6 years

Why It’s Important Measles causes runny nose, sore throat, cough, fever and a rash that spreads all over the body.  Mumps causes flu-like symptoms and swollen salivary glands, while Rubella produces symptoms similar to measles.

A highly-contagious respiratory virus, measles used to be quite common; in fact, virtually all children used to contract the disease by the age of 15.  Measles vaccinations began in the mid-1950’s and served to largely eliminate the disease as a common occurrence.  As with pertussis, however, there have been reports of measles occurrences in non-immunized children.  In 2014, 150 people contracted measles in an outbreak that began in an amusement park.

A mumps outbreak in Iowa in 2006 demonstrated that when individuals are not vaccinated, they can contract the illness and also spread it into the vaccinated population.

“The MMR vaccine is 95 percent effective – it provides very good protection, but if exposed to measles or mumps, a vaccinated person remains slightly vulnerable to contracting it.  This simply underscores that for vaccinations to truly be effective, everyone must be vaccinated.”

Dr. Mark Bernhard


Varicella a.k.a. chickenpox (VAR)
When Children Need It 12-15 months AND

4-6 years

Why It’s Important Chickenpox is highly contagious. It causes a severe rash, fever and fatigue.  The virus that causes chickenpox can also cause shingles in adults.

First approved in the United States in 1995, the chickenpox vaccine is relatively new.  Chickenpox used to be very common, usually affecting children ages 10 and younger.  Before the vaccine, up to four million people contracted the illness each year in the United States.


Hepatitis A (HepA)
When Children Need It  12-18 months (two doses)
Why It’s Important Hepatitis A attacks the liver.  It generally spreads through accidental ingestion of microscopic amounts of fecal matter.


Meningococcal (MenACWY)
When Children Need It: 11-12 years AND

16 years

Why It’s Important There are several different forms of meningococcal disease, some of which can be prevented through vaccinations.  In general, this illness attacks the central nervous system by infecting membranes on the brain and spinal cord.

Meningitis can be transmitted between teenagers and college students through sharing drinks, kissing and living in close quarters, such as a dorm. Meningitis is a highly-contagious, dangerous illness that can cause death.  Vaccinations are the best way to prevent infection.


Tetanus, diphtheria & acellular pertussis (Tdap)
When Children Need It  11-12 years
Why It’s Important Tdap provides continued protection from the same diseases as the DTaP.


Human papillomavirus (HPV)
When Children Need It  11-12 years (girls and boys)
Why It’s Important HPV is the primary cause of cervical cancer and can also lead to cancers of the vagina, vulva, penis, anus, rectum, throat, head and neck.  HPV is a common virus transmitted through sexual contact.  The CDC reports that at least half of the sexually active population has HPV, and many who have it will never realize it.

In most cases, HPV is harmless, but sometimes it can alter cells and cause cancer.  Parents should ask their child’s doctor about the HPV vaccine, as it can protect the child from HPV later in life.  The HPV vaccine dramatically reduces a girl’s odds of ever developing cervical cancer and protects boys, as well.


Optional for Young Adults

Meningococcal B (MenB)
Who Needs It & When  Young adults 16-18 years old who wish to receive the vaccine, after consultation with a physician
Why It’s Important The MenB vaccine provides additional protection against a form of meningitis.


Adult Immunizations

While we receive the majority of our immunizations during childhood, there are some vaccines adults need to get, as well.  The following recommended immunization schedule is for most adults.

Additional immunizations and/or a modified immunization schedule may be recommended by your physician based upon medical history and overall health.  For adults who did not receive or are unsure if they received certain vaccines in their youth, such as meningitis, HPV, chickenpox and MMR, they should discuss this with their provider, as it may be recommended to receive those vaccinations as an adult.

Who Needs It & When  Everyone, once a year
Why It’s Important “Getting an annual flu vaccine is one of the best things you can do for your health.  The vaccine greatly reduces your risk of getting the flu, which at minimum is a serious illness that will put you in bed for several days.  At worst, it can land you in the hospital, cause pneumonia or even lead to death.”

Dr. Ramu Rangineni, Hospitalist


Tetanus, diphtheria & acellular pertussis (Tdap) 
Who Needs It & When Any adult who did not receive a Tdap as a child (11-12 years) should receive one dose

Women who are pregnant should receive a Tdap between the 27th and 36th week of pregnancy for the protection of the mother and baby

ü Family members and others who will be spending time around a newborn should receive a Tdap at least two weeks before the child is born for the child’s protection

Why It’s Important Pertussis continues to be a significant health risk, with more than 48,000 cases of the disease in 2012.  As babies are more vulnerable to the disease, a Tdap during pregnancy helps provide protection.
Tetanus/diphtheria (Td)
Who Needs It & When  Once one has received a Tdap, regardless of age, everyone needs to get a Td booster every 10 years
Why It’s Important Unlike other infections, tetanus does not spread from person to person.  It is a type of bacteria that live in soil, dust and manure and can enter the body through a superficial wound, even one as minor as a cut or scrape.  Getting a tetanus booster every 10 years is critical to protecting against this risk.


Zoster (Shingles)
Who Needs It & When  Adults at age 50
Why It’s Important Shingles is a painful skin rash caused by the same virus that causes chickenpox.  If you have had the chickenpox – or the chickenpox vaccine – you are at risk for shingles.


Pneumococcal (PCV13/PPSV23)
Who Needs It & When Adults at age 65 AND

Second dose 1 year later

Why It’s Important Senior citizens are much more susceptible to developing pneumonia, a severe respiratory illness that claims the lives of more than 50,000 Americans each year.


“By following recommended immunization schedules for your children – and for yourself – you will help protect your family against an array of preventable diseases,” says Dr. Paresh Patel, a primary care physician.  “Remember, if you are unsure about a vaccine or have questions, please visit with your health care provider – we can answer your questions and make sure you have all the information you need about immunizations.”

This article contains information sourced from:

The U.S. Centers for Disease Control and Prevention

The Dallas Morning News

The Texas Tribune



April 17, 2017

THC Privia Partnership

Attention THC Patients:

The doctors of Texas Health Care (THC) have partnered with Privia Medical Group – North Texas. This partnership will allow your physicians to continue to offer superior care. We proudly remind our patients that we are fully contracted with BCBS, UHC, Aetna, Cigna, as well as other North Texas payers. In addition, we are not limited in our affiliation with any particular hospital system. We have physicians who participate with Baylor, THR facilities (HFW, HSW, Huguley, Alliance), Medical Plaza, Methodist Mansfield, JPS and others in our area. Please contact your physician if you have any questions.

April 3, 2017

2017 Top Doctors

44 Texas Health Care/Privia Medical Group North Texas Physicians Named to Magazine’s Prestigious List

The April cover story of Fort Worth Texas: The City’s Magazine features the publication’s annual “Top Doctors” list and once again, Texas Health Care/Privia Medical Group North Texas physicians are featured prominently on the prestigious list: 44 of its members across 17 specialty areas have been recognized as tops in their fields by their peers.

To select the physicians who are included in the “Top Doctors” list, the magazine sends an annual survey to more than 4,500 Tarrant County physicians, asking them to list the colleagues they believe to be the best in a variety of practice areas. The list includes doctors in Fort Worth and the greater Tarrant County area.

Eight of the 2017 Texas Health Care honorees are members of the John Peter Smith (JPS) Hospital surgical division. The public-private partnership between JPS, Tarrant County’s only Level I Trauma Center, and Texas Health Care affords patients some of the best surgical care in North Texas, delivered in a public hospital setting. At the same time, Tarrant County taxpayers benefit from the unique value that Texas Health Care/Privia surgeons deliver to the hospital.

“Texas Health Care members have always been committed to providing exceptional care for every patient, every time,” said Dr. Larry Tatum, the group’s CEO. “Now, with our new partnership with Privia Medical Group, a nationally-recognized health care leader known for innovations in population health, we’re poised to play an even bigger role in health care delivery for North Texas. Having 44 of our physician members on the 2017 ‘Top Doctors’ list is added proof of that.”

Texas Health Care has 219 providers in North Texas and surrounding areas.

The Texas Health Care/Privia Medical Group North Texas 2017 Top Doctors are:

Breast Oncology Surgery

Anita W. Chow*

Joseph Heyne*

Cardiac/Thoracic Surgery

Reza Khalafi*


Scott Ewing

Mohan Sathyamoorthy

Colon/Rectal Surgery

Jason Allen

Edward Castillo

Lori Gordon

Glen D. Hooker

Female Pelvic Medicine & Reconstructive Surgery

Michael England

General Surgery

John Mark Bayouth*

John L. Birbari

Scott Bloemendal

Antonio Castaneda

Mark Collins

Rajesh Gandhi*

Domingo Tan


Larry D. Tatum

Gynecology & Obstetrics

Cynthia A. English

Jay Herd

Beatrice G. Kutzler

Elisabeth Wagner

Robert Zwernemann

Internal Medicine

John Briscoe

Jason S. Ledbetter

Amber Lesley

Craig L. Dearden

Orthopedic Surgery

Donald Dolce

Joseph Milne

Brian Tobias

Torrance Walker

Orthopedic Back Surgery

James Brezina

Orthopedic Hand Surgery

Nathan Lesley

Ryan Reardon

Eric Wroten


Phillip Anthony

Yadro Ducic

John L. Fewins

Todd E. Samuelson

Jesse E. Smith*

Pain Management

Christopher C. Pratt

Plastic/Reconstructive Surgery

Larry E. Reaves*

Sports Medicine

Steven Meyers

Vascular Surgery

James E. Anderson*

*Denotes THC member who is part of the John Peter Smith Hospital surgical unit

April 1, 2017

Forty Texas Health Care Physicians Named 2015 “Top Doctors”

Once again, Texas Health Care physicians are featured prominently in Fort Worth Texas: The City’s Magazine’s annual list of “Top Doctors.” This year’s list, which will appear in the April issue of the magazine, features 40 Texas Health Care physicians.

To select the physicians who are included in the “Top Doctors” list, the magazine sends an annual voluntary survey to more than 4,500 Tarrant County physicians, asking them to list the colleagues they believe to be the best in a variety of practice areas. The list includes doctors in Fort Worth and the greater Tarrant County area.

Twelve of the Texas Health Care physicians who have been recognized for 2015 are members of the John Peter Smith (JPS) Hospital surgical division. The public-private partnership between JPS and Texas Health Care affords patients some of the best surgical care in North Texas, delivered in a public hospital setting. At the same time, taxpayers benefit from the unique value that Texas Health Care surgeons deliver to the hospital.

“We could not be more proud of our Texas Health Care members who have been recognized as 2015 Top Doctors. Each and every one of these physicians is committed to providing the best care to their patients, and it’s great to see their work honored by their peers,” said Dr. Michael Korenman, a Texas Health Care board member.

Texas Health Care has 150 physician members in 33 different specialties across Tarrant County and surrounding areas.

The Texas Health Care 2015 Top Doctors are:

Breast Oncology Surgery

Anita W. Chow*

Cardiac/Thoracic Surgery

James E. Anderson*

Reza Khalafi*


Scott Ewing

Colon/Rectal Surgery

Jason W. Allen

Lori L. Gordon

Glen D. Hooker

Paul R. Senter

Britton R. West*

Female Pelvic Medicine & Reconstructive Surgery

Michael J. England

General Surgery

John Mark Bayouth*

John L. Birbari

Scott Bloemendal

John Crawford

Rajesh Gandhi*

General/Family Practice

Lynne R. Tilkin


Cynthia A. English

Beatrice G. Kutzler

Larry D. Tatum

Internal Medicine

Alan Davenport

Jason S. Ledbetter

Amber Lesley

Craig L. Dearden


Carlos S. Bahrami


Harry Rosenthal

Orthopedic Surgery

Stephen Brotherton

Nathan Lesley

Ryan Reardon

Eric Wroten


Ricardo Cristobal*

Yadro Ducic

John L. Fewins

Todd E. Samuelson

Jesse E. Smith*

Pain Management

Christopher C. Pratt

Thomas M. Ratino

Plastic/Reconstructive Surgery

Larry E. Reaves*

Vascular Surgery

James E. Anderson*

Harshal S. Broker*

David L. Stroman*

*Denotes THC member who is part of the John Peter Smith Hospital surgical unit

April 1, 2017

Texas Health Care physicians recognized as 2014 “Top Doctors”

Record Number of Texas Health Care physicians recognized as 2014 “Top Doctors” in Fort Worth, Texas: The City’s Magazine

Texas Health Care is proud to congratulate a record number of its members who have been recognized as 2014 “Top Doctors” in the April edition of Fort Worth, Texas: The City’s Magazine. This year a total of 43 Texas Health Care physicians, spanning 15 different specialties and practice areas, have received the “Top Doctors” honor.

To select the physicians who are included in the “Top Doctors” list, the magazine sends an annual voluntary survey to more than 4,500 Tarrant County physicians, asking them to list the colleagues they believe to be the best in a variety of fields. The list includes doctors in Fort Worth and the greater Tarrant County area.

Fourteen of the Texas Health Care physicians who have been recognized are members of the John Peter Smith (JPS) Hospital surgical unit. The public-private partnership between JPS and Texas Health Care affords patients some of the best surgical care in North Texas, delivered in a public hospital setting. At the same time, taxpayers benefit from the unique value that Texas Health Care surgeons deliver to the hospital.

“We congratulate all of our members who have been recognized as 2014 ‘Top Doctors,’” said Michael Korenman, M.D., one of Texas Health Care’s Board members. “Each and every one of our physicians is dedicated to providing excellent care to their patients, and it is gratifying to see their work recognized by our peers,” he added.

The Texas Health Care 2014 “Top Doctors” are:

Breast Surgery

Anita Chow*

Joseph Heyne*

Cardiac/Thoracic Surgery

James Anderson*

Reza Khalafi*


Scott E. Ewing

Colon/Rectal Surgery

Jason Allen

Eduardo Castillo*

Lori Gordon*

Glen Hooker

Paul R. Senter

Britton West*

Cosmetic Surgery

Yadro Ducic*

Larry Reaves*

Jesse Smith*

General Surgery

John Mark Bayouth*

John Birbari

L. Scott Bloemendal

Antonio Castaneda

Mark F. Collins

John Crawford

Travis Crudup


Cynthia English

Bea Kutzler

Jennifer Motley

Larry Tatum

Internal Medicine

Charles Carlton

Norman A. Davenport

Craig Dearden

Jason Ledbetter

Amber Lesley


Carlos Bahrami


Harry Rosenthal

Orthopedic Surgery

Stephen Brotherton

Nathan Lesley

Ryan Reardon

Eric Wroten

Mark Wylie


Ricardo Cristobal*

Yadro Ducic*

John Fewins

Todd E. Samuelson

Plastic/Reconstructive Surgery

Larry Reaves*

Sports Medicine

Steven J. Meyers

Vascular Surgery

James Anderson*

Harshal Broker*

David Stroman*

*Denotes THC member who is part of the John Peter Smith Hospital surgical unit

June 1, 2017

Texas Health Care Honored with “Spirit of Community” Award for Charitable Giving

We’re proud to be recognized for our role in The Greatest Gift Catalogue Ever, which helps raise money for area non-profits. Texas Health Care was recently honored with the “Spirit of Community” award by the Shared Community Benefit Foundation for supporting the group’s communications efforts through the catalogue – a guide connecting area non-profits with prospective donors. THC is the fourth recipient of the “Spirit of Community” award – a group that includes Ted Blevins, Chris Robinson, and the Lena Pope Home.

Elliot Goldman, one of the founders of The Greatest Gift Catalogue Ever, said the “Spirit of Community” award is the people’s choice from Tarrant County’s charitable community. Goldman said of THC: “A lot of people know that Texas Health Care is group of caring and committed physicians. But not everyone is aware of their charitable giving and contribution to the local non-profit community.”

In its fifth year of supporting the charitable-giving catalogue, THC physicians and employees have had a significant impact on its success, Goldman said. Texas Health Care was the catalog’s first non-conventional distribution partner and one of the first large business groups to support the organization when it was founded. Texas Health Care President and CEO Larry Tatum, MD went to his board with the idea to place the catalog in member physician reception areas.

At the time, the catalog could not afford to advertise, so Texas Health Care’s participation was instrumental to its early growth. It has paid off in a big way: in just four holiday seasons, the catalog has resulted in a $2.5 million impact to local charities. Last year, the catalogue’s beneficiaries included: Boys and Girls Clubs, Meals on Wheels, Kids Who Care Inc., Catholic Charities, Ronald McDonald House, and the Tarrant County Women’s Center, to name a few.

“We’re delighted and honored to receive the award. But, honestly, we participate in the catalogue program because we see the impact that this charitable giving is having on our community and we’re proud to participate in any way that we can,” Dr. Tatum said.