MEDICAL BLOG FROM WESTCHESTER, NEW YORK AND MANHATTAN

1. SLEEP The immune system is directly affected by sleep. Enough sleep is crucial to stay healthy- the ideal amount of sleep is 8 hours a night. Try to go to sleep and wake up approximately the same time every day. If you snore, you may have sleep apnea and should have a sleep study Poor or insufficient sleep leads to infections, difficulty concentrating and chronic fatigue 2. EXERCISE: aerobic and weight bearing Exercise is important for your heart, your bones and your mental health. One hour 3 days a week (or more) would be great, but even a 10 minute work out is better than nothing. If you don’t have time to go to the gym, walk the stairs, do jumping jacks, jump rope, run in place 3. HEALTHY EATING: YOU ARE WHAT YOU EAT You can get most supplements from food, which is better/more natural than getting them in pill form. Antioxidants are heart healthy. - ANTIOXIDANTS Many of these foods are also high in fiber and vitamin C

Why is there a membership in New York City? Managed-care has not been kind to doctors. In fact, it has not been kind to patients, either. Reimbursements dropped significantly over the past few years. Some essential services stopped being covered. I was losing money, in an attempt to practice the way I thought patients deserved. Most practices implemented very short visits and started hiring NP’s and PA’s; they were making up the difference in volume. Patients were spending thousands of dollars in health insurance, seeing a health care professional for 15 minutes and possibly not even their doctor! I didn’t want to practice medicine that way. In 2019, I implemented a membership fee in the Manhattan office, while still accepting insurance for every visit. . It was a way to keep the practice afloat and not abandon my patients or my own moral agenda. I’m thankful to say, it was a huge success! Then came COViD. Most don’t know that, as health care professionals risked their lives, the government dropped reimbursements even lower, while not providing them with PPE. As an Infectious Disease doctor, my expenses were huge. I then had to raise the membership, making sure to still keep it affordable to my patients. Did we do this well? Maybe not. My policy became, there is a the membership fee, but if you truly can’t afford it, we will not send you away. A few new patients thought we were bargaining or “haggling”; we were not. I couldn’t turn away patients I’ve known for years and developed a close relationship with, if the fee was a financial burden to them. After two bad google reviews related to this policy, I learned, no good deed goes unpunished. So much for kindness. Our practice continues to thrive and the membership fee is now fixed. For those who can’t afford it, I am truly sorry. Concierge in Westchester? Honestly, I never thought I’d do this. I didn’t became a doctor to become rich. I did it for the love of medicine. So why concierge? Another lesson from the COViD pandemic. I was approached by a wonderful pediatrician in Westchester, practicing that way. He was giving his patients long visits and going to their homes. He told me that he became part of their family, joining them for a meal and learning about their lives. He said the parents wanted a doctor like that, too, but he was a children’s doctor. He asked if I would be interested in seeing some of the adults. That is how Scarsdale Health & House calls was born! I saw my first concierge patient yesterday. An elderly man that was home bound and thus couldn’t get to doctors. The family welcomed me into their home. I spent two hours with them, getting to know my new patient and figuring out his needs. Time consuming? Yes! Worth it? Absolutely! I feel good that I have helped a man, who otherwise wouldn’t have gotten help. For those of you who have read this, thank you for doing so and be well!

When I was in my 20s and was just starting my career, I had the opportunity to live and work in Africa. I went on safari in Kenya and Tanzania, frequented Egypt and my fate was sealed; I had the travel “bug”! I started traveling the globe. Luckily, I had learned during my Infectious Disease fellowship how not to get sick, what vaccinations I needed (country dependent) and what malaria prevention to take. I then realized that there was a need for this. I started doing travel medicine. A travel consultation consists of a thorough discussion of what vaccinations are recommended for the particular country being visited, how not to get diarrhea and whether or not malaria prevention is indicated. Vaccinations and prescriptions are given that visit, as well as handouts, outlining diarrhea and malaria prevention. The goal is to make sure the person has a great trip, not mired by illness. I also took a particular interest in Parasitology, during my Infectious Disease training. I got to see many of those diseases first hand, in Africa and then back in the United States. I enjoy seeing people who have acquired an illness during travel. Why? The answer is simple: they come very sick and I can cure them! It’s a very rewarding feeling and one of the many reasons I chose a career in Infectious Diseases. I’ve treated Malaria, Dengue, traveler’s diarrhea, Chikungunya, Zika, and the list goes on. If you love to travel, as I do, but don’t want to get sick, please schedule a travel consultation with me. If you have returned from a country and are ill, I can help you. Enjoy traveling and stay safe!

My father was a physician. I was always struck by how much he loved what he did. It wasn’t a job for him, it was a calling. He was my role model, as I embarked upon a career in medicine. I knew I wanted to help people and I found the study of diseases fascinating. What I didn’t realize back then, was that the relationships I’ve formed with my patients over the years, would be the most rewarding part of my job. People are scared when they go to the doctor. It’s my job to make them feel relaxed and to make sure all their questions are answered before they leave. The doctor-patient relationship is crucial. We don’t just need answers, we need empathy. My goal is that when my patients leave my office, both their medical and emotional needs have been met. If I’ve accomplished that, I’ve done my job.

Hiking is fun, ticks are not! Dr. Gilbert is a leading expert in Lyme disease and concomitant infections. Lyme disease can be very difficult to diagnose. Many cases are left undiagnosed, causing potentially serious complications, in years to come. Others are misdiagnosed as having Lyme disease and get treated for months, or even years, for a disease they don’t have. If you have been bitten by a tick or have symptoms you think might be Lyme disease, Anaplasma or a different tick borne disease, please call and set up a consultation. After taking a history, Dr. Gilbert will do a thorough examination, explain to you any testing you’ve already had done and send out additional tests, if indicated. Whether you have Lyme disease or a different illness, proper diagnosis and treatment is crucial!

Why did I start doing house calls? In a word, COVID. I have never done house calls prior to that. In fact, I didn’t even have an office in Westchester. COVID changed all that. People were really sick and weren’t leaving their houses. They needed to be examined and tested. It was then that I started doing house calls locally, testing and treating those who were sick and vaccinating those who were healthy. I open the second office shortly there after.It has been quite a rewarding experience, seeing the very young to the very old, in a time of great fear and uncertainty. I know I have made a difference, and for that. I am grateful. So, when the pandemic is over, will I continue to do house calls and have a Westchester office? Yes! Will I continue to have a New York city office? Yes! I have known many of my Manhattan patients for over 20 years. I don’t intend to leave them now. For all those reading this, stay safe and be well.