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Jaheda Begum and Dr. Alex Kocsik

Dr. Alex Kocsik entered Crozer Health’s Family Medicine Residency Program in the fall of 2022 as an intern.  We interviewed her last year in the first of a three-part series following her progress through the program.  We caught up with her again in December for a conversation about her second year.  She shared that she is hitting her stride as she’s gained experience.  “The transition from intern to resident was a lot smoother than the transition from medical school to intern year!   I think the biggest change that I’ve found in how I’m practicing medicine and how I feel is just more confidence.  Through trial and error, through seeing hundreds of patients, you just start to feel more confident in yourself and how you counsel patients and talk with them and you start to see more patients as we increase our patient loads from first year to 2nd year.  It’s been wonderful that I’ve got to spend so much more time here at ChesPenn, which is where I want to be.”



Seasonal Affective Disorder, or SAD, typically begins to manifest in October or November and often lifts in March or April.  While a clear-cut cause has not been determined, studies show that people with SAD have decreased levels of serotonin in their blood.

Research also suggests that sunlight affects levels of molecules that help maintain normal serotonin levels. Shorter daylight hours may prevent these molecules from functioning properly, contributing to decreased serotonin levels in the winter.  According to the National Institutes of Mental Health, vitamin D deficiency, which is more likely to occur during the winter months, may also contribute.  Some studies also show that too much melatonin can contribute to SAD.

Millions of people experience some level of “winter blues,” from a mild sense of sadness or sluggishness, to severe depression, self-isolation, fatigue, weight gain and other symptoms.  More women than men experience SAD.  Diagnosis is made based on the patient’s self-report of symptoms and the timing of their onset.

Treatment of SAD can include:

  •    Light therapy
  •    Psychotherapy
  •    Antidepressant medication
  •   Vitamin D

If it feels like you may be experiencing SAD, start by talking to your healthcare provider.  Depending on the severity of your symptoms, here are some ways to combat SAD:

  • First, talk to your healthcare provider, especially if you’ve experienced SAD in previous years.
  • Spend more time outdoors.
  • Increase physical activity.
  • Use a lightbox or dawn simulator.
  • Keep a consistent schedule.
  • Keep, or start, a journal or find some other creative outlet.
  • Some studies suggest aromatherapy can be helpful.
  • If your symptoms don’t improve or become worse, consider psychotherapy and/or antidepressants. And if you experience a crisis, don’t hesitate to call 988.

The short days of winter don’t have to make us blue.  If we embrace the season and take reasonable steps to take care of ourselves it can be a season filled with wonder and beauty.

 

 



As a little girl, DaNesha Mack was fascinated by germs and knew she wanted to work in healthcare.  She thought she might want to be a doctor.  In college she was able to explore different aspects of health and medicine and found her niche in public health.  She started to study health equity and took courses in health and social justice.

After school, DaNesha worked in New York until her mother was diagnosed with cancer.  She moved to the Philadelphia area to support her mom and saw an opening at ChesPenn for a Patient Health Educator in our new Complex Care Program. The program was similar to work she had done in New York.  She came to our Center for Family Health at Coatesville for an interview and tour with Sheila Church, Director of Patient and Community Services, and loved what she saw.  In March 2019, DaNesha joined Dr. Tina Ahmadinejad and other staff in developing the new program, which focuses on patients with multiple chronic illnesses who are high utilizers of hospital emergency services.



Would you like to guide your neighbors towards programs and resources, such as affordable connectivity programs for internet service and devices, and teach basic technological concepts that will help them access the resources they need to support their health on the internet?

ChesPenn is partnering with the National Health Corps, Americorps, and the Health Federation to offer a position as a digital navigator at our Upper Darby health center.

Becoming a member of the National Health Corps comes with the following benefits:

$15/hr Living Stipend
$6,895 Education Award
Healthcare Coverage
Public Health Trainings
Loan Forbearance
Childcare Reimbursement

If you’d like to build a career in healthcare while serving your community check it out!

 



One thing we learned during the COVID 19 pandemic was the value of telehealth.  Patients could see their physician from home, avoiding the danger of infection – and also eliminating the transportation barrier that many of our patients struggle with.  We also quickly came face to face with its limitations. For example, we couldn’t measure blood pressure, which made management of patients’ hypertension difficult.

The exciting news is that recent innovations have made it possible for patients to track their own blood pressure with wi-fi enabled blood pressure cuffs. 

In May 2021, ChesPenn launched our self-monitoring blood pressure management program with funding from a grant provided by the Health Resources and Services Administration (HRSA) and assistance from the Health Federation of Philadelphia. Patients receive instructions in taking their blood pressure and are asked to record measurements twice in the morning and twice in the evening. Patient Engagement Specialist Amyah Blakely reviews results daily that feed into a portal and then reports them to each patient’s provider through the EMR. 

In May 2021, ChesPenn launched our self-monitoring blood pressure management program with funding from a grant provided by the Health Resources and Services Administration (HRSA) and assistance from the Health Federation of Philadelphia. Patients receive instructions in taking their blood pressure and are asked to record measurements twice in the morning and twice in the evening. Patient Engagement Specialist Amyah Blakely reviews results daily and reports them to each patient’s provider.  When providers see elevated results, they can adjust the patient’s medication until the blood pressure returns to a healthy level.  This means patients don’t have to wait months for their next visit to have their provider check their blood pressure and make any changes needed.  To date, we have distributed blood pressure cuffs to over 250 patients and our goal is to expand the program to every patient whose blood pressure is not well controlled.

Patients have embraced their new ability to monitor their blood pressure.  The cuffs include an app that patients can download to their phones so that they can also keep track of both blood pressure and heart rate.  We’ve found that this tool helps increase patients’ engagement in their health management.

This initiative provides a powerful new tool for our participation in the Million Hearts® Collaboration.  Million Hearts® is a national collaboration co-led by the Center for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS).
Current priorities for the program include optimizing care with blood pressure control. 

ChesPenn Chief Medical Officer Dr. Letitia O’Kicki commented on the program that, “The Million Hearts® project has been a very important program advancing health equity and contributing to the health of the communities we serve.  Through team-based care and evidence-based guidelines, blood pressure is closely monitored and medication added or adjusted, if needed. The focus has been to better control blood pressure in our patients, preventing strokes and heart attacks.  Self-monitoring blood pressure machines have allowed patients to be very engaged in their health care. Our team-based approach includes the clinical care team: providers, nurses, medical assistants, health educator, behavioral health consultant, pharmacist, and the quality improvement team, along with the patient engagement specialist.”

During our 50th anniversary year, we’ve focused on celebrating 50 years of caring for the communities we serve while looking to the future, exploring innovative strategies to meet our patients’ evolving needs.  This new program is a wonderful glimpse into the possibilities for community health care in the coming years.



Letitia O’Kicki grew up in a small town in western Pennsylvania.  The eldest of 7 siblings, caring for others came naturally and her maternal uncle, who was a family medicine physician, also had a profound impact on her.   “We had this close relationship so when I went to Penn as an undergrad and Temple medical school and began to take rotations I would go back home and take them with my uncle in his office.  He was very warm, very tender, very nurturing and had a really wonderful relationship with his patients.  He took care of generations of families which was really nice to see.  When a woman went into labor in a in a snowstorm someone would come on a snowmobile to take him to deliver the baby.   He was just a great role model and mentor.”

After medical school Dr. O’Kicki first pursued surgery, attracted by the fast pace and high energy.  After a year of internship she realized that surgery wasn’t a fit for her and she once again turned to family medicine.  And again, her family became an important influence on how she thought about practicing medicine.

“When I was a fourth-year medical student my grandfather got very sick.  He had cholangiocarcinoma which is a very difficult cancer even now to treat and he died within six weeks.  I was very grateful that I was given the time off to go back and be with him.  One of the things that struck me was that every patient is someone’s family member.  No matter who you’re treating, you treat them as if they’re your family member because they belong to someone.   It really helped develop my empathy for patients and their families.   I decided right then that I wanted to work in an FQHC in public health.  As soon as I walked through the door (at the City of Philadelphia Ambulatory Health Services) I said this is where I belong.

“Every single day I would be happy to go to work and every single night I thought I’m so grateful for what I have but also boy I’m so glad I went to work today.”  The ability to help patients get connected to services, diagnosing their illnesses made every day of her 12 years with the city fulfilling.

After taking some time for her family and for research, Dr. O’Kicki was ready to dive back into primary care.  In 2012 she learned of a faculty position at Crozer in their Family Medicine Residency Program.  She found that the position would be at the Center for Family Health at Upper Darby, which operated in partnership with ChesPenn.  She jumped at the chance to get back into a community health setting and to teach the next generation of family medicine residents, passing on the passion and dedication she’d learned as a child from her uncle. In 2016, after Dr. Rekha Yagnik’s passing, she became ChesPenn’s Medical Director and was named Chief Medical Officer in 2020.

“I really love what I do.  Doctor Yagnik laid a strong foundation, and we want to build it higher and stronger and with Sue (Susan Harris McGovern) as CEO we have a really nice team.”   Under Dr. O’Kicki’s direction, ChesPenn participates in nationally recognized programs including the American Heart Association’s Million Hearts Program and Crucial Catch, a collaboration with the American Cancer Society and the NFL.  The leadership team is also exploring possible new collaborations with major health care systems in the region, made possible in part because of Dr. O’Kicki’s academic appointments at Drexel and Temple Universities.

In the next 3 to 5 years, Dr. O’Kicki sees ChesPenn continuing to grow, adding new programs and expanding our current services.  One project that’s especially important to her is an expansion of the Upper Darby location and addition of dental care there.   She envisions ChesPenn continuing to explore cutting edge approaches to community health and teach new generations of healthcare professionals her own irst lesson as a physician – that every patient is someone’s mother, father, sibling, or child.

 


Locations

Center for Family Health at Eastside
125 E. 9th Street
Chester PA, 19013
Medical Phone: 610-872-6131
Dental Phone: 610-874-6231

Center for Family Health at Coatesville
744 East Lincoln Highway
Suite 110
Coatesville, PA 19320
Medical Phone: 610-380-4660
Dental Phone: 610-383-3888

Center for Family Health at Upper Darby
5 South State Road
Upper Darby, PA 19082
Phone: 610-352-6585

Administration

1510 Chester Pike,
Suite 200
Eddystone, PA 19022

Phone: 610-485-3800
Fax: 610-485-4221

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