Newsletter - Winter 2018
Women’s Care Medical Group/Stanford Children’s Health  

California Fires: Wildfires in Butte, Los Angeles and Ventura counties have destroyed thousands of homes, structures and medical practices, as well as displaced thousands of Californians. The plans and insurers are taking action to ensure patients in affected areas have continued access to care. Below are the designated phone numbers for patients to call and get more information if they are experiencing difficulty refilling prescriptions, replacing medical supplies or obtaining access to care: 

“Telehealth” visits: Women’s Care is now scheduling virtual visits in appropriate situations: you would access the visit through your smart phone with a camera and your physician would speak to you through a camera on our computer in the office; this would save you travel and parking time—a serious cause of anxiety in our crowded and busy Bay Area  lives. The Telehealth visits would be scheduled with the doctor and charged to you as would the same length office visit; you would be contacted by our office just before the scheduled time to complete registration. Situations where this would be appropriate are: consultations about menopause, anxiety and depression, weight and sleep issues, trying to conceive, and  adjustment of medications. A virtual visit is not appropriate if you actually need a breast or pelvic exam, or if this is a postoperative visit. Phone calls lasting less than 5 minutes to review lab results would still be done as normal without cost to you and don’t necessitate scheduling a telehealth visit. 

Health care legislation update: California’s health care system revolves around those elected in the fall: Governor Gavin Newsom and Lt. Governor Eleni Kounalakis are poised to focus the administration on universal access to health care and controlling the spiraling healthcare costs faced by all of us. Senator Dr. Richard Pan is now chair of the Senate Health Committee and will continue to do his best with bills facing the legislators in 2019. 

“HeartMath”: research since 1993 has focused on the relationship of stress to emotional states, and the effect of stress on the autonomic nervous system, the hormonal and immune systems, heart and brain. Stanford University has suggested that physicians read up on these inner balance tools as one technique to improve mental clarity, creativity, emotional balance and personal effectiveness- just think: the heart has its own brain! You can access the reading materials, ear clip and monitor for cell phone app usage, and lots more at: During this holiday season and all the stress of year-end planning, each one of us could use a “period of coherence”. Please check it out! 

Sugar-sweetened beverages: Did you know that sports and energy drinks are overtaking soda as the primary source of liquid sugar in kids’ diets? Drinking beverages that contain added sweeteners is linked to adults and children becoming overweight or obese, which increases the risk of developing Type 2 diabetes, liver disease, dental decay and other health problems. Given a choice, reach for the water and herbal teas this holiday! 

“Do I need an annual exam?”: there has been a great deal of debate about the answer to this question. Our answer is YES: it is a once-a-year opportunity to “touch base” with a physician and make sure there screening and treatments are appropriate for both your illnesses and your continued great health. We make every effort to avoid “unnecessary tests” and allow time for you to voice concerns about what is really bothering you (weight, memory, sleep, sex—or no sex!). All kidding aside: most plans offer this as a once-annual “free of deductibles or co-pays” opportunity so why  waste it? Some still call it an “annual pap” but it is SO MUCH MORE! And not everyone has to go through a pelvic exam depending on age and circumstances. Don’t let the thought of a “pap” scare you away! 

Pap smears: HPV DNA testing increases our ability to accurately diagnose and predict risk of severe dysplasia and cervical cancer. Different recommendations exist based on age, risk factors, and past history. To complicate matters, some of your health plans are now trying to dictate how often we can perform the test. Keep in mind that the “annual well women visit” for those under age 65 is still allowed under all plans except Medi-Cal. Don’t let this valuable benefit lapse: there is usually no deductible or co-pay linked to the well-woman visit whereas problem visits always go against your (progressively increasing) deductible. 

HPV and cancer: the CDC reports that cancers linked to HPV have increased significantly over the past 15 years with throat cancer now the most common HPV-related malignancy: 43,000 new cases in 2015 alone. HPV vaccination rates around the world rates are also rising with nearly half of those aged 13-17 having received all the recommended doses, and two thirds having received the first dose. Already there is a marked decrease in new cervical cancer incidence in those who had been vaccinated. 

Medicare Well-Woman visit: Unfortunately Medicare has cut back to every other year as a “well women breast/pelvic check” (coded G0101), but you can still see us in the other year to go over your problems and concerns (follow-up on prolapse, use of hormones, fibrocystic breast changes, abnormal bleeding, repeated infections, or any other symptoms). This visit would be labelled with whichever problems were discussed by us and be billed to Medicare with an E/M code, and paid by Medicare just as any other problem visit is paid subject to deductibles and co-pays. Since gynecologists are not considered primary care physicians by Medicare, we do not do the complete “wellness exams” and lab work that your internist does- so every one over the age of 65 should have a relationship with an Internist as well. 

Shingrix: the new shingles vaccine is much more effective than prior vaccines, and is now available in pharmacies and covered by most health  plans for those over 55. Ask at your next visit: we can send Rx to your pharmacy. 

Flu season: can a flu shot give you the flu? NO, it cannot. The most common side effects are soreness, redness, tenderness or swelling where the shot was given; low grade fever, headache and muscle aches occur less frequently. Those who have been vaccinated but still get influenza are more likely to survive, rather than die, when they do catch the flu.

Season's Greetings from Drs. Andy Liu, Dolly Shoup, Beverly Joyce, Tanya Spirtos, Virginia Chan and Anjie Li with nurse practitioners Lindsay Pettit and Marjan Hafezi and office manager, Karen Palladino.
Payor Phone Number
Aetna (877) 238-6200
Anthem Blue Cross (844) 839-4049 
Blue Shield of California   (800) 393-6130 
California Health & Wellness     (855) 330-2338
Cigna (800) 244-6224 
HealthNet (800) 867-6564
Medi-Cal (800) 541-5555 
Medicare (800) 633-4227 
TRICARE (877) 363-1303
UnitedHealthcare (866) 633-2446