Connecticut. Freedom Network

Transcription

1 Connecticut Freedom Network Roster of Participating Physicians a nd Providers Spring/Summer 2012

2 Table of Contents Introduction...3 Hospital Listings...4 Speciality Descriptions...7 Primary Care Physician...31 Fairfield...31 Hartford...53 Litchfield...81 Middlesex...84 New Haven...88 New London Tolland Washington Windham Specialists Fairfield Hartford Litchfield Middlesex New Haven New London Tolland Washington Windham Complementary and Alternative Medicine Ancillary Services Index of Providers

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4 Introduction Getting information about a doctor or hospital can be difficult. That s why providing you with important tools and data that give you greater access to information about quality and costeffective care is one of our priorities. Introducing the UnitedHealth Premium designation program for Oxford. The UnitedHealth Premium designation program is a physician performance assessment initiative that evaluates network physicians based on national standards established by medical specialty societies to evaluate physicians for quality of care and local market benchmarks for cost efficiency. A quality of care designation depends on how often a physician follows national industry, evidence-based clinical guidelines. A cost efficiency designation evaluates how a physician s total cost of treatment compares with the average market cost of the treatment. A physician cannot be designated in cost efficiency without first meeting the guidelines for quality care. How to Find a Designated Physician: Simply visit search the physician directory and look for these symbols next to your search results: ** * Meets UnitedHealth Premium Quality and Efficiency Criteria Meets UnitedHealth Premium Quality Criteria p Not evaluated/declined designation For a complete description of the UnitedHealth Premium designation program, including details on the methodology used, geographic availability, program limitations and medical specialties participating, please visit The providers in this roster are listed alphabetically by county and type of practice. The sections are divided into the categories of Primary Care Physicians, Specialists, Complementary and Alternative Medicine Providers and Ancillaries. There is also an index in the back of the book so you can easily look up a provider by their last name. Please Note: We are constantly adding new providers to the network. In addition, current providers may occasionally have a change in their participation status and this roster may not reflect the latest changes. For the most current information, please visit our website at and click on Find a Physician or Facility to find providers and facilities within our service area or outside of the service area using the UnitedHealthcare Choice Plus network. Or, you can call Customer Service at the telephone number on your health plan ID card or call If you are hearing impaired and require assistance, please call our TTY/TDD line at Please call for assistance in Chinese, for assistance in Korean, or the telephone number on your health plan ID card for assistance in English and other languages. *The Oxford service area includes the following: Connecticut, New Jersey and New York (the five boroughs and all counties south of and including Ulster). Important Note: UnitedHealthcare Choice Plus providers are not considered in-network for members enrolled in the following types of products: Freedom and Liberty Network HMO plans, Freedom and Liberty Network exclusive provider organization (EPO) plans, Oxford Medicare Advantage plans, and Individual plans. 3

5 Hospital Listings Fairfield HO3178 Bridgeport Hospital 267 Grant St (203) HO3177 Danbury Hospital 24 Hospital Ave (203) HO4040 Greenwich Hospital 5 Perryridge Rd (203) GRWH HO3170 Norwalk Hospital 24 Stevens St Norwalk, CT (203) HO4512 Saint Vincent s Medical Center 2800 Main St (203) SVMC HO3172 Stamford Hospital Shelbourne W Broad St Stamford, CT (203) Hartford HO4722 Bristol Hospital 41 Brewster Rd (860) BRIS HO9999 Connecticut Childrenàs Medical Center (860) CCMC HO1316 Hartford Hospital (860) HO4254 Manchester Memorial Hospital 71 Haynes St (860) MANM HO9863 Saint Francis Hospital & Medical Center (860) HO2258 The Hospital Of Central Connecticut 100 Grand St (860) NBGH HO4491 Uconn Health Center - John Dempsey Hospital (860) Litchfield HO9265 Charlotte Hungerford Hospital 540 Litchfield St (860) HUNF HO4479 New Milford Hospital 21 Elm St New Milford, CT (860) NEWM HO4380 Sharon Hospital 50 Hospital Hill Rd Sharon, CT (860) SHAR Middlesex H Middlesex Hospital 28 Crescent St (860) New Haven HO3255 Griffin Hospital 130 Division St Derby, CT (203) GRIF HOSPITAL LISTING KEY Provider Code: HO1234 Facility Name: XYZ Medical Center Address: 123 Main Street Telephone: Short Code: XYZM 4

6 HO3446 Hospital Of Saint Raphael (203) STRA HO9638 Midstate Medical Center 435 Lewis Ave Meriden, CT (203) MIDS HO4381 Milford Hospital 300 Seaside Avenue (203) MILF HO1112 Saint Mary s Hospital 56 Franklin St Waterbury, CT (203) STMH HO1120 Waterbury Hospital 64 Robbins St Waterbury, CT (203) WTBY HO4716 Yale New Haven Hospital (203) Tolland HO5555 Johnson Memorial Hospital 201 Chestnut Hill Rd Stafford Springs, CT (860) JMEH HO2601 Rockville General Hospital 31 Union St Vernon, CT (860) RVIL Washington H Westerly Hospital 25 Wells St Westerly, RI (401) WESTER Windham HO3414 Day Kimball Hospital 320 Pomfret St Putnam, CT (860) DAYK HO1661 Windham Community Hospital 112 Mansfield Ave Willimantic, CT (860) WIND New London HO4961 Lawrence And Memorial Hospital 365 Montauk Ave (860) HO4529 William W Backus Hospital 326 Washington St (860) WWBH 5

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8 Speciality Descriptions A specialty is a branch of medicine in which a health care provider specializes. Refer to these descriptions for additional information. Specialty is self-reported by the physician and confirmed when the physician first joins the network by verification of the physician s training in the specialty or his/her Board Certification status. Primary Care Specialties Alternative Medicine Specialties Specialist Specialties Hospital Specialties Dentist Specialties Ancillary Facility Specialties Primary Care Specialties Family Practice Family physicians treat a wide variety of ages, ranging from infants to the elderly. Patient care is comprehensive with preventive, diagnostic and treatment available for individuals or families. Family physician practices will typically include pediatrics, geriatrics, obstetrics, gynecology and internal medicine. Internal Medicine An internal medicine physician, or internist, is a type of primary care physician who specializes in the treatment of long-term comprehensive care for adults. Internists care for individuals with a wide variety of diseases or conditions. Internists may limit their scope of practice (e.g., endocrinology, gastroenterology, pulmonology). Nurse Midwife An advanced practice specialty of nursing, which requires two additional years of training. The nurse midwife works under the supervision of an OB/GYN medical doctor to provide prenatal care, uncomplicated delivery of babies and post-partum care. Nurse Practitioner An advanced practice specialty of nursing that requires three additional years of training. The nurse practitioner works under the supervision of a doctor in the specific specialty. The nurse practitioner generally provides less complex care in primary care settings. Obstetrics Gynecology An obstetrician/gynecologist specializes in the diagnosis, prevention and medical care of the female reproductive system in addition to the daily management of pregnant women. Obstetrics is the discipline associated with the pregnancy, delivery and immediate care of a mother and child following birth. Gynecology is the study of women s reproductive system. Pediatrics A pediatric physician specializes in the development, growth, care and diseases of children. Pediatricians see a broad range of medical, social and emotional disorders in children. Pediatricians frequently see individuals as they mature into young adulthood. In addition, they often serve as a consultant to other medical providers as children need more specialized care. Specialists Adolescent Medicine Adolescent Medicine is a growing subspecialty of Pediatrics, Internal Medicine and Family Practice. Specialists in Adolescent Medicine provide comprehensive health services to teenagers that are appropriate for their physical and emotional development. 7

9 Advanced Practice Registered Nurse An Advanced Practice Registered Nurse (APRN) is a registered nurse with a master s degree who specializes in cardiothoracic surgery as a Nurse Practitioner or Clinical Specialist. Allergy and Immunology The study of allergic and immunologic diseases (such as pollen, chemical and food allergies, asthma and AIDS) and their respiratory complications. Anesthesia Registered Nurse Nurse anesthetists or Certified Registered Nurse Anesthetists (CRNAs) are licensed, professional nurses who provide services similar to an anesthesiologist. Anesthesiology Anesthesiology is an area of medicine that assists with both surgical procedures and pain control. Anesthesiologists deliver medications that reduce or eliminate sensation during surgical procedures. The physician will monitor patient vital signs, blood pressure, heart rate, etc. to ensure safety. Anesthesiologists also typically administer medication to help manage individuals suffering from chronic pain or illness. Audiology A health care professional trained to evaluate hearing loss and related disorders, including vestibular (balance) disorders and tinnitus (ringing in the ears) and to rehabilitate individuals with hearing loss and related disorders. Behavioral Health Clinical Nurse Specialist A nurse specialist with a high degree of knowledge, skill and competence in a specialized area of nursing who has been legally authorized (registered) to practice after examination by the state nurse examiners board or similar regulatory authority, and who is legally entitled to use the designation "RN." Behavioral Health Marriage and Family Therapy Practitioners, called marriage and family therapists, are trained in individual psychotherapy and family systems to assess and treat mental, emotional and behavioral disorders, and address an array of relationship issues within the context of marital/couple, family and other relational systems. Cardiac Electrophysiology The electrical conduction system that controls the heart rate, this system generates electrical impulses and conducts them throughout the muscle of the heart, stimulating the heart to contract and pump blood. Cardiothoracic Surgeon A physician who specializes in diseases of the heart, this type of heart physician primarily uses surgical treatments as opposed to medical treatments. Cardiology (Cardiovascular Disease) A cardiologist diagnoses and treats various diseases associated with the heart, lungs and blood vessels. This specialty of medicine will manage various illnesses that require a broad set of treatments, including medication management, procedures such as balloon angioplasty, behavior modification etc. Cardiologists often see a wide variety of disorders ranging from heart attacks to blood vessel blockage. Chiropractor A non-physician professional practicing chiropractic medicine based on the interrelationship between the spinal column and nervous system. Colorectal Surgeon Specializes in diseases of the large intestine (bowel), rectum and anus that require surgical operation for diagnosis or treatment. 8

10 Convenience Care Clinic Clinics that provide access to care seven days a week without appointment. Usually located within retail pharmacies. Critical Care Medicine The specialized care of patients whose conditions are life-threatening and who require comprehensive care and constant monitoring, usually in intensive care units. Dermatological Immunology Dermatological immunology is the laboratory study of the immune system of the skin. A dermatological immunologist deals with disorders of the skin caused by allergic reactions and other immune system disorders. Dermatology A dermatologist focuses his/her scope of practice to the diagnosis and treatment of skin, hair, nails and mouth. Dermatologists treat skin cancers, contact dermatitis and other allergic and non-allergic skin disorders. Dermatologists typically use a wide range of treatments, including medications, ultraviolet light and dermatologic surgical procedures. Dermatology-Dermatopathology The branch of medicine concerned with the diagnosis, treatment and prevention of diseases of the skin, hair, nails, oral cavity and genitals. Developmental-Behavioral Pediatrics A medical specialty focusing on assessment and treatment of children with behavioral issues, developmental disabilities, adjustment and coping issues, learning and attention disorders, enuresis and encopresis, pain, psycho physiological disorders, habit problems, anxiety and stress. Diagnostic Laboratory Immunology A facility that performs genetic testing, flow cytometry and cellular immunology studies to diagnose and monitor immunologic disorders. Dietitian Nutritional therapy helps prevent and treat illnesses by promoting healthy eating habits, scientifically evaluating patients diets and often suggesting modifications to them. Nutritionists help people learn how to maintain optimal physical and psychological health as they help promote longevity and work to prevent chronic diseases. Emergency Medicine An emergency physician focuses on the immediate decisions and actions necessary to prevent death or any further disability both in the pre-hospital setting, by directing emergency medical technicians, and in the emergency department. The emergency physician provides immediate recognition, evaluation, care and stabilization of a diverse population of adult and pediatric patients. Empowerment Coach Empowerment coaching is the practice of assisting clients to determine and achieve goals and manage stress while being a caregiver. Endocrinology A subspecialty of Internal Medicine with a concentration on disorders of the endocrine glands such as the thyroid and adrenal glands. Endocrinologists treat disorders such as diabetes, metabolic and nutritional disorders, pituitary diseases and menstrual and sexual problems. Endocrinology, Diabetes and Metabolism A sub-specialty of Internal Medicine that deals with conditions such as diabetes that affect the endocrine glands. The endocrine glands consist of the adrenal glands, thyroid, parathyroid, pancreas and pituitary gland. 9

11 Family Practice Family physicians treat a wide variety of ages, ranging from infants to the elderly. Patient care is comprehensive with preventive, diagnostic and treatment available for individuals or families. Family physician practices will typically include pediatrics, geriatrics, obstetrics, gynecology and internal medicine. Gastroenterology A gastroenterologist treats various disorders relating to the digestive system, including disorders of the stomach, intestines, liver, gallbladder and pancreas. Gastroenterologists use advanced technology in both diagnostic and treatment methods. Common problems treated by gastroenterologists include stomach ulcers, acid reflux, hepatitis, irritable bowel and cancer. General Dentistry A physician who specializes in the care of teeth and associated structures of the oral cavity. This specialty is concerned with the prevention, diagnosis and treatment of diseases of the teeth and gums. General Practice A general practitioner (GP), family physician or family practitioner (FP) is a physician/medical doctor who provides primary care. A GP/FP treats acute and chronic illnesses, provides preventive care and health education for all ages and both sexes. Some also care for hospitalized patients and do minor surgery and/or obstetrics (if they have hospital privileges). Genetic Counselor Genetic Counselors work with patients and families who have genetic or inherited disorders and birth defects. They also counsel people who are at risk for these problems. Genetics, Biochemical and Molecular See below. Genetics, Clinical (Md) Clinical Genetics is the medical specialty that provides a diagnostic service and "genetic counseling" for individuals or families with, or at risk of, conditions that may have a genetic basis. Genetics, Clinical Biochemical Clinical biochemical genetics involves the biochemical analysis of chromosomes as they relate to inherited tendencies. A clinical biochemical geneticist performs and interprets tests done for genetic purposes, such as diagnosing a genetic disease or disease risk. Genetics, Clinical Molecular The study of the molecular structure of genes, involving DNA and RNA (ribonucleic acid). Genetics, Cytogenetics The study of the structure, function and abnormalities of human chromosomes. Geriatric Medicine A Family Physician with an added certificate in geriatrics that is capable of advising older patients in the prevention, diagnosis, treatment and rehabilitation of disorders common to old age. Gynecology An obstetrician/gynecologist specializes in the diagnosis, prevention and medical care of the female reproductive system in addition to the daily management of pregnant women. Obstetrics is the discipline associated with the pregnancy, delivery and immediate care of a mother and child following birth. Gynecology is the study centered on women s reproductive system. 10

12 Gynecological Oncology An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. Hematology Hematology is a subspecialty of Internal Medicine or Pathology with additional training that specializes in diseases of the blood, spleen, and lymph glands. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma. A related physician specialist, an oncologist, treats disorders related to tumors and cancer. Many physicians practice both specialties as many blood-forming organs are closely related to cancer. (See below) Hematology-Oncology Hematology is a subspecialty of Internal Medicine or Pathology with additional training that specializes in diseases of the blood, spleen, and lymph glands. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma. Oncology is a subspecialty of Internal Medicine that specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers chemotherapy for malignancy, as well as consults with surgeons and radiotherapists on other treatments for cancer. Infectious Disease A subspecialty of Internal Medicine that deals with infectious diseases of all types and in all organs. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with unexplained fevers. Infectious disease specialists may also have expertise in preventive medicine and conditions associated with travel. Internal Medicine An internal medicine physician, or internist, is a type of primary care physician who specializes in the treatment of long-term comprehensive care for adults. Internists care for individuals with a wide variety of diseases or conditions. Internists may limit their scope of practice (e.g., endocrinology, gastroenterology, pulmonology). Interventional Cardiology This doctor takes care of people with hypertension, heart disease and heart conditions, and performs procedures like angioplasty and angiograms. Licensed Pastoral Psychotherapy Clergy people with graduate training enabling them to provide psychotherapy, marital and family therapy. Licensed Professional Counselor A non-physician specialty that utilizes counseling and psychotherapy to evaluate and treat emotional and mental problems. Individual and group techniques are used to facilitate problem-solving, decision-making and behavior changes. Licensed professional counselors assist people in identifying and resolving personal, social, vocational and interpersonal concerns. Maternal and Fetal Medicine An obstetrician/gynecologist who cares for, or provides consultation to patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their affect on both the mother and the fetus. They also have expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies. Neonatal Perinatal Medicine A pediatrician is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. 11

13 Neonatology A neonatologist treats diseases and conditions affecting newborns. Neonatologists work with high-risk pregnancies, birth and post birth care. As a result, neonatologists frequently consult with both obstetricians and pediatricians in the delivery and post-birth stages of care. Nephrology A nephrologist specializes in conditions affecting structure, function and disease of the kidneys. Patients whose kidneys have failed, necessitating ongoing dialysis (a treatment to remove toxins and waste from the bloodstream), are typically under the care of a nephrologist. Further, nephrologists are important team members in the planning and follow-up care for individuals needing a kidney transplant. Nurse Midwife An advanced practice specialty of nursing, which requires two additional years of training. The nurse midwife works under the supervision of an OB/GYN medical doctor to provide prenatal care, uncomplicated delivery of babies and post-partum care. Nurse Practitioner An advanced practice specialty of nursing that requires three additional years of training. The nurse practitioner works under the supervision of a doctor in the specific specialty. The nurse practitioner generally provides less complex care in primary care settings. Nurse Practitioner-Psychiatry A Registered Nurse (RN) who has earned a separate license as a Nurse Practitioner through additional education and experience in psychiatry. Nurse practitioners may diagnose, treat and prescribe for a patient s condition within the area of psychiatry, in collaboration with a licensed psychiatrist and in accordance with an approved written practice agreement and protocols. Nurse Practitioners are autonomous and do not practice under the supervision of the collaborating physician. Neurological Surgery Neurosurgeons provide surgical diagnosis and treatment of diseases and conditions related to the nervous system. Neurosurgeons typically perform surgery on the brain or the neck area of the spine. They often work within a team of physicians to manage both the surgical and non-surgical components of a patient s care. Neurology A neurologist specializes in both impaired function and disease as it applies to the brain, spinal cord, nerves and skeletal muscle. Neurologists routinely deal with disorders such as Alzheimer s disease, Parkinson s disease, migraine headaches and stroke. Nuclear Medicine Nuclear medicine specialists produce images by injecting radiopharmaceuticals into the body and making pictures of the internal organs that would not be visible on an ordinary X-ray. Nuclear Studies The study of nuclear medicine; see above. Nurse A person trained, licensed or skilled in nursing. Obstetrics Gynecology An obstetrician/gynecologist specializes in the diagnosis, prevention and medical care of the female reproductive system in addition to the daily management of pregnant women. Obstetrics is the discipline associated with the pregnancy, delivery and immediate care of a mother and child following birth. Gynecology is the study centered on women s reproductive system. 12

14 Occupational Medicine Therapeutic use of activities to maximize a person s ability to function independently, enhance development and prevent disease. Occupational Therapy A form of therapy that encourages and instructs manual activities for therapeutic or remedial purposes in mental and physical disorders. Oncology Oncology is a subspecialty of Internal Medicine that specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers chemotherapy for malignancy, as well as consults with surgeons and radiotherapists on other treatments for cancer. Ophthalmology An ophthalmologist treats, diagnoses and prevents disease associated with the eye. Ophthalmologists are the only practitioners medically trained to treat disease and conditions of the eye with both surgical and non-surgical forms of care. Diseases and conditions typically treated by ophthalmologists include glaucoma, retinal detachment, cataracts and macular degeneration. Optometry A non-physician professional specializing in examining eyes and prescribing corrective lenses or other treatments for visual defects. Oral Pathology Oral pathology is the specialty of dentistry and pathology which deals with the nature, identification and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes and effects of these diseases. Oral Surgery (Dental) Surgery performed within the mouth cavity, especially around the gums and teeth, for the purpose of preservation or replacement of teeth. Oral Surgery (Medical) Also referred to as maxillofacial surgery, this is a specialization of dentistry that focuses on problems around the mouth, jaw and neck. Orthopedic Surgery A physician who specializes in the diagnosis and correction of injuries or disorders of the bones, joints, muscles and other support structures (such as ligaments and tendons). Otolaryngology (Ent) An otolaryngologist diagnoses and provides medical and/or surgical therapy for prevention of diseases, allergies, deformities, disorders and injuries. Head and neck oncology, facial plastic and reconstructive surgery, and the treatment of disorders of hearing and voice are fundamental areas of expertise. An otolaryngologist head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, respiratory and upper alimentary systems and related structures of the head and neck. Pain Management The process of providing medical care that alleviates or reduces pain. Pain management is an extremely important part of healthcare, as patients forced to remain in severe pain often become agitated and/or depressed and have poorer treatment outcomes. Pathology, Anatomic A medical specialty concerned with the diagnosis of disease based on the gross, microscopic, chemical immunologic and molecular examination of organs, tissues, and whole bodies (autopsy). 13

15 Pathology, Clinical Clinical pathology is the diagnosis of disease through the laboratory analysis of bodily fluids and/or tissues. Pathology, Blood Banking/Transfusion The blood banking division performs clinical testing and consultation research of the areas of blood banking, transfusion medicine and hematopoietic stem cell processing. Pathology, Chemical Chemical Pathology encompasses detecting changes in a wide range of substances in blood and body fluids (electrolytes, enzymes and proteins) in association with many diseases. In addition, it involves detecting and measuring tumor (cancer) markers, hormones, poisons and both therapeutic and illicit drugs. Pathology, Clinical The clinical pathology specialty laboratories include hematology, microbiology, immunology, clinical chemistry (and toxicology), the blood bank (transfusion medicine), and laboratory data management. In these areas, the pathologist acts as a consultant to the clinician, defining appropriate tests and interpreting their results. Many of these tests solidify a clinical diagnosis. Pathology, Cytopathology Cytopathology is the branch of pathology that studies and diagnoses diseases on the cellular level. A common application of cytopathology is the Pap smear, used as a screening tool to detect precancerous cervical lesions and prevent cervical cancer. Pathology, Dermatopathology Dermatopathology is specialized pathology of the skin under a microscope. The subspecialty of dermatopathology is a combination of both dermatology (the diagnosis and treatment of skin, hair and nail diseases) and pathology (identification of diseases microscopically). Dermatopathology cases may include melanoma and other skin disorders, immunologic, infectious and pediatric diseases. Pathology, Forensic Forensic Pathology is the branch of pathology that deals with the examination of the bodies of people who died suddenly, unexpectedly or violently. Forensic pathologists are responsible of determining the cause (the ultimate and immediate reasons for the cessation of life) and manner (homicide, suicide, accidental, natural, or unknown) of death. Pathology, Hematology The branch of pathology dealing with diseases of the blood and blood-producing organs. Pathology, Immunopathology The branch of pathology dealing with immune system reaction, including fatigue, muscle weakness, rash, headache, photosensitivity, pain anywhere, numbness, nausea, diarrhea, constipation, ringing in the ears, toothache, sinus congestion, nasal stuffiness, fever/chills, flu-like body ache, cough, irritability, depression, sleep disturbances and brain fog. Pathology, Neuropathology Neuropathology is the study, diagnosis and consultations on disorders of the brain and central nervous system. Pedi-Neurodevelopmental Disabilities The study of neurodevelopmental disability (impairment of the growth and development of the brain or central nervous system) in children. Disorders of brain function can affect emotion, learning ability and memory and unfold as the individual grows. 14

16 Pediatric Allergy and Immunology An allergist that specializes in the identification and treatment of disorders dealing with children s immune systems. Often allergists treat allergies caused by substances or events that result in adverse physical reactions, such as bee stings, medicine, soaps etc. Pediatric Cardiology A cardiologist that diagnoses and treats various diseases associated with the heart, lungs and blood vessels of infants, children and adolescents. This specialty of medicine will manage various illnesses that require a broad set of treatments, including medication management procedures such as balloon angioplasty, behavior modification etc. Cardiologists often see a wide variety of disorders ranging from heart attacks to blood vessel blockage. Pediatric Critical Care Medicine Treatment of an accident of urgent and pressing medical need of infants, children and adolescents. Pediatric Emergency Medicine Treatment of an accident of urgent and pressing medical need of infants, children and adolescents. Pediatric Endocrinology An endocrinologist that specializes in the treatment of glands, hormones and other metabolic functions of infants, children and adolescents. Endocrinologists also routinely deal with such problems as diabetes, thyroid disorders and nutritional problems. Pediatric Gastroenterology A gastroenterologist that treats various disorders relating to the digestive system, including disorders of the stomach, intestines, liver, gallbladder and pancreas of infants, children and adolescents. Gastroenterologists use advanced technology in both diagnostic and treatment methods. Common problems treated by gastroenterologists include stomach ulcers, acid reflux, hepatitis, irritable bowel and cancer. Pediatric Hematology-Oncology A hematologist specializes in diseases of the blood and lymph glands of infants, children and adolescents. A related physician specialist, an oncologist, treats disorders related to tumors and cancer. Often, physicians practice both specialties as many blood forming organs are closely related to cancer. Pediatric Nephrology A nephrologist that specializes in conditions affecting structure, function and disease of the kidneys of infants, children and adolescents. Patients whose kidneys have failed, necessitating ongoing dialysis (a treatment to remove toxins and waste from the bloodstream), are typically under the care of a nephrologist. Further, nephrologists are important team members in the planning and follow-up care for individuals needing a kidney transplant. Pediatric Neurological Surgery Pediatric neurological surgery is a discipline of medicine and the specialty of neurosurgery which deals with the diagnosis, evaluation and treatment of disorders of the central, peripheral and autonomic nervous systems of children. Pediatric neurological surgery includes the evaluation and diagnosis, operative and non-operative treatment, critical care and rehabilitation of children with disorders of the nervous system. Pediatric Neurology A neurologist that deals with disease and conditions of the brain and nervous system of the child. Pediatric Ophthalmology An ophthalmologist that specializes with diseases and conditions of the eye and is able to perform surgery on the eyes of children. 15

17 Pediatric Orthopedics An orthopedist that specializes in the treatment of neuromuscular and musculoskeletal disorders of childhood, extending into adult life. Pediatric Otolaryngology An otolaryngologist that treats conditions, diseases and performs surgery on the ears, nose and throat of children. Pediatric Pathology Pediatric pathology is the subspecialty of surgical pathology that deals with the diagnosis and characterization of neoplastic (tumor) and non-neoplastic diseases of children. Pediatric pathologists generally work closely with pediatricians. Pediatric Plastic Surgery A surgeon that treats conditions, diseases and performs surgery on the skin (trauma, burns), face, nose, ears and throat of children, as well as other areas needing reconstructive surgery. Pediatric Pulmonology A pulmonologist that specializes in the functioning, diagnosis and treatment of the lungs of children with a variety of lung and breathing diseases and conditions. Pediatric pulmonologists commonly treat diseases such as pneumonia, asthma and bronchitis. Pediatric Radiology Diagnosis of children s illnesses and injuries with the use of X-ray and other forms of radiant energy. Pediatric Rheumatology Diagnosis and nonsurgical treatment of arthritis and some disorders of the immune system of infants, children and adolescents. Pediatric Sports Medicine Diagnosis and treatment of injuries sustained in athletic endeavors. Pediatric Surgery A subspecialty of general surgery dealing with the management of surgical conditions in premature and newborn infants, children and adolescents. Pediatric Urology A urologist that treats conditions and diseases of, and performs surgery on, the bladder, kidneys and urinary tract system of children. Pediatrics A pediatric physician specializes in the development, growth, care and diseases of children. Pediatricians see a broad range of medical, social and emotional disorders in children. Pediatricians frequently see individuals as they mature into young adulthood. In addition, they often serve as a consultant to other medical providers as children need more specialized care. Physical Medicine and Rehabilitation Treatment of disease using physical agents such as heat, cold, light, electricity manipulation or the use of mechanical devices for the restoration of physiologic function. Physical Therapy A branch of rehabilitative health that uses specially designed exercise and equipment to help patients regain or improve their physical abilities. Physical therapists work with many types of patients from infants born with musculoskeletal birth defects, to adults suffering from sciatica or the after-effects of injury, to elderly post-stroke patients. 16

18 Physician Assistant A mid-level medical practitioner who works under the supervision of a licensed doctor (an ) or osteopathic physician (a DO). Plastic Surgery A plastic surgeon specializes in the surgical repair and reconstruction of facial and body defects due to birth disorders, trauma, burns and disease. Plastic surgeons are also involved with enhancement of personal appearance through surgical procedures. Podiatry A podiatrist is a physician that specializes in the evaluation and treatment of diseases of the foot. Podiatric Medicine includes studies in the basic medical sciences emphasizing the health and conditions affecting the lower extremities, their diagnosis and treatment, including surgery. Preventive Medicine Preventive medicine is routine care (for example, annual physical appointments) that aims to help prevent diseases, such as cancer and heart disease. Psychiatry A psychiatrist specializes in the prevention, diagnosis and treatment of mental, addictive and emotional disorders. The psychiatrist is able to understand the biologic, psychological and social components of illness and is therefore able to treat the whole person. A psychiatrist is qualified to order diagnostic laboratory tests and to prescribe medications; evaluate and treat psychologic and interpersonal problems; and to intervene with families who are coping with stress, crises and other problems in living. Psychiatry, Addiction A medical specialty dealing with the prevention, assessment, diagnosis, treatment and rehabilitation of addiction. Psychiatry, Child and Adolescent A medical specialty dealing with the prevention, assessment, diagnosis, treatment and rehabilitation of mental illness in children and adolescents. Psychiatry, Clinical Neurophysiology A medical specialty that studies the central and peripheral nervous systems through the recording of bioelectrial activity, whether spontaneous or stimulated. Psychiatry, Geriatric A medical specialty dealing with the prevention, assessment, diagnosis, treatment and rehabilitation of mental illness in geriatric patients. Psychology A psychologist specializes in diagnosing and treating diseases of the brain, emotional disturbances, and behavioral problems. Psychologists use talk therapy as treatment; you must see a psychiatrist or other medical doctor to be treated with medication. Psychologists may have a master s degree or doctorate (Ph.D.) in psychology. Public Health and Preventive Medicine Public Health is the science and practice of protecting and improving the health of a community, as by preventive medicine, health education, control of communicable diseases, application of sanitary measures and monitoring of environmental hazards. Pulmonary Medicine A pulmonologist specializes in the functioning, diagnosis and treatment of the lungs. Pulmonologists treat patients of all ages with a variety of lung and breathing diseases and conditions. Pulmonologists commonly treat diseases such as pneumonia, asthma, emphysema and bronchitis. 17

19 Radiation Oncology Radiation oncologists are specialist with training and experience in the treatment of cancer. They coordinate the care of cancer patients and, when needed, prescribe radiation and other anti-cancer drugs. Radiology A radiologist utilizes radiology methodologies to diagnose and treat disease. Physicians practicing in the field of radiology most often specialize in radiology, diagnostic radiology, radiation oncology, or radiological physics. Radiology, Diagnostic Radiology, diagnostic X-ray, ultrasound and other imaging techniques such as Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI). Radiology, Diagnostic/Nuclear The use of radioactive isotopes or as an aid in diagnosis and/or therapy. Radiology, Neuro-Radiology The branch of radiology that deals with the nervous system; the use of X-rays in the diagnosis and treatment of nervous system disorders. Radiology, Nuclear The branch of radiology that uses radioactive materials in the diagnosis and treatment of health disorders. Radiology, Vascular and Interventional A subspecialty of radiology that involves performing minimally invasive procedures to diagnose and treat disease. Most interventional radiology procedures are performed on an outpatient basis, using a local anesthetic or moderate sedation. Reproductive Endocrinology A specialist in obstetrics and gynecology who is capable of managing complex problems relating to reproductive endocrinology and infertility and whose current professional activity involves the practice of reproductive endocrinology. Rheumatology A rheumatologist specializes in diseases affecting joints, muscles, bones and tendons. Rheumatology is a sub-specialty within internal medicine. Rheumatologists treat a variety of diseases and conditions, such as rheumatoid and osteoarthritis, lupus, collagen disorders and other joint pains. Sleep Medicine Sleep medicine is a medical specialty or subspecialty devoted to the diagnosis and therapy of sleep disturbances and disorders. Sleep/Wake Disorders A subspecialty in clinical assessment, physiologic testing, diagnosis, management, and prevention of sleep and circadian rhythm disorders. Social Work A social worker is trained to talk with people and their families about emotional or physical needs and to find them support services. 18

20 Speech and Language Therapy Speech and language therapists diagnose and treat disorders of speech, voice and language, and problems with swallowing or feeding. If a total cure is not possible, they assist people to overcome or minimize the difficulties associated with these conditions and provide them with support. Although much of the work is with children, people of all ages are treated. Patients problems may be congenital, may be due to learning difficulties or special educational needs, or may have been caused by injury or by a medical condition like a degenerative illness such as Parkinson s disease or a stroke. Speech Pathology The science concerned with the diagnosis and treatment of functional and organic speech defects and disorders. Surgery, General General surgery is the treatment of injury, deformity and disease using operative procedures. Surgery, Hand A surgical specialty that deals with problems of the hand, wrist and forearm. Surgery, Thoracic A surgical specialty concerned with diagnosis and treatment of disorders of the heart, lungs and esophagus. Two major types of thoracic surgery are classified as pulmonary and cardiovascular. Surgery, Vascular The branch of surgery that occupies itself with surgical interventions of arteries and veins, as well as conservative therapies for disease of the peripheral vascular system. A cardiothoracic surgeon specializes in surgery of the heart and its vessels. A neurosurgeon specializes in surgery involving vessels in the brain (e.g., intracranial aneurysms). Surgical Critical Care Surgery pertaining to the care of seriously ill patients needing immediate and continuous care. Undersea and Hyperbaric Medicine Hyperbaric oxygenation is an increased amount of oxygen in organs and tissues resulting from the administration of oxygen in a compression chamber at an ambient pressure greater than 1 atmosphere of pressure. Urology A urologist specializes in the medical and surgical treatments of the urinary system and the male reproductive system. Urologists treat diseases and conditions such as kidney stones, prostate disorders and impotence. Dentist Specialties Endodontics A specialty of dentistry that deals with the tooth pulp and tissues surrounding the root of a tooth. The pulp (containing nerves, arterioles and venules, as well as lymphatic tissue and fibrous tissue) can become diseased or injured and thus is unable to repair itself. The pulp then dies and endodontic treatment is required. General Dentistry A physician who specializes in dentistry (the care of teeth). Oral Surgery (Dental) Involves surgery for diseases, injuries and deformities of the teeth, mouth and jaw. An oral surgeon (also called a dental surgeon) removes wisdom teeth, repairs broken jaws and treats many other conditions. 19

21 Orthodontics Orthodontics is a specialty of dentistry that is concerned with the study and treatment of malocclusions (improper bites), which maybe a result of tooth irregularity, disproportionate jaw relationships or both. Pediatric Dentistry Dentistry of children and adolescents. Periodontics This dental specialty is concerned with the prevention, diagnosis, and treatment of functional and structural disease of the periodontal membrane and related tissues that support the teeth. Alternative Medicine Specialities Please verify your benefits. Acupuncture The gentle insertion of hair-fine needles into specific points on the body to help stimulate the flow of one s Qi (pronounced chee) or natural healing energies. Acupuncturists work to relieve obstructions in energy channels that interrupt the flow of energy in the body. Applying needles to the acupuncture points releases chemicals in the nervous system that help to moderate pain and stimulate the body s natural healing abilities. While considered a non-traditional treatment in Western medicine, acupuncture has been practiced in China for thousands of years. The World Health Organization recognizes the use of acupuncture in the treatment of a wide variety of medical problems, including digestive disorders, respiratory disorders, neurological and muscular disorders and urinary, menstrual and reproductive problems. Additionally, acupuncture is especially useful in resolving physical problems related to tension, stress and emotional conditions. Chiropractor A non-physician professional practicing chiropractic medicine based on the interrelationship between the spinal column and nervous system. Massage Therapy Massage therapy, or the manipulation of soft tissue, helps reduce muscle fatigue and pain by promoting healthy blood circulation, cleansing toxins from muscle tissues and providing overall relief from muscle tension. Massage can help loosen and relax contracted muscles and disperse accumulated by-products of muscle action that can cause irritation, thus increasing muscle recovery time from physical activity. Naturopathic Medicine Naturopathic medicine (or naturopathy) is a philosophy based on the belief that the body can heal itself following the laws of nature and that treatments should support normal body functions. Naturopathic medicine attempts to improve health, prevent disease and treat illness by promoting the use of organic foods and exercise; maintaining a healthy, balanced lifestyle; and applying concepts from other areas of complementary medicine (such as ayurveda, homeopathy and herbal therapies). The goal of naturopathy is to help people become well and stay well, which is believed to be the natural state of the body. Naturopathy was developed in the late 1800s in the United States. Today, a licensed naturopathic physician (ND) attends a four-year, graduate-level naturopathic medical school and is educated in all of the same basic sciences as a medical doctor (). However, the ND also studies alternative approaches to therapy, such as herbal medicine, acupuncture and bodywork. Nutritionist Nutritionists help prevent and treat illnesses by promoting healthy eating habits, scientifically evaluating patients diets and offering diet modifications. Most experts agree that good nutrition, including nutritional supplements, may be effective for a variety of illnesses, injuries and age-related problems. 20

22 Yoga A system of personal development that encompasses the body, the mind and the spirit through its unique meditation, stretching and breathing exercises. Yoga exercises are a complex and interwoven series of exact and controlled movements of major muscle groups which affect the alignment and structure of the body. Yoga has been proven to help reduce stress, lower blood pressure and regulate heart rate. Hospital Specialties *Hospital Accreditation status is verified directly with the Joint Commission, or American Osteopathic Association (AOA) when the provider is first credentialed and then at least every three years thereafter. For more information, please visit one of these websites. Acute Care Hospital A facility that provides short-term medical treatment for patients having an acute illness or injury or recovering from surgery. Alcohol/Drug Rehab Hospital Private A privately operated hospital that specializes in providing inpatient and outpatient counseling services for individuals who are coping with alcoholism and substance abuse. Facility typically consists of the following specialists: Behavioral Health Clinical Nurse Specialist, Psychiatrist of Addiction, Licensed Professional Counselor, Behavioral Health Marriage and Family Therapist, Nurse Practitioner of Psychiatry, Psychologist, Social Worker. Alcohol/Drug Rehab Hospital State Operated A state-operated hospital that specializes in providing inpatient and outpatient counseling services for individuals who are coping with alcoholism and substance abuse. Facility typically consists of the following specialists: Behavioral Health Clinical Nurse Specialist, Psychiatrist of Addiction, Licensed Professional Counselor, Behavioral Health Marriage and Family Therapist, Nurse Practitioner of Psychiatry, Psychologist, Social Worker. Behavioral Health Provider A person, partnership or professional corporation comprised of appropriately licensed persons (e.g., Certified Substance Abuse Counselor, Clinical Psychologist, Clinical Social Worker, Licensed Substance Abuse Treatment Practitioner, Licensed Practical Nurse, Marriage and Family Therapist, Mental Health Professional, Physician, Professional Counselor, Psychologist, Registered Nurse, School Psychologist, Social Worker). Hospice A hospice center is generally a not-for-profit community facility that supports terminally ill patients in their preparation for death. The philosophy of a hospice center is to provide comfort, not cure. People that are within six months of death are given comfort care along with specific comfort measures prescribed by their personal doctor. Other Ancillary Providers who do lab tests; radiology tests (X-rays); physical, speech and occupational therapies; ambulance services; and more. Outpatient Alcohol/Drug Rehab Facility A facility that specializes in providing counseling service in an outpatient setting for individuals who are coping with alcoholism and substance abuse. Facility typically consists of the following specialists: Behavioral Health Clinical Nurse Specialist, Psychiatrist of Addiction, Licensed Professional Counselor, Behavioral Health Marriage and Family Therapist, Nurse Practitioner of Psychiatry, Psychologist, Social Worker. Physical Rehabilitation Facility A facility providing therapy and training for physical rehabilitation. 21