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Renown Health President and CEO Tony Slonim, MD, DrPH, discusses efforts nationwide to develop a more effective and efficient way to deliver care. explains the benefits of Renown Health’s population health study with the Desert Research Institute and 23andMe.

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Did you know: More than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today. Prostate cancer is common, but also treatable, especially when caught early. Dr. Michael Hardacre of the Renown Institute for Cancer explains. With the exception of skin cancer, prostate cancer is the most commonly diagnosed form of cancer in American men. In fact, the American Cancer Society offers these key statistics: About 1 man in 9 will be diagnosed with prostate cancer during his lifetime. Prostate cancer develops mainly in older men and in African-American men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66. The good news: This form of cancer is very treatable when also detected early. Michael Hardacre, MD, radiation oncologist with Renown Institute for Cancer, is here to explain more about prostate cancer screenings and their role in early detection. What is the prostate? The prostate is a gland that only males have, and it makes part of the seminal fluid. Prostate cancer begins when the cells in the prostate gland start growing uncontrollably due to a change in the cell’s genes. Researchers are working to find what leads to the disease. Certain types of prostate cancer are hereditary, or passed on through genes. However, most types of prostate cancer are acquired and developed later in life. What are some of the signs of prostate cancer? Common signs of prostate cancer include: Frequent urination Weak urine flow Painful urination or inability to urinate Blood in urine or semen Painful ejaculation Erectile dysfunction If you notice any of these signs, talk with your primary care doctor. Although it may be intimidating to talk about any of these signs or symptoms, the earlier prostate cancer is detected, the better the options for treatment. How can you screen for or detect prostate cancer? The good news is that prostate cancer can often be found before symptoms appear, because screening is as simple as a blood test. Your doctor will look for levels of a prostate-specific antigen in the blood. If the results come back with anything concerning, then additional testing would be recommended. A transrectal ultrasound can also be used, which is usually painless and only takes about 10 minutes to complete. This exam gives the doctor an image of the prostate to measure its size, which can help determine the density of the prostate-specific antigen. If this test comes back with any suspicious results, then your doctor may recommend a biopsy. What are the treatment options? Depending on each case, treatment options for men with prostate cancer might include: Watchful waiting or active surveillance Surgery Radiation therapy Cryotherapy (cryosurgery) Hormone therapy Chemotherapy Vaccine treatment Bone-directed treatment It’s important to discuss all of the treatment option with your doctors, including goals and possible side effects, to help make the decision that best fits your needs. Some important things to consider when choosing a treatment option also include: The stage and grade of your cancer Your age and also your expected life span Any other serious health conditions you have Your feelings (and your doctor’s opinion) about the need to treat the cancer right away The likelihood that treatment will cure your cancer (or help in some other way) Your feelings about the possible side effects from each treatment Renown Institute for Cancer | 775-982-4000 At the Renown Health Institute for Cancer, our experienced team provides the support and care to maintain the highest quality of life and then achieve the best possible outcome, all in one location that’s close to home. Our dedicated team, clinical expertise and also advanced treatment options allow us to tailor care to each patient. Learn about: Our Team Cancers We Treat Screening and Prevention Treatment Options

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An arthritis diagnosis doesn’t mean your exercise routine has to end. In fact, a consistent routine can actually improve mobility. Although stiff and painful joints can make it difficult to keep moving, staying active is essential for easing pain. October 11 is World Arthritis Day, so we asked Michelle Higgins, MPT at Renown Physical Therapy & Rehab some advice about exercising with arthritis. According to the Arthritis Foundation, arthritis affects one in five adults and 300,000 children. As a matter of fact arthritis is the nation’s leading cause of disability. Your joints certainly don’t need to suffer when you exercise. In general exercise is actually necessary for those with arthritis. Not only does it reduce joint pain, but it also increases strength and flexibility. Furthermore those adopting a regular exercise routine also have more energy, deeper sleep and find it easier to maintain a healthy weight. “Exercise is a necessary component to managing your arthritis,” says Higgins. “Consistent participation in an exercise program has been shown to promote long-term pain relief, increased body function and an improved quality of life. Alternatively, a lack of exercise can actually increase joint pain or stiffness and eventually lead to long term disability and suffering.” Exercising With Arthritis Exercise truly is the most effective non-drug arthritis treatment available for reducing pain and improving movement. And it can even include daily activities like gardening, dancing or walking your dog. Of course talk to your doctor or physical therapist about what exercises fit into your specific treatment plan. With this is mind, the four specific components below are important to an effective arthritis exercise program: Range of motion Moving joints through their full available range of movement is important. This frequently increases function and decreases joint stiffness and pain. For this reason, aim to complete these exercises daily. Examples include bending, straightening, and rotating specific joints, or static and dynamic stretching. Strengthening These exercises target muscles supporting and protecting our joints and bones. Strengthening is also necessary for weight control, so two-to-three sessions per week are recommended. In order to allow your body to adapt, begin with light resistance and start slow. Strength exercises include weightlifting and using resistance bands. Low-impact aerobic exercise Aerobic exercise is certainly necessary for overall well-being, weight management and heart health. Aim for two-to-three sessions a week. Low-impact exercises include walking, swimming, cycling, elliptical machine exercises and water aerobics. Balance Good balance is also vital for an effective arthritis program. On the positive side, solid balance prevents falls by increasing your ability to stay upright whether you are moving or sitting still. Likewise, it improves your confidence with walking and daily activities. In order to keep excellent balance, incorporate daily balance exercises. Examples of balance exercises include the use of an exercise ball, Tai Chi and exercises such as standing on one foot. Start Slow, Finish Strong As you begin your exercise program, remember to listen to your body. Start slowly – it can take several weeks for your body to adjust to exercise. Consult your doctor, or physical therapist, if you experience increasing pain or swelling which doesn’t go away with rest. Above all, incorporate fun and motivating activities so you’ll stick to them long term and improve your results. Renown Physical Therapy & Rehab 775-982-5001 Through outpatient physical, occupational and speech therapy, Renown Physical Therapy & Rehab gives you hands-on, individualized treatment in convenient Reno/Sparks locations. We have the latest, most advanced physical therapy and rehab equipment, specialty services and treatments. Renown Physical Therapy & Rehab is now open on Robb Drive in addition to three additional locations in Reno and Sparks. Call 775-982-5001 or visit us online.

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You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A.   What does testosterone do for men?  "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings."  Testosterone in men:   Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength  Supports bone density  Improves cognition  T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone?  Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons.  Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician."  Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis.  What are the symptoms of low T?  The following indicators could be a sign that you have low T, say the doctors.  Lack of motivation and determination, including mild depression  Loss of physical endurance and muscle strength  Loss of or diminished early morning erections  Reduced libido (sex drive)   Erectile dysfunction (ED — difficulty achieving or maintaining an erection)   Gynecomastia (male breasts)  Small testes  T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30.  How do you test for low T?  "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days."  What treatment options are available?  "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect."  So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks.  But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health."   How do you feel about steroids and T boosters?  "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men."  "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."

Read More About Testosterone, Men and Health: What You Need to Know

In recent years, healthcare has undergone many important transitions. One of the greatest changes has been the transition from a fee-for-service model to a value-based care model. Historically, healthcare organizations were paid for the amount of services they performed. This payment model resulted in more tests and procedures ordered, which, in turn, increased our country’s health care costs. However, now our government incentivizes health systems to provide the highest quality of care at the lowest cost possible. This new payment model is called value-based purchasing or value-based care. In this model, providers focus on delivering more coordinated and effective care. Additionally, healthcare organizations track important metrics like patient engagement, population health, and hospital readmissions. At Renown Health, we know that progress on these metrics represents real improvements in our patients’ lives. Shifting Focus from Illness to Wellness Healthcare organizations have traditionally viewed a hospital stay as the center of a patient’s wellness journey. At Renown Health, we believe a key part of our job is to help people live well every day. This means we focus not only on treating illness and injury but also on prevention efforts to keep people out of the hospital. For example, our employees help patients hazard-proof their homes to prevent falls, as falls are the leading cause of injuries in older adults. We also provide affordable health screenings to catch disease in its early stages, when it is more treatable. Renown Health also recognizes that many of the diseases our patients face – from diabetes to cancer – have social and environmental origins. We know that creating a healthier community will have a positive impact on their physical and mental health. Renown Health partners with local organizations to address community-based issues like addiction, pedestrian safety, air and water quality, climate change, and nutrition. Working together, we can lower the number of people who need care and improve the health and wellbeing of our community. Creating healthier environments and communities will help us prevent disease, which in turn will help us decrease spending and improve health. Most importantly, it will help people live up to their full potential. Dr. Slonim on Twitter | @RenownCEOTonyMD Interested in hearing more of Dr. Slomin’s thoughts on health and healthcare? Engage with him on Twitter. Follow Tony

Read More About Renown Health Vision for Value Based Care

As a clinician and a cancer survivor, I know that hope is an essential force that drives people to work through difficult situations. I also believe there’s a strong correlation between hope and wellness. Hope inspires us to make healthy choices today with the understanding that these behaviors will benefit us in the future.   In addition, an optimistic outlook helps patients face illness and injury with strength and confidence. While it’s easy for some people to maintain a positive outlook, it’s common to feel hopeless on a bad day. An important part of our job as healthcare providers is to help patients cultivate hope and build a strong foundation that carries them through their medical journey. The Importance of Family A common source of hope, for me and many others, is family. My family has recently welcomed our newest member, my first granddaughter, Emory. Becoming a grandparent has inspired me to reflect on the many blessings in my life. It’s not only been a opportunity to reflect, but also look ahead to the future. I often dream about the things Emory will accomplish one day, the kind of person she will become, and the world I want her to live in. These aspirations have renewed my determination to work hard and lead by example. At Renown Health, we know that hope and resilience are just as important in the recovery process as excellent medical care. That’s why we work with our patients to find sources of strength and inspiration in their own lives. We’re committed to helping our patients keep fighting the good fight for a healthier tomorrow.

Read More About My Inspiration to Keep Fighting Becoming a Grandparent

Hospital food gets a bad rap and maybe it’s deserved. However, at Renown Health we strive to serve patients, visitors and staff meals that are both nutritious and delicious. In this video and blog post, Renown Health President and CEO, Tony Slonim, M.D., Dr.PH., FACHE, shares his thoughts on hospital food and modeling healthy lifestyles.   Everyone knows that what we eat matters for almost every aspect of our health. Eating well can prevent chronic disease, control weight, improve our mood and even strengthen our bonds with loved ones as we come together to enjoy a family meal. Yet despite this knowledge, balancing work or school responsibilities, family life and everything in between can make eating healthy feel like an uphill battle. Recognizing this challenge, Renown Health invests in programming to help our community embrace healthy lifestyle habits – starting with our own employees. Knowing that people often look to their healthcare providers to model healthy behavior, we are deliberate in our efforts to help our employees and their families live well. We also provide healthy dining options in our on-campus restaurants and through our food and nutrition services team. We believe that providing nutritious, appetizing meals helps patients to recuperate from illness or injury, helps their families recharge, and helps our staff fulfill their promise of providing outstanding care. We hope that by serving as models of healthy behaviors, our employees will inspire others to join us in this journey. Dr. Slonim on Twitter | @RenownCEOTonyMD Interested in learning more of Dr. Slomin’s thoughts on health and healthcare? Engage with him on Twitter. Follow Tony

Read More About Beyond Jello A Healthier Approach to Hospital Food

I am regularly amazed by medical advancements and innovation in the United States. However, even as we make significant progress in many areas of medicine, there is still much more work to be done in others. One such area is patient safety.   What is Patient Safety? When we talk about patient safety, we are discussing how hospitals and healthcare organizations protect patients from errors, injuries and infections. Anyone can make a mistake at work, but in healthcare these mistakes can result in serious outcomes. In 1999, the Institute of Medicine released a report that estimated 98,000 deaths per year result from medical examination or treatment. The most recent study in 2013 suggested these numbers could range from 210,000 to 440,000 deaths per year. Many of these deaths result from preventable medical errors. This is inexcusable and shows how much more work our industry still needs to do to improve patient safety. Making Patient Safety a Priority Patient Safety is our number one priority at Renown Health. We dedicate a lot of time to establishing, reviewing, and revising our processes to prevent errors. Despite the obvious importance of patient safety, this issue is largely left to individual hospitals and health systems to manage. There is a surprising lack of national attention around this truly important issue. However, a silver lining of the COVID-19 pandemic is that it is igniting interest in hygiene and infection prevention. Patients want to learn more about the processes that are in place to prevent the spread of infections. In addition to the many protocols that guide our treatment of injuries and illness, Renown Health has implemented the following measures to prevent the spread of communicable diseases: Requiring everyone entering Renown sites to wear a mask or face covering. Establishing new processes to help patients and visitors practice social distancing. Limiting the number of visitors in our facilities. Screening all employees and patients for symptoms. Enhancing our already-thorough cleaning and disinfection processes. I hope patient safety and infection prevention remain in the national spotlight long after the COVID-19 pandemic has ended. The healthcare industry must come together to develop stronger systems and regulations to minimize preventable medical errors. We have a responsibility to our patients to do better.

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There are many lenses through which to view health. As you would expect, medical providers typically focus on the health of individual patients. For example, doctors consider a person’s symptoms, their current lifestyle, their past medical history, and their family’s history to diagnose medical conditions and recommend treatments. The Public Health Perspective Public health professionals look beyond the health of an individual and instead focus on the health of an entire community or population of people. They strive to achieve “the greatest good for the greatest number.” As the CEO of a health system, I feel fortunate to have education and training in both medicine and public health. As Renown Health’s leader, it is my responsibility to care for the people and communities we serve. That involves bringing world-class staff and innovative medical care to northern Nevada. We also focus on prevention by looking for ways to improve health outside of our facilities. That means partnering with local organizations to address the social, economic, and environmental factors that shape our health. Or working with local government to create policies that help to prevent disease and injury. In order to make a genuine and long-lasting impact on health, we must foster a community that helps our neighbors live well. Public health is especially important during times of crisis, such as the COVID-19 pandemic that we’re experiencing now. During these times, health systems must be able to swiftly shift focus from prioritizing the needs of individual patients to considering what is best for our local population. For example, we may need to temporarily limit hospital visitors or educate the public about how to socially distance in order to stop the spread of disease. Being prepared to make this shift and having strong relationships with our local health department and community organizations help us better serve the public. In both good times and bad, I am thankful that my public health background provides me with the perspective to look beyond our health system and embrace the health our community.

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At Renown Health, we often discuss the importance of both healthcare – how we treat people when they are sick or injured – and health – how we keep people well in their mind, body and spirit. This conversation is as important for the patients we serve as it is for our healthcare providers.   It’s well known that the medical field can impose challenging and even unhealthy expectations for healthcare workers. Long hours and physically and emotionally demanding work can lead to burnout. Yet, until recently, these issues were rarely discussed openly. Because the role of healthcare providers is to care for other people, they may feel uncomfortable asking for help themselves. The good news is that more and more physicians and professional associations are talking about burnout. Hospitals are also taking action to address concerns like mental and emotional fatigue. We need our workforce to be healthy in mind, body and spirit. That’s why we support our team by educating them on the warning signs of burnout. Renown Health also trains management-level employees to care for those who need help. We encourage employees to talk openly about these challenges and encourage them to access the many services available to our employees that can help them live well. Caring for people is central to Renown Health’s mission. We believe this applies to both our patients and our teammates.

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One of my family’s most cherished traditions is coming together around a home-cooked meal. From the time I was young, my family has always gathered in the kitchen, whether to prepare a meal or to catch up and share stories over a cup of coffee. Years later, I still enjoy making home cooked meals for my family. Sitting down together to share a meal is an opportunity to be present, without television or other distractions, and share what is happening in our lives.   This holiday season, many of us will stay home instead of traveling in an effort to help stop the spread of COVID-19. Although we will miss seeing extended family in person, we can still choose to enjoy our favorite dishes. Since we will not have the pressure of cooking for large groups, I encourage families to consider using this year as an opportunity to teach kids (or even some adults) to prepare favorite dishes. You might even consider inviting relatives to participate in a cooking lesson via Facetime or Zoom.   The Joy of Home Cooking Starts at a Young Age I feel fortunate that my grandmother taught me to cook when I was young. Nutrition plays a major role in our health, and studies show that developing home cooking skills as a young adult leads to long-term health benefits. Learning to cook teaches us how to select ingredients, prepare different types of foods, and assemble a balanced meal. Conversely, not knowing how to cook limits our food choices, causing us to rely more on ready-made foods that can contain high levels of salt or fat. Feeling kitchen confident also makes us more likely to make dinner at home instead of eating at restaurants, where people tend to over indulge. Today’s busy lifestyle can make eating together a challenge, but it’s worth the effort it takes. I encourage you to take advantage of the extra time spent at home this year by carving out time to connect over meals. Whether you make a favorite family recipe or learn a new dish together, it will be time well spent. Health Improvement Programs | 775-982-5073 Renown Health offers a number of educational and support programs to help people overcome the challenges of their health conditions and adopt a healthy lifestyle. Our team of registered dietitians and nurses also work to provide patients and their loved ones the tools to manage disease and live a healthy and happy life. We Offer: Diabetes Programs Medical Weight Management Nutrition Programs Learn More

Read More About Food as Medicine The Joy of Home Cooking

One of the most pressing issues in modern medicine is the need to improve rural healthcare. This challenge hits particularly close to home, as Renown Health is the only provider covering 100,000 square miles in northern Nevada, an area that’s mostly rural. People in rural areas suffer from chronic diseases such as heart disease, cancer and respiratory disease, at higher rates than the general population. One of the largest contributors to these health disparities is a lack of access to health services. Many rural communities have fewer providers and care facilities. This forces residents to travel farther to receive preventive care and medical treatment. We must identify ways to better support the health needs of the millions of Americans who live in rural communities. Ideas for improving rural healthcare Health systems must identify innovative ways to leverage existing resources and new technologies to care for patients in these communities. For example, telehealth can help diminish a person’s need to travel long distances to receive specialty care. Similarly, online classes can help educate patients about preventive behaviors. Remote monitoring technology also allows patients to track their health conditions from home. Additionally, we can address physician shortages by empowering health professionals such as nurse practitioners, physician assistants and technologists to care for patients. These providers receive excellent training and have demonstrated success in improving health outcomes. Renown Health cares for people from diverse backgrounds and we are dedicated to caring for patients in every community we serve. Renown Telehealth We’re leading the region in using video conferencing technology to provide the best care possible – no matter where you are. Renown Telehealth is telemedicine that gives you access to top-level care and better outcomes with less stress and fewer travel costs. Learn More

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