Plus important tips for a healthy summer
Atlantic Health System’s Christopher Zipp, DO, is chair of the Department of Family Medicine at Morristown Medical Center. In his experience, among the many aspects of comprehensive care provided by family medicine practitioners, one of the most important is creating lasting relationships with patients.
Dr. Zipp sat down for a Community Conversation to discuss the role of family medicine in modern life, to talk about the importance of long-term plans for a person’s health, and to offer advice for avoiding the pitfalls of summer pastimes.
The Family Medicine Advantage
Perhaps the most important advantage to family medicine is that its practitioners can really get to know their patients. They learn their patients’ social structure and support networks and the impact those relationships have on the patient’s life and care. This gives family doctors insight into issues that come up in an exam room. Problems can be understood holistically, as part of where the patient lives and works, the pastimes they enjoy and with whom they enjoy them.
For Dr. Zipp, the value in knowing his patients this way increased significantly in the spring of 2020. As New Jersey locked down to help prevent the spread of COVID-19, people who would normally have come to the office were instead making Virtual Visits. And while that can be a powerful tool, it doesn’t let you hold a stethoscope up to a chest or test for reflexes. When Dr. Zipp had a relationship with the patient on the screen, he felt more confident in his diagnoses and decisions because he could hear differences in their voice and in their behavior that indicated problems and he knew them well enough to ask about what he saw and heard.
According to Dr. Zipp, family medicine engages patients in their own long-term care. As he gets to know a patient, one conversation that frequently arises is patients’ goals for their medical care and for their life more broadly. “You’re X-age,” Dr. Zipp asks hypothetically, “how does your condition look 40 years from now? How can we manage that now? What investment in your health do we need to make now so that you have a 40-year plan that allows you to enjoy your life?”
When Dr. Zipp offers his patients this big-picture perspective, he’s found it to be a powerful motivator. People are more likely to exercise, get better nutrition, and take their health more seriously, when they understand they’re working for their own future.
Potential threats of summer fun
Summer is an opportunity to spend time outside and enjoy the weather. But it comes with health challenges that often bring people to their doctor.
“Everybody knows,” Dr. Zipp says, “to wear sunblock. But something people forget is that you have to put it on 30 minutes before you’ll need it.” A minimum SPF (Sun Protection Factor) of 15 is recommended – under ideal conditions, it blocks 93% of the sun’s rays. SPF 50 can block as much as 98%. Going above that isn’t really beneficial. Choosing something in between, based on your needs, is ideal, Dr. Zipp says. Remember to reapply sunscreen every hour or two, depending on your activity. If you’re swimming or sweating heavily, for example, it’s worth increasing that frequency. However, cautions Dr. Zipp, “Children younger than six months shouldn’t be exposed to the sun. Keep them in the shade, with cool clothing.”
Everyone, and especially young children, should wear hats that provide cover for their neck and ears – not just baseball caps.
With the summer sun comes rising temperatures – and it’s critically important to stay hydrated in the heat.
While many people know the signs of heat exhaustion and heat stroke, what they fail to realize is that the process starts before those easily recognized symptoms begin. Heavy sweating, or a little bit of faintness or dizziness, are early signs of heat exhaustion that often go ignored. Heat cramps and rashes are also early symptoms that can be treated by cooling down the body’s core temperature and by hydrating.
If you experience any of these symptoms, stop what you’re doing. Find some shade or air conditioning. Get something to drink with electrolytes. Children especially, when they’re outside playing, need to be reminded to take breaks and stay hydrated.
If you’re with someone who seems to be disoriented due to overheating, that’s a very big problem. The person needs to be cooled down immediately.
Bugs and other pests
Summer puts people more at risk of meeting insects, arachnids, and other pests. But especially in 2020, when many amenities are still in lockdown and people are looking to spend their time outside socially distancing, the chances are increased of having a bad encounter with ticks, chiggers, fleas, spiders, mosquitoes, bees, wasps, and more.
According to Dr. Zipp, many people opt for natural repellents such as lemon or eucalyptus, “but nothing is more effective than DEET,” he says. DEET is safe for children as young as two-months-old. It’s safe to apply to the skin, but follow the instructions on the label – often, application only once a day is recommended.
Especially for children, don’t apply DEET to the hands. Over the past few months, as we all have worked to prevent the spread of COVID, how difficult it can be to not touch our own face has become something of a meme. While safe when used properly, DEET needs to be kept away from the face and especially out of the eyes and mouth – which means not putting it on the hands, either.
Returning to life during COVID-19
Nationally, the U.S. is still seeing roughly 50,000 new COVID cases per day. New Jersey, meanwhile, has gotten its case load down to averaging less than 500 per day. While that’s great news for New Jerseyans, it’s important to remember that we have our continued vigilance to thank for that success.
Public swimming pools in New Jersey were allowed to reopen June 22, provided they met critical health standards. Athletes are returning to sports practices and competitions both in schools and in clubs in the coming weeks, if they haven’t already. And, of course, families want to take vacations.
All of that comes with some risk. “The best way to mitigate those risks,” says Dr. Zipp, “is to be smart. Listen to the guidance. Individualize your decisions.” If you had planned a trip to Texas or Arizona or another current hotspot, ask yourself if you can follow the guidelines to quarantine for 14 days.
If your habit in 2019 was to go to the pool on the weekends, ask yourself if you can do that and remain physically distant from other swimmers. If you have a 16-year-old who’s okay staying six feet away from other people, not lining up for the diving board or playing Marco Polo, then probably that’s okay. But if you have a toddler who has a habit of grabbing the hand of every adult they pass, you might need to rethink that trip to the pool.
“The key,” Dr. Zipp stresses, “is to heed the guidance to mitigate the disease.” And remember that, while New Jersey is doing well, the pandemic isn’t over.
Health care in summer 2020
When asked about the safety of visiting a family doctor considering COVID-19, Dr. Zipp says, “It’s amazing the transformation that’s gone on in health care … the complete workflow has changed.” Instead of people congregating in waiting rooms, they now ‘sign in’ by calling the office from their cars. As they come into the building, they’re screened for fever or other symptoms, and are brought straight to an exam room.
The opportunity ever to cross paths with another patient – or even unnecessary medical professionals – has been minimized. And that’s on top of the increased mask-wearing, heightened hand-washing policies, strict cleaning, and all the other best-practices that are being followed.
An ounce of prevention …
The basic tenets of long-term health haven’t been much changed in 2020; exercising, eating right and getting plenty of rest is still the foundation of success. “And as an added bonus this year,” Dr. Zipp quips, “wear your mask.”
On top of that, Dr. Zipp encourages people to know their numbers regarding things like cholesterol, diabetes, and blood pressure. “Get a doctor,” he stresses. “See your doctor. Know your risks, and go into your 30-, 40-, or 50-year plan wide-eyed, with knowledge, and make informed decisions about how you want to live your life.”