Healthy Weight, Diabetes and Your Child

By Troy Nelson, MD, Medical Director at DMG Children’s Rehabilitative Services

children outdoors


Did you know November was American Diabetes Month?  According to the American Diabetes Association, more than 34 million people in the United States have diabetes, and more than seven million of those people are undiagnosed. About 210,000 Americans under age 20 are estimated to have diagnosed diabetes.

Type 1 Diabetes: Diagnosed at Younger Ages

According to the Centers for Disease Control and Prevention (CDC), type 1 diabetes accounts for approximately 5-10% of diabetes cases in the United States.  Symptoms of type 1 diabetes often develop quickly. It’s usually diagnosed in children, teens, and young adults.

Type 2 Diabetes: Increasing Pediatric Cases

Type 2 diabetes is the most common type and is generally diagnosed in middle age or older.  However, the incidence is on the rise in children because more children are becoming obese.  Being overweight or obese increases the risk of developing type 2 diabetes, regardless of age.

Symptoms of Type 2 Diabetes in Children

Your child may develop type 2 diabetes so gradually that there are no noticeable symptoms. Sometimes, the disorder is diagnosed during a routine check-up, which is why regular well-child exams are important.

Symptoms of type 2 diabetes in your child may include:

• Blurry vision
• Darkened areas of skin, especially around the neck and armpits
• Fatigue
• Frequent urination
• Increased thirst

Type 2 Diabetes Risk Factors in Children

• Age and sex: Many children develop type 2 diabetes in their early teens. Adolescent girls are more likely to develop type 2 diabetes than are adolescent boys.
• Family history
• Inactivity
• Overweight, especially in the abdomen
• Pre-term birth (before 39-42 weeks)
• Race or ethnicity: Black, Hispanic, American Indian, and Asian American people are more likely to develop type 2 diabetes

Preventing and Managing Pediatric Type 2 Diabetes

You can help decrease the risk of your child getting type 2 diabetes as well as help manage it if your child has been diagnosed.

• Get an annual well-child exam with your child’s pediatrician or family medicine provider.
• Eat healthy foods as a family; encourage your child to participate in meal planning and preparation.
• Ensure your child gets plenty of physical activity; identify activities you can do as a family, like hiking or walking the dog.
• Help your child maintain a healthy weight.

DMG Children’s Rehabilitative Services includes pediatric and young adult providers,  endocrinologists and nutritionists to support your child and your family.  We are committed to educating you and your child and developing treatment plans to optimize your child’s health and long-term wellness.


Supporting Your Kids through Holiday Stress

By Melissa Meyer, DNP, PMHNP-BC, child psychiatry specialist at DMG Children’s Rehabilitative Services

family at Christmas


The holidays are a time of peace, love, joy, and family, but it’s also a time where schedules are irregular, routines are disrupted, meals are heavier, and sugar abounds.  For children of all ages, these changes can be difficult; if the child has depression, anxiety, an eating disorder, attention deficit disorder (ADHD) or other emotional or behavioral health challenges, the holidays can compound the issue.

Did you know?

  • Depression and anxiety: According to a 2019 study published in the Journal of Pediatrics, about 1.9 million children ages 3 to 17 years have been diagnosed with depression, and 4.4 million have been diagnosed with an anxiety disorder.
  • ADHD: Nearly 6.1 million kids ages 2 to 17 have been diagnosed with ADHD, according to a 2018 study in the Journal of Clinical Child & Adolescent Psychology.

If your child suffers with emotional or mental health issues, here’s some tips to help you child and your family decrease the stress and impact of the holidays:

  • Communicate plans: With each activity or outing, let the child know what will be happening ahead of time- who will be there, how long you will be staying, what food to expect, etc.  Knowing what will be happening will help decrease anxiety.
  • Share feelings: If you are feeling stressed, tired, or anxious, share your feelings with the child.  He or she will take comfort in knowing that even adults get nervous and stressed during the holidays.
  • Maintain a sleep schedule: Everyone in the family will benefit from a good night’s rest, especially children. According to the American Academy of Sleep Medicine, kids with mental health issues need adequate sleep; for teens, 8 to 10 hours per night is recommended.
  • Manage screen and device time: When adults are busy, it’s easy for children of all ages to occupy themselves with television, video games, and social media. However, too much “technology time” has proven to negatively impact sleep as well as contribute to depression.
  • Keep medication schedules: If a child takes medication, ensure he or she continues to take it at the same time each day.
  • Watch sugar intake: Help keep the child’s diet balanced with regular nutritious meals and limit sweets and sugar-filled drinks, especially before bedtime.

Most importantly, be aware of the child’s mood and listen to him or her.  The child or teen make need some downtime in between the hustle and bustle of the holidays.  Allow time in the family’s schedule for everyone to decompress, so each member of your family can enjoy the spirit of the holidays.

What’s the Connection between Healthy Weight and Diabetes?

By Brett Willden, DO, family medicine physician

overweight family near the water


Did you know November is American Diabetes Month?  According to the American Diabetes Association, more than 34 million people in the United States have diabetes, and more than seven million of those people are undiagnosed.  

There are two types of diabetes, type 1 and type 2, and in both cases, healthy weight management is important.  However, why weight management is important is different.

Type 1 Diabetes 

According to the Centers for Disease Control and Prevention (CDC), type 1 diabetes accounts for approximately 5-10 percent of diabetes cases in the United States.  Symptoms of type 1 diabetes often develop quickly. It’s usually diagnosed in children, teens, and young adults.

Like type 2, increased thirst and urination are common symptoms of type 1 diabetes.  Undiagnosed or untreated, type 1 diabetes can cause weight loss.  

Unlike type 2, developing type 1 diabetes is not related to being overweight, but keeping a healthy weight is important. Too much fat tissue can make it hard for insulin to work properly, leading to both higher insulin needs and trouble controlling blood sugar.

Type 2 Diabetes 

Type 2 diabetes is the most common and is generally diagnosed middle age or older.  Being overweight or obese increases your risk for developing type 2 diabetes, regardless of age.  As well, if you have type 2 diabetes, weight gain complicates the condition as it makes blood sugar levels even harder to control.

Healthy Weight Management

Many primary care providers (PCP) treat patients with diabetes and other chronic conditions, as well as help patients understand how to live a healthy lifestyle to decrease their risks of diabetes and other diseases.  Our goal, as PCPs, is to identify treatment plans that are achievable based on the patient’s lifestyle.  Talk with your PCP about identifying a weight loss program that’s right for you, your lifestyle, and weight loss goals.  And remember, weight management is a long-term lifestyle- not a short-term fix.

Dental Health in Children: Get the Facts

By Lyn Hughes, dental hygienist, DMG Children’s Rehabilitative Services

parent and doctor showing young child how to brush teeth

October is Dental Hygiene Month, which is somewhat ironic as Halloween, the day of the year where children probably get more candy than ever, is also in October.  So, why not take this month to talk to your children about the importance of taking care of their teeth?

Getting your children into healthy dental habits now can save them time and pain and give them advantages throughout their lives.  According to the Centers for Disease and Control and Prevention (CDC), children who have poor oral health often miss more school and receive lower grades than children who don’t.

Did you know cavities are one of the most common childhood diseases in the United States?

When untreated, tooth decay can cause pain and infections which can lead to problems with eating, speaking, playing, and learning.

The CDC also shares these facts about cavities in children:

  • 20 percent of children ages 5-11 and 13 percent of adolescents have at least one untreated cavity.
  • Children ages 5-19 from low income households are more than twice as likely to have untreated tooth decay.
  • About one-third of cavities in baby teeth can be prevented by a fluoride varnish.
  • Dental sealants applied to the surfaces of back teeth can prevent 80 percent of cavities.

Beginning dental care when your child is a baby is a great first step towards optimal dental health.  Schedule your child’s first pediatric dental care appointment at the age of one to spot signs of early problems.  We’ll help you identify good at-home dental habits to engage your child in taking care of his or her pearly whites for a lifetime.

What Is Pediatric Physical Therapy?

By Linda Thunn, DPT, physical therapist at DMG Children’s Rehabilitative Services

young child receiving physical therapy

Did you know October is National Physical Therapy Month?  Each year during October, the physical therapy team at DMG Children’s Rehabilitative Services (DMG CRS) supports the Spina Bifida Association of Arizona through their annual Walk-N-Roll® fundraiser.  The team is passionate about serving patients I and outside of the clinic.

What do pediatric physical therapists do?

Pediatric physical therapists provide services for children with developmental disabilities from birth to 21 years-old; in addition, the team provides support and education to the patient’s family.  At DMG CRS, our goal is to develop, restore and/or improve mobility to enhance quality of life for the child and his/her family.

Pediatric physical therapy benefits children and their families and/or caregivers by promoting activity and participation in everyday routines, increasing functional independence, improving strength and endurance, facilitating motor development and mobility, and easing the challenges of daily caregiving.

The team has also begun serving adults with disabilities who may benefit from the services specifically available through DMG CRS.

DMG CRS physical therapists treat patients one-on-one in the physical therapy and rehabilitation clinic at DMG CRS as well as serve patients being treated at other DMG CRS clinics such as:

DMG CRS physical therapists also perform equipment evaluations, trialing each child in specialized equipment before ordering it to determine what works best. Types of equipment evaluations provided include:

  • Adaptive seating
  • Adaptive car seats
  • Forearm crutches
  • Gait trainers
  • Standers
  • Walkers
  • Wheelchairs

Additional Content

For more information on DMG CRS equipment evaluation services, watch this video.

For additional information on  the services offered by DMG CRS physical therapists, view this video.


Detecting Breast Cancer Early

By Faith Cutrona, FNP-C, family nurse practitioner

happy group of people in front of brick wall


October is Breast Cancer Awareness Month, and as a primary care provider and woman, sharing information to help women understand the importance of early detection is the most important care I provide.  The more each patient is educated, the greater the chance that she will get regular exams so breast cancer- or another disease- can be caught early.

Did You Know?

According to the American Cancer Society, breast cancer……

  • Is the second most common cancer in women in the United States. The first is skin cancer. The average risk of a woman developing breast cancer sometime in her life is about 13 percent.
  • Typically has no symptoms when the tumor is small and most easily treated.
  • Impacted approximately 268,000 women in 2019.
  • Risk increases with age.
  • Survival rate drops to less than 30 percent if the cancer has spread (aka “metastasizes”) outside of the breast to other organs in the body.

Early Detection: What You Need to Do

Remember, if detected early, the breast cancer survival rate greatly increases.  Women who get breast cancer screenings decrease their chance of dying from breast cancer by 30 percent.  Breast cancer screening saves lives, and getting an annual mammography is the single most important thing a woman can do to lessen her chances of dying from breast cancer. Mammography can detect cancer at early stages before a lump can be felt or symptoms are experienced.  

An annual mammography is recommended for women age 40 and older and may be recommended sooner if the patient has had cancer or if a history of cancer is in the family.  Understanding and sharing your complete family medical history with your primary care provider (PCP), therefore, is critical.  In addition to annual mammography, your PCP will also recommend you do self-exams of your breasts at-home and can help you understand how to do these exams.

Screening Mammography: What to Expect

A breast screening are also called  a “screening mammogram,” which is the type of mammogram ordered when the patient has no symptoms and/or signs of changes in breast tissue.  A mammography is a fast procedure (about 20 minutes), and discomfort is minimal for most women. During a mammography, a low-energy x-ray is used to examine the breast for early signs of breast cancer.  The small amount of radiation the patient is potentially exposed to is so small that the benefits outweigh the risk.

3D mammography is being used increasingly, especially for women with dense breast tissue. FDA-approved, 3D mammography takes pictures of thin “slices” of the breast from different angles, and computer software is used to reconstruct an image.  In contrast, a standard mammography takes a single image.

Changes in the Breast: What Next?

If changes in one or both breasts are detected, a diagnostic mammogram will be ordered.  Changes in breast include:

  • Changes in skin texture of the breast
  • Inversion in the nipple
  • Nipple discharge
  • Pain in the breast
  • Palpated lump

If breast cancer is detected early, a mastectomy or total breast removal can be avoided.  Localized cancers can be managed through other treatments, which may include a lumpectomy, radiation and/or chemotherapy.

The key is early detection.  Schedule your annual exam with your PCP today, and include breast screenings in your wellness plan.

Healthy Aging: Tips for Your Health

By Lauren Lambert, FNP-C, family nurse practitioner

couple running the forest


First introduced when baby boomers began turning 50, September is Healthy Aging Month.  While September marks “back-to-school” for children, we adults can use this time to learn some new lessons to support our overall health and wellbeing.

As a primary care provider (PCP), I support the health and wellbeing of adult patients, and each patient is different.  However, one thing remains the same: our health is dependent on physical, emotional, and mental wellbeing.  Here’s some tips to support each of these areas for healthy aging.

Preventive medical exams

Stay on top of your annual wellness exams and screenings.  As we age, the types of screenings recommended change and include:

  • Diabetes testing: Begins at age 45 and should be completed every three years
  • Colon cancer screening: Should begin no later than age 50 and be done every five years
  • Osteoporosis screenings: Should start no later than age 65
  • Blood pressure readings: Should be taken annually, beginning at age 45
  • Vision and balance: To prevent falls resulting in hip fractures, traumatic brain injuries or even death, both your vision and balance should be checked at least annually.

For all the above, if you have a personal or family history, your physician may recommend tests or screenings begin earlier or be done more frequently.

Physical activity

Staying active is exercise for your body and brain and helps reduce stress.

  • Exercise: Exercise daily. Choose an activity you like so you look forward to doing it.
  • Balance: Identify an activity that helps you maintain balance and flexibility, like yoga, to decrease your risk of falls.  Your PCP can also provide exercises to improve your balance.


See old friends as well as make new ones; socializing is great for the brain and supports emotional wellbeing.  In addition, you may find others with whom to enjoy exercising and new activities.

  • Volunteer: Most of us have a ton of life experience, which can enrich the lives of others. Find a cause that speaks to you and volunteer your time and skills to help others.
  • Play cards or board games: Games keep our minds sharp and provide a great way to socialize and meet new people.


Getting the right amount of sleep is important throughout our lives.  As we get older, ensuring we get enough sleep- but not excessive- is important to refresh our bodies and minds.

Prostate Cancer Awareness

By Richard Fowler, MD, internal medicine physician

prostate cancer awareness


Each year, more than 160,000 men in the United States are diagnosed with prostate cancer, and approximately 19 percent die from it.  Prostate cancer is the second leading cancer-related cause of death among men.  To raise awareness and early detection, September is designated as Prostate Cancer Awareness Month.

Five facts about prostate cancer:

  1. Prostate cancer is typically slow-growing, making early detection more likely if the patient sees his physician for regular exams and screenings.
  2. Older men are more likely to get prostate cancer. About 60 percent of cases are in men age 65 and older.
  3. African-American men are more likely to develop prostate cancer than white or Hispanic men; Asian men have a lower risk.
  4. Major risk factors are genetics and family history. Studies examining the link between prostate cancer and a diet high in red meat, chemical exposures including smoking, sexually transmitted infections and having had a vasectomy have produced conflicting results.


The American Cancer Society recommends that at age 50, men discuss the risks and benefits of screening with their physician.  African American men and those with a family history of prostate cancer should have this discussion at age 40-45.  Screening includes two tests one of which is a blood test and the other a digital rectal exam.


Early stage prostate cancer may cause few or no symptoms.  As this cancer progresses and tumors grow, symptoms may include:

  • Blood in the urine or semen
  • Difficulty getting an erection
  • Difficulty urinating
  • Pain in the lower back and hips

As the cancer spreads and/or metastasizes, other symptoms, like bone pain, may occur.  Treatment is dependent on the stage of the cancer and may include medications, surgery, radiation, chemotherapy, hormone therapy, and/or other options.

Talk with your primary care physician for more information on prostate cancer and your risks.

Newborn Screenings: What You Need to Know

By Troy Nelson, MD, pediatrician and medical director, DMG Children’s Rehabilitative Services

Newborn Baby

Did you know September is Newborn Screening Awareness Month?  Newborn screening allows identification and treatment of a disease before symptoms even emerge.  A newborn may appear healthy, but still have a serious condition that cannot be seen.  If left untreated, these conditions can lead to slow growth, blindness and/or intellectual disability, and may be life threatening. Early detection and treatment can help prevent these serious problems, which is why newborn screening is critical.

Based on published research by Dr. Robert Guthrie in 1963, newborn screenings have evolved with newborns now being screened for more than 25 conditions within days of birth; screenings involve just a few drops of blood.  According to the National Institute of Health, newborn screening detects a treatable condition in about 1 in 300 babies born each year, a total of about 12,500 cases each year. In Arizona, approximately 100 babies annually are found to have a serious condition identified through newborn screening.

Providers in Arizona are required by law to order newborn screening tests for all newborns.  Arizona requires newborns to be screened twice to help ensure accuracy, as some conditions are easier to detect on a subsequent screen.  In addition, approximately 98 percent of all infants born in Arizona are screened for hearing loss prior to hospital discharge.  The first screening sample will be taken before the newborn leaves the hospital and the second will be taken between 5-10 days after birth, or at the first well-baby visit, whichever comes first. For those newborns born at home, the healthcare provider present at the birth will collect the first screen.

At DMG Children’s Rehabilitative Services (DMG CRS), we provide specialized treatment for newborns for which a condition was detected during screening.  Our goal is to provide most medical specialties and services in one location by physicians and staff that work exclusively with children.  With early detection, intervention, and treatment, we can partner with you and your family to enable your baby to thrive to the maximum of his or her abilities.

UV Safety for Motorcyclists

By Ivan Filner, DO, family medicine physician

Dr. Fillner on a MotorcycleAnyone who knows Dr. Filner knows that when he is not caring for patients, he can be found riding his Harley. In Arizona, we are fortunate to have many great months for long rides due to Arizona having more sunny days (85-90 percent per year) than almost all other states. In fact, we have more sunny days per year than California and Florida.

Have you ever heard the saying, “For every strength, there is a weakness?” This “law of opposites” applies to our good fortune in having so many sun-drenched days. The downside is more exposure to ultraviolet (UV) rays, which can result in premature aging of the skin and worse- skin cancer. Even on sunny days in winter, UV rays are just as harmful.

As a motorcycle rider, we wear protective gear from head-to-toe, so why would we need to worry about excessive UV ray exposure? Even with a full face helmet, parts of the face- primarily the nose, cheeks and lips- are exposed for longer than you think…long enough to put you at risk of a severe sunburn, which can lead to skin cancer, including melanoma.

Fortunately, protecting yourself from dangerous UV rays while riding is easy. Follow these tips year-round to ensure you’re riding for a long time to come.

1. Protect your face, neck, ears, and other exposed skin

Carry a small tube of sunscreen with an SPF of 30 or more in your jacket pocket, tank bag or panniers, and re-apply every two hours during your ride. If your sleeves do not quite meet your gloves, put sunscreen on your wrists.

2. Shield your lips

As your lips are also vulnerable to skin cancer, use a lip balm with an SPF of 30 (but no less than 15) and, like sunscreen, reapply throughout your ride.

3. Safeguard your eyes

Did you know melanoma can occur in your eyes? While they may be a bit more expensive, choose sunglasses that provide 100 percent UV protection, or UV 400 protection.

4. Protect the back of your neck

In addition to sunscreen, a light neck sock with an SPF rating is a good way to protect the back of your neck (and parts of your face), especially for sports bike riders who are bent over.

When many of us stop during our ride, we take off some gear, leaving more of our skin exposed to the sun. Be certain to apply sunscreen to those areas. A sunburn and/or the start of melanoma only take minutes, especially when in direct sun during our beautiful Arizona days.

We’re Here for You…Safely

doctor with gloves and face mask

Valued DMG Patient:

As part of the District Medical Group (DMG) family, we want to ensure you know we are here for you. Throughout the COVID-19 pandemic, DMG locations across the Valley have remained open to support the health of our patients.

We understand you may have concerns about leaving your home right now, especially if you or a family member is not feeling well and needs medical care. We are employing safety measures recommended by the Centers for Disease Control and Prevention (CDC) to protect you and your family as well as our staff, including:

  • Safe screening practices for all patients and families prior to an in-person office visit
  • Availability of telehealth appointments, as appropriate, so you can meet with your DMG provider safely and securely from home
  • Enhanced office cleaning and personal protection procedures, with hand sanitizer readily available in our locations
  • Social distancing measures at check-in, checkout and in our waiting rooms, including rapidly moving patients that are sick to a private room
  • Use of masks and face shields by all providers and staff while caring for our patients
  • Providing cloth facial coverings to patients and any required family member entering the clinics without a cloth masks

Whether you or a family member needs to visit a DMG primary care location for preventive care (i.e. annual exams, screenings or vaccines), treatment of seasonal allergies or illness, behavioral health support, or management of a chronic or complex condition, we are here for you, providing a safe, clean environment. Our DMG primary care and behavioral health locations are open and available for in-person and telehealth appointments.

Contact the desired location to get the care you need when you need it:


Behavioral Health

DMG Desert Horizon Integrative Medicine
840 E. McKellips Rd., Ste. 110
Mesa, AZ 85203
(602) 470-5520


Internal Medicine

District Medical Group- East Mesa
(formerly Arizona Center for Internal Medicine)
6315 E. Main St., Ste. 4
Mesa, AZ 85205
(480) 830-4164


Family Practice

District Medical Group- Anthem*
(formerly Choice Medical Walk-in)
3624 W. Anthem Wy.
Anthem, AZ 85086
(623) 434-5748

District Medical Group- Lake Pleasant*
(formerly Choice Medical Walk-in)
10144 W. Lake Pleasant Pkwy., Ste. 1110
Peoria, AZ 85382
(623) 434-5748

*Walk-in care available at these locations

District Medical Group- Arrowhead
(formerly M&M Medical)
15182 N. 75th Ave.
Peoria AZ 85381
(623) 487-3334


For more information on each location’s hours of operations, services, and providers, visit If you have any concerns, do not hesitate to call us. You are part of the DMG family, and we are here for you.

David Wisinger, MD
Chief Medical Officer
District Medical Group

Three Tips for Parents of Children with Differences

By Nicholas Tanner, PhD, Pediatric Psychologist at DMG CRS
PHOENIXNovember 30, 2018 /

Dr. Nick Tanner

As a parent of a child with health, developmental and/or behavioral differences, you become more than a parent- you are an advocate, a champion and your child’s loudest voice. Here’s three tips to help you and your child’s health and quality of life. And, never forget that your child’s care team at DMG Children’s Rehabilitative Services is here to support you every step of the way.

(1)  Advocate relentlessly.  Sometimes, your life may feel a little like it is “us against the world.” When parents have a kid with extra needs or differences, contentious situations and relationships can arise between parents and your child’s school, healthcare providers, and/or government agencies; never stop advocating as you know your child best.

As a pediatric psychologist, part of my job is encouraging parents to engage with these complex systems of care, help them navigate the procedural challenges inherent in these systems, and facilitate collaboration to help patients and families thrive. Although it’s important to have realistic expectations, the old saying is true- “the squeaky wheel gets the grease.” Families and parents who are persistent tend to be more successful in getting enhanced individualized and intensive attention. Though conflict can be uncomfortable, it’s important to be your child’s biggest champion; advocate relentlessly.

(2)   Focus on the big picture. Parents can understandably get caught up in what their children’s
limitations are- right now-in the present. They may lose sight of the long-term goals and potential of their child- what’s really important. Part of my job at DMG CRS is helping parents and families identify and connect with their values. Most parents want their children to live vital and meaningful lives, and sometimes an extra need or illness can make it hard to see what’s important in the long run.

Identifying values is one way to help figure out the big picture. Values can act as a compass, providing direction and assisting parents to move from a place of “My child can’t do this,” “What if they fail?” or “My child will never….” to a more productive vision of possibilities. My goal is to help parents begin to ask, “What can my kid do now?” “What do I hope they’ll be able to do in the future?” and “How can we help them get there?” Think about the long-term vision for your child’s life and his/her possibilities; dare to dream and focus on what’s important.

(3)  Take care of yourself. For good reason, many parents do not consider themselves or their well=being a priority or critical to their child’s outcome. On top of the already hectic demands of parenting, families of children with extra needs have additional financial and time requirements and/or strains. Many families I work with manage busy schedules that include juggling therapy appointments, doctor visits, school, parenting other children, and work.

Remember, there’s a reason the flight attendant tells parents to “put on your air masks before putting on your child’s air mask in the event of an emergency;” it’s impossible to help other people if you do not take care of yourself. Research shows that socially-isolated parents struggle to build fulfilling relationships with their children and are more likely to develop mental illnesses, including depression. It’s not “selfish” to take care of yourself; it is essential and necessary.  So, go ahead and make that therapy appointment for yourself, get a pedicure, or meet up with some supportive friends. It might be one of the  best things you can do for yourself and  your child.



District Medical Group Children’s Rehabilitative Services Adds Providers to Serve More Children with Complex Medical Needs

PHOENIX (October 2, 2018) – District Medical Group Children’s Rehabilitative Services (DMG CRS) announced the addition of two pediatric specialty physicians serving patients at its multi-specialty interdisciplinary clinic (MSIC) located in Central Phoenix at 3141 N. 3rd Avenue in Park Central Mall. A first-of-its-kind MSIC in Maricopa County, DMG CRS has been the exclusive medical home for AHCCCS Complete Care patients since 2012.


Ashley Tian, MD


Kelvin S. Panesar, MD

The following pediatric specialists are serving patients at DMG CRS effective October 1, 2018, bringing the total number of pediatric medical providers at the Valley of the Sun’s only MSIC to 88 across more than 25 medical specialties.

• Pediatric Neurosurgery: Ashley Tian, MD
• Pediatric Pulmonology: Kelvin S. Panesar, MD

Three to five more pediatric specialists are anticipated to be added by the end of 2018, and DMG CRS will continue to add specialists in 2019.

“Helping children with complex medical conditions have the highest possible quality of life is the reason I became a physician,“ said Ashley Tian, MD, a Banner Children’s pediatric neurosurgeon who treats patients at DMG CRS. “I chose to work at DMG CRS to be part of a team that coordinates care and supports, not just the patient, but the whole family, as part of the treatment plan.”

complete-careIn its commitment to providing coordinated care, DMG CRS also has primary care, dental, social workers, patient advocates, CRS enrollment specialists, child life and care coordinators and other services on-site to support patients and their families.

“Serving pediatric patients with complex medical conditions is what DMG CRS was specifically designed for; we are the only clinic in metropolitan Phoenix that provides coordinated care across medical specialties all in a one-story, easy-to-access clinic, “said Wendy Burkholder Chief Clinical Operating Officer for DMG. “Our patients rely on us to make care for complex conditions as easy and accessible as possible, and we are thrilled to have providers join our team that share our vision.”

Effective October 1, 2018, changes to AHCCCS Complete Care (ACC) expanded services, enabling families with CRS patients to bring other children in the family to DMG CRS. For more information on ACC changes, visit

Pediatric providers interested in serving patients at DMG CRS can call the director of operations at (602) 914- 1522 or email

About District Medical Group and DMG Children’s Rehabilitative Services (DMG CRS)

District Medical Group (DMG) is a nonprofit entity consisting of more than 650 providers representing all major medical and surgical specialties and subspecialties. DMG providers serve acute care and psychiatric hospitals, diagnostic centers, family health centers, an internationally-recognized burn center, and numerous outreach programs. DMG Children’s Rehabilitative Services (DMG CRS) is a first-of-its-kind clinic in the Phoenix area, serving AHCCCS Complete Care (ACC) pediatric patients with complex conditions and other children within the family. For more information visit

Media Contact
Toni J. Eberhardt
President, Prescriptive Communications
C: (602) 418-7767
Email Toni


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Innovative use of EMR helps identify more Make-A-Wish kids

Make-A-Wish Arizona, the local chapter of the international wish-granting organization, and District Medical Group (DMG), a Phoenix-based non-profit medical group comprised of more than 650 providers across medical specialties, are piloting a unique referral process to increase life-changing wish opportunities for eligible children receiving care at DMG Children Rehabilitative Services (DMG CRS) in Phoenix.

The “Medical Champions” program was created by DMG using their electronic medical records (EMR) system to better identify and track children with critical illnesses who would qualify for a wish experience. Read more

Ask a Doc: Do your kids need sunscreen if they’re in the shade?

You should put sunscreen on your kids even if they’re playing outside in the shade. – Paul Bradbury, Getty Images

Mansi Sarihan, MD  |  Contributor
As originally published 9:20 p.m. June 18, 2018

Question: Do you need to wear sunscreen if you’re outside in the shade?

Answer: I receive this question often and every time I answer:

Definitely yes!

You may think you’ve got it made in the shade, but you can still be hit by harmful UV rays that bounce off the sand, sidewalk, pool or ocean. They can even bounce off grass!

Even under an umbrella or a shade structure, UV rays can slink through the fabric and cause skin damage.

Yes, shade is a blessing. But if you’re relying on it to protect your skin from sunburn, you may be very disappointed. That’s why you’ll want to apply sunscreen before you step outside, even if you’ll stay in the shade.

Here’s the best way to protect yourself and your loved ones from direct and indirect UV rays:

  1. Use sunscreen of at least SPF 50 or higher, with full UV spectrum. Find a brand that you like – you’ll be more likely to use it. Reapply sunscreen every two hours you’re outside.
  2. Wear wide-brimmed hats (at least 3 inches of brim all around the head) and UV protective clothing.
  3. Avoiding the sun during peak hours is essential. From around 10 a.m. to 2 p.m., try not to go outside. Or, stick to shaded areas such as swimming at times when the pool is out of the direct sun.
  4. Get in the habit of applying sunscreen. Daily application of sunscreen in the morning, regardless of your activities during the day (even just driving in the car), can yield healthier and happier skin.

Follow these rules and your skin will thank you.

Mansi Sarihan, MD, is chief of dermatology at Maricopa Integrated Health System and Clinical Assistant Professor, University of Arizona, College of Medicine-Phoenix.

As originally published 9:20 p.m. June 18, 2018

Engaging Children with Spina Bifida for Increased Mobility

Wednesday, April 11, 2018 – Linda Thunn

CRS partners with SBAAZ to encourage best mobility in young patients

SCOOOT provides an early experience of independence for kids with mobility challenges. It frees them to explore their home, play, chase and race friends and siblings without any help. Expert clinicians, designers and engineers worked hard to create a device that will help kids discover new skills as well as new pals. The potential for physical and cognitive development was a key factor in every element of the design.

Spina Bifida Association of Arizona Inc. (SBAAZ), an organization committed to enhancing the lives of those affected by spina bifida in Arizona, was awarded a grant from the PayPal Gives Corporate Advised Fund at Silicon Valley Community Foundation. The grant was recommended by PayPal’s employee-volunteer led Chandler, AZ GIVE Team.

The SCOOOT program idea was presented to the SBAAZ by CRS’s Myelomeningocele Planning Clinic Lead Physician Pamela S. Murphy, MD, FAAP. The program was coordinated by Sharri Runnels, executive director of the SBAAZ, along with SBAAZ board member Linda Thunn, PT, DPT who is also the Myelomeningocele Planning Clinic physical therapist at CRS.

The CRS Myelomeningocele Planning Clinic occurs every Friday, and they see approximately seven patients for all day clinic, visiting up to 13 different providers, having blood work drawn, and if necessary they will get casted for their orthotics and/or have x-rays. SBAAZ provides lunch and signs people up for their medical alert bracelets. Free Arts of AZ is there for the kids to create projects at lunch time.

The SCOOOT program involves readiness assessments, equipment placement, activities and progress checks that will empower ‘toddlers’ to keep pace with their siblings and peers as they establish a sense of mastery over their world. The mobility device, resembling a toy more than a piece of medical equipment, allows children to reach items from the floor, ambulate, and enter/exit the seat safely at will.

“CRS is a great partnership for SBAAZ as we are able to share resources with clients and assess needs over lunch with families that are served by the fantastic care team brought together by District Medical Group,” stated Runnels, “SBAAZ is very grateful for the relationship with DMG and wanted to share the first SCOOOT placement with their staff as they pour so much into the kiddos!”

Spina bifida (Myelomeningocele) is a birth defect in which the spinal canal and the backbone don’t close before the baby is born. This type of birth defect is also called a neural tube defect.

The SCOOOT Earliest Mobility Program kicked off was on Friday, November 10, 2017 with placements being made at the CRS Myelomeningocele Planning Clinic.

Children’s Rehabilitative Services (CRS) Physical Therapy Department Spotlight

Thursday, April 5, 2018 – Linda Thunn

The Children’s Rehabilitative Services (CRS) Pediatric physical therapists provide support and services for children (birth to 21 years) with developmental disabilities, and their families. They aim to develop, restore and improve mobility to improve quality of life.

Pediatric physical therapy benefits children and their families/caregivers by promoting activity and participation in everyday routines, increasing functional independence, improving strength and endurance, facilitating motor development and mobility, and easing the challenges of daily caregiving. Because patient’s are allowed to ”opt in” for services past the age of 21, there are several physical therapists qualified to treat individuals over the age of 21 as well.

Besides treating children one-on-one in the rehab clinic our providers also work in CRS’s Multidisciplinary clinics such as:

• Amputee Clinic
• Cerebral Palsy Orthopedic Clinic
• Cystic Fibrosis Care Center
• Myelomeningocele Planning Clinic
• Spasticity Planning and Follow-up Clinic

Our providers also perform equipment evaluations. They trial each child to determine what works best for them. Those evaluations are done on:

• Adaptive Seating
• Adaptive Car Seats (onsite at NuMotion)
• Forearm Crutches
• Gait Trainers
• Standers
• Walkers
• Wheelchairs (onsite at NuMotion)

A Spotlight on DMG Pediatrics

Wednesday, March 28, 2018 – Prabodh Hemmady, MD | Eileen Maddix | Jeanine Pittman

Pediatrics Overview

DMG Pediatrics is multifaceted, responsible for patient care in many locations. At Maricopa Integrated Health System (MIHS), there is a robust ambulatory clinic at the Comprehensive Health Center (CHC) where both general pediatric and subspecialty patients are seen.

In partnership with the Ambulatory Care division of DMG, Pediatrics staffs primary care physicians at some of the MIHS Family Health Centers (Maryvale, South Central and Mesa). With the implementation of Proposition 480 (“Care Reimagined”), we are hoping to grow pediatric ambulatory care at MIHS. The Pediatric Emergency Department (ED) and inpatient care units at Maricopa Medical Center are also great resources for Phoenix and the surrounding communities.

The Pediatric ED is open 24/7/365 and is staffed by Pediatric ED trained physicians. The inpatient units consist of a neonatal intensive care unit (NICU), pediatric intensive care unit (PICU) and acute care unit. We also care for non-ICU newborns who stay with their mothers on the post-partum unit until discharged home.

In addition, DMG Pediatrics supports the DMG Children’s Rehabilitative Services (CRS) clinic located near 3rd Ave and Thomas Road by providing genetics, neurology and gastroenterology subspecialty care on site.

Pediatric Subspecialties

Subspecialties at the MIHS CHC include the following fields:

Adolescent Medicine
Infectious Disease

Pediatric Residency Program and Medical School Affiliations

DMG Pediatrics is a strong partner with Phoenix Children’s Hospital (PCH) and MIHS in training resident physicians, and for many years it has been known as the PCH/MMC Pediatric Residency Program.

There are 32 categorical pediatric positions per year and well over 100 pediatric residents who rotate through MIHS when the medicine-pediatric residents and the pediatric/pediatric neurology residents are added. The pediatric residency program receives well over 1000 applications and interviews over 275 people for the 32 pediatric spots each year. The residents come from all over the country and bring with them a variety of backgrounds.

The department is also very active in educating medical students from the University of Arizona College of Medicine and Midwestern College of Osteopathic Medicine. We also teach medical students from the Mayo School of Medicine and are excited about the relationship developing with Creighton Medical School.

Learn More About DMG Pediatrics

Would you like to know more about DMG’s Department of Pediatrics? The website is available in Spanish as well as English to better serve our patient population, giving them full access to the great information about us!

DMG’s Dr. Kevin Foster Discusses Vaping Hazards in Arizona Republic

The Arizona Burn Center recently began monitoring e-cigarette explosions, with plans to document the phenomenon in a medical journal. Arizona Burn Center has documented 12 cases of exploding e-cigarettes over the past 12 weeks. These vaping devices can explode when the batteries malfunction.

Kevin_FosterHailey Boyce was chatting and relaxing with friends on the front porch of a friend’s Maricopa home when she leaned in, ignited her electronic-cigarette device and inhaled. Then the 17-year-old fired up the device for another hit.

“It exploded like a rocket,” Boyce recalls of the accident on Mother’s Day. “I was with my friend. He told me I was on fire. I was screaming.”

The vaping device had exploded. Part of the device launched to a driveway three houses away. The battery that powered the device fell toward Boyce, igniting her clothes, blackening her tank top and searing her hand and parts of her upper body. Boyce would spend about three weeks at Maricopa Medical Center’s Arizona Burn Center, undergoing three surgeries and skin grafts.

Officials at the Arizona Burn Center say such accidents occur regularly with one dozen patients reporting burns from e-cigarettes fires or explosions over the past three months. The burn center recently began monitoring these cases with plans to to document the phenomenon in a medical journal.

Some explosions cause extensive burns that require multiple skin grafts. Many others suffer minor injuries and are quickly discharged from the hospital.

“They are coming in so fast and furious,” said Dr. Kevin Foster, Arizona Burn Center’s chief of burn services. “We are trying to keep track of all of them.”

Foster said some explosions have occurred when users were in the process of igniting the device. Others received severe burns when the device’s battery exploded in their pants’ pocket. One man in his 20’s was left with severe second-degree burns when the device caught fire in his pockets.

While there are no studies on how frequently the accidents occur, the U.S. Fire Administration released a report in October 2014 that documented 25 cases of an exploding e-cigarette that occurred over a five-year period.

The fire administration’s report was based on anecdotal media reports gathered from local fire department responses and not meant to be comprehensive. The federal agency has since created a incident code that local fire departments are encouraged to use to track how frequently these e-cigarette explosions occur, according to Larry McKenna, a fire protection engineer with the fire administration.

While such explosions are seemingly rare among the more than 2.5 million Americans who vape, the report said the shape and construction of e-cigarette devices can propel them like “flaming rockets” if the device’s lithium-ion battery malfunctions or overheats.

The fire administration said the most common explosions occurred while the batteries were charging. Lithium-ion battery explosions can occur when the battery’s internal pressure builds and breaks through the battery’s seal.

These small batteries have caused fires in consumer products such as cellphones and laptop computers, but those industries have made design changes to reduce fire risk, McKenna said.

The fire administration’s report said that batteries in laptop computers and other portable devices include strong plastic cases that work to contain the fire and prevent the rocket-like effect that can occur with vaping devices.

McKenna said said higher-end batteries can include a circuit board that shuts down an overheating battery. Charging devices, too, include protective designs that limit chances of fires or explosions.

McKenna said he has communicated with tobacco companies that also have vaping brands, and he said these larger companies are aware of this and have taken steps to address the problem. However, he said the vaping industry also include manufacturers abroad and “do-it-your-selfers” that may not meet safety standards.

The Food and Drug Administration this year moved toward regulating e-cigarettes like traditional tobacco products, and those proposed regulations would include new standards for manufacturers, including battery safety.

Yet some critics say the FDA’s regulations put a freeze on existing efforts to upgrade defective batteries.

Gregory Conley, president of the American Vaping Association, said that consumers need to be educated to not swap out batteries that come in damaged wrapping. People also can injured themselves if they put a spare battery in their pocket, he said.

“Battery incidents are almost completely avoidable,” Conley said. “These incidents should not be used to scare away people who switch to these products to try to quit tobacco.”

The Arizona Burn Center’s Foster said the public should be aware that these battery-powered devices can explode. “The fact that these devices can be made so poorly, and we are seeing injuries that can be really, really severe,” Foster said. “If it blows up in your hand or your face, that’s a big deal.”

Boyce said her injuries require constant attention. She needs to do exercises to strengthen and stretch her skin, and she applies cocoa butter to moisturize her skin several times each day.

Boyce said she purchased her vaping device from an online retailer about seven months ago. She enjoyed the flavor and smell and socializing with friends.

She said she has “mixed feelings” about the safety of the devices. She does not think there is anything the could have done to prevent her accident, but she also said her device likely exploded due to a problem with the battery casing.

Now, she is more cautious around friends who are vaping, particularly when they fire up their devices.

“Every time I am around a friend (who is vaping), it makes the hairs on the back of my neck stand up.”

As seen on The Arizona Republic website

In Pediatrics: DMG’s Children’s Rehabilitative Services Leads the Way

Children with special needs require care from a wide range of specialties: Physical and Occupational Therapy, Orthopedics, Speech, Audiology, Plastic Surgery, Cardiology, Neurology and Psychology.

District Medical Group’s Childrens Rehabilitative Services Clinic houses these specialties and more under the same roof, as the largest multi-specialty, interdisciplinary clinic in the State of Arizona. We provide a full spectrum of pediatric specialty care from birth to the age of 21.