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 DMGCRS.org/ACC.

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

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 DMGAZ.org.

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Toni J. Eberhardt
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Article as originally posted at https://www.dmgcrs.org/dmgcrs-providers-complex-needs/

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 USAToday.com 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 USAToday.com 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.

AHCCCS Behavioral Health Services for Children in Foster Care  

Arizona Health Care Cost Containment System (AHCCCS) is committed to ensuring the availability of timely, quality health care for foster children, including behavioral health services through our three contracted regional behavioral health authorities (RBHAs) and the Children’s Rehabilitative Services (CRS) program.

If you experience any difficulty accessing needed behavioral health services or have any concerns regarding the quality of those services, we encourage you to contact the RBHA or CRS in your area.