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Meet DAP Health Chief Compliance Officer …

In My Life

DAP Health Chief Compliance Officer Dana O’Neal Erwin lives by Maya Angelou’s motto: Do the best you can until you know better. Then when you know better, do better.

Words by Kay Kudukis

 

DAP Health Chief Compliance Officer Dana O’Neal Erwin was born in Punta Gorda, Florida, and raised in Miami and Tallahassee alongside four sisters. Dad was a lobbyist. Mom was a housewife who’d gotten a full nursing scholarship at Tulane but who did not practice in the field post-graduation. Instead, she married and had children. “I always felt like she would have been happier had she had a career,” says Erwin. “I think that’s why I’m a career person.”

Five years older than Erwin, sister Donna was 15 when she turned to drugs, creating great stress for the family. Donna got pregnant and had a daughter, whom their parents adopted. That’s how Erwin came to have four sisters, but she wasn’t around for most of that. At 14, she was sent to a boarding school in Tennessee. That’s where she cleaned the school’s restrooms after classes, made brooms at a broom factory, sold on the floor at a department store, and rang up customers at McDonald’s. “I’ve just always worked,” she says with a smile.

She dreamed of being an attorney. “Girls aren’t lawyers,” claimed Dad. “You will be a nurse, like your mother.” Disappointing, but Erwin admits she did love dissecting stuff in biology. Two years were spent at Southern College in Collegedale, Tennessee. The rest at Walla Walla Community College and Walla Walla University in Washington state, where she married.

 

Neurosurgery, Nursing, and Night Shifts

After graduation, Erwin experienced being a nightshift neurosurgery nurse overwhelmed with tragic accidents. “It’s the most depressing job I’ve ever had in my life,” she laments. “We had an unusual number of new paraplegics and quadriplegics.” Some survivors begged for mortal release post-surgery. Dark stuff.

­“I had no business being the lead nurse fresh out of school,” she continues, “but I was the only RN they had on nightshift on the unit. There were licensed practical nurses (now known as licensed vocational nurses) who worked on that floor for 18 years and knew everything about neurosurgery.” She loved the challenge, but the veterans weren’t thrilled to take orders from a kid just out of college.

After a year and half on that neurosurgery unit, Erwin transferred to the much cheerier labor and delivery department. “When one of the OB-GYNs had a terrible skiing accident and was unable to do surgeries, she became the chief quality officer,” Erwin explains. “That was when quality in health care was becoming ‘a thing.’ She recruited me to help her build the Quality program. So, I worked with her after my labor and delivery shifts.”

Erwin would call in patient reviews to the insurance companies, which led to her being offered a position with Kaiser-Group Health. “They were starting complex case management in their contracted network in Eastern Washington, and asked if I could come assist with a pilot program.” It ticked all of Erwin’s boxes. She accepted, spending a wonderful decade working with a high-functioning and loyal team of nurses.

During that time, Erwin and her husband had three children, then divorced after eight years. “We’re still very good friends,” she says. Not long after, pals set her up with a wheat farmer at a friend’s birthday party. That man had three children too, and they clicked. They married, Brady Bunch-ed it up on his farm for the next 20 years, the eight growing together as a family.

 

Degrees, Data, and DAP Health

By 2015, their nest was empty. The farm was sold, hubby started consulting in Denver and Canada, and Erwin craved a new challenge. Although she’d already furthered her education in health care administration and management, and had been consulting for years herself, she wanted a master’s. Not an overachiever at all, she obtained one in nursing leadership. Through that experience, she found out she excelled at statistics — using data to solve real-world problems, which comes in super handy in compliance and quality management. And no, she’s not a lawyer, but the compliance and risk piece scratches that itch.

Erwin spent five years at a federally qualified health center (FQHC) in Washington state. A friend from the Joint Commission kept calling with consulting opportunities, which led to her spending three years at a large hospital in Idaho, two years at a critical access hospital back in Washington state, and two years in Colorado as chief compliance officer for a national PACE program.

When Erwin was called to join Borrego Health, she politely sent regrets. But they were persistent, and in 2021, she finally acquiesced. She’d barely signed on as their CCO when DAP Health acquired them, offering her their CCO role. She was thrilled.

“I've never worked for an organization that has the mission and philanthropy we have here, and the support we get from the community and the state,” she says enthusiastically. “Thanks to our very active board and CEO, we have such a great reputation. It’s one of the most exciting places I’ve worked.”

Life is full of surprises, both cruel and kind. Sister Donna overdosed at 28, leaving her institutionalized until her death eight years ago. Dad suffered a massive heart attack that resulted in his death at 59. Remembering the past with her remaining sisters has been healing, and although she recently divorced Hubby #2, they, too, remain great chums.

Erwin believes everything that happens is an opportunity to rethink one’s values. “It’s all in how we look at the human race, despite color, gender, whatever,” she says. “We have patients down in Indio who are hardworking, but who don’t have running water or proper housing. Everyone has different challenges, but everyone can greatly benefit from the culture DAP Health has built.”

“In my life, I’ve loved them all.”

– Lennon & McCartney.

Meet DAP Health Chief Operating Officer …

Against All Odds

The average age of a chief operating officer is 51. Corina Velasquez had earned that esteemed title by 36.

Words by Kay Kudukis • Photo by Yohana Moreno

 

Being a medical assistant (MA) wasn’t the dream of Corina Velasquez in grade school. She was into poetry and prose. She was good at it too. Won an award and everything. In high school, that dream morphed into one of law school and a seat on the bench. All that changed with one test.

 

“I dropped out of high school midway through because I got pregnant with my daughter,” Velasquez says. She was 17 when she gave birth. It didn’t take long for her to realize that, domestically, she was in a bad situation. She left the father within two years.

 

“Statistics say I’d still be at my house on government assistance, but I didn’t let my fear of not being good enough stop me,” she says. She returned to her studies, became a certified phlebotomist, and took a job working in-patient at Eisenhower Health.

 

But Velasquez had her sights set on becoming an MA, so it was back to school. After a few internships, she got her first paid MA position at Borrego Health’s Centro Medico Cathedral City, which had previously been a private practice. Velasquez was also able to draw blood in the small, one-doctor clinic, where it was hard enough to get a patient through the door, much less go elsewhere for blood tests.

 

It was a great time in Velasquez’s life. She was 24, had a full-time job in an exciting field, and she’d found love again. They had two daughters, but after 10 years together (three of them married), they divorced. They’re such good co-parents, people think they’re still a couple.

 

The Humble Beginnings

Born in Ventura County, Velasquez completed kindergarten in Coachella after her single mom moved the family of four there, courtesy of a new job. A middle child, she was sandwiched between an older brother and younger sister. Eventually, her mom purchased the mini-mart where she worked full-time, and where Velasquez also worked after school and on weekends. That came in handy when she was transferred back to her old stomping grounds, subbing for the Coachella clinic’s MA, Carmen Ruiz, who now pulls double duty as the clinic manager at both Palm Springs Family Health and Desert Hot Springs Specialty Care. Both are former Borrego Health centers now under DAP Health’s auspices.

 

As Velasquez learned more about federally qualified health centers (FQHCs), she asked her mom to refer mini-mart customers to their clinic, emphasizing their zero-discrimination policy, discounted medications, and sliding scale fees. When Ruiz returned from maternity leave, she discovered that, due to Velasquez’s expert outreach, Coachella had gone from treating six patients a day to routinely more than 30.

 

“I had worked with the company for a couple of years, and it was very different working with Corina,” Ruiz emphasizes. “Very different than working with anyone else. We would just look at each other and I’d say, ‘Did you see what’s going on in the lobby?’ And she’d say, ‘Yeah, I got it.’” Ruiz is referring to drop-in patients and the workload ahead. “Corina knew exactly what I was talking about. She was always going the extra mile, and I was the same way. We made a really good team.”

 

Velasquez agrees. “Carmen and I had this amazing working relationship where we could communicate without even talking. Just boom, boom! It was awesome.”

 

A Born Leader

When Borrego Health graduated from paper to electronic health records (EHR), it chose to conduct training at the small Coachella facility. Trainers came in but didn’t bring step-by-step learning tools.

 

“I created screenshots at the nurses’ station so I could remember, because I knew the instructors weren’t going to be there forever,” Velasquez recalls. Shortly thereafter, she happily accepted a promotion to become the trainer of the new system — for all Borrego Health MAs.

 

Velasquez also began learning about quality and compliance. Soon she was auditing charts, helping with audit tools, and in 2011, was asked to manage a brand-new clinic. She would be stocking, staffing, and problem-solving.

 

She did so well that it was requested that she find her replacement, and do it all over again. Wet, lather, rinse, repeat. Every clinic, from soup to nuts.

 

At the same time, changes were going on at the upper levels of the organization. The VP of operations was promoted to COO, the regional director of operations became VP, and Velasquez applied to be — and was appointed — regional director in 2012, where she stayed until her 2015 promotion to VP of patient access.

 

Entering the C-Suite

Her rise to the C suite came in 2021. With Borrego Health then serving more than 120,500 patients (roughly 463,000 annual visits) throughout Riverside and San Diego counties, being chief operating officer was a big job. It’s an even bigger job now that she serves in that capacity at DAP Health. It’s a role that was previously absent at the organization — one created just for her.

 

“Corina is simply a force to be reckoned with,” says DAP Health CEO David Brinkman. “Her journey is such an inspiring one. She’s a doer whose presence is nonetheless so warm and welcoming. I’m tremendously excited to have her keep doing what she does best for us now that we are one, integrated health care agency.”

 

Here’s an anecdote from her early years, which shows why Velasquez has been so successful: She was working with a provider who had a reputation for being “a little too direct” (as she gently puts it), when he snapped at her in front of a patient.

 

“I went into his office when we were done, shut the door, and said, ‘Let that be the last time that happens. I’m here to work with you. So, let’s make this a good day.’ He just looked at me, then smiled and said, ‘We’re gonna do just fine.’ After that, it was a really good relationship. At the end of the day, everybody wants the same thing. Sometimes, they just need a different map on how to get there.”

 

Now 39, Velasquez can look back and offer advice to other young adults, no matter their situation. “Even when you don’t believe in yourself, be curious enough to ask the questions because that can open so many doors to things that you never thought you’d even be in the right vicinity of.”

 

Before DAP Health’s acquisition of Borrego Health, when things were up in the air, Ruiz one day felt inspired to call Velasquez to say, “I just want to thank you. I know what you’ve done, and what you’re capable of doing. We don’t know exactly what you do for us behind the scenes, but things happen because of you. Good things.”

 

As it turns out, Velasquez has core values — strength, truth, justice, optimism—that she shares with Wonder Woman. Like Velasquez, Wonder Woman has profound healing, telepathy, and supernatural leadership powers. Isn’t it interesting that Wonder Woman and Velasquez have never been seen in the same place at the same time. Make of that what you will.

Meet DAP Health Chief Medical Officer Dr …

Semper Gumby

In English, the Latin unofficial motto of the U.S. Navy translates as “Always Flexible.” It perfectly describes DAP Health’s new Chief Medical Officer Dr. Joseph Aquilina

Words by Kay Kudukis

His parents were first-generation Sicilian-American, so of course the entire family went to Grandma’s house for Sunday sauce. It was a nice break from the other six days when, evenings and after school, the three kids helped Mom and Dad in the family’s cleaning business. Cleaning neither garments nor houses. Car dealerships and fitness centers — any business in Buffalo that hired them. In addition, Dad worked two more jobs hoping to give his kids a better version of the American dream than his.

Joseph Aquilina, the only boy, a middle child, took up trombone and football. Maybe because he had an interest, or maybe because after school extracurriculars were more fun than cleaning. But he was drawn to the social aspects, the camaraderie. He even ended up combining both activities when the band performed at Rich Stadium for a Buffalo Bills game. Quite a score for the teenager.

Young Joe played offensive guard and defensive end in high school football. Generally, those positions had a heavier body type than that of Aquilina, who’d grown tall but not thick. His build was more like a quarterback, or a tennis player. He picked up the racket when he was stationed in London, but more on that later.

Because of his size, Joe worked harder to stay on the team, and can still recall the fantastic feeling at homecoming when they called his name: “Playing first string, defensive end, Joseph Aquilina.”

 

College Bound

Some plan their post-secondary life and know exactly where they’ll be after their senior summer. Others haven’t a clue. Aquilina fell into the latter category. He thought he might like to go to college — that’s what all the kids in his honors classes were doing — but he didn’t quite know how he was going to do that. His sister had been the first of any generation to attend college, but she stayed local. He did not want to do that.

His parents didn’t have the knowledge or funds to assist, so he relied on his friends for help and ideas. The University of Rochester came up, so he applied and received academic scholarships. Bonus: It was 90 miles away from Buffalo. Far enough away to live on campus, yet close enough to bring his laundry home on the weekends. “I thought I was busting out,” Aquilina says with a laugh.

He loved Rochester. “I had such a sense of independence. You can control your own schedule. I got my first non-family job at the Fine Arts Library. It was wonderful. I was a gallery guard. I could do my homework, watch the art exhibit, make sure no one touched anything, and get paid to study.”

 

Life in the Lab Was Too Boring

He chose microbiology as a major, but discovered the monotony of the lab didn’t really suit him. That was a problem. One day, a solution walked in: Urologist Dr. Bob, who came to take his wife (head of the lab) to lunch. “He was an affable, gregarious, fun guy,” Aquilina recalls. “And I just asked, ‘Hey, Dr. Bob. Can I join you one day, kind of see what your day is like?’”

Dr. Bob was equally as affable at work with patients, nurses, and staff. “Everybody knew and liked him. I thought, ‘I could do this,’” Aquilina grins, remembering. “It just seemed like a very social, fun job, and he really enjoyed it. So I thought maybe I should consider medical school. I had no idea what that meant.”

His counselor knew, and the news was good. Aquilina already had most of the credits needed. He just had to take the MCAT. His score did not disappoint. He was going to be a doctor!

 

In the Navy

His father wanted to mortgage the family home to pay for it, which terrified Aquilina. “What if I fail? Then he’s gonna lose the house. No way.” He had friends in ROTC at Rochester. “I thought, ‘Well, they seem like they’re happy.’” He cold-called the Navy. The recruiter couldn’t believe his luck. “Yes, we’ll absolutely pay for medical school. When can you start?”

Aquilina graduated from Loyola’s Stritch School of Medicine in Chicago in May of 1994. In July of 1995, he reported for flight surgeon training at Naval Operational Medicine Institute in Pensacola.

For the two years he worked as a flight surgeon, he was deployed for six months on the USS Tarawa, attended to 500 Marine flyers, got a pilot’s license, and logged more than 300 flight hours in a CH46 helicopter.

He got married, they had twin daughters, and he continued to move up in positions and responsibilities within the Navy’s medical sector. That included three years in the U.K., and six months deployed in Kuwait before returning to San Diego. There he earned his MBA, explored his tech fascination with a “side hustle” in dental charting software while concurrently wrapping up his 22 years of service as the director of outpatient health clinics.

 

In Uniform No More

Now both single and a civilian, Aquilina was ready to explore different opportunities. He worked in business development for a year, then shifted back to a team environment overseeing larger medical groups and implementing new initiatives.

For eight years, he served on the board of Glenner Memory Care Centers, specializing in adult day care centers and family resources, becoming well-versed in the workings of nonprofits.

If you peep his social media, you’ll see his playful side: goofy pictures with his kids, visits to tennis matches, and adventures in sailing. In 2014, he met his now fiancé, a concierge physician in San Diego. Last summer, Dr. Joe was a tennis coach for the Special Olympics. 

 

At Long Last, DAP Health

When he learned of DAP Health’s merger with Borrego Health, he saw a unique opportunity. “It’s a beautiful mission, and that was a huge attraction for me,” he says. “It seemed like an organization that really lived its values, which was really, really enticing.”

Right now, he splits his time between San Diego and Palm Springs, and his personal needs are simple: tennis partners. He says he ranks himself a solid 4.0, but “I will play whenever, wherever, with whomever.” 

Semper Gumby.

Everything You Ever Wanted to Know About …

Everything You Ever Wanted to Know About Injectable PrEP to Prevent HIV

Words by Daniel Hirsch

When it first came out in 2012, Truvada — the first-to-market pre-exposure prophylactic (PrEP) to prevent HIV — was a gamechanger. Since then, the CDC reports that more than 300,000 people in the U.S. take PrEP in the form of a daily pill. The FDA also ultimately approved both generic Truvada and a gentler-on-the-kidneys PrEP medication known as Descovy. In 2022, a new player hit the field: Apretude, a brand of longer-lasting injectable PrEP.

To learn more about injectable PrEP, I spoke with DAP Health PrEP Navigation Manager Andrew Glorioso, who has worked in HIV care for 25 years, and who has lived with HIV for even longer.

What is Apretude?

Apretude is an injectable medication that’s used to prevent someone from acquiring HIV. It involves coming to the clinic once every two months for an injection.

What’s the benefit of injectable PrEP over taking a pill? Isn’t oral PrEP enough?

It’s all about lifestyle and being able to provide more options. There was a time when all we had to provide people were condoms. Then we got PrEP. We’ve been continuing to expand what’s available.

Both oral and injectable PrEP protect against HIV with the same level of efficacy — both are 99.9% effective [if taken as prescribed]. However, what Apretude has is the benefit of medication adherence. People who are on oral medication are taking one pill once a day, but are they really taking it once a day? Having to come into the clinic every two months for Apretude actually helps with medical adherence.

Who exactly is injectable PrEP for?

It can help people in situations where it’s difficult to adhere to a regimen. It’s not a one size fits all kind of thing. It takes talking to each individual and determining what makes sense based on their lifestyle. We deal with lots of individuals who may have mental health, substance use, or housing stability issues. Apretude might be a great option because they don’t have to worry about storing their medication or keeping track of pills.

Also, if somebody comes in and they’re interested in Apretude, one of the first things I ask them is: How do you feel about getting a shot? If you really don’t like needles, Apretude is not the thing for you.

Do the shots hurt? Are there any other side effects?

It’s a regular-gauge shot. It’s not like a little pin prick in the shoulder. Some people have reported having injection-site soreness for a couple of days and maybe a little nodule developing under the skin. So, it’s not completely without its possibility of adverse effects. That said, we also have people who are using Apretude and love it. They love knowing they don’t have to worry about taking their PrEP for two months.

Is injectable PrEP more expensive? Is it covered by insurance?

Our ability to get Apretude for individuals depends greatly on the type of health care coverage they have. If somebody is on the state’s Medicaid program (MediCal), or IEHP out here in the Coachella Valley, those programs actually give individuals the option of injectable or oral PrEP, so it’s great. Medicare will cover both versions of PrEP. For people who have private insurance, it depends on the plan. And then for people who are uninsured, we don’t really have a mechanism right now to get them access to Apretude. We can easily get them access to oral PrEP medication for little to no cost. Anybody who wants PrEP can be on oral PrEP. All they have to do is visit Injectable PrEP - DAP Health to make an appointment to see me or one of my colleagues in the PrEP Navigation department.

Meet DAP Health CEO David Brinkman

Once Upon a Time in Iowa: A Profile of DAP Health CEO David Brinkman

In a new, ongoing series, writer Kay Kudukis profiles the executive and senior leaders who have found their mission match at DAP Health.

 

“I’m from Iowa, we don’t know what cool is.” ~ Ashton Kutcher

 

DAP Health CEO David Brinkman is a fifth-generation Iowan who actually is cool, Ashton.

His father was an endocrinologist. Mom was not only a nurse but executive director of a women’s health organization. Involved in the women’s rights movement her entire career, she also served on a committee approving FDA medical devices.

Sundays, she took the three kids to church while Dad visited the forgotten in local nursing homes. That was his church, and he never missed a Sunday. Both parents gave of themselves tirelessly, instilling those values in their brood.

Thirteen-year-old Brinkman didn’t exactly know he was gay, but he was a fashionista — side note: he’s still got it — with a pension for dying his hair colors not found in nature. Dad surmised his son might not survive tiny-town high school. ‘Out’ didn’t exist in Mason City, but surprisingly it did at Shattuck-St. Mary’s Episcopal Boarding School in Faribault, Minnesota, where Brinkman was sent to receive his secondary education. With only eight students to a classroom, you couldn’t hide in the back. Brinkman had a best friend named Megan, whose father was gay and out.

There was also the gay boy across the hall, who’d pester him with “You’re gay, Brinkman. Admit it!” Brinkman never did. Maybe that was confusion, but it was definitely influenced by the sounds of the beatings the other boys gave the gay one. That he never did anything to help that kindred spirit agonized Brinkman for years, until he finally tracked his former classmate down. There was grace and understanding on the other end of the line: “I would have done the same thing.”

 

The Birth of an Activist

The Lewis & Clark College campus in Oregon was a beehive of activism. Brinkman led the student LGBTQ organization for his four years, majoring in sociology and anthropology, minoring in gender studies. He came out to his parents, then promptly had his first panic attack. He felt lost. It was the early nineties. His community was dying. He was afraid for them. And for himself. Sophomore year, he fought for his rights in response to a statewide ballot initiative to outlaw homosexuality. “Run to the front line, son,” his parents suggested. “Do not back away. When whatever happens, happens — you want to be there.”

So, he did, applying at the Cascade AIDS Project for the only job available: condom fairy. Late nights spent at bathhouses distributing condoms and literature had its moments, but didn’t pay the bills. Two other hourly jobs — running a support group at Harry’s Mother, a homeless youth organization, and running another for LGBT kids at the Urban League of Portland, weren’t much help. And sleep? What was that?

Brinkman wanted to stay on the front line at Cascade AIDS, so he took a 40-hour-a-week salaried position: case manager. Every week, two or three clients died. His psyche couldn’t handle this reality, and when he wasn’t working, he was depressed.

He eventually stopped caring about himself altogether. His friend, an undergrad in psychology, recognized the once tireless activist’s darkness. “You can’t do this anymore, David,” she said. “It’s affecting your health. You have to leave.”

Brinkman informed his boss, Susan Stoltenberg, who gave him not a lifeline but, as it turned out, his life’s work. “You’re smart, dedicated, and charming AF,” she said. “You’d be great at fundraising.” She taught him the ropes, took him to benefits at wealthy gay men’s homes, and together they watched the donations come pouring in.

 

Finding His Groove Leading Nonprofits

The next step was to lead the charge, so Brinkman got his MBA at Pepperdine Graziadio Business School in Los Angeles, with an emphasis in ethical business management. He was now armed and ready.

He spent four years as executive director at My Friend’s Place, a nonprofit for homeless kids in L.A., but when the executive director position opened up at what was then known as Desert AIDS Project in Palm Springs, it was as if everything Brinkman had done in his life up until that point had led him to this. Except he almost didn’t get the gig.

It was at his fifth “audition” dinner with the board of directors that a member questioned their responsibility to write personal checks to DAP. Brinkman stated in no uncertain terms that he believed members of the community would only make contributions to the nonprofit if they firmly understood the board was similarly invested — that each of its members had skin in the game. “If you don’t believe in that,” Brinkman told the group, “then I’m not the executive director for you.”

Every board member voted Brinkman in. Except for that skinless square peg, who resigned. That was 17 years ago.

 

Three Marvelous Humans

Through DAP Health, Brinkman has met many a marvelous human, but three get a shout-out here. The first, Marvin Sholl, proclaimed himself Brinkman’s “West Coast dad,” and 12 years ago, over dinner, said, “David! Ruthie and I love you. But we need to tell you…” Long pause for dramatic effect. “There’s another man in our lives.”

Brinkman waited for a punchline that never came. “This man is your husband,” Sholl continued. “You have yet to meet, but for two years, Ruthie and I have been preparing.”

The next evening, Dr. Will Grimm walked into Barry Manilow’s Gift of Love concert at the McCallum Theatre for his blind date with Brinkman, and fairy dust appeared anywhere the good doctor was. It danced from his fingertips, and when he spoke, it came out of his mouth like cartoon music from a saxophone. The men married in 2019. So, there you have Marvelous Human Shout-Out Number Two.

Number Three is a Ugandan physician working for UNAIDS in Rwanda four years ago, when Brinkman was part of a DAP delegation presenting at an international AIDS conference in Kigali. The man goes by Musah Lumumba because to say his real name would be catastrophic for him and for those he loves.

He and Brinkman spoke this past Ramadan, while Lumumba was in the streets serving the hungry. He said something that skyrocketed across the Atlantic ocean and two continents, piercing Brinkman’s core existence. “David,” he said, “the reason you and I are alive today is to address the issues our communities are facing today.”

That, Brinkman says, is the why of it all. “It’s why DAP was founded,” he says. “It’s why Borrego Health was acquired. And it’s why I came into work today.”

Your move, Kutcher!

Urgent Care vs. ER

Knowing when to go to urgent care, and when to head to the emergency room, can make a world of difference to your health and well-being.

Words by Daniel Vaillancourt

 

In the realm of health care, knowing when to seek urgent care (AKA immediate care) or head straight to the emergency room can be crucial for timely and effective treatment. Both urgent care centers and ERs serve distinct purposes, and understanding the differences can help you make informed decisions about where to seek medical attention.

 

Urgent Care: Swift Solutions for Minor Ailments

Urgent care centers are designed to handle non-life-threatening illnesses and injuries promptly. They’re ideal for situations where immediate attention is necessary but doesn’t require the full-scale resources of an ER. Common issues treated at urgent care include minor cuts, sprains, colds, flu, and infections. Additionally, urgent care is a suitable option for conditions like mild asthma attacks or minor allergic reactions.

One key advantage of urgent care is accessibility. These centers typically offer extended hours, including evenings and weekends, making them a convenient choice for those seeking prompt medical attention without having to schedule an appointment. Moreover, the cost of care at an urgent care facility is generally lower than that of an emergency room, making it a cost-effective option for non-emergent situations.

 

Emergency Room: Critical Care for Life-Threatening Situations

The ER is reserved for serious, life-threatening conditions that demand immediate attention and a higher level of care. If you or someone you know is experiencing symptoms such as severe chest pain, difficulty breathing, sudden and severe pain, or signs of a stroke, it’s imperative to head to the emergency room without delay.

Emergency rooms are equipped with specialized staff, advanced diagnostic tools, and resources to handle critical situations. They provide a wide range of services, including trauma care, surgical interventions, and treatment for severe illnesses. Time is of the essence in emergencies, and the ER is designed to provide swift and comprehensive care to stabilize patients and address urgent medical issues.

 

When to Choose Urgent Care vs. the ER

Understanding when to opt for urgent care versus the emergency room can save time and resources while ensuring you receive the most appropriate care for your condition. Here are some guidelines to help you make the right decision:

 

Urgent Care

Minor injuries and illnesses

Common cold, flu, and fever

Minor cuts and burns

Sprains and strains

Mild allergic reactions

 

ER

Chest pain and difficulty breathing

Severe injuries, fractures, or head injuries

Sudden and severe abdominal pain

Signs of a stroke (sudden numbness, confusion, trouble speaking)

Loss of consciousness or severe dehydration

 

In case of doubt, it’s essential to prioritize your safety and seek immediate medical attention. If you’re unsure whether your condition is an emergency, it’s better to err on the side of caution and go straight to the ER.

By recognizing the appropriate setting for your medical concern, you can ensure timely and effective care, promoting better health outcomes.

Click here to see DAP Health's four urgent care locations.

Dr. Joseph Cerjan Named Permanent Princi …

Dr. Joseph Cerjan Named Permanent Principal Provider at DAP Health's Borrego Medical Clinic  

The bilingual physician, eager to serve patients in Borrego Springs and the surrounding areas, fills a long-vacant role, bringing a sense of permanence and stability.

Words by Daniel Vaillancourt

 

Dr. Joseph Cerjan — a physician with more than 30 years of experience in a variety of settings, who is fluent in both English and Spanish — has been hired to fulfill the long-vacant role of permanent principal medical provider at DAP Health’s Borrego Medical Clinic.

In that capacity, he will oversee disciplines such as family medicine, pediatrics, women’s health (including OB-GYN), behavioral health, and sexual wellness at the center, located at 4343 Yaqui Pass Road in Borrego Springs, California.

“The people in and around Borrego Springs have long needed and deserved a permanent medical provider whom they can grow to trust, admire, and appreciate,” says DAP Health CEO David Brinkman. “Thanks to his deep well of professional expertise and his wide array of real-life experiences, I believe Dr. Cerjan is the perfect physician to help eradicate barriers to care while broadening programs and services. All of us at DAP Health — and every member of the communities we serve in Borrego Springs — are fortunate to have found him.”

It is with great enthusiasm that Dr. Cerjan looks forward to serving at Borrego Medical Clinic. “I don’t really see myself as a seed that’s being planted,” he says. “I’m a tree that’s being grafted. It has to be pruned, branch out, and hopefully produce the fruit — the benefits to everyone — that we’re hoping for. We’re establishing continuity of care for the area’s patients. Expanding some services. It’s going to be a fun challenge. Personally, this might be the seventh or eighth inning for me, but it might be the best part of my game.”

 

About Dr. Joseph Cerjan

Dr. Joseph Cerjan (sir-JAHN) is a seasoned physician with a distinguished career spanning more than three decades. Born in Youngstown, Ohio, he has dedicated his life to providing exemplary medical care and service to communities across the United States and beyond.

He began his academic journey at Ohio State University in Columbus, Ohio, where he pursued a B.A. in biochemistry. During his undergraduate years, he received prestigious honors, including membership in Bucket and Dipper, the freshmen men’s honorary, and Romophos, the sophomore men’s honorary.

Eager to expand his horizons, Dr. Cerjan pursued his medical education at the Universidad Autonoma de Guadalajara in Guadalajara, Mexico, graduating with distinction in 1981. Following medical school, he completed several postgraduate years, including internship, social service, and externship, further honing his skills and knowledge.

Dr. Cerjan continued his training with a residency at University Hospital, University of Cincinnati, where he served as chief resident in his final year. Board-certified by the American Academy of Family Physicians since 1989, the good doctor has maintained an active and unwavering commitment to excellence in patient care.

Throughout his illustrious career, Dr. Cerjan has held various positions in prestigious medical institutions, including the Share Reese Stealy Medical Group in San Diego, and the Yuma Regional Medical Center in Yuma, Arizona, where he served in the department of emergency medicine for an impressive 26 years.

In addition to his clinical work, Dr. Cerjan has demonstrated a passion for serving underserved populations, including periods as the house physician at the Fresno County Jail and as a physician at California’s Chuckwalla Valley State Prison.

Fluent in both English and Spanish, Dr. Cerjan is dedicated to breaking down language barriers to ensure the highest quality of care for all patients. His commitment to medicine is underscored by his active licensure in Arizona and California, as well as his current ACLS certification. With a wealth of experience and a compassionate approach to patient care, he continues to make a profound impact on the field of medicine, enriching the lives of those he serves.

Everything You Ever Wanted to Know About …

Everything You Ever Wanted to Know About DoxyPEP

Words by Daniel Hirsch

 

A hefty dose of antibiotics. A big syringe in the derrière. Getting treated for an STI is not fun — to say nothing of the symptoms and risks involved with contracting one like syphilis, gonorrhea, or chlamydia. With the CDC reporting rising numbers — gonorrhea is up 11% over the last five years, syphilis is up 79% — risk of infection is on the rise.

 

However, clinicians around the country, spurred by recently released guidance from the CDC, are recommending the antibiotic doxycycline as a means of post-exposure prophylaxis (DoxyPEP for short) to prevent the spread of STIs. I spoke with DAP Health Chief of Community Health C.J. Tobe about this prevention strategy.

 

Let’s start with the basics. What is DoxyPEP?

DoxyPEP, or doxycycline, is a 200 milligram pill that can be taken within 24 to 72 hours after sex. It reduces a person’s chance of contracting either chlamydia, gonorrhea, or syphilis by up to 70%. Doxycycline has been around for quite some time and is used to treat STIs and acne.

 

How sexually active do you need to be to justify a prescription?

It’s going to look different depending on a person’s lifestyle and the conversation with their provider. For example, if you have sex Friday, Saturday, and Sunday, you can take DoxyPEP that Monday morning and you’re good. Let’s say you’re having sex five times a week, then you should probably talk to your doctor about switching to DoxyPrEP.

 

And what’s DoxyPrEP?

DoxyPrEP would be taking 100 milligrams of doxycycline daily as a preventative measure. That’s typically for people who either want to make sure they’re protected, or they’re having frequent sex, or they may be a sex worker.

 

Are there side effects? Isn’t doxy tough on the GI tract?

A lot of the side effects that get reported are GI issues. So we recommend people take the medication with food or a carbonated drink. When people take a higher dose of doxycycline, like 200 milligrams twice a day, the side effects increase. If you go on DoxyPrEP, that’s just 100 milligrams once a day. And I can tell you it’s such a low dose that the majority of folks don’t have side effects.

 

One of my worst nightmares, and it’s one shared by the World Health Organization, is that an STI becomes resistant to antibiotics. Is that a concern with people regularly taking doxy?

Part of the medical community is hesitant to embrace this strategy because they don’t know what could happen in terms of drug resistance. The other half are saying, “We need to get people on it right now because it’s an important preventative tool.” There’s always going to be a risk of drug resistance when people don’t follow the dosing recommendation of a doctor. As a public health person seeing the rise in STIs, I think a patient who is having sex should have that conversation with their doctor and see if DoxyPEP is right for them. Personally, I’ve been on doxy since 2020 and it’s been a lifesaver.

Feeding a Family on a Budget

Feeding a Family on a Budget

Here are eight tips for smart shopping.

Words by Maggie Downs

 

Feeding a family while on a budget can be challenging. But with strategic planning and smart shopping, it’s possible to provide nutritious meals without breaking the bank, says registered dietician Robert Davis from the Comprehensive Perinatal Services program at DAP Health. Here are his tips to maximize your budget while keeping your family well-fed.

 

Meal Planning

Start by planning your meals for the week ahead. Take stock of what ingredients you already have on hand and build your meals around those. Plan meals that use similar ingredients to minimize waste and save money. “Choose just one day to do your planning and shopping so you know what you have and can shop for just enough to take you through the week,” Davis says.

 

Shop With a List

Make a grocery list before heading to the store — and stick to it. This will help prevent impulse buys and ensure you have everything you need to prepare your planned meals. “Don’t get distracted by sale items,” Davis says. “So many times, the sale items are tricky at getting us in the door at the grocery store, but they tend to be the highly processed foods, like cookies or chips or crackers. Some of these foods won’t provide as much nutrition, and they might even make us more hungry.”

 

Don’t Skip the Frozen Aisle

Frozen produce is nutritious, readily available, and can be even more economical than buying fresh. It can also save time in the kitchen, since the produce doesn’t require trimming and washing.

 

Embrace Meatless Meals

Incorporating vegetarian meals into your weekly menu is an excellent way to save money. Beans, lentils, tofu, and eggs are all affordable sources of protein that can be used in place of more expensive meats and dairy. “Non-animal foods are very nutritious and budget-friendly as well,” Davis says. “Consider two days a week having a family meal that doesn’t involve animal proteins.”

 

Shop Seasonally

Purchase fruits and vegetables that are in season, as they tend to be less expensive and more flavorful. Visit the farmers market for fresh produce that supports local growers.

 

Buy in Bulk

Stocking up on staple items can save you money in the long run. Look for deals on larger quantities, and consider joining a wholesale club to access greater savings. “Some of the shelf-stable grain options can be created faster than going out and getting something from a restaurant,” Davis says. He recommends keeping the pantry packed with brown rice, whole wheat pasta, or quinoa, which are all high in fiber, offer B vitamins, and can be cooked quickly with some veggies and a protein.

 

Utilize Leftovers

Don’t let leftovers go to waste! Get creative and repurpose leftover ingredients into new meals. For example, leftover roasted vegetables can be added to salads or turned into a hearty soup. Davis likes myplate.gov for recipe ideas.

 

Cook From Scratch

Pre-packaged and convenience foods are often more expensive than cooking from scratch. Invest in basic ingredients, and learn to prepare simple meals at home. Not only will this save you money, but the time spent with family can be priceless.

Dining Out For Life Greater Palm Springs …

Annual Philanthropic Foodie Event Happens Thursday, April 25

 

DAP Health participates in the one-day North American gastronomic fundraiser for the 19th year.

 

 

Dining Out For Life® — the annual, North American foodie fundraising event that has collected more than nearly 100 million dollars for community-based organizations that serve people living with or impacted by HIV since its inception in 1991 — will take place in Palm Springs and across the Coachella Valley on Thursday, April 25, 2024.

Every year since 2005, Greater Palm Springs has participated in the all-day/all-night affair on behalf of DAP Health. And on each of those occasions, locals, snowbirds, and tourists have swelled with pride and come out in droves to raise much-needed funds while enjoying the generosity of participating local restaurants, bars, cafés, and bakeries that donate anywhere from 30 to 110% of their entire day’s and/or evening’s receipts — not just the profits — to the legendary effort.

Thanks to the generous support of participating restaurants, volunteers, and community members, Greater Palm Springs perennially places in the top three successful markets in the country. In 2023, 72 desert establishments participated to raise more than $270,000 — more than San Francisco, Los Angeles, New York City, Chicago, and other large urban centers.

With more than 12,000 local supporters expected to dine out for life at breakfast, lunch, happy hour, dinner, and/or late night this year, the 2024 goal is for Dining Out For Life Greater Palm Springs to grab the number one spot.

Eager participants are urged to visit daphealth.org/dofl, make reservations well in advance, and prepare to satisfy their hunger and thirst as many times as possible on April 25 to beat the North American record right here in our own back yard. If their favorite eatery hasn’t yet made its participation public, diners should speak up and urge the powers that be to sign up ASAP.

For the second year in a row, on the night before — from 4:00 to 8:00 p.m. — DAP Health will host a Bar Crawl on Arenas Road in Palm Springs that will serve as the official kickoff of DOFLGPS 2024. Drag performer Jackett Knightley, the event’s special ambassador, will “Pied Piper” patrons from bar to bar, where DAP Health volunteers will provide proof of participation by punching each revealer’s Bar Crawl bingo card.  

DOFL National’s website states that each year “more than 50 local HIV service organizations partner with 2,400+ participating restaurants, 4,100+ volunteers, and 300,000+ diners to raise over $4.5 million for people living with HIV/AIDS in the United States and Canada. The best part? All funds raised through a city’s Dining Out For Life event stay in that city to provide help and hope to people living with or impacted by HIV/AIDS.”

“Because we were founded 40 years ago as a response to the AIDS crisis, Dining Out For Life has always been of supreme importance to DAP Health’s staff and patients,” says CEO David Brinkman. “Since our recent tremendous expansion has allowed us to increase our award-winning HIV/AIDS care from three to five of our 25 clinics, this annual event is more important to us than ever.”

To register as a Dining Out For Life in-restaurant volunteer ambassador on April 25 — or to sign on as a participating establishment, please contact Bruce Benning at [email protected] or 760.320.7854.

Participating Restaurants at Press Time

1501 Uptown Gastropub

Aspen Mills Bakery & Café

Barracks Bar

Bongo Johnny’s

Carousel Bakery

Chef Tanya’s Kitchen Palm Desert

Chef Tanya’s Kitchen Palm Springs

Chicken Ranch

Clandestino

Copley’s on Palm Canyon

Cork & Fork

Dickey’s Barbecue Pit

Eight4Nine Restaurant & Lounge

El Mirasol at Los Arboles

El Mirasol Cocina Mexicana

El Patio Palm Springs

Elmer’s

FARM

Gelato Granucci

Grand Central

Heirloom Craft Kitchen

Impala Bar & Grill Nightclub

Johannes

Johnny Costa’s Ristorante

Kaiser Grille

Le Donne Cucina Italiana

Lulu California Bistro

Palm Greens Café

Purple Room

Spencer’s Restaurant at the Mountain

Tac/Quila

The Front Porch

Toucan’s

Townie Bagels

Trio Restaurant

Willie’s Modern Fare

Zin American Bistro

Dining Out For Life Greater Palm Springs 2024 Sponsors at Press Time

Steve Tobin, Johnny Krupa, and The Grace Helen Spearman Charitable Foundation

Media Sponsors

Alpha Media

KESQ ABC News Channel 3

KGAY 106.5 & 92.1, GayDesertGuide.LGBT and 103.1 MeTVfm

NBC Palm Springs