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Meet 2015's Top Doctors

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Meet Amy J. Silverman, MD 

Specialty: Child and Adolescent Psychiatry
Hospital Affiliation: Four Winds Hospital, Katonah

Dr. Amy Silverman had always known that she wanted to work with children and adolescents. “While in college and then medical school [Mt. Sinai School of Medicine], I worked at a summer camp, taught religious school, and advised a high school youth group at a synagogue. In medical school, I loved my pediatrics rotations, but the component of treatment I enjoyed the most was helping to address the
psychosocial and emotional issues facing the children.” In 2008, Silverman left the fulltime faculty at Cornell to go into fulltime private practice in Harrison.  

How important is family involvement when it comes to childhood mental health?

I think family involvement is absolutely essential and such an important part of the work in child and adolescent mental health. One can’t effectively work with children without involving their parents. I find that working with families can be incredibly rewarding and productive; it is one of my favorite components of treatment.  

What are the most common problems kids in Westchester face?

I see many children with anxiety disorders who struggle to effectively manage stress. I am also seeing an increasing number of young adults who are finding it difficult to achieve independence and to successfully navigate the transition to the next phase of their lives. I think technology and social media add another layer of complexity to the challenges our children face. It is wonderful when we can provide substantial resources for our children, but sometimes that creates a level of stress and pressure as well.  

Is childhood stress a bigger problem in Westchester than in other parts of the country?

I think we have our fair share of stress here in Westchester among both children and parents! We feel pressure to be “perfect parents” and to give our children all the tools and resources that we can. And often our children feel pressure to do exceptionally well and keep up with peers in academics, athletics, and social activities. Is it worse in Westchester than in other parts of the country? I think we experience a high level of stress in general, but we are certainly not the only community facing these challenges.  

Are we making progress in how we think about mental illness and psychiatric disorders in children?

There is a tremendous amount of work being done looking at the biological underpinnings of mental illness and also how our genetics may influence vulnerability to psychiatric disorders and response to various treatments. We now have research and data guiding treatment decisions for psychiatric disorders specifically in children, which were not available only a short time ago.  

What do you find most rewarding about your work with children and adolescents?

I love helping the children in my practice to get back on track, find happiness or conquer anxiety, and then watching them go on to do amazing things in high school, college, and beyond. I can’t imagine any work that could be more meaningful!  


 

Meet Bonnie Wolf Greenwald, MD 

Specialty: Endocrinology 
Practice: Maple Medical
Hospital Affiliation: White Plains Hospital, White Plains

For Dr. Bonnie Wolf Greenwald, Director of the Endocrinology & Diabetes Department at White Plains Hospital, helping her patients understand how both healthy eating and exercise impact their health is an important part of her practice. “As part of being an endocrinologist, I am passionate about nutrition and exercise. I love to talk about it! I am not a nutritionist, but I do like to provide my patients with new recipes and healthy snacks. Now my patients have started bringing new recipes to me,” she says. “For exercise, I try to find videos available online for all levels of ability and give suggestions for classes that are available in the community.” She is experienced in all aspects of endocrinology, diabetes, metabolism, and osteoporosis, with an expertise in procedures such as thyroid ultrasound-guided biopsy. 

Greenwald says she loves working at White Plains Hospital because her home and heart are tied to the people who live here. “I love practicing here because I’m a physician in my own community,” she says. 

Diabetes has been called the chronic epidemic of this millennium. How are we handling this epidemic in Westchester?

Westchester patients are fortunate to have access to diabetes care and endocrine specialists who are experienced in treating patients with both Type 1 and Type 2 diabetes. In addition, most hospitals in Westchester and some private offices have clinical diabetes educators and nutritionists who work with endocrinologists to provide additional care. White Plains Hospital has a Diabetes Education and Treatment Center, which is equipped to educate patients on insulin management, self-monitoring of blood glucose, and nutritional counseling. 

Are we making strides in diabetes care?

As endocrinologists, we are always trying to provide excellent care to our diabetic patients. Part of this responsibility is keeping abreast of new medications and technologies as they become available. In the past few years, for instance, the SGLT-2 inhibitors (a new class of oral medications, used mostly to treat patients with Type 2 diabetes) were FDA-approved. In addition, inhaled insulin has become available as an alternative to injections in appropriate patients. On the horizon, there is a “closed-loop” insulin pump that acts as an artificial pancreas.

How difficult is it to diagnose endocrine disorders?

Endocrine disorders are sometimes very complex and difficult to diagnose. Often, patients present to the endocrinologist as a last resort for more extensive testing. These disorders may take quite a while to diagnose and require additional laboratory and radiologic studies. One case that I saw recently was a patient who’d had the “worst headache of his life” one month prior to his presentation to me. He had been feeling cold, fatigued, losing weight, and could barely get out of bed. That morning, a cortisol level was checked and undetectable. He was finally diagnosed with panhypo-
pituitarism, most likely secondary to pituitary apoplexy. He has now been treated appropriately, and he is feeling quite well. 

What do you love most about practicing in Westchester?

I love being able to provide advice and help to my friends and family as they navigate the hospital and their medical concerns. In this, I’m more than just an endocrinologist. I can be a liaison providing advice and guidance—connecting people to the right medical professionals and generally ensuring that everyone I know is getting the best possible care.


 

Meet Alon Gitig, MD, FACC

Specialty: Cardiology
Practice: Mount Sinai Riverside Medical Group
Hospital Affiliation:
St. John’s Riverside Hospital, Yonkers

Dr. Alon Gitig didn’t become enamored with cardiology until he began his residency training at New York Presbyterian–Weill Cornell. “I was originally drawn to cardiology during my residency training because the physiology of normal heart function and the pathophysiology of cardiac disease was fascinating,” says Gitig, who has been in practice since 2007 at the Mount Sinai Riverside Medical Group in Yonkers. “No matter how long one has been practicing, there continue to be complex diagnostic dilemmas that require outside-of-the-box thinking to properly solve. The satisfaction of grappling with a clinical puzzle and finally figuring out how all the pieces fit together is hard to equal in any other profession that I know of.” 

But it’s not all about solving the clinical puzzle—Gitig is equally passionate about his role in preventative care. “Cardiology is an amazing field because of the role that prevention plays in so many people’s lives.  The opportunity to help disease-free individuals optimize their cardiovascular health and minimize their risk for future disease allows me to reach the greatest number of people in my work.”

What are the biggest contributors to heart disease?

With the obesity epidemic in full-swing, I would say the biggest contributor is probably the combination of lack of exercise and carbohydrate-laden diets. This leads to the condition known as insulin resistance or metabolic syndrome, in which there are several physiologic alterations that increase risk of developing diseased artery walls, heart attacks, and strokes.

Do your healthiest patients share any common traits or habits?  The healthiest patients I see tend to be more mindful, in general, about how they are living. This may mean mindful eating, with a degree of advance planning and forethought about their meals and shopping lists, instead of exposing themselves to the hazards of whatever processed food is readily available to them at the instant that they become hungry during their busy day.  Or it may mean thinking about where in their hectic lives they can begin to fit even a small amount of time for increased activity or movement.

How are Westchester residents doing when it comes to heart health? 

Westchester residents are susceptible to the same pitfalls of modern living as everybody else—including more sedentary lifestyles, and diets saturated with sodium, processed foods, and, especially, processed carbohydrates.  However, I
increasingly notice a trend among my Westchester patients to be more know-ledgeable about these unhealthy patterns and motivated to try to reverse them.

I find that a large proportion of my Westchester patients are sincerely motivated to live healthy lives. It is very rewarding to counsel people on how to maintain optimal health when they themselves are active participants in that process and truly want to get well or remain well. When people come into my office having successfully lost 25 pounds, or two inches of waist circumference, and they are just as excited to share that progress with me as I am to hear it, it motivates me that much more to keep trying to help them in these efforts.


 

Meet Regina Giuffrida, MD

Specialty: Gynecology
Practice: Mount Kisco Medical Group 
Hospital Affiliation: Northern Westchester Hospital, Mount Kisco

Dr. Regina Giuffrida’s path to medicine began as a child, when her father, an anesthesiologist, taught her reverence for the human body and respect for the human soul. Still, Giuffrida didn’t set her sights on becoming a gynecologist until her third year at New York Medical College. “Initially, I thought that [my career path] would be ophthalmology,” Giuffrida recalls. “But then, I stepped into the mysterious and enticing world of OB/GYN. First, the science of it intrigued me—the microscopic egg and sperm packed with all the genetic information necessary, when combined, to become a human being. Then came all the mechanics as the body prepares for and executes its own procreation. Then I met the patients, delivered their babies, learned their surgeries—and I was hooked!” 

After delivering many Westchester babies, Giuffrida, who has been in practice since 1984 and at Mount Kisco Medical Group since 1997, stopped practicing obstetrics in 2009 to focus solely on gynecology. “I still love it and cannot imagine doing eye exams!”

What are the biggest mistakes women make regarding their health?

Taking it for granted. As partners and mothers, we often put ourselves on the back burner. Every day, I see patients who are overdue for exams, screening tests, vaccinations. Once we lose our health, it’s often a struggle to get it back. Keep your eye on it!

What’s your best advice to women on how to take care of themselves?

Live a healthy lifestyle with a healthy portion of self-concern and find doctors you trust to help you do it.

What advances in gynecology are you most excited about?

One that is particularly gratifying is the focus on quality of life in cancer survivors, not just 5- or 10-year survival statistics. For example, when I was a student, surgical treatment for breast cancer was so radical that women were essentially left with only skin covering their rib cage—a daily disfiguring reminder of their disease. Now, the approach to breast-cancer surgery is nothing short of remarkable. In addition, in years past, the gynecologist was out there on his or her own, trying to restore sexual function after certain types of breast- and GYN-cancer treatments. Now, sexual function in survivors is directly addressed by surgeons, medical and radiation oncologists, and each patient knows this is an important issue—not one to be silent about.

What do you love most about practicing in Westchester?

It’s rewarding to live amongst the women who’ve come through the door of my office. We have so many parallel paths—working, raising kids, helping aging parents. I’ve grown up with many of my patients—through our days of childbearing and our nights of menopausal night sweats, with decades of weight gain and attempted weight loss in between!


 

Meet Gregg Caporaso, MD, PhD

Specialty: Neurology
Practice: Westchester Health
Hospital Affiliation: Northern Westchester Hospital, Mount Kisco
 

Dr. Gregg Caporaso started making a name for himself in the field of Alzheimer’s treatment in 1988, when he was a grad student at the Rockefeller University in New York City and working in the lab of Dr. Paul Greengard. “I knew almost nothing about neuroscience when I joined Paul’s lab, but I had the great fortune of working with Dr. Sam Gandy, a neurologist who had just started a project on Alzheimer’s disease. A protein called amyloid is believed to be a key trigger for developing Alzheimer’s, and we were among the first scientists to study how this protein was made by cells,” he says. Caporaso explains that this work has had direct clinical relevancy, since most drugs in clinical trials are aimed at preventing the production of amyloid or removing it from the brain. “It was a great privilege to work with such eminent researchers,” he says. “Paul actually went on to win a Nobel Prize!”

Twenty-five years later, at the top of his field, with a practice at Westchester Health, Caporaso still considers his experience working with Drs. Greengard and Gandy “what inspired me to become a neurologist.”

Is Alzheimer’s disease more closely linked to environment or genetics?

With the exceptions of a few unfortunate families with inherited, early-onset forms of Alzheimer’s disease, most people develop the illness through a combination of genes and environment. There are genes like ApoE4, which increase one’s risk of Alzheimer’s disease, and factors such as level of education, amount and type of lifelong activities, and tobacco or alcohol use, which impact the expression of that risk. For most people, the greatest risk factor for dementia is age. Some studies have estimated that approximately 40 percent of people over the age of 85 have Alzheimer’s disease. Having close relatives with Alzheimer’s disease also raises one’s risk. 

Do you have any advice on how to prevent Alzheimer’s?

In general, about the only thing one can do to prevent Alzheimer’s at present is to live healthy. What’s good for the heart is good for the brain. I would also recommend being socially active and undertaking new challenges, such as learning a new language or taking up a new hobby.

Do you think there will ever be a cure for Alzheimer’s?

There are lots of smart scientists who have been working a long time to find treatments to prevent or halt the progression of Alzheimer’s. The main conundrum with the disease is that the pathological changes in the brain that eventually result in dementia are believed to take place decades before the first symptoms appear. So the problem is identifying who is most at risk for Alzheimer’s when they are still relatively young and then starting a therapy that provides lifelong protection. I think we will eventually find an answer to prevent Alzheimer’s, but I think it will take years to find it.


 

Meet Carol L. Karmen, MD, FACP

Specialty: Internal Medicine
Practice: Westchester Medical Center Advanced Physician Services, PC 
Hospital Affiliation: Westchester Medical Center, Hawthorne 

In 1990, after completing three years of residency in Internal Medicine at Westchester Medical Center, Dr. Carol L. Karmen became Westchester Medical Center’s first woman chief resident in the Department of Medicine. Twenty-five years later, she still holds her position in General Internal Medicine at WMC. It  has been a perfect match, although not the career Karmen originally envisioned for herself. “I had planned to become a neonatologist and work in the ICU, caring for premature infants,” she recalls. “During my third year of medical school, I realized that I liked babies, but I was upset when babies—and their parents—cried. I ultimately pursued Primary Care Internal Medicine because I love to develop a rapport with my patients and enjoy such a long-term relationship.”  Karmen says she still treats some of the same patients she did when she first started, “and now their children and even some of their grandchildren!” 

Why is preventative health so important?

It is much better to prevent a disease than to treat it. For example, we are facing an epidemic of diabetes. Close attention to diet, weight loss, and exercise may prevent this disease from ever occurring. In cancer screening, it is much better to find a cancer early, when the chance of cure is greatest.

What is your best preventative health advice? 

Continue to engage in the activities that have always given you pleasure. This is especially true as we age. I often see elderly patients who begin to decline because they have become removed from the people and activities they have always enjoyed. My advice is, therefore, to continue to participate. If you enjoy baseball, continue to follow the sport. If you like to read, continue to find out about new books and revisit some old ones, or join a book club.


 

Meet Thomas J. Rush, MD

Specialty: Infectious Disease 
Practice: Hudson Infectious Diseases Associates 
Hospital Affiliation: Phelps Memorial Hospital Center, Sleepy Hollow

Having worked in the area of infectious disease in Westchester County for the past 28 years, Dr. Thomas Rush was present at the beginning of the AIDS epidemic, when a diagnosis was tantamount to a death sentence. He has witnessed a change in both the disease itself, which is now considered a chronic illness—thanks to research and development of new and better medications—and the public perception of it. “Being part of this transformation has been the most meaningful thing I’ve been involved in during my career,” he says. In addition to working in private practice at Hudson Infectious Diseases Associates in Briarcliff Manor, Rush works with the New York State Department of Corrections, caring for patients with HIV and Hepatitis C. 

Rush, who was initially drawn to the field of infectious disease for the intellectual challenge, says, “It is a very cerebral specialty, which involves piecing together medical clues, making sense of symptoms, and solving medical dilemmas; that’s what keeps drawing me back in!”

Which infectious disease causes the most serious problems in Westchester?

Obviously, one big problem in Westchester is tick-borne illness. In addition, HIV infection and Hepatitis C are pretty widespread as well. And because Westchester is an affluent but aging population, a lot of the cases I see are older people who are nearing the end of their lives and get infections. 

In the realm of infectious disease, what concerns you most?

The problems created by resistant bacteria is a real concern. I have been seeing more and more resistant bacteria, and I’m concerned we will be dealing with more infections that we call gram-negative organisms, for which we have no antibiotics yet.

What is the best strategy for avoiding infectious disease?

It’s mostly common sense. Generally, stay healthy. Stay fit, eat well, don’t smoke, and get your vaccinations. We have a lot of ways of preventing infectious disease these days that are very effective. A lot of the infections I see are the results of smoking, diabetes, and obesity.

How do you feel about the anti-vaccination movement?

I think it is very destructive. It’s this conspiracy theory stemming from a suspicion of doctors, medicine, and science in general, and it’s very unfortunate because when parents refuse to have their children vaccinated, they potentially put a lot of other people at risk—not just their kids and themselves.

You were present at the beginning of the AIDS epidemic. How are we doing in the fight against AIDS?

Progress has been spectacular in transforming what was once a uniformly fatal illness into something that is now a chronic manageable illness—along the lines of diabetes and high blood pressure. We are doing incredibly well, but there is always room to improve. The problem is that there are still a lot of infected people out there who are not in care. The big challenge today is connecting them with care and keeping them in care. If they take their medicine and the virus is suppressed in their bloodstream, they are less likely to pass it on to other people, and they are less likely to get sick themselves.


 

Meet Cynthia S. Chin, MD

Specialty: Thoracic Surgery
Practice  White Plains Hospital Physician Associates 
Hospital Affiliation: White Plains Hospital, White Plains

As the director of the Women’s Cancer Program Services at White Plains Hospital, Dr. Chin says she was drawn to pursue a career in oncology because of the patients who inspire her. “I find patients who are faced with cancer or the possible diagnosis of it to be remarkable human beings. It is extremely rewarding to be part of their care during this time. I find every case I do meaningful. Every patient and their family dynamics and disease are unique. I always feel honored to be a part of their care.” Why thoracic oncology in particular? “It allows me to combine my enthusiasm for cancer patients with my love for performing surgeries of the chest.”

Chin, who grew up in Croton-on-Hudson and attended Cornell University and SUNY Stony Brook for medical school, says practicing in Westchester just feels like home. “Although I live in the city, I feel like I came home when I started practicing here. I feel a real bond with my patients that is partly due to the fact that they work, live, and/or raise their families where I grew up.” 

Who is most susceptible to lung cancer?

Eighty percent of women and 90 percent of men with lung cancer have a smoking history. Smoking is far and away the No. 1 cause. Other causes include asbestos, radon, and other environmental exposure. 

Do women face different risks then men?

A greater percentage of women with lung cancer have never smoked compared with their male counterparts. We really don’t know the reason for this, but the medical community is currently trying to figure it out.

What is your advice on how to lower your chances of getting lung cancer?

My best advice is to never start smoking and, if you do smoke, to quit immediately. Although a higher amount of cigarette smoking increases the risk for lung cancer, there is no safe level of exposure to tobacco smoke.  A landmark article in The New England Journal of Medicine published in 2011 showed that lung-cancer screening with chest CAT scans can save lives. Smokers or former smokers should ask their primary-care physicians if they qualify for a chest CT scan. In 2012, we started a free lung-cancer screening program at White Plains Hospital. This was done in an effort to help the community combat lung cancer, which has a high mortality if found at advanced stages. The idea of lung-cancer screening is that we find early, potentially curable, cancer. The program is successful and still accepting patients. Readers who are over 50, smoked a pack a day for 20 years or more or half a pack a day or more for 40 years and are current or former (quit last 20 years) smokers should call (914) 681-2365 to see if they qualify for a lung-cancer screening CAT scan.


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