Community Health Policy

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How can we safely open up our lives in Southwest Oklahoma?

How can we safely open up our lives in Southwest Oklahoma?

The most important lessons about reopening the community are learned from places that never locked down in the first place: hospitals.

As the author of this linked article describes it, in the face of enormous risks, American hospitals have learned how to avoid becoming sites of coronavirus spread.

This approach to reopening the community that is documented to make the difference can be thought of like a “combination therapy” or a “drug cocktail.” These ingredients (below) are all familiar to you. Each has flaws. But skip one, and the treatment doesn’t work. Taken together – and taken seriously – the virus is shut down.

1. Hygiene measurescleaning your hands frequently. In the previous 2002 SARS epidemic, hand washing 10 times a day cut down transmission by over 50%. Disinfecting surfaces is likely very important, also, though less research exists.

2. Screeningtaking temperatures prior to entry to a building; and also self-reporting of a new fever, cough, sore throat, shortness of breath, loss of taste or smell, and even just persistent nasal congestion/runny nose.

Ideally, we will test people with new symptoms to allow people to quickly get back to work or to life, without quarantine. Without testing, people with symptoms should self-quarantine for at least seven days from the start of their symptoms and until they’ve been fever-free and with improving symptoms for 72 hours.

3. Distancing – SARS-CoV-2, the coronavirus that causes COVID-19, spreads primarily through respiratory droplets emitted by infected people when they cough, sneeze, talk, or simply exhale, and the droplets are then breathed in by others. This is why social distancing is so important.

4. Masks – three major points here. First, it turns out that infected people just on the verge of having early symptoms or just beginning to have mild symptoms, are important sources of coronavirus spread.

Second, the effectiveness of masks has recently been extensively reviewed and suggests that if at least 60% of the population wore masks that were just 60% effective in blocking viral particles – which a well-fitting, two-layer cotton mask is – the epidemic could be stopped.

Third, since cloth and surgical masks do not fit tightly, you can breathe air coming in around the sides. They are designed to safeguard others, not the wearer, although laboratory research finds that surgical masks reduce inhalation of respiratory-droplet-size particles by about three-quarters. The basic logic is: I protect you; you protect me.

The linked article is a quick and entertaining read, and answers a number of obvious questions about coronavirus and COVID-19. I urge you to read it, and then: embrace the desire to keep others safe, not just ourselves.

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Flattening the Curve


Understanding the Importance of Social Distancing and Isolation to Slow the Spread of the Coronavirus

Much has been said on the news and in social media about “social distancing” and “flattening the curve.” But what do those mean? And why do they matter?


In the Common Sense Family Doctor Blog, Kenny Lin, MD offers a concise description of what it is and why it matters.

Read Dr. Kenny Lin’s entire post here

“If the peak of the epidemic curve exceeds the surplus capacity of our health care system (and as others have pointed out, it’s not like hospitals maintain thousands of empty intensive care unit beds just waiting for an epidemic to strike), then more people will die, as health care professionals fall ill or succumb to exhaustion and there aren’t enough resources for the critically ill to go around.

That’s why it’s so important to start social distancing now, and to cancel or postpone mass gatherings such as conferences, concerts, political rallies, and athletic events.”

Here in SW Oklahoma, we anticipate adequate testing soon. Meanwhile, please take every precaution to keep your distance (for now) and avoid attracting or spreading this and all viruses.

Read Common Sense Practical Advice from a Medical Expert

Read The Coronavirus (COVID-19) and How We Can Prepare in SW Oklahoma

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Preventing COVID-19, Practical Advice

Preventing COVID-19, Practical Advice

Common Sense Practical Advice from a Medical Expert

Dr. James Robb is a consulting pathologist at the National Cancer Institute. Among the first molecular virologists in the world to work on the coronavirus category of viruses back in the 1970s, he knows what he’s talking about more than many of those who have spoken publicly on the coronavirus. And he also knows how to translate his expertise into practical advice.

Minor edits were made to these recommendations due to new information.

Here’s Dr. Robb’s advice to his colleagues:

Dear Colleagues: These are the precautions that I take and will take:

  1. NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
  2. Use ONLY your knuckle to touch light switches, elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
  3. Open doors with your closed fist or hip. Do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
  4. Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
  5. Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
  6. Keep a bottle of sanitizer available at each of your home’s entrances. AND in your car for use after getting gas or touching other contaminated objects when you can’t immediately wash your hands.
  7. If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
  8. Hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.
  9. Zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY “cold-like” symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.

Note: This virus only has cell receptors for lung cells (it only infects your lungs). The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average – everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon.

I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this virus before and have no internal defense against it.

Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.

I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share.

Good luck to all of us!
James Robb, MD FCAP

James Robb, MD was professor of pathology at the University of California San Diego and one of the first molecular virologists in the world to work on coronaviruses (the first strains that were identified in the 1970s). He was first to demonstrate the number of genes the virus contained. Since then, he has kept up with the coronavirus field and its multiple transfers into the human population (e.g., SARS, MERS), from different animal sources.

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The Coronavirus (COVID-19) and How We Can Prepare in SW Oklahoma

The Coronavirus (COVID-19) and How We Can Prepare in SW Oklahoma

The first step is to be educated about the disease and how it spreads

It is time – now – to prepare for the coronavirus (COVID-19). Day by day, community spread is documented around the country, and although the first case in Oklahoma was travel-related, NOT attributed to “community spread,” it is more and more likely to happen. This is particularly true because of Ft. Sill and the many comings and goings from around the country and around the world.

The first confirmed Oklahoma case of COVID-19 was reported March 6 in Tulsa County.

There are steps we can take to prepare. The first step is to be educated about the disease and how it spreads.


Please read this page. Coronavirus is very flu-like in that it spreads from person-to-person,

  • between people who are in close contact (within about 6 feet)
  • via respiratory droplets produced when an infected person coughs or sneezes, or
  • by touching a surface and then touching your own mouth, nose or eyes (less likely).

Coronavirus can spread even before symptoms appear, although the data on this is still being confirmed.

Symptoms can take between 2 and 14 days to appear after being infected.


Main symptoms appear to be Fever, Cough and Shortness of breath. Although some have presented with abdominal pain or other unexpected symptoms.

These facts make coronavirus hard to stop once community spread has started. Read this page for more information.


There is NO vaccine to prevent infection. Best estimates for availability of a vaccine: 2021. There is no treatment for this infection, either.

Testing: The Oklahoma State Department of Health said in a news release March 6 that the state’s lab began testing Friday and will continue to test as specimens are received from health care providers. Hopefully Comanche County will be able to test for coronavirus soon.

Please follow everyday preventive actions recommended by the CDC to prevent spread of respiratory diseases:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.

As always contact your primary care provider ASAP if you feel symptoms or are concerned that you may be infected.

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MainSt. Clinic Third Anniversary Celebration Goes On The Road

MainSt. Clinic Third Anniversary Celebration Goes On The Road

Open House Wednesday, November 7 at the Lawton Food Bank 3:00 to 4:30 pm

Dr. Brian Birdwell announced that MainStreet Clinic will celebrate its third anniversary on Wednesday, November 7 with the theme “MainSt. Clinic Gives” by hosting an Open House at the Lawton Food Bank, 1819 SW Sheridan Road in Lawton, from 3:00 to 4:30 pm.

Members of the Clinic and the entire Lawton area community are invited to attend and bring at least one item of non-perishable food or a financial contribution to help the Lawton Food Bank meet the food and nutritional needs of our community this holiday season.

“We want to promote healthy lives throughout our community, wherever and whenever people need care. This holiday season, we will take our anniversary celebration “on the road” to the Lawton Food Bank,” Dr. Birdwell said.

Please join us November 7 to meet Jeri Mosiman, executive director, and tour the Lawton Food Bank facility. Viridian Coffee and refreshments will be served.

About Brian Birdwell, MD and MainSt. Clinic

MainStreet Clinic is a direct primary care membership clinic offering innovative medical services in the old fashioned style of a personal physician caring for each patient individually. MainStreet Clinic provides comprehensive primary care services for individuals and families, regardless of insurance coverage, and occupational health and wellness services for employers.

Established in 2003, our clinic has grown steadily along with business and the community in Southwest Oklahoma. We are a team of medical professionals dedicated to health care that is accessible to all, affordable, and a quality experience for our patients.

Board Certified in Internal Medicine, Brian Birdwell, MD has worked in private practice in Lawton since 2001. He has more than 25 years of experience in occupational medicine. He served as medical director for McBride Occupational Medicine in Oklahoma City and served 11 years as medical director and plant physician for Goodyear Tire and Rubber Co. in Lawton, Oklahoma.

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Direct Primary Care Legislation Passes Congress

Direct Primary Care Legislation Passes Congress

Updated October 31, 2018

Thank you Congressman Tom Cole

The U.S. House of Representatives passed HR 6199 the Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 on July 25 by a vote of 277-142. View votes

Our Congressman Tom Cole joined a bipartisan majority to fix an IRS problem that has prevented Oklahomans from using their health savings accounts (HSAs) to pay membership dues at MainSt. Clinic and other direct primary care (DPC) clinics across Oklahoma and the U.S.

The IRS has ruled that direct primary care (DPC) clinic membership is a “separate health plan.” Under this IRS rule, taxpayers are prevented from spending their own HSA money on membership at MainStreet Clinic or any DPC clinic – or even belonging to a DPC clinic if they are currently contributing to an HSA. Congressional action is required to fix this and overrule the IRS.

Thanks also to our Washington lobbyist Jay Keese at Capitol Advocates for his hard work over the past five years to make this happen. But we’re not finished!

Next Step: On To The Senate

What can you do?

1. Call or write Congressman Tom Cole to thank him for his leadership on this matter. Tom Cole just happens to be the Chairman of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies. Mr. Cole’s subcommittee has a voice in shaping health care policy and he is an important leader in Congress. Ask Mr. Cole to use his leverage to pass future legislation to permanently fix this problem (see #3 below). 

2. Contact Senators Jim Inhofe and James Lankford to request they do the same: support the Restoring Access to Medication and Modernizing Health Savings Accounts Act of 2018 in the Senate and co-sponsor the Primary Care Enhancement Act, SB 1358, with Sen. Bill Cassidy (R-LA).

3. Ask Rep. Cole and Sens. Inhofe and Lankford to support future legislation to permanently fix this problem by making direct primary care (DPC) clinic membership fees normal, qualified medical expenses under Section 213(d) of the U.S. Tax Code, like other doctor’s fees already are!

Yes, this sounds confusing because it is.

What this means is that when the cost of belonging to MainSt. Clinic is considered a “qualified medical expense” by the IRS, and no longer a “separate health plan,” then your membership fees will be tax-deductible and all the problems of paying for membership with health reimbursement accounts (HRAs) or flex spending accounts (FSAs) will be eliminated!

Contact Congress:

Rep. Tom Cole

2467 Rayburn HOB
Washington, DC 20515
Phone: (202) 225-6165

Sen. Jim Inhofe


205 Russell Senate Office Building
Washington, DC 20510
Phone: (202) 224-4721

Sen. James Lankford


316 Hart Senate Office Building
Washington, D.C. 20510
Phone: (202) 224-5754

Posted in: Community Health Policy, Direct Primary Care, News

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Annual Lupus Walk Raises Awareness and Money to Fight Terrible Disease

Annual Lupus Walk Raises Awareness and Money to Fight Terrible Disease

Less than one-half of one percent of Americans suffer Lupus, yet for those 1.5 million people, it is a devastating disease.

You can help easily by supporting the Lupi-Shenanigans Team this week! The annual OKC Lupus Walk is June 2nd at the OKC Zoo. Walk in OKC this Saturday if you can or donate to help improve the diagnosis and treatment of lupus, support people affected by the disease and find the cause and the cure.

MainStreet Clinic is one of two local sponsors of the Lupi-Shenanigans Team at the annual Oklahoma fundraising event this year. Donate $30 to The Lupi-Shenanigan’s Team Page and receive this cool Lupi-Shenanigans Adventure hat (while supply lasts)!

According to the Mayo Clinic, Lupus is a systemic autoimmune disease that prompts your body’s immune system to attack your own tissue and organs. Inflammation caused by lupus can affect many body systems, including joints, skin, kidneys, blood cells, brain, heart and lungs.

Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus is a facial rash that resembles the wings of a butterfly unfolding across both cheeks. 90 percent of lupus suffers in the U.S. are women and when this facial symptom arises, it feels like terror.

Your donation will have a lasting effect on Lupus research right here in Oklahoma. All monies donated to the Oklahoma Lupus Foundation stays in our great state to work toward new drug therapies and eventually a cure. Learn more at the Oklahoma Lupus Foundation.

Lupi-Shenanigan’s Team Page:

Team Lupi-Shenanigans Adventure Hat

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Supercharge Your Summer Salads with High-Protein Vegetables and Grains

Supercharge Your Summer Salads with High-Protein Vegetables and Grains

Adding Protein-Rich Plant Foods to Your Diet

Getting protein in your diet from vegetables and grains is one of the best weapons you have to fight cardiovascular disease.

But how do you change your diet gradually?

Crisp, leafy salads with plant proteins are a perfect choice for those seeking high nutrition and healthy weight loss. According to Prevention Magazine, these protein-rich plant foods can help you supercharge your summer salads, soups or stir fries for better nutrition and cardiovascular health.

Many protein-rich legumes, grains and vegetables can be found right here at the Murphy Farms Store in Walters.

See recipes ideas for:

Quinoa Fiesta Stuffed Peppers

Indian-Style Red Lentil Soup

Gazpacho: Salad With A Spoon

Organic Edamame (cooked soy beans)
Protein: 18 g per 1-cup serving

Protein: 9 g per ½-cup serving

Protein: 8 g per 1-cup serving

Black Beans
Protein: 7.6 g per ½-cup serving

Lima Beans
Protein: 7.3 g per ½-cup serving

Peanuts or Peanut Butter
Protein: 7 g per ¼-cup serving (or 2 Tbsp peanut butter)

Wild Rice
Protein: 6.5 g per 1-cup serving

Protein: 6 g per ½-cup serving

Protein: 6 g per ¼-cup serving

Protein: 5 g per ¼-cup serving

Protein: 3 g per ½-cup serving

So how much protein should we get every day?

WebMD offers these suggested amounts of protein per day:

Babies 10 g

School-age kids 19-34 g

Teenage boys up to 52 g

Teenage girls and women 46 g

Adult men 56 g

Pregnant and breastfeeding women 71 g

Download Our May-June Newsletter PDF

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The Local Y Is Your Pathway To Better Heart Health Through Exercise

The Local Y Is Your Pathway To Better Heart Health Through Exercise

Lawton Family YMCA Offers More Than 20 Healthy Exercise Classes and a Free Strength and Flexibility Test with Beginner Workout Plan

The local Y is your pathway to better heart health through exercise. The Lawton Family YMCA offers a wide range of health and exercise classes from Boot Camp to Stepping, Spinning to Water Aerobics, Yoga and many more options.

Read the current class schedule here

But how do you know what exercise plan is safe and effective for you?

Not to worry. The local Y offers the Polar USA physical test completely free to members measuring your blood pressure, heart rate, BMI, strength, and flexibility. After your assessment, the Y will help you make a beginner workout plan.

Contact the Lawton Family YMCA Welcome Center to set an appointment with the health and wellness staff. Call 580 355-9622 or visit 5 SW 5th St in Lawton.

Download Our May-June Newsletter PDF

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Agency for Healthcare Research and Quality Under Fire

Agency for Healthcare Research and Quality Under Fire

Common Sense Family Doctor is a regular feature on our website. Today’s topic involves the Agency for Healthcare Research and Quality (AHRQ).

In the ‘Fake News’ era, AHRQ is one of the good guys. The nerd’s nerds. AHRQ is the ultimate eat-your-spinach news that’s good for you, even if you don’t want to hear it or believe it. Not every medical recommendation proves to be fully correct, and we learn from practice. But it is the fact-free ideas that are zealously embraced and defended despite evidence.

Science is much more painstaking.

(One example: the argument that “vaccinations cause autism.” No, it turns out they don’t. That research was never duplicated, and the ‘science’ that initially suggested it was pure cheating by an unethical researcher. Those claims have been thoroughly debunked — partly through the independent efforts of the AHRQ.)

The AHRQ uses transparent science to scrutinize health claims without regard for the prestige or commercial influence of the source. AHRQ must remain independent of political or commercial bias to insure our health care spending actually improves the public’s health.

Read the Common Sense Family Doctor here: Once again, the Agency for Healthcare Research and Quality stands in the line of fire, published March 6, 2018

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