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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

Posted in: Community Health Policy, News, Your Health

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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.

Posted in: Community Health Policy, News, Your Health

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Announcement of Katherine Moore, APRN, CNP at MainSt. Clinic

Announcement of Katherine Moore, APRN, CNP at MainSt. Clinic

Dr. Brian Birdwell and the MainStreet Clinic are excited to welcome Katherine Moore, Certified Nurse Practitioner. Katherine is joining the clinic with 10+ years of experience as a Registered Nurse and is offering services for all ages.

Katherine is now accepting memberships for personalized health care in the direct primary care model at MainSt. Clinic. Her goal is to make a difference in the lives of her patients, through a personal relationship built on trust, transparency and availability. Katherine seeks to make every client feel like family, where personal values and beliefs are respected.

Clinic membership includes unlimited office visits, home visits when needed, timely access to your provider via text, cell phone calls, emails, video chat or even through the Spruce online medical support app.

In 2007, Katherine graduated from the University of Oklahoma Health and Science Center with a Bachelor’s in Science and Nursing and has been a practicing Registered Nurse ever since. In 2018, she graduated with a Master of Science in Nursing and achieved her certifications as an Advanced Practice Registered Nurse and Family Nurse Practitioner.

Her reputation as an avid community volunteer and leader is well known, as a past board member for the United Way of Southwest Oklahoma, heading the Community Investment Committee for several years; a current Cameron University Alumni Association Board member; and nationally, on the Community Education Committee for the American Association of Neuroscience Nurses.

For more information or to schedule your appointment, contact Katherine Moore via her website or call MainSt. Clinic at 580-248-9966.

Posted in: Direct Primary Care, News

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How To #FightFlu This Season

How To #FightFlu This Season

Getting a flu shot is the best way to protect yourself, your family and vulnerable people in our community

Flu shots can reduce flu illnesses, doctor visits, and missed work or school due to the flu, as well as prevent flu-related hospitalizations.

A 2017 study in Pediatrics was the first to show that flu vaccination also significantly reduced a child’s risk of dying from influenza.

The more people who get vaccinated, the more people will be protected from the fluincluding older people, very young children, pregnant women, and people with certain long-term health conditions who are more vulnerable to serious flu complications.

What’s new this flu season?

Flu vaccines have been updated to better match circulating viruses [the B/Victoria component was changed and the influenza A(H3N2) component was updated].

Fluzone High-Dose is licensed specifically for people 65 years and older. Fluzone High-Dose helps build up protection against flu viruses. The higher dose of antigen in the vaccine is intended to give older people a better immune response, and therefore, better protection against flu.

This high-dose vaccine is not available at MainSt Clinic, however it can be gotten at most major pharmacies, and is covered if you have Medicare A and B.

Fact Check: Can the flu vaccine give me the flu?

No. The flu vaccine is made with killed virus or a recombinant method using non-living ingredients.
So the flu shot can’t give you the flu. But a few people may develop flu-like symptoms after getting a flu shot for a variety of reasons, including:

  • Reaction to the vaccine. Some people experience muscle aches and a slight fever for a day or two after receiving a flu shot. This may be a side effect of your body’s production of protective antibodies.
  • The two-week window. It takes about two weeks for the flu shot to take full effect. If you’re exposed to the influenza virus shortly before or during that time period, you might catch the flu.
  • Mismatched flu viruses. In some years, the influenza viruses used for the vaccine don’t match the viruses circulating during the flu season. If this occurs, your flu shot will be less effective, but may still offer some protection.
  • Other illnesses. Many other diseases, such as the common cold, also produce flu-like symptoms. So you may think you have the flu when you actually don’t.

Posted in: Health Blog, News, Workplace Health, Your Health

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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

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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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MainStreet Clinic Anniversary Open House Nov. 2


MainStreet Clinic Anniversary Open House

LAWTON – October 28, 2016 – MainStreet Clinic members and the Lawton area community are invited to an Anniversary Open House on Wednesday, November 2, 2016 from 4:00 until 6:00 p.m. at MainStreet Clinic, 415 W. Gore Blvd in Lawton.

Featured guest this year will be Elisabeth Murphy of Murphy Farms in Walters. Murphy will demonstrate the many organic fruits and vegetables grown year-round in neighboring Cotton County. Also Dr. Birdwell will present contributions from the Clinic’s generous members to the Lawton Family YMCA scholarship fund and to the Lawton Food Bank. These community partners exemplify the Clinic’s commitment to the “Keys to Health” – Eating Real Food, Getting Regular Exercise, and Access to Real Care. Please R.S.V.P. at (580) 248-9966.

MainStreet Clinic introduced an innovative health care payment model called direct primary care clinic membership to southwest Oklahoma.

“Clinic membership is a new health care model that is really old-fashioned, person-to-person health care. It’s a direct system between the doctor and the patient. I am available to you anytime you need a question answered or have a need. Even house calls. It’s whatever you need to stay well and be cared for,” Dr. Brian Birdwell said.

For a flat monthly membership fee, patients are assured

  • access to all clinic services on the same day or next day;
  • unhurried extended-time clinic visits;
  • contact with the doctor anytime by text or phone;
  • discounts on many generic medications dispensed directly from our clinic; and
  • other premium services.

No health insurance is required since MainStreet Clinic does not file insurance claims or do any billing for our care. But the Clinic does work with private insurance or government coverages for which members are eligible.

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MainStreet Clinic Celebrates National Health Education Week


Chronic Diseases in Oklahoma Are Common, Costly, and Can Be Reduced Through Exercise, Good Nutrition and Access to Health Care

Health Education Week Prevent Chronic Diseases

LAWTON, OK – During the week of October 17-21, MainStreet Clinic joins the Society for Public Health Education to promote National Health Education Week to raise public awareness of the importance of

  • exercise and physical activity,
  • good nutrition and
  • access to health care

in the prevention of chronic diseases.

Chronic diseases, such as heart disease, lung disease and diabetes, can be very costly, disabling and deteriorate the quality of life, especially when undiagnosed or untreated.

According to the Oklahoma State Department of Public Health: “Chronic disease is the most common and costly of all health problems. A person’s risk of developing a chronic disease can be greatly reduced by avoiding tobacco, being physically active and eating well. However, individual behavior is not enough. Access to affordable health care saves lives, reduces disability, prevents hospitalizations and lowers medical costs.”

Today, more than half of adults aged 18 years or older did not meet recommendations for aerobic exercise or physical activity. More than one-third of adolescents and 38 percent of adults said they ate fruit less than once a day, while 38 percent of adolescents and 23 percent of adults said they ate vegetables less than once a day.

According to the Oklahoma Hospital Association, more than one in six or 17 percent of Oklahomans are uninsured and Oklahoma ranks seventh highest in the nation in percent of uninsured.

“Access to affordable primary care should not be a barrier to Oklahomans with limited or no health insurance. MainStreet Clinic membership is open to everyone with or without health insurance,” said Dr. Brian Birdwell.

MainStreet Clinic supports and collaborates with community non-profits including the Lawton Food Bank and the Lawton Family YMCA to promote consumer health education along with prevention and treatment of chronic diseases. And through a unique program named Care First Employee Benefits, MainStreet Clinic works with employers to offer clinic membership through employer group health plans.

About National Health Education Week

National Health Education Week ( is recognized by the U.S. Department of Health and Human Services and sponsored by the Society of Public Health Education, a non-profit professional organization founded in 1950 to provide leadership to the profession of health education and to promote health and wellness in the community. National Health Education Week is celebrated annually during the third week of October and focuses national attention on public health issues, provides public education, and improves consumer understanding of health education’s role in promoting public health.

The Chronic Disease Service of the Oklahoma State Department of Health can be reached at 405 271-4072 or 1000 NE 10th Street, Oklahoma City, OK 73117. The Chronic Disease in Oklahoma Data Book is available at

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Care First Alliance To Help Lawton Business Adopt Direct Primary Care


Care First provides Lawton business with creative alternatives in health benefits featuring direct primary care membership

Care First Alliance Direct Primary Care

LAWTON — Dr. Brian Birdwell announced the introduction of Care First Benefits to  provide Lawton area employers with creative alternatives featuring direct primary care membership benefits for employees.

“Health care has been turned upside down by radical changes and spiraling insurance costs, and business owners need fresh alternatives that provide affordable care their people can actually access and use,” said Craig Scurato of Simplifi Benefits.

“Direct primary care membership is relationship-based medicine, where patients have all the time they need, as often as they need it, and same day or next day clinic access for one, flat monthly membership fee averaging about $60 per employee, per month,” said Dr. Brian Birdwell.

Lawton area business owners are invited to a Care First Employer Briefing Tuesday afternoon, March 8, come and go between 4:00 and 7:00 pm at the Chianti Wine Bar, 5370 NW Cache Road, presented by MainStreet Clinic, Direct Care Partners and Simplifi Benefits. Please R.S.V.P. at (580) 248-9966.

About Brian Birdwell, MD and MainStreet Clinic

Lawton internist Brian Birdwell, M.D. is owner and physician-director of the MainStreet Clinic team of medical professionals. 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. Clinic services include complete primary care services for individuals and families, regardless of insurance coverage, and occupational health and wellness services for employers

About Direct Care Partners, LLC

Dr. Brian Birdwell co-founded Direct Care Partners, LLC with Rob Bartlett, Jr. in order to accelerate and scale the growth of direct primary care in the Greater Lawton Area and across Oklahoma.

About Craig Scurato

Craig Scurato, president of Simplifi Benefits (, provides consulting assistance to direct primary care physicians, and offers small and mid-size employers with a competitive advantage in the health insurance marketplace, through its own private marketplace exchange and access to a wide range of insurance and benefits products.

Posted in: Direct Primary Care, Health Blog, News

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