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How is a Well-Child Exam Different from an Athletic Physical?

girl stretchingChildhood is a time of rapid growth and change. The Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the “periodicity schedule.” It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence which includes children up to age 18.

If your child is in grades 7-12 and wants to participate in sports or other activities, they are required to have an Athletic Pre-Participation form completed by a medical provider. This form can be completed during either a well-child exam or an athletic physical. So, how do Well-Child exams compare to Athletic Physicals? A well-child annual visit is similar to the Athletic Physical, but much more comprehensive.

An Athletic Physical usually includes a physical examination and a brief examination of child’s medical history. The Athletic Physical is also a time to ensure your child is current on his or her vaccinations. Most schools require children to be vaccinated in order to attend classes. What is not included in a sports physical are developmental histories, long-term health concerns and risk factors and advice for developing a healthy lifestyle.

A Well-Child Exam is a schedule of screenings and assessments recommended from infancy through adolescence. “Well-child visits are also key times for communication with your practitioner,” said Dr. Markham. “We talk about normal childhood development, nutrition, sleep, safety, and healthy options for your child. Talking about ways to improve care and prevent problems helps keep your child healthy.” A well-child check is generally covered 100% by most insurance companies, with no co-pay. These exams are generally covered on a once yearly basis and allows the practitioner more time with your child.  It also allows the practitioner a chance to further address any developmental, emotional, or social concerns with the child and parent.

As children become teens and begin to face new social and physical issues, a well-child annual visit gives them an opportunity to discuss topics they may not feel comfortable discussing with their parents, topics like drugs, smoking, alcohol, sex, and sexually-transmitted diseases. A doctor’s insight on these subjects can provide another point of view and guidance in a child’s life.

Here are a few things parents can do to make the well-child visit more productive:

  • Take note of any odd or unusual behavior you have noticed in your child. Family physicians have a great deal of experience with children at each stage of development and can often offer professional insight into whether or not you should be concerned about particular behaviors in your child.
  • Sit down ahead of time with your child to prepare a list of questions for your doctor. You can cover topics ranging from nutrition to emotional issues, to sports injuries, or just odd aches or pains.
  • Be sure to bring any health documentation you have received from your child’s school that needs to be completed for sports, school-related trips or anything else. Schools will provide a list of vaccinations and other requirements of their students.

A well-child annual visit includes the following:

  • Vital Sign Checks. Vital signs are checked by reading blood pressure and checking heart and respiratory rates. Blood pressure should be checked at least once every year unless there is something in your child’s history to indicate otherwise. It is possible for even young children to have hypertension so regular blood pressure checks should begin at age 3.
  • Updated Health History and Tracking Growth. Your doctor will want to know of any updates and changes in your health to add to your chart and history. Talk with your doctor about your child’s development. You can discuss your child’s milestones, social behaviors and learning, sleeping habits and development behavior.
  • Physical Exam. Your doctor will visually check your appearance for signs of any potential conditions. They will check the abdomen, eyes, head, chest, hands and wrists, musculoskeletal system and nervous system functions such as walking and speech. They will also examine the ears, eyes, nose, throat, heart, and lungs. This exam also includes touching parts of your body to feel for abnormalities – abdomen, skin, hair, and nails, possibly genitalia and rectum, and testing your reflexes and motor functions.
  • Team Approach. Regular well-child visits create strong, trustworthy relationships among your practitioner, parent and child. This team approach helps in the development of optimal physical, mental and social health of your child.

Is the Athletic Physical Covered by Insurance?

The Athletic Physicals are an out of pocket expense – meaning no insurance claim is filed. However, the Well-Child yearly visits are reimbursed by insurance, typically with no co-pay. And the Athletic Pre-Participation form can be completed at the time of your regular well-child exam. If you need to have an Athletic Pre-Participation form filled out and your child has already had a yearly physical examination in the past 12 months, bring the form in and your provider will complete it.

We are proud of our medical practitioners, leadership, and staff who have dedicated their lives to delivering the utmost quality of healthcare for all who walk through our doors. We want your child to be as healthy as possible. Myrtue Medical Center is committed to you, your family and the health of our community. Please visit our website or contact us at (712) 755-5161.


Myrtue Medical Center and Harlan Community School Meet with Governor Reynolds Second Time to Discuss Innovative Approaches to Mental Health in the Schools

School based Therapy-Governor ReynoldsSchool-based therapist, Katie Sandquist, and Harlan Community School High School Principal, Scott Frohlich, were invited to the Governor’s Teachers Cabinet to discuss mental health in schools.  The Teachers Cabinet is a group of educators that advises the governor on education policy for the state. The Governor reached out and asked Frohlich and Sandquist to share their innovative approach of removing barriers for kids and building collaboration between the school and Myrtue Medical Center in addressing mental health issues for students and staff in the school district.

The school-based therapy program got the attention of Governor Kim Reynolds and Lieutenant Governor Adam Gregg when they visited Harlan Community Schools earlier this year. Governor Reynolds was interested in the success of Myrtue Medical Center’s unique permanency model within the school versus mobility of care that others tend to offer across the state.  With the Governor’s recent bill covering recommendations for establishing an Iowa children’s mental health system in Iowa, the state board will take a comprehensive look at current resources and create a strategic plan with specific recommendations to implement a better approach to help children with mental health issues.

“If we are going to effectively address mental health in schools, we have to come together in a collaborative and mutually supportive way,” said Katie Sandquist, Myrtue’s School-Based Therapist for 6th through 12th grade students. “Partnership and service are two of the core values of Myrtue Medical Center, so this program is a natural extension of our mission.”

Sandquist shared with Governor Reynolds and the Teachers Cabinet ways to creatively remove barriers to evidence-based treatment and grow a school culture that is trauma-responsive and promotes holistic wellness for students and staff.

School-based mental health services are outpatient services delivered in schools to work through behavioral, emotional and social challenges that impact success at school and at home. Families have the option for greater collaboration between the therapist and other supports at the school. With the parent/guardian’s support, the child’s therapist can work with school staff such as school counselors, administrators and teachers to develop a plan for support that will help the student thrive in and outside of school.  Therapy provided at the school mirrors therapy provided at the main Behavioral Health office, including use of the same process for intake, diagnosis, and planning goals for treatment.

“The partnership with Myrtue has been a seamless transition to better meet our student’s mental health needs,” said Mr. Scott Frohlich, Harlan Community High School Principal. “The support and collaboration has been a crucial link in making this a successful program. This partnership provides service to our students much quicker than if they would schedule with an outside clinic. Students are scheduled on a regular basis either weekly or bi-weekly within the school day, which reduces instructional time missed from the classroom.”

If you want to learn more about school-based therapy services, please call Myrtue Medical Center’s Behavioral Health at (712) 755-5056.

Rabies Remains a Health Threat for Iowans

RabiesEvery 10 minutes someone in the United     States is treated for possible exposure to rabies, accounting for about 55,000 people each year. About 5,000 animals that have tested positive for rabies each year in the U.S. Seven out of 10 Americans who die from rabies in the U.S. were infected by bats.

Any mammal can be infected with rabies, but in Iowa, rabies is most commonly identified in skunks and bats, accounting for 78% of the animals that have tested positive for rabies over the last 10 years. Cats, cows and dogs are the next most commonly identified rabies-infected animals in Iowa.

Rabies is spread when the virus from an animal’s saliva or neural tissue gets through a person’s skin via bite, contact to wounds, or contact with the eyes, nose or mouth. In addition, people known to be in the same room as a bat, but do not know for certain that they were bitten or had direct contact with the bat, may have been exposed to rabies. This would include persons who awaken to find a bat in the room or children alone with a bat in the room.

Prevention Tips

Leave all wildlife alone, including injured animals. If you find an injured animal, don’t touch it; contact local authorities for assistance.

Because pets can get rabies from wildlife and then could spread it to humans, preventing rabies in pets is also an important step in preventing human rabies cases. 

If Exposure Occurs

If you do come into contact with a rabid animal, rabies in humans is 100% preventable through prompt appropriate medical care. If you are bitten, scratched, or unsure, talk to a healthcare provider about whether you need post exposure treatment.

The Iowa Department of Public Health (IDPH) provides 24/7 rabies consultation and receives about 500 rabies-related calls each year. IDPH can be reached at 800-362-2736 during business hours or 515-323-4360 after hours.

Myrtue Medical Center-The First Critical Access Hospital in the state of Iowa to receive American Heart Association’s Mission: Lifeline Silver Referring Achievement Award

Lifeline STEMIMyrtue Medical Center has received the Mission: Lifeline® Silver Referring Quality Achievement Award for implementing specific quality improvement measures outlined by the American Heart Association for the treatment of patients who suffer severe heart attacks. Myrtue is the first Critical Access Hospital in the state of Iowa to receive this elite cardiac care designation.

Every year, more than 250,000 people experience an ST elevation myocardial infarction (STEMI), the deadliest type of heart attack, caused by a blockage of blood flow to the heart that requires timely treatment. To prevent death, it’s critical to restore blood flow as quickly as possible, either by mechanically opening the blocked vessel or by providing clot-busting medication.

The American Heart Association’s Mission: Lifeline program’s goal is to reduce system barriers to prompt treatment for heart attacks, beginning with the 9-1-1 call, to EMS transport and continuing through hospital treatment and discharge. The initiative provides tools, training and other resources to support heart attack care following protocols from the most recent evidence-based treatment guidelines.

Myrtue Medical Center earned this award by meeting specific criteria and standards of performance for promptly diagnosing STEMI patients and transferring them to hospitals that provide emergency procedures to re-establish blood flow to blocked arteries when needed.

“Every second counts in these types of critical situations. This recognition for our level of cardiac care is truly an honor,” said Jenny Lefeber, manager of Myrtue’s Emergency Department.

“We commend Myrtue for this award in recognition for following evidence-based guidelines for timely heart attack treatment,” said Tim Henry, M.D., Chair of the Mission: Lifeline Acute Coronary Syndrome Subcommittee. “We applaud the significant institutional commitment to their critical role in the system of care for quickly and appropriately treating heart attack patients.”

Myrtue Medical Center’s Economic Impact on Local Economy Tops $29 Million in 2019

Economic Impact-Myrtue Medical Center-5.19

In all, Iowa’s Healthcare Sector Provides 342,914 Jobs Across State

DES MOINES – According to the latest economic impact study by the Iowa Hospital Association, Myrtue Medical Center generates 613 jobs that add $29.7 million to Shelby County’s economy. A multiplier methodology is used to determine the level of impact, which means that the health sector and employees in the health sector purchase a large amount of goods and services from local businesses, having a multiplying effect in the community. It is also estimated that Myrtue Medical Center’s employees by themselves spend $4.3 million on retail sales and contribute $259,832 in state sales tax revenue.

“At a time when many rural hospitals throughout the country are struggling financially, with some closing, this report is critical in illustrating the enormous impact that hospitals in rural areas have on the economies of the communities they serve,” said Barry Jacobsen, CEO-Myrtue Medical Center.

The IHA study examined the jobs, income, retail sales and sales tax produced by hospitals and the rest of the state’s health care sector. The study was compiled from hospital-submitted data on the American Hospital Association’s Annual Survey of Hospitals and with software that other industries have used to determine their economic impact.

The study found that Iowa hospitals directly employ 76,203 people and create another 64,453 jobs outside the hospital sector. As an income source, hospitals provide $5 billion in salaries and benefits and generate another $2.7 billion through other jobs that depend on hospitals.

“Hospitals positively influence their local economies not only with how many people they employ and the salaries of those employees, but also through hospital purchases from local businesses as well as the impact of employee spending and tax support,” said Kirk Norris, IHA president/CEO. “Whether at the local level or statewide, there are few Iowa employers that generate economic activity comparable to hospitals.”

In all, the health care sector, which includes offices of physicians, dentists and other health practitioners, nursing home and residential care, other medical and health services and pharmacies, contributes $18 billion to Iowa’s economy while directly and indirectly providing 342,914 jobs, or about one-fifth of the state’s total non-farm employment.

The Iowa Hospital Association is a voluntary membership organization representing hospital and health system interests to business, government and consumer audiences. All of Iowa’s 118 community hospitals are IHA members.

Myrtue Medical Center Achieves Pinnacle Level Status for Congestive Heart Failure Practice

Health Coaches 2019Photo Caption: Myrtue Medical Health Coaches, Alicia Madsen, Prudy Kloewer, and Jan Hastert help improve congestive heart failure outcomes through tailored education and improved patient self-monitoring.

Myrtue Medical Center has received designation as a Pinnacle Level Practice through Compass PTN (Practice Transformation Network) for large-scale health transformation of clinical practices leading to improved patient outcomes. Specifically, a team of employees identified congestive heart failure as the number one diagnosis for hospital admissions and readmissions from the Emergency Department and took action. Collaboration among Myrtue Medical Center’s primary care clinics, the ER, discharge planning, medical coders, community health, specialty clinics and medical staff has resulted in a 5 percent decrease in congestive heart failure admissions and readmissions, combined.

Myrtue Medical Center is among only the top 5 percent of practices enrolled in the Compass PTN to receive the award. According to the Compass PTN, “Myrtue Medical Center has hardwired effective changes and identified best practices throughout their phase progression in the program which has allowed them to excel to the top 5 percent of enrolled practices.  Myrtue Medical Center has merged person and family engagement into their practice which encourages the patient and their family to partner with the medical staff in their care. Not only is Myrtue Medical Center a recognized and awarded Pinnacle practice, but the story they tell is scalable and worth emulating.”

PTNs are peer-based learning networks designed to coach, mentor and assist clinicians in developing core competencies that are specific to practice transformation. The Compass Practice Transformation Network (Compass PTN) is a clinician-led, patient-focused partnership of over 7,000 clinicians across Georgia, Iowa, Kansas, Nebraska, North Dakota, Oklahoma, South Dakota and Wisconsin, committed to transforming primary and specialty care practices in order to achieve better care, smarter spending and healthier people.

Applications being accepted for health care educational grants

Education-GrantsApplications for healthcare educational grants from the Endowment for Education are now being accepted.  The grants are made available through the Lucille Petersen Endowment Fund, which was established in 1988.  The funds will be distributed to selected applicants seeking short or long-range educational assistance to pursue healthcare occupations.  A June 30th deadline has been set for applications to be submitted for the fall 2019 semester.

The funds will be distributed as grants—loans that will be forgiven if the recipient is employed within a 20-mile radius of Harlan in his or her specialized healthcare occupation following completion of courses.  If a recipient cannot fulfill the service terms under which the loan will be forgiven, the money is subject to a five percent interest rate and repayment of principal.

Application forms and more information are available by contacting Ruth  Pitkin, Myrtue Medical Center, 1213 Garfield Ave., Harlan, IA, 51537, phone 712-755-4316 or email  The grants can be for new, entry-level, or advanced training or certifications.

Create and Maintain Your Mental Wellness

Mental HealthOne in five adults in the U.S. will experience a mental illness in a given year and around one in five teenagers will experience a severe mental health disorder at some point during their lifetime, according to Psychology Today.

May is Mental Health Month and brings awareness to the importance of mental health for people of all ages and break the stigma. Myrtue Medical Center’s theme for 2019’s Mental Health Month is Thriving, meaning that health is about your overall well being.

Myrtue Medical Center suggests eating a healthy diet full of nutritious foods, getting a good amount of sleep every night, exercising enough, and hydrating well because all of these affect our overall well being. Our mind and body are one unit and we need to take care of both equally in order for our mental health to remain stable and thrive. If you are looking for behavioral health and mental health treatment center, Myrtue Medical Center are the experts in spotting mental health symptoms and coping mechanisms like suicide prevention, diagnosing anxiety disorders, bipolar disorder, helping PTSD, OCD, substance abuse treatment, stress, and more.

In order to change your mental health, you have to start by changing your habits. Myrtue Medical Center encourages everyone to focus on improving a few aspects of their daily routine in order to improve their mental wellness. Some of these include:

  • Get 8 hours of sleep every night
  • Eat 2-3 healthy well-balanced meals each day
  • Drink half your body weight in ounces of water every day
  • Avoid sugar, processed foods, greasy fried foods, and saturated fats
  • Exercise at least 30-minutes a day
  • Avoid toxic thoughts, people and conversations
  • Take some time for yourself every day
  • Learn how to manage stress and avoid stressful situations
  • Practice meditations daily
  • Visit your doctor regularly for routine health screenings

Myrtue Medical Center provides high-quality, cost-effective health care services to improve the well-being of the people it serves. Small changes over time add up and will improve your well being and mental health. Call Myrtue Medical Center at 833-662-2273 to schedule an appointment or visit our website to learn more.


Myrtue Medical Center Responds to Community Health Needs

woman with group in backgroundMyrtue Medical Center works with community partners and the general public to determine health care priorities through a Community Health Needs Assessment (CHNA) provided by Myrtue’s Public Health Department.  The most recent Public Health CHNA was completed in early 2016. Among the highest level of responses was a need for mental wellness and more willingness to seek help. This is one of several priorities identified by the community and being addressed by Myrtue Medical Center, in partnership with Shelby County Public Health.

“Myrtue’s response to the increased need is encouraging and supportive to the Behavioral Health Department,” said Deb Meissner, Director of Myrtue Medical Center’s Behavioral Health Department. “We are hiring qualified candidates and providing support, education, ongoing training and loan forgiveness to qualified health providers via the National Health Service Corps. Mental Health is becoming more understood and accepted because the human experience includes experiencing stress, grief, and at times difficulty adjusting to a life change. This normalization has lessened people’s fears of seeing a mental health provider, which in turn, has put a strain on access to mental health care,” said Meissner.

According to the U.S. Health Resources and Services Administration (HRSA), workforce projections show demand for addiction and mental health services will outpace supply of practitioners in the next decade.

The National Health Service Corps Loan Repayment Program supports behavioral health therapists, registered nurses (RNs), and advanced practice registered nurses (APRNs), by paying for a portion of their unpaid education debt. Myrtue is an approved site under the Health Service Corps student loan forgiveness program and currently has employees within the Myrtue system enrolled in the program.

To meet the growing demand for mental health services, the Behavioral Health Department is continuing to expand and increase its staff. Currently, Myrtue has eight Therapists and three Community Support Services staff. Two Nurse Practitioners provide counseling and medication management. A Substance Abuse Counselor manages the Drug and Alcohol Program which includes individual and family counseling, assessment, evaluation, Intensive Outpatient and Extended Outpatient therapies. Myrtue’s Behavioral Health Department contracts with 11 organizations throughout Shelby County to provide Employee Assistance Program services.

In addition, Myrtue has a Psychiatrist, Dr. Rodney Dean, who offers clinic in Harlan three times a month. Also, a child and adolescent psychiatrist, Dr. Matthew Eggers, provides telemedicine through a video conference session to children and adolescent clients four times a month.

By recognizing the consequence of trauma and the effects on mental wellness, Behavioral Health has emerged as a center of excellence in understanding, learning and training on how to provide trauma-informed care. Myrtue’s Behavioral Health is committed to practicing evidence-based, cutting-edge therapy and protocols to address the cumulative impact of trauma and mental health and substance abuse issues.

In response to priorities identified by the community, Myrtue Medical Center, Behavioral Health and Public Health Departments, have several notable Community Health Improvement Plan achievements in the past year:

  • Collaboration with the Shelby County Wellness Alliance in promoting physical activity among all ages. Six community health/resource educational events have been held in the past year throughout the community.
  • Partnering with specialty providers to bring specialized care to Myrtue, including a female OB/GYN coming in 2020.
  • Increased access to medical care through extended hours at the Harlan Rural Health Clinic, as well as extended hours at Behavioral Health.
  • The formation of the Lean Into Life Support Group for widows/widowers.
  • Collaboration with Northwestern University for Mothers and Babies Support Groups/Curriculum for pregnant women.
  • Board of Health approval of Radon and E-smoking Community Ordinances.
  • Community radon education, contributing to approximately 20% greater radon kit sales in the past year.


Additional information on the Community Health Needs Assessment is available on Myrtue’s website.

Media Advisory – Second Measles Case Confirmed in Iowa

measlesA second case of measles has been confirmed in Iowa, through testing at the State Hygienic Lab. This case is an unvaccinated Northeast Iowa resident, who is a household contact of the recently confirmed measles case (an unvaccinated Northeast Iowa resident with recent travel to Israel, where measles transmission is occurring).

This person was identified as part of the initial case investigation and was under a public health voluntary confinement order in the home to prevent further exposures. Because this second measles case has been isolated at home during the measles incubation period, there is no current threat to the general public.

“Measles is a highly contagious disease that spreads through the air when an infected person coughs or sneezes,” stated Lori Hoch, Director of Public Health. “The measles virus can remain in the air for up to two hours after an infected person leaves a room. The best way to prevent measles is to ensure that vaccinations are up-to-date for all persons in your family.”

If you have questions about measles or vaccine recommendations to prevent measles, please contact your health care provider or call Public Health at 712.755.4422.