SIMEDHealth CEO, Dr. Duncanson, featured in House Calls magazine!

House Calls Magazine, a seasonal publication by the Alachua County Medical Society, recently sat down with our CEO, Dr. Dan Duncanson. As the head of our growing medical practice, Dr. Duncanson was able to speak about the guiding principles of fairness, respect, excellence and trust that SIMEDHealth is built on.

Keep reading for the full article. 

It's Flu Shot Time Again (Already?)

Don't get sick. Get the flu shot. A woman blows her nose.
It may seem like we just finished up the last Flu season however it’s time to start considering getting this season’s Flu shot.  We asked SIMED Primary Care physician Dr. Daniel Duncanson some questions about the Flu season and the Flu shot.

Can it already be time for another Flu shot?

Yes.  The “Flu season” in the United States runs from fall through winter.  In some parts of the world, Flu season is year round so we can consider ourselves lucky to have an “off season.”

What is the Flu?

The flu illness is caused by an infection of the Influenza virus. 
First, the virus enters the air around us in droplets when someone infected with the virus coughs, sneezes, or talks.  
Second, droplets are inhaled, entering our body through the lining of our respiratory system in our nasal passages, sinuses or lungs.  
Once the flu is in our system, we start to feel sick 1- 4 days later.
The symptoms can vary but usually are a combination of fever (or feeling of fever), chills, cough, sore throat, sinus congestion, runny nose, headache, and fatigue (often much more so than with other viral illnesses).  Children commonly have vomiting and diarrhea associated with an Influenza illness.

Who is at risk of getting the Flu?

Everyone.  We’re all breathing, and if the droplets are around, anyone can inhale them and develop the flu.  Those that have been vaccinated tend to have a much less severe illness and some don’t develop any noticeable illness.

Are there people who are at higher risk of getting the Flu?

Some people are at an increased risk of having a more serious illness when exposed to the Influenza virus.  These people include the very young, those older than 65 years, those with chronic medical conditions (for example asthma, diabetes, heart disease), and during pregnancy and up to two weeks after delivery.

Flu Season infographic about the flu shot and how you get the flu

You stated those who received the Flu shot have a less serious illness.  Tell us about the Flu shot.  When should we get it?  Why do we need to get it every year?

The Influenza virus is different than many other viruses because it can frequently alter its outer envelope.  The outer envelope is what our immune system recognizes and uses to fight the virus.  
When you are administered a vaccine, you are enhancing your immune system’s ability to respond aggressively to the virus. For a virus like the chicken pox virus, the outer envelope doesn’t change much over time so a single vaccination cycle provides excellent life-long protection from illness.  However, because the Influenza virus changes often, we have to update our immune system’s response based on the recent years’ Influenza events.  
The vaccine changes year to year and provides protection against the 3 or 4 Influenza virus strains infectious disease and epidemiology experts predict will be most prevalent in the upcoming Flu season.
Each season’s Flu shot (Influenza vaccines) tend to become available in late summer and can be administered into the early spring.  Flu season tends to peak in the US during the colder weather months.  
It takes about 2 weeks after receiving the vaccine before protection begins, and the protection lasts for several months.  The vaccine, a single dose injection, is advised for everyone over the age of 6 months except people who previously had a serious adverse reaction to an Influenza vaccine dose.
The Influenza vaccine is cultivated in eggs, and a small amount of egg protein may be contained in the vaccine.  Regardless, people with egg allergies are now advised to receive the vaccine.  People with egg allergy symptoms that go beyond hives (for example, people who develop angioedema, respiratory distress, light-headed, recurrent vomiting, or previously required epinephrine administration due to the allergy) are advised to have the vaccine administered in a health care setting with a health care provider supervising who has the ability to recognize and manage severe allergic reactions.

I see pharmacies all over the place advertising the Flu shot.  Does it matter whether I receive the vaccine from my pharmacist versus my doctor’s office?

No, it doesn’t matter where you receive the vaccine. The important thing is to receive the vaccine each season.  As a physician, I prefer my patients get it from our clinics.  That way, we can get the administration information and update our immunization record on each patient.  
Wherever you decide to receive it, make sure you have a single entity maintaining your immunization record.  Your medical record at your Primary Care physician is a logical place for your complete immunization record to be maintained, so wherever you receive any immunization, make sure your Primary Care physician’s office is aware of this information.

What is the difference between the “high-dose” vaccine and the regular vaccine?

For decades the annual Influenza vaccine was a trivalent vaccine.  Trivalent refers to the three different strains of Influenza viruses that were covered in each vaccine.  
A few years ago, studies showed those at high risk of serious illness fared better by receiving a quadrivalent vaccine, containing protection against four strains of Influenza viruses.  Thus, the “high-dose” refers to the 4 strains vs. 3 strains of virus protection.
People who should receive the quadrivalent, “high-dose” vaccine include anyone 65 years old and older and anyone else at risk of serious illness from the Flu.

If everyone else at home and work receives the Flu shot, why should I?

Because receiving the Flu shot doesn’t mean you can’t get the Influenza virus and won’t spread droplets.  In fact, the opposite is true.  People who get the Flu shot can still feel ill from the Influenza virus, but the illness is much less likely to be severe.  They can still develop a milder cough, runny nose, congestion, etc. and spread droplets.  Their illness is likely to be mild and of shorter duration with complete recovery.  If you don’t get the Flu shot, you can get the Flu from them.

So, if I get the Flu, what can be done?

As soon as possible, visit your Primary Care Physician’s office, or if they aren’t available, go to an urgent care center (like SIMED’s First Care in Gainesville).  
Testing can be done to confirm the illness is from the Influenza virus, and if confirmed, there are medications that can be prescribed to decrease the duration of illness and reduce the risk of serious complications.  
These medications are:
1. Tamiflu (oseltamivir) taken as a pill or in liquid form
2. Relenza (zanamivir) an inhaled powder
3. Rapivab (peramivir) dosed intravenously usually in a hospital setting.  
Tamiflu is also approved for prevention if a household contact has been diagnosed with an Influenza illness. This medication has been shown to decrease the risk of others exposed to Influenza from becoming ill.
All SIMED’s Primary Care locations and First Care are stocked with this season’s Flu shot.  If you are already a patient of SIMED, no appointment is needed to receive the immunization.  Walk-ins for the Flu shot are accepted at First Care.
If you’d like to establish with a SIMED Primary Care physician, call 352-224-2225 to schedule your initial appointment or contact us with an appointment request online via our website 
First Care is SIMED’s Gainesville urgent care center and is available for walk-in visits.

SIMED Awarded for Outstanding Clinical Practice

SIMED was awarded the 2017 Outstanding Clinical Practice Award by the Alachua County Medical Society.


On May 9th, SIMED received the 2017 Outstanding Clinical Practice Award from the Alachua County Medical Society (ACMS). The award was given for the first time to recognize a medical practice or service line for providing exemplary patient care. 

“This award recognizes the efforts of every SIMED employee over the last several years” Dr. Daniel Duncanson, the CEO of SIMED, said, “SIMED embraces the opportunity for change, and endeavors to continuously develop ourselves to meet the needs of our patients, communities, and physician populations we serve.  This took effort from everyone at SIMED to break down old ways of doing things, and replace them with a true patient centered approach.”  

SIMED was recognized as the first and only Medicare Shared Savings Program (accountable care organization) in the region from Alachua County north to the state line that has driven down total healthcare costs for its patient population while maintaining excellent quality of care.  SIMED had numerous quality of care measures ranking in the 90th percentile for the country.

In his letter of support for the nomination, Duncanson explained that in 2010 SIMED decided to turn its focus towards the Institute of Medicine’s population health “’triple aim’ to provide care to patients and their caregivers that measurably improves their health, in a satisfying manner, and with efficiencies toward costs.”

SIMED is working with other insurance providers to develop similar accountable care relationships and recently began reaching out to other health care groups in the region in an effort share information to help the groups learn more about their impact on local health care costs and quality.

“Because this issue extends beyond SIMED’s walls,” Duncanson said, “it is a much bigger challenge but one SIMED intends to take head on for the betterment of our communities and society as a whole.”

The ACMS president Dr. David E. Winchester said he felt there was a need to recognize organizations like SIMED and that ACMS had the ability to make it happen.

To learn more about the Medicare Shared Savings Program. click here.

Get some relief this Ragweed Season

Get some relief this Ragweed Season

Fall is just around the corner. As the season changes we trade I the sweltering hot days of summer for the cooler, crisp days of autumn. The humidity drops, the days get shorter and the nights longer. Being outdoors becomes much more comfortable. The fall season brings changes to the weather, but other things in the environment change as well.

For people with allergies, the fall season can lead to increased suffering. At SIMED Allergy & Asthma autumn triggers Ragweed Season and a significant increasing allergic reactions. Ragweed Season usually begins in the late summer, peaks in mid-September and lasts into November. For some people ragweed pollen is simply a nuisance creating a little sniffle, but for others it can interfere with daily living and comfort resulting in constant runny nose, sneezing and/or itchy eyes. Some may even develop asthma symptoms.

What could you do if you have ragweed allergy?

The best way to minimize ragweed allergy symptoms is to stay indoors in an air-conditioned environment. When outdoors activities occur try to minimize being outdoors early in the morning and wash off quickly once coming indoors. Over-the-counter, long-acting, non-sedating anti-histamines are good for treating the itchy eyes, nasal drip and sneezing. Taking anti-histamines daily starting just prior to and throughout the season works best at preventing the symptoms from building. The best medications for treating airborne allergies are the nasal steroid sprays.

If medications aren’t controlling symptoms, or you are not a fan of taking pills there are methods to desensitize your allergies. Desensitization uses allergy shots to reduce your response to ragweed exposure.

SIMED’s allergists have specialized training and expertise above and beyond any other medical or surgical specialty to evaluate your allergies and develop a treatment plan for your individual condition. The goal is to enable you to lead a life that is as normal and symptom free as possible.

For more information about our allergy division please visit SIMED Allergy & Asthma, or to schedule an appointment at any of our locations including Gainesville, Ocala, Chiefland and Lake City please click on this link to request an appointment online.