Blog

Meet Our Providers


Dr. Dana Shanis Board Certified Gynecologist 


Dana Shanis M.D. is a Board Certified Gynecologist and active researcher at the National Institutes of Health. She joins us from the Hospital of the University of Pennsylvania, where she honed her procedural skills, and was active in medical student and resident education. 

Dr. Shanis received her medical degree from Temple University School of Medicine and completed her Ob/Gyn residency at Sinai Hospital of Baltimore. She attended fellowship at the National Institutes of Health, where she studied the gynecologic care of cancer survivors and other medically-complicated women. Since fellowship, Dr. Shanis has remained involved in her research, publishing articles and presenting at meetings and conferences across the country. In 2011, she was honored with the American College of Obstetricians and Gynecologists Cervical Cancer Prevention Award for her work with cancer survivors.

Dr. Shanis provides individualized care to women through all stages of life and strives to educate and empower each patient to be active in her healthcare decisions.

See Dr. Shanis' CV.

Allison Andrews Board Certified Women's Health Nurse Practitioner

Allison_gradientsm.pngAllison Andrews, WHNP, is a board certified women’s health nurse practitioner. She graduated from Thomas Jefferson University with her Bachelor’s of Science in Nursing. Her career as a nurse began at Kennedy University Hospital Emergency Department where she has spent five years providing urgent and emergent medical care to all patient populations. While working in the ED, she expanded her background and was on staff as a labor and delivery nurse at the Hospital of the University of Pennsylvania.

Allison gained outstanding clinical experience in gynecology, obstetrics, urogynecology, breast and gynecologic oncology and graduated from Drexel University with her Master’s of Science in Nursing. Allison is a member of The National Association of Nurse Practitioners in Women's Health's and Sigma Theta Tau International Honor Society of Nursing.

Allison is excited to join Rittenhouse Women’s Wellness Center and is dedicated to building an open and trusting relationship with her patients. She believes in empowering women through education and encourages women to take an active participation in their healthcare. She starts at Rittenhouse Women's Wellness Center in October.

Dr. Monica Duvall Board Certified Family Physician

monica_duvall.jpg
Monica Duvall, M.D., is a board certified family physician with over 10 year experience. She joins us from the University of Pennsylvania Health System where she practiced medicine and held a faculty position. She is currently accepting new patients age 13 and older.

Dr. Duvall received her Doctorate in Medicine from Temple University’s School of Medicine and completed her Family Medicine residency at the Hospital of the University of Pennsylvania where she was a Benjamin Franklin Scholar and received a general honors certificate. Her professional interests include: preventive medicine as well as women’s medicine.

Dr. Duvall is an active member of the American Academy of Family Physicians and The Union League of Philadelphia  Dr. Duvall currently resides in Gladwyne section with her husband.

See Dr. Duvall's CV.

Elizabeth Galbrecht Board Certified Women's Health Nurse Practitioner

Elizabeth Galbrecht, MSN, AGNP-C, WHNP-BC, is a dual board-certified Adult-Gerontology and Women's Health Nurse Practitioner.  She received her Master of Science in Nursing from Yale School of Nursing and joins Rittenhouse Women’s Wellness Center from a community health center in New Haven, Connecticut, where she has spent two years providing primary care and gynecologic services to her own panel of patients.  Prior to becoming a Nurse Practitioner, Elizabeth received her Bachelor's degree in biology from Macalester College in St. Paul, Minnesota and then went on to spend two years serving as a Peace Corps Volunteer in Mozambique.  It was during her time as a Peace Corps Volunteer that she was exposed to the unique complexities of women's health needs and decided to pursue a career path that would allow her to help women meet their own health goals by providing high-quality and patient-centered care.  While obtaining her Master of Science in Nursing at Yale, Elizabeth worked as a Registered Nurse at a family planning clinic and was also involved in several student organizations.  She directed the reproductive health department at a student-run free clinic, co-directed a student organization that provided free diabetes and hypertension screening to patrons of a local soup kitchen, and was actively involved in a student organization that advocates for the inclusion of reproductive health education and training in nursing schools around the country.  Elizabeth is especially interested in gynecology, reproductive and sexual health, and family planning.  She is also experienced in providing preventive medicine, chronic disease management, and full-scope primary care.  She is looking forward to providing all of these services to the patients of Rittenhouse Women's Wellness Center.

Dr. Maria Mazzotti Board Certified Physician

Maria Mazzotti, D.O., is a board certified physician with over 15 years of experience. Patients describe her as “caring, professional and compassionate” Prior to joining our practice, she practiced at Penn Care’s Spruce Internal Medicine. She is currently accepting new patients at our Rittenhouse Square location.

Dr. Mazzotti received her Doctorate in Osteopathic Medicine and completed her residency at the Philadelphia College of Osteopathic Medicine (PCOM). Between 1996 and 1997, she also held the position of Chief Resident of Family Medicine at PCOM. Her professional interests include: family medicine and community health.

Dr. Mazzotti is a member of the American Osteopathic Board of Family Physicians, American Academy of Family Physicians and the American Osteopathic Association. She currently resides in Philadelphia with her husband and children.

See Dr. Mazzotti's CV.

Catherine McGinty Board Certified Nurse Practitioner

Catherine D. McGinty, MSN, FNP-BC, is a board certified family nurse practitioner. She attended Villanova University where she received her Bachelor of Science degree in Nursing as well as completed their Navy ROTC program. After graduating with her Bachelors degree, she went on to work on an inpatient surgical floor at the Naval Medical Center of San Diego where she provided care to wounded warriors, other military personnel and their families. She deployed to Camp Buehring, Kuwait where she provided emergency and general medicine to deployed troops and defense contractors. After serving in Kuwait, she went on to serve two years at the United States Naval Hospital in Guantanamo Bay, Cuba where she was Charge Nurse. During this time, she was awarded the Navy Achievement Medal for outstanding training and implementation of hospital wide electronic medical record system ensuring, training compliance as well as a smooth transition.  In 2013, she went on to receive her Masters of Science degree in Nursing from George Mason University in Fairfax, Virginia. While working toward her Masters of Science degree, Catherine held a staff nurse position at George Washington University Hospital in Washington, D.C. She joins us from CVS Minute Clinic after working there as a Family Nurse Practitioner, where she performed routine services such as physical assessments, vaccinations and diagnosing and treating illnesses. 

Catherine is a member of the American Association of Nurse Practitioners. She brings the Rittenhouse Women’s Wellness Center a great deal of experience and hopes to offer her patient’s the finest in medical care.

Dr. Lauren O'Brien Board Certified Family Physician

Lauren O’Brien, M.D., is a board certified family physician with years of experience. She joins us from Hatboro Medical Associates where she practiced family medicine for the past 5 years. Patients describe her as professional and personable. She is currently accepting new patients at Rittenhouse Internal Medicine.

Dr. O’Brien received her Doctorate in Medicine from Georgetown University School of Medicine and completed her Family Medicine residency at York Hospital where she held Chief Resident position. While completing her residency at York Hospital, she received the Society of Teachers of Family Medicine Resident Teacher Award. Her professional interests include: women’s health and dermatologic procedures.

Dr. O’Brien is an active member of the American Academy of Family Physicians, Pennsylvania Academy of Family Physicians and Abington Hospital Medical Staff.

See Dr. O'Brien's CV.

Dr. Jillian Rowbotham Board Certified Internist

Jillan Rowbotham, D.O., a board certified internist, was first exposed to medicine while volunteering for Hospice of Lansing during her third year of college, and it was a life-changing experience that made her want to become a doctor. She went on to earn her medical degree from the Philadelphia College of Osteopathic Medicine. She received her training in Internal Medicine at Main Line Health’s Lankenau Hospital in Wynnewood, Pennsylvania where she was one of the top residents in her program “Dr. Rowbotham remains one of our best residents. She is absolutely dedicated to the well-being of her patients and is a wonderful communicator with patients and their families.” Dr.  Rowbotham’s schedule began filling up weeks in advance with women patients and this gave her the experience and solid grounding to focus on women’s health. Her professional interests include gastroenterology, weight management, nutrition and food policy.

Dr. Rowbotham completed her undergraduate work at Michigan State University, earning a B.S. in Human Biology with High Honors. Prior to completing her residency training, Dr. Rowbotham volunteered to travel to Guayaquil, Ecuador where she assisted in reconstructive surgeries.

Dr. Rowbotham is the co-founder of Physicians for Humanity; and is also an active member of the American Medical Association, American College of Physicians, The Obesity Society and has been awarded the William Dickerson Memorial Award. As an undergraduate, she was also selected as the Academic Woman of the Year. Dr.  Rowbotham currently resides in Philadelphia with her husband.

See Dr. Rowbotham's CV.

Preconception tips for optimal fertility and a healthy pregnancy

By: Dana Shanis, Gynecologist

Trying to conceive is an exciting time and a little preparation can help improve your experience and the likelihood of a healthy child. Good health before and during pregnancy will ensure the safest environment for your baby to grow. Here are some tips that can help prevent problems that may affect you or your child’s future health:


Exercise

One of the best things you can do to help your long-term health, including during pregnancy, is to exercise. This decreases inflammation, reduces stress levels, and has been shown to decrease the risk of pregnancy complications, such as gestational diabetes or hypertension. Physical activity does not increase your risk of miscarriage, a low birth weight baby, or early delivery. If you have any medical problems, it is important to discuss with your provider what types of exercise may be suitable for you. 

Balanced diet and vitamins

Eating a well-rounded diet including adequate fruits and vegetables will help prevent a nutrient-deficiency, such as iron or vitamin D, which can cause problems for you in pregnancy. Most women are able to get adequate nutrition in their diet. For women with a modified diet, like gluten-free or vegan, it may be beneficial to supplement other nutrients and should be discussed with your healthcare provider or a nutritionist. In the month prior to attempting pregnancy, regardless of diet, it is helpful to start supplementing 400 micrograms of folic acid daily, which has been shown to decrease the likelihood of neural tube defects in the baby.   

Healthy weight

Maintaining a healthy weight is important to optimize your reproductive system. Obesity has been shown to decrease fertility and increase the risk of pregnancy complications for both mother and child. Underweight women also experience effects on fertility and increase the risk of a low birth weight baby, who is at risk for problems during labor and may have behavioral or health problems that last through childhood. Your provider can offer recommendations to help you reach a healthy weight range.

Control stress

Stress hormones can affect your menstrual cycle and have been shown to decrease fertility. In addition, studies have shown women in stressful jobs, have higher rates of preterm delivery and preeclampsia, a potentially dangerous complication of pregnancy. While it is impossible to remove all sources of stress, learning how to limit and physically handle stressors can decrease their impact. 

Limiting caffeine

Significant caffeine intake can increase your heart rate, lead to dehydration, and increase stress hormone levels. In small doses, likely less than 200mg or 12oz of normal strength coffee, these changes are unlikely to affect your health or the pregnancy. Spacing out the caffeine intake and drinking enough water can help prevent issues.

Work to stop drinking, smoking or other drugs

Pregnancy can be a great motivator to decrease use of harmful substances, as many have been shown in studies to cause adverse outcomes in pregnancy. There is no level of alcohol use that has been proven to be safe in pregnancy so it is recommended to abstain. Alcohol use can also decrease both male and female fertility for some. Smoking cigarettes while pregnant can increase the likelihood of having a low birth weight baby and other adverse events. 

See your healthcare provider

Most women would benefit from a preconception visit with a healthcare provider. This visit can help assess any medical problems, medications, personal or family history that could affect your pregnancy or your ability to get pregnant. Your provider will help to determine what testing, vaccinations, and medication changes may be recommended, as well as any other risk factors that require intervention. She can also review your menstrual cycle and determine the best time for you to discontinue your current contraception or time intercourse to promote fertilization.

Optimizing your health prior to trying to conceive will give you the best chance for a healthy mother and child, and our providers are here to help get you ready.

Emotional well-being, dementia and nutrition

 
By: Marissa Martino, RD, LDN

Not everyone may realize, but nutrition has everything to do with our mental health. In fact, all body functions are connected and intertwined in one way or another. The recognition of the brain-gut axis, or connection, has been on the rise and we are finally acknowledging the importance of a healthy gut. And by gut, we don’t mean the “stomach, belly or tummy”, we mean the GI tract- specifically the small and large intestines. To many, it’s a foreign concept that our overall health lies in the condition of our gut.


Alzheimer’s, which is just one form of dementia, has actually been termed Diabetes Type 3 due to the correlation of dramatic decline in cognitive function and chronic insulin resistance… Lot’s of big words. Let’s back up a minute. What causes insulin resistance in the first place? Well, we have three macronutrients that fuel our bodies- Carbs, Proteins, and Fats. Can you guess which one is related to diabetes? 

You guessed it- Carbs. 

All carbs eventually turn into glucose, which raises our blood sugar. Insulin then is released to allow the digested sugar into our cells. However, eventually our cells become insulin resistant and stop absorbing glucose, leaving sugar in the blood stream. Uncontrolled insulin resistance leads to type 2 diabetes. 

So what about the previously mentioned “Type 3”? Well first off, increased sugar in the body causes chronic inflammation. This means that our gut, which has also been termed our “second brain”, is so inflamed that it cannot properly absorb any nutrients from the food that we’re eating- assuming that we are even eating nutrient dense foods.  

Free flowing sugar also means sticky, or viscous, blood. Increased viscosity can impair blood flow to the brain which affects how much oxygen and nutrients the brain cells are receiving. When circulation in the brain is compromised, you are at an increased risk of stroke and the development of dementia. In addition, insulin resistance impairs signaling to the brain and prevents brain cells from properly utilizing glucose for energy. Overall brain functioning suffers as a result of this.1  Ever have difficulty thinking straight due to low blood sugar? This is the same concept- except a bit more deep-rooted. 

The gut-brain axis is complex yet fascinating. We have discounted the association for so long but recently are coming to terms with just how powerful the health of our gut is, (or lack thereof). “The gut–brain axis seems to influence a range of diseases, and researchers have begun to target communication pathways between the nervous system and the digestive system in an attempt to treat metabolic disorders specifically.” 2

Have you ever been nervous, felt nauseous or had butterflies in your stomach? This is because the GI tract is sensitive to emotions, which go hand in hand with the hormones that are regulated by the brain.3 The connection goes both ways since over 90% of serotonin (the happy hormone) is produced in the gut. Therefore, if your gut is inflamed from an unhealthy diet, say goodbye to serotonin and hello to mood swings, anxiety, and depression! 

If you’re interested to find out if you have a healthy gut, before you spend the copay on a very uncomfortable endoscopy or colonoscopy, see a registered dietitian who can assess whether your daily intake is helping or hurting you.

 1 http://dlife.com/type-3-diabetes/

2 https://www.scientificamerican.com/article/metabolism-in-mind-new-insights-into-the-gut-brain-axis-spur-commercial-efforts-to-target-it/

3 http://www.health.harvard.edu/diseases-and-conditions/the-gut-brain-connection

Our 2 new services for Sexual Dysfunction



Reclaim. Restore. Revive. 

A noninvasive vulvovaginal rejuvenation the produces great results without surgery.


THERMIva treatments deliver controlled thermal energy to the desired areas – external (labia) and/or internal (vagina) – using temperature controlled radio frequency energy to gently heat tissue so that women can reclaim, restore and revive feminine wellness without discomfort or downtime.

THERMIva treatments are gentle, relaxing and feel like an internal, warm massage. An “S” shape probe is used gently on the external labia to improve appearance.  The same “S” shape probe can be used inside the vagina to reduce vaginal laxity, prolapse and incontinence. For orgasm dysfunction the THERMIva treatment includes applying the “S” shape wand to the clitorial area to improve nerve sensitivity and sexual response.

Results can last for 9-12+ months

Treatment time: 30 minutes

3 sessions of treatment in a series

Top 6 reasons why women love and trust THERMIva

  ·         Increased vaginal moisture
  ·         Strengthens vaginal muscles
  ·         Improves painful intercourse
  ·         Reduces urinary leakage
  ·         Improves vaginal looseness
  ·         Increases vaginal sensitivity

NO Surgery, NO Pain, NO Downtime

RECLAIM your sexual health

RESTORE your well being

REVIVE your relationships



 
A revolutionary treatment for women. This completely natural procedure improves sexual relations, urinary incontinence and symptoms of Lichen Sclerosus. 

What is the O-Shot?

The O-Shot is a ground-breaking, non-surgical treatment invented by Charles Runels, MD to improve lubrication and sensitivity, ease pain, increase intensity or orgasm and often resolve urinary incontinence. 

How is it done?

During the procedure, blood is drawn from the patients arm. It is places in a special tube and spun in a centrifuge. This separates the platelet rich plasma (PRP) from the blood. The doctor then takes the PRP and injects it into the upper wall of the vagina, as well as an injection directly into the clitoris. This delivers more blood flow to the organ.

Why does it work?

The PRP that is extracted from the body contains growth factors. These growth factors stimulate regeneration and rejuvenation. This procedure utilizes the body’s own regenerative ability to create new tissue; similar to how the body heals itself when it has an injury. 

Does it hurt?

These areas are numbed with a local anesthetic cream before injection, causing patients to experience little or no discomfort during the procedure. 

Benefits Include…

  ·         Increased natural vaginal lubrication
  ·         Relief from painful intercourse (dyspareunia)
  ·         Increased clitorial sensitivity and arousal
  ·         Improved skin texture of the vulva (vaginal lips)
  ·         Tighter vaginal opening for more pleasurable intercourse
  ·         Increased arousal from G-Spot stimulation
  ·         More intense and frequent orgasms 
  ·         Decreased or resolved urinary incontinence 
  ·         Improved symptoms of Lichen Sclerosus

Results last as long as 12-18 months for most women and there has been no reported complications in over 45,000 users


Our providers trained to administer this procedure include…

Dana ShanisMD, Board Certified Gynecologist

Allison Andrews, Board Certified Women’s Health Nurse Practitioner

Catherine McGintyBoard Certified Nurse Practitioner

Elizabeth GalbrechtBoard Certified Women’s Health Nurse Practitioner



Our 2 new services for Sexual Dysfunction



A revolutionary treatment for women. This completely natural procedure improves sexual relations, urinary incontinence and symptoms of Lichen Sclerosus. 

What is the O-Shot?

The O-Shot is a ground-breaking, non-surgical treatment invented by Charles Runels, MD to improve lubrication and sensitivity, ease pain, increase intensity or orgasm and often resolve urinary incontinence.

How is it done?

During the procedure, blood is drawn from the patients arm. It is places in a special tube and spun in a centrifuge. This separates the platelet rich plasma (PRP) from the blood. The doctor then takes the PRP and injects it into the upper wall of the vagina, as well as an injection directly into the clitoris. This delivers more blood flow to the organ.

Why does it work?

The PRP that is extracted from the body contains growth factors. These growth factors stimulate regeneration and rejuvenation. This procedure utilizes the body’s own regenerative ability to create new tissue; similar to how the body heals itself when it has an injury.

Does it hurt?

These areas are numbed with a local anesthetic cream before injection, causing patients to experience little or no discomfort during the procedure.

Benefits Include…

  ·         Increased natural vaginal lubrication
  ·         Relief from painful intercourse (dyspareunia)
  ·         Increased clitorial sensitivity and arousal
  ·         Improved skin texture of the vulva (vaginal lips)
  ·         Tighter vaginal opening for more pleasurable intercourse
  ·         Increased arousal from G-Spot stimulation
  ·         More intense and frequent orgasms
  ·         Decreased or resolved urinary incontinence
  ·         Improved symptoms of Lichen Sclerosus

Results last as long as 12-18 months for most women and there has been no reported complications in over 45,000 users


Our providers trained to administer this procedure include…

Dana Shanis, MD, Board Certified Gynecologist

Allison Andrews, Board Certified Women’s Health Nurse Practitioner

Catherine McGinty, Board Certified Nurse Practitioner

Elizabeth Galbrecht, Board Certified Women’s Health Nurse Practitioner





Reclaim. Restore. Revive. 

A noninvasive vulvovaginal rejuvenation that produces great results without surgery.


THERMIva treatments deliver controlled thermal energy to the desired areas – external (labia) and/or internal (vagina) – using temperature controlled radio frequency energy to gently heat tissue so that women can reclaim, restore and revive feminine wellness without discomfort or downtime. 

THERMIva treatments are gentle, relaxing and feel like an internal, warm massage. An “S” shape probe is used gently on the external labia to improve appearance.  The same “S” shape probe can be used inside the vagina to reduce vaginal laxity, prolapse and incontinence. For orgasm dysfunction the THERMIva treatment includes applying the “S” shape wand to the clitorial area to improve nerve sensitivity and sexual response. 

Results can last for 9-12+ months

Treatment time: 30 minutes

3 sessions of treatment in a series

Top 6 reasons why women love and trust THERMIva

  ·         Increased vaginal moisture
  ·         Strengthens vaginal muscles 
  ·         Improves painful intercourse
  ·         Reduces urinary leakage
  ·         Improves vaginal looseness
  ·         Increases vaginal sensitivity 

NO Surgery, NO Pain, NO Downtime

RECLAIM your sexual health

RESTORE your well being

REVIVE your relationships







FAQ's

ALL OF YOUR QUESTIONS, ANSWERED

Welcome to Rittenhouse Internal Medicine! We are recognized as a ‘Patient-Centered Medical Home’, which means we do our best to accommodate all of your healthcare needs in as many ways as possible and try to break down any barriers that are preventing you from enjoying a healthy lifestyle. Part of our mission is to provide our patients with all of the information you need to help you make the best decisions about your health. If you are in need of additional resources about your condition or medication, please let us know and we will share information to your patient portal or give you printed out copies.

How do I schedule appointments?

You can either contact the office or set up an appointment through the patient portal. If you are uncertain about what type of appointment you need, please contact the office and we can help schedule you appropriately. Most of our appointments are limited to 15 minutes so if there are multiple issues you wish to discuss or an issue that is more complex, the call center staff is able to determine how much time the provider will need to address all of your concerns.

Am I able to schedule same day appointments?

Our office does offer same-day appointments for illnesses. Availability is limited so if you require an urgent appointment contact the office as soon as possible.

Can I cancel my appointment?

While you are certainly able to cancel or reschedule an appointment, our office does require at least 24 hours’ notice. If you cancel within 24 hours or no-show for your appointment, you will be subject to a cancellation fee. The fees are $50 for pcp and gyn visits, $150 for mental health visits, $125 for initial nutrition visits, $65 for follow-up nutrition visits, and a $50 fee for DermaCenter visits. We also have a 7 minute grace period, so if you are more than 7 minutes late to your appointment you may need to be rescheduled. These policies are in place to help our providers stay on time, so that there is a minimal delay when you come in for your appointment.

How can I contact my doctor?

For non-urgent matters, you can send a message to your provider through the patient portal. For anything urgent please contact the office. Even when the office is closed, our call center will have the on-call provider contact you within 1-2 hours if you are in need of medical advice.

What do I do if I cannot get a hold of the office?

If you are not able to reach us, it is most likely because of some type of rare office complication such as a power outage. You can refer to our Twitter, we keep it up to date with any issues that we are having. If you are having an urgent medical issue, we will change our phones over to the answering service as soon as possible that will be able to reach a provider or staff member that can assist you.

Who can I contact for billing information?

The billing department’s direct phone number is 215-947-2023. Receptionists are also able to direct you to billing during routine calls. You can contact billing to discuss any questions or concerns, pay your balance over the phone, or set up a payment plan. Please be advised that the billing department does not handle bills coming from outside facilities - such as hospitals, labs or imaging centers.

What is the patient portal and how do I setup my account?

Our office offers the use of a “patient portal” for all established patients. The patient portal has a multitude of uses including scheduling appointments, requesting refills, requesting insurance referrals, and communicating with your doctor regarding non-urgent matters. To setup your account you will simply need to contact our office and provide your email and you will be sent login information. The temporary password is only valid for 48 hours, so please login right away.

How do I get a refill for my prescriptions?

You can request refills by either calling our office or submitting a refill request through the patient portal. For urgent or same-day refills, please contact the office to ensure it is sent to an in-office provider. If you have not been seen in the office for a year or more or are in need of a refill for controlled substances, you will need an appointment for refills.

Why do I need to be up-to-date with my annual physical if I need a refill or a form?

Most forms need information from a physical that has to be within a certain period of time (anywhere from 3-12 months). If you have not had a physical in several years we may be missing information for your form. It is also important to remember that medications affect your body in different ways also – this is why we need to see you at least once a year to make sure that you are not experiencing any side effects, that the medication is working and that it has not negatively affected your organs – such as your kidney or liver, which break down most medications. Physicals are a good time to check in and make sure that your body is working as well as possible to help you achieve your goals and try to correct any problems that may be slowing you down!

Is (blank) covered by my insurance?

Our providers rely on evidence-based medical protocols to determine the testing and treatment that is best for you; however, this does not mean that your insurance will cover these services. Unfortunately, since we are not aware ahead of time what may be required during your appointment, we cannot make any guarantees of coverage. You can contact your insurance to know more about your specific plan. If you do receive a denial from your insurance, we will do our best to provide you with as much information as possible (such as visit notes or lab results) for you to appeal the determination.

How do I get a referral for my insurance?

Certain insurances such as KHPE and Aetna require referrals for non-PCP (Primary Care Physician) providers. In order to have a referral submitted to your insurance you will need to schedule an appointment at the other facility and contact our office with the name of the facility, name of the provider, address, NPI number, date, and any relevant diagnosis codes or procedure codes. Please contact our office at least a week before your appointment in order for the referral to be completed on time.

How do I get my previous records sent to RWWC?

You can request records from your previous providers by filling out a record release form. We do require the name, address, and phone number of the previous provider to be able to send the request to them.

How do I get my records from RWWC sent to a different provider?

If you need to have all of your records sent to a new PCP, you will need to request a records request form from the new provider. If you need records sent to a specialist for an appointment, please call the office before your appointment and we will fax them.

How do I set up an appointment with a nutritionist or a psychologist?

If you are interested in seeing one of our nutritionists or psychologists, please contact your insurance to find out your coverage for nutritional visits or mental health visits prior to scheduling. While our nutritionists or psychologists may accept your insurance, some insurance’s do not cover nutritional visits or mental health visits and you will be held responsible for the out-of-pocket fee.

Where can I go for radiology?

Please check your insurance to see if you are capitated to an imaging center. We recommended Penn Radiology - you can schedule with them by calling 215-662-7366. Radiology appointments will require a script from a provider so please contact the office in order to obtain a script. If you lose or forget your script at your appointment, please call our office and we will fax a copy of the script to the radiology office.

When should I go to the ER?

If you are experiencing a medical emergency, please contact the office during or after hours to have a provider determine if you should be seen in the office, an urgent care, or head to the ER. These facilities do have different equipment and goals, so please be aware that an ER may not necessarily determine the cause of symptoms which you are having. This is why we ask patients who do visit an ER to contact us and set up a follow-up appointment. This is the best way to resolve any underlying illnesses which may have caused your symptoms. Patients who have been seen in an ER should come in for a follow-up within a week of discharge if possible.

Do I need a follow up for controlled substances?

Once you get your first script from your provider, they will sign an agreement with you regarding follow-up care. Most patients need to be seen every month for the first few months and then every 3 months. This will depend on the substance and whether it has been used as directed. Controlled substances can be detrimental to your health long-term, and can lead to organ damage or addiction. We want you to be safe and healthy, which is why your doctor wants to see you regularly if you are taking a controlled substance.

What is covered during an Annual Physical and Annual Gyn?

Annual visits are considered preventative, ‘wellness’ visits and are usually covered at 100% every 12 months by insurance companies. The annual physical covers a physical exam and discussion of preventative services including a mammogram, colonoscopy, dexa scan, recommended blood work, and vaccines. The annual gyn exam covers a breast exam, pelvic exam, Pap smear, and discussion of contraception. Discussion of anything outside of ‘wellness’ care will likely result in a co-pay set by your insurance company.     

How often do I need a pap?

This depends on your personal history – some patients only need a pap every 3-5 years, while others may need one annually. However, we do ask all of our patients to come in for an annual gynecological exam every year – outside of cervical cancer testing – this is a visit where we do an internal exam to check for other masses in your pelvis as well as a breast exam to make sure you have no pain or breast masses. Your annual gynecological exam is also a good time to get any birth control refills or advice, mammogram scripts if this is appropriate for your age and STD screenings.

Do I need to be seen for a UTI or a yeast infection?

Urinary tract infections (UTIs) and vaginal infections (which may be caused by yeast or bacteria) are a very common problem for women. Sometimes over-the-counter treatments are very helpful but other times they simply prolong your illness. There are a variety of medications that treat different agents that cause these infections, so we do need to see you in the office and take samples to make sure we are treating you appropriately. Sometimes what seems like a simple yeast infection can turn out to be an STD, so we urge all of our patients to come in and get tested and treated, even if it seems like just a minor discomfort. Remember, untreated UTIs can lead to kidney infections and untreated vaginal infections can result in pelvic inflammatory disease and fertility problems. Don’t delay and bear any discomfort - just give us a call and we will be happy to see you!

The Importance of Annual Dermatology Skin Checks

 By: Allison Andrews, N.P.

Why are we recommending “annual” dermatology skin checks? Well, because the most important strategy in combating skin cancer is early detection. By having a proper screening by a licensed dermatologist yearly, you significantly reduce the chance of developing skin cancer. 

Skin cancer is the most common cancer that anyone will face and one of the only cancers that can be seen on the surface of your skin. Yet, one in five Americans will be diagnosed with skin cancer in their lifetime and one person dies from the deadliest form of skin cancer, melanoma every hour. 

The most common cause of skin cancer is sun-damaged skin. It is also important to know, that this means all levels of damage; not just sunburn. No matter the season, any unprotected exposure can cause damage to the skin, because natural skin has no protection from UV rays of the sun. 

Skin cancer can be broken up into two basic categories; melanoma and non-melanoma. Non-melanoma includes basal cell carcinoma and squamous cell carcinoma. When non-melanoma affects the head and neck, this will present as a sore or bump that does not disappear. On other parts of the body, non-melanoma can appear flesh colored or a brown tinted scar that often bleeds or releases a liquid substance. Generally, basal cell is characterized by a smooth, white appearance, while the squamous cell bumps are rough. 

To spot melanoma, dermatologists suggest using the ABCDE rule. Even when doing your self-exams and using the ABCDE rule, remember that not all irregularities are problematic:
 

                 Asymmetry – does one side have a different shape than the other

                Border- is it irregular, scalloped or poorly defined?

                Color- is the color varied from one area to another?

                Diameter- is it greater than the size of a pencil eraser?

                Evolving- is it changing from what it once looked like?


Always prepare for your annual dermatology skin check by doing a head to toe self-exam and note any concerns to take with you to your visit. You are primarily looking for spots or bumps that are new, that do not go away, and that change in color, size shape, or all three. At the time of your visit, point out any abnormalities to your dermatologist who will closely examine any moles, growths, or lesions you noted and may even take a biopsy if needed. 

Remember, the two best ways to reduce your risk of skin cancer is to protect your skin from the sun and have your annual dermatologic skin checks!

Sexual Dysfunction and Painful Sex

 By: Dr. Dana Shanis

A woman’s sexuality is a complex mix of many physical and psychological responses, which can affect the way a woman thinks and feels about herself and her relationships. More than 40% of women in the United States report some kind of sexual dysfunction, according to a study published in the Journal of the American Medical Association (JAMA). While common, problems with sex often cause personal distress and can interfere in the relationship with a partner. Many women are hesitant to discuss these concerns with their providers and some women have had their concerns dismissed by healthcare providers in the past, left to suffer in silence.


Sexual Dysfunction

Women can experience problems in any of the stages of sexual activity, including desire, arousal, or orgasm. Psychological and intrapersonal issues can have a significant effect on all aspects of sexual function. It can be helpful to discuss your concerns with your partner and many couples benefit from individual or partnered counseling with a therapist trained in sexual dysfunction.

Sexual desire varies greatly from woman to woman, and can fluctuate from one time to another throughout a woman’s life. Lack of sexual desire is a common issue for women, with a national survey showing a third of women reporting this concern in the past year. When this causes personal distress, it is known as Hypoactive Sexual Desire Disorder (HSDD).

During the arousal stage of sexual activity, there is typically increased blood flow to the clitoris and vagina, increased lubrication and relaxation of vaginal muscles. An interruption in this can be caused by many factors, including medical illnesses, such as diabetes or thyroid disease. Medications also can affect the arousal response, and often there are alternative drug options that may have a less significant effect on libido. Along with your symptoms, it is important to inform your provider of any medications you are taking.

The absence or delay in orgasm can result from problems with desire or arousal, or from a variety of medical or physical factors. Issues with orgasm are most common in young women, but can occur at any stage of life.  

Many women experience urinary incontinence (leaking urine) during intercourse, especially common in women after pregnancy and during menopause. For many, this can cause embarrassment and anxiety that prevents enjoyable sexual activity.

Painful Sex

Painful sex affects 2 out of 3 women at some time in their lives, according to the American College of Obstetricians and Gynecologists (ACOG). There are some causes that are temporary, such as a vaginal infection or changes in hormones or medications. But others causes can remain until addressed. Occasionally, pain with sex can be a sign of a more significant illness, infection, or tumor, a reason discussing your symptoms with a provider is important.

Vaginal dryness is a common cause of pain, which can result from taking birth control pills or other medications, or following cancer treatments or menopause. Pelvic floor spasms are also commonly found in women who experience painful sex. These spasms can result from previous painful experiences, such as a pelvic infection or sexual assault, or in some cases occur spontaneously. Once a woman experiences pain during sex, anxiety can arise with future activity that can interfere with other aspects of sexual function, creating a negative feedback cycle.

Research in sexual health has become more commonplace in modern medicine and new diagnoses and treatments are being discovered every year. The GYN providers at Rittenhouse Women’s are trained in assessing and treating many causes of sexual dysfunction. We offer several treatment options, procedures, and new technology to address painful sex and related issues in the office, including:

  • Behavioral and medical treatments for decreased desire, dryness, and pain
  • Pelvic floor injections for muscle spasms leading to painful sex or pelvic pain
  • ThermiVa® for dryness, vaginal laxity, pain, incontinence, and decreased sexual function
  • O-shot® (Plasma-rich protein injection) for decreased arousal, unsatisfactory orgasm frequency/intensity, and urinary incontinence

 

 

It is important to discuss symptoms with your provider, as sometimes they can be a sign of a more significant problem. Do not suffer in silence.

Endometrial Ablation for Heavy Periods

By: Dana Shanis, M.D.

Many women across the US suffer from heavy periods.  For some it is only an inconvenience, but for other women it can interfere with their daily activities or lead to health issues like anemia. Heavy bleeding can be a sign of a benign growth in the uterus, such as a polyp or fibroid.  While some women experience a normal increase in menstrual bleeding as they get older, heavy or increasing bleeding should be evaluated to rule out abnormal growth in the uterus that could lead to cancer over time.


There are several medical treatments that can help with heavy bleeding, but typically this response is temporary.  Many women are looking for more definitive treatment to help control their cycles. In the past, women with heavy periods that have completed childbearing were often treated by a hysterectomy (surgical removal of the uterus), which has significant risk of complication and often requires a hospital stay.  As a result, lower risk procedures have been created for women who wish to keep their uterus, avoid major surgery or who are not good surgical candidates.

The most effective of these procedures is called endometrial ablation, which is the destruction of the lining of the uterus.  This procedure is minimally invasive and does not require an incision.  Previous techniques involved using electric current with a rollerball or circulating hot water in a balloon to destroy the lining.  These procedures were technically difficult to perform and limited in their success.

Current technology uses plasma or radiofrequency energy to more effectively target the uterine lining, increasing success rates and decreasing risk of complications.  These procedures are performed without a hospital stay and can even be done in the office, avoiding the risk of intravenous anesthesia.   

The Minerva device, the newest of the endometrial ablation technologies, has a soft conforming balloon, which increases comfort during the procedure. It also takes only 120 seconds to run, making it an ideal procedure to be performed in the office.  Due to its design and energy source, it is the most effective of current ablation options, with 66% of women having no more periods after the procedure and a 98% satisfaction rate. 

While endometrial ablation is not a form of contraception, it is not recommended that women get pregnant after it is performed, as there is an increased risk of serious complications. If desired, an additional procedure for sterilization can be performed at the time to address this concern.

Prior to endometrial ablation, evaluation of the uterine cavity and sampling of the uterine lining is performed to assess for abnormalities.  This is done by hysteroscopy (camera in the uterus) with endometrial biopsy, which can also be performed in the office with minimal discomfort.

Most insurance companies currently cover hysteroscopy and endometrial ablation, making it an affordable and effective option for diagnosing and treating heavy periods.
____
If you are experiencing increased or heavy bleeding, you should see your provider for evaluation and to discuss which treatment options are right for you. 

The Medical Treatment of Acne

By: Lauren O'Brien, M.D.

Everyday I have patients ask me, “Why am I still breaking out? I thought acne was just for teenagers!”. Unfortunately, this is a myth and more and more women are dealing with acne into the 20s, 30s, and 40s. Skin specialists are not sure what is causing this increase in acne, but it is our new reality.

Why do we treat acne?

Acne can have a huge impact on a woman’s self esteem so early treatment is paramount. These days, almost all cases of acne can be treated successfully. The best results occur when treated early. If left untreated, scarring and hyperpigmentation can occur which can be permanent.

What treatments and solutions do we have for you?

Our DermaCenter medical spa can treat acne with chemical peels such as Environ's Tca peel, which can combat acne by killing bacteria in the skin, controlling oil production and removing dead skin cells from the surface which will break up congestion allowing the skin to breath and products to penetrate more effectively. For best results Environ's TCA peels should be done 3-4 weeks apart. We also have Environ's Sebu line which includes various products specifically designed to treat acneic skin.

What can I do at home?

There are many over the counter products geared at treating acne. If you have mild-moderate acne, these over the counter regimens can be very helpful. Ingredients to look for include:

  1. Benzoyl peroxide- kills the bacteria responsible for acne
  2. Salicylic acid- helps breakdown blackheads and whiteheads. Also helps cut down the shedding of cells lining the hair follicle
  3. Sulfur- helps breakdown blackheads and whiteheads
  4. Adapalene- new to the over the counter market, this is a vitamin A derivative (in the same class as Retin A). This medication regulates skin cell turnover to keep pores from clogging as well as reducing redness and inflammation.

Just because these medications are over the counter does not mean they are free of side effects. Burning, dryness, and redness are common and will often go away with time. If you experience severe or prolonged side effects, stop the medication and come in to see us.

It is important to realize that any treatment regimen for acne takes time. The life cycle of a pimple can be up to 8 weeks, so patience is key. Before stopping any medication for lack of benefit, give it 8 weeks for the best chance of success.

OTC products didn’t work, now what?

If the over the counter products were not successful, it’s time to head into the office for more advanced treatments. There are many prescription options for treating acne these days. Depending on the history and severity of your acne, your provider may start with a topical medication. These include: antibiotics and vitamin A derivatives either alone or in combo with other medications.

Oral medications treat acne in a more systemic way. For individuals with moderate to severe acne on the chest, back and face, a course of oral antibiotics may be warranted to control acne. Some women may have hormonally influenced acne. Clues that this may be the case include: excessive hair growth, acne only on the jaw/lower face, premenstrual acne flares, or irregular menstrual cycles. In these cases different medications such as birth control pills or anti-androgen drugs (spironolactone) can be utilized.

For individuals with severe nodular or cystic acne, oral isotretinoin (Accutane) can be very effective. This is a Vitamin A derivative taken once or twice a day for 15-20 weeks. If reduces the size of oil glands leading to a reduction in oil production and decreased growth of bacteria. Though very effective, this medication certainly has its downside. Isotretinoin is known to cause birth defects, so it is imperative that women are not pregnant and do not get pregnant while taking this medication. Two forms of birth control are required when taking this drug and blood tests are often followed to monitor for any organ damage. Given the extensive monitoring required, this medication is generally only prescribed by dermatologists.

Is there anything else I can do?

Here are some basic tips from the American Academy of Dermatology to help you get the most out of your acne treatments:

  1. Wash twice a day and after sweating
  2. Use fingertips to apply a gentle, non-abrasive cleanser- washcloths/mesh sponges can irritate skin
  3. Be gentle with your skin- use alcohol-free products and avoid astringents/toners and exfoliants if they irritate your skin.
  4. Rinse with lukewarm water
  5. Shampoo regularly- especially if you have oily hair
  6. Let your skin heal naturally- no picking!
  7. Keep your hands off your face throughout the day
  8. Stay out of the sun and tanning beds

Begin Your Journey to Total Wellness

Sign up to learn more about Rittenhouse Women’s Wellness Center™
Location*
Please select a location
Name*
Please enter your name
Email*
Please enter a valid email address
Phone*
Invalid Input