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TCDagel iCIEASE
"One of my patients, who is paralyzed, needed an
ultrasound on her kidney," Diskin said. "I arranged for
the ultrasound to come to her home."
Adult Primary Care is one of three independent
nurse practitioner offices in Michigan. More frequent-
ly, nurse practitioners work as part of a physician's
office.
Because Diskin's practice also works with Dr.
Barbara Cingel and Dr. Larry Dell, she and her co-
workers can write their own prescriptions under the
physicians' licensure. Larger medical insurers, such as
Aetna, Blue Cross/Blue Shield and Medicare, cover
accepted procedures at the practice just as they would
at a physician's office, although the field is still strug-
gling to win acceptance from smaller insurers.
"We are paid 85 percent of what physicians receive,
based on Medicare standards," Diskin said. "So you'd
think they'd want the people they insure to go to us."
Nurse practitioners are not allowed to do major sur-
gery, although the Michigan Council of Nurse
Practitioners is working to gain surgery credentials for
its members.
The collaboration of Drs. Cingel and Dell facilitates
hospital admittance, should that become necessary,
Diskin said. She refers to the two as her "collabora-
tors."
Dr. Michael Sandler of West Bloomfield said nurse
practitioners require the more direct supervision of a
physician.
"Many nurses do an outstanding job in doing home
health care," said Dr. Sandler, who chairs the board of
directors of the Michigan Medical Society. "They are
frequently outstanding caregivers. However, we in the
medical profession believe nurse practitioners are not
sufficiently trained in diagnosis and the efficacy of
treatment to work independently of a physician."
Dr. Sandler referred to Michigan's Public Health
Code, specifically Act 368 of 1978, which calls for
"supervision" of medical professionals who are not
physicians. Among the definitions of supervision in
the code are "continuous availability of direct commu-
nication in person or by radio, telephone or telecom-
Really Listening
Nurse practitioners provide skilled hands and an attentive ear.
DIANA LIEBERMAN
Special to the Jewish News
ickilyn Calvert knew the pain in her neck was-
n't psychosomatic.
The West Bloomfield resident had been
examined by five neurosurgeons and neurologists over
a five-year period and, she said, none of them realized
her recurring pain was caused by a broken neck.
Then she carne to Adult Primary Care Associates, a
Southfield-based medical practice run by nurse practi-
tioner Cindy Diskin.
"Cindy really listened to me," said Calvert, whose
daughter attends Hillel Day School of Metropolitan
Detroit. "She took a simple X-ray and found that I
had a fractured cervical vertebra."
Diskin compared Calvert's injury to that suffered by
the late actor Christopher Reeve while horseback rid-
ing. "If she'd fallen again, she'd be paralyzed from the
neck down," said Diskin, a board-certified nurse prac-
titioner.
When Diskin opened Adult Primary Care in July
2003, she had just this sort of situation in mind.
"Nurse practitioners take quite a bit of time listen-
ing to each patient, to what they say, how they say it
and even what they don't say," she said. "I would hope
that all health care professionals would listen. But we
specifically take the time to engage the patient and the
entire family."
Six months after opening, Diskin hired two associ-
ates, Kathi Payson and Linda Urso. Today, the trio
treats about 400 patients.
Nurse practitioner Caroline Broida Trapp of
Farmington Hills, who works with people with dia-
"Nurse practitioners can do exactly the same thing as
physicians would, within their specialty," Diskin
explained. "Mine is internal medicine."
Diskin received her registered nurse and bachelor of
science degrees from Wayne State University in
Detroit in 1984. In 1998, she added a master's degree
in nursing from Madonna University in Livonia, spe-
cializing in chronic health conditions in adults; this
was followed by a post-master's specialty certification
as a nurse practitioner.
At her office, Diskin and her associates do every-
thing from medical consultations and tests to sutures,
skin biopsies and other minor surgery.
In addition, they spend time at West Bloomfield's
Danto Health Care Center, the West Bloomfield
Nursing and Convalescent Center, Lillian and Samuel
Hechtman Jewish Apartments and other retirement
and nursing homes, giving lectures and demonstra-
tions on such topics as chronic pain, diabetes and
nutrition.
Residents of these facilities can request private visits,
where Diskin or her associates function just as they
would in the Adult Primary Care offices. They also
make house calls.
Joel H. K.aitifitraa_ri
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betes, called Diskin "a great clinician and a caring
human being.
"I would be comfortable having any member of my
family under her care," said Trapp, director of diabetes
care at the Southfield-based Premier. Internists and
Northwest Internal Medicine, a division of
Millennium Medical Group, PC.
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