Services

Family Physicians Practice Today’s Medicine

What really is a Family Physician? Family Physicians learn and use the most up-to-date treatments and technologies. Unlike General Practitioners, Family Physicians are trained for three additional years in real practice settings treating children and adults in the office as well as in the hospital. Board Certified Family Physicians must re-certify more often than any other medical specialty. With this Continuing Medical Education, it means that Family Physicians are experts at applying the latest medical breakthroughs to the every day care of the patient, so patients benefit from state-of-the-art advancements as they become available.

Family Physicians are specialty trained in preventative medicine and believe that preventing a health problem is better than having to overcome one. They assist patients in making the right health choices, which helps keep their families both happier and healthier. Their role is to diagnose and treat the entire family.

Urgent Care

Urgent Care in RocklinFor acute illnesses and injuries we offer Urgent Care. Evenings as well as Saturday visits are available by appointment or on a walk-in basis. Some of the services available in Urgent Care are the following:
  • Laceration Repair (stitches)
  • Treatment of Broken/Fractured Bones-splinting & casting
  • Abrasions & Burns
  • EKG-chest pain
  • Nebulizer Breathing Treatments
  • Catheter Insertion & Removal
  • Ear infections
  • Cold/Flu
  • Foreign Body Removal
  • Sports & School Physicals/Certified for DMV physicals
  • Car accident Injuries
  • Lab Testing
  • Ultrasound

Urgent Care casting 300 dpi

Our Urgent Care staff is ACLS certified and our Urgent Care Physicians are Board Certified in Emergency Medicine. It’s like going to the ER without the high cost.

After being seen in the Urgent Care we will forward a medical record (with your permission) of your care to your Primary Care Physician for follow up.

Family Medicine & Pediatrics

rocklin family and pediatric medicine

Family Medicine physicians specialize in caring for the physical, mental and emotional well-being of patients and their families. They know how a family’s health history and situations can affect their health and they are trained to care for patients through all stages of life. Being trained in all major medical areas, they can diagnose and treat the full range of problems that are encountered in everyday life. They know when to treat and when to bring in the proper specialist that can be trusted. They understand that YOU are a person and not just a collection of parts, symptoms or conditions and they take that notion very seriously.

Turnure Medical Group has physicians Board Certified in Family Medicine as well as double boarded in Internal and Pediatric Medicine. Therefore, our physicians are qualified to see patients of all ages- from the cradle to the grave so to speak. It is actually very common for parents and children to see the same physician which in turn brings a special bond to the doctor patient relationship. By seeing the entire family the physician can understand the entire family dynamics that play an important role in keeping families healthy both physically and emotionally.

Medical Weight Loss & Nutrition

At Turnure Medical Group we are committed to helping patients obtain a healthy weight, but more importantly teaching them to maintain a healthy weight by establishing lifestyle modifications to their diet and exercise. Our program is quite different than most commercial weight loss programs as it is tailored to each patient’s individual metabolism. The program uses only science evidence-based medicine and all instruction is given by qualified and trained professionals with college degrees.

LogoWe Offer Several Approaches to Weight Loss:

  • Nutrition & behavioral counseling with a Registered Dietitian/Nutritionist
  • Individualized exercise prescriptions with a Certified Health Coach/Therapeutic Exercise Specialist
  • Weight and body measurement print out using our state-of-the-art scale
  • Nutrition plans tailored to YOU
  • Medical weight loss program with FDA approved prescription meal replacements
  • Safe FDA approved medications
chopping healthy food

Our programs are closely linked with dietary and behavioral counseling as well as exercise instructions. Our Medical Weight Loss and Nutrition Program is medically sound, individualized by a Nutritionist, Registered Dietitian, and Certified Health Coaches. Our Therapeutic Exercise Specialist is certified by the American Council on Exercise and all providers are supervised by medical doctors in the office so patients can be assured that any medical conditions will be addressed during the process. Dr. Turnure (Board Certified in Obesity Medicine) is  the Medical Director of the program.  Our staff also maintains continuing education through the Obesity Medical Association.

Why Is Being Overweight Unhealthy?

Being overweight is not an appearance problem, it’s a medical problem.  There are over 53 serious diseases that are caused by being overweight – heart disease, high blood pressure, high cholesterol, stroke, diabetes and cancer to name a few.  It is the 2nd most preventable cause of death killing over 300,000 people per year.  Studies show that even losing as little as 10 pounds can reduce blood pressure.

Visit Turnure Medical Weight Loss & Nutrition Centers’s profile on Pinterest.

Getting Started

The first step is to make a consultation appointment with one of our professional staff. They will explain the options of our program as well as the cost. Consultations are $35 and we have plans as low as $60 for a half hour visit. We are also able to bill some insurances and offer 12 months of “interest free” financing through *Care Credit.

*Upon approval of credit, minimum purchase required

At your first appointment, we will do a Body Composition Analysis. Our scale uses bioelectrical impedance (BIA) to estimate your body composition. It runs a light electrical current through your body, measures the degree of resistance (or impedance) to the flow of the current, then uses this information to estimate how much body fat you have.

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Why the Scale?

It’s a simple fact that you can’t improve what you don’t measure. Getting on the scale promotes accountability as well as reliability. We agree that it is not always about the number and that is why we offer a scale with bio-electrical impedance. Using this technology we can accurately measure your body fat and muscle mass index.  The purpose is not to discourage you but encourage you.

Dr weighing patient

 

How the Program Works

  • Starting Phase: You will be prescribed low-calorie FDA approved meal replacements or a modified meal plan with your own food. We recommend weekly weigh-ins with behavioral, exercise and nutritional counseling for accountability. FDA medications will be administered by a physician if needed.  We offer a monthly Newsletter with Nutrition and Exercise tips.
  • Transitional Stage: You will be on a modified low-calorie diet where regular food will be put back into your daily routine. Meal plans can be provided by our Nutritionist or Registered Dietitian. Behavioral, nutritional and exercise instruction will continue to be used until you are comfortable that you can do this on your own. Some patients continue to see our staff on a bi-weekly or monthly basis.
  • Maintenance Phase: You are now a Pro and have learned how to maintain a healthy lifestyle to keep the weight off. We offer an Annual Membership where you are able to purchase the shakes and bars at a discount as well as come in for weigh-ins every quarter.  We realize that maintaining a healthy weight can be a lifetime challenge so we welcome you to come back if needed.

Turnure Medical Group Weight Loss Group Staff

Turnure Medical Weight Loss & Nutrition Team

Urology & Urogynecology

Urology doctor with prostate cancer blue ribbon

The sub-specialty of Urology manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland.  A Urologist has comprehensive knowledge and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.  They do procedures such as kidney stone removal, vasectomies, circumcisions, and reconstruction of these areas.  They also treat (surgically and chemotherapy treatments) those patients that have developed cancer in the prostate, bladder or kidneys.  A Urogynecologist works with female reconstruction such as repair of the bladder and surgeries for incontinence.

The Urology Department is run by Dr. David Couillard, MD.

Pediatric Urology

pediatric urologyDr. Couillard is fellowship-trained in pediatric urological reconstruction and neurourology.  He treats newborns all the way through adulthood for all urological needs. As a father of 3 children, Dr. Couillard knows how precious children can be.  It is important to know that when choosing Dr. Couillard for pediatric urology, he has specific training in pediatrics and he truly enjoys taking care of children.

Dr. Couillard is experienced in the repair of pediatric congenital defects such as hypospadius, reflux and undescended testes. Voiding dysfunction, bedwetting, and urinary infections in children are also his specialty and he performs routine circumcisions on newborns.

Hypospadius is when the urethra does not develop all the way to the tip of the penis and requires surgical reconstruction using plastic surgical techniques. This is done usually at about 6-9 months of age. It most often involves one repair but may require revisions in some cases. These are short outpatient procedures in most. The repair is needed to establish normal look and function for later in life and for fatherhood.

Women’s Urology / Urogynecology

Dr. Couillard has specialized fellowship training in pelvic gynecological repair and reconstruction. He has seen and treated thousands of these patients successfully and performed several thousand operations for incontinence and prolapse with a high success rate.

 

A Urogynecologist is a gynecologist who specializes in the same problems. This field (a sub-specialty within Gynecology and Urology) is dedicated to the treatment of women with pelvic floor disorders such as urinary or fecal incontinence and prolapse womens urology(bulging or falling) of the vagina, bladder, rectum and/or the uterus.  Most women often hesitate to talk to their doctor or wait years to admit these symptoms to their doctor because they are embarrassed. Below is a list of the different types of incontinence that can happen:

  • Urinary incontinence (leakage of urine) is a very common condition affecting at least 10-20% of women under age 65 and up to 56% of women over the age of 65. While incontinence also affects men, it occurs much more commonly in women.
  • Stress incontinence is when urine leaks during activity or strain such a cough, laugh or lifting. Pelvic exercises rarely control this problem and simple, safe outpatient surgery is the cure.
  • Urge incontinence is due to an overactive bladder and it causes frequent urination and sudden leakage – “commonly known as not making it to the bathroom on time.”   Urge incontinence is treated with medications, behavior modification, and occasionally biofeedback or electrical stimulation. There is a wide variety of surgical and non-surgical options available.
  • Prolapse simply means displacement from the normal position. When this word is used to describe the female organs, it usually means bulging, sagging or falling. It can occur quickly but usually happens over the course of many years. On average, 11% of women will undergo surgery for this condition.

We never put plastic or mesh in our vaginal repairs as it can be unsafe and can cause lasting problems.

Men’s Urological Health

Although going under a vasectomy can be a scary consideration for most men, we are here to tell you that it is considered nearly 100% effective and a very safe procedure.

no scalpel vasectomiesAbout half a million American men each year chose a vasectomy as a form of permanent birth control.  A vasectomy is actually safer than the sterilization process for a woman which requires an anesthetic and an intra-abdominal procedure.  It does not interfere with sexual pleasure or manhood.  It is quick and it is relatively painless with rare complications that are easily managed. Dr. Couillard has done thousands of vasectomies using the No-Scalpel Vasectomy (NSV) technique.

What is the No-Scalpel Vasectomy (NSV)?

The no-scalpel vasectomy is a quick procedure (15 minutes) and it is relatively painless with rare complications that are easily managed. It is less invasive and tends to be gentler which causes minimal bleeding.  As the name suggests, the “No Scalpel” method does not involve a scalpel, but rather a small opening.  Special instruments are used that allow the procedure to be done with generally less manipulation of a man’s tissues. In an NSV procedure, Dr. Couillard locates the vas deferens under the skin of the scrotum by hand, and holds the tiny tube in place with a small clamp. Small pointed forceps separate the layers of tissue which creates a tiny opening in the skin to form an opening for the vas deferens to be gently lifted out, then cut, tied, clipped and/or cauterized and put back into place.  The skin is then closed with sutures.  This is all done in the office under a local anesthetic so that the procedure is very comfortable.

Urological Oncology

Dr. Couillard has extensive training and over 20 years of experience in treating and managing all urological cancers, laparoscopy and post surgical reconstruction (when necessary).

Prostate Cancer (CAP)

Prostate cancer is the most common cancer in men, but the good news is it can be treated very effectively when it is detected early. Despite what you have seen and heard from the government or maybe your doctor, PSA (Prostate Specific Antigen) screening is essential and necessary to save lives. More importantly, many men have read or have heard that prostate cancer surgery and other treatments can cause permanent dysfunction that will lower their quality of life. For most men this is not true. Most men after a short period of healing and recovery are able to return to sexual function and urinary control. Those who do not can often be treated with other methods.

It is true that if you are not going to live more than 10 more years you probably will receive no benefit from a PSA screening. In the United States, men who have less than 10 years left are being screened and treated for prostate cancer. This is what has led the government to recommend no screening. However, since we are now diagnosing CAP in most men from 55 to 75 years old they now can have more than 15 years left of life. Prostate cancer in those patients will kill many of them if not discovered early and cured.

To detect prostate cancer early, Dr. Couillard recommends that all men be screened regularly when over the age of 50 (over 40 if you have a strong family history). Since over 90% of prostate cancers detected early are curable with treatment, Dr. Couillard offers the following treatments for prostate cancer:

  • Radical Prostatectomy
  • Radiation Therapy
  • Hormone Therapy

Kidney Cancer

Dr Couillard has one of the most extensive experiences in Laparoscopic Nephrectomies in Northern California. He has performed hundreds of radical and partial surgical removals of kidney cancer.

Kidney cancer is most often found incidentally when a CAT scan or ultrasound is done for other reasons. Sometimes hematuria (blood in the urine) or more rarely, flank pain can be due to kidney cancer.

Laparoscopic (full or partial removal) surgery results in over a 90% cure in most patients with early detected kidney cancer.

Bladder Cancer

prostate cancer, kidney cancer and bladder cancerBladder Cancer is a common cancer in both men and women. It increases with age and with a history of smoking. It most often presents with gross or microscopic hematuria (blood found in the urine). Evaluation includes a radiographic study of the upper tracts (kidney and ureter) and a cystoscopy (looking in the bladder with a scope). These are simple, quick and very safe tests that are necessary to detect bladder cancer.

Bladder cancer most often is superficial and easily cured but on rare occasions, invasive cancer is found and must be treated aggressively. When this happens a Transurethral Resection of  the Bladder Tumor (TURBT) is used to remove and accurately diagnose the grade and stage of the cancer. Often, superficial bladder cancer is later treated with intravessical therapy or washing the bladder with agents such as Bacillus Calmette-Guerin (BCG) to prevent the cancer from returning.  BCG is a vaccine used to prevent tuberculosis (TB). Even though doctors do not know why, they have found that this type of immunotherapy drug (BCG) is very effective in treating bladder cancer.

After treatment a surveillance schedule is implemented with routine cystoscopies so if recurrence is found it will be found early and safely managed.

If invasive bladder cancer is found then removal of the bladder is considered, called radical cystectomy. Following this, Dr. Couillard must reconstruct a new pathway for the urine to get out. Most urologists are not trained or comfortable offering a surgical reconstruction of the bladder when appropriate. Experience does matter and Dr Couillard is specially trained and experienced in complex bowel reconstruction of new bladders.

Other Urological Cancers treated effectively include:
• Testicular Cancer
• Penile Cancer

Almost all urological cancers are treated effectively with surgery if caught before they spread. It is not always necessary to see an oncologist (medical cancer specialist who gives chemotherapy). An oncologist is needed when there is a need for radiation therapy. At that point, Dr. Couillard will refer you appropriately to his colleagues.

Neurologic Rehabilitation

 

neurology rocklinTurnure Medical Group in Rocklin is dedicated to neurologic rehabilitation treatment for both children and adult survivors of strokes, traumatic brain injuries and cerebral palsy. Through the provision of individualized assessment, physical therapy and Botox® injections patients that were untreatable in years previous now have hope. We seek to assist our patients in attaining their maximum level of function and quality of life through education and foundational retraining in their physical function. If you or a loved one have suffered from these conditions please contact us to evaluate treatment.

Travel Medicine

Travel medicine in Rocklin

Planning a dream vacation to a tropical paradise, visiting family overseas, going on a Safari or mission trip to Central America? Whatever your travel plans may be, Turnure Medical Group in Rocklin, CA is here to help. Dr. Darilyn Falck is an ER doctor with extra certification in Travel and Tropical Medicine.

With international travel comes the possibility of exposure to exotic diseases, parasites, and other conditions. Before you travel, our goal is to prepare you with knowledge, appropriate immunizations and prophylactic medications to protect against diseases and conditions you may encounter on your trip.

Dr. Falck will spend approximately 30 minutes in consultation with you to discuss your specific travel plans, tailor her recommendations and advice to meet your needs, and answer any questions you may have. She will review your pertinent medical history and immunization history with you. Her goal is to educate you with the knowledge, medications, and immunizations you need so you can stay safe and healthy both during and after your trip.

We suggest you schedule an appointment as soon as you know you will be traveling since many vaccines need to be given weeks before you travel and some are done in a series months ahead. This will give you ample time to prepare so that you have maximum benefit and protection from the vaccines.

We also ask that you complete a Travel Questionnaire prior to your scheduled appointment. Click here for questionnaire.