My archives might be a little outdated especially the older blogs. My links above are all new and current.

I have only positive things to say about Permission to Mother, an autobiographical account of a thoughtful mother and clinician who courageously writes from her heart, soul, brain, and personal experience; who is open to change in her views and opinions and is not guided by the safety of rules of any group or the status quo; she is guided by love and openness to the experiences life brings her and her family. Her process benefits her and those around her and those who read her words. And to add to that, the writing style and story telling ability here make it a very enjoyable read speckled with both the humor and seriousness of life. ~Laura Keegan RN FNP, author of Breastfeeding with Comfort and Joy

Readers enjoy your feedback and Reviews (82!) on amazon. Kindle Version Available!

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E-care 2015

E-care 2015-- Reassurance from Dr. Punger is just an e-mail away!

This service may be for you if you desire the convenience of email  access with a  concise written  response from Dr. Punger avoiding the telephone or coverage service. E-care is selectively offered to those who have  shown the need for accessibility and individualized care.

A low annual fee of $300.00 will include 8-10 E-mail contacts/problems per year/per family for established family members. A one-time payment in full is required.

It is your responsibility to schedule an office visit  following e-care contact for complex  problems. E-care is about having the convenience of individual access & expedited care, and not necessarily for the coordination and finalization  of the treatment plan. Any e-mail “care” that requires photos, labs,  x-rays, referrals or requires research will be billed to insurance & copays will apply.  

If it is an emergency, call 911. Don’t e-mail if you need a reply within seconds (Nor does Dr. Punger need to interrupt dinner with her family or yoga class/swim lessons, or pull to the side of the Turnpike to message back or  call your pharmacy. It is sad, but necessary,  that this must be said.)

It is reasonable to expect that it may be 4-6 hours for a response. Dedicated time to reply to e-mail is scheduled at regular intervals. That said, overall,  responses tend to be fairly prompt.  We appreciate you using sensible hours and reasonable expectations. Using office hours is appreciated when you know you need something as opposed to “waiting it out.”

(To expedite care include LEGAL name, pharmacy name, and THE pharmacy number, (not the main store number), your phone number and patient date of birth). Send e-care concerns to Do  not text or use social media for medical care.

E-care is about building healthy physician/patient relationship and long term respect for each other.  Privileges can be revoked for abusive and unreasonable demands. Lack of planning on your part does not constitute an emergency on our part.

Dr. Punger may unplug for a few days over winter holidays, Yom Kippur and during medical mission trips. The gmail will be checked during office hours by staff during those times.

Your e-care will terminate in 12 months unless you initiate renewal.

This is not a replacement program for the uninsured.
*Notify our office if your insurance changes or is dropped.
(You will be responsible for services rendered.)


"Thank you, Denise! I've always appreciated your willingness to be available and interested in our medical needs. You are the only physician I know who goes to these lengths to provide patient care in times of need. Truly you are a physician of the people! Again, thank you. Be blessed!" bc

"I text you for antibiotics on New Year's Eve when I was out of town. My friends were amazed I could reach my doctor quickly." la

"I received your letter regarding your availability for your being accessible without office visits. I think this is fantastic, well deserved and want to sign up. My family is leaving Friday for a summer camping trip until the 1st week in August, so I'm SURE that means we'll need you. Like I said before - it's just not a vacation unless someone gets sick & we need to contact Dr. Punger!" jj  

"You've always been there for my family. We are glad to have this service." pp 

"It is just wonderful to have you available via email.   It has been a huge help with a young toddler and with breastfeeding.  As nervous first time parents it is a lifesaver. We also know you aren't going to just tell us to run to the pharmacy and we love that about you. We trust you and it is fantastic to have your attention via email also when times get rough." lp

"We couldn't be happier to be a part of your "E-Care" program. Living more than an hour away, it is a relief to know that we can reach you with any concerns and that you respond in such a timely manner to those concerns without us having to pack up the little ones who are under the weather and drive down to the office (although we would have if you felt it was necessary). Thankfully, we have only had to contact you a few times this year and thankfully you were able to provide more than sufficient care thru e-mail and a call to the pharmacist if needed. It has worked out extremely well for our family. 

Prior to this program I was pondering whether we should try to seek out a Dr. who is more local "just in case" all the while knowing that I would have a hard time finding a local physician who takes on a holistic/integrative approach, who is well versed in HEALTHcare, and who knows us without our charts the way you do. I am very thankful that this program allows us to keep a family Dr. who understands and promotes those ideals. I was also impressed that after the last time I contacted you for care, you took the initiative to contact ME a day later to find out how he was feeling." bk

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