Winter 2018

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in this issue SANTA ROSA IS RISING OBSERVATIONS FROM THE ENCHANTED LAND AND FROM SOUTHERN CALIFORNIA

Leading the future of health care. ADULT & FAMILY MEDICINE PHYSICIAN OPPORTUNITIES Northern & Central California

The Permanente Medical Group, Inc. (TPMG) is one of the largest medical groups in the nation with over 9,000 physicians, 22 medical centers, numerous clinics throughout Northern and Central California and a 70 year tradition of providing quality medical care. WE OFFER • Physician-led organization–career growth and leadership • Professional freedom • State-of-the-art facilities • Multi-specialty collaboration and integration • Technology driven • Mission driven, patient care-centered and one of the largest progressive medical groups in the nation! EXTRAORDINARY BENEFITS • Shareholder track • Moving allowance • Home loan assistance (approval required)

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En Kaiser Permanente, a nosostros los médicos nos encanta nuestro trabajo. Nuestra misión es servir a nuestros pacientes. Innovar, avanzar, ser inclusivos. Intégrate a nuestro equipo de atención de la salud, en apoyo a la comunidad.

LA SALUD PERMANENTE

At The Permanente Medical Group, Inc., we practice a multi-lingual, culturally inclusive approach to care that celebrates the diversity of our patients and physicians. By developing medical programs that are in tune with every aspect of our patients’ lives—from the language they speak to the heritage they embrace—we are actively investing in initiatives and services that reflect the diversity of our member community. Here, our bilingual physicians can act as true advocates for their patients, delivering care that’s as medically advanced as it is culturally sensitive.

FAMILY MEDICINE OPPORTUNITIES: Contact Aileen Ludlow at: Aileen.M.Ludlow@kp.org | (800) 777-4912 INTERNAL MEDICINE OPPORTUNITIES: Contact Bianca Davis at: Bianca.X.Davis@kp.org | (800) 777-4912 Connect With Us: http://physiciancareers-ncal.kp.org

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April 27-28, 2018 Aria Hotel, Las Vegas, NV CO-CHAIRS Brooks D. Cash, MD Chief, Division of Gastroenterology Director, USA Digestive Health Center Professor of Internal Medicine University of South Alabama Health System Mobile, AL Steven L. Flamm, MD Chief, Liver Transplantation Program Professor of Medicine Northwestern Feinberg School of Medicine Chicago, IL Jointly Provided By

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Immediate Past President Lee Ralph, MD President-elect Lisa Ward, MD, MPH Speaker Walter Mills, MD Vice-Speaker ĂǀŝĚ ĂnjnjŽ͕ D Secretary/Treasurer Shannon Connolly, MD Executive Vice President ^ƵƐĂŶ ,ŽŐĞůĂŶĚ͕ Foundation President ŶƚŚŽŶLJ ŚŽŶŐ͕ D

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Nathan Hitzeman, MD, Editor Shelly Rodrigues, CAE, Managing Editor The California Family Physician is published quarterly by the California Academy of Family Physicians. Opinions are those of the authors and not necessarily those of the members and staff of the CAFP. Non-member subscriptions are $35 per year. Call 415-345-8667 to subscribe.

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California Family Physician Winter 2018

California

Winter 2018

FAMILY PHYSICIAN stron g

m edi ci ne

f or

C ali fo r nia

Lisa Ward, Tara Scott, Shelly Rodrigues, Patricia Hiresote and Susan Hogeland touring the Vista Clinic.

features 14 Observations from the Enchanted Land 16 Santa Rosa Is Rising! Reflections and Recovery

Hal L. Grotke, MD, FAAFP

Lisa Ward, MD, MPH; Tara Scott, MD; Jay W. Lee, MD, MPH; Patricia Hiserote, DO; Bo Greaves, MD; and Marshall Kubota, MD

26 And, in Southern California

David Araujo, MD

27 CAFP’s 2018 Officers to be Elected at the AMAM

departments 6

Editorial

Survival Medicine

8

President’s Message

What Do You Need to Keep Your Cup Full?

Nathan Hitzeman, MD Michelle Quiogue, MD, FAAFP

10 Political Pulse

CAFP Helps Secure More Than $1 Billion in 2017

Carla Kakutani, MD

12 Membership News

Celebrating 70 Years ... Sharing 10,000 Stories

Shannon Goecke

30 EVP Forum

We’re Keeping our Eyes, Ears and Hearts Open!

Susan Hogeland, CAE

&Žƌ ƵƉĐŽŵŝŶŐ D ĂĐƟǀŝƟĞƐ ǀŝƐŝƚ ĨĂŵŝůLJĚŽĐƐ͘ŽƌŐͬĐŵĞ California Family Family Physician Physician Winter Winter 2018 ϮϬϭϴ California

5

editorial

Nathan Hitzeman, MD

Survival Medicine The one-inch thick pane of glass you look through on your ĐƌŽƐƐͲĐŽƵŶƚƌLJ ŇŝŐŚƚ Ăƚ ϯϬ͕ϬϬϬ ĨĞĞƚ͘ dŚĞ ƌĂƩůĞ ŝŶ LJŽƵƌ ĞŶŐŝŶĞ ĂƐ LJŽƵ ĚƌŝǀĞ ĚŽǁŶ Ă ůŽŶĞůLJ ƌŽĂĚ ŽŶ Ă ĨƌŽƐƚLJ ĚĂLJ ŝŶ ƚŚĞ ^ŝĞƌƌĂƐ͘

/Ŷ ƚŚŝƐ ŝƐƐƵĞ͕ ǁĞ ƌĞŇĞĐƚ ŽŶ ŶĂƚƵƌĂů ĚŝƐĂƐƚĞƌ ĂŶĚ ĐĂƚĂƐƚƌŽƉŚĞ͘ EŽƚ ƐƵƌƉƌŝƐŝŶŐůLJ͕ ĨĂŵŝůLJ ĚŽĐƚŽƌƐ ĂƌĞ ǁĞůů ƐƵŝƚĞĚ ƚŽ ƐƚĞƉ ƵƉ ŝŶ Ă ĐƌŝƐŝƐ ʹ ǁŚĞƚŚĞƌ ďĞŝŶŐ ƐƵŵŵŽŶĞĚ ŽŶ Ă ƉůĂŶĞ ĨŽƌ Ă ĚŽĐƚŽƌ ŽŶ ďŽĂƌĚ͕ Žƌ Ă ĐŽŵŵƵŶŝƚLJ ĚŝƐĂƐƚĞƌ ƌĞƋƵŝƌŝŶŐ ƚƌŝĂŐĞ͕ ĮƌƐƚ ĂŝĚ ĂŶĚ ƐƵƉƉŽƌƚ ƐĞƌǀŝĐĞƐ ʹ ǁŚĞŶ ƚŚĞ ĂƐŚĞƐ ƐĞƩůĞ͕ ǁĞ ƵŶĚĞƌƐƚĂŶĚ ƚŚĞ ŶĞĞĚƐ ŽĨ ƚŚĞ ŵŝŶĚ ĂŶĚ ƐŽƵů ĂƐ ǁĞůů ĂƐ ƚŚĞ ďŽĚLJ͘ tĞ ĂƌĞ Ă ƐƵƉƉŽƌƟǀĞ ďƵŶĐŚ ǁŚŽ ƉƌĞǀĂŝů͘ At home, I have Auerbach’s Wilderness Medicine and Field & Stream’s Outdoor Survivor Guide in my nightstand. I’ve rarely ƵƐĞĚ ŵƵĐŚ ŽĨ ǁŚĂƚ / ƌĞĂĚ͕ ďƵƚ ƚŚĞ ŵŽƌĞ / ůŝƐƚĞŶ ƚŽ ĐƵƌƌĞŶƚ ĞǀĞŶƚƐ͕ ƚŚĞ ŵŽƌĞ / ĚƵƐƚ ƚŚŽƐĞ ƉƵƉƉŝĞƐ Žī ĂŶĚ ƉƌĞƉĂƌĞ ĨŽƌ ƚŚĞ ǁŽƌƐƚ͘ ,ĞƌĞ ĂƌĞ Ă ĨĞǁ ƐƵƌǀŝǀĂů ƟƉƐ /͛ǀĞ ůĞĂƌŶĞĚ ŽǀĞƌ ƚŚĞ LJĞĂƌƐ͘ •

• •

6

ůǁĂLJƐ ƚĞůů ƐŽŵĞŽŶĞ ǁŚĞƌĞ LJŽƵ ĂƌĞ ŐŽŝŶŐ͘ dŚĂƚ ǁĂƐ ƚŚĞ ƵŶĚŽŝŶŐ ŽĨ Ă dĞdžĂŶ ďƵƐŝŶĞƐƐŵĂŶ ǁŚŽ ŐŽƚ ŝŶũƵƌĞĚ ĂŶĚ ůŽƐƚ ŽŶ ƚŚĞ ůĂǀĂ ĮĞůĚƐ ŽĨ ,ĂǁĂŝŝ ĨŽƌ ĮǀĞ ĚĂLJƐ͕ ĂŶĚ ŽĨ ƌŽŶ ZĂůƐƚŽŶ͕ ĞdžƉĞƌƚ ĐůŝŵďĞƌ ǁŚŽ ŐŽƚ ƉŝŶŶĞĚ ďLJ Ă ƌŽĐŬ ŝŶ ϮϬϬϯ ŚŝŬŝŶŐ ĂůŽŶĞ ŝŶ hƚĂŚ͛Ɛ ĂŶLJŽŶůĂŶĚ EĂƟŽŶĂů WĂƌŬ ;ŚĞ ŚĂĚ ƚŽ ĂŵƉƵƚĂƚĞ ŚŝƐ ŽǁŶ ĂƌŵͿ͘ zŽƵ ĐĂŶ ůŝǀĞ ƚŚƌĞĞ ŵŝŶƵƚĞƐ ǁŝƚŚŽƵƚ ŽdžLJŐĞŶ͕ ƚŚƌĞĞ ŚŽƵƌƐ ǁŝƚŚŽƵƚ ǁĂƌŵƚŚ͕ ƚŚƌĞĞ ĚĂLJƐ ǁŝƚŚŽƵƚ ǁĂƚĞƌ͕ ƚŚƌĞĞ ǁĞĞŬƐ ǁŝƚŚŽƵƚ ĨŽŽĚ͘ ^ĞǀĞƌĂů ĐŽŵŵŽŶ ĞǀĞƌLJĚĂLJ ŝƚĞŵƐ ŚĂǀĞ ƐŝŐŶŝĮĐĂŶƚ survival uses: safety pin (remove foreign bodies or ƐƉůŝŶƚĞƌƐ͕ ŚŽůĚ ŐĂƉŝŶŐ ǁŽƵŶĚƐ ƚŽŐĞƚŚĞƌ͕ ƐĞĐƵƌĞ ĂŶ

California Family Physician Winter 2018

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“

With our modern day conveniences and ease of travel, it is easy to forget we live in a wilderness of inhospitable elements and predators that threaten our very existence.

“

With our modern day conveniences and ease of travel, it is ĞĂƐLJ ƚŽ ĨŽƌŐĞƚ ǁĞ ůŝǀĞ ŝŶ Ă ǁŝůĚĞƌŶĞƐƐ ŽĨ ŝŶŚŽƐƉŝƚĂďůĞ ĞůĞŵĞŶƚƐ and predators that threaten our very existence. I’ve had Ă ĨĂƐĐŝŶĂƟŽŶ ǁŝƚŚ ƐƵƌǀŝǀĂů ĂŶĚ ǁŝůĚĞƌŶĞƐƐ ŵĞĚŝĐŝŶĞ ƐŝŶĐĞ ĐŚŝůĚŚŽŽĚ͘ ŌĞƌ ǁĂƚĐŚŝŶŐ ZĂŵďŽ͕ ŵLJ ďĞƐƚ ĨƌŝĞŶĚ ĂŶĚ / ŽƌĚĞƌĞĚ ƚŚĞ ƐƉĞĐŝĂů ƐƵƌǀŝǀĂů ŬŶŝĨĞ ǁŝƚŚ ƚŚĞ ŚĂŶĚůĞ ĐŽŶƚĂŝŶŝŶŐ ƚŚĞ ǁŝƌĞ ƐĂǁ ĂŶĚ ƐƚƌŝŬĞ ĂŶLJǁŚĞƌĞ ŵĂƚĐŚĞƐ͘ tĞ ƚŽŽŬ ƐŶĂŬĞ ďŝŬĞ ŬŝƚƐ ĂŶĚ ƚŽƵƌŶŝƋƵĞƚƐ ǁŚĞŶ ǁĞ ĐĂŵƉĞĚ ŽƵƚ ŝŶ ƚŚĞ ŚŝůůƐ ďĞŚŝŶĚ ŽƵƌ ĂLJ ƌĞĂ ƐƵďƵƌďĂŶ ŚŽŵĞƐ͘ >ƵĐŬŝůLJ͕ ǁĞ ǁĞƌĞ ŶĞǀĞƌ ĞŶǀĞŶŽŵĞĚ͕ ŶŽƌ ŚĞŵŽƌƌŚĂŐĞĚ ƉƌŽĨƵƐĞůLJ ʹ ǁŚŝĐŚ ŝƐ ŐŽŽĚ ďĞĐĂƵƐĞ ǁĞ ƉƌŽďĂďůLJ ǁŽƵůĚ ŚĂǀĞ ĚŽŶĞ ŵŽƌĞ ŚĂƌŵ ƚŚĂŶ ŐŽŽĚ ǁŝƚŚ ƚŚĞ ƚŽƵƌŶŝƋƵĞƚ͘ Ƶƚ ŝƚ ĨĞůƚ ĞŵƉŽǁĞƌŝŶŐ ƚŽ ďĞ ƉƌĞƉĂƌĞĚ͘

Ăƌŵ ƐůŝŶŐ͕ ƌĞƉůĂĐĞ Ă ďƌŽŬĞŶ njŝƉƉĞƌͿ͕ ƚĂŵƉŽŶ ;ǁŽƵŶĚ ĐĂƌĞ͕ ĞŵĞƌŐĞŶĐLJ ƟŶĚĞƌ͕ ƉůƵŐ ďƵůůĞƚ ŚŽůĞƐͿ͕ ĐŽŶĚŽŵƐ ;ĞŵĞƌŐĞŶĐLJ ďůĂĚĚĞƌ͕ ǁĂƚĞƌƉƌŽŽĨ ƉŽƵĐŚ͕ ƐůŝŶŐƐŚŽƚ ďĂŶĚ͕ ŝƌƌŝŐĂƟŽŶ ƐŽƵƌĐĞͿ͕ ƉĂŶƚLJ ŚŽƐĞ ;ŵŽƐƋƵŝƚŽ ŶĞƚ͕ ǁĂƌŵƚŚ͕ ǁĂƚĞƌ ĮůƚĞƌ͕ ŚĂŶŐ ĨŽŽĚ Žƌ ƟŶĚĞƌ ŽŶ ƚƌĞĞ ůŝŵďƐͿ͕ ƉŽĐŬĞƚ ŬŶŝĨĞ ĂŶĚ ŚĞĂĚ ůĂŵƉ ;ƐĞůĨͲĞdžƉůĂŶĂƚŽƌLJͿ͕ ƚĂƌƉ͕ ůĞĂƚŚĞƌ ŐůŽǀĞƐ ĂŶĚ ǁŽŽů ďůĂŶŬĞƚ ;ŬĞĞƉ ŝŶ LJŽƵƌ ĐĂƌ Ăƚ Ăůů ƟŵĞƐ ʹ ƌĞŵĞŵďĞƌ͗ ƚŚƌĞĞ ŚŽƵƌƐ ǁŝƚŚŽƵƚ ǁĂƌŵƚŚͿ͘ DĂŬĞ LJŽƵƌ ŽǁŶ ĮƌƐƚ ĂŝĚ ŬŝƚƐ͘ dŚĞLJ ĂƌĞ ŵƵĐŚ ďĞƩĞƌ ƚŚĂŶ ƐƚŽƌĞͲďŽƵŐŚƚ ĂŶĚ LJŽƵ ǁŝůů ďĞ ĨĂŵŝůŝĂƌ ǁŝƚŚ ƚŚĞŵ ǁŚĞŶ you need them.

ƵĞƌďĂĐŚ ŚĂƐ Ă ǁŚŽůĞ ĐŚĂƉƚĞƌ ŽŶ ƐƵƌǀŝǀŝŶŐ ǁŝůĚĮƌĞƐ͘ /Ĩ LJŽƵ ĂƌĞ ŝŶ Ă ǀĞŚŝĐůĞ͕ ŝƚ ŝƐ ďĞƐƚ ƚŽ ƐƚĂLJ ƚŚĞƌĞ ĂŶĚ ĨĂĐĞ ŝƚ ƉĂƌŬĞĚ ƚŽǁĂƌĚ ƚŚĞ ĮƌĞ ĂŶĚ ƐƚĂLJ ĐŽǀĞƌĞĚ ŽŶ ƚŚĞ ŇŽŽƌ ;ĐĂƌƐ ƌĂƌĞůLJ ĞdžƉůŽĚĞͿ͘ /Ĩ LJŽƵ ĂƌĞ ŝŶ ƚŚĞ ďƵƐŚ͕ ƌƵŶ ĚŽǁŶŚŝůů ĂǁĂLJ ĨƌŽŵ ƚŚĞ ŇĂŶŬ ŽĨ Ă ĮƌĞ Ăƚ Ă ϰϱͲĚĞŐƌĞĞ ĂŶŐůĞ͘ /Ĩ LJŽƵ ŚĂǀĞ ƟŵĞ͕ ďƵƌŶ Ă ƐĂĨĞƚLJ njŽŶĞ ĂƌŽƵŶĚ LJŽƵ ŝŶ Ă ĚƌLJ ŐƌĂƐƐͬůŽǁ ƐŚƌƵď ĂƌĞĂ ƚŽ ĞdžŚĂƵƐƚ ƚŚĞ ĨƵĞů͘ /Ĩ Ăůů ĞůƐĞ fails, lie covered prone on the ground. KĨ ĐŽƵƌƐĞ͕ ƐŵĂƌƚƉŚŽŶĞƐ ĐĂŶ ĂŝĚ ŝŶ ŽƵƌ ƐƵƌǀŝǀĂů ǁŚĞŶ ƚŚĞLJ ĂƌĞ ŶŽƚ ĐŽŵƉƌŽŵŝƐŝŶŐ ŝƚ ďLJ ĚŝƐƚƌĂĐƟŶŐ ƵƐ͘ ƋƵŝĐŬ ŐŽŽŐůĞ ƐĞĂƌĐŚ ĐĂŶ ŵĂŬĞ LJŽƵ ĂŶ ĞdžƉĞƌƚ ŽŶ ĮƌƐƚ ĂŝĚ͕ ĞĚŝďůĞ ƉůĂŶƚƐ͕ ĐŽŵƉĂƐƐ skills, radio scanning, knot-tying and measurement tools. tĞ ǁŝůů ƐƵƌǀŝǀĞ͊

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California Family Physician Winter 2018

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p r e s i d e n t ’s m e s s a g e

Michelle Quiogue, MD, FAAFP

What Do You Need to Keep Your Cup Full? Ɛ ƚŚĞ ŵĞĚŝĂ ŚĂǀĞ ƚŽůĚ ƐƚŽƌŝĞƐ ŽĨ ƚŚĞ ĚĞǀĂƐƚĂƟŶŐ ĮƌĞƐ͕ ŶĂƚƵƌĂů ĚŝƐĂƐƚĞƌƐ ĂŶĚ ŵĂƐƐ ƐŚŽŽƟŶŐƐ ƚŚĂƚ ŚĂǀĞ ĐŚĂŶŐĞĚ ƚŚŽƵƐĂŶĚƐ ŽĨ lives in our state in recent months, their coverage has shined Ă ůŝŐŚƚ ĂŶĚ ďƌŽƵŐŚƚ ƚŽ ƚŚĞ ƉƵďůŝĐ͛Ɛ ĂƩĞŶƟŽŶ ƚŚĞ ĞǀĞƌLJĚĂLJ ŚĞƌŽĞƐ ǁĞ ŬŶŽǁ ĂƐ ĨĂŵŝůLJ ĚŽĐƚŽƌƐ͘ ƚ ƚŚĞ ƐĂŵĞ ƟŵĞ͕ ƐƵĐŚ ĂƩĞŶƟŽŶ ƵŶĚĞƌƐĐŽƌĞƐ ƚŚĞ ƉŝƞĂůůƐ ŽĨ ŚŝŐŚůŝŐŚƟŶŐ ĂĐƚƐ ŽĨ ƐĂĐƌŝĮĐĞ͕ ƌĞƐŝůŝĞŶĐĞ ĂŶĚ ĐŽŵƉĂƐƐŝŽŶ ǁŝƚŚŽƵƚ ĂůƐŽ ĂĐŬŶŽǁůĞĚŐŝŶŐ ƚŚĞ ĐŽƐƚ ƚŽ ƚŚŽƐĞ ŝŶ ŽƵƌ ƉƌŽĨĞƐƐŝŽŶ ǁŚŽ ďĞĂƌ ƚŚĞƐĞ ŚĞĂǀLJ ƌĞƐƉŽŶƐŝďŝůŝƟĞƐ͘ dŚĞ ĂĐƟŽŶƐ ŽĨ ŽƵƌ ĐŽůůĞĂŐƵĞƐ ŝŶ ƚŚĞƐĞ ƐƚƌĞƐƐĨƵů ƟŵĞƐ ĂƌĞ ƚŽŽ ŽŌĞŶ ƵƐĞĚ ƚŽ ƉĂŝŶƚ ƚŚĞŵ ĂƐ ƐƵƉĞƌͲŚƵŵĂŶ͕ ǁŚĞŶ͕ ƌĞĂůůLJ͕ ǁŚĂƚ ƚŚĞLJ ĚŽ ŝƐ ĞƐƐĞŶƟĂůůLJ ŚƵŵĂŶ͘ dŚŝƐ ƚƌƵƚŚ ǁĂƐ ĚƌŝǀĞŶ ŚŽŵĞ ƚŽ ŵĞ ǁŚĞŶ ƌĞĂĚŝŶŐ ĂŶ ĂƌƟĐůĞ ĂďŽƵƚ ƐĞůĨͲĐŽŵƉĂƐƐŝŽŶ͕ ĂŶĚ / ǁĂŶƚ ƚŽ ƐŚĂƌĞ ƚŚŝƐ ƉĂƐƐĂŐĞ ǁŝƚŚ ƚŚŽƐĞ ŝŶ ŽƵƌ ŵĞŵďĞƌƐŚŝƉ ǁŚŽ ŵĂLJ ŶĞĞĚ ƌĞŵŝŶĚŝŶŐ ƐŽŵĞƟŵĞƐ͗ tĞ ŶĞĞĚ ƚŽ ĮƌƐƚ ƌĞŵĞŵďĞƌ ƚŚĂƚ ĂƐ ƐƚƌŽŶŐ͕ ĂƐ ďƌŝůůŝĂŶƚ͕ ĂƐ loving, and as powerful as we may be, we weren’t built to be ƐƵƉĞƌŚĞƌŽĞƐ൷Ͷ൷ǁĞ ǁĞƌĞ ďƵŝůƚ ƚŽ ďĞ ŚƵŵĂŶ͘ ͞tĞ ǁĞƌĞ ďƵŝůƚ ƚŽ ďĞ ŚƵŵĂŶ͘͟ dĂŬĞ Ă ďƌĞĂƚŚ͘ Ž LJŽƵ ŚĞĂƌ ƚŚĂƚ͍ tĞ ǁĞƌĞ ďƵŝůƚ ƚŽ ďĞ ŚƵŵĂŶ͘ ĞĂƵƟĨƵů ĂŶĚ ŵĞƐƐLJ͕ ĂŶĚ ǁŝƚŚ ŽƵƌ ŽǁŶ ůŝŵŝƚƐ ĂŶĚ ƐƚƌĞŶŐƚŚƐ ĂŶĚ ŶĞĞĚƐ ƚŚĂƚ ŵĂŬĞ ƵƐ ǁŚŽ ǁĞ ĂƌĞ͘ tŝƚŚ ŽƵƌ ŽǁŶ ĐƵƉƐ ƚŚĂƚ ŶĞĞĚ ƚŽ ďĞ ĮůůĞĚ ŝĨ ǁĞ ǁĂŶƚ ƚŽ ƌĞŵĂŝŶ ǁŚŽůĞ͘ /Ĩ ǁĞ ǁĂŶƚ ƚŽ ƌĞŵĂŝŶ ǁŚŽůĞ͕ ǁĞ ŶĞĞĚ ƚŽ ƌĞĐŽŐŶŝnjĞ ƚŚĂƚ ĞǀĞŶ ǁŚĞŶ ǁĞ ƐĞĞ ƚŚĞ ĚĞĞƉ ƵƌŐĞŶĐLJ ŽĨ ĞǀĞƌLJƚŚŝŶŐ ƚŚĂƚ ŶĞĞĚƐ ƚŽ ďĞ ĚŽŶĞ͕ ĂŶĚ ĐŚĂŶŐĞĚ͕ ĂŶĚ ĨŽƵŐŚƚ ĨŽƌ ŝŶ ŽƵƌ ǁŽƌůĚ͖ ĞǀĞŶ ǁŚĞŶ ǁĞ ƐĞĞ ƚŚŝƐ ǁŝƚŚ ŐƌĞĂƚĞƌ ĐůĂƌŝƚLJ ƚŚĂŶ ŵĂŶLJ ŽĨ ƚŚĞ ŵŽƌĞ ƉƌŝǀŝůĞŐĞĚ ƉĞŽƉůĞ ĂƌŽƵŶĚ ƵƐ͖ ĂŶĚ ĞǀĞŶ ǁŚĞŶ ǁĞ ŬŶŽǁ ǁĞ ŚĂǀĞ ƐŽ ŵƵĐŚ ƚŽ ŐŝǀĞറͶറŝƚ ũƵƐƚ ŝƐŶ͛ƚ ƉŽƐƐŝďůĞ ĨŽƌ ĂŶLJ ŽŶĞ ŽĨ ƵƐ ƚŽ ƚĂŬĞ Ăůů ŽĨ ƚŚŝƐ ŽŶ͘ <ŶŽǁŝŶŐ ĂŶĚ ƌĞƐƉĞĐƟŶŐ ŽƵƌ ŽǁŶ ůŝŵŝƚƐ ĚŽĞƐŶ͛ƚ ƚĂŬĞ ĂǁĂLJ ĨƌŽŵ ŽƵƌ ĂďŝůŝƚLJ ƚŽ ŐŝǀĞ ŝŶ Ă ŵĞĂŶŝŶŐĨƵů ǁĂLJ͕ ŝƚ ĂĐƚƵĂůůLJ ĂĚĚƐ ƚŽ ŽƵƌ ĂďŝůŝƚLJ͕ ŝĨ ǁĞ ƐƚĂƌƚ ĨƌŽŵ Ă ƉůĂĐĞ ŽĨ ĨĞĞůŝŶŐ ǁŚŽůĞ ĂŶĚ ĨĞĞůŝŶŐ ŶŽƵƌŝƐŚĞĚ͕ ǁĞ ǁŝůů ďƌŝŶŐ ƚŚŝƐ ƚŽ Ăůů ƚŚĞ ǁŽƌŬ ǁĞ ĐŚŽŽƐĞ ƚŽ ƐŚĂƌĞ ǁŝƚŚ ŽƚŚĞƌƐ͘ ZĞĂĚ ŵŽƌĞ Ăƚ ŚƩƉƐ͗ͬ​ͬŵĞĚŝƵŵ͘ĐŽŵͬΛ ^ŽůŝĚĂƌŝƚLJtK ͬŐŝǀŝŶŐͲĨƌŽŵͲĂŶͲĞŵƉƚLJͲĐƵƉͲŚŽǁͲŶŽƚͲƚŽͲĚŝĞͲ ĂϵϬĞϳďĂĐĞϵϳϴ &Žƌ ŵĞ͕ ƚŚĞ ƉĂƐƐĂŐĞ ĞĐŚŽĞƐ ƚŚĞ ĮŶĚŝŶŐƐ ŽĨ ƐŽĐŝĂů ǁŽƌŬ ƉƌŽĨĞƐƐŽƌ ĂŶĚ ƌĞƐŝůŝĞŶĐĞ ƌĞƐĞĂƌĐŚĞƌ ƌĞŶĠ ƌŽǁŶ ŽŶ ƚŚĞ ƐŽƵƌĐĞ 8

California Family Physician Winter 2018

of compassion and generosity: namely, that compassionate ƉĞŽƉůĞ ĂƌĞ ĐůĞĂƌ ĂďŽƵƚ ƚŚĞŝƌ ďŽƵŶĚĂƌŝĞƐ͘ tŚĞŶ ǁĞ ƐƚĂƌƚ ƚŽ ĨĞĞů ŽǀĞƌǁŚĞůŵĞĚ͕ ƵŶĂƉƉƌĞĐŝĂƚĞĚ͕ ƚĂŬĞŶ ĂĚǀĂŶƚĂŐĞ ŽĨ ĂŶĚ ƌĞƐĞŶƞƵů͕ ƚŚĞŶ ǁĞ ĂůƐŽ ŶĞĞĚ ƚŽ ĐŚĞĐŬ ǁŚŝĐŚ ŽĨ ŽƵƌ ďŽƵŶĚĂƌŝĞƐ ŚĂǀĞ ďĞĞŶ ĐƌŽƐƐĞĚ ĂŶĚ ƌĞĐŽŐŶŝnjĞ ǁŚŝĐŚ ůŝŵŝƚĂƟŽŶƐ ǁĞ ŚĂǀĞ ƌĞĂĐŚĞĚ͘ tŚĞŶ ǁĞ ĂƌĞ ƐƚƌŽŶŐ͕ ĂƐƐĞƌƟǀĞ ĂŶĚ ĐůĞĂƌ ĂďŽƵƚ ǁŚĂƚ ǁĞ ďĞůŝĞǀĞ ŝƐ ŽŬĂLJ ĂŶĚ ǁŚĂƚ ŝƐ ŶŽƚ ŽŬĂLJ͕ ƚŚĞŶ ǁĞ ĂƌĞ ĂůƐŽ ĐůĞĂƌ ĂďŽƵƚ ǁŚĂƚ is needed to keep our cups full. Thus, through self-respect, ǁĞ ĐĂŶ ĐŽŶƟŶƵŽƵƐůLJ ŐŝǀĞ ĞŵƉĂƚŚLJ ĂŶĚ ƐĞƌǀĞ ƚŚĞ ŶĞĞĚƐ ŽĨ ŽƵƌ ĐŽŵŵƵŶŝƟĞƐ͘ Ɛ ǁĞ ĨĂĐĞ ĞĂĐŚ ĚŝƐĂƐƚĞƌ ƚŽŐĞƚŚĞƌ͕ ůĞƚ ƵƐ ĐŽŵŵŝƚ ƚŽ ƌĞĂĐŚ out, check in and support one another in understanding our ůŝŵŝƚĂƟŽŶƐ ĂŶĚ ƌĞƐƉĞĐƟŶŐ ŽƵƌ ďŽƵŶĚĂƌŝĞƐ͘ /Ŷ ĂĚĚŝƟŽŶ͕ / ŚŽƉĞ ƚŚĂƚ ŽŶĞ ŽĨ ƚŚĞ ƌĞƐŽƵƌĐĞƐ ůŝƐƚĞĚ ďĞůŽǁ ǁŝůů ďĞ ŚĞůƉĨƵů ƚŽ LJŽƵ ĂƐ LJŽƵ ĐŽŶƟŶƵĞ ƚŽ ďĞĂƌ LJŽƵƌ ƐƵƉĞƌŚƵŵĂŶ ƌĞƐƉŽŶƐŝďŝůŝƟĞƐ ĞǀĞŶ ĂƐ you care for your merely human self. The more I learn about the causes of physician burnout, the more I am convinced that ŵĞĂŶŝŶŐĨƵů ǁŽƌŬ ĂŶĚ ĐŽŶŶĞĐƟŽŶ ƚŽ ŽƵƌ ĐŽůůĞĂŐƵĞƐ ĂƌĞ ĞƐƐĞŶƟĂů factors to building resistance against it. In this and many other ǁĂLJƐ͕ / ďĞůŝĞǀĞ &W ŚĞůƉƐ ƵƐ ŬĞĞƉ ŽƵƌ ĐƵƉƐ ĮůůĞĚ͘ DƵĐŚ ǁŽƌŬ ŵƵƐƚ ďĞ ĚŽŶĞ͖ / Ăŵ ŐƌĂƚĞĨƵů ǁĞ ŚĂǀĞ ĐŚŽƐĞŶ ƚŽ ƐŚĂƌĞ ŝƚ ƚŽŐĞƚŚĞƌ͘ ZĞƐŽƵƌĐĞƐ ĨŽƌ ŵĞŶƚĂů ŚĞĂůƚŚ ƐƵƉƉŽƌƚ ;ĨƌŽŵ ŚƩƉƐ͗ͬ​ͬŵĞĚŝƵŵ͘ ĐŽŵͬΛ^ŽůŝĚĂƌŝƚLJtK ͬĮůůŝŶŐͲŽƵƌͲĐƵƉƐͲϰͲǁĂLJƐͲƉĞŽƉůĞͲŽĨͲĐŽůŽƌͲ ĐĂŶͲĨŽƐƚĞƌͲŵĞŶƚĂůͲŚĞĂůƚŚͲĂŶĚͲƉƌĂĐƟĐĞͲƌĞƐƚŽƌĂƟǀĞͲŚĞĂůŝŶŐͲ ϲϰĞϱĞϳϱϴϰϭϮϳͿ͗ • hƟůŝnjĞ LJŽƵƌ ŵƉůŽLJĞĞ ƐƐŝƐƚĂŶĐĞ WƌŽŐƌĂŵ ; WͿ ĂŶĚ ŵĞŶƚĂů ŚĞĂůƚŚ ďĞŶĞĮƚƐ • &ŝŶĚ ůĂĐŬ ƚŚĞƌĂƉŝƐƚƐ Ăƚ ĨƌŝĐĂŶ ŵĞƌŝĐĂŶdŚĞƌĂƉŝƐƚƐ͘ĐŽŵ ĂŶĚ dŚĞ ƐƐŽĐŝĂƟŽŶ ŽĨ ůĂĐŬ WƐLJĐŚŽůŽŐŝƐƚƐ͘ • Read this guide, Going To Therapy As A QTPOC, Without ĞŝŶŐ ,ĂƌŵĞĚ͕ ƌĂƐĞĚ Kƌ ĂŋĞĚ͕ ĂŶĚ ĮŶĚ ƋƵĞĞƌ ĂŶĚ ƚƌĂŶƐ ƚŚĞƌĂƉŝƐƚƐ ŽĨ ĐŽůŽƌ ƚŚƌŽƵŐŚ ƚŚĞ EĂƟŽŶĂů YƵĞĞƌ Θ dƌĂŶƐ dŚĞƌĂƉŝƐƚƐ ŽĨ ŽůŽƌ EĞƚǁŽƌŬ͘ • &ŝŶĚ ŽƵƚƉĂƟĞŶƚ ƐĞƌǀŝĐĞƐ ƚĂŝůŽƌĞĚ ĨŽƌ ƐŝĂŶ ŵĞƌŝĐĂŶƐ using Hyphen Magazine’s resource guide. • Find a therapist or psychiatrist of color near you through ƚŚĞ dĞƐƐĞƌĂ ŽůůĞĐƟǀĞ • ŚŽŽƐĞ ƚŚĞ ƐƉĞĐŝĮĐ ƌĂĐĞͬĞƚŚŶŝĐ ƉĂƌĂŵĞƚĞƌƐ LJŽƵ͛ƌĞ looking for using Psychology Today’s clinician directory. • /ƐůĂŵŝĐ ŽƵŶƐĞůŝŶŐ ŝƐ ďĂƐĞĚ ŝŶ ƚŚĞ h<͕ ďƵƚ ƚŚĞŝƌ ŚĞůƉĨƵů

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links page has some counselors available for Skype sessions. dƌLJ ŽƵƚ ŽŶĞ ŽĨ ƚŚĞƐĞ ϭϮ ŵĞŶƚĂů ŚĞĂůƚŚ ĂƉƉƐ͕ ĞĂĐŚ ĚĞƐŝŐŶĞĚ ĨŽƌ Ă ƐƉĞĐŝĮĐ ƉƵƌƉŽƐĞ ;ƚŽ ĞĂƐĞ ŝŶƐŽŵŶŝĂ͖ ŝŵƉƌŽǀĞ ŵŽŽĚ͖ ƐƚŽƉ ƐĞůĨͲŚĂƌŵ͖ ĞƚĐ͘Ϳ͘ dĞdžƚ ϳϰϭϳϰϭ ĨƌŽŵ ĂŶLJǁŚĞƌĞ ŝŶ ƚŚĞ h͘^͘ ƚŽ ĐŚĂƚ ǁŝƚŚ Ă ƚƌĂŝŶĞĚ ĐƌŝƐŝƐ ĐŽƵŶƐĞůŽƌ through Crisis Text Online. Seek out, research, and listen ƚŽ ƐŽƵƌĐĞƐ ŽĨ ŬŶŽǁůĞĚŐĞ ĨƌŽŵ marginalized, underserved, and ŶĞŐůĞĐƚĞĚ ĐŽŵŵƵŶŝƟĞƐ ĂďŽƵƚ ŵĞŶƚĂů health beliefs, healing, and community needs ŚƩƉƐ͗ͬ​ͬŵĞĚŝƵŵ͘ĐŽŵͬΛ^ŽůŝĚĂƌŝƚLJtK ͬ ĮůůŝŶŐͲŽƵƌͲĐƵƉƐͲϰͲǁĂLJƐͲƉĞŽƉůĞͲŽĨͲĐŽůŽƌͲ ĐĂŶͲĨŽƐƚĞƌͲŵĞŶƚĂůͲŚĞĂůƚŚͲĂŶĚͲƉƌĂĐƟĐĞͲ ƌĞƐƚŽƌĂƟǀĞͲŚĞĂůŝŶŐͲϲϰĞϱĞϳϱϴϰϭϮϳ

“Offer it Up”

You must have an empty cup my sister You must have an empty cup You have given to everyone but yourself and Your cup is now empty We are going to work on making sure that your cup remains full so that when you are giving, you give from your saucer. That is your overflow. Your excess. Never give from your cup because when your cup is empty, so are you. You can’t empty your cup and expect to remain whole. Yetta Young—Butterfly Confessions http://butterflyconfessions.com/ Butterfly Confessions, a stage-play, is a love letter to women of color that reveals heartfelt emotions about intimacy, sexual responsibility and overcoming adversity. The play blends humor and heartbreak with education, empowerment and inspiration while bringing awareness to domestic violence and HIV/ AIDS. Butterfly Confessions was created and conceived by Yetta Young as a collective effort with (12) contributors.

California Family Physician Winter 2018

9

political pulse

Carla Kakutani, MD

CAFP Helps Secure More than $1 Billion in 2017 dŚĂŶŬƐ ƚŽ ŽƵƌ ŵĞŵďĞƌƐ͕ <ĞLJ ŽŶƚĂĐƚƐ ĂŶĚ 'ŽǀĞƌŶŵĞŶƚ ZĞůĂƟŽŶƐ ƚĞĂŵ͕ &W ŚĂĚ ŽŶĞ ŽĨ ŝƚƐ ŵŽƐƚ ƐƵĐĐĞƐƐĨƵů ĂĚǀŽĐĂĐLJ LJĞĂƌƐ ĞǀĞƌ͊ • tĞ ƉƌŽƚĞĐƚĞĚ ŽƵƌ ŚĂƌĚͲǁŽŶ $100 million three-year state ŝŶǀĞƐƚŵĞŶƚ ŝŶ ƚŚĞ ^ŽŶŐͲ ƌŽǁŶ WŚLJƐŝĐŝĂŶ dƌĂŝŶŝŶŐ WƌŽŐƌĂŵ͕ ǁŚŝĐŚ ĨƵŶĚƐ ƉƌŝŵĂƌLJ ĐĂƌĞ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵƐ ŝŶ ƵŶĚĞƌƐĞƌǀĞĚ ĂƌĞĂƐ ƚŚĂƚ ƉƌŽǀŝĚĞ ĐĂƌĞ ĨŽƌ ƵŶĚĞƌƐĞƌǀĞĚ ƉŽƉƵůĂƟŽŶƐ͘ • tĞ ĞŶƐƵƌĞĚ ƚŚĂƚ Ă ƐŝŐŶŝĮĐĂŶƚ ƉŽƌƟŽŶ ŽĨ ƚŚĞ ƌĞǀĞŶƵĞ ĨƌŽŵ ƚŚĞ ƌĞĐĞŶƚůLJ ƉĂƐƐĞĚ WƌŽƉŽƐŝƟŽŶ ϱϲ ;ƚŽďĂĐĐŽ ƚĂdžͿ ŝƐ ƐƉĞŶƚ ŽŶ DĞĚŝͲ Cal provider payment – ŵŽƌĞ ƚŚĂŶ Ψϭ ďŝůůŝŽŶ ǁŚĞŶ ŵĂƚĐŚĞĚ ǁŝƚŚ ĨĞĚĞƌĂů ĨƵŶĚƐ ʹ ĂŶĚ ƉƌŝŵĂƌLJ ĐĂƌĞ ƌĞƐŝĚĞŶĐLJ ƚƌĂŝŶŝŶŐ ;$40 million annuallyͿ͘

ϰϬ ;^ĂŶƟĂŐŽͿ hZ ^ ĚĂƚĂďĂƐĞ͗ ŚĞĂůƚŚ ŝŶĨŽƌŵĂƟŽŶ ƚĞĐŚŶŽůŽŐLJ system ͙ ĂůůŽǁƐ ƋƵĂůŝĮĞĚ ŚĞĂůƚŚ ŝŶĨŽƌŵĂƟŽŶ ƚĞĐŚŶŽůŽŐLJ ƐLJƐƚĞŵƐ͕ such as EHRs, to connect to the ŽŶƚƌŽůůĞĚ ^ƵďƐƚĂŶĐĞ hƟůŝnjĂƟŽŶ ZĞǀŝĞǁ ĂŶĚ ǀĂůƵĂƟŽŶ ^LJƐƚĞŵ ; hZ ^Ϳ ĚĂƚĂďĂƐĞ ĞŶĂďůŝŶŐ ĚŝƌĞĐƚ ŝŵƉŽƌƚĂƟŽŶ ŽĨ hZ ^ ĚĂƚĂ ŝŶƚŽ ƉĂƟĞŶƚ ƌĞĐŽƌĚƐ͘

^ ϮϮϯ ; ƚŬŝŶƐͿ ,ĞĂůƚŚ ĐĂƌĞ ůĂŶŐƵĂŐĞ ĂƐƐŝƐƚĂŶĐĞ ƐĞƌǀŝĐĞƐ … ensures Ăůů ĂůŝĨŽƌŶŝĂŶ ƉĂƟĞŶƚƐ ƌĞĐĞŝǀĞ ĞƋƵĂů ĂĐĐĞƐƐ ƚŽ ůĂŶŐƵĂŐĞ ĂƐƐŝƐƚĂŶĐĞ ĂŶĚ ĐůĞĂƌ ŶŽƟĮĐĂƟŽŶ ŽĨ ƚŚĞŝƌ ƌŝŐŚƚƐ ƚŽ ƌĞĐĞŝǀĞ ŚĞĂůƚŚ ĐĂƌĞ ǁŝƚŚŽƵƚ ĚŝƐĐƌŝŵŝŶĂƟŽŶ͕ ƌĞŐĂƌĚůĞƐƐ ŽĨ ĨĞĚĞƌĂů ĐŚĂŶŐĞƐ͘

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None of these victories would be possible without a strong and growing membership.

ϰϲϭ ;DƵƌĂƚƐƵĐŚŝͿ ZĞĚƵĐŝŶŐ dĂdžĞƐ ĨŽƌ DĞĚŝĐĂů ^ƚƵĚĞŶƚƐ ǁŝƚŚ Student Loans … ensures that gross income does not include any ůŽĂŶ ĂŵŽƵŶƚ ĐĂŶĐĞůĞĚ Žƌ ƌĞƉĂŝĚ ďLJ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ ^ĞĐƌĞƚĂƌLJ ŽĨ ĚƵĐĂƟŽŶ͕ ŵĞĂŶŝŶŐ ŵĞĚŝĐĂů ƐƚƵĚĞŶƚƐ ǁŝůů ŶŽƚ ŝŶĐƵƌ Ă ƐƚĂƚĞ ƚĂdž liability once loans are forgiven under federal programs. ϴϰϭ ;tĞďĞƌͿ ŶƐƵƌŝŶŐ ,ŝŐŚ EƵƚƌŝƟŽŶ ŝŶ ^ĐŚŽŽůƐ … prohibits Ă ƐĐŚŽŽů͕ ƐĐŚŽŽů ĚŝƐƚƌŝĐƚ Žƌ ĐŚĂƌƚĞƌ ƐĐŚŽŽů ĨƌŽŵ ĂĚǀĞƌƟƐŝŶŐ ĨŽŽĚ Žƌ ďĞǀĞƌĂŐĞƐ ĚƵƌŝŶŐ ƚŚĞ ƐĐŚŽŽů ĚĂLJ ĂŶĚ ĨƌŽŵ ƉĂƌƟĐŝƉĂƟŶŐ ŝŶ Ă ĐŽƌƉŽƌĂƚĞ ŝŶĐĞŶƟǀĞ ƉƌŽŐƌĂŵ ƚŚĂƚ ƌĞǁĂƌĚƐ ƉƵƉŝůƐ ǁŝƚŚ ĨƌĞĞ Žƌ ĚŝƐĐŽƵŶƚĞĚ ĨŽŽĚƐ Žƌ ďĞǀĞƌĂŐĞƐ ƚŚĂƚ ĚŽ ŶŽƚ ĐŽŵƉůLJ ǁŝƚŚ ŶƵƚƌŝƟŽŶĂů standards.

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Adding to this success, Governor :ĞƌƌLJ ƌŽǁŶ ƐŝŐŶĞĚ ϭϯ ŽĨ ϭϰ &WͲ supported bills, including:

^ ϭϳ ;,ĞƌŶĂŶĚĞnjͿ ,ĞĂůƚŚ ĐĂƌĞ͗ ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐ ĐŽƐƚƐ … ƌĞƋƵŝƌĞƐ ŚĞĂůƚŚ ƉůĂŶƐ ƚŽ ƌĞƉŽƌƚ ĐŽƐƚ ŝŶĨŽƌŵĂƟŽŶ ƌĞŐĂƌĚŝŶŐ ĐŽǀĞƌĞĚ ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐƐ͕ ŝŶĐůƵĚŝŶŐ ŐĞŶĞƌŝĐ ĚƌƵŐƐ͕ ďƌĂŶĚ ŶĂŵĞ ĚƌƵŐƐ ĂŶĚ ƐƉĞĐŝĂůƚLJ ĚƌƵŐƐ͘ dŚĞ ůĂǁ ĂůƐŽ ƌĞƋƵŝƌĞƐ ŚĞĂůƚŚ ƉůĂŶƐ ƚŽ ĚŝƐĐůŽƐĞ ŝŶĨŽƌŵĂƟŽŶ ƌĞŐĂƌĚŝŶŐ ƚŚĞ ƌĞůĂƟŽŶ ŽĨ ƉƌĞƐĐƌŝƉƟŽŶ ĚƌƵŐ ĐŽƐƚƐ ƚŽ ƉůĂŶ or insurer spending and premium charges.

EŽŶĞ ŽĨ ƚŚĞƐĞ ǀŝĐƚŽƌŝĞƐ ǁŽƵůĚ ďĞ ƉŽƐƐŝďůĞ ǁŝƚŚŽƵƚ Ă ƐƚƌŽŶŐ ĂŶĚ ŐƌŽǁŝŶŐ ŵĞŵďĞƌƐŚŝƉ͘ WůĞĂƐĞ ƌĞĂĐŚ out to your colleagues and let ƚŚĞŵ ŬŶŽǁ ƚŚĞ ŐƌĞĂƚ ƚŚŝŶŐƐ &W is doing on behalf of California ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ͖ ĞŶĐŽƵƌĂŐĞ ƚŚĞŵ ƚŽ ũŽŝŶ ŽƵƌ ŽƌŐĂŶŝnjĂƟŽŶ ĂŶĚ ŽƵƌ ĮŐŚƚ ĨŽƌ ƉĂƟĞŶƚƐ ĂŶĚ ƉƌŝŵĂƌLJ ĐĂƌĞ͊

I’d also like to highlight the important role our FP-PAC plays. dŚĞ &ĂŵŝůLJ WŚLJƐŝĐŝĂŶƐ WŽůŝƟĐĂů ĐƟŽŶ ŽŵŵŝƩĞĞ ;&WͲW Ϳ ŝƐ Ă ĐƌƵĐŝĂů ƚŽŽů ŝŶ ŽƵƌ ĂĚǀŽĐĂĐLJ ĞīŽƌƚƐ͘ &WͲW ƐƵƉƉŽƌƚƐ ĐĂŶĚŝĚĂƚĞƐ ĨŽƌ ŽĸĐĞ ĂŶĚ ƐŝƫŶŐ ůĞŐŝƐůĂƚŽƌƐ ǁŚŽ ƐŚĂƌĞ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ͛Ɛ ǀĂůƵĞƐ ĂŶĚ ŝƚ ĞŶƐƵƌĞƐ ƚŚĂƚ ĐĂŶĚŝĚĂƚĞƐ ĂƌĞ ĂǁĂƌĞ ŽĨ ŽƵƌ ƉƌŝŽƌŝƟĞƐ͘ &WͲW ĂůƐŽ ĂůůŽǁƐ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶƐ ƚŽ ŚĂǀĞ ĚŝƌĞĐƚ ĂĐĐĞƐƐ ƚŽ ůĞŐŝƐůĂƟǀĞ ůĞĂĚĞƌƐ ǁĞ ǁŽƵůĚ ŶŽƚ ŽƚŚĞƌǁŝƐĞ ďĞ ĂďůĞ ƚŽ ƉĞƌƐŽŶĂůůLJ ŵĞĞƚ͕ ŝŶĐůƵĚŝŶŐ ƚŚĞ ^ƉĞĂŬĞƌ ŽĨ ƚŚĞ ƐƐĞŵďůLJ ĂŶĚ ^ĞŶĂƚĞ WƌĞƐŝĚĞŶƚ͘ /Ŷ ϮϬϭϲ͕ &WͲW ŚĞůƉĞĚ ĞůĞĐƚ ŵŽƌĞ ƚŚĂŶ ϮϬ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ĐŚĂŵƉŝŽŶƐ ͙ ĞůĞĐƟŽŶƐ ĐƌƵĐŝĂů ŝŶ ƚŚĞ ϮϬϭϳ ĞīŽƌƚƐ ƚŽ ŵĂŝŶƚĂŝŶ ƚŚĞ ΨϭϬϬ ŵŝůůŝŽŶ ĂůůŽĐĂƟŽŶ ƚŽ ƚŚĞ ^ŽŶŐͲ ƌŽǁŶ WƌŽŐƌĂŵ͘ &Žƌ ƚŚĞ ĮƌƐƚ ƟŵĞ ŝŶ ĂůŝĨŽƌŶŝĂ͛Ɛ ŚŝƐƚŽƌLJ͕ ŽƵƌ ƐƚĂƚĞ ǁŝůů ďĞ ŝŶǀĞƐƟŶŐ ŵŝůůŝŽŶƐ ŽĨ ĚŽůůĂƌƐ ƚŽ ŝŶĐƌĞĂƐĞ the number of family medicine residency slots, helping to ensure ƚŚŽƐĞ ǁŚŽ ǁĂŶƚ ƚŽ ƚƌĂŝŶ ŚĞƌĞ ŚĂǀĞ ƚŚĂƚ ŽƉƉŽƌƚƵŶŝƚLJ͘ WůĞĂƐĞ ĐŽŶƐŝĚĞƌ ƐƵƉƉŽƌƟŶŐ &WͲW ƚŽĚĂLJ͊

ƌ͘ <ĂŬƵƚĂŶŝ ŝƐ ƚŚĞ ĐŚĂŝƌ ŽĨ &W͛Ɛ >ĞŐŝƐůĂƟǀĞ īĂŝƌƐ ŽŵŵŝƩĞĞ͘ 10

California Family Physician Winter 2018

California Family Physician Winter 2018

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membership news

Shannon Goecke Director, Membership and Member Services

Celebrating 70 Years ... Sharing 10,000 Stories ^ƚŽƌLJƚĞůůŝŶŐ ŵĂLJ ƐĞĞŵ ůŝŬĞ ĂŶ ŽůĚͲĨĂƐŚŝŽŶĞĚ ƚŽŽů ƚŽĚĂLJ Ͷ and it is. That’s exactly what makes it so powerful. Life happens in the narratives we tell one another. A story can go where quantitative analysis is denied admission: our hearts. Data can persuade people, but it doesn’t inspire them to act; to do that, you need to wrap your vision in a story that inspires the imagination and stirs the soul. – Author and coach Harrison Monarth, Harvard Business Review, March 2014. ,ĂƉƉLJ EĞǁ zĞĂƌ͊ ϮϬϭϴ ŝƐ Ă ďŝŐ LJĞĂƌ ĨŽƌ LJŽƵƌ ĐĂĚĞŵLJ ĂŶĚ ǁĞ͛ƌĞ ĞdžĐŝƚĞĚ ƚŽ ƐŚĂƌĞ ƐŽŵĞ ŽĨ ƚŚĞ ƌĞĂƐŽŶƐ ǁŚLJ͘ &ŝƌƐƚ͕ ĂŶĚ ŵŽƐƚ ŶŽƚĞǁŽƌƚŚLJ͕ LJŽƵƌ ĐĂĚĞŵLJ ǁŝůů ĐĞůĞďƌĂƚĞ ŝƚƐ ϳϬƚŚ ďŝƌƚŚĚĂLJ͊ &W ŝƐ ƚŚĞ ůĂƌŐĞƐƚ ĐŚĂƉƚĞƌ ŽĨ ƚŚĞ ŵĞƌŝĐĂŶ ĐĂĚĞŵLJ ŽĨ &ĂŵŝůLJ WŚLJƐŝĐŝĂŶƐ ĂŶĚ ǁĞ ĞdžƉĞĐƚ ƚŽ ƌĞĂĐŚ Ă ŵĞŵďĞƌƐŚŝƉ ŽĨ ϭϬ͕ϬϬϬ ĨŽƌ ƚŚĞ ĨŝƌƐƚ ƚŝŵĞ ƚŚŝƐ LJĞĂƌ ĂƐ ǁĞůů͘ DŝůĞƐƚŽŶĞƐ ƐƵĐŚ ĂƐ ƚŚĞƐĞ ŵĞƌŝƚ ďŝŐ ĐĞůĞďƌĂƚŝŽŶƐ͕ ǁŝƚŚ members and their stories at the heart of it all, and that’s ĞdžĂĐƚůLJ ǁŚĂƚ ǁĞ ŝŶƚĞŶĚ ƚŽ ĚŽ͘ KƵƌ LJĞĂƌͲůŽŶŐ ĐĞůĞďƌĂƚŝŽŶ͕ ϳϬ zĞĂƌƐ ͙ ϭϬ͕ϬϬϬ ^ƚŽƌŝĞƐ͕ centers on our members’ stories about family medicine, about patients, about training, about mentors and more. tĞ ǁŝůů ďĞ ĐŽůůĞĐƚŝŶŐ ŵĞŵďĞƌƐ͛ ƐƚŽƌŝĞƐ ƚŚƌŽƵŐŚŽƵƚ ƚŚĞ LJĞĂƌ͕ both online and at CAFP’s in-person events. Stories can be ŝŶ ƚŚĞ ĨŽƌŵ ŽĨ ǁƌŝƚƚĞŶ ŶĂƌƌĂƚŝǀĞƐ͕ ĂƵĚŝŽ Žƌ ǀŝĚĞŽ ƌĞĐŽƌĚŝŶŐƐ͕ photographs, illustrations, poems – anything that fires your ŝŵĂŐŝŶĂƚŝŽŶ͊ dŚĞƐĞ ƐƚŽƌŝĞƐ ǁŝůů ĐŽŵĞ ƚŽŐĞƚŚĞƌ ƚŚƌŽƵŐŚŽƵƚ the year, creating a rich and beautiful tapestry of diverse voices. tĞ ŚŽƉĞ LJŽƵ ǁŝůů ĂĚĚ LJŽƵƌ ǀŽŝĐĞ ƚŽ ŽƵƌ ŶĂƌƌĂƚŝǀĞ͘ &W ǁŝůů ƉƌŽǀŝĚĞ ƐƚŽƌLJƚĞůůŝŶŐ ƚŝƉƐ ĂŶĚ ŐƵŝĚĞůŝŶĞƐ͖ ĨĞĞů ĨƌĞĞ ƚŽ ƌĞĂĐŚ ŽƵƚ ƚŽ ƵƐ Ăƚ ĂŶLJ ƚŝŵĞ ǁŝƚŚ ƋƵĞƐƚŝŽŶƐ͘ zŽƵ ĐĂŶ ĂůƐŽ ĐŚĞĐŬ ŽƵƚ ƌĞƐŽƵƌĐĞƐ ĂǀĂŝůĂďůĞ ƚŚƌŽƵŐŚ 'ĞŽƌŐĞƚŽǁŶ hŶŝǀĞƌƐŝƚLJ͛Ɛ ĞŶƚĞƌ ĨŽƌ ^ŽĐŝĂů /ŵƉĂĐƚ ŽŵŵƵŶŝĐĂƚŝŽŶƐ Ăƚ ǁǁǁ͘ďŝƚ͘ůLJͬŶŽŶƉƌŽĨŝƚƐƚŽƌLJƚĞůůŝŶŐ͘ tĞ ĐĂŶ͛ƚ ǁĂŝƚ ƚŽ ƌĞĂĚ ʹ Žƌ ǁĂƚĐŚ Žƌ ůŝƐƚĞŶ ƚŽ ʹ LJŽƵƌ ƐƚŽƌŝĞƐ͘

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California Family Physician Winter 2018

&W͛Ɛ ŶĞǁ DĞŵďĞƌ ŶŐĂŐĞŵĞŶƚ ŽŵŵŝƩĞĞ ;D Ϳ͕ ĐŚĂŝƌĞĚ ďLJ ƌ͘ :ĂLJ >ĞĞ͕ ĂůƐŽ ǁŝůů ďĞ ůŝƐƚĞŶŝŶŐ ƚŽ ŵĞŵďĞƌƐ͛ ƐƚŽƌŝĞƐ ƚŚŝƐ LJĞĂƌ͘ ŽŵŵŝƩĞĞ ŵĞŵďĞƌƐ ǁŝůů ŚŽƐƚ ͞ĐŽīĞĞ ŬůĂƚĐŚĞƐ͟ ĂĐƌŽƐƐ ĂůŝĨŽƌŶŝĂ ƚŽ ŵĞĞƚ ǁŝƚŚ ŵĞŵďĞƌƐ ĂŶĚ ĐŽůůĞĐƚ ĨĞĞĚďĂĐŬ ŽŶ ĐĂĚĞŵLJ ĂĐƟǀŝƟĞƐ ĂŶĚ ƌĞƐŽƵƌĐĞƐ͘ ^ƚĂLJ ƚƵŶĞĚ ƚŽ ĮŶĚ ŽƵƚ ĂďŽƵƚ gatherings in your area. dŚĞ D ĂůƐŽ ƌĞĐŽŵŵĞŶĚĞĚ &W ĂĚŽƉƚ ŽŶůŝŶĞ ĐŽŵŵƵŶŝƟĞƐ ǁŝƚŚ ,ŝŐŚĞƌ >ŽŐŝĐ͕ Ă ůĞĂĚŝŶŐ ƉƌŽǀŝĚĞƌ ŽĨ ŽŶůŝŶĞ ĞŶŐĂŐĞŵĞŶƚ͘ DĂŶLJ &W ŵĞŵďĞƌƐ ĂůƌĞĂĚLJ ĂƌĞ ĨĂŵŝůŝĂƌ ǁŝƚŚ ŽŶůŝŶĞ ĐŽŵŵƵŶŝƟĞƐ ĂƐ ƉĂƌƟĐŝƉĂŶƚƐ ŝŶ &W͛Ɛ DĞŵďĞƌ /ŶƚĞƌĞƐƚ 'ƌŽƵƉƐ ;D/'ƐͿ͘ &W͛Ɛ ŽŶůŝŶĞ ĐŽŵŵƵŶŝƚLJ͕ ^W Z<͕ ǁŝůů ŶŽƚ ĚƵƉůŝĐĂƚĞ ƚŚĞ &W D/' ĞdžƉĞƌŝĞŶĐĞ͕ ďƵƚ ĐŽŵƉůĞŵĞŶƚ ŝƚ͕ ǁŝƚŚ ĂůŝĨŽƌŶŝĂͲ ƐƉĞĐŝĮĐ ƚŽƉŝĐƐ͕ ƌĞƐŽƵƌĐĞ ůŝďƌĂƌŝĞƐ͕ ŵĞŵďĞƌ ƉƌŽĮůĞƐ ĂŶĚ ŵƵĐŚ ŵŽƌĞ͘ &W ƐƚĂī ŝƐ ďƵƐLJ ďƵŝůĚŝŶŐ ƚŚĞ ^W Z< ĞdžƉĞƌŝĞŶĐĞ ʹ Ğ ŽŶ ƚŚĞ ůŽŽŬ ŽƵƚ ĂƐ ǁĞ ƉůĂŶ ƚŽ ůĂƵŶĐŚ ŽƵƌ ƉŝůŽƚ ĐŽŵŵƵŶŝƟĞƐ ŝŶ ůĂƚĞ February. dŚĞƐĞ ĂƌĞ ũƵƐƚ Ă ĨĞǁ ŽĨ ƚŚĞ ĞdžĐŝƟŶŐ ŝŶŝƟĂƟǀĞƐ &W ŝƐ ůĂƵŶĐŚŝŶŐ ƚŚŝƐ LJĞĂƌ͘ zŽƵƌ ƐƚĂī ŝƐ ŚĂƌĚ Ăƚ ǁŽƌŬ ĂŶĚ ĞdžĐŝƚĞĚ ĂďŽƵƚ ƚŚĞ LJĞĂƌ ĂŚĞĂĚ ʹ ǁĞ ŚŽƉĞ LJŽƵ ĂƌĞ͕ ƚŽŽ͘ From the sublime to the mundane … if you have not already ĚŽŶĞ ƐŽ͕ ƉůĞĂƐĞ ďĞ ƐƵƌĞ ƚŽ ƌĞŶĞǁ LJŽƵƌ ŵĞŵďĞƌƐŚŝƉ ĨŽƌ ϮϬϭϴ͘ zŽƵ ĐĂŶ ƌĞŶĞǁ ŽŶůŝŶĞ Ăƚ ǁǁǁ͘ĂĂĨƉ͘ŽƌŐͬĐŚĞĐŬŵLJĚƵĞƐ͕ Žƌ ďLJ ĐĂůůŝŶŐ ƚŚĞ &W DĞŵďĞƌ ZĞƐŽƵƌĐĞ ĞŶƚĞƌ͕ ǁĞĞŬĚĂLJƐ ďĞƚǁĞĞŶ ϲ͗ϬϬ Ă͘ŵ͘ ĂŶĚ ϯ͗ϯϬ Ɖ͘ŵ͘ WĂĐŝĮĐ ƟŵĞ͕ Ăƚ ;ϴϬϬͿ ϮϳϰͲϮϮϯϳ͘ ƌĞ LJŽƵ ŝŶ ƚŚĞ ϮϬϭϳ D ƌĞƉŽƌƟŶŐ ŐƌŽƵƉ͍ ǀĞŶ ŝĨ LJŽƵ ŚĂǀĞ ƉĂŝĚ LJŽƵƌ membership dues, make sure you report all your CME to the &W ĂƐ ƐŽŽŶ ĂƐ ƉŽƐƐŝďůĞ͘ /Ĩ LJŽƵ ŶĞĞĚ ĂƐƐŝƐƚĂŶĐĞ ǁŝƚŚ ƌĞŶĞǁŝŶŐ ŵĞŵďĞƌƐŚŝƉ ĂŶĚͬŽƌ ƌĞƉŽƌƟŶŐ D ͕ ƉůĞĂƐĞ ĐŽŶƚĂĐƚ ƵƐ Ăƚ ĐĂĨƉΛ familydocs.org. Ɛ ĂůǁĂLJƐ͕ ƉůĞĂƐĞ ƌĞĂĐŚ ŽƵƚ ƚŽ ^ŚĂŶŶŽŶ 'ŽĞĐŬĞ ƐŐŽĞĐŬĞΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ ǁŝƚŚ LJŽƵƌ ŵĞŵďĞƌƐŚŝƉ ƋƵĞƐƟŽŶƐ͕ ĐŽŶĐĞƌŶƐ Žƌ ƐƵŐŐĞƐƟŽŶƐ͘ dŚĂŶŬ LJŽƵ ĨŽƌ LJŽƵƌ ŵĞŵďĞƌƐŚŝƉ͘ Here’s to another great year together.

DƐ͘ 'ŽĞĐŬĞ ŝƐ &W͛Ɛ ŝƌĞĐƚŽƌ ŽĨ DĞŵďĞƌƐŚŝƉ ĂŶĚ DĂƌŬĞƟŶŐ͘

A new rural medicine clinic in NE California is looking for FT/PT Medical Provider

At Pafford Health, we practice medicine the way it should be – centered on the patient using a team-based, non-narcotic approach.

Come help us create a truly innovative rural health resource. Highlights include: Integrated EMR with scribe/MA support HRSA loan repayment site Scenic surroundings with flexible work schedule Virtual specialty care using telemedicine and “store-and-forward” e-consults. Research and rural workforce development.

paffordhealth.org 581 S. Main Street Cedarville, CA 96104 Email: customer.service@paffordhealth.org Tel: 530-279-2148

INSPIRE greatness Seeking Family Medicine Physician (Bilingual-Spanish) at our Novato, California clinic location 32-40 hours per week doing Primary Care, generous benefits, including CME and Sabbatical Program.

At Dignity Health, we lead by example. By always striving to give our personal best-and encouraging our patients and colleagues to do the same-we're able to achieve and do more than we ever imagined. If you're ready to inspire greatness in yourself and others, join us today.

OUTPATIENT FAMILY MEDICINE PHYSICIANS Northern and Central California - (El Dorado Hills, Grass Valley, Merced, Redding, Sacramento, San Francisco, Santa Cruz, Stockton & Woodland) Practice Highlights: • Autonomy with administrative and clinical support

• Salary guarantee period and excellent earning potential based on productivity model

• An established, growing medical group OR an independent single specialty group practice

• Attractive bonus structure

• Full-time and part-time practice options

Marin Community Clinics is a Federally Qualified Health Center (FQHC), the largest in Marin County. We serve 35,000 patients annually. We offer a multi-clinic network with a wide array of primary care and specialty services. Our mission is to improve the health of our patients and community by providing high quality, cost-effective, culturally sensitive, patient-centered health care.

For more information visit:

www.marinclinics.org

• A Medical Foundation aligned with one of the largest health systems in the nation and the largest hospital system in California

• Sunny California locations with easy access to San Francisco, Napa, and Lake Tahoe

Please contact/send your CV to: Physician Recruitment providers@dignityhealth.org | 888-599-7787 www.dignityhealth.org/physician-careers

TM

Hello humankindness

reflections and recovery

H a l L . G r o t k e , M D , FA A F P

Observations from the Enchanted Land &Žƌ ƚŚĞ ĮƌƐƚ ƟŵĞ ŝŶ ŵLJ ĐĂƌĞĞƌ͕ / Ăŵ ĂďůĞ ƚŽ ĂĐƚ ŽŶ ŝŵƉƵůƐĞ͘ tŚĞŶ / ŚĞĂƌĚ ĂďŽƵƚ ƚŚĞ ĚĞǀĂƐƚĂƟŽŶ ŝŶ WƵĞƌƚŽ ZŝĐŽ ĨƌŽŵ ,ƵƌƌŝĐĂŶĞ DĂƌŝĂ / ĚĞĐŝĚĞĚ ƚŽ ŐŽ ĂŶĚ ŚĞůƉ ŝŶ ĂŶLJ ǁĂLJ / ĐŽƵůĚ͘ dŚƌŽƵŐŚ &ĂĐĞŬ͕ / ŵĂĚĞ ĐŽŶŶĞĐƟŽŶƐ ĂŶĚ ͞ŵĞƚ͟ ĂŶ ĞŵĞƌŐĞŶƚŽůŽŐŝƐƚ ; DͿ ǁŚŽ ŚĂĚ ŐƌŽǁŶ ƵƉ ŝŶ ƚŚĞ ŵƵŶŝĐŝƉĂůŝƚLJ ŽĨ ĂďŽ ZŽũŽ ŽŶ ƚŚĞ ƐŽƵƚŚǁĞƐƚ ĐŽƌŶĞƌ ŽĨ ƚŚĞ ŝƐůĂŶĚ͘ D ƚŽůĚ ŵĞ ƚŚĂƚ Ă ŵĂŬĞƐŚŝŌ ĐůŝŶŝĐ ŚĂĚ ďĞĞŶ ĞƐƚĂďůŝƐŚĞĚ ŝŶ ƚŚĞ ĐŽŶǀĞŶƟŽŶ ĐĞŶƚĞƌ ĂŶĚ ƚŚĂƚ ĐĞƌƚĂŝŶůLJ ŝƚ ǁŽƵůĚ need a family physician. EŽ ĞůĞĐƚƌŝĐŝƚLJ ĂŶĚ ŶŽ ǁĂƚĞƌ ŵĞĂŶƚ ďƵLJŝŶŐ ƐŽůĂƌͲƉŽǁĞƌĞĚ ďĂƩĞƌLJ ĐŚĂƌŐĞƌƐ ĂŶĚ ĮůƚĞƌƐ ƚŽ ŵĂŬĞ ĐŽŶƚĂŵŝŶĂƚĞĚ ǁĂƚĞƌ ƐĂĨĞ ƚŽ ĚƌŝŶŬ͘ / ŚĞĂƌĚ ĂďŽƵƚ ŽƵƚďƌĞĂŬƐ ŽĨ ŝŶĨĞĐƟŽƵƐ ĚŝƐĞĂƐĞƐ͕ ŝŶĐůƵĚŝŶŐ ůĞƉƚŽƐƉŝƌŽƐŝƐ͘ / ŚĞĂƌĚ ĂďŽƵƚ ŵĞĚŝĐĂƟŽŶ ƐŚŽƌƚĂŐĞƐ ĂŶĚ ĐŽŶƚĂĐƚĞĚ ĂŶ ĂĐƋƵĂŝŶƚĂŶĐĞ ǁŚŽ ŽǁŶƐ ƚŚƌĞĞ ƉŚĂƌŵĂĐŝĞƐ ŚĞƌĞ ŝŶ ,ƵŵďŽůĚƚ ŽƵŶƚLJ ĨŽƌ ŚĞůƉ͘ dŽŐĞƚŚĞƌ ǁĞ ĐĂŵĞ ƵƉ ǁŝƚŚ Ă ůŝƐƚ ŽĨ ŵĞĚŝĐĂƟŽŶƐ ƚŚĂƚ ǁŽƵůĚ ďĞ ƵƐĞĨƵů͖ ŚĞ ŽƌĚĞƌĞĚ ƚŚĞŵ ĂŶĚ ƐŽůĚ ƚŚĞŵ ƚŽ ŵĞ ďĞůŽǁ ǁŚŽůĞƐĂůĞ ƉƌŝĐĞƐ͕ ĐŽǀĞƌŝŶŐ ƉĂƌƚ ŽĨ ƚŚĞ ĐŽƐƚ ŚŝŵƐĞůĨ͘ /

ŬĞĚ ŵLJ ŇŝŐŚƚƐ͘ / ƉĂĐŬĞĚ ůŽŶŐ ƐůĞĞǀĞƐ͕ ůŽŶŐ ƉĂŶƚƐ͕ ůŽƚƐ ŽĨ sunscreen and loads of DEET insect repellent. / ŇĞǁ ƚŽ DŝĂŵŝ͕ ƐƉĞŶƚ ƚŚĞ ŶŝŐŚƚ ĂŶĚ ƚŚĞŶ ŇĞǁ ƚŽ ^ĂŶ :ƵĂŶ͕ ǁŚĞƌĞ / ǁĂƐ ŵĞƚ ďLJ Ă ƚĂdžŝ ĚƌŝǀĞƌ ĂƌƌĂŶŐĞĚ ďLJ ƚŚĞ ZĞĚ ĂƉĞ ŐƌŽƵƉ͘ KŶ ƚŚĞ ĚƌŝǀĞ ĂĐƌŽƐƐ ƚŚĞ ŝƐůĂŶĚ / ƐĂǁ ŵĂŶLJ ŚŽƵƐĞƐ ǁŝƚŚŽƵƚ ƌŽŽĨƐ ĂŶĚ ƐŽŵĞ ǁŝƚŚŽƵƚ ǁĂůůƐ͘ WŽǁĞƌ ůŝŶĞƐ͕ ƉŽǁĞƌ ƉŽůĞƐ ĂŶĚ ƚƌĞĞƐ ǁĞƌĞ ďůŽǁŶ ĐƌŽƐƐ ƚŚĞ ĨƌĞĞǁĂLJƐ͘ dŚĞ ƐƚĂƌŬĞƐƚ ĨĞĂƚƵƌĞ ǁĂƐ ƚŚĞ ůĂĐŬ ŽĨ ĂŶLJ ůĞĂǀĞƐ ŽŶ ƚŚĞ ƚƌĞĞƐ ʹ ƚŚĞLJ ǁĞƌĞ ƐƚƌŝƉƉĞĚ ďĂƌĞ͘ I arrived on a Saturday. The City’s director of emergency services ůĞƚ ŵĞ ŝŶƚŽ ƚŚĞ ĐŽŶǀĞŶƟŽŶ ĐĞŶƚĞƌ ǁŚĞƌĞ / ĨŽƵŶĚ Ă ĐŽƚ ƚŽ ƐůĞĞƉ ŽŶ ŝŶ Ă ƌŽŽŵ ůŝƚ ďLJ ŽǀĞƌŚĞĂĚ ŇƵŽƌĞƐĐĞŶƚ ůŝŐŚƚƐ͘ dŚĞ ƌŽŽŵ ŚĂĚ Ă ƐŵĂůů ƌĞĨƌŝŐĞƌĂƚŽƌ ĂŶĚ ŵŝĐƌŽǁĂǀĞ ŝŶ Ă ĐŽƌŶĞƌ ĂŶĚ Ă ďŝŐ ďĂƚŚƌŽŽŵ ĚŽǁŶ ƚŚĞ ŚĂůů͘ dŚĞ ďƵŝůĚŝŶŐ ǁĂƐ ƉŽǁĞƌĞĚ ďLJ Ă ďŝŐ ĚŝĞƐĞů ŐĞŶĞƌĂƚŽƌ͘ EM’s brother picked me up from the center for a trip to the ƐƵƉĞƌŵĂƌŬĞƚ͕ ǁŚĞƌĞ ƚŚĞ ŝĐĞ ĐƌĞĂŵ ĨƌĞĞnjĞƌ ǁĂƐ ǁĞůůͲƐƚŽĐŬĞĚ ĂŶĚ

ƌ͘ 'ƌŽƚŬĞ͕ ƌŝŐŚƚ ƐŝĚĞ ǁŝƚŚ ďůƵĞ ƐŚŝƌƚ ĂŶĚ ĂƌŵƐ ƐƉƌĞĂĚ͕ ƚƌĂǀĞůĞĚ ƚŽ WƵĞƌƚŽ ZŝĐŽ ƚŽ ǀŽůƵŶƚĞĞƌ ƉŽƐƚͲ,ƵƌƌŝĐĂŶĞ DĂƌŝĂ͘ 14

California Family Physician Winter 2018

ƚŚĞ ƉŽŝŶƚ ŽĨ ƐĂůĞ dD ŵĂĐŚŝŶĞ ǁĂƐ ǁŽƌŬŝŶŐ͘ tĞ ǁĞŶƚ ƚŽ ŚŝƐ ĨĂǀŽƌŝƚĞ ƌĞƐƚĂƵƌĂŶƚ ĂŶĚ / ŚĂĚ ŵLJ ĮƌƐƚ ͞ŵŽĨŽŶŐŽ͕͟ ŝŶ ƚŚŝƐ ĐĂƐĞ ŽŶĞ ƐƚƵīĞĚ ǁŝƚŚ lobster in creole sauce. The clinic opened Monday morning – in the municipality of Cabo ZŽũŽ ʹ ƚŚĞ ƉƌŝŵĂƌLJ ĐĂƌĞ ĚŽĐƚŽƌƐ ŵĞƚ ǁŝƚŚ ƚŚĞ ĐŝƚLJ ƚŽ ĞƐƚĂďůŝƐŚ ƚŚĞ ĐůŝŶŝĐ ŝŶ Ă ďƵŝůĚŝŶŐ ǁŚĞƌĞ ƉĞŽƉůĞ ĐŽƵůĚ ĂůƐŽ ŵĞĞƚ ǁŝƚŚ & D ĂŶĚ ĐŝƚLJ ŽĸĐŝĂůƐ͘ KƚŚĞƌ ƚŚĂŶ DĞĚŝĐĂƌĞ͕ WƵĞƌƚŽ ZŝĐŽ ŝƐ ĂůŵŽƐƚ Ăůů ĐĂƉŝƚĂƚĞĚ ĐĂƌĞ͕ ŝŶĐůƵĚŝŶŐ ĐĂƉŝƚĂƚĞĚ DĞĚŝĐĂŝĚ͘ dŚĞ ƉĂƟĞŶƚƐ ǁĞƌĞ ƐĞĞŝŶŐ ƚŚĞŝƌ ŽǁŶ ƉŚLJƐŝĐŝĂŶƐ ĂŶĚ ŝŶ ƚŚƌĞĞ ĚĂLJƐ / ƐĂǁ ŽŶůLJ ƚŚƌĞĞ ƉĂƟĞŶƚƐ͘ / ĐĂůůĞĚ the taxi driver and had him take me to the municipality to the north, ǁŚŝĐŚ / ŚĞĂƌĚ ;ĐŽƌƌĞĐƚůLJ͕ ŝƚ ƚƵƌŶƐ ŽƵƚͿ ŚĂĚ ŝŶƚĞƌŶĞƚ ĐŽŶŶĞĐƟŽŶ͘ / ŐŽƚ ďĂĐŬ ŽŶ &ĂĐĞŬ ĂŶĚ ĐŽŶŶĞĐƚĞĚ ǁŝƚŚ ĂŶŽƚŚĞƌ ŵĂŬĞƐŚŝŌ ĐůŝŶŝĐ ŽŶ ƚŚĞ ŶŽƌƚŚ ĐŽĂƐƚ ŵƵŶŝĐŝƉĂůŝƚLJ ŽĨ dŽĂ ĂũĂ͘ dŽĂ ĂũĂ ŝƐ ďƵŝůƚ ŽŶ ͞ƌĞĐůĂŝŵĞĚ ůĂŶĚ͕͟ ŵĞĂŶŝŶŐ ǀĞƌLJ ůŽǁ ůĂŶĚ͘ DŽƐƚ ŚŽƵƐĞƐ ŇŽŽĚĞĚ ǁŝƚŚ ƚŚĞ ƐƚŽƌŵ ƐƵƌŐĞ͘ dŚĞ ƐŝƚƵĂƟŽŶ ǁĂƐ ĐŽŶƐŝĚĞƌĂďůLJ ŵŽƌĞ ĚĞƐƉĞƌĂƚĞ͕ ĂůƚŚŽƵŐŚ / ǁĂƐ ĂŐĂŝŶ ƐƚĂLJŝŶŐ ŝŶ Ă ƉůĂĐĞ ǁŝƚŚ Ă ŐĞŶĞƌĂƚŽƌ͕ ůŝŐŚƚƐ ĂŶĚ Ăŝƌ ĐŽŶĚŝƟŽŶŝŶŐ͘ dŚĞ ƉĞŽƉůĞ ĐŽƵůĚŶ͛ƚ ĮŶĚ ƚŚĞŝƌ ĚŽĐƚŽƌƐ͖ ŝƚ ŝƐ ďĞůŝĞǀĞĚ ŵŽƐƚ ůĞŌ ƚŚĞ ŝƐůĂŶĚ͕ ďƵƚ ŶŽ ŽŶĞ ŬŶŽǁƐ ĨŽƌ ƐƵƌĞ͘ WŚĂƌŵĂĐŝĞƐ ǁĞƌĞ ŽƉĞŶ ďƵƚ ŶŽƚ ĮůůŝŶŐ ƉƌĞƐĐƌŝƉƟŽŶƐ ďĞĐĂƵƐĞ

ƐĐƌŝƉƚƐ ǁĞƌĞ ŽŶůLJ ĐŽǀĞƌĞĚ ŝĨ ǁƌŝƩĞŶ ďLJ ƚŚĞ ,DKͲĂƐƐŝŐŶĞĚ ƉƌŝŵĂƌLJ doctor. It had been more than a month since the hurricane, so ƉĞŽƉůĞ ǁĞƌĞ ŽƵƚ ŽĨ ƚŚĞŝƌ ĚŝĂďĞƚĞƐ ĂŶĚ ŚLJƉĞƌƚĞŶƐŝŽŶ ŵĞĚŝĐŝŶĞ ĂƐ ǁĞůů ĂƐ ĂŶƟĐŽŶǀƵůƐĂŶƚƐ͘ dŚĞ ĚŽŶĂƚĞĚ ŵĞĚŝĐŝŶĞƐ ŝŶ ƚŚĞ ĐůŝŶŝĐ ǁĞƌĞ ďĂƌĞůLJ ĂĚĞƋƵĂƚĞ ĂŶĚ ƐŽŵĞƟŵĞƐ ŝŶĂĚĞƋƵĂƚĞ͘ ƉƉĂƌĞŶƚůLJ͕ ƉŚĂƌŵĂ ĚĞĂůĞƌƐ ĂƌĞ ƋƵŝƚĞ ƐƵĐĐĞƐƐĨƵů ŽŶ ƚŚĞ ŝƐůĂŶĚ ĂƐ ĨĞǁ ƉĞŽƉůĞ ǁĞƌĞ ŽŶ ƚŚĞ ŐĞŶĞƌŝĐƐ ƚŚĂƚ ǁĞƌĞ ĂǀĂŝůĂďůĞ ƚŽ ƵƐ͘ &ŽƌƚƵŶĂƚĞůLJ͕ ƉĂƟĞŶƚƐ ǁĞƌĞ ǀĞƌLJ ĂĐĐĞƉƟŶŐ ŽĨ ǁŚĂƚ / ĐŽƵůĚ ŚŽŶĞƐƚůLJ ƚĞůů ƚŚĞŵ ǁĂƐ ǀĞƌLJ ƐŝŵŝůĂƌ ƚŽ ƚŚĞ ŵĞĚŝĐĂƟŽŶƐ ƚŚĞLJ ŶŽƌŵĂůůLJ ƚŽŽŬ͘ KŶĞ ƉƌŽďůĞŵ ŝƐ ƚŚĞ ŵĂũŽƌŝƚLJ ŽĨ ƉĞŽƉůĞ ǁŝƚŚ ƚLJƉĞ Ϯ ĚŝĂďĞƚĞƐ ƚƌƵůLJ ƌĞƋƵŝƌĞ ŝŶƐƵůŝŶ͘ dŚĞ ĐůŝŵĂƚĞ ŝƐ ŚŽƚ ĂŶĚ ǀĞƌLJ ĨĞǁ ƉĞŽƉůĞ ĐƵƌƌĞŶƚůLJ ŚĂǀĞ ƌĞĨƌŝŐĞƌĂƟŽŶ Žƌ Ăŝƌ ĐŽŶĚŝƟŽŶŝŶŐ ʹ ŶŽƚ ŽƉƟŵĂů ĐŽŶĚŝƟŽŶƐ ĨŽƌ ŝŶƐƵůŝŶ ƐƚŽƌĂŐĞ͘ /ƚ ŝƐ ŇƵ ƐĞĂƐŽŶ ĂŶĚ / ƐĂǁ Ă ŶƵŵďĞƌ ŽĨ ƉĂƟĞŶƚƐ ƐƵīĞƌŝŶŐ ĨƌŽŵ ƐŽŵĞ ƐŽƌƚ ŽĨ ǀŝƌĂů ĨĞďƌŝůĞ ŝŶĨĞĐƟŽŶƐ͘ ĨĞǁ ƟŵĞƐ / ǁĞŶƚ ǁŝƚŚ ƚŚĞ ŐƌŽƵƉ ŝŶƚŽ ƚŚĞ ĐŽŵŵƵŶŝƚLJ͕ ǀŝƐŝƟŶŐ ƌƵƌĂů͕ ŵŽƵŶƚĂŝŶŽƵƐ ĂƌĞĂƐ ǁŚĞƌĞ ƌŽĂĚƐ ǁĞƌĞ ŶŽƚ LJĞƚ ĐůĞĂƌĞĚ ĂŶĚ ƉĞŽƉůĞ ĂƌĞ ƵŶůŝŬĞůLJ ƚŽ ŚĂǀĞ ĞůĞĐƚƌŝĐŝƚLJ Žƌ ĐůĞĂŶ ǁĂƚĞƌ ĨŽƌ Ăƚ ůĞĂƐƚ ĂŶŽƚŚĞƌ LJĞĂƌ͘ /Ŷ Ă ƐŚŽǁ ŽĨ ŝŶĐƌĞĚŝďůĞ ƌĞƐŝůŝĞŶĐĞ͕ / ǁĂƐ ƚŽůĚ ŵŽƌĞ ƚŚĂŶ ŽŶĐĞ͕ ͞ ĞĨŽƌĞ DĂƌŝĂ ƚŚĞ ĨŽƌĞƐƚ ǁĂƐ ƐŽ ƚŚŝĐŬ ǁĞ ĐŽƵůĚŶ͛ƚ ƐĞĞ ŽƵƌ ŶĞŝŐŚďŽƌƐ͖ ŶŽǁ ǁĞ ŚĂǀĞ Ă ďĞĂƵƟĨƵů ǀŝĞǁ ŽĨ ƚŚĞ ǀĂůůĞLJ ĂŶĚ ǁĞ ĐĂŶ ƐĞĞ ŽĨ ŶĞŝŐŚďŽƌƐ͛ ŚŽŵĞƐ͘ /ƚ ŚĂƐ ďƌŽƵŐŚƚ ƵƐ ĐůŽƐĞƌ ƚŽŐĞƚŚĞƌ͘͟

Physician Opportunity’s Santa Barbara, CA

PHYSICIAN OPPORTUNITIES • Open 8 to 8 every day • Flexible schedules, no call • Guaranteed $240,000 averaging 4 shifts a week • Additional bonus pay based on productivity • Malpractice coverage • Medical and dental for physician and dependents at no cost • Long term disability insurance • Retirement plan with matching funds

Based in Santa Barbara, Sansum Clinic is the oldest and largest non-profit, multi-specialty group between San Francisco and Los Angeles with over 200 physicians and surgeons and a staff of healthcare professionals in over 30 specialized areas of medicine. Sansum Clinic has garnered recognition, accreditation and awards from national and state agencies.

Our current openings are Family Medicine Urgent Care Occupational Medicine Geriatrician/Palliative Care

For More Information Contact: Shawneen Flanders-Clark Physician Recruiter sflander@sansumclinic.org 805-689-8256 www.sansumclinic.org

Benefits Free Medical/Dental/Vision CME Stipend 1 MA Per Provider

Malpractice Insurance Disability Retirement: 401K & Profit Sharing

Annual Leave Licensure/DEA Fees Board Exam Fee

Contact Merl O’Brien, MD, at: (916) 791-1300, ext.11111; or email CV to:sherry@med7atwork.com. California Family Physician Winter 2018

15

reflections and recovery

L i s a Wa rd , M D , M P H CAFP President-elect

Santa Rosa Is Rising! In the early morning hours of Monday, October 9, Santa Rosa Community Health’s largest health center, our Vista ĂŵƉƵƐ͕ ǁĂƐ ŽŶĞ ŽĨ ŵŽƌĞ ƚŚĂŶ ϱ͕ϬϬϬ ƐƚƌƵĐƚƵƌĞƐ ĚĞƐƚƌŽLJĞĚ in the firestorm that devastated Northern California. In a ĨĞǁ ƐŚŽƌƚ ŚŽƵƌƐ Ϯϰ͕ϬϬϬ ŽĨ ŽƵƌ ϱϬ͕ϬϬϬ ƉĂƚŝĞŶƚƐ ůŽƐƚ ƚŚĞŝƌ ŵĞĚŝĐĂů ŚŽŵĞ͖ ŽƵƌ ϯϲ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ƌĞƐŝĚĞŶƚƐ ůŽƐƚ ƚŚĞŝƌ ĐŽŶƚŝŶƵŝƚLJ ĐůŝŶŝĐ͖ ϭϬ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ĨĂĐƵůƚLJ ŵĞŵďĞƌƐ ůŽƐƚ ƚŚĞŝƌ ƚĞĂĐŚŝŶŐ ŚŽŵĞ͖ ĂŶĚ ŵŽƌĞ ƚŚĂŶ ϭϱϬ ƐƚĂĨĨĞƌƐ ůŽƐƚ ƚŚĞŝƌ ǁŽƌŬƐŝƚĞ͘

ƐƚĂĨĨ ƚŽ ĚĞůŝǀĞƌ ƉĞƌƐŽŶĂůůLJ Ă ϭϬͲĨŽŽƚ ůŽŶŐ ŚŽŵĞŵĂĚĞ ďĂŶŶĞƌ ŽĨ ŐŽŽĚ ĐŚĞĞƌ ĨŽůůŽǁĞĚ ďLJ Ă ŚƵŐĞ ďŽdž ŽĨ ĐŽŽŬŝĞƐ͘ WĞƚĂůƵŵĂ ,ĞĂůƚŚ ĞŶƚĞƌ ĐŽŽƌĚŝŶĂƚĞĚ ŝƚƐ ŵŽďŝůĞ ǀĂŶ ƚŽ ĚĞůŝǀĞƌ ϮϱϬ flu shots to the evacuation sites and homeless shelters in Santa Rosa. An FQHC from the Central Valley drove its van ƚŽ ^ĂŶƚĂ ZŽƐĂ ĂŶĚ ĚŽŶĂƚĞĚ ŝƚ ƚŽ ƵƐ ŽŶ ƚŚĞ ƐƉŽƚ͊ ŶĚ ŽƵƌ in-house pharmacy rose from the ashes at Vista Campus and ƚƌĂŶƐĨŽƌŵĞĚ ŝƚƐĞůĨ Ăƚ ŽƵƌ >ŽŵďĂƌĚŝ ĂŵƉƵƐ ĨŝůůŝŶŐ ϭϬ ƚŝŵĞƐ ƚŚĞ ƌĂƚĞ ŽĨ ƉƌĞƐĐƌŝƉƚŝŽŶƐ ŝƚ ǁĂƐ ĂĐĐƵƐƚŽŵĞĚ ƚŽ ĨŝůůŝŶŐ ƚŚƌŽƵŐŚ ŽƵƌ ĨŝƌƐƚ ǁĞĞŬ ŽĨ ƚŚĞ ĨŝƌĞ͘ / Ăŵ ŝŶĐƌĞĚŝďůLJ ƉƌŽƵĚ ŽĨ ŽƵƌ ŚĞĂůƚŚ ĐĞŶƚĞƌ͗ ŝƚ ǁĂƐ ƚŚĞ ĨŝƌƐƚ ĂŵďƵůĂƚŽƌLJ ĐůŝŶŝĐ ƐLJƐƚĞŵ ƚŽ ŽƉĞŶ dŚĞ ƌĞƐƉŽŶƐĞ ƚŽ ƚŚŝƐ ĐŽŵŵƵŶŝƚLJͲǁŝĚĞ ƚƌĂŐĞĚLJ ǁĂƐ ŝƚƐ ĚŽŽƌƐ ŽŶ ĂLJ dǁŽ ĂĨƚĞƌ ƚŚĞ ĨŝƌĞƐ ƐƚĂƌƚĞĚ͖ ŝƚ ƉƌŽǀŝĚĞĚ ƚƌĞŵĞŶĚŽƵƐ͘ hŶĐŽƵŶƚĂďůĞ ĂĐƚƐ ŽĨ ƉŚLJƐŝĐĂů ĂŶĚ ĞŵŽƚŝŽŶĂů fully comprehensive services including HIV, mental health ƚŽŝů ǁĞƌĞ ďƌŽƵŐŚƚ ƚŽ ďĞĂƌ ďLJ ůŝƚĞƌĂůůLJ ŚƵŶĚƌĞĚƐ ŽĨ ĨŝƌƐƚ ƌĞƐƉŽŶĚĞƌƐ͘ DŽƌĞ ƚŚĂŶ ϯϬ ƐƚĂĨĨ ŵĞŵďĞƌƐ ĂŶĚ ƉƌŽǀŝĚĞƌƐ ĨƌŽŵ ƐĞƌǀŝĐĞƐ͕ D d ĂŶĚ , s ƚƌĞĂƚŵĞŶƚ ďLJ ĂLJ dŚƌĞĞ͖ ĂŶĚ ŝƚ ƐĂǁ every soul regardless of health insurance, immigration Santa Rosa Community Health staffed several evacuation ĐĞŶƚĞƌƐ ĚƵƌŝŶŐ ƚŚĞ ĨŝƌƐƚ ĨĞǁ ǁĞĞŬƐ ŽĨ ƚŚĞ ĨŝƌĞƐ͕ ĐĂƌŝŶŐ ĨŽƌ ƚŚĞ ƐƚĂƚƵƐ Žƌ ĂďŝůŝƚLJ ƚŽ ƉĂLJ͘ dŚŝƐ ŝƐ ƚƌƵůLJ ĐŽŵŵƵŶŝƚLJ ŚĞĂůƚŚ͊ ƐŚŽĐŬĞĚ ĂŶĚ ƐĐĂƌĞĚ͕ ƚŚĞ ĨƌĂŝů ĞůĚĞƌůLJ ĂŶĚ ƚŚŽƐĞ ǁŚŽ ůĂĐŬĞĚ ĞƐƉŝƚĞ ƚŚĞ ďƌĂǀĂĚŽ ĂŶĚ ŚĞƌŽŝĐƐ ŽĨ ƚŚĞ ĨŝƌƐƚ ĨĞǁ ǁĞĞŬƐ͕ ƚŚĞ ƐƵƉƉŽƌƚ ƚŽ ďĞ ĂŶLJǁŚĞƌĞ ďƵƚ ŝŶ Ă ƐĐŚŽŽů ŐLJŵ͕ ƐŝƚƚŝŶŐ ŽŶ the health centers suffered a huge loss. The organization is a cot. The community health center family is tightly knit ŵŽƌƉŚŝŶŐ ŝŶƚŽ ƐƉĂĐĞƐ ĂŶĚ ƉůĂĐĞƐ ƚŚĂƚ ĐŚĂŶŐĞ ďLJ ƚŚĞ ǁĞĞŬ͘ ĂŶĚ ŵĞĚŝĐĂů ĚŝƌĞĐƚŽƌƐ ĂŶĚ ĞdžĞĐƵƚŝǀĞ ĚŝƌĞĐƚŽƌƐ ƐŚŽǁĞĚ ƵƐ ^ŝŶĐĞ ƚŚĞ ĨŝƌƐƚ ŽĨ ĞĐĞŵďĞƌ͕ ǁĞ ŚĂǀĞ ĂĚĚĞĚ ϭϱ ĞdžĂŵ ƌŽŽŵƐ support and generosity. West County Health Center sent

^ĂŶƚĂ ZŽƐĂ &D ĨĂĐƵůƚLJ ĂŶĚ ƌĞƐŝĚĞŶƚƐ ǁŝƚŚ <ĞǀŝŶ 'ƌƵŵďĂĐŚ͕ D ;ůŽǁĞƌ ƌŝŐŚƚͿ͕ ƚŽŽŬ ĐĂƌĞ ŽĨ ƉĂƚŝĞŶƚƐ ƚŚƌŽƵŐŚŽƵƚ ƚŚĞ ĨŝƌĞƐ ĂŶĚ ĞǀĂĐƵĂƚŝŽŶƐ͘ 16

California Family Physician Winter 2018

Lisa Ward

ǁŽƌŬĨůŽǁƐ ͙ ĂŶĚ LJĞƚ͕ ƚŚĞ ƌĞĂůůLJ ĨƵŶĚĂŵĞŶƚĂů ƚŚŝŶŐƐ͕ ƚŚŽƐĞ elemental parts of our lives that really matter have only been emboldened and clarified: connection, gratitude and ŬŝŶĚŶĞƐƐ͘ ĚĚ ŝŶ Ă ƉĞƉƉĞƌŝŶŐ ŽĨ ƉĂƚŝĞŶĐĞ ĂŶĚ LJŽƵ ŶŽǁ ŚĂǀĞ ƚŚĞ ƌĞĐŝƉĞ ĨŽƌ ƚŚĞ ƌĞƐƉŽŶƐĞ ƚŽ Ă ĐŽŵŵƵŶŝƚLJͲǁŝĚĞ ƚƌĂŐĞĚLJ͘

dƌŝĂů ďLJ &ŝƌĞ͗ DLJ &ŝƌƐƚ zĞĂƌ ĂƐ WƌŽŐƌĂŵ ŝƌĞĐƚŽƌ Tara Scott, MD

When I stepped into the role of program director in Santa ZŽƐĂ ůĂƐƚ :ƵŶĞ͕ / ŚĂĚ ŶŽ ŝĚĞĂ ǁŚĂƚ ůĂLJ ĂŚĞĂĚ ŽĨ ŵĞ͘ / ĨŽůůŽǁĞĚ in the footsteps of my residency friend and classmate, Dr. Jeff ,ĂŶĞLJ͕ ǁŚŽ ǁĂƐ ďƌŝůůŝĂŶƚ ŝŶ ƚŚĞ ũŽď ĨŽƌ ƐĞǀĞŶ LJĞĂƌƐ͘ ,Ğ ǁĂƐ highly competent, seasoned and, importantly, had already ĨŝŐƵƌĞĚ ŽƵƚ ŚŽǁ ƚŽ ĚĞĐŝƉŚĞƌ ƚŚĞ ŶƵŵĞƌŽƵƐ 'D ĂĐƌŽŶLJŵƐ and required tasks that permeate the day-to-day life of a ƌĞƐŝĚĞŶĐLJ ĚŝƌĞĐƚŽƌ ʹ ǁŚĞƌĞĂƐ / ŚĂĚ ŶŽƚ͘ ŽƵƚƐŝĚĞ ƚǁŽ ŽƚŚĞƌ ĞdžŝƐƚŝŶŐ ĐůŝŶŝĐ ƐŝƚĞƐ ͙ ǁŝƚŚ Ă ĨĞǁ ůŝŐŚƚƐ ĂŶĚ Ă ƚĞŶƚ ǁĞ ŚĂǀĞ ďŝƌƚŚĞĚ ͞>Ă ůŝŶŝĐĂ &ŝĞƐƚĂ͘͟ LJ &ĞďƌƵĂƌLJ͕ ǁĞ ƉůĂŶ ƚŽ ŽƉĞŶ ŶĞǁ ĐůŝŶŝĐĂů ƐƉĂĐĞƐ ŝŶĐůƵĚŝŶŐ ĂƉƉƌŽdžŝŵĂƚĞůLJ Ϯϱ ĞdžĂŵ ƌŽŽŵƐ ƚŽ ŚŽƵƐĞ ƚŚĞ ƌĞƐŝĚĞŶĐLJ͕ ŝƚƐ ĨĂĐƵůƚLJ ĂŶĚ ƚŚĞ ƚĞĂĐŚŝŶŐ ĐůŝŶŝĐƐ ĂƐ ǁĞůů ĂƐ ƚĞĂĐŚŝŶŐ ƐƉĂĐĞƐ͘ ƚ ƚŚĞ ƐĂŵĞ ƚŝŵĞ͕ ǁĞ ŚĂǀĞ Ă ďĞĂƵƚŝĨƵů ŶĞǁ ĐůŝŶŝĐ͕ ŽƵƌ ƵƚƚŽŶ ĂŵƉƵƐ͕ ŽƉĞŶŝŶŐ ŝŶ &ĞďƌƵĂƌLJ͘ ůĂƐ͕ ŝƚ ǁŝůů ŶŽǁ ŽƉĞŶ ǁŝƚŚ ƚǁŝĐĞ ƚŚĞ ĐĂƉĂĐŝƚLJ for patients and staff previously imagined. So much for a ƐŽĨƚ ŽƉĞŶŝŶŐ͊ &ŝŶĂůůLJ͕ ǁĞ ĞdžƉĞĐƚ ƚŽ ƌĞďƵŝůĚ͕ ƌĞŶŽǀĂƚĞ ĂŶĚ ƌĞŽƉĞŶ sŝƐƚĂ ĂŵƉƵƐ ŝŶ ĞĂƌůLJ ϮϬϭϵ͘ dŚĞ ĂƌĐŚŝƚĞĐƚƐ ĂƌĞ ĚƌĂĨƚŝŶŐ ĂŵĞŶĚĞĚ ďƵŝůĚŝŶŐ ƉůĂŶƐ͖ ƚŚĞ ƌĞĐŽǀĞƌLJ ĐƌĞǁ ŚĂƐ ŐƵƚƚĞĚ ƚŚĞ ďƵŝůĚŝŶŐ͖ Ă ŶĞǁ ƌŽŽĨ ŝƐ ŽǀĞƌ ƵƐ͕ ƉƌŽƚĞĐƚŝŶŐ ƚŚĞ ŐƵƚƐ͘ ŶĚ ƐŽ͕ ŝƚ ƉƌŽŵŝƐĞƐ ƚŽ ďĞ Ă LJĞĂƌ ŽĨ ƌŽůůŝŶŐ ƚƌĂŶƐŝƚŝŽŶƐ ĂƐ ǁĞ ŐƌŽǁ ĂĐĐƵƐƚŽŵĞĚ ƚŽ ĂŶ ƵŶĐŽŵĨŽƌƚĂďůĞ ŵĂŶƚĞů ŽĨ LJĞĂƌͲůŽŶŐ ĐŚĂŶŐĞ͘ ŚĂŶŐĞĚ ĐĂƌĞ ƚĞĂŵƐ͕ ĐŚĂŶŐĞĚ ŚĂůůǁĂLJƐ͕ ĐŚĂŶŐĞĚ

^ƵĐŚ ǁĞƌĞ ŵLJ ĐŽŶĐĞƌŶƐ ŝŶ ƚŚĞ ĞĂƌůLJ ĚĂLJƐ ĂŶĚ ǁĞĞŬƐ ŽŶ ƚŚĞ ũŽď͘ tŚŽ ĐŽƵůĚ ŚĂǀĞ ŝŵĂŐŝŶĞĚ ƚŚĂƚ ŽŶůLJ Ă ĨĞǁ ƐŚŽƌƚ ŵŽŶƚŚƐ ĂĨƚĞƌ ƚĂŬŝŶŐ ƚŚĞ ŚĞůŵ͕ / ǁŽƵůĚ ďĞ ĂǁĂŬĞŶĞĚ ŝŶ ƚŚĞ ǁĞĞ ŚŽƵƌƐ ŽĨ ƚŚĞ ŵŽƌŶŝŶŐ ǁŝƚŚ ŵLJ ĐŽŵŵƵŶŝƚLJ ŝŶ ƚŚĞ ŵŝĚƐƚ ŽĨ ƚŚĞ ŵŽƐƚ ĚĞƐƚƌƵĐƚŝǀĞ ǁŝůĚĨŝƌĞƐ ƚŚĞ ĐŽƵŶƚƌLJ ŚĂĚ ŬŶŽǁŶ͍ DLJ ƚĞdžƚ ƐƚƌĞĂŵ ƌĞĂĚ͕ ͞ZĞƐŝĚĞŶƚƐ ŝŶ ŚŽƵƐĞ ƐĂLJ ƚŚĞ ŚŽƐƉŝƚĂů ŝƐ ƵŶĚĞƌ ĞǀĂĐƵĂƚŝŽŶ͕ ŶŽďŽĚLJ ĐĂŶ ĐŽŵĞ Žƌ ŐŽ͘͟ LJ ƚŚĞ ƚŝŵĞ / ǁĂƐ ĂĐƚƵĂůůLJ ĂǁĂŬĞ ĂŶĚ ƌĞĂĚŝŶŐ ƚŚĞ ƚĞdžƚ͕ ƚŚĞ ĐĂĐŽƉŚŽŶLJ ŽĨ ƐŝƌĞŶƐ racing across the city started to make sense and I came to ƵŶĚĞƌƐƚĂŶĚ ƚŚĂƚ ƐŽŵĞƚŚŝŶŐ ǀĞƌLJ ŽŵŝŶŽƵƐ ǁĂƐ ƚĂŬŝŶŐ ƉůĂĐĞ͘ dŚĞ ƌĞƐƚ ŽĨ ƚŚĞ ƐƚŽƌLJ ǁĂƐ ĐŽǀĞƌĞƌĚ ŽŶ ŶĂƚŝŽŶĂů ƚĞůĞǀŝƐŝŽŶ ĨŽƌ the next seven days. /Ŷ ƚŚŽƐĞ ĞĂƌůLJ ĚĂLJƐ ŽĨ ƚŚĞ ĨŝƌĞ͕ ǁĞ ĚŝĚ ŶŽƚ ŬŶŽǁ ƚŚĞ ĨƵůů ĞdžƚĞŶƚ of the damage to our hospital or clinic. Countless community

Tara Scott California Family Physician Winter 2018

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reflections and recovery

partners from private and community health systems reached out to offer our residents continuity sites so their training ǁŽƵůĚ ŶŽƚ ďĞ ŝŶƚĞƌƌƵƉƚĞĚ ĂŶĚ ƚŚĞ ƉƌŽŐƌĂŵ ĐŽƵůĚ ƌĞŵĂŝŶ ǁŚŽůĞ͘ ,ĂƉƉŝůLJ͕ ŽƵƌ ƐƉŽŶƐŽƌ͕ ^ƵƚƚĞƌ ^ĂŶƚĂ ZŽƐĂ ZĞŐŝŽŶĂů Hospital made it through the fire and despite the loss of our flagship Vista clinic, Santa Rosa Community Health pulled off Ă ŵŝƌĂĐůĞ ĂŶĚ ŽĨĨĞƌĞĚ Ăůů ϯϲ ƌĞƐŝĚĞŶƚƐ Ă ĐŽŶƚŝŶƵŝƚLJ ƐŝƚĞ ǁŝƚŚŝŶ its system. tŚĂƚ Ăůů ƚŚŽƐĞ ŽƚŚĞƌ ĐŽŵŵƵŶŝƚLJ ƉĂƌƚŶĞƌƐ ǁŚŽ ĐĂŵĞ ĨŽƌǁĂƌĚ ƚŽ ŚĞůƉ ŝŶ ƚŚĞ ĨŝƌƐƚ ĨĞǁ ĚĂLJƐ ŬŶĞǁ ƚŽŽ ǁĞůů ǁĂƐ ƚŚĂƚ ŚĂǀŝŶŐ Ă ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵ ŝŶ ŽƵƌ ƚŽǁŶ ŝƐ 'K> ͘ /Ŷ ĂŶLJ ŐŝǀĞŶ LJĞĂƌ͕ Ɛŝdž Žƌ ƐĞǀĞŶ ŽĨ ŽƵƌ ϭϮ ŐƌĂĚƵĂƚĞƐ ƐƚĂLJ ŝŶ ^ŽŶŽŵĂ ŽƵŶƚLJ ƚŽ ƉƌĂĐƚŝĐĞ ƉƌŝŵĂƌLJ ĐĂƌĞ͘ dŚĞ ůŽƐƐ ŽĨ ƚŚĞ ƉƌŽŐƌĂŵ ǁŽƵůĚ ďĞ ĚĞǀĂƐƚĂƚŝŶŐ ĨŽƌ ƚŚĞ ƉƌŝŵĂƌLJ ĐĂƌĞ ǁŽƌŬĨŽƌĐĞ ŝŶ ŽƵƌ ĐŽƵŶƚLJ͘ tŚĂƚ ǁŽƵůĚ ŚĂƉƉĞŶ ŝĨ ƚŚĞ ĨĂŵŝůLJ ƉŚLJƐŝĐŝĂŶ ƉŝƉĞůŝŶĞ ŝŶ ^ŽŶŽŵĂ ŽƵŶƚLJ ŚĂĚ ƐƚŽƉƉĞĚ͍ ,Žǁ ǁŽƵůĚ ƚŚĂƚ ĂĨĨĞĐƚ ƚŚĞ ŚĞĂůƚŚ ŽĨ ƚŚĞ ĐŽƵŶƚLJ͍ tĞ Ăůů ŬŶŽǁ ƚŚĞ ĂŶƐǁĞƌ͗ ĨĞǁĞƌ ƉƌŝŵĂƌLJ care doctors and poorer health for the community. Luckily, our program made it through. We helped the ĐŽŵŵƵŶŝƚLJ ĂŶĚ ǁĞ ǁĞƌĞ ĂůƐŽ ƐĂǀĞĚ ďLJ ƚŚĞ ĐŽŵŵƵŶŝƚLJ͘ &ĂŵŝůLJ medicine friends from all over the state came in to help. ůƵŵŶŝ ĨůĞǁ ŝŶ ƚŽ ƐƚĂĨĨ ƚŚĞ ƐŚĞůƚĞƌƐ ĂůŽŶŐƐŝĚĞ ŽƵƌ ǀĂůŝĂŶƚ ƌĞƐŝĚĞŶƚƐ ĂŶĚ ĨĂĐƵůƚLJ͘ Ƶƚ ĞǀĞŶ ĂƐ / ǁƌŝƚĞ ƚŚĞƐĞ ǁŽƌĚƐ͕ ŽƵƌ extended family at Ventura County Medical Center is in the ƐĂŵĞ ƐŝƚƵĂƚŝŽŶ ǁĞ ǁĞƌĞ ŝŶ ũƵƐƚ Ă ĨĞǁ ǁĞĞŬƐ ĂŐŽ͕ ďĂƚƚůŝŶŐ ĨůĂŵĞƐ ƚŚĂƚ ƚŚƌĞĂƚĞŶ ƚŽ ĞŶŐƵůĨ ƚŚĞŝƌ ƚŽǁŶ͘ dŚĞ ƚĞŵƉŽƌĂů proximity of the Sonoma County fires to those of Southern California and the hurricanes of the South paint a picture of a volatile environment and more disasters to come. Given our recent collective experience, I believe disaster medicine should be elevated on all of our lists as a key competency for family medicine. Many generations of residents have passed through our program, enjoying the history and the lore of the place ǁŝƚŚŽƵƚ ŐĞƚƚŝŶŐ Ă ĐŚĂŶĐĞ ƚŽ ƐĞĞ ǁŚĂƚ ƚŚŝƐ ƉƌŽŐƌĂŵ ĐĂŶ ƌĞĂůůLJ ĚŽ͘ ,ĂǀŝŶŐ ĨĂĐĞĚ ƚŚĞ ƚŚƌĞĂƚ ŽĨ ƚŚĞƐĞ ĨŝƌĞƐ ƚŽŐĞƚŚĞƌ ǁŝƚŚ ƚŚĞ residents of the county and having had a chance to serve and see family medicine’s consummate utility in times of ŶĞĞĚ͕ / ďĞůŝĞǀĞ ŽƵƌ ĐƵƌƌĞŶƚ ƌĞƐŝĚĞŶƚƐ ĂŶĚ ĨĂĐƵůƚLJ ǁŝůů ŚĂǀĞ Ă ƵŶŝƋƵĞ ƉĞƌƐƉĞĐƚŝǀĞ ŐŽŝŶŐ ĨŽƌǁĂƌĚ͘ KƵƌ ƐƉĞĐŝĂůƚLJ ŝƐ ƉĞƌĨĞĐƚůLJ positioned to serve the needs of the community in times of peace and in times of disaster. The Sutter Santa Rosa Family Medicine Residency began in 1939 as a general practice residency and operated out of

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California Family Physician Winter 2018

the county hospital until it became one of the first family practice residencies in 1969, the year the specialty was born.

tŽƌŬŝŶŐ ƚŚĞ KǀĞƌŶŝŐŚƚ ^ŚŝĨƚ

Jay W. Lee, MD, MPH Chief Medical Officer, Venice Family Clinic Ɛ ŶĞǁƐ ŽĨ ƚŚĞ ĨŝƌĞƐ ŝŶ ^ŽŶŽŵĂ ŽƵŶƚLJ ƐƚĂƌƚĞĚ ƚŽ Ĩŝůů ŽƵƌ ŶĞǁƐĨĞĞĚƐ ůĂƐƚ KĐƚŽďĞƌ͕ / ďĞĐĂŵĞ ŝŶĐƌĞĂƐŝŶŐůLJ ĐŽŶĐĞƌŶĞĚ ĂďŽƵƚ ŵLJ ĨĞůůŽǁ &ĂŵŝůLJ DĞĚŝĐŝŶĞ ZĞǀŽůƵƚŝŽŶĂƌŝĞƐ ŝŶ ƚŚĞ EŽƌƚŚ ĂLJ͘ tĞ ŚĂĚ ďĞĐŽŵĞ Ă ĐůŽƐĞͲŬŶŝƚ ŐƌŽƵƉ ĚƵƌŝŶŐ ŵLJ LJĞĂƌ ĂƐ &W ƉƌĞƐŝĚĞŶƚ ŝŶ ϮϬϭϱͲϮϬϭϲ͕ ƚŚĂŶŬƐ ƚŽ Ă ŵĞŵŽƌĂďůĞ ĐŚĂƉƚĞƌ ŵĞĞƚŝŶŐ ĨŽĐƵƐĞĚ ŽŶ ŚĂƉƉŝŶĞƐƐ ĂƉƚůLJ ŶĂŵĞĚ ͞dŚĞ ,ĂƉƉŝŶĞƐƐ

Nurses House, Inc. ǀĞŜƚÍ&#x; Ä‚Ćš ^ĂŜƚĂ ZĹ˝Ć?Ä‚ ŽžžƾŜĹ?ƚLJ ,ĞĂůƚŚ͛Ć? ĨůÄ‚Ĺ?Ć?ĹšĹ?Ɖ sĹ?Ć?ƚĂ Ć?Ĺ?ĆšÄžÍ˜ /Ćš Ç Ä‚Ć? ƚŚĞ Ć‹ĆľĹ?ŜƚĞĆ?Ć?ĞŜƚĹ?Ä‚ĹŻ Ç Ĺ?ŜĞ Ä?ŽƾŜĆšĆŒÇ‡ ĞǀĞŜƚ ĆŒÄžĆ‰ĹŻÄžĆšÄž Ç Ĺ?ƚŚ Ç Ä‚ĆŒĹľ Ä?ŽžĆ‰Ä‚ŜLJ͕ ƚŚŽƾĹ?ŚƚĨƾů ÄšĹ?Ä‚ĹŻĹ˝Ĺ?ƾĞ͕ ƚĂĆ?ƚLJ ĨŽŽÄš ĂŜĚ Ç Ĺ?ŜĞĆ? Ć‰ĆŒĹ˝ÄšĆľÄ?ĞĚ Ä?LJ ĨÄ‚ĹľĹ?ůLJ ĚŽÄ?Ć?͘ / ĨĞůƚ ŚĂƉƉLJ ĂŜĚ Ç ÄžĹŻÄ?ŽžÄžÍ˜ / Ç Ä‚Ć? ĨĹ?ůůĞĚ Ç Ĺ?ƚŚ Ć?ĂĚŜĞĆ?Ć? Ç ĹšÄžĹś / ĹšÄžÄ‚ĆŒÄš ƚŚĞ sĹ?Ć?ƚĂ Ć?Ĺ?ƚĞ Ç Ä‚Ć? Ĺ?Ĺś ƚŚĞ ƉĂƚŚ ŽĨ ƚŚĞ ĨĹ?ĆŒÄž ĂŜĚ ŚĂĚ Ä?ĞĞŜ ĚĞĆ?ĆšĆŒĹ˝Ç‡ÄžÄšÍ˜ DLJ ĹśÄžÇ Ć?ĨĞĞĚ Ä?ÄžĹ?Ä‚Ĺś ƚŽ ĨĹ?ĹŻĹŻ Ç Ĺ?ƚŚ ƉĹ?Ä?ĆšĆľĆŒÄžĆ? ĂŜĚ Ć?ĆšĹ˝ĆŒĹ?ÄžĆ? ŽĨ the courageous members of Santa Rosa ŽžžƾŜĹ?ƚLJ ,ĞĂůƚŚ Ç Ĺ˝ĆŒĹŹĹ?ĹśĹ? Ä‚ĆŒŽƾŜÄš ƚŚĞ clock to care for their patients, including moving nursing home patients to the relative safety of a local high school Ĺ?LJžŜÄ‚Ć?Ĺ?ƾžÍ• Ç ĹšĹ?ĹŻÄž ĞŜĆ?ĆľĆŒĹ?ĹśĹ? ƚŚĞĹ?ĆŒ Ĺ˝Ç Ĺś ĨÄ‚ĹľĹ?ĹŻĹ?ÄžĆ? ĂŜĚ ĹšŽžÄžĆ? Ç ÄžĆŒÄž Ć?Ä‚ĨĞ͘ Ç€ÄžĆŒÇ‡ Ć?ĆšĹ˝ĆŒÇ‡ Ĺ?ĹśĆ?ƉĹ?ĆŒÄžÄš žĞ ĂŜĚ / Ç Ä‚Ć? žŽĆšĹ?ǀĂƚĞĚ ƚŽ ĚŽ something other than donate money. / ŚĂĚ Ä?ĞĞŜ Ä?ŚĞÄ?ĹŹĹ?ĹśĹ?ͲĹ?Ĺś Ç Ĺ?ƚŚ žLJ ĨĆŒĹ?ĞŜĚ ĂŜĚ ĨÄžĹŻĹŻĹ˝Ç Ä?ĹšĹ?ÄžĨ žĞĚĹ?Ä?Ä‚ĹŻ ŽĨĨĹ?Ä?ÄžĆŒ ĆŒÍ˜ >Ĺ?Ć?Ä‚ tÄ‚ĆŒÄšÍ• Ç ĹšĹ˝ Ĺ?ŜĨŽĆŒĹľÄžÄš žĞ ƚŚĂƚ Ć?ŚĞ ĂŜĚ ĹšÄžĆŒ ĨÄ‚ĹľĹ?ůLJ Ç ÄžĆŒÄž Ć?Ä‚ĨÄž ĂŜĚ ƚŚĂƚ ĆšĹšÄžĆŒÄž Ç Ĺ˝ĆľĹŻÄš Ä?Äž Ä‚ Ç Ä‚Ç‡ ĨŽĆŒ žĞ ƚŽ ŚĞůƉ žŽĆŒÄž ÄšĹ?ĆŒÄžÄ?ƚůLJ͗ Ç Ĺ˝ĆŒĹŹ Ä‚ shift at the local shelter. So, I checked my calendar, I checked flights and I checked Ç Ĺ?ƚŚ žLJ Ç Ĺ?ĨĞ͗ Íž,ŽŜĞLJ͕ Ä?ŽƾůÄš LJŽƾ ĹŻĹ?ǀĞ Ç Ĺ?ƚŚ žĞ Ä?ÄžĹ?ĹśĹ? Ä‚Ç Ä‚Ç‡ ŽŜ Ä‚ &ĆŒĹ?ĚĂLJ ĞǀĞŜĹ?ĹśĹ? Ć?Ĺ˝ / Ä?Ä‚Ĺś Ç Ĺ˝ĆŒĹŹ Ä‚Ĺś Ĺ˝Ç€ÄžĆŒĹśĹ?Ĺ?Śƚ Ć?ĹšĹ?ĨĆš Ä‚Ćš Ä‚ Ć?ĹšÄžĹŻĆšÄžĆŒ Ĺ?Ĺś ^ĂŜƚĂ ZĹ˝Ć?Ä‚Í?Í&#x; When I arrived a little before midnight ƚŚĂŜŏĆ? ƚŽ Ä‚ ĨůĹ?Ĺ?Śƚ ĚĞůĂLJ͕ / Ç Ä‚Ć? Ĺ?ĆŒÄžÄžĆšÄžÄš Ç Ĺ?ƚŚ Ä‚ Ç Ä‚ĆŒĹľ Ä?ÄžÄ‚ĆŒ ŚƾĹ? ĨĆŒŽž ĆŒÍ˜ Ĺ˝ 'ĆŒÄžÄ‚Ç€ÄžĆ? and given sign-out. Suffice it to say, my &ĆŒĹ?ĚĂLJ ĹśĹ?Ĺ?Śƚ Ç Ä‚Ć? Ä‚ĆŒĹ?ƾĂÄ?ůLJ žŽĆŒÄž ĞdžÄ?Ĺ?ĆšĹ?ĹśĹ?

<89'9 3<9' -9 ! Œ‡ˆl$mŠ 38+!2-A!ধ32 !99-9ধ2+ Z9 -2 2''&W ( @3<T 38 ! 2<89' @3< 023>T !8' -2 2''& 3( )2!2$-!ÂŁ !99-9;!2$' &<' ;3 ! ,'!ÂŁ;, 38 3;,'8 ÂŁ-(' $8-9-9T 6ÂŁ'!9' =-9-; ;,' >'#9-;'T $!ÂŁÂŁ 38 '1!-ÂŁ ;3&!@W www.nurseshouse.org

518-456-7858 x125

A National Fund for Nurses in Need

mail@nurseshouse.org

BECOME AN INTEGRAL PART OF AN EXCITING YOUNG RESIDENCY PROGRAM!

Faculty, Family Medicine Residency Rancho Mirage, CA

'KUGPJQYGT /GFKECN %GPVGT KP 4CPEJQ /KTCIG %CNKHQTPKC TGEGPVN[ YGNEQOGF KVU Ć‚ HVJ class of residents and has a full 10-year ACGME accreditation. Eisenhower Medical Associates, Inc., a California Professional Corporation, is seeking to enhance its team of employed physicians to serve as Family Medicine Residency faculty members for the Eisenhower Medical Center Residency Program. Options include outpatient-only, inpatient-only, or combined inpatient and outpatient care responsibilities. You may precept family medicine residents in our outpatient center and/or supervise residents on our family medicine inpatient service. You will have protected time for curriculum management, resident advising, and scholarly work. $QCTF EGTVKĆ‚ ECVKQP KP (COKN[ /GFKEKPG KU TGSWKTGF (CEWNV[ CECFGOKE CRRQKPVOGPVU CTG EQPĆ‚ TOGF HTQO C PWODGT QH NQECN WPKXGTUKVKGU DCUGF WRQP GZRGTKGPEG CPF SWCNKĆ‚ ECVKQPU 'KUGPJQYGT /GFKECN #UUQEKCVGU UGGMU ECPFKFCVGU YJQUG GZRGTKGPEG teaching, research, and community service has prepared them to contribute to our commitment to serving the Coachella Valley. 3WCNKĆ‚ GF CRRNKECPVU KPENWFKPI TGEGPV TGUKFGPE[ ITCFWCVGU CTG GPEQWTCIGF VQ apply. Candidates should submit an electronic CV and statement of interest to Anne Montgomery, MD, MBA, Program Director, at amontgomery@emc.org with a copy to tdunn@emc.org. (QT SWGUVKQPU QT KPSWKT[ RNGCUG EQPVCEV /KEJGNNG *CTFKPI (/ 4GUKFGPE[ 2TQITCO Manager, at mharding@emc.org or 760-773-4504.

FAMILY MEDICINE

Vista Community Clinic With locations in Vista/No San Diego County, Lake Elsinore/So Riverside County and La Habra/Orange County Seeking: Full-time, part-time and per diem Family Medicine Physicians Requirements: California License, DEA License, Board Certified

Contact Us:

emc.org/GME

Visit our website at www.vistacommunityclinic.org Forward resume to hr@vistacommunityclinic.org California Family Physician Winter 2018

19

reflections and recovery

ƚŚĂŶ ŝƚ ŽƚŚĞƌǁŝƐĞ ŵŝŐŚƚ ŚĂǀĞ ďĞĞŶ ǁŝƚŚ ƚŚƌĞĞ LJŽƵŶŐ ŬŝĚƐ Ăƚ ŚŽŵĞ ĂŶĚ / ĐĞƌƚĂŝŶůLJ ƐƚĂLJĞĚ ƵƉ ǁĞůů ƉĂƐƚ ŵLJ ďĞĚƚŝŵĞ ƐĞĞŝŶŐ patients throughout the night. sŝƐƚĂ ůŝŶŝĐ͛Ɛ ďĞůŽǀĞĚ >ƵĐLJ ;ƐŚŽǁŶ ŽŶ ƉĂŐĞ ϭϴͿ ƐƵƌǀŝǀĞĚ͕ ďƵƚ ƚŚĞ ĐůŝŶŝĐ ƐŚĞ ƉƌŽƚĞĐƚƐ ǁŝůů ďĞ ĐůŽƐĞĚ ƵŶƚŝů ϮϬϭϵ͘ /ƚ ǁĂƐ Ă ŵĞŵŽƌĂďůĞ ƚƌŝƉ ĂŶĚ / Ăŵ ƉƌŽƵĚ ƚŽ ŚĂǀĞ ďĞĞŶ Ă ǁŝƚŶĞƐƐ ƚŽ ^ĂŶƚĂ ZŽƐĂ ZŝƐŝŶŐ͘

,Žǁ ĂďŽƵƚ /ŶƚĞƌǀŝĞǁƐ ŝŶ ƚŚĞ DŝĚĚůĞ ŽĨ Ă Disaster? Patricia Hiresote, DO

^ĂŶƚĂ ZŽƐĂ ŝƐ Ă ŐƌĞĂƚ ĐŽŵŵƵŶŝƚLJ ʹ ǁĞ͛ƌĞ ůƵĐŬLJ ƚŽ ďĞ ƉĂƌƚ ŽĨ ƚŚĞ ĂLJ ƌĞĂ ŐƌŽƵƉ ŽĨ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ƌĞƐŝĚĞŶĐŝĞƐ͘ dŚĞLJ͛ǀĞ been collegial and supportive. We’re proud to be part of the &D ZĞǀŽůƵƚŝŽŶ͘ tĞ͛ǀĞ ĂůƐŽ ƐĞĞŶ ǁŚĂƚ ŝƚ ŵĞĂŶƐ ƚŽ ďĞ ĂŶ &W in our community – patients have been emailing to ask if I’m ok. <ĂŝƐĞƌ WĞƌŵĂŶĞŶƚĞ ^ĂŶƚĂ ZŽƐĂ͛Ɛ ŶĞǁ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵ ŝƐ ŽƉĞŶŝŶŐ ŝŶ :ƵůLJ ϮϬϭϴ͘ Ɛ ǁĞ ǁĞƌĞ ďĞŐŝŶŶŝŶŐ ŝŶƚĞƌǀŝĞǁƐ ǁŝƚŚ prospective residents, flames broke out in Santa Rosa. The /ŶƚĞƌǀŝĞǁƐ ĐŽŶƚŝŶƵĞĚ ĚƵƌŝŶŐ ĂŶĚ ĂĨƚĞƌ ƚŚĞ ĨŝƌĞƐ͕ ĂůƚŚŽƵŐŚ ǁĞ moved them to San Francisco. Our GME office also provided

20

California Family Physician Winter 2018

additional resources. We struggled to find hotel rooms for ƚŚĞ ĐĂŶĚŝĚĂƚĞƐ ďĞĐĂƵƐĞ ƚŚĞ ŚŽƚĞůƐ ǁĞ͛Ě ƌĞĐŽŵŵĞŶĚĞĚ ʹ ůŝŬĞ &ŽƵŶƚĂŝŶ 'ƌŽǀĞ /ŶŶ ŝŶ ^ĂŶƚĂ ZŽƐĂ ʹ ŚĂĚ ďƵƌŶĞĚ ĚŽǁŶ͘ LJ ƚŚĞ ǁĞĞŬ ŽĨ KĐƚŽďĞƌ ϯϬ͕ ǁĞ ƌĞƐƵŵĞĚ ŝŶƚĞƌǀŝĞǁƐ ŝŶ ^ĂŶƚĂ ZŽƐĂ ĂŶĚ ǁĞ ŚĂǀĞ ĐŽŵŵŝƚƚĞĚ ƚŽ ƐƵďƐŝĚŝnjŝŶŐ ƌĞƚƵƌŶ ƚƌŝƉƐ ĨŽƌ ĐĂŶĚŝĚĂƚĞƐ ǁŚŽ ǁĂŶƚ ƚŽ ǀŝƐŝƚ ƚŚĞ ĐĂŵƉƵƐ͘ ƵƌŝŶŐ ŝŶƚĞƌǀŝĞǁƐ͕ ǁĞ ŶŽƚ ŽŶůLJ ĂƐƐƵƌĞĚ ƉŽƚĞŶƚŝĂů ƌĞƐŝĚĞŶƚƐ ǁĞ ǁŽƵůĚ ďĞ ŽƉĞŶ ĂƐ ƉůĂŶŶĞĚ͕ ǁĞ ĞŶĐŽƵƌĂŐĞĚ ƚŚĞŝƌ ĐŚŽŝĐĞ ŽĨ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ĂƐ Ă ƐƉĞĐŝĂůƚLJ ǁŝƚŚ Ă ƵŶŝƋƵĞ ŽƉƉŽƌƚƵŶŝƚLJ to participate in the rebuilding of a community. We told ƚŚĞŵ ͞/ƚ ǁŝůů ƚĂŬĞ Ă ĚĞĐĂĚĞ ƚŽ ƌĞďƵŝůĚ ^ŽŶŽŵĂ ŽƵŶƚLJ͘ ZĞƐŝĚĞŶƚƐ ǁŝůů ďĞ ĂďůĞ ƚŽ ƐĂLJ͕ ͚/ ǁĂƐ ƉĂƌƚ ŽĨ ƚŚĂƚ ĂŶĚ / ŚĞůƉĞĚ͛͘͟ ŽŽƉĞƌĂƚŝŽŶ ĂŵŽŶŐ ƚŚĞ ƚǁŽ ^ĂŶƚĂ ZŽƐĂ ƌĞƐŝĚĞŶĐLJ ƉƌŽŐƌĂŵƐ ƚŽ ƐƵƉƉŽƌƚ ƚŚĞ ƌĞƐŝĚĞŶƚƐ ĂĨƚĞƌ ƚŚĞ ĨŝƌĞ ǁĂƐ ũƵƐƚ ĂŵĂnjŝŶŐ͘ dŚĞ ĚŝƐĂƐƚĞƌ ƌĞŝŶĨŽƌĐĞĚ ƚŚĞ ďŽŶĚ ďĞƚǁĞĞŶ ŽƵƌ ƚǁŽ ŝŶƐƚŝƚƵƚŝŽŶƐ ;<W ĂŶĚ ^ƵƚƚĞƌͬh ^&Ϳ ĂŶĚ ƌĞǀĞĂůĞĚ ƌĞĂů ĐŽůůĞŐŝĂůŝƚLJ ďĞƚǁĞĞŶ ƚŚĞ ƚǁŽ ŝŶĚĞƉĞŶĚĞŶƚ ƉƌŽŐƌĂŵƐ ĂƐ ǁĞ ĨŝŐƵƌĞ ŽƵƚ ŚŽǁ ďĞƐƚ ƚŽ serve the community. We talk daily. dŚŝƐ ĚŝƐĂƐƚĞƌ ŝƐ ŶŽǁ ƉĂƌƚ ŽĨ ƚŚĞ ĨĂďƌŝĐ ŽĨ ŽƵƌ ŶĞǁ ƉƌŽŐƌĂŵ͘ Coming together in the crisis and seeing the community’s needs have underscored the need for more family and primary care physicians.

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reflections and recovery tĞ tŝůů WƌĞǀĂŝů ʹ ŶĚ EŽƚ :ƵƐƚ ƚŚĞ &ŝƌĞƐ Ž 'ƌĞĂǀĞƐ͕ D ͞,Žǁ ĂƌĞ LJŽƵ ĚŽŝŶŐ͍ /Ɛ LJŽƵƌ ĨĂŵŝůLJ K<͍ zŽƵƌ ŚŽŵĞ͍͟ /Ŷ ƚŚĞ ĚĂLJƐ ĂŶĚ ǁĞĞŬƐ ĨŽůůŽǁŝŶŐ ƚŚĞ ŵĂƐƐŝǀĞ ^ŽŶŽŵĂ ŽƵŶƚLJ ĨŝƌĞƐ͕ ƚŚĞƐĞ ǁĞƌĞ ƚŚĞ ǁŽƌĚƐ ƐŚĂƌĞĚ ďLJ ĨƌŝĞŶĚƐ ĂŶĚ ƐƚƌĂŶŐĞƌƐ ĂůŝŬĞ͕ ŽĨƚĞŶ ĨŽůůŽǁĞĚ ďLJ Ă ŚƵŐ͘ 'ŽŶĞ ǁĞƌĞ ƚŚĞ ƉƌŽďůĞŵƐ ƚŚĂƚ ƐŽ often divide us. A disaster this huge affects everyone, and brings the ĐŽŵŵƵŶŝƚLJ ƚŽŐĞƚŚĞƌ͘ tĞ ƐŚŽǁĞĚ ŽƵƌ ƌĞƐŝůŝĞŶĐĞ ŝŶ ƐŽ ŵĂŶLJ ǁĂLJƐ͘ dŚĞ ŝƚLJ ĂŶĚ ŽƵŶƚLJ ĚŝĚ Ă ŚĞƌŽŝĐ ũŽď͕ ĨƌŽŵ ĨŝƌƐƚ responders to establishing dozens of shelters to beginning ƚŚĞ ũŽď ŽĨ ƌĞĐŽǀĞƌLJ͘ ,ĞĂůƚŚ ĐĂƌĞ ǁŽƌŬĞƌƐ͕ ŵĂŶLJ ŽĨ ǁŚŽŵ ŚĂĚ ũƵƐƚ ůŽƐƚ ƚŚĞŝƌ ŚŽŵĞƐ͕ ǁĞƌĞ ŚĞƌŽŝĐ ĞǀĂĐƵĂƚŝŶŐ ƚǁŽ ŚŽƐƉŝƚĂůƐ͕ meeting triple the demand at the one remaining hospital ĂŶĚ ĐŽƉŝŶŐ ǁŝƚŚ ƚŚĞ ůŽƐƐ ŽĨ ŵĂũŽƌ ŽƵƚƉĂƚŝĞŶƚ ĐůŝŶŝĐ ĨĂĐŝůŝƚŝĞƐ͘ And at the same time establishing and coordinating clinician staffing at the many shelters. And the community at large ƌĞĂĐŚĞĚ ŽƵƚ ǁŝƚŚ ďŝŐ ĂƌŵƐ͕ ĚŽŶĂƚŝŶŐ ŚƵŐĞ ĂŵŽƵŶƚƐ ŽĨ clothing and food, money and housing.

DLJ ŚĞĂƌƚ ďƌŽŬĞ ǁŚĞŶ / ƐĂǁ ŽƵƌ ďĞůŽǀĞĚ sŝƐƚĂ ,ĞĂůƚŚ ĞŶƚĞƌ ƐŽ ĚĂŵĂŐĞĚ͘ dŚĞ ŵĞĚŝĐĂů ŚŽŵĞ ĨŽƌ Ϯϰ͕ϬϬϬн ƉĂƚŝĞŶƚƐ ĂŶĚ ŵLJ ǁŽƌŬ ŚŽŵĞ ĨŽƌ ƚŚĞ ůĂƐƚ Ɛŝdž LJĞĂƌƐ ŽĨ ŵLJ ĐĂƌĞĞƌ͕ ŝƐ ŽƵƚ ŽĨ ĐŽŵŵŝƐƐŝŽŶ ĨŽƌ ϭϴ ŵŽŶƚŚƐ͘ dŚĞ ƌĞƐƉŽŶƐĞ ŽĨ ^ĂŶƚĂ ZŽƐĂ Community Health has been amazing. My friend, former boss and next CAFP President Lisa Ward and her team have ǁŽƌŬĞĚ ŵŝƌĂĐůĞƐ ƚŽ ƉƌŽǀŝĚĞ ĐŽŶƚŝŶƵŽƵƐ ĐĂƌĞ ĨŽƌ Ăůů ƚŚŽƐĞ ƉĞŽƉůĞ ǁŚŽ ĚĞƉĞŶĚ ŽŶ ƵƐ ƐŽ ŵƵĐŚ͘ Santa Rosa and our Sonoma County are rising up and meeting ƚŚŝƐ ĐƌŝƐŝƐ ǁŝƚŚ ŚĞĂƌƚ ĂŶĚ ĚĞƚĞƌŵŝŶĂƚŝŽŶ͘ dŚĞ ƐĂŵĞ ǁŽƵůĚ ďĞ ƚƌƵĞ ŝŶ ĞǀĞƌLJ ĐŽŵŵƵŶŝƚLJ ŝŶ ŵĞƌŝĐĂ͘ ^ŽŵĞŚŽǁ͕ ǁĞ ŶĞĞĚ ƚŽ capture some of this determination, this common purpose, ĂŶĚ ĨŽĐƵƐ ŝƚ ŽŶ ƚŚĞ ŵĂŶLJ ƉƌŽďůĞŵƐ ǁĞ ĨĂĐĞ ŝŶ ƚŽĚĂLJ͛Ɛ ŵĞƌŝĐĂ͘ /Ĩ ǁĞ ĚŽ͕ ƚŚĞ ƉĞŽƉůĞ ǁŝůů ƉƌĞǀĂŝů͘

tŚĂƚ tŽƵůĚ zŽƵ 'ƌĂď͍ Marshall Kubota, MD

/͕ ĂůŽŶŐ ǁŝƚŚ ĂŶ ĞƐƚŝŵĂƚĞĚ ϮϬϬ ŽƚŚĞƌ ƉŚLJƐŝĐŝĂŶƐ͕ ůŽƐƚ ŵLJ home of 35 years in the Tubbs Fire in Sonoma County. After Ž 'ƌĞĂǀĞƐ

<ĂƚŚƌLJŶ ĂŶĚ DĂƌƐŚĂůů <ƵďŽƚĂ

22

California Family Physician Winter 2018

Ă ƌĂŝŶLJ ƐƉƌŝŶŐ ŽĨ ŐƌŽǁƚŚ͕ Ă ǁĂƌŵ ĚƌLJŝŶŐ ƐƵŵŵĞƌ͕ ǁŝƚŚ ϱϬ ŵƉŚ ǁŝŶĚƐ ĂŶĚ ƉŽƐƐŝďůLJ ƐƚĂƌƚĞĚ ďLJ ĂƌĐŝŶŐ ƉŽǁĞƌůŝŶĞƐ͕ ƚŚĞ dƵďďƐ Fire roared from Napa to Sonoma County through some of ƚŚĞ ǁĞĂůƚŚŝĞƐƚ ŶĞŝŐŚďŽƌŚŽŽĚƐ͘ ƌŝǀĞŶ ďLJ ƚŚĞ ǁŝŶĚ ũƵŵƉŝŶŐ ƚLJƉŝĐĂů ďĂƌƌŝĞƌƐ͕ ůŝŬĞ ,ŝŐŚǁĂLJ ϭϬϭ͕ ŝƚ ƐĞƚ ďůĂnjĞƐ ŝŶ ĞŶƚŝƌĞ neighborhoods separated by miles. My son, Evan, living in ŚŝƐ ŚŽŵĞ ŵŝůĞƐ ǁĞƐƚ͕ ĂĐƌŽƐƐ ϭϬϭ͕ ůŽƐƚ ŚŝƐ ŚŽŵĞ ĂŶĚ ƚŚĞ ĞŶƚŝƌĞ ƐƵďĚŝǀŝƐŝŽŶ ĂƐ ǁĞůů͘ In our small branch office, of the nine or so stationed employees, three of us lost our homes, establishing a psychologic ǁĂůů ďĞƚǁĞĞŶ ƚŚĞ ĞdžƚƌĂŽƌĚŝŶĂƌŝůLJ compassionate sympathetic from the small club members of the empathetic. The emotional impact continues to evolve ƌĂƉŝĚůLJ͕ ŶŽƚ ĂůǁĂLJƐ ĞŶĐŽƵƌĂŐŝŶŐůLJ ĂŶĚ ŝƐ difficult to describe for the uninitiated. tĞ ĂƌĞ ĂǁĂƌĞ ƚŚĂƚ ŵĂŶLJ ĐĂŵĞ ŽƵƚ ŽĨ ƚŚŝƐ ǁŽƌƐĞ ƚŚĂŶ ƵƐ͕ ůŽƐƚ ůŝǀĞƐ͕ ĨŝŶĂŶĐŝĂůůLJ ƌƵŝŶĞĚ͕ ĂŶĚ͕ ŝŶ Ă ŐůŽďĂů ƉŝĐƚƵƌĞ͕ ǁĞ ĂƌĞ the most fortunate of this incident’s unfortunate. Among the many competing emotions ĂƌĞ ƚŚĞ͕ ͞/ ǁŝƐŚ / ŚĂĚ͕͟ ŐƌŽƵƉ ƚŚĂƚ ŝŶ ƌĞƚƌŽƐƉĞĐƚ ŵŝŐŚƚ ŚĂǀĞ ƌĞƐƵůƚĞĚ ŝŶ ĨĞǁĞƌ ƉƐLJĐŚŽůŽŐŝĐ ǁŽƵŶĚƐ ĂŶĚ ƐĐĂƌƐ͘ dŚĞLJ are about the things lost, left behind, ĨŽƌ ǁŚŝĐŚ ŽŶůLJ ŵĞŵŽƌŝĞƐ ƐƵƌǀŝǀĞ͕ ƚŚĂƚ ǁŝƚŚŽƵƚ ƚŚĞŝƌ ƉŚLJƐŝĐĂů ƉƌĞƐĞŶĐĞ ǁŝůů ĨĂĚĞ͕ ŶŽƚ ƚŽ ďĞ ƉĂƐƐĞĚ ĚŽǁŶ ƚŽ ŽƵƌ ĐŚŝůĚƌĞŶ͘ Here’s the list: ϭ͘

Ϯ͘

3.

ƚŽ ƐĂǀĞ͍ ƐƐƵŵŝŶŐ LJŽƵƌ ĨĂŵŝůLJ ŵĞŵďĞƌƐ ĂŶĚ ƉĞƚƐ ĂƌĞ ŽƵƚ͕ ƚŚĞŶ ǁŚĂƚ͍ tĞĚĚŝŶŐ ƌŝŶŐƐ ĂƌĞ Ă ĐŽŵŵŽŶ ĂŶƐǁĞƌ ʹ ďƵƚ ƚŚĞŶ ǁŚĂƚ͍ Critically important medications (meds you ĐĂŶŶŽƚ ŵŝƐƐ ĨŽƌ Ă ĨĞǁ ĚĂLJƐͿ͕ ŵĂLJďĞ͕ ďƵƚ ĞǀĞŶ ƚŚĞŶ pharmacies may replace them – especially if you

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BMGRecruiting@epiclp.com 909.335.4189

dŚĞ ĞǀĂĐƵĂƚŝŽŶ ŵĂLJ ďĞ hyperurgent (in an interior fire a room can be engulfed ŝŶ ϭϬ ŵŝŶƵƚĞƐ Žƌ ůĞƐƐ ǁŝƚŚ ƚŚĞ temperature at head height ŽĨ ϰϬϬ ĚĞŐƌĞĞƐͿ͘ dŚŝŶŬ ʹ ǁŚĂƚ ŝƐ ƚŚĞ KE ƚŚŝŶŐ LJŽƵ ǁŽƵůĚ ǁĂŶƚ ƚŽ ƚĂŬĞ ŽƵƚ ŽĨ ƚŚĞ ŚŽŵĞ͘ /Ĩ LJŽƵƌ ĂŶƐǁĞƌ ŝƐ ƚŚĞ ĨĂŵŝůLJ photos then you haven’t ĂŶƐǁĞƌĞĚ ƚŚĞ ƋƵĞƐƚŝŽŶ͘ dŚĞ ONE thing. You can grab and run. It should be easily ƌĞĂĐŚĂďůĞ͘ / ǁĂƐ ŶŽƚ ƉƌĞƉĂƌĞĚ and lost it forever. /Ĩ LJŽƵ ŚĂǀĞ ƚŚĞ ůƵdžƵƌLJ ŽĨ ƚŝŵĞ ǁŚĂƚ ƚŚĞŶ ĂƌĞ LJŽƵƌ ƉƌŝŽƌŝƚŝĞƐ California Family Physician Winter 2018

23

reflections and recovery

ĂƌĞ Ă ĚŽĐƚŽƌ͘ /Ĩ ŝƚ͛Ɛ Ă ďŝŐ ĨŝƌĞ͕ ƐŵŽŬĞ ǁŝůů ďĞ ŝŶ ƚŚĞ ϭϭ͘ <ĞĞƉ LJŽƵƌ ŝŶƐƵƌĂŶĐĞ ƵƉͲƚŽͲĚĂƚĞ ĂŶĚ ĐŽŶƐŝĚĞƌ Ăŝƌ ĨŽƌ ĚĂLJƐ͕ Ă ĐŚĂůůĞŶŐĞ ƚŽ ƚŚŽƐĞ ǁŝƚŚ ƌĞƐƉŝƌĂƚŽƌLJ inflation additions. We did, but still may be ĂŝůŵĞŶƚƐ͘ 'ƌĂď LJŽƵƌ ŐůĂƐƐĞƐ ʹ LJŽƵ ǁŝůů ďĞ ƵŶĚĞƌŝŶƐƵƌĞĚ ĨŽƌ ƌĞƉůĂĐĞŵĞŶƚ ĐŽƐƚƐ͘ KǁŝŶŐ LJŽƵƌ miserable if you are myopic and don’t have them. home, free and clear, doesn’t relieve you of the ϰ͘ dŚŝŶŐƐ ŽŶ LJŽƵƌ ůŝƐƚ ƐŚŽƵůĚ ŶŽƚ ďĞ ƚŚĞ ƌĞƉůĂĐĞĂďůĞ need for insurance unless you can afford to lose it ŝƚĞŵƐ͘ /ƚ ǁŝůů ďĞ ƚŚŽƐĞ ŝƚĞŵƐ ƚŽ ǁŚŝĐŚ LJŽƵ ĂŶĚ Ăůů͘ tĞ ǁĞƌĞŶ͛ƚ ŝŶ ƚŚĞ ŚŝůůƐ ĂŶĚ ƚŚŽƵŐŚƚ ǁĞ ǁĞƌĞ your family have emotional, not financial, connections. 5. While it is a hassle to replace drivers’ licenses, credit cards, birth and marriage certificates, they are of relative value and ƌĞƉůĂĐĞĂďůĞ͘ hŶůĞƐƐ ƚŚĞ AVAILABLE PROVIDEROPPORTUNITIES disaster is truly apocalyptic, ƚŚĞƌĞ ǁŝůů ďĞ ĨŽŽĚ ĂŶĚ ǁĂƚĞƌ͘ IN FAMILY MEDICINE ϲ͘ <ŶŽǁ ŚŽǁ ƚŽ ŽƉĞŶ LJŽƵƌ garage door if there is no ƉŽǁĞƌ͘ /Ĩ ƚŝŵĞůLJ͕ ĐŽŶƐŝĚĞƌ WHAT WE HAVE TO OFFER: taking more than one car. • Salary based on experience (I say this having lost a car • Sign on bonus and relocation assistance ŝŶ ƚŚĞ ŐĂƌĂŐĞͿ͘ Ƶƚ ŝƚ ǁŝůů • 5 days of CME, $3,000 CME separate the drivers for a reimbursement and 10 paid holidays ǁŚŝůĞ͘ • Quarterly bonuses SACRAMENTO ϳ͘ /ƚ ŝƐ ŝŵƉŽƌƚĂŶƚ ƚŽ ŚĂǀĞ Ă based on quality and productivity smart phone – it is your SAN FRANCISCO YOSEMITE • Cap Exempt and connection to family and Offering Visa resources. FRESNO Sponsorship ϴ͘ ^ĂĨĞƐ͕ ǁŚŝůĞ ƉƌŽƚĞĐƚŝŶŐ • National Health Service against fire, do not protect Corp Scholar and Loan against heat. They turn into Recruitment eligible ovens that reduce paper to • Organizational HPSA (Health ash after a short period of Provider Shortage Area) score of 16 time. Consider a safe deposit • Many sites within 1 hour of Yosemite National Park, 2 hours from box. the San Francsico Bay Area, and Monterey 9. Put your photos and images • 30 sites located throughout the central valley of California of important documents in the cloud – or copy to hard drives and distribute to your kids (although my son’s house also burned and my daughter CONTACT ME TO DISCUSS OUR AMAZING OPPORTUNITIES: ŬĞƉƚ ŚĞƌƐ ŝŶ ŽƵƌ ŚŽƵƐĞ͖ Joshua Skunca, Director of Provider Recruitment ĂŶŽƚŚĞƌ ƐŽŶ ŚĂĚ ƚŚĞŵ͘Ϳ jskunca@gvhc.org | Office: 209.384.6489 | Cell: 209.291.9750 ϭϬ͘ ŽŶƐŝĚĞƌ ĂŶ ŝŶǀĞŶƚŽƌLJ ŽĨ LJŽƵƌ ŚŽƵƐĞ͘ ǀĞŶ Ă ǁĂůŬ around video. Open closets, ĐƵƉďŽĂƌĚƐ ĂŶĚ ĚƌĂǁĞƌƐ͘ zŽƵ may need this for your claims. Do it and put it in the cloud. There are apps for this.

JOIN OUR TEAM!

SAN JOAQUIN COUNTY

STANISLAUS COUNTY

MERCED COUNTY

PLEASE VISIT US AT www.gvhc.org

24

California Family Physician Winter 2018

ŶŽƚ ŚŝŐŚ ƌŝƐŬ ʹ ƐĂĚůLJ͕ ǁĞ ǁĞƌĞ ǁƌŽŶŐ͘ ϭϮ͘ ŶƌŽůů ŝŶ ĂŶĚ ĚŽǁŶůŽĂĚ community alert services. They are one of the best ǁĂLJƐ ƚŽ ŐĞƚ ĂŶ ĞĂƌůLJ ǁĂƌŶŝŶŐ͕ ĂůƚŚŽƵŐŚ ŝƚ ĐĂŵĞ too late for many in the Tubbs Fire. ϭϯ͘ WƌĂĐƚŝĐĞ ʹ ƚŚĞ Ěƌŝůů ǁŝůů ďĞ different for fire in the ŚŽƵƐĞ͕ ĨŝƌĞ ŽŶ ƚŚĞ ǁĂLJ͕ flood and earthquake. / ǁĂŶƚ ƚŽ ƚŚĂŶŬ ƚŚĞ ŵĂŶLJ ĨƌŝĞŶĚƐ ǁŚŽ ŚĂǀĞ ŚĞůƉĞĚ ŝŶ ĞǀĞƌLJ ǁĂLJ͘ dŽ the Academy for its broad shoulders. ŶĚ ĨŽƌĞǀĞƌ͕ ƚŚĂŶŬ LJŽƵ ƚŽ ŵLJ ǁŝĨĞ͕ <ĂƚŚƌLJŶ͕ ŵLJ ŬŝĚƐ ĂŶĚ ŐƌĂŶĚŬŝĚƐ ĂƐ ǁĞ ďƵŝůĚ ŶĞǁ ŵĞŵŽƌŝĞƐ͘

UCSF FRESNO FAMILY MEDICINE FACULTY OPPORTUNITY The UCSF Fresno Medical Education Program and Central California Faculty Medical Group (CCFMG) are recruiting for a physician to join the teaching faculty. The successful applicant must be board certified in Family Medicine, have a license to practice medicine in the United States, and be eligible to obtain a California medical license at the time of hire. This position provides an opportunity for teaching, clinical research, and community practice. Proficiency in OB optional. Administrative/leadership opportunities are available. A competitive salary is offered. The program is based in Fresno, California, which offers a high standard of living combined with a low cost of living. The result is a quality of life uniquely Californian, yet surprisingly affordable. Fresno is a vibrant, growing city located in Central California. There is much to see and do in Fresno and the city is ideally located for fast, convenient getaways to the scenic Central Coast as well as the majestic Sierra Nevada mountains. Fresno is the only major city in the country with close proximity to three national parks, including renowned Yosemite National Park.

PLEASE APPLY ONLINE AT: https://aprecruit.ucsf.edu/apply/JPF01168 Visit our websites: www.fresno.ucsf.edu | www.communitymedical.org

UC San Francisco seeks candidates whose experience, teaching, research, or community service that has prepared them to contribute to our commitment to diversity and excellence. The University of California is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.

California Family Physician Winter 2018

25

reflections and recovery

David Araujo, MD

And, in Southern California In the late evening of ,ŽƐƉŝƚĂů ĂŶĚ ŵĞĚŝĐĂů ƐƚĂī DŽŶĚĂLJ ĞĐĞŵďĞƌ ϰ͕ ϮϬϭϳ͕ also lost their homes and the Thomas Fire, named ƚŚĞ ĐŽƵŶƚ ŝƐ ŶŽƚ ĮŶĂů͘ ĂŌĞƌ ^ƚ͘ dŚŽŵĂƐ ƋƵŝŶĂƐ College located above Santa The response of the Paula, ignited in the midst residency and faculty has ŽĨ ƚĞƌƌŝďůĞ ^ĂŶƚĂ ŶĂ ǁŝŶĚ ďĞĞŶ ĂǁĞƐŽŵĞ͘ tĞ ƋƵŝĐŬůLJ ĐŽŶĚŝƟŽŶƐ͘ dŚĞ ^ĂŶƚĂ ŶĂƐ formed an electronic e-mail ĂƌĞ ŚŽƚ ŐƵƐƚLJ ǁŝŶĚƐ ďůŽǁŝŶŐ ƚŚƌĞĂĚ ĨŽƌ ĐŽŵŵƵŶŝĐĂƟŽŶ͘ in from the desert to the Residents rapidly took ĞĂƐƚ ŽĨ sĞŶƚƵƌĂ͘ tŝƚŚŝŶ ƚǁŽ ŝŶ ĨĞůůŽǁ ƌĞƐŝĚĞŶƚƐ ǁŚŽ ŚŽƵƌƐ ŽĨ ƚŚĞ ŝŶŝƟĂů ƌĞƉŽƌƚƐ had been displaced. The ŽĨ ƚŚĞ ĮƌĞ͕ ƚŚĞ sĞŶƚƵƌĂ ƌĞƐŝĚĞŶĐLJ ĂĚŵŝŶŝƐƚƌĂƟǀĞ ŚŝůůƐŝĚĞ ĐŽŵŵƵŶŝƟĞƐ ǁĞƌĞ support team called all ƵŶĚĞƌ ŵĂŶĚĂƚŽƌLJ ĞǀĂĐƵĂƟŽŶ the applicants arriving ŽƌĚĞƌƐ͘ dŚĞ ĮƌĞ ƚƌĂǀĞůĞĚ December 6 and ŵŽƌĞ ƚŚĂŶ ϮϬ ŵŝůĞƐ ŝŶ ůĞƐƐ ƌĞƐĐŚĞĚƵůĞĚ ƚŚĞ ŝŶƚĞƌǀŝĞǁƐ͘ ƚŚĂŶ ƚǁŽ ŚŽƵƌƐ͘ Ɛ ŽĨ ƚŚŝƐ The residents put on an ǁƌŝƟŶŐ ; ĞĐĞŵďĞƌ ϴͿ ŵŽƌĞ all-residency dinner that ƚŚĂŶ ϭϱϬ ƐƋƵĂƌĞ ŵŝůĞƐ evening to provide support ŚĂǀĞ ďƵƌŶĞĚ͕ ĐůŽƐĞ ƚŽ ϱϬϬ ĂŶĚ Ă ƟŵĞ ŽĨ ƌĞƉƌŝĞǀĞ͘ tĞ structures/homes are lost formed a GoFundMe site, ĂŶĚ Ϯϳ͕ϬϬϬ ƉĞŽƉůĞ ĂƌĞ spearheaded by Dr. Tipu displaced. Ventura County Khan, to provide funds for Medical Center and the ƚŚĞ ĮǀĞ ƌĞƐŝĚĞŶĐLJ ŵĞŵďĞƌƐ Family Medicine Residency ǁŚŽ ůŽƐƚ ƚŚĞŝƌ ŚŽŵĞƐ͘ Program, located at the Residents and faculty ďĂƐĞ ŽĨ ƚŚĞ ŚŝůůƐ͕ ǁĂƐ ŝŶ ƚŚĞ quickly volunteered to ŝŶŝƟĂů ĞǀĂĐƵĂƟŽŶ njŽŶĞ͘ dŚĞ provide medical care at the hospital chose to shelter in ĞǀĂĐƵĂƟŽŶ ƐŚĞůƚĞƌƐ͘ tĞ place and provided support ƉĂƌƚŶĞƌĞĚ ǁŝƚŚ ƚŚĞ sĞŶƚƵƌĂ sĞŶƚƵƌĂ ĨĂŵŝůLJ ŵĞĚŝĐŝŶĞ ƌĞƐŝĚĞŶƚƐ ũƵŵƉĞĚ ŝŶƚŽ ĂĐƟŽŶ ĚƵƌŝŶŐ ƚŚĞ dŚŽŵĂƐ ĮƌĞƐ͘ for the residents in the County Health Care Agency area. The residents and ĂŶĚ ƐƚĂīĞĚ ƚŚĞ DŽďŝůĞ ĨĂĐƵůƚLJ ŽŶ ĚƵƚLJ ƚŚĂƚ ŶŝŐŚƚ ƐƚĂīĞĚ ƚŚĞ ŵĞƌŐĞŶĐLJ ĞƉĂƌƚŵĞŶƚ ůŝŶŝĐ Ăƚ ƚŚĞ ĞǀĂĐƵĂƟŽŶ ĐĞŶƚĞƌƐ͘ dŚĞ ƐƵƉƉŽƌƚ ďLJ ƚŚĞ ĨĂŵŝůLJ ĂŶĚ ǁĞƌĞ ŝŶƚĞŐƌĂů ƚŽ ƚŚĞ ĨƵŶĐƟŽŶŝŶŐ ŽĨ ƚŚĞ ŚŽƐƉŝƚĂů͘ tĞ ĂƌĞ medicine community has been incredible. Special thanks to Dr. ƚŚĞ ĚĞƐŝŐŶĂƚĞĚ ƚƌĂƵŵĂ ĐĞŶƚĞƌ ĨŽƌ ǁĞƐƚĞƌŶ sĞŶƚƵƌĂ ŽƵŶƚLJ dĂƌĂ ^ĐŽƩ ŝŶ ^ĂŶƚĂ ZŽƐĂ ǁŚŽ ƉƌŽǀŝĚĞĚ ŚĞƌ ĞdžƉĞƌŝĞŶĐĞ ǁŝƚŚ ƚŚĞ ĂŶĚ ƚŚĞ ƌĞƐŝĚĞŶƚƐ ĨŽƌŵ ƚŚĞ ƚƌĂƵŵĂ ƌĞƐƉŽŶƐĞ ƚĞĂŵ ǁŝƚŚ ŽƵƌ ƌĞĐĞŶƚ ^ŽŶŽŵĂ ĮƌĞƐ͘ ƚƌĂƵŵĂ ƐƵƌŐĞŽŶƐ͘ ĐŽŵŵĂŶĚ ĐĞŶƚĞƌ ǁĂƐ ƐƚĂƌƚĞĚ ďLJ ϯ͗ϬϬ Ăŵ ŽŶ ĞĐĞŵďĞƌ ϱ ĂŶĚ ƚŚĞ ƌĞƐŝĚĞŶĐLJ ƉĂƌƟĐŝƉĂƚĞĚ ŝŶ Ăůů ĚĞĐŝƐŝŽŶƐ tĞ ŚŽƉĞ ƚŽ ďĞ ďĂĐŬ ŝŶ ŽƵƌ ĐůŝŶŝĐ DŽŶĚĂLJ ĞĐĞŵďĞƌ ϭϭ about the medical center. Smoke and soot caused us to be on ĂƐ ůŽŶŐ ĂƐ ƚŚĞƌĞ ĂƌĞŶ͛ƚ ĂŶLJ ŵŽƌĞ ĐĂƚĂƐƚƌŽƉŚĞƐ͘ tĞ ǁŝůů ďĞ ďĂĐŬƵƉ ŐĞŶĞƌĂƚŽƌ ƉŽǁĞƌ ĂŶĚ ĐůŽƐĞĚ ƚŚĞ ƌĞƐŝĚĞŶĐLJ ĐůŝŶŝĐ͘ &ŽƵƌ ŝŶƚĞƌǀŝĞǁŝŶŐ ĂŶĚ ƌĞĂĚLJ ƚŽ ĐŽŶƟŶƵĞ ŽƵƌ ŵŝƐƐŝŽŶ ŽĨ ĐĂƌŝŶŐ ĨŽƌ ŽĨ ŽƵƌ ϭϯ ĐŽƌĞ ĨĂĐƵůƚLJ ŵĞŵďĞƌƐ ĂŶĚ ŽŶĞ ƌĞƐŝĚĞŶƚ ůŽƐƚ ƚŚĞŝƌ the underserved of Ventura County. Many thanks to the all ŚŽŵĞƐ ƚŽ ƚŚĞ ŇĂŵĞƐ͘ DĂŶLJ ŵŽƌĞ ĂƌĞ ĚŝƐƉůĂĐĞĚ ĂŶĚ ĞǀĂĐƵĂƚĞĚ͘ ǁŚŽ ŚĂǀĞ ƉƌŽǀŝĚĞĚ ƐƵƉƉŽƌƚ ĨŽƌ ƵƐ ŝŶ ƚŚŝƐ ĚŝĸĐƵůƚ ƟŵĞ͘

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California Family Physician Winter 2018

CAFP’s 2018 Officers to be Elected at the AMAM dŚĞ &W EŽŵŝŶĂƟŶŐ ŽŵŵŝƩĞĞ͕ ĐŚĂŝƌĞĚ ďLJ /ŵŵĞĚŝĂƚĞ WĂƐƚ WƌĞƐŝĚĞŶƚ >ĞĞ ZĂůƉŚ͕ ŚĂƐ ƉƌŽƉŽƐĞĚ ƚŚĞ ĨŽůůŽǁŝŶŐ ƐůĂƚĞ ŽĨ ĐĂŶĚŝĚĂƚĞƐ ĨŽƌ ϮϬϭϴ &W ŽĸĐĞƐ͗ WƌĞƐŝĚĞŶƚͲĞůĞĐƚ ϮϬϭϴͲϭϵ ʹ tĂůƚĞƌ DŝůůƐ͕ D ^ƉĞĂŬĞƌ ϮϬϭϴͲϭϵ ʹ ĂǀŝĚ ĂnjnjŽ͕ D sŝĐĞ ^ƉĞĂŬĞƌ ϮϬϭϴͲϭϵ ʹ ^ŚĂŶŶŽŶ ŽŶŶŽůůLJ͕ D &W ĞůĞŐĂƚĞ ϮϬϭϴͲϭϵ ʹ ĂƌŽů ,ĂǀĞŶƐ͕ D &W ůƚĞƌŶĂƚĞ ĞůĞŐĂƚĞ ϮϬϭϴͲϮϬϭϵ ʹ >ĞĞ ZĂůƉŚ͕ D EĞǁ WŚLJƐŝĐŝĂŶ ŝƌĞĐƚŽƌ͕ &W ŽĂƌĚ ϮϬϭϴͲϮϬϮϭ ʹ ůĞdž DƌŽƐnjĐnjLJŬͲDĐ ŽŶĂůĚ͕ D EŽŵŝŶĂƟŶŐ ŽŵŵŝƩĞĞ ŵĞŵďĞƌƐ ĨŽƌ ϮϬϭϴͲϭϵ ĨƌŽŵ ƚŚĞ ůů DĞŵďĞƌ ĚǀŽĐĂĐLJ DĞĞƟŶŐ ĞůĞŐĂƚĞƐ ʹ Asma Jafri, MD and Monique George, MD ^ĞĐƌĞƚĂƌLJͬdƌĞĂƐƵƌĞƌ ϮϬϭϴͲϮϬϭϵ ;ŽŶĞͲLJĞĂƌ ƚĞƌŵͿ ʹ >ĂƵƌĞŶ ^ŝŵŽŶ͕ D ĚŝƚŽƌ ϮϬϭϴͲϮϬϮϭ ʹ ƌĞŶƚ <͘ ^ƵŐŝŵŽƚŽ͕ D ͕ DW, dŚĞ ĞůĞĐƟŽŶƐ ƚĂŬĞ ƉůĂĐĞ Ăƚ ƚŚĞ ϮϬϭϴ ůů DĞŵďĞƌ ĚǀŽĐĂĐLJ DĞĞƟŶŐ͕ DĂƌĐŚ ϭϬͲϭϭ͕ ŝŶ ^ĂĐƌĂŵĞŶƚŽ͘ ŚĂƉƚĞƌ ĚĞůĞŐĂƚĞƐ ĂƌĞ ĞůŝŐŝďůĞ ƚŽ ǀŽƚĞ ĨŽƌ Ăůů ƉŽƐŝƟŽŶƐ͕ ĞdžĐĞƉƚ ^ĞĐƌĞƚĂƌLJͬdƌĞĂƐƵƌĞƌ͕ ǁŚŽ ŝƐ ĞůĞĐƚĞĚ ŽĨ ĂŶĚ ďLJ ƚŚĞ ŽĂƌĚ ŽĨ ŝƌĞĐƚŽƌƐ͕ ĂŶĚ ĚŝƚŽƌ͕ ĂůƐŽ ĐŚŽƐĞŶ ďLJ ƚŚĞ ŽĂƌĚ͘ dŚĞ D D ŝƐ ŽƉĞŶ ƚŽ Ăůů &W ŵĞŵďĞƌƐ͘ ZĞŐŝƐƚĞƌ ƚŽĚĂLJ ĂŶĚ ĐŽŶƚĂĐƚ ^ŚĂŶŶŽŶ 'ŽĞĐŬĞ͕ ƐŐŽĞĐŬĞΛĨĂŵŝůLJĚŽĐƐ͘ŽƌŐ ĨŽƌ ŵŽƌĞ ŝŶĨŽƌŵĂƟŽŶ ŽŶ LJŽƵƌ ĐŚĂƉƚĞƌ͛Ɛ ĚĞůĞŐĂƟŽŶ͘

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FAIRMONT ORCHID KOHALA COAST, BIG ISLAND, HAWAII MARCH 5–9, 2018 Optional Pre-Course Sessions: March 4, 2018

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California Family Physician Winter 2018

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Mayo Clinic School of Continuous Professional Development

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Susan Hogeland, CAE

We’re Keeping our Eyes, Ears and Hearts Open! California is an amazing state – amazingly good and, ƐŽŵĞƟŵĞƐ͕ ĂŵĂnjŝŶŐůLJ ďĂĚ͘ ĂƚĂƐƚƌŽƉŚĞ ĂůǁĂLJƐ ůŽŽŵƐ ʹ ǁŚĞƚŚĞƌ ŝƚ ŝƐ ĚƌŽƵŐŚƚ͕ ĮƌĞƐ͕ ŵƵĚƐůŝĚĞƐ͕ ŇŽŽĚƐ Žƌ ĞĂƌƚŚƋƵĂŬĞƐ ʹ ǁĞ ůŝǀĞ ůŝƚĞƌĂůůLJ ŽŶ ƚŚĞ ĞĚŐĞ͘ dŚĞ ĐLJĐůĞ ĐĂŶ ďĞ ƐŽŵĞǁŚĂƚ ƉƌĞĚŝĐƚĂďůĞ͕ ĂůƚŚŽƵŐŚ ŶŽƚ ĂůǁĂLJƐ͘ ƵƌŝŶŐ ŽƵƌ ŵŽƐƚ ƌĞĐĞŶƚ ĚƌŽƵŐŚƚ͕ ŽƉƉŽƌƚƵŶŝƐƟĐ ĚŝƐĞĂƐĞƐ ƐƚƌƵĐŬ ŽƵƌ ǁŽŶĚĞƌĨƵů ƉŝŶĞƐ͕ live oaks and other trees, making them more vulnerable to ĮƌĞ͘ tŚĞŶ ǁĞ ĮŶĂůůLJ ŐŽƚ Ă ďĞƩĞƌ ƚŚĂŶ ŶŽƌŵĂů ƌĂŝŶĨĂůů ŝŶ ϮϬϭϲ͕ ƉƌĞĚŝĐƟŽŶƐ ŽĨ ŵƵĚƐůŝĚĞƐ͕ ŇŽŽĚ ĂŶĚ ĮƌĞ ǁĞƌĞ ŵĂĚĞ͘ dŚĞ ŵƵĚƐůŝĚĞƐ ǁĞƌĞ ĨĞǁ͕ ĂŶĚ ƚŚĞ ŇŽŽĚƐ ;ĂŶƟĐŝƉĂƚĞĚ ĨƌŽŵ ƐƵƉĞƌĂďƵŶĚĂŶƚ ƐŶŽǁĨĂůů ŝŶ ƚŚĞ ^ŝĞƌƌĂƐͿ ĨĂŝůĞĚ ƚŽ ŵĂƚĞƌŝĂůŝnjĞ ĨŽƌ ƌĞĂƐŽŶƐ ƵŶŬŶŽǁŶ ƚŽ ŵĞ͘ dŚĞ ǁĞĞĚƐ ĂŶĚ ŐƌĂƐƐĞƐ ŐƌĞǁ ůŝŬĞ ĐƌĂnjLJ͕ ŽĨ ĐŽƵƌƐĞ͘ Ƶƚ ƚŚĞ ĮƌĞƐ ǁĞ ĞdžƉĞƌŝĞŶĐĞĚ ŝŶ KĐƚŽďĞƌ ĂŶĚ ĞĐĞŵďĞƌ ǁĞƌĞ ďĞLJŽŶĚ ŽƵƌ ǁŽƌƐƚ ŶŝŐŚƚŵĂƌĞƐ͘ Ɛ Ă ϰϬͲƉůƵƐ LJĞĂƌ ƌĞƐŝĚĞŶƚ ŽĨ ƚŚĞ ƐƚĂƚĞ͕ /͛ǀĞ ŶŽǁ ĞdžƉĞƌŝĞŶĐĞĚ ƚŚĞ ϭϵϴϵ ϲ͘ϵ ŵĂŐŶŝƚƵĚĞ ĞĂƌƚŚƋƵĂŬĞ͖ ƚŚĞ ϭϵϵϭ KĂŬůĂŶĚ ,ŝůůƐ ĮƌĞ͕ Ă ĨĞǁ ƌƵŶͲŽĨͲƚŚĞͲŵŝůůͲƌŽĐŬͲĂŶĚͲƌŽůů ĞĂƌƚŚƋƵĂŬĞƐ ŽĨ ŶŽ ŐƌĞĂƚ ĐŽŶƐĞƋƵĞŶĐĞ ĂŶĚ ƚŚĞ ĮƌĞƐ ŝŶ ^ŽŶŽŵĂ͕ EĂƉĂ͕ ^ŽůĂŶŽ ĂŶĚ DĞŶĚŽĐŝŶŽͬ>ĂŬĞ ĐŽƵŶƟĞƐ͘ /Ŷ ĨĂĐƚ͕ / ǁĂƐ ŝŶ ,ĞĂůĚƐďƵƌŐ ʹ ĂďŽƵƚ ϭϱ ŵŝŶƵƚĞƐ ŶŽƌƚŚ ŽĨ ^ĂŶƚĂ ZŽƐĂ ŽŶ ,ŝŐŚǁĂLJ ϭϬϭ ʹ ƚŚĞ ŶŝŐŚƚ ƚŚĞ ^ŽŶŽŵĂ ĐŽŶŇĂŐƌĂƟŽŶ ďĞŐĂŶ͖ ƚŚĞ ƐƚƌŽŶŐ ƐŵĞůů ŽĨ ƐŵŽŬĞ ĂǁĂŬĞŶĞĚ ŵĞ Ăƚ ϭ Ăŵ ŽŶ KĐƚŽďĞƌ ϵ͘ /ƚ ǁĂƐ ƐŽ ƐƚĂƌƚůŝŶŐ ĂŶĚ ĐŽŵƉĞůůŝŶŐ ƚŚĂƚ / ƌĂŶ ŽƵƚ on the deck and looked up at the roof to see if our ŚŽƵƐĞ ǁĂƐ ŽŶ ĮƌĞ͘ dŚĞ ŶĞdžƚ ĚĂLJ ƚŚĞ ŐƌĂLJ Ăŝƌ ǁĂƐ ũƵƐƚ ĂƐ ďĂĚ ĂƐ LJŽƵ ƐĂǁ ŝŶ ŶĞǁƐ ĨŽŽƚĂŐĞ ʹ ĂƐŚ ǁĂƐ ĨĂůůŝŶŐ ŽǀĞƌ ĞǀĞƌLJƚŚŝŶŐ͕ ďƌĞĂƚŚŝŶŐ ǁĂƐ Ă ĐŚĂůůĞŶŐĞ ĂŶĚ ŶĞƌǀĞƐ ǁĞƌĞ ĨƌĂLJĞĚ͘ /ƚ ǁĂƐ ŚĂƌĚ ƚŽ ŐĞƚ ŶĞǁƐ ƐŝŶĐĞ ĐĂďůĞͬt/&/ ǁĞŶƚ ŽƵƚ͘ KŶĞ ŽĨ ŽƵƌ ŶĞŝŐŚďŽƌƐ ǁĂƐ ŽŶ Ă ĚŝīĞƌĞŶƚ ĐĂďůĞ ƐĞƌǀŝĐĞ͕ ĂŶĚ ƚŚĞŝƌ ds ǁĂƐ ǁŽƌŬŝŶŐ ĮŶĞ͕ ƐŽ ǁĞ ǁĂƚĐŚĞĚ ŝŶ ŚŽƌƌŽƌ ĂƐ ƚŚĞ ƉůĂĐĞƐ ǁĞ ƐŚŽƉƉĞĚ ĂŶĚ ǀŝƐŝƚĞĚ ǁĞŶƚ ƵƉ ŝŶ ŇĂŵĞƐ͕ ĐĞƌƚĂŝŶ ƚŚĂƚ ƚŚĞ ĚĞĂƚŚ ƚŽůů ǁŽƵůĚ ďĞ ŵƵĐŚ ŚŝŐŚĞƌ ƚŚĂŶ ƵůƟŵĂƚĞůLJ ŝƚ ǁĂƐ͘ >ĂƚĞƌ ŝŶ ƚŚĞ ĚĂLJ͕ ƌĞƐŝĚĞŶƚƐ ŝŶ ŽƵƌ ĚĞǀĞůŽƉŵĞŶƚ ǁĞƌĞ ƵƌŐĞĚ ƚŽ ĞǀĂĐƵĂƚĞ ŽŶ Ă ǀŽůƵŶƚĂƌLJ ďĂƐŝƐ͕ ďƵƚ ƵůƟŵĂƚĞůLJ ŽƵƌ ŚŽŵĞƐ ǁĞƌĞ ƐƉĂƌĞĚ͘ The Santa Rosa Press Democrat reports that one of every six ĚŽĐƚŽƌƐ ŝŶ ƚŚĞ ĐŝƚLJ ůŽƐƚ ƚŚĞŝƌ ŚŽŵĞƐ͘ dŚĞLJ ƚĂůůŝĞĚ ϳϳ Ăƚ <ĂŝƐĞƌ͕ ϯϳ Ăƚ ^ƵƩĞƌ ,ĞĂůƚŚ ĂŶĚ ϱϰ Ăƚ DĞŵŽƌŝĂů ,ŽƐƉŝƚĂůͬ^ƚ͘ :ŽƐĞƉŚ ,ĞĂůƚŚ͘ dŚĞ ƚŽůů ĂŵŽŶŐ ƚŚĞ ĞŶƟƌĞ ƐƚĂī ŽĨ ƚŚĞ ƚŚƌĞĞ ĨĂĐŝůŝƟĞƐ ǁĂƐ ϰϬϲ ĚĞƐƚƌŽLJĞĚ ŚŽŵĞƐ͘

30

California Family Physician Winter 2018

KƚŚĞƌƐ ǁƌŝƚŝŶŐ ŝŶ ƚŚŝƐ ĞĚŝƚŝŽŶ ǁŝůů ĞdžƚŽůů ƚŚĞ ŽƵƚƌŝŐŚƚ heroism of the family medicine residents, attending physicians and other health care clinicians and support ƐƚĂĨĨ ǁŚŽ͕ Ăƚ ƚŚĞŝƌ ŽǁŶ ŐƌĞĂƚ ƉĞƌŝů͕ ĞǀĂĐƵĂƚĞĚ ĞǀĞƌLJ ƉĂƚŝĞŶƚ from the Sutter and Kaiser facilities and then cared for them in gymnasiums, community centers, schools, etc. ƵŶƚŝů ƚŚĞLJ ĐŽƵůĚ ďĞ ŵŽǀĞĚ ƐĂĨĞůLJ ƚŽ ŚŽƐƉŝƚĂůƐ ĞůƐĞǁŚĞƌĞ͘ KƵƌ ŽǁŶ WƌĞƐŝĚĞŶƚͲĞůĞĐƚ͕ >ŝƐĂ tĂƌĚ͕ ^ĂŶƚĂ ZŽƐĂ ZĞƐŝĚĞŶĐLJ Program Director Tara Scott and Kaiser Residency Program ŝƌĞĐƚŽƌ WĂƚƌŝĐŝĂ ,ŝƐĞƌŽƚĞ ǁĞƌĞ ĂŵŽŶŐ ƚŚŽƐĞ ǁŚŽ ŵŽƌĞ ƚŚĂŶ ƌŽƐĞ ƚŽ ƚŚĞ ĐŚĂůůĞŶŐĞ ŝŶ ƚŚĞ ĚĂLJƐ ĨŽůůŽǁŝŶŐ ƚŚĞ ĨŝƌĞ ĂŶĚ ĞǀĞŶ ŶŽǁ ƚŽ ĞŶƐƵƌĞ ƉĂƚŝĞŶƚƐ ĂƌĞ ĐĂƌĞĚ ĨŽƌ ĂŶĚ ĨĂŵŝůLJ medicine residents’ training is not critically disrupted. The challenges to our members in the affected counties ĂƌĞ ĨĂƌ ĨƌŽŵ ŽǀĞƌ͘ dŚĞ ƉĂƌĂĚĞ ŽĨ ƉĂƚŝĞŶƚƐ ĚĞĂůŝŶŐ ǁŝƚŚ ƚŚĞŝƌ ŽǁŶ ƚƌĂƵŵĂƐ ĨƌŽŵ ƚŚĞ ĨŝƌĞƐ ĂƐ ǁĞůů ĂƐ ƚŚĞŝƌ ŚĞĂůƚŚ conditions continues unabated if not at a greater rate than before. Our members have provided their care despite ĚĞĂůŝŶŐ ǁŝƚŚ ƚŚĞŝƌ ŽǁŶ ƚƌĂƵŵĂƐ ĂŶĚ ůŽƐƐĞƐ ĂŶĚ ĚŝƐƌƵƉƚĞĚ Žƌ ĚĂŵĂŐĞĚ ĐůŝŶŝĐƐ͕ ŽĨĨŝĐĞƐ ĂŶĚ ŚŽƐƉŝƚĂůƐ͘ /ƚ͛Ɛ ǁŚĂƚ ƚŚĞLJ do. The CAFP Foundation and CAFP each have contributed ΨϭϬ͕ϬϬϬ ƚŽ ƚŚĞ &W &ŽƵŶĚĂƚŝŽŶ &ŝƌĞ &ƵŶĚ͕ ǁŚŝĐŚ ŝƐ ŶĞĂƌůLJ ΨϰϬ͕ϬϬϬ ŶŽǁ͕ ƚŚĂŶŬƐ ƚŽ ƚŚĞ ŐĞŶĞƌŽƐŝƚLJ ŽĨ ŽƵƌ ŵĞŵďĞƌƐ and members of the family medicine family. We are ǁŽƌŬŝŶŐ ǁŝƚŚ ĂƌĞĂ ƉŚLJƐŝĐŝĂŶ ůĞĂĚĞƌƐ ƚŽ ĚĞƚĞƌŵŝŶĞ ƚŚĞ ďĞƐƚ ŝŶǀĞƐƚŵĞŶƚ ŽĨ ƚŚĞƐĞ ĨƵŶĚƐ ĂŶĚ ŚŽǁ ƚŽ ƉƌŽǀŝĚĞ ƚŚĞ ƐƵƉƉŽƌƚ ŽƵƌ ŵĞŵďĞƌƐ ŶĞĞĚ ĨŽůůŽǁŝŶŐ ƚŚĞƐĞ ĚĞǀĂƐƚĂƚŝŶŐ ĨŝƌĞƐ͕ ĂŶĚ ǁŝůů ŬĞĞƉ LJŽƵ ĂƉƉƌŝƐĞĚ͘ As this goes to press, more devastating fires have struck, this time in Southern California. Faculty members and at least one resident at the Ventura Family Medicine Residency Program have lost their homes. The CAFP &ŽƵŶĚĂƚŝŽŶ ǁŝůů ĂŐĂŝŶ ƐĞĞŬ ƚŽ ƌĂŝƐĞ ĨƵŶĚƐ ƚŽ ƐƵƉƉŽƌƚ ŽƵƌ members in the south. tĞ͛ƌĞ ŬĞĞƉŝŶŐ ŽƵƌ ĞLJĞƐ͕ ĞĂƌƐ ĂŶĚ ŚĞĂƌƚƐ ŽƉĞŶ͊ tĂŶƚ ƚŽ ĂƐƐŝƐƚ͍ ŽŶĂƚĞ ƚŽ ƚŚĞ &W &ŽƵŶĚĂƚŝŽŶ Fire Relief Fund: ŚƚƚƉƐ͗ͬ​ͬĨĂŵŝůLJĚŽĐƐ͘ƐĞĐƵƌĞ͘ĨŽƌĐĞ͘ĐŽŵͬĨŽƵŶĚĂƚŝŽŶͬ

A well established federally qualified health center in Long Beach, California for almost 80 years is adding team members to our Primary Care Department.

Full-time, Part-time, and Per Diem Family Medicine Physicians Requirements: California license, DEA license, CPR certification and Board Certified. Bilingual English/Spanish preferred.

TCC is an equal opportunity employer, supporting workplace diversity. We have great interest in candidates with diverse background and unique experiences. ATTN: Annissa Jaramillo, Executive Assistant to CMO ajarmillo@thechildrensclinic.org • (562) 264-4674

Please feel free to visit us at our website

www.thechildrensclinic.org

communitymedicalcenters.org

BE A PART OF IMPROVING THE HEALTH OF OUR COMMUNITY If you are passionate about patient care and want to work with a dedicated and diverse staff, CMC is for you. Headquartered in Stockton, California, we are a Joint Commission accredited FQHC with 16 community health centers in San Joaquin, Solano, and Yolo counties. We are looking for enthusiastic, mission-driven Family Practice physicians to join our team. Teaching opportunities are available.

Competitive Salary • Moving Allowance • CME • Incentives • Loan Repayment For more information or to send us your CV now: Carol Llewellyn | cllewellyn@cmcenters.org Fax (209) 373-2878 | P.O. Box 779| Stockton, CA 95201

CALIFORNIA ACADEMY OF FAMILY PHYSICIANS 1520 PACIFIC AVE SAN FRANCISCO, CA 94109 -2627

Presorted Standard U.S. POSTAGE PAID

Little Rock, AR Permit No. 2437

MIEC just announced $13 Million in dividends* MIEC provides Medical Professional Liability Insurance with a dividend policy vastly superior to our competitors and we’ve never lost site of the medical associations who back our policyholders. Our mission: provide our policyholders and local medical communities with the exemplary service and support they deserve. For more information or to apply: www.miec.com

800.227.4527

underwriting@miec.com

* On premiums at $1/3 million limits. Future dividends cannot be guaranteed.

MIEC

Owned by the policyholders we protect CAFP_ad_12.11.17

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