January 2011
o ff i c i a l pu b l i c a t i o n o f
the san diego county medical society
Reaching
8,500 Physicians
Every Month
CMA Goals
2011 for
Working Together With SDCMS, We Are Indeed Stronger
“ P h y s i c i a n s U n i t e d F o r A H e a l t h y S a n D i e g o ”
We hate lawsuits. We loathe litigation. We help doctors head off claims at the pass. We track new treatments and analyze medical advances. We are the eyes in the back of your head. We make CME easy, free, and online. We do extra homework. We protect good medicine. We are your guardian angels. We are The Doctors Company. Donald J. Palmisano, MD, JD, FACS Board of Governors, The Doctors Company Past President, American Medical Association
The Doctors Company is devoted to helping doctors avoid potential lawsuits. For us, this starts with patient safety. In fact, we have the largest Department of Patient Safety/Risk Management of any medical malpractice insurer. And, local physician advisory boards across the country. Why do we go this far? Because sometimes the best way to look out for the doctor is to start with the patient. The San Diego County Medical Society has exclusively endorsed our medical professional liability program since 2005. To learn more about our program for SDCMS members, call (800) 328-8831, extension 4390, or visit us at www.thedoctors.com/sdcms.
Exclusively endorsed by
B
S A N  D I E G O  P HY S I CI A N .or g ja n u a ry 2011
ARE YOU READY FOR EHR? ARE YOU READY FOR EHR? ARE YOU READY FOR EHR? CHMB – The Choice for EHR & Successful Adoption CHMB – The performance Choice forstarts EHR Successful among Adoption Improved business with&CHMB—ranked the top providers for EHRfor Adoption &&Implementation Here’s Improved starts with CHMB—ranked among the top CHMB inbusiness – California The performance Choice EHR SuccessfulServices. Adoption
why hundreds of physicians have selected&CHMB for building and installing providers in California for EHR Adoption Implementation Services. Here’s Improved business performance starts with CHMB—ranked among the top the Allscripts EHR application into their community practices: why hundreds of physicians have selected CHMB for building and installing providers in California for EHR Adoption & Implementation Services. Here’s the Allscripts EHR application into their community practices: why hundreds of LOCAL physicians have selected CHMB for building and installing NATIONAL AND EXPERTISE the Allscripts EHR application into their community practices: AND LOCALwith EXPERTISE •NATIONAL Established footprint 1,000 community physicians and clinics statewide ••NATIONAL Established footprint with physicians&and clinics statewide AND LOCAL EXPERTISE Experts who know the full1,000 story–community Hardware Selection Procurement, Network Configuration, Application SupportSelection • Experts who know the full story–community Hardware Procurement, Established footprint with 1,000 physicians&and clinics statewide Network Configuration, Application Support TARGETED SOLUTIONS • Experts who know the full story– Hardware Selection & Procurement, SOLUTIONS •TARGETED World Class Portfolio – Clinical and Business Network Configuration, Application Support Solutions – Allscripts, Dell,
“CHMB has been our trusted “business CHMB has been our trusted partner for more than business partner forperfect more than years. Itbeen madeour sense “six CHMB has trusted six years. It sense that whenpartner wemade decided to move business forperfect more than that when wemade decided to practice, move forward with EHR in our six years. It perfect sense forward with EHR in our practice, we entrusted our implementation that when we decided to move we entrusted our implementation of Allscripts them as well. They forward withtoEHR in our practice, of toour them asevery well. step They have been there for us weAllscripts entrusted implementation have been there for us of way!” of the Allscripts to them asevery well. step They of the way!” have been there for us every step ELIZABETH SILVERMAN, MD
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Orange County — 7700 Irvine Center Drive, Ste 290, Irvine, CA 92618 Geoff Doyle • 1.760.520.1343 Marianne Gregson • 1.760.520.1333 760.520.1400 800.727.5662 • www.chmbsolutions.com Ron Anderson • 1.760.520.1340 San Diego County —• 1121 East Washington Ave., Escondido, CA 92025 Geoff Doyle • 1.760.520.1343 www.chmbsolutions.com 760.520.1400 • 800.727.5662 • Orange County — 7700 Irvine Center Drive, Ste 290, Irvine, CA 92618 Marianne Gregson • 1.760.520.1333 Geoff Doyle • 1.760.520.1343 760.520.1400 • www.chmbsolutions.com CHMB delivers tHe HigHest level of serviCe and expertise to ensure•a800.727.5662 swift, sMootH and suCCessful eHr CoMpletion. CHMB delivers tHe HigHest level of serviCe and expertise to ensure a swift, sMootH and suCCessful eHr CoMpletion.
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5/26/10 12:04 PM
thismonth Volume 98, Number 1
Managing Editor Kyle Lewis Editorial Board Van L. Cheng, MD, Adam F. Dorin, MD, Kimberly M. Lovett, MD, Theodore M. Mazer, MD, Robert E. Peters, PhD, MD, David M. Priver, MD, Roderick C. Rapier, MD Marketing & Production Manager Jennifer Rohr Sales Director Dari Pebdani Project Designer Lisa Williams Copy Editor Adam Elder
features CMA Goals for 2011
24 departments
24 Working Together With Sdcms, We Are Indeed Stronger by James T. Hay, MD 28 CALPAC: Physicians Fighting for Physicians by Susan Kaweski, MD
SDCMS Board of Directors Officers President Susan Kaweski, MD Past President Lisa S. Miller, MD President-elect Robert E. Wailes, MD Treasurer Sherry L. Franklin, MD Secretary Robert E. Peters, MD, PhD geographic and geographic alternate Directors East County William T. Tseng, MD, Heywood “Woody” Zeidman,
MD (A: Venu Prabaker, MD) Hillcrest Niren Angle, MD, Steven A. Ornish, MD Kearny Mesa John G. Lane, MD (A: Jason P. Lujan, MD) La Jolla J. Steven Poceta, MD, Wynnshang “Wayne” Sun, MD (A: Matt H. Hom, MD) North County James H. Schultz, MD, Doug Fenton, MD (A: Steven A. Green, MD) South Bay Vimal I. Nanavati, MD, Mike H. Verdolin, MD (A: Andres Smith, MD) At-large and At-large alternate Directors Jeffrey O. Leach, MD, Bing S. Pao, MD, Kosala Samarasinghe, MD, David E.J. Bazzo, MD, Mark W. Sornson, MD, Mihir Y. Parikh, MD (A: Carol L. Young, MD, Thomas V. McAfee, MD, Ben Medina, MD, James E. Bush, MD, Alan A. Schoengold, MD)
12
4 SDCMS Seminars, Webinars, and Events for 2011 Mark Your Calendars!
other board members Communications Chair Theodore M. Mazer, MD Young Physician Director Van L. Cheng, MD Alternate Young Physician Director Kimberly M. Lovett, MD
6 Community Healthcare Calendar
Resident Physician Director Katherine M. Whipple, MD Alternate Resident Physician Director Steve H. Koh, MD
8 Briefly Noted SDCMS Medical Office Manager Bulletin Board, and More …
Retired Physician Director Rosemarie M. Johnson, MD Alternate Retired Physician Director Mitsuo Tomita, MD Medical Student Director Adi J. Price
10 Sdcms Foundation
CMA PRESIDENT-ELECT James T. Hay, MD
12 Health Information Technology
CMA Past Presidents Robert E. Hertzka, MD (LEGISLATIVE
CMA VICE SPEAKER OF THE HOUSE Theodore M. Mazer, MD
Scholarship Awardee: Embodying the Spirit of Service
ex-officio, nonvoting board members COMMITTEE CHAIR), Ralph R. Ocampo, MD
Transitioned to an EHR System Yet? If Not, CalHIPSO Is Here to Help!
14 SDCMS Membership Thank You to These SDCMS-CMA Members for Your 40+ Years of Membership 18 SDCMS Benefits
20 Ways to Make SDCMS.org Work for You!
34 Physician Marketplace
CMA district I Trustees Albert Ray, MD, Robert E. Wailes, MD,
Sherry L. Franklin, MD CMA Trustee (other) Catherine D. Moore, MD,
18
CMA SOLO AND SMALL-GROUP PRACTICE FORUM DELEGATES
Michael T. Couris, MD, James W. Ochi, MD ALTERNATE CMA SOLO AND SMALL-GROUP PRACTICE FORUM DELEGATE Dan I. Giurgiu, MD AMA Delegates James T. Hay, MD, Robert E. Hertzka, MD Alternate AMA Delegates Lisa S. Miller, MD, Albert Ray, MD
Classifieds
36 A Dinosaur’s Story
A Few Words From an Old Doc
2
S A N D I E G O P HY S I CI A N .or g ja n u a ry 2011
Opinions expressed by authors are their own and not necessarily those of San Diego Physician or SDCMS. San Diego Physician reserves the right to edit all contributions for clarity and length as well as to reject any material submitted. Not responsible for unsolicited manuscripts. Advertising rates and information sent upon request. Acceptance of advertising in San Diego Physician in no way constitutes approval or endorsement by SDCMS of products or services advertised. San Diego Physician and SDCMS reserve the right to reject any advertising. Address all editorial communications to Editor@SDCMS.org. All advertising inquiries can be sent to DPebdani@SDCMS.org. San Diego Physician is published monthly on the first of the month. Subscription rates are $35.00 per year. For subscriptions, email Editor@SDCMS.org. [San Diego County Medical Society (SDCMS) Printed in the U.S.A.]
FAST. ACCURATE. POWERFUL. THAT’S HOW CANCER TREATMENT SHOULD BE. At San Diego Radiosurgery, we offer treatment using the Novalis Tx platform for image-guided radiosurgery. Novalis Tx incorporates advanced imaging, treatment planning, and treatment delivery technologies from Varian Medical Systems and BrainLAB, enabling fast, highly precise, non-invasive radiosurgery treatments for cancers and other conditions in the brain, head, neck and body. Offering a dose rate of 1,000 MU per minute, Novalis Tx is the most powerful and fastest radiosurgery system available, penetrating deeper to treat tumors previously considered inoperable. Call or visit our website for more information. Palomar Medical Center Department of Radiation Oncology 555 East Valley Parkway | Escondido, CA 92025 760-739-3835 / SDRadiosurgery.com
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january 2011 SAN DIEGO P HY SIC I A N. o rg
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sdcmsbenefits
sdcms seminars / webinars / events for 2011 For further information or to register for any of the following SDCMS seminars, webinars, or events, visit SDCMS.org or contact Sonia Gonzales at (858) 300-2782 or at SGonzales@SDCMS.org.
January DATE
DAY
S=Seminar • W=Webinar • E=Event TIME
TOPIC
PRESENTER
S
W
13
Thursday
11:30AM –1:00PM
Collection Procedures
TSC Accounts Receivable Solutions
x
x
20
Thursday
11:30AM –1:00PM
Palmetto GBA/Medicare • Provider Enrollment
Palmetto GBA
x
x
22
Saturday
8:00AM –1:00PM
Advocacy Training
SDCMS
x
26
Wednesday
6:30PM –7:30PM
Simple Approaches to Informed Consent and Informed Refusal
The Doctors Company
x
27
Thursday
11:30AM –12:30PM
Simple Approaches to Informed Consent and Informed Refusal
The Doctors Company
x
30
Sunday
4:00PM –7:00PM
Membership Social
SDCMS
E
x
February DATE
DAY
TIME
TOPIC
PRESENTER
S
W
3
Thursday
11:30AM –1:00PM
Treating Patients Right
Practice Performance Group
x
x
4, 11, 18, 25
Fridays
8:00AM –4:00PM
Certified Medical Insurance Specialist
Practice Management Institute
x
10
Thursday
11:30AM –1:00PM
Contract Negotiations
Coastal Healthcare Consulting Group
x
x
24
Thursday
11:30AM –12:30PM
Identity Theft
Detective Jim Troussel (SDPD)
x
x
E
March DATE
DAY
TIME
TOPIC
PRESENTER
S
W
3
Thursday
11:30AM –1:00PM
Legalities of Hiring
(TBD)
x
x
12
Saturday
8:00AM –12:00PM
Media Training
SDCMS
x
17
Thursday
11:30AM –1:00PM
Medicare Updates
CMA
x
26
Saturday
8:00PM –11:30AM
Outlook for Busy Docs
SDCMS
x
E
x
April
4
DATE
DAY
TIME
TOPIC
PRESENTER
S
(TBD)
(TBD)
8:00AM –4:00PM
Preparing to Practice
Multiple Presenters
x
W
7
Thursday
11:30AM –1:00PM
Anticipating Retirement
Practice Performance Group
x
14
Thursday
11:30AM –1:00PM
Disciplinary Actions/Employee Terminations
Koumas Law Group
x
x
27
Wednesday
6:00PM –7:30PM
Disclosure Doing the Right Thing in the Right Way
The Doctors Company
x
x
28
Thursday
11:30AM –1:00PM
Disclosure Doing the Right Thing in the Right Way”
The Doctors Company
x
x
S A N D I E G O P HY S I CI A N .or g ja n u a ry 2011
x
E
May
S=Seminar • W=Webinar • E=Event
DATE
DAY
TIME
TOPIC
PRESENTER
S
W
5
Thursday
11:30AM –1:00PM
Best Practices in Revenue Cycle
CHMB Solutions
x
x
12
Thursday
11:30AM –1:00PM
Medi-Cal Updates
Medi-Cal Training
x
x
19
Thursday
11:30AM –1:00PM
IT Update and Overview
SOUNDOFF Computing
x
x
20, 21
Friday – Saturday
8:00AM –4:00PM
Leader’s Toolbox
SDCMS
x
26
Thursday
11:30AM –1:00PM
Coding Specifics: ICD-10
CHMB Solutions
x
x
DAY
TIME
TOPIC
PRESENTER
S
W
E
june DATE 2
Thursday
11:30AM –1:00PM
Legal Issues for Physicians
CMA
x
x
9
Thursday
11:30AM –1:00PM
Focus on Payer Contracts
Coastal Healthcare Consulting Group
x
x
DATE
DAY
TIME
TOPIC
PRESENTER
S
W
6
Wednesday
6:30PM –7:30PM
Risky Business: Avoiding Common Medical Malpractice Concerns in a Busy Office
The Doctors Company
x
7
Thursday
11:30AM –12:30PM
Risky Business: Avoiding Common Medical Malpractice Concerns in a Busy Office
The Doctors Company
x
E
july E
august DATE
DAY
TIME
TOPIC
PRESENTER
S
W
4
Thursday
11:30AM –1:00PM
HIPAA And HiTech Act Updates
PrivaPlan
x
x
11
Thursday
11:30AM –1:00PM
OSHA Updates
(TBD)
x
x
20
Saturday
8:30AM –11:30AM
Microsoft Outlook for Busy Docs
SDCMS
x
E
SEPTEMBER DATE
DAY
TIME
TOPIC
PRESENTER
S
W
1
Thursday
11:30AM –1:00PM
Changes to Medicare Regulations
CMA
x
x
8
Thursday
11:30AM –1:00PM
Deposition Seminar for Doctors
Alexander & Alexander
x
x
15
Thursday
11:30AM –1:00PM
The How-to’s of Appeals
(TBD — possibly MedClaims)
x
x
W
E
OCTOBER DATE
DAY
TIME
TOPIC
PRESENTER
S
7, 14, 21, 28, Nov. 4
Fridays
8:00AM –4:00PM
Certified Medical Coder
Practice Management Institute
x
13
Thursday
11:30AM –1:00PM
10 Strategies for Economic Survival
AKT CPA
x
x
27
Thursday
11:30AM –1:00PM
How to Oversee Your Biller(s)
MedClaims
x
x
S
W
E
NOVEMBER DATE
DAY
TIME
TOPIC
PRESENTER
16
Wednesday
6:30PM –7:30PM
Litigation Traps for Surgical Practices
The Doctors Company
x
17
Thursday
11:30AM –12:30PM
Litigation Traps for Surgical Practices
The Doctors Company
x
E
january 2011 SAN DIEGO P HY SIC I A N. o rg
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calendar
community Healthcare Calendar 30th Annual Advanced Nephrology: Nephrology for the Consultant Jan. 27–29 • Estancia La Jolla Hotel and Spa • AMA PRA Category 1 Credit • http://cme. ucsd.edu/nephrology Perioperative Care of the Older Patient Symposium Jan. 28 • 7:30am–4:00pm • Arnold and Mabel Beckman Center of the National Academies of Sciences and Engineering, Irvine • http://www.som.uci.edu/ Geriatrics/PDF/perioperative_ symposium1-28-11.pdf
West Coast Geriatric Psychiatry Conference Feb. 16–19 • Catamaran Resort Hotel, San Diego • http://cme. ucsd.edu Cell Society — First Annual Clinical Meeting Feb. 18–19 • Estancia La Jolla Hotel and Spa • https:// xmedicacme.com/cell_society • http://www.cellsociety.com Cross-cultural Considerations in End-of-life Care Until Feb. 28 • http://cme.ucsd. edu/crosscultural
To submit a physician-focused, San Diego County healthcare event for possible publication, email KLewis@SDCMS.org.
6
S A N D I E G O P HY S I CI A N .or g ja n u a ry 2011
Topics and Advances in Internal Medicine March 7–13 • San Diego Marriott, La Jolla • http://cme.ucsd.edu Emerging Molecular and Cellular Insights Into Heart Failure and Arrhythmias — The 13th La Jolla-International Cardiovascular Research Conference March 11–13 • Hilton Torrey Pines Hotel, La Jolla • AMA PRA Category 1 Credit • http://cme. ucsd.edu Topics and Advances in Pulmonary and Critical Care Medicine March 13–14 • San Diego Marriott, La Jolla • http://cme.ucsd.edu
Annual San Diego Science Festival, to Encourage Kids to Better Understand Science and Consider Careers in Science March 19–26 • PetCo Park • Email Mitsuo Tomita, MD, at mitsuo@cox.net • http://www. sdsciencefestival.com/host-anevent.html 12th Annual UC San Diego Stroke Conference May 14 • AMA PRA Category 1 Credit • http://cme.ucsd.edu/ stroke
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brieflynoted
SDCMS Medical Office Manager Save the Dates Ask Your Office Manager Advocate!
Question:
-10 Can you please provide me with ICD g doin be to need we t wha w kno information and let me now?
Answer:
the ICDIt is important to prepare now for are steps g win follo The n. 10 and Version 5010 transitio you can take to get started: ntation strategy • Providers: Develop an impleme impact on your the of nt ssme asse that includes an a budget. and line, time iled deta a , organization ringhouse, or Check with your billing service, clea or about their practice management software vend dle billing and han compliance plans. Providers who ld plan for shou ly rnal software development inte finance staff and IT, ical, clin g, medical records/codin transition 5010 ion Vers and -10 to coordinate on ICD efforts. since the transition • Payers: Review payment policies rules. Ask your to ICD-10 will involve new coding s plans and ines software vendors about their read ng, availtesti ent, timelines for product developm ICD-10. You and 5010 ion ability, and training for Vers transition and plan ion ntat should have an impleme budget in place.
By Sonia Gonzales,
Your Off ice Manager Advocate 8
S A N D I E G O P HY S I CI A N .or g ja n u a ry 2011
for these, The Best medical office manager seminars and Events!
✓ JAN 20: Palmetto GBA/Medicare “Provider Enrollment”
✓ JAN 26/27: “Simple Approaches to Informed Consent and Informed Refusal”
✓ FEB 3: “Treating Patients Right” ✓ FEB 4/11/18/25 (Four Fridays): Certified Medical Insurance Specialist Course
✓ FEB 10: “Contract Negotiations” ✓ MAR 3: “Legalities of Hiring”
• Software Vendors, Cle aringhouses, and Third party Billing Services: You should have produ cts and services in developm ent that will allow pay ers and providers to fully im plement Version 5010 on Jan. 1, 2012, and ICD-10 on Oct. 1, 2013. Begin talking to your customers now about preparing for the transition. Your produ cts and services will be obsolete if you do not take ste ps now to get ready. The Centers for Medic are and Medicaid Servic es (CMS) website — www.cms.go v/ICD10 — has official CMS resources to help you pre pare for Version 5010 an d ICD10. CMS will continue to add new tools and inf ormation to the site through out the course of the tra nsition, so check the site frequent ly for updated resource s. ICD-10 diagnosis codes must be used for all hea lthcare services provided in the United States on or after Oct. 1, 2013. ICD-10 pro cedure codes must be use d for all hospital inpatient pro cedures performed on or after Oct. 1, 2013. Claims wit h ICD-9 codes for servic es provided on or after Oct. 1, 2013, cannot be paid.
Win an iPod Touch!
SDCMS Office Ma na
gers: Here’s your chance to win an iPod Touc h! Please send your qu estions, comments , pictures, ideas — an ything that you woul d like to see on your SD CMS Medical Office Manager Bulletin Bo ard — to me, Sonia , at Sonia.Gonzales@ SDCMS.org or call me at (858) 300-27 82. The first five ide as received will be ente red into a drawing to receive an iPod Touc h. The winner will be announced in our Fe bruary issue.
: FOCUS L A SBEPCOECI CAL DI ME D FIE ME A CERTI Y 2011
IALIST IN FEBRUAR INSURANCE SPEC Key Course Objectives*: • Compliance nce • Basics of Health Insura ns Pla re Ca • Managed • Medicare te Programs • Medicaid and Other Sta on ati • Workers’ Compens
ctives, visit the tion of key course obje ns. *For a detailed descrip SDCMS.org/publicatio at an sici Phy go Die issue of San
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August
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Practice Management IS course presented by Register now for the CM mimd.com): Institute (PMI) (www.p ary: 4, 11, 18, 25 bru Fe in s day • Four Fri • 8 a.m.–4 p.m. Rd., Ste. 250, eting Room, 5575 Ruffin • Held at the SDCMS Me San Diego, CA 92123 99 (includes ers and Their Staff: $4 • Cost for SDCMS Memb ) ials tructional mater breaks, lunch, and ins taff: $999 s/S ber em nm No • Cost for Register: Questions or to nager advocate, S , your SDCM office ma Contact Sonia Gonzales MS.org. Sonia.Gonzales@SDC at (858) 300-2782 or at
CODING CORNER by Michelle Pena, CPC, CHMB (CAHealth.com)
Question: I heard that in 2011 Medicare will cover beneficiaries’ annual exams with no coinsurance. Is this true? Answer: Yes. As health reform continues to get under way, there have been some preventive care benefit changes for employer-based health plans and Medicare for 2011. The Patient Protection and Affordable Care Act mandates that group coverage plans provide coverage for preventive services without cost sharing (deductibles, copayments, etc.). It further instructs Medicare to provide “annual wellness visits resulting in a personalized prevention plan.” For Medicare beneficiaries, there will be two types of wellness exams covered with no deductible or coinsurance. The first is the “Welcome to Medicare” physical exam. This exam is covered within the first 12 months of the patient’s Part B effective date, and HCPCS code G0402 is used to identify this service. The second exam effective Jan. 1, 2011, is the “Annual Wellness Visit.” This exam is covered annually to develop or update a personalized prevention plan based on the patient’s health and risk factors. There is some speculation about the HCPCS code assigned, but, to date, nothing has been officially published by Medicare, so be on the lookout for Medlearns. References: Medicare.gov: www.medicare.gov/Publications/Pubs/ pdf/10050.pdf The Patient Protection and Affordable Care Act: democrats. senate.gov/reform/patient-protection-affordable-care-actas-passed.pdf CMS Manual System Transmittal 2093: www.cms.gov/ transmittals/downloads/R2093CP.pdf
january 2011 SAN DIEGO P HY SIC I A N. o rg
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Embodying the Spirit of Service
S AN D I E G O P HY S I CI A N. or g ja n u a ry 2011
J
essica Cruz knew from a young age that she wanted to pursue a career in medicine. As the youngest of six children to immigrant parents, she took responsibility for helping her parents manage their chronic health conditions. Raised in southeast San Diego, a community struggling with issues of drugs, gang violence, ethnic strife, and underemployment, Jessica was one of only four Latino students in her class to attend a University of California school. She graduated from the University of California, Los Angeles in 2007 with a B.S. in physiology science. While applying to medical schools, Jes-
you take care of the san diego communit y ’s health. we take care of san diego’s
healthcare communit y.
sica worked with HIV-positive patients as a case manager at Charles Drew University. She also has extensive experience volunteering to support students and vulnerable populations. In 2010, Jessica was accepted to her first choice of medical schools, the University of California, San Diego, School of Medicine. Jessica is interested in pursuing a career where she can focus on vulnerable patients. Regarding the scholarship, Jessica says, “Even more than the monetary assistance, I am grateful for the vote of confidence from the SDCMS Foundation. I am looking forward to a long medical career in San Diego.” Dr. Ellen Beck, chair of the Student Scholarship Committee, says, “The selection committee was very impressed with the quality and depth of the applicants. Several finalists, including Jes-
“Even more than the monetary assistance, I am grateful for the vote of confidence from the SDCMS Foundation. I am looking forward to a long medical career in San Diego.”
3 income Tax Planning 3 Wealth Management 3 employee Benefit Plans 3 Profitability Reviews 3 outsourced Professional services (CFo, Controller) 3 organizational and Compensation structure 3 succession Planning 3 Practice Valuations 3 internal Control Review and Risk Assessment
akt A KT LLP, CPAs and Business Consu LTAnTs CARL SBAD
ESCONDIDO
760-431-8440
sica, have overcome obstacles, served the community with dedication and commitment, and have dreams of service to the underserved.” The SDCMS Foundation is proud to support Jessica’s medical career through a $1,000 per year scholarship. For more information about the SDCMS Foundation Scholarship Program, or to support the Scholarship Program through a gift, please contact Kitty Bailey at Kitty.Bailey@SDCMS.org or at (858) 300-2780. About the Author: Ms. Bailey is the executive director of the SDCMS Foun-
S A N DIEGO
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RMITCHELL@AKTCPA.COM
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healthinformationtechnology By Kitty Bailey
Transitioned to an EHR System Yet? If Not, CalHIPSO Can Help!
CalHIPSO, the California Health Information Partnership and Services Organization, is a nonprofit, vendor-neutral organization founded by clinical providers1 to make available technical assistance, guidance, and information on best practices that support and accelerate providers’ efforts to become meaningful users of certified electronic health record (EHR) technology. CalHIPSO’s extensive products and services are designed to help physicians navigate the complex world of EHR adoption. CalHIPSO is primarily supported through stimulus funding to provide services to “priority primary care providers” (PPCP) to adopt EHRs by 2014. A PPCP is defined as a licensed clinician with a primary care practice and prescriptive privileges (MD, DO, NP, PA) who works in one of the following practice care settings: 1. private physician practice of 10 or fewer 2. nonprofit primary care clinics, including community health centers and rural health clinics 3. the ambulatory care clinics associated with public, rural, and critical access hospitals. Beginning in 2011, Medicare and Medi-Cal will make payments of between $44,000 and $63,750 to providers who can demonstrate that they are “meaningfully using” EHRs. The sooner you can demonstrate “meaningful use,” the more funding you will receive, since EHR incentive payments will end in 2014. As a PPCP member of CalHIPSO, you will have access to subsidized services including: • access to group purchasing discounts • assistance locating qualified EHR vendors • project management services • access to extensive training and education
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S AN D I E G O P HY S I CI A N. or g ja n u a ry 2011
If you are interested in learning more about CalHIPSO or in signing up, please visit the CalHIPSO website at www.calhipso. org or contact Kitty Bailey at the San Diego County Medical Society Foundation at Kitty.Bailey@SDCMS.org or at (858) 300-2780. health information technology to local communities. In San Diego and Imperial counties, the San Diego County Medical Society Foundation and the Community Clinics Health Network are providing technical services. If you are interested in learning more about CalHIPSO or in signing up, please visit the CalHIPSO website at www.calhipso. org or contact Kitty Bailey at the San Diego County Medical Society Foundation at Kitty. Bailey@SDCMS.org or at (858) 300-2780. 1) The California Medical Association, the California Primary Care Association, and the California Association of Public Hospitals and Health Systems. About the Author: Ms. Bailey is executive director of the SDCMS Foundation.
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• assistance with demonstrating meaningful use in order to begin receiving the federal incentive payments Non-PPCPs are also eligible to join CalHIPSO, but they must pay membership fees at the time of enrollment if they are not practicing in a predominantly primary care setting. Non-PPCPs are not eligible for subsidized CalHIPSO services but can purchase services on a fee-for-service basis (fees to be determined). CalHIPSO is working with 10 Local Extension Centers (LECs) around the state to bring
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sdcms-cmamembership SDCMS Would Like to Thank the Following Physicians for Their 40+ Years of SDCMS-CMA Membership Your Long-term Dedication to the Health and Wellbeing of Your Patients and of San Diego’s Physician Community Is to Be Applauded!
Joseph De Luca, MD
Milan L. Brandon, MD
Charles T. Fitch, MD
Ernest E. Pund, MD
Michael A. Zirpolo, MD
SDCMS-CMA Member Since 1948
SDCMS-CMA Member Since 1961
SDCMS-CMA Member Since 1961
SDCMS-CMA Member Since 1964
SDCMS-CMA Member Since 1967
Stanley J. Lloyd, MD
John C. Carson, MD
John E. Milner, MD
Richard M. Braun, MD
SDCMS-CMA Member Since 1951
SDCMS-CMA Member Since 1961
SDCMS-CMA Member Since 1962
SDCMS-CMA Member Since 1967
Margaret E. Branscom, MD SDCMS-CMA Member Since 1968
Lino P. Trombetta, MD
Marjorie A. Crews, MD
Edward J. Sheldon, MD
Garry E. Goldfarb, MD
Richard N. Learn, MD
SDCMS-CMA Member Since 1959
SDCMS-CMA Member Since 1961
SDCMS-CMA Member Since 1963
SDCMS-CMA Member Since 1967
SDCMS-CMA Member Since 1968
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S AN D I E G O P HY S I CI A N. or g ja n u a ry 2011
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619.287.9730 Michael I. Keller, M.D., Director Puja Chitkara, M.D. Ara H. Dikranian, M.D. Oleg Gavrilyuk, M.D. G. Paul Ignat, M.D. Mahmood Pazirandeh, M.D. Soumya Rao, M.D. Timothy F. Lazarek, N.P. Kevin Delgadillo, P.A.
Please support the advertisers who support your magazine!
www.SanDiegoArthritis.com january 2011 SAN DIEGO P HY SICIA N. o rg
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sdcms-cmamembership
Louis Lurie, MD
John A. Berger, MD
Frank B. Flint, MD
Donald J. Ritt, MD
SDCMS-CMA Member Since 1968
SDCMS-CMA Member Since 1969
SDCMS-CMA Member Since 1970
SDCMS-CMA Member Since 1970
SDCMS-CMA Member Since 1970
George N. Riffle, MD
Robert Penner, MD
Allan H. Rabin, MD
Duane Blickenstaff, MD
George W. Kaplan, MD
SDCMS-CMA Member Since 1968
SDCMS-CMA Member Since 1969
SDCMS-CMA Member Since 1970
SDCMS-CMA Member Since 1970
Leonard S. Bernstein, MD SDCMS-CMA Member Since 1971
Robert A. Bullock, MD
Leonard David Rutberg, MD SDCMS-CMA Member Since 1969
Richard O. Butcher, MD
Miguel A. Losada, MD
Sidney H. Levine, MD
SDCMS-CMA Member Since 1969
SDCMS-CMA Member Since 1970
SDCMS-CMA Member Since 1970
SDCMS-CMA Member Since 1971
Sanford M. Izner, MD
Harold J. Simon, MD
James C. Esch, MD
William L. Nyhan, MD
SDCMS-CMA Member Since 1969
SDCMS-CMA Member Since 1970
SDCMS-CMA Member Since 1970
Raymond M. Peterson, MD SDCMS-CMA Member Since 1971
SDCMS-CMA Member Since 1969
Thank you for your continued membership! Robert Matthew Thomas, MD SDCMS-CMA Member Since 1971
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Support the advertisers who support your magazine!
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When calling an advertiser, mention you saw their advertisement in San Diego Physician magazine. january 2011 SAN DIEGO P HY SICIA N. o rg
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sdcmsbenefits
20 Ways to Make SDCMS.org Work for You! Supporting You, Your Staff, Your Patients, and Your Practice
Last fall the San Diego County Medical Society (SDCMS) launched version three of our website — SDCMS.org — with a number of usability improvements and functionality enhancements. Take a look at the following, and if you have any questions, please contact Kyle Lewis at KLewis@SDCMS.org or at (858) 300-2784.
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Join Online in Under Five Minutes!
If you’re not yet an SDCMS-CMA member, joining is as easy as answering eight simple yes/no questions to determine your membership type (new, rejoining, young physician, military, government-employed, resident, medical student, etc.), after which the system calculates your dues rate, you enter your payment information, and you’re a member — it’s as simple as that!
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S AN D I E G O P HY S I CI A N. or g ja n u a ry 2011
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Access Valuable Members-only Content!
Signing in to access membersonly content is as easy as clicking on “Sign In” at the top left of the screen and entering your email address or username and your password. If you have any trouble at all signing in, contact Kyle Lewis at SDCMS at (858) 300-2784 or at KLewis@SDCMS.org and he’ll get you signed in. Some of the content available to members and their staff includes valuable toolkits, access to previously recorded seminars, access to our FAQ database, and more!
Cl ick h
er e
3
Manage Your Account, Your Private Messages, Your Profile, and Your Classified Ads
7
Communicate With Physicians and Patients in a HIPAA-compliant Environment!
Click here
After you sign in, you’ll notice “Welcome, Dr. X” appears at the top of the homepage, which hyperlinks directly to your profile. If you hover your cursor over “Your Account” in the upper left, a dropdown menu will appear that will give you direct access to your account (where you can edit your username, password, email address, etc.), your private messages (see #7), your profile, and your classified ads.
Click here
As an SDCMS-CMA member physician, you can send HIPAA-compliant messages to other physicians and to your patients at SDCMS.org. In order to send a message to another
Click he re
5
Renew Your Membership With Just a Few Clicks!
If you have trouble signing in in order to renew your SDCMS-CMA membership, contact Kyle Lewis at SDCMS at (858) 300-2784 or at KLewis@ SDCMS.org, and he’ll fix the problem.
Click he re
4
Ensure Your Public Profile Is Accurate and Complete!
All current SDCMS-CMA member physicians have a public profile at SDCMS.org, which you can edit when logged in. Update your training information, your board-certified specialties, your selfdesignated interests, the health insurances you accept, the programs (Medicare, Medi-Cal, etc.) you accept, the languages you speak, your affiliations, your practice location(s), and any information you would like to provide about your practice, including a basic description of your practice, what your new patients need to know, information for your current patients, your practice hours, and more. The more information you provide in your profile, the easier patients and physicians can find you when doing a physician search.
6
Tell Your Patients to Register With SDCMS.org Today!
member physician, log in and go to that physician’s profile. Each physician profile has a “Send This Physician a Message” button at the top that, when clicked, will bring up a messaging tool. Patients who have registered with SDCMS.org and are logged in (see #6) can do the same as well. When a message is sent to you at SDCMS.org, an email is sent to your regular email account notifying you that you have a message waiting for you at SDCMS.org.
Click he re
If you would like to communicate with your patients in a HIPAA-compliant environment, tell them to register at SDCMS.org. Once registered, they will be able to send you HIPAAcompliant messages, to which you can respond within the same HIPAAcompliant environment. When a patient (or other SDCMS member physician) sends you a message, you receive a notification email in your regular email account to let you know that you have a message waiting for you at SDCMS.org. january 2011 SAN DIEGO P HY SICIA N. o rg
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sdcms-cmabenefits
ick l C
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re e h
Hyperlink to the California Medical Association (CMA) Website
9
Your Office Staff Can Access Members-only Content Too!
Office staff of current SDCMS-CMA member physicians can contact Sonia Gonzales, their SDCMS office manager advocate, to be assigned a unique username and password that will allow them to access all of the valuable content available to members at SDCMS. org. Contact Sonia at (858) 300-2782 or at Sonia.Gonzales@SDCMS.org.
here k c i l C
To access CMA’s ON-CALL documents, valuable toolkits, and other members-only content at cmanet.org, click on CMA’s logo in the upper right. If you’ve never logged in to CMA’s website, you’ll need your CMA ID, which Marisol Gonzalez, your SDCMS physician advocate, can help you with. Contact Marisol at (858) 300-2783 or at MGonzalez@ SDCMS.org.
10
Find Information on All Other SDCMS-CMA Member Physicians!
We designed our Find a Doctor tool to be user-friendly and powerful by allowing patients to cast their net wide at the beginning of their search and filter down from there. Searchers can type in a keyword to get an initial list, which they can then filter down by choosing board-certified specialties, special interest Clic areas, programs ack he re cepted, and more. Physician profiles that are accurate, up-to-date, and complete are more likely to appear at the top of search results.
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S AN D I E G O P HY S I CI A N. or g ja n u a ry 2011
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Quickly Find What You Need With Our Filtering Search Function!
Searching for content at SDCMS.org is as simple as entering a keyword and filtering down from there. If you enter “Medicare,” for example, more than 1,500 pieces of content will show up in your search results. From there you can filter down by checking (and unchecking) “Physician Profile,” “Article,” “FAQ,” “Event,” “Classified,” etc. You can also filter by using multiple keywords.
12
Affect and Effect Legislation Critical to Your Practice and to Your Patients
Our advocacy tool allows physicians to quickly and easily affect and effect legislation and regulations important to you, your patients, and the practice of medicine. SDCMS’ and CMA’s advocacy efforts run the gamut from protecting MICRA and maintaining the corporate bar, to fighting unfunded mandates, holding the line on practice intrusions, seeking regulatory relief, protecting physician reimbursement, and ensuring fair and equitable physician contracts. With our advocacy tool you can sign petitions, send letters to newspaper editors, and contact politicians with just a few clicks.
here Click
Click here
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Search Our FAQ Database to Find the Answers You Need When You Need Them!
We have uploaded the answers to hundreds of questions already asked of our physician advocate and office manager advocate, ranging from economic advocacy and employment questions, to legal advocacy, medical licensure, member benefits, and more. If you don’t find the answer to your question, simply give Marisol (your physician advocate) or Sonia (your office manager advocate) a quick call, and they’ll find the answer for you!
13
Post Your Own Classified Ads Free of Charge and Search SDCMS’ Physician Marketplace
As a member physician, you can log in to SDCMS. org and post classified ads in a number of different categories — Physician Positions Available, Clinical Trials, Office Space, Medical Equipment, Services Offered, and much more — all free of charge. Let SDCMS’ online marketplace be your first stop when looking to buy and sell goods and services with others in San Diego County’s physician community.
Clic k he
Clic k he
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Read San Diego Physician Online
Every month we post a complete copy of that month’s issue of San Diego Physician online in order to ensure the broadest possible distribution of SDCMS’ official publication and to make accessing previous issues easy and enjoyable. january 2011 SAN DIEGO P HY SICIA N. o rg
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sdcms-cmabenefits
17 Clic k he
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Never Miss an SDCMS Seminar, Webinar, Event, or Meeting
A complete list of all currently scheduled SDCMS seminars, webinars, events, and meetings is available at SDCMS.org/event. If you have any suggestions for future seminars or webinars, don’t hesitate to let us know!
here k c i l C
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View All of SDCMS’ Past Seminars and Webinars When You Have the Time!
SDCMS’ seminars and webinars are all made available for viewing online by members and their staff within 24 hours of recording. For those busy physicians and office staff who can’t tear themselves away from the office to attend in person, you can always go to SDCMS.org within a day of the seminar/webinar, log in, and view it in its entirety.
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Follow SDCMS on Twitter! Get the latest healthcare news and updates from SDCMS, CMA, and respected media sources from across the country by following SDCMS on Twitter.
19 ere h ck Cli
Meet Your Leadership and Support Teams
Clic k he
re
re Click he
here Click
You have a dedicated team of physician leaders and staff at SDCMS who are here to support you, your staff, your practice, and your patients. Get to know us, and let us know how we can serve you better!
Learn More 20 About Your SDCMS Foundation
Founded and directed by physicians, the SDCMS Foundation manages a host of programs that help physicians, patients, and our community. Together, your Foundation solves unmet healthcare needs by offering efficient and meaningful access to care, preventative health education, resource information, and support for local medical students. The SDCMS Foundation is actively recruiting board-certified physicians in all medical and surgical specialties — physicians willing to see at least one uninsured patient. Contact the Foundation today to learn more!
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CMA Goals for 2011 Working Together With SDCMS, We Are Indeed Stronger
By James T. Hay, MD By Dorothy Crockett, MA, M/Div
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S AN D I E G O P HY S I CI A N. or g ja n u a ry 2011
Your Goals So what do you expect your CMA to do for you and your patients in 2011? I’m pretty sure you want maintenance and improvement of the physician-patient relationship, fair compensation for services rendered, and removal of the barriers to providing the care your patients need. At the annual session of CMA’s House of Delegates (HOD) in October 2010, the highest priorities assigned to actions were for fixing the problems of the Affordable Care Act (ACA) and helping physicians address the Accountable Care Organizations (ACOs) it enabled. CMA’s member survey conducted last summer also told us that you believe the “uninsured/underinsured” to be the greatest challenge for our future, followed by “reimbursement,” “limited access,” and “funding/ solvency.” My Goal I am delighted that the CMA HOD has chosen me to become CMA’s president-elect, but no one person creates the agenda, nor does any one person achieve its goals. I believe in building consensus, in building the team, and, by doing so, in creating the internal governance that makes real accomplishment possible. Therefore, my goal for this year and the next is to work with President Hinsdale and the entire CMA Executive Committee (EC), Board of Trustees (BOT), and all the CMA components to have CMA become what the AMA motto says we should be: “Together, we are stronger.”
promoting membership by paying better attention to component and subsidiary relationships. Accountable Care Organizations Commonly referred to as “unicorns” (because no one has seen one yet), ACOs are an attempt to tie together the parts of the care delivery system for improvement in quality and economy. By aligning the incentives of systems created of physicians, hospitals, ancillary care, and others in models that deliver total care to at least 3,000 Medicare patients over at least three years, 80 percent of any savings achieved relative to the cost of traditional care can be returned to the ACOs. Beyond that basic premise, the rest of who, how, and how it will be measured or regulated is as yet unknown. CMA’s job will be to educate physicians about the opportunities and threats this provides. First and foremost, physicians must be in control of all clinical decision-making in any new systems created, and certainly must be wary of ceding governance control to any nonphysician entity in order to create an ACO. Hospitals cannot be an ACO without physicians, but physicians can be an ACO without a hospital. Of course, the best design will include both. The CMA HOD adopted “The Physician-Hospital Alignment TAC Report” in October, which established 12 principles that should guide us as we enter into this effort, the first of which is the key guiding principle: “to increase access to care, improve the quality of care, and ensure the efficient delivery of care.” The second states that “ACOs must be physician-led.” Members can access the full report and its recommendations on CMA’s website at www.cmanet.org. The September issue of San Diego Physician was devoted entirely to this subject (see http://sdcms.org/san-diego-physician-magazine), but it bears reminding ourselves of the sea change that this is likely to create in the way we deliver care. CMA and its leadership are aware of this and will advocate vigorously to protect your interests and those of your patients. Solo practice is not dead, and the corporatization of medicine has not happened … yet. We will find innovative ways to connect privately practicing physi-
I believe in building consensus, in building the team, and, by doing so, in creating the internal governance that makes real accomplishment possible.
Our Goals The CMA EC has recommended focusing on a few very important issues for the coming year, and I’ll discuss them individually. They are 1) helping members address the coming ACOs; 2) helping members implement the health reform law while working to reform the reform by revising its harmful pieces; 3) defeating the MICRA challenge certain to be awaiting us this year; 4) creating an entirely new communications system within CMA, including a userfriendly and compelling website; and 5)
january 2011 SAN DIEGO P HY SICIA N. o rg
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cians into virtual or more tightly integrated entities, to achieve relief from the antitrust laws that prevent such alignment, and to ensure that attempts to be more “efficient” do not aggravate the financial stresses physicians now face or diminish the quality of or access to care for our patients. Implementing and Reforming Reform There are many excellent parts of the ACA that physicians welcome, including the reduction in the number of uninsured patients, the insurance reforms that will make health insurers better perform what they are chartered to do, the emphasis on increasing access to primary care, and the experiments with ways to get better data about what care is most effective, what liability reform efforts might be tested by the states, and how we can connect with each other for the sharing of patient information. CMA will continue to educate members about how to prepare for the increased volume of patients in an already stretched delivery system, how to adapt to the electronic world (EHRs and Project4:Layout 1 9/22/08 11:22 HIEs, for example), and how to participate
in the financial rewards the ACA created for doing so. We will advocate for state laws and regulations that will implement the federal mandates in a positive way. Meanwhile, however, we will be traveling to Washington, DC, as often and as long as it takes to correct the flaws in the new law. SGR and GPCI must be fixed. The IPAB (Independent Practice Advisory Board) must be killed or at least made accountable to someone open to hearing reasonable arguments before it can make its mandated cuts to funding in order to balance federal healthcare budgets. We must continue to fight to convince Congress that “private contracting” isn’t a way to gouge seniors, but a way to replace the funding of medical care with OPM (other people’s money) and actually therefore reduce federal spending, while also enabling seniors the liberty of choosing how they want to receive their care. Boosts in reimbursements for Medicare and Medicaid should be for all specialties and reflective of what the costs of delivering that care actually are. “Value modifiers” as proposed by those in the Midwest must be defeated. AM Page 1 No way should a region that has one third
the rental costs and one half the labor costs be rewarded because they deliver care more cheaply. And the ridiculous mandate to create 1099 reports for everyone we pay for service must be defeated as well. MICRA Challenge It is clear that the trial lawyers will test the new governor’s position on MICRA in this legislative session. We were protected for many years by governors who were certain to veto any attempt to modify the 1975 law that is the envy of the nation in liability reform. Consequently, few attempts were made to do so, but there is rising sentiment among some legislators and many in the media that the cap on non-economic damages should be indexed to some inflation or cost-of-living standard. A doubling or tripling of the $250,000 cap, as has been proposed, would have a significant effect on the premiums we physicians pay to our liability carriers and also harm the clinics, the hospitals, and the universities already struggling to stay afloat. Access to care, not a concern of the trial bar apparently, will seriously suffer. We will need every one of you to help fight
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this attack, and we are already beginning plans for fund-raising to mount that fight. Communications Every focus group and every survey CMA does reinforces the understanding that physicians, members and nonmembers, rarely know what CMA does and what CMA stands for. This year you will see the rollout of a new website and an entirely new way of communicating with members and nonmembers, not just to “tell” you what we do, but to be able to “ask” you what you want and need. CMA’s new vice president of communications, Rosanna Westmoreland, has already transformed what is happening internally. You will soon recognize the difference and see the benefit, including better public awareness of our advocacy. Management and Governance Changes It isn’t your father’s CMA, and this isn’t Kansas, Toto. CEO Dustin Corcoran has changed the culture at CMA’s office and revitalized an already powerful team. Now it is up to the physician leadership to follow his lead and
re-create the relationships among the parts of organized medicine. The county medical societies need to be more tightly aligned with CMA and with each other. The specialty societies need to work with CMA and each other to avoid conflicting messages to the public and the legislature. The subsidiaries of CMA are already more closely tying their missions to CMA’s. All components need to better promote leadership development to enable the “Team” of the future. We will lose to the corporate and governmental forces if they can divide us. We must not be divided. Disagreements and conflicts in needs must be hammered out within the walls of the house of medicine, not in the media or in the halls of Congress. CMA’s strategic plan, adopted by the BOT, and the focused priorities of the EC both consider this goal to be essential to the accomplishment of all others; hence both have unity of purpose as one of the top five priorities for this year. Conclusion Focus does not mean other issues will be ignored. I personally will continue to lead the effort to re-create a viable and effective Physi-
cian Health Program for California to replace the Diversion Program ended by action of the Medical Board in 2007. I will continue to work to see that liability coverage becomes available to physicians who volunteer their efforts for the uninsured. And I will continue, while no longer the speaker, to assist Speaker Luther Cobb and Vice Speaker Ted Mazer in assuring that the HOD remains the force it is in establishing the policies you want that will guide our actions in the future. I am available to you at any time. Please let me know what your goals and priorities are. SDCMS remains the most vibrant and effective county medical society in the state, and your leadership and staff make it so. CMA is one of the most influential and effective state associations in the country. With SDCMS working together with CMA, we are indeed stronger. About the Author: Dr. Hay, SDCMSCMA member since 1985, is a full-time family physician in Encinitas. He was president of SDCMS in 2001, is currently presidentelect of the California Medical Association, and an AMA delegate.
ProjECTcomPassion Have you ever considered going on a medical mission trip? Project comPassion offers you the opportunity to do short term medical mission trips around the world. This multi-denominational Christian organization will provide the supplies and make all the travel arrangements for you to spend 8-12 days using your skills to treat the underserved in developing nations. Each trip brings various medical professionals together to work as a team in an outpatient setting in remote villages. Every trip is a life-changing experience.
Visit www.projectcompassion.org for more information and to join one of our trips 11315 rancho Bernardo road, Suite 146, San Diego, CA 92127 858.485.9694 • info@projectcompassion.org Project Compassion is a Non-Profit, Multi-Denominational, 501(C)3 Charitable Medical Relief Organization Incorporated in the State of California since 1992.
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CALPAC Physicians Fighting for Physicians By Susan Kaweski, MD
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In these trying times, physicians ask why we should contribute to CALPAC, the California Medical Association Political Action Committee. The most important reason is, who knows better than physicians about healthcare issues and medical decisions? Yet it seems that only nonphysicians seem to legislate and regulate healthcare for us and our patients. Some of you contribute to candidates who represent your views. So why should you also contribute to CALPAC? In order for legislative advocacy to be successful, lobbying and grassroots activities have to be integrated. CALPAC is all about physicians fighting for physicians. Before we support specific legislators, we question them concerning their views regarding certain key topics in healthcare. Chief among these issues is MICRA, the Medical Injury Compensation Reform Act of 1975, the bill that reformed the medical malpractice insurance system in California and has allowed us to practice medicine with affordable medical malpractice insurance. This measure is keeping the cap on non-economic damages at $250,000, while providing for unlimited actual economic damages and a sliding scale of attorney fees. CALPAC also protects California’s patients by defending the ban on corporations practicing medicine. The “corporate bar” ensures that those who make decisions affecting the provision of medical services understand the quality of care implications of that medical service, have a professional ethical obligation to place the patient's interest first, and are subject to oversight of the Medical Board of California. California has the largest number of uninsured in the nation — almost 7 million. Many of us care for these individuals on a daily basis, whether it is in our community clinics,
offices, or hospitals. CMA supports expansion of employer-based insurance through state-operated insurance pools, mandated catastrophic and preventive insurance, and expanded healthy families programs. Many of us are deeply concerned about the abuses of the for-profit health insurance plans, with their take-it-or-leave-it contracts, fear of retaliation from HMO administrators, continued undermining of the physicianpatient relationship, and decreased quality of care. Scope-of-practice issues will continually plague our profession. We will continue to advocate that proper training and education is necessary to treat patients safely, with the physician as the definitive decision maker. Finally, the California budget always finds a way to cut healthcare to the medically indigent and working poor because it is the only thing that they can cut —with education and prison guards being relatively protected. What the legislators cannot understand is that this costs taxpayers more in the long term, with the development of significant public health problems. Collectively, we are much more effective. Just last November, thanks to CALPAC’s ability to spend $250,000, we were able to elect a pediatrician who understands MICRA and who supports what we at CMA believe, as opposed to a candidate whom the trial lawyers wanted to see win. Please join us in support of our political action committee. Any dollar amount will help preserve our vision for the future of healthcare in our state. Remember, “Those things which are precious are saved only by sacrifice.” About the Author: Dr. Kaweski, SDCMSCMA member since 1991, is president of the San Diego County Medical Society (SDCMS) and sits on the board of CALPAC.
For further information and to support CALPAC, please visit www.CALPAC.org. january 2011 SAN DIEGO P HY SICIA N. o rg
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Does Your Office Manager Have an Ally She Can Turn To? Let your office manager and staff know that they have a full-time office manager advocate at SDCMS ready to help them with any questions they may have, free of charge. Contact Sonia Gonzales at (858) 300-2782 or at SGonzales@SDCMS.org.
Is Your Prescription Pad Re-order Rut Costing You Money? SDCMS has endorsed American Security Rx, which is a California Department of Justice and California Board of Pharmacy approved Security Printer (SP9), to provide tamper-resistant California security prescription forms for controlled medications. SDCMS members receive discounts on tamperresistant prescription forms. Visit American Security Rx online at AmericanSecurityRx.com or contact American Security Rx at (877) 290-4262 or at info@ americansecurityrx.com.
Is Outsourcing Your Billing the Solution? SDCMS has endorsed CHMB Solutions, which provides outsourced medical billing, revenue cycle management services, information technology support, and hardware solutions to physician practices, clinics, and multi-specialty organizations. SDCMS members receive a 50% discount on startup fees and a $33 per-physician-per-month services credit, 10% off of outsourced IT support, 10% off of already discounted Dell hardware solutions, and a free coding hotline. Contact Ron Anderson at (760) 520-1340 or at randerson@ chmbsolutions.com, or visit CHMB Solutions online at CHMBSolutions.com.
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Professional Services Medical Billing Connection
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Sexuality Clinic of San Diego Cognitive/behavioral/psychodynamic therapy allows for understanding and treatment of sexual dysfunction, sexual addiction, and mental health problems. Relationships with others kindle thoughts in our minds about one’s self. The dramas are powerful and maintain their status at various levels of one’s psyche resulting in sexual and psychological turmoil. The therapeutic relationship with Dr. Silbert rn,cns,phd,faacs, promotes healing by trusting expression and freedom of the authentic self.
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classifieds office space DOWNTOWN OFFICE SPACE AVAILABLE: Family practice physician in downtown San Diego has office space available. Preferably a primary care physician, but open to any healthcare provider. If interested, please call (858) 270-7633. [735]
NEW MEDICAL BUILDING ALONG I-15: Pinnacle Medical Plaza is a new 80,000 SF building recently completed off Scripps Poway Parkway. The location is perfect for serving patients along the I-15 from Mira Mesa to Rancho Bernardo and reaches west with easy access to Highway 56. Suites are available from 1,000—11,000 SF and will be improved to meet exact requirements. FREE RENT INCENTIVES and a generous improvement allowance is provided. For information, contact Ed Muna at 619-702-5655, ed@lankfordsd.com www.pinnaclemedicalplaza.com MEDICAL OFFICE SPACE AVAILABLE PART TIME TO SHARE IN SOLANA BEACH: Excellent location off I-5 by coast. Space includes three fully equipped exam rooms, waiting room, lunchroom, two bathrooms. Available all day Thursdays and other half days — flexible schedule. Great opportunity for a start-up practice that can’t fill a full-time schedule. Affordable rent and flexible arrangements. Call (858) 259-9708 or email solanabeachmed@sbcglobal.net for more information. [878] EL CAJON OFFICE SPACE: 1685 E. Main St, El Cajon suite is first floor with exposure on East Main Street. Currently occupied by a Quest Diagnostics, and is suitable for medical offices or other retail. Other tenants are Planned Parenthood, pharmacy, and law office Two tenants are general office. Numerous medical offices in neighborhood. Great freeway access. Total of 1,200 square feet, which includes two exam rooms, waiting area, reception booth, and break room. Rate negotiable. Occupancy available February 1, 2011. Contact John Williamson, Broker (LIC# 01709354), JD Bols & Associates, at telephone (619) 300-0689 or fax (619) 342-9816. [877] AVAILABLE CONSULTATION ROOM ON THE CAMPUS OF SCRIPPS ENCINITAS: Close to 5 freeway. Private entry to wheelchair accessible unit with soundproof walls. Spacious waiting room shared with one doctor. Bathroom with shower. Reserved parking. Flexible sublease terms. To view the property (avail January 1, 2011), please contact Beverly at (760) 944-9263 or email sdvi. office@gmail.com. [876] HILLCREST OFFICE SPACE AVAILABLE: Office space available at the corner of 8th Avenue and Washington St in Hillcrest. Approximately 3,000ft2. Surgical center building. Ample parking
and freeway access. Proximity to Scripps Mercy Hospital. Contact Laura Hurshman at (619) 2995000 or at laura@sdhandcenter.com. [874] POWAY GATEWAY BUILDING OFFICE TO SHARE/SUBLEASE: Beautiful, newly renovated, ground floor, 1,467ft2, close to main entrance, spacious office in a class A medical office building. Close to Pomerado Hospital. Large windows, ample room, must see furnished office. Ample parking. Labs and radiology onsite in building. Negotiable rent. Looking to occupy with another subspecialist who needs a satellite location for 1–2 days a week. Contact Maryam at (760) 518-8767 or email mzarei@cox.net. [873] OFFICE SPACE LA MESA: Office space adjacent to Grossmont Hospital. Up to 3,000ft2 for shortterm sublease. Two consultation rooms, six exam rooms . Space can be sublet in whole or partially. Attractive rates. Inquiries to richrach57@gmail. com. [871] AVAILABLE CONSULTATION ROOM ON THE CAMPUS OF SCRIPPS ENCINITAS, CLOSE TO 5 FREEWAY: Private entry to wheelchair accessible unit with soundproof walls, spacious waiting room shared with one doctor, BR with shower, reserved parking. Flexible sublease terms. To view the property (available January 1, 2011), please contact Beverly at (760) 944-9263 or email sdvi. office@gmail.com. [868] SHARE OFFICE SPACE IN LA MESA JUST OFF OF LA MESA BLVD: 2 exam rooms and one minor OR room with potential to share other exam rooms in building. Medicare certified ambulatory surgery center next door. Minutes from Sharp Grossmont Hospital. Very reasonable rent. Please email KLewis@sdcms.org for more information. [867] PROFESSIONAL OFFICE SPACE TO SHARE OR LEASE: Part time, full time, flexible terms and incentives. Up to 1,400ft2 in a medical complex. Near Alvarado Hospital, SDSU college area. Ample parking. High visibility street location. Ideal for any specialty or allied medical professionals. Call (858) 243-2425. [733] OFFICE SPACE IN UTC: Full-time office in 8th floor suite with established psychologists, marriage and family therapist, and psychiatrist in Class A office building. Features include private entrance, staff room with kitchen facilities, active professional collegiality and informal consultation, private restroom, spacious penthouse exercise gym, storage closet with private lock in each office, soundproofing, common waiting room, and abundant parking. Contact Christine Saroian, MD, at (619) 682-6912. [862] MEDICAL OFFICE OWNER/USER OPPORTUNITY — ADJACENT TO SCRIPPS MERCY HOSPITAL: Two-story medical building for sale, located on the corner of Lewis St. and 3rd Ave. at 233 Lewis Street, adjacent to Scripps Mercy Hospital. Property has tremendous foot traffic, a flexible floor plan, 10 off-street parking spaces, and is
elevator-served. Take advantage of this exclusive opportunity to own on-campus via SBA Financing (with as little as 10% down) for effectively less than renting in Hillcrest’s dense medical office submarket. For more information or to schedule a property tour, contact Nic Lyon or Evan Kovac at (858) 373-3100 or email Nic.Lyon@MarcusMillichap.com. [859] NEW SPACE TO SHARE IN KEARNY MESA: Located directly across from Sharp Memorial Hospital in a Class A medical office building. The 2400ft2 space is perfect for a part-time or fulltime, shared office arrangement. The reception area was designed to comfortably accommodate those with disabilities. Dual windows facilitate easy check-in. There are ample, built-in staff work stations. Staff also enjoy a private lounge. A furnished office and dedicated exam room are available for the physician. The office suite also includes a leaded room for minor procedures. Terms negotiable. Please contact carla.young@ clyoungmdinc.com for more information. [857] MEDICAL OFFICE SPACE FOR RENT IN ENCINITAS:Convenient location five minutes from Scripps Encinitas Hospital. Close to 5 freeway. The 800ft2 space includes two spacious exam rooms, private consultation/doctor’s office, private bathroom, lunchroom, and a spacious waiting room shared with one other doctor. Very affordable rent. Office located at the corner of Encinitas Blvd. and Manchester Ave. Call (760) 519-0102 or email ktagdiri@gmail.com for more information. [855] SCRIPPS RANCH OFFICE SPACE TO SHARE: Located at 10672 Wexford St. in San Diego with easy access to I-15. 4,000ft2 office with nine exam rooms (four available) and digital X-ray suite in a class A medical building. Office is currently occupied by an orthopedic surgeon looking to share space. Options available for space sublease or cost sharing of staff, X-rays, and office equipment. Practice currently uses CCHIT certified eClincalWorks EMR with e-prescribing. For more information, please contact Ian at (858) 536-9500 or email at info@mcclurgmd.com. [852] SCRIPPS ENCINITAS CONSULTATION ROOM/ EXAM ROOMS: Available consultation room with two examination rooms on the campus of Scripps Encinitas. Will be available a total of 10 half days per week. Located next to the Surgery Center. Receptionist help provided if needed. Contact Stephanie at (760) 753-8413. [703] OFFICE SPACE TO SHARE: Currently occupied by orthopaedic surgeon. Great location close to Scripps/Mercy and UCSD Hospital. Looking to share with part-time or full time physician. Fully furnished, fully equipped with fluoro machine and 4 exam rooms and staff. (NEGOTIABLE) Please contact Rowena at (619) 299-3950. [804] REAL ESTATE SURGICAL CENTER FOR SALE OR LEASE: Conveniently located in the El Cajon area off
To submit a classified ad, email Kyle Lewis at KLewis@SDCMS.org. SDCMS members place classified ads free of charge (excepting “Services Offered” ads). Nonmembers pay $150 (100-word limit) per ad per month of insertion.
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highway 125. Medicare- and AAAASF-certified, reception area, physician’s lounge, two operating rooms with C-arm, three recovery beds, medical gases, emergency back-up power. Ample parking and surveillance cameras on site, 2,400ft2. Please call (619) 203-9831or email pain92120@ aol.com for details. [870] PHYSICIAN POSITIONS AVAILABLE CALIFORNIA-LICENSED MD FOR CONSULTATIVE WORK:Alternative care/medical marijuana clinic in Carlsbad Village looking for Californialicensed MD for consultative work. Part time with excellent compensation. Contact James Gould (760) 703-3767. [880] SEEKING BOARD-CERTIFIED PEDIATRICIAN FOR PERMANENT FOUR-DAYS-PER-WEEK POSITION: Private practice in La Mesa seeks pediatrician four days per week on partnership track. Modern office setting with a reputation for outstanding patient satisfaction and retention for over 15 years. A dedicated triage and education nurse takes routine patient calls off your hands, and team of eight staff provides attentive support allowing you to focus on direct, quality patient care. Clinic is 24–28 patients per eight-hour day, 1-in-3 call is minimal, rounding on newborns, and occasional admission, NO delivery standby or rushing out in the night. Benefits include tail-covered liability insurance, paid holidays/vacation/ sick time, professional dues, health and dental insurance, uniforms, CME, budgets, disability and life insurance. Please contact Venk at (619) 5045830 or at venk@gpeds.sdcoxmail.com. Salary $ 102–108,000 annually (equal to $130–135,000 full-time). [778] GREAT FP OPPORTUNITY IN RAMONA: Immediate opening for CA-licensed physician in thriving family practice with small-town, rural atmosphere. We are flexible and friendly with excellent working conditions, loyal staff, and wonderful patients. No hospital work, easy call, attractive compensation package. Email fredarsham@hotmail.com. [807] PRIMARY CARE JOB OPPORTUNITY: Home Physicians (www.thehousecalldocs.com) is a fastgrowing group of house-call doctors. Great pay ($140–$200+K), flexible hours, choose your own days (full or part time). No ER call or inpatient duties required. Transportation and personal assistant provided. Call Chris Hunt, MD, at (858) 2791212 or email CV to hpmg11@yahoo.com. [801] SEEKING A FULL-TIME FAMILY PRACTICE PHYSICIAN FOR AMBULATORY CLINIC: Southern Indian Health Council is made up of board-certified physicians who are experts in primary care and health management. Working closely with a well-trained support staff, our medical providers have established a solid reputation of delivering quality outpatient care and a broad scope of services to individuals of all ages. We are seeking a full-time, board-certified family practice physician, Monday–Friday, 8:00am–4:30pm. Must have current CA and DEA licenses; computer skills. Malpractice coverage provided. Forward resume to jobs@sihc.org or fax to (619) 445-7976 or visit our website at www.sihc.org. Contact jobs@sihc.org or HR phone at (619) 445-1188, ext. 291, or HR fax at (619) 445-7976. [866]
INTERNAL MEDICINE, PART-TIME POSITION, PRIVATE PRACTICE, WONDERFUL JOB OPPORTUNITY! Outstanding opportunity to work part time or more in a mature, premiere private practice setting in North San Diego County, outpatient only. This unique position blends the rewards of private practice and traditional continuity of care with scheduling flexibility. Perfect for any physician who wants to transition from the demands of a full-time position, or who wants to maximize job satisfaction in an extremely high quality work environment while still working part time. Contact (619) 248-2324 for more information. [861] INTERNAL MEDICINE PHYSICIAN: Internal medicine physician to join a well-established turnkey practice located near Alvarado Hospital. New physician will take over existing practice, weekend call one in five weekends. Full laboratory, dexa machine, 2D echos, and vascular studies done in the office. Traditional in- and out-patient practice. Benefits and salary leading to partnership. Interested candidates should contact Lydia Gormish at (619) 229-5055 and submit curriculum vitae to lydiagormish@cox.net. [853] PROFIL INSTITUTE FOR CLINICAL RESEARCH SEEKING CONTRACT PHYSICIAN: At Profil, we combine the careful and critical attitude of academic science with the professionalism of the biopharmaceutical industry. Located in Chula Vista, Profil Institute for Clinical Research is currently accepting applications for a highly qualified contract physician. Reports to medical director. Main purpose of job: Ensure the safety and wellbeing of human subjects; ensure integrity of study data; provide medical leadership and supervision for human clinical trials within PICR. Work side by side with a highly committed team proud of its contribution to diabetes and obesity research. Profil offers a competitive salary, excellent benefits, and career opportunities in a dynamic, quality-focused environment. For further information, visit SDCMS.org/classifieds/physician-positions-available. Forward resumes to hrpicr@profil-research.com. No faxes or phone calls, please. [851] PRACTICE FOR SALE CARDIOLOGY MEDICAL PRACTICE: In practice since 1982. Very successful practice with 100% private pay PPO and Medicare population. La Mesa area. No managed care. Practice demographics are middle to upper income. Practice includes equipment, including stress testing, echo, and nuclear camera. Both echo and nuclear programs are certified by ICAEL and ICANL
(this is a requirement for being reimbursed by Medicare starting January 2012). Reason for sale is retirement. Will stay to introduce. Terms available. Inquiries to richrach57@gmail.com or to (619) 501-6858. Excellent opportunity. [872] NONPHYSICIAN POSITIONS AVAILABLE PROVIDER PRACTICE MANAGER: About Us: San Diego Hospice and The Institute for Palliative Medicine (SDHIPM) is one of the 10 largest community-owned, not-for-profit hospice programs in the nation, caring for the 1,000 patients daily in their homes or other facilities in San Diego County. Our mission is to prevent and relieve suffering and to promote quality of life, at every state of life, through patient and family care, education, research, and advocacy. Position Description: The provider practice manager oversees all medical staff support, including administration, planning, budgeting, financial management, provider scheduling, and credentialing. Working in conjunction with the practice director, the provider practice manager ensures full and effective administrative and compliance support for the provider practice group. Works with IT, finance, and health information on documentation, billing, electronic medical record activities, and other activities of, and supports for, the provider practice group. Participates as appropriate in strategic and planning discussions related to provider and patient care services operating models and supports integration of direction. Education: Requires a bachelor’s degree, preferably in health administration or business administration. Experience: Must have at least three years of experience in managing the operations a physician practice group. Prior experience in a home health or hospice setting is preferred. Experience with electronic health records ideal. Must demonstrate ability to not only use computer systems effectively but also to employ them to improve processes. Familiarity with hospital and/or hospice regulations required. Position is full time, Monday through Friday. Shift is 8:00am to 5:00pm. sdhospice. org/careers [858] MEDICAL EQUIPMENT CHART RACKS FOR SALE: Three free-standing metal chart racks for sale in very good condition. Each rack has nine shelves with four metal dividers per shelf. Dimensions are 36” wide by 92” tall by 13” deep. Each chart rack can hold approximately 575–625 charts, depending on size. These chart racks cost over $600 each brand new. Asking $375 or best offer. [879]
Reach 8,500 doctors by advertising in San Diego Physician magazine. Contact Dari Pebdani today! 858-231-1231 or DPebdani@SDCMS.org
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adinosaur’sstory By F. Bruce Kimball, MD
A Few Words From an Old Doc 1949 in Michigan … a Polio Epidemic
As an orthopedic surgeon now in my nineties who has not practiced for 25 years, I am a cardcarrying dinosaur. This is the first of a series of short anecdotes about one man’s practice 50 years ago. “First a doctor, second an orthopedist.” With these words, Dr. Badgley, chief of the department at Michigan, welcomed me into the program. When I completed my residency, I opened a practice in a small town in Michigan. In 1949 there was a poliomyelitis epidemic, and we had many cases. I became the local polio expert by default. Sister Kenny was an Australian nurse who encountered many cases of polio in the Australian outback. She found that applying squares of hot wet wool relieved the pain. She also claimed that the treatment cured
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the disease. She was a very charismatic woman who brooked no criticism. Her methods were put into practice around the world, including my little town in Michigan. The social gathering place of town was the Elks Club. I was inducted into the club one night. It proved to be a very solemn ceremony. I was blindfolded and marched from place to place, receiving instructions and many handshakes. In the middle of the ceremony a voice said, “There is an emergency call for Dr. Kimball.” The caller was frantic about his wife because she was paralyzed and in great pain. I was quickly made an Elk and drove off to meet the caller. He waited for me at the end of a dirt road, waving a lantern. From there we walked to a trailer, lit only by a kerosene lamp. It was so dark I could hardly see the patient lying on the bed. In the background I could hear
the coughing of little children. I could not properly examine her, but, obviously, this had to be polio. When you hear hoof beats, think horses. An ambulance took her to the hospital where I could begin treatment. She had severe pain in the left leg, and it was “paralyzed.” However, a physical examination revealed a painful infected Bartholin cyst. No wonder she couldn’t move her leg! What about the abscess? It needed draining, so I incised it. First a doctor, and then an orthopedist. About the Author: Dr. Kimball, who first joined SDCMS-CMA in 1957, is now both a retired member and a retired orthopedic surgeon. San Diego Physician is happy to publish a series of articles by Dr. Kimball under the rubric “A Dinosaur’s Story.”
We Celebrate Excellence – Calvin Lee, MD CAP Member, Internationally Renowned Violinist, and Dedicated Philanthropist
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For over 30 years, the Cooperative of American Physicians, Inc. (CAP) has provided California’s finest physicians, like general surgeon Calvin Lee, MD, with superior medical professional liability protection through its Mutual Protection Trust (MPT). Physician owned and physician governed, CAP rewards excellence with remarkably low rates on medical professional liability coverage – up to 40 percent less than our competitors. CAP members also enjoy a number of other valuable benefits, including comprehensive risk management programs, best-in-class legal defense, and a 24-hour CAP Cares physician hotline. And MPT is the nation’s only physician-owned medical professional liability provider rated A+ (Superior) by A.M. Best. We invite you to join the more than 11,000 preferred California physicians already enjoying the benefits of CAP membership.
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$5.95 | www.SANDIEGOPHYSICIAN.org PRSRT STD U.S. POSTAGE PAID DENVER, CO PERMIT NO. 5377
San diego County Medical Society 5575 RUFFIN ROAD, SUITE 250 SAN DIEGO, CA 92123 [ RETURN SERVICE REQUESTED ]
MEDICAL OFFICE SPACE AVAILABLE OUR COUNTY’S FINEST CLASS ‘A’ MEDICAL BUILDINGS Central San Diego PACIFIC MEDICAL PLAZA
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1,000 - 55,000 Sq. Ft. High Image Medical Space For Sale 1.0 Miles from New Palomar Medical Centre West
4S Ranch | Rancho Bernardo 4S RANCH MEDICAL PLAZA 1,000 - 40,000 Sq. Ft. Untapped Patient Base “Main & Main” Location
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1,000 - 42,000 Sq. Ft. For Sale or Lease High Growth, Low Competition Area
Contact San Diego’s #1 Healthcare Real Estate Services Team: PAUL BRAUN | 858.677.5324 | paul.braun@colliers.com | Lic. No. 00891709 CHRIS ROSS | 858.677.5329 | chris.ross@colliers.com | Lic. No. 01469025
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Colliers International | Accelerating success. | www.colliers.com