official publication of the san diego county medical society September 2012
Doctors and Patients Only
All Others Keep out! “Physicians United For A Healthy San Diego”
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S A N D I E G O P HY S I CI A N .or g O c tob e r 2011
Octo ber 2011 SAN DIEGO P HY SIC I A N. o rg
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this month Volume 99, Number 9
Managing Editor: Kyle Lewis Editorial Board: Van L. Cheng, 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 Art Director: Lisa Williams Copy Editor: Adam Elder
SDCMS Board of Directors Officers President: Sherry L. Franklin, MD (CMA TRUSTEE) President-elect: Robert E. Peters, PhD, MD Treasurer: J. Steven Poceta, MD Secretary: William T-C Tseng, MD, MPH Immediate Past President: Robert E. Wailes, MD (CMA TRUSTEE) geographic and geographic alternate Directors East County: Alexandra E. Page, MD, Venu Prabaker, MD Hillcrest: Theodore S. Thomas, MD (A: Gregory M. Balourdas, MD)
features SDCMS MEMBER BENEFITS 12 How Well Do You Know the Issues Critical to Physicians? 16 Success Stories From Your SDCMS Physician Advocate 20 Do You Qualify for an SDCMS-CMA Dues Discount? 22 Did You Know You Could Save Money on … ?
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26 Take Advantage of SDCMS and CMA Member Benefits!
departments
30 Schedule Your 5-Minute Benefits Check-up Today!
4 Briefly Noted
32 SDCMS Member Benefits Policies and Procedures
Calendar • Join Our Editorial Board Honor Your Mentor • Nominate Your Office Manager • And More …
36 Get Involved!
Kearny Mesa: John G. Lane, MD, Jason P. Lujan, MD (A: Sergio R. Flores, MD) La Jolla: Geva E. Mannor, MD, Wynnshang “Wayne” Sun, MD (A: Matt H. Hom, MD) North County: Niren Angle, MD, Douglas Fenton, MD, James H. Schultz, MD (A: Anthony H. Sacks, MD) South Bay: Vimal I. Nanavati, MD, Michael H. Verdolin, MD (A: Andres Smith, MD)
At-large Directors Karrar H. Ali, MD, David E.J. Bazzo, MD, Jeffrey O. Leach, MD (DELEGATION CHAIR), Mihir Y. Parikh, MD (EXECUTIVE COMMITTEE BOARD REP), Peter O. Raudaskoski, MD, Kosala Samarasinghe, MD, Suman Sinha, MD, Mark W. Sornson, MD (EXECUTIVE COMMITTEE BOARD REP) At-large ALTERNATE Directors James E. Bush, MD, Theresa L. Currier, MD, Thomas V. McAfee, MD, Carl A. Powell, DO, Elaine J. Watkins, DO, Samuel H. Wood, MD, Holly Beke Yang, MD, Carol L. Young, MD other voting members Communications Chair: Theodore M. Mazer, MD (CMA VICE SPEAKER) Young Physician Director: Van L. Cheng, MD Retired Physician Director: Rosemarie M. Johnson, MD Medical Student Director: Suraj Kedarisetty
OTHER NONVOTING MEMBERS Young Physician Alternate Director: Renjit A. Sundharadas, MD Retired Physician Alternate Director: Mitsuo Tomita, MD SDCMS Foundation President: Stuart A. Cohen, MD, MPH CMA President: James T. Hay, MD (AMA DELEGATE) CMA Past Presidents: Robert E. Hertzka, MD (LEGISLATIVE COMMITTEE CHAIR, AMA DELEGATE), Ralph R. Ocampo, MD CMA Trustee: Albert Ray, MD (AMA ALTERNATE DELEGATE) CMA Trustee (OTHER): Catherine D. Moore, MD CMA SSGPF Delegates: James W. Ochi, MD, Marc M. Sedwitz, MD
6 The Engaged Patient: Toward Patient-Physician Partnerships for Better Outcomes
CMA SSGPF Alternate Delegates: Dan I. Giurgiu MD, Ritvik Prakash
Mehta, MD
by PEG FORD
8 Preventing Suicide and Its Devastating Consequences in San Diego County
by HOLLY SALAZAR
10 Effective Informed Consent: Fostering a Dialogue
by THE DOCTORS COMPANY
34 Physician Marketplace Classifieds
2 septem b er 2012
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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.]
Special Mortgage Financing for Physicians Our special home financing program is designed to meet your needs as a physician for the purchase, refinance or construction of your primary residence. • Financing for single family homes available with low down payment up to $1,750,000. Refinances with high loan-to-values are also available • Private mortgage insurance is not required • One-Time Close Construction Loan - one application, one approval and one closing for both construction and permanent loans. For information on this special home financing program from BBVA Compass, give us a call today. Bryan Yaninek, NMLS #392774 Mortgage Banking Officer 719-499-9000 • bryan.yaninek@bbvacompass.com apply online at: bbvacompass.com/mortgages/byaninek
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All loans subject to approval, including credit approval. Eligible properties must be located in Alabama, Arizona, California, Colorado, Central Florida, North Florida, New Mexico or Texas where BBVA Compass has a market presence. BBVA Compass is a trade name of Compass Bank, Member FDIC.
8.4375x11_SMF Physicians AD.indd 1
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brieflynoted featured member
calendar SDCMS Seminars, Webinars & Events SDCMS.org/event
For further information or to register for any of the following SDCMS seminars, webinars, and events, visit SDCMS.org/event or contact Rhonda Weckback at (858) 300-2779 or at Rhonda. Weckback@SDCMS.org. Media Training (workshop) SEP 29 • 8:00am–12:00pm Medicare E/M Services: Understanding the Principles and Guidelines (seminar) OCT 26 • 12:00pm–3:30pm Identity Theft (seminar/webinar) NOV 1 • 11:30am–1:00pm Tax Time (seminar/webinar) NOV 8 • 11:30am–1:00pm The (Physician) Leader’s Toolbox (workshop) NOV 10–11 • 8:00am–4:00pm on Nov. 10, and 8:00am–12:00pm on Nov. 11 Top 10 Patient Safety Issues for Office Practice (seminar/webinar) NOV 15 • 11:30am–12:30pm
Cma Webinars
CMAnet.org/events
What Doctors Need to Know About the CBAS Transition SEP 26 • 12:15pm–1:15pm Protect Your Practice From Payor Abuse OCT 3 • 12:15pm–1:15pm Impact of ICD-10 OCT 10 • 7:30am–9:00am or 12:15pm–1:45pm Establishing Expectations for High Performance From Medical Staff OCT 17 • 12:15pm–1:15pm Essentials for ICD-10-CM: Part 1 OCT 18 • 7:45am–8:45am or 12:15pm–1:15pm
4 septem b er 2012
Essentials for ICD-10-CM: Part 2 OCT 25 • 7:45am–8:45am or 12:15pm–1:15pm Essentials for ICD-10-CM: Part 3 NOV 1 • 7:45am–8:45am or 12:15pm–1:15pm Understanding ARC and CARC Revenue Codes NOV 7 • 12:15pm–1:15pm State Disability Insurance Online for Your Patients and You NOV 14 • 12:15pm–1:15pm
Become an SDCMS
you co heruld app e ne e xt! ar
Featured Member!
SDCMS would like to feature some of our member physicians for their noteworthy accomplishments in these pages. If you would like to be considered for our next “Featured Member” spotlight, please email Editor@SDCMS.org. Thank you for your membership in SDCMS and CMA!
Community Healthcare Calendar To submit a community healthcare event for possible publication, email KLewis@SDCMS.org. Events should be physician-focused and should take place in or near San Diego County. Hyperglycemia Management Using Insulin Therapy OCT 10 • Ruth’s Chris Steak House, Del Mar • 6:00pm • scripps. org/conferenceservices CMA / CMA Foundation Gala — Save the Date! OCT 14 • California Museum, Sacramento • Contact Enid at egallegos@cmanet.org for sponsorship and advertising or Shelley at stirsbeck@ thecmafoundation.org for individual or group ticket sales. 13th Annual Science and Clinical Application of Integrative Holistic Medicine OCT 28 – NOV 1 • Hilton San Diego Resort • www.scripps.org/events/ science-and-clinical-applicationof-integrative-holistic-medicine 13th Annual Science and Clinical Application of Integrative Holistic Medicine NOV 2 • Hilton San Diego Resort RCMA’s “Cruisin Thru CME” — French Waterways: Highlights of Burgundy & Provence JUL 1–13, 2013 • Call RCMA at (800) 472-6204
legislator birthdays One way to let your legislators know that you’re paying attention and that you vote is by wishing them a happy birthday! BIRTHDAY: OCT. 3 State Senator Christine Kehoe (District 39) E: senator.kehoe@sen.ca.gov W: dist39.casen.govoffice.com Sacramento Office: State Capitol, Rm. 5050 Sacramento, CA 95814 T: (916) 651-4039 • F: (916) 327-2188 San Diego Office: 2445 Fifth Ave., Ste. 200 San Diego, CA 92101 T: (619) 645-3133 • F: (619) 645-3144
BIRTHDAY: OCT. 27 State Senator Mark Wyland (District 38) E: (via website) cssrc.us/web/38 E: senator.wyland@sen.ca.gov Sacramento Office: State Capitol, Rm. 4048 Sacramento, CA 95814 T: (916) 651-4038 • F: (916) 446-7382 Carlsbad Office: 1910 Palomar Point Way, #105 Carlsbad, CA 92008 T: (760) 931-2455 • F: (760) 931-2477
San Diego Physician Editorial Board
SDCMS Member Physicians: If you are interested in learning more about possibly joining the San Diego Physician editorial board, please email Editor@SDCMS.org.
office managers
Nominate Your Office Manager for SDCMS’ 4th Annual “Outstanding Medical Office Manager” Contest today! SDCMS member physicians can nominate their office manager by explaining in writing (up to 600 words) why their office manager is the best in San Diego County. Send nominations (and questions) to Kyle Lewis at SDCMS at KLewis@SDCMS.org. Nominations deadline is Oct. 31, 2012. The winner will be announced in the December issue.
honor your mentor
Honor a Mentor in the November Issue of San Diego Physician magazine! SDCMS will be paying homage to those individuals who, either recently or in decades past, have inspired San Diego County’s physicians in ways professional or personal to strive to achieve something beyond themselves. SDCMS members who would like to share their stories about their mentors are encouraged to submit those stories to Editor@ SDCMS.org (anywhere from a paragraph to several hundred words) by Oct. 1, 2012.
Erratum
In our July 2012 issue, we reported that Mai Duong, MD, and Jane Bugea, MD, were pursuing medical careers in family practice, when, in fact, they are both pursuing medical careers in pediatrics, and both at UCSD/Rady Children’s Hospital. Our sincere apologies for the errors!
get in touch Your SDCMS and SDCMSF Support Teams Are Here to Help!
SDCMS Contact Information 5575 Ruffin Road, Suite 250, San Diego, CA 92123 T (858) 565-8888 F (858) 569-1334 E SDCMS@SDCMS.org W SDCMS.org • SanDiegoPhysician.org CEO • EXECUTIVE DIRECTOR Tom Gehring at (858) 565-8597 or Gehring@SDCMS.org COO • CFO James Beaubeaux at (858) 300-2788 or James.Beaubeaux@SDCMS.org DIRECTOR OF ENGAGEMENT Jennipher Ohmstede at (858) 300-2781 or JOhmstede@SDCMS.org DIRECTOR OF MEMBERSHIP SUPPORT • PHYSICIAN ADVOCATE Marisol Gonzalez at (858) 300-2783 or MGonzalez@SDCMS.org DIRECTOR OF BUSINESS DEVELOPMENT Brian R. Gerwe at (858) 300-2782 or at Brian.Gerwe@SDCMS.org DIRECTOR OF MEMBERSHIP OPERATIONS Brandon Ethridge at (858) 300-2778 or at Brandon.Ethridge@SDCMS.org DIRECTOR OF COMMUNICATIONS AND MARKETING • MANAGING EDITOR Kyle Lewis at (858) 300-2784 or KLewis@SDCMS.org OFFICE MANAGER • DIRECTOR OF FIRST IMPRESSIONS Betty Matthews at (858) 565-8888 or Betty.Matthews@SDCMS.org MEMBERSHIP ADMINISTRATIVE ASSISTANT Rhonda Weckback at (858) 300-2779 or Rhonda.Weckback@SDCMS.org LETTERS TO THE EDITOR Editor@SDCMS.org GENERAL SUGGESTIONS SuggestionBox@SDCMS.org
SDCMSF Contact Information 5575 Ruffin Road, Suite 250, San Diego, CA 92123 T (858) 300-2777 F (858) 560-0179 (general) W SDCMSF.org EXECUTIVE DIRECTOR Barbara Mandel at (858) 300-2780 or Barbara.Mandel@SDCMS.org project access PROGRAM DIRECTOR Francesca Mueller, MPH, at (858) 565-8161 or Francesca.Mueller@SDCMS.org Patient Care Manager Rebecca Valenzuela at (858) 300-2785 or Rebecca.Valenzuela@SDCMS.org Patient Care Manager Elizabeth Terrazas at (858) 565-8156 or Elizabeth.Terrazas@SDCMS.org IT PROJECT MANAGER Rob Yeates at (858) 300-2791 or Rob.Yeates@SDCMS.org IT PROJECT MANAGER Victor Bloomberg at (619) 252-6716 or Victor.Bloomberg@SDCMS.org
SAN DIEGO PHYSICIAN.org 5
The Patient’s Perspective
The Engaged Patient Toward Patient-Physician Partnerships for Better Outcomes by Peg Ford
6 septem b er 2012
As a cancer survivor and patient advocate, I have focused my efforts on promoting projects that encourage patients and physicians to work in partnership toward better outcomes. My journey started in early 2007 after I was diagnosed with ovarian cancer. As there is no screening test for early detection, a dismal five-year survival rate of only 45% for late-stage disease, and, unfortunately, as most women will face recurrences, I felt compelled to get involved. The internet proved invaluable in the beginning. I discovered a pioneering program of the Ovarian Cancer National Alliance — Survivors Teaching Students — designed to increase ovarian cancer symptom and risk factor awareness among medical students. Working with a local physician, I launched the first presentation to third-year medical students at UC San Diego in late 2008. Since then, once every six weeks on the students’ OB/
GYN rotation, a team of ovarian cancer survivors shares their personal stories, how they were diagnosed, what happened, and where they are now in treatment. As one student commented afterward, “It put a very personal and human view on something always presented as statistics and facts.” From there, identifying a need to reach physicians out of medical school for several years, I approached Afshin Bahador, MD, gynecologic oncologist, and asked to participate in his grand rounds. Our collaboration proved highly successful in several Scripps and Sharp hospitals around the county. Dr. Bahador commented, “This opportunity afforded me the experience to see ovarian cancer patients actively involved in bringing awareness of this deadly disease to my colleagues. As survivors, they not only placed a face on this disease, but they dispelled the widely held belief that ovarian
cancer is the ‘silent killer.’” Realizing the benefit of broadening our efforts, I expanded the program to 10 nursing schools, with the personal goal of not having one nurse practitioner graduate in the county who has not attended one of our presentations. According to a City College associate dean and director, “It was wonderful having all 120 of our students in the same room so engaged and so inspired in just one hour’s time!” Another novel physician-patient partnership program was developed by the Sharp Chula Vista Medical Center Pathology Department in conjunction with the Medical Center’s oncologists and the Breast Cancer Patient Navigator Program. This program was designed to assist breast cancer patients by educating them to be better prepared to ask informed questions about their diagnosis and treatment options. Patients attend a “Meet the Pathologist” session where the physician gives an overview of the anatomy and pathology of the breast, with each patient receiving a copy of their pathology report. Additional projects outside San Diego County include Decision Services, a UCSF pilot program designed with specially trained interns specifically for the newly diagnosed cancer patient, and Open to Options, launched by the Cancer Support Community to reach a greater number of patients through its network of 150 locations across the country. I am grateful to those progressivethinking physicians who are actively supporting the movement toward a new era of physician-patient partnerships. We have demonstrated the value of collaborative efforts and the importance of reaching out to survivors so that they can confidently take an active role in their treatments. I envision the examples above to be only the tip of the iceberg of possibilities, and I call on our healthcare community to continue developing physician-patient partnerships in order to positively impact both our communities. Ms. Ford, an ovarian cancer survivor and patient advocate, is chair of the Ovarian Cancer Advocacy Alliance, San Diego. She can be reached at pegsioux2001@yahoo.com or at (619) 437-8438.
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SAN DIEGO PHYSICIAN.org 7
Public Health
Preventing Suicide And Its Devastating Consequences in San Diego County by Holly Salazar, Director of Strategic Outcomes, Community Health Improvement Partners
8 septem b er 2012
Is your office staff trained in basic suicide prevention? Do they know how to recognize warning signs for suicide, how to ask patients if they are thinking of suicide, and where to direct patients for help? Do you have a patient screening and assessment protocol in place? Do you have an action plan if you suspect a patient is thinking about suicide? Sept. 9–15, 2012, was National Suicide Prevention Week. In support of suicide prevention, please take a minute to review your office policies and protocol for suicide risk assessment and screening. 77% of people who die by suicide had contact with a health professional within a year of death, and 45% of these contacts were within one month (Source: Luoma, Martin, and Pearson, Am. J. Psychiatry,
2002). Many people die by overdosing on medications prescribed to them at physician visits. Because of this, healthcare providers and other medical staff are critical partners in reducing suicides and their devastating consequences. The San Diego County Suicide Prevention Action Plan, published in October 2011, proposes strategies designed to enhance efforts to increase understanding and awareness of suicide, decrease stigma associated with suicide, and ultimately prevent suicide. For more information and to learn how to get involved, please visit www.sdchip. org/spap.aspx or contact Holly Salazar at (858) 609-7966. For mental health and suicide prevention resources and screening tools, visit www.mdhelpsd.org.
Alzheimer’s Disease It takes time to talk about it. We have the time. A diagnosis of Alzheimer’s disease can cause feelings of fear and confusion in both people with dementia and their families. Our professionally staffed 24/7 FREE Helpline offers information and advice to more than 250,000 callers a year and provides translation services in more than 170 languages.
800.272.3900
The 24/7 Helpline allows individuals and their families to: • Talk with a caring professional about questions and concerns. • Learn about the Alzheimer’s disease and other dementias. • Consult with master’s-level clinicians to help with decision making support and crisis management. Discover resources including: • Content rich website: www.alz.org/sandiego • 40+ Support groups in San Diego County • Local free information workshops • Clinical trial matching: alz.org/trialmatch
For a FREE referral pad go to www.alz.org/physicians or for more local resources email sandiegophysicians@alz.org
SAN DIEGO PHYSICIAN.org 9
Risk Management
Effective Informed Consent Fostering a Dialogue
by The Doctors Company For more patient safety articles and practice tips, visit www.thedoctors.com.
Hippocrates once promoted the beneficence model of medicine, which encouraged minimal communication with patients about their condition. Like Hippocrates, those days are long gone, and guidance now supports the idea that patients need to understand planned medical procedures adequately so they can make informed decisions about their treatment. Effective informed consent requires a dialogue with the patient wherein he or she feels comfortable fully participating by asking clarifying questions and offering personal concerns. Requirements for informed consent have not changed in modern healthcare, but the delivery has seen strong consumer momentum to encourage a better exchange of information. Traditionally, informed consent was limited to operative procedures, but, in recognition of the high-tech nature of medicine and the potent medications that have been developed, it must now encompass a broader range of medical care, including: • surgical procedures • significant medical treatments • prescriptions with severe side-effects Physicians are bound, in advance of this medical care, to provide the patient with detailed information on the risks, benefits, and alternatives, including the option to not perform the procedure or treatment 10 septem b er 2012
regimen and the effect that doing nothing would have on that patient’s health status. They are also required to inform the patient about any potential clinically significant adverse drug reactions or other concerns when a new medication is ordered. Patients can be overwhelmed by medical jargon and may be medically naïve, so it is imperative for the physician to foster an open dialogue with the patient and allow adequate time for discussion, translating key terms to common language and providing commonly asked questions that may put the patient at ease and stimulate further questions. It is important to base information not only on personal experience, but on broader sources as well. Verify understanding by asking patients to restate or recall key elements so the patient has
an accurate understanding and does not develop unrealistic expectations, which often result in unfair complaints about the practitioner’s care. An area often minimized prior to medical care is the recovery period. Prior to treatment, the physician should discuss any limitations or unwelcome surprises that may arise. Often the focus is on early medical issues (e.g., pain, possible infection, drainage), but it is valuable for the patient to also understand what life will be like for a longer period of time. Perhaps they will require readily accessible restrooms or will not be able to perform household activities. Finally, physicians will strengthen understanding and reduce potential complaints by including family members or friends in the discussions.
august 2012 SAN DIEGO PHYSICIAN.org 11
SDCMS
MemberBenefits
How Well Do You Know the Issues Critical to Physicians?
12 septem b er 2012
WHAT DOES “SGR” STAND FOR, AND WHY SHOULD I CARE?
The flawed and (un) Sustainable Growth Rate formula has since 1997 determined how much you get paid by Medicare for the services you provide. In 2002, SGR cut your reimbursement rate by 4.8%: • 2002: -4.8% • 2003: 1.4% • 2004: 1.8% • 2005: 1.5% • 2006: 0.2% • 2007: 0.0% • 2008: 0.5% • 2009: 1.1% • 2010: 1.3% • 2011: 0.9% • 2012: 0.0% And on Jan. 1, 2013, SGR will cut your rate again by 27% — plus a 2% sequestration budget cut! SDCMS and CMA continue to lobby intensely to stop the approaching draconian Medicare cuts, and continue to work with congressional leadership to permanently repeal the SGR. We are promoting long-term payment reform starting with a period of transition to test alternative payment methods and will eventually implement physicianled, patient-centered payment models and delivery systems.
WHAT IS CMA’S POSITION ON NONPHYSICIAN SCOPE-OF-PRACTICE EXPANSIONS?
While CMA does not oppose all expansions of scope of practice for nonphysician providers (physical therapists, optometrists, nurse anesthetists, pharmacists, nurse practitioners, psychologists, audiologists, chiropractors, podiatrists, dentists, clinical social workers, naturopaths, etc.), these proposals must be examined carefully to ensure that patient care is not jeopardized, i.e., that nonphysician providers have the proper experience, training, and education to treat patients safely, and that the physician is the final decision maker.
WHAT DOES “MICRA” STAND FOR, AND WHY SHOULD I CARE?
The 1975 Medical Insurance Compensation Reform Act has kept the doors of medicine open and has protected the healthcare safety net in California by keeping medical malpractice insurance available and affordable. CMA supports continuation of MICRA and keeping the cap on non-economic damages (one of its many provisions) at $250,000. CMA defended MICRA in 2012 before the 5th Appellate District Count, which upheld the constitutionality of MICRA’s $250,000 cap.
WHAT DOES “GPCI” STAND FOR, AND WHY SHOULD I CARE
The U.S. Department of Health and Human Services has knowingly used an outdated system — the Geographic Practice Cost Index — to pay physicians for more than 10 years, assigning to San Diego — America’s eighth largest city — a RURAL cost-of-living multiplier. GPCI results in the underpayment of 14 California counties, including San Diego, up to 14% per year. Three physicians (including an SDCMS physician) and seven California counties sued the DHHS for $3.2 billion in 2007. As recommended by the IOM, CMA urges Congress to update the localities to Metropolitan Statistical Areas consistent with the way Medicare organizes and pays hospitals. Support the Farr-Bilbray budget-neutral solution! SAN DIEGO PHYSICIAN.org 13
WHAT IS THE BAR TO THE CORPORATE PRACTICE OF MEDICINE, AND WHY SHOULD I CARE?
Unlike many states, California outlawed the practice of medicine by businesses and nonphysicians. This “corporate bar” protects patients and preserves physician autonomy by keeping hospitals and other commercial entities from directly hiring physicians and from dictating clinical decisions based on profit. With tightening economic pressures, hospitals and others are constantly seeking to erode the corporate bar. They would like to directly hire doctors and control physician freedom and patient access to care. Compromising physicians’ professional judgment would result in higher healthcare costs and diminished quality of care for our patients.
HOW DID CMA DEFEND MEDI-CAL IN 2011-12, FOLLOWING YEARS OF HARD WORK?
CMA led a coalition that spent more than $1 million in legal fees to successfully block a 10% Medi-Cal reimbursement rate reduction, to stop $5 doctor copays, to protect access to care for Medi-Cal patients, and to stop $137 million in Medi-Cal physician payment cuts for services provided to children! In addition, CMA was party to a lawsuit that reached the U.S. Supreme Court that now ensures physicians can sue in order to block Medi-Cal cuts.
HOW HAVE SDCMS AND CMA FOUGHT TO PROTECT SAN DIEGO COUNTY’S EMERGENCY SERVICES? CMA prevented any diversion of the $55 million in Maddy Fund monies, which provide critical resources to reimburse physicians for uncompensated care provided in the ER. CMA also protected funding for the Emergency Services Commission, which oversees planning for emergency services. 14 septem b er 2012
HOW DOES SDCMS HELP ENSURE SAN DIEGO COUNTY HAS A REQUISITE PHYSICIAN WORKFORCE? In 2002, SDCMS conducted San Diego County’s first Physician Workforce and Compensation Survey. The results provided SDCMS and local healthcare policymakers with their first insights into physicians’ attitudes toward their work, as well as San Diego County’s physician compensation environment. Subsequent Physician Workforce and Compensation surveys conducted by SDCMS in 2005, 2007, 2009, and again in 2011, continue to yield valuable data and insights for our San Diego County physician community, and local and state legislators.
HOW DOES SDCMS ENSURE I HAVE A VOICE AT THE TABLE IN LOCAL HEALTHCARE DISCUSSIONS?
SDCMS physician leaders and staff are active participants in healthcare stakeholder meetings throughout the county: • Adult Obesity • Childhood Obesity • Countywide Health Information Exchange • Regional Chamber of Commerce • County Health Services Advisory Board • Healthy San Diego • San Diegans for Healthcare Coverage • Mental Health America • San Diego Beacon Community Health Information Exchange • San Diego / Imperial Counties Chapter of the American Red Cross As well, SDCMS physician leaders and staff are asked regularly to speak at hospital general staff meetings, hospital medical executive committee meetings, resident physician meetings, medical student meetings, and retired physician meetings.
HOW DOES SDCMS SUPPORT ACCESS TO CARE FOR OUR REGION’S UNINSURED POPULATIONS? The SDCMS Foundation’s outreach and commitment to serve the medical needs of those less fortunate in San Diego County have created a healthy network of medical professionals determined to make a difference. More than 620 physicians volunteer with the Foundation’s flagship program, Project Access San Diego, which has assisted more than 1,600 uninsured adults in the community in receiving specialty health services. The Foundation’s programs help physicians, patients, and our community at large by offering efficient and meaningful access to specialty care, preventive health education, and by serving as a resource of information and support for medical students. Project Access San Diego has coordinated $5.5 million in donated care by San Diego County doctors, hospitals, and ancillary providers. The Foundation as well continues to support our future physicians, having awarded 13 UC San Diego medical students $31,000 in scholarships since 2007, and has increased the professional capacity of primary care physicians and improved patient care through its eConsultSD.
HOW HAS CMA BEEN INVOLVED IN FEDERAL HEALTHCARE REFORM?
With the U.S. Supreme Court ruling to uphold the Affordable Care Act (ACA) and the State of California moving swiftly to implement health reform, CMA continues to focus on implementation of the Health Benefits Exchange and improvements to the ACA. CMA supports the ACA’s expansion of affordable healthcare coverage to California’s uninsured, expanding access to primary care, investments in public health, and stopping the for-profit insurance industry abuses. While the ACA expanded coverage, it fails to ensure that such coverage will result in real access to a doctor. CMA advocates the following improvements to the ACA to ensure access to care: Repeal the Medicare SGR; eliminate the Independent Medicare Payment Advisory Board (IPAB); and increase the Medi-Cal payment rates to Medicare levels. Healthcare reform will not work unless Medi-Cal is fixed.
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Physician Access is a dedicated line that allows you to speak directly with one of our physicians at UC San Diego Health System. This number gives you real and immediate access to a fellow physician, and a trusted partner. So whether you want to talk about a particular case, facilitate a transfer or refer your patient for highly specialized care, our physicians are standing by to take your call.
855-543-0555 | health.ucsd.edu/access
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Success Stories From Your SDCMS Physician Advocate By Marisol Gonzalez
16 septem b er 2012
SDCMS member physicians are encouraged to contact their SDCMS physician advocate, Marisol Gonzalez, for practice management and membership assistance. Marisol can help with, for example, getting insurance reimbursements, connecting with experts in the field, answering your benefits and membership questions, helping with legal issues, helping with incentive program complexities, or support in finding the answers to keep your practice running smoothly. Marisol can be reached at (858) 300-2783 or at MGonzalez@SDCMS.org.
QUESTION: I’m looking for disability insurance. As an SDCMS member, do you have any recommendations for me? — Submitted by a 34-year member
ANSWER: SDCMS members can contact The Doctors Company Insurance Services at (800) 852-8872 or at kcollins@ thedoctors.com. The Doctors Company Insurance Services offers SDCMS members discounts on coverage such as worker’s compensation insurance, health and disability, property and general liability, and directors and officers/management liability.
QUESTION: I have a small private practice, and I have regular discussions with my staff about HIPAA. I would like to offer my staff training by an expert. We missed your HIPAA webinar. Do you have archives of your webinars or is anyone available to do an in-service on HIPAA guidelines for our practice? — Submitted by a three-year member practicing family medicine ANSWER: All SDCMS webinars can be found archived on our website at www.SDCMS. org. We do have an excellent HIPAA guru that we go to for all HIPAA-related questions, and
SAN DIEGO PHYSICIAN.org 17
A Sampling of Past Physician Advocate Success Stories
he is also the speaker at all of our HIPAA seminars/webinars. David Ginsberg is the president of PrivaPlan Associates, Inc. He provides SDCMS members with a discount on his services. He can be reached at (877) 2187707 or at dginsberg@privaplan.com.
QUESTION: I need an office equipment appraisal. Does SDCMS recommend anyone locally? — Submitted by a 35-year member
ANSWER: Practice Performance Group is SDCMS’ endorsed practice management partner. They have an algorithm for valuing equipment that is suitable for most transactions. Where there is equipment of significant value (exotic test equipment, for example), a certified appraiser is more appropriate, and they will use one. Please contact Jeff Denning at (858) 459-7878 or at jeff@ ppgconsulting.com.
QUESTION: I am looking to purchase a computer server for my practice, and I’m not quite sure what I need. Do you have any recommendations for someone I can talk to? — Submitted by 20-year member practicing family medicine ANSWER: Soundoff Computing Corporation is our endorsed IT solutions partner. They do free site inspection and subsequent infrastructure recommendations. They also do free inventory and assessment of network and hardware computing assets. Please contact Ofer Shimrat at (858) 569-0300 or at ofer@soundoffcomputing.com.
Michael J. Rensink, MD, SDCMS-CMA member since 1979, had an issue getting paid for parts of a surgery he performed on one of his patients who is insured by United Healthcare (UHC). UHC argued that there was a “supposed surgical date” that was not kept, and that they were never notified about the change for the surgery date. There was never a proposed date for surgery given by Dr. Rensink’s office because they do not schedule surgeries until they have the authorization in hand. The procedure that was performed in this surgery requires a prior authorization, and his office did have all of the paperwork showing the approval for the authorization. UHC ended up partially paying for the claim but did not pay for the procedure. Dr. Rensink tried to appeal on his own, to no avail — he even tried to speak to a supervisor at UHC, but with no success. He reached out to SDCMS, and, with the help of CMA’s Center for Economic Services team, Dr. Rensink’s denial was overturned, and he was paid for the surgery. A two-physician pediatric group had difficulties with Medi-Cal’s stopping payments on their checks because of a change of address form that was lost in the shuffle. Through CMA’s Economic Advocacy team, the change of address form was expedited to avoid any further delay in payments. A medium-size cardiology group had a terrible time when Palmetto took over as the intermediary for Medicare. This affected their entire group, including their allied health professional staff. Through our contacts at Palmetto, we were able to fix all of the outstanding issues for the practice, and their reimbursements began flowing again. A solo allergy and immunology physician, who was new to the area and in her first few years of practice, had questions about billing practices. SDCMS was able to educate her and provide her with the information she needed to prevent her from potentially adopting illegal billing practices in her office. A medium-size orthopedic group had multiple problems with Medicare, such as refunds, credentialing of physicians, and lost paperwork. The practice contacted Palmetto several times and received conflicting courses of action to remedy their issues. Through SDCMS’ Palmetto contacts, we were able to communicate to the practice exactly what was needed; their Medicare checks started flowing again, and everything got squared away. A solo psychiatrist noticed a marked increase in Anthem Blue Cross’ repeatedly denying payment of psychiatric medications in doses that are above package insert but well within the standard
18 septem b er 2012
practice of care. The physician attempted to appeal these denials on her own to no avail. CMA’s Economic Advocacy team connected with the pharmacy division at Blue Cross through their contacts, and the denials were overturned. A two-physician oncology group ran into several obstacles with their Medicare credentialing. Their NPIs were not linking, and every time they contacted Palmetto, they received conflicting answers as to what they needed to do. During this time, Palmetto held all of their claims, and there was no money flowing into the practice for Medicare patients. SDCMS was able to work with Palmetto and communicate to the practice exactly what was needed to get them squared away. Palmetto quickly released $114,000 in back claims. A solo surgeon had an outstanding claim with Health Net. It had been denied and appealed several times, and the practice had no other solution to the problem. At the time, the physician was not an SDCMS-CMA member. In talking to another physician who is a member, the surgeon decided to join in order to see if CMA’s Economic Advocacy team could assist with the issue. CMA’s team was able to get the claim paid, with interest, which paid for the cost of the physician’s dues and then some: $6,800. “As a byproduct of reengineering our practice, we learned how best to incorporate SDCMS’ and CMA’s support resources, body of knowledge repositories, and key program initiatives into the framework of our updated business model and practice management structure. We have gained economies in areas not seen before, and, through participation in SDCMS’ seminars and engagement with CMA’s Center for Economic Services, we have significantly improved our revenue cycle management efforts. We have accomplished this with the use and adoption of CMA’s Best Practices, Back to Basics, and Taking Charge publications, allowing us to create and sustain a balanced scorecard for our practice.” — Solo Physiatrist SDCMS-CMA Member A solo dermatologist got yelled at by one of her patients because the physician would not refill the patient’s prescription without seeing the patient first, as it had been almost over two years since the patient had last been seen. The prescription was a non-schedule II–V drug, and the physician wanted to make sure her prescription refill practices were correct. SDCMS was able to provide her with the legalities of refilling prescriptions for non-schedule II–V drugs, and she thanked us for confirming with her that her prescription refill practices were appropriate for her practice.
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Verdolin Pa in Specialis ts is a com based Inte prehensive, rventional officePain Manag Eastlake, Sa ement Cent n Diego. We er in offer the late techniques, st interventio including m inimally inva nal dures, proven sive spine pr to reduce th ocee fellowshipSpecialized Services: trained, doub burden of chronic pain . Our le-board-ce arey highly • Obesit rtified phys skilled with • Diabetes icians many years manResist agemance • Insulin ent experie of pr • Pump Therapy ac tic al pain nce. In conc prim lararPeriod • Irregu y cares phys ert with a • Nutrition Counseling ician, we ca patient’s and ing sterol • Chole n also help pain m • Growth Hormone anagement m od ify Issues re existceride gimens to be Trigly Deficiency more effectiv stic Ovarian e. • Small for Gestational Age • Polycy • Idiopathic Short Stature • Thyroid • Turner Syndrome • Prader-Willi Syndrome • Adrenal Problems • Ambiguous Genitalia • Hypoglycemia
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SDCMS
MemberBenefits
Do You Qualify for an SDCMS-CMA Dues Discount? For further information on SDCMS-CMA dues or whether or not you might qualify for a dues discount, contact Brian Gerwe at (858) 300-2782 or at Brian.Gerwe@SDCMS.org.
20 septem b er 2012
How much are nondiscounted SDCMS-CMA dues? for $970 Unchanged Five Years!
What is SDCMS’ portion?
$380 (39%) What is CMA’s portion?
$590 (61%) What dues discounts can physicians qualify for?
The following SDCMS-CMA dues discounts are available to qualifying physicians: »50% » Initial Discount if You’ve Never Been a Member of CMA »71% » Initial Discount if You’re 40 Years Old or Younger »71% » Initial Discount if You’re Within Your First Eight Years of Practice »90% » Discount if You’re in the Military »50% » Discount if You’re Government-employed »50% » Discount if You’re 65 Years Old or Older and Work 20 Hours a Week or Less »10% » Discount if You Sign up for a Three-year Membership »5% » Discount if You Pay by Nov. 1, 2012
Are SDCMS-CMA dues tax deductible?
Association dues are not deductible as a charitable contribution for federal tax purposes but may be partially deductible as a business expense. 32% of CMA dues for 2012 cannot be deducted as a business expense for federal tax purposes because of lobbying activities on behalf of CMA members.
SAN DIEGO PHYSICIAN.org 21
SDCMS
MemberBenefits
Did You Know You Could Save Money on …
… Medical Liability Insurance Premiums?
SDCMS exclusively endorses The Doctors Company, the nation’s largest insurer of physician and surgeon medical liability. In return, SDCMS members receive unique savings on insurance premiums, as well as continuing medical education and an unrivaled financial career reward. IGO Medical Group, one of San Diego’s oldest and most respected medical practices specializing in infertility, obstetrics, and gynecology, has benefited from membership in The Doctors Company and SDCMS for the past 25 years. “The programs and benefits provided by The Doctors Company through its partnership with SDCMS have had a significant impact on our operations,” says Sheila Hendry, IGO Medical Group’s administrator. “We have saved thousands of dollars on core insurance policies, allowing us to add new coverage for billing errors and third-party liability, along with wage and hour protection.” Through SDCMS’ partnership with The Doctors Company and The Doctors Company Insurance Services, SDCMS members benefit from a 5% savings on medical malpractice insurance and a 22% discount on workers’ compensation insurance. For example, IGO Medical Group has received: • Medical Malpractice: IGO Medical Group saves 5% on its medical malpractice insurance premiums each year and will save more than $26,000 this year alone. • Property/General Liability: The Doctors Company reduced IGO Medical Group’s premium by more than 55%, while increasing the quality of coverage. • Employment Practices Liability: IGO Medical Group saw a premium reduction of more than 18% and decreased its deductible from $10,000 to $5,000. • Tribute® Plan: The Doctors Company provides physicians with a significant financial award when they retire from the practice of medicine. To date, more than 200 SDCMS members have qualified for a Tribute award, with an average balance of $11,500. The highest Tribute balance is more than $55,000 — and every year, these numbers continue to grow. • Continuing Medical Education (CME): The Doctors Company continues to provide innovative and timely patient safety and risk management courses that meet the educational needs of its members. Medical liability insurance premium credits are available for members who participate in an approved program. The next program, titled “Top 10 Patient Safety Issues for Office Practices,” will be held on Nov. 15, 2012. Contact Rhonda at SDCMS at Rhonda.Weckback@SDCMS.org or at (858) 300-2779 to learn more about the program and to sign up.
»POTENTIAL VALUE
Thousands of Dollars per Year
22 septem b er 2012
… Income Replacement and Business Overhead Reimbursement Insurance? Wealth Legacy Group offers SDCMS members: • A customized disability program that only SDCMS members can access • 10–43% discount on individual disability premiums • 10% premium savings on overhead expense reimbursement insurance based on eligibility • Stress claims (mental, emotional, and nervous disorders) treated as any other condition — no 24-month maximum cap on benefits • “Own Occupation” subspecialty coverage — receive benefits even if able to perform duties in another area of medicine SDCMS Member Testimonial: “I wanted to write and thank the San Diego County Medical Society for the introduction to RJ Kelly. He has provided a great asset to my surgical practice. I now have disability insurance that covers my practice in the event that I am ill or injured. I had tried to obtain this type of insurance with multiple other agencies, but was unable to because of a childhood illness and surgery. RJ was able to lobby on my behalf, and with his extensive contacts I was able to obtain a three-year policy. I hope that others can benefit from this association as I have.” — Leslie A. Giesemann, MD, SDCMS-CMA Member Since 2008
»POTENTIAL VALUE Thousands of Dollars per Year
… Your Legal Needs? The law firm of Alexander & Alexander, created by a physician-attorney, can provide unique insight into all of your legal needs, including medical malpractice, business law, real property transactions, tax planning, and trust and estate planning. Let the firm’s unique Tower Law System save you about half of what you might normally pay. SDCMS members receive an additional 10% discount!
… Tamper-resistant Prescription Pads With American Security Rx?
»POTENTIAL VALUE $300
»POTENTIAL VALUE $500
… Medical Supplies, Equipment, and Pharmaceuticals?
STAT Pharmaceuticals, San Diego’s only full-line physician supply distributor — family owned since 1982 — offers SDCMS members: • Free analysis of your current purchases • 10% bottom line savings compared to your current cost from competitors on medical supplies and pharmaceuticals (excludes vaccines, blood and plasma products, oncology drugs, HGH and HIV/AIDS drugs) • 30-day notice on all medical supply price increases • Same-day service to most San Diego County locations • Your calls answered by a person, not a machine • No-backorder guarantee program • 24/7 web ordering, convenient online customized shopping lists • 100% satisfaction guaranteed on all of STAT’s products SDCMS Member Testimonial: “For the past 12–13 years our office has been ordering from STAT Pharmaceuticals for our medical supply needs. No other place can compare with STAT Pharmaceutical’s excellent customer service, low prices, and quick deliveries. When I call and need an item that they may not carry or that they may not have in stock, Dee, Cathy, or Dennis go out of their way to find it and get to us as soon as possible. If we have a return, there is no problem. The item gets picked up and we get refunded. The best part is that they are all very patient and pleasant to speak to. As for their prices, there are numerous times when other medical supply places have an item on sale. I just call STAT Pharmaceuticals for the same item and they either match the price or even give it to me at a lower price. Another plus about STAT Pharmaceuticals is their quick delivery. There have even been a few times where I get an order delivered on the same day I have placed the order. But I always get my items the next day. How many other places can do that? When I can, I recommend STAT Pharmaceuticals services to other doctors’ offices and to new doctors who are getting started with their business. STAT Pharmaceuticals has always been good to our office. Their customer service, low prices, and quick delivery cannot be beat.” — Office Manager for Terry L. Winegar, MD, SDCMS-CMA Member Since 1985
»POTENTIAL VALUE
$200–$1,000+ per Month
… Banking Services?
First Citizens Bank offers SDCMS member physicians: • No points on lines of credit and loans • Half off points on commercial and construction real estate loans • Free online banking • Bank at work and courier service • Waived ATM fees • Free first order of checks SDCMS Member Testimonial: “I started with one personal account. I was very impressed that when I walked into the bank three months later they knew me by name. After that I brought some of my business accounts over. My previous bank got the job done, but in a less personal way. The people at First Citizens Bank are friendly, highly efficient, and offer genuine personalized service. They have helped me save time and money. My banker has always been able to answer my questions in a very clear and concise manner. She is easily accessible via phone or email. I would encourage my fellow physicians to consider First Citizens Bank. They are very customeroriented and offer personalized, efficient service that is distinctly different from other banks.” — Lisa S. Miller, MD, SDCMS-CMA Member Since 1992
»POTENTIAL VALUE $2,500
… Your Technology Needs?
SOUNDOFF Computing Corporation provides best-ofbreed hardware, software, and network technologies for your medical practice, utilizing best practices for all aspects of IT implementation. SDCMS members receive: • Free site inspection and subsequent infrastructure recommendations • Free inventory and assessment of network and hardware computing assets • Free analysis of Internet/telco/data activity and subsequent ROI recommendations
»POTENTIAL VALUE $1,000 SAN DIEGO PHYSICIAN.org 23
SDCMS
MemberBenefits
… Your Billing Needs?
CHMB, Inc., provides outsourced medical billing, revenue cycle management services, information technology support, and hardware solutions to physician practices, clinics, and multispecialty organizations. SDCMS members receive: • 50% discount on startup fees • $33 per-physician-per-month services credit • 10% off of outsourced IT support • 10% off of already discounted Dell hardware solutions • Free coding hotline SDCMS Member Testimonial: “Our goals in EHR adoption were to improve the entire operation — better workflows, enhance internal communication, and relieve the entire staff of ever-expanding paper charts. Of course, we wanted to qualify for the meaningful use incentives; however, we were more focused on improving the practice’s operations, which in turn makes it easier for both of us to focus on the patients and their care. “Since we integrated Enterprise EHR into our practice, we have surpassed our initial goals of improving practice operations. We have cut our transcription costs by $12,000 annually, which actually pays for our EHR subscription. We complete all patient visit documentation, including charge capture by the end of each day, allowing faster submission to payers. We now have bidirectional lab interfaces and will soon be connected with our hospital to streamline patient care. CHMB customized our notes specific to ENT procedures and methodology. And using Dragon has been such a timesaver for both of us. “CHMB worked alongside our clinical staff to ensure we optimize the EHR; in fact, we became one of the first practices to use the iPad. The patients loved seeing us use “new technology” and are very supportive of our efforts to modernize the group. We are extremely thankful to have made the decision to adopt EHR and to work with CHMB and their entire team. They made the transition manageable and really went the extra mile in making it successful. One more thing: Both of us attested and achieved meaningful use in 2012, and our checks are on their way.” — Robert D. Jacobs, MD, SDCMS-CMA Member Since 1993, and Bruce K. Reisman, MD, SDCMS-CMA Member Since 1995, of ENT Associates
»POTENTIAL VALUE $1,000
24 septem b er 2012
… Contract Analyses?
Coastal Healthcare Consulting Group is a specialty consulting firm that assists clients with managed care contracting, contract negotiations, credentialing, revenue enhancement, and strategic planning. SDCMS members receive: • Free contracting analysis • Discount on hourly rates • Package price on services for contract negotiations, including health plan contracts
»POTENTIAL VALUE 10% of Net Revenue
… Practice Management Consulting?
Practice Performance Group provides high-performance medical practice management services for physicians, including consulting, expert witness, workshops, speaking, and a monthly newsletter. SDCMS members receive: • Discounted management consulting on productivity and patient flow, personnel, governance and management, market strategy and tactics, practice acquisitions, sales and mergers • A free one-year subscription to UnCommon Sense A “No Pain” Recruiting Success Story: A small single-specialty medical group completed negotiations with a physician who was just finishing his fellowship. In only 90 days initial talks proceeded to signed documents with a minimum of drama. In just a few years, the medical group’s founders had built a busy and well-managed practice. They had room and demand for another physician and a great candidate in mind. They called SDCMS for a referral to someone who could help them structure a fair offer. That’s when our phone at PPG rang. After we explained our concept of the “all issues covered” offer, we were commissioned to lay out the deal for the accountants and lawyers to draft. We valued the practice and divided by the number of shareholders after the buy-in. About one-third of that amount represented tangible assets, the rest was goodwill. The new physician purchased shares in the corporation from the existing shareholders valued at this amount. Next, we drafted the terms of the Employment Agreement they would all sign, which called for identical terms for all physicians save one clause: the compensation calculation. The compensation package would be determined by their individual cashflows, but the new physician would be charged a “first distribution” off the top, a pro-rated “earn in” payment to the other doctors over a period of months as their compensation for the goodwill element of the transaction. Another clause in the Employment Agreement specified the amount an exiting employee is paid as “separation pay,” which is reduced if the termination is on short notice, to compete, or due to some adverse circumstance like loss of hospital privileges or license to practice. During the first three years, separation pay is zero whether the new doctor resigns or is terminated. The other document we designed was the Shareholders’ Agreement, which was identical for all doctors. It specified how and how much an exiting shareholder would be paid for his or her shares and contained a non-compete clause for non-founders joining the group. This sounds like a lot for a candidate contemplating a career choice to take in. It is. But we softened the risk aspect with the understanding that the new doctor could and would be bought back out — for exactly what he paid — during the first three years if things didn’t go well. The only “cost” to the new doctor of an unsuccessful tenure with the practice would be his monthly “first distribution” payments. This clause works for both sides: If the founders want to end the relationship, they can during the first three years. After that, if a shareholder is voted out, he’ll get his separation pay.
»POTENTIAL VALUE $1,000–$2,500
… Accounting Services?
AKT LLP, CPAs and Business Consultants, has provided audit, tax preparation and planning, accounting assistance, and business consulting to San Diego County clients for more than 50 years. SDCMS members receive: • 15% discount on standard rates for professional services, with an unconditional satisfaction guarantee: “SDCMS members who are not completely satisfied with the work AKT performs for them pay only what they thought the work was worth.” SDCMS Member Case Study: Ronald E. Feldman, MD, and his wife, Jane, are clients of AKT LLP and also of AKT Retirement Plan Services. AKT currently prepares their 1040 tax return, Dr. Feldman’s 1065 partnership return and his 1120 corporate return, and Retirement Plan Services administers the pension plan for his corporation. Additionally, once a month, AKT’s accounting staff visit his office and prepare the bank and payroll reconciliations. Over the years, this has provided Dr. Feldman with substantial savings due to intercompany tax planning. Since AKT is able to communicate within its firm regarding Dr. Feldman’s business and individual tax compliance and planning situations, it makes AKT’s work more efficient, and it is much more convenient for Dr. Feldman to have one firm take care of his tax and accounting needs. Note: AKT LLP, CPAs and Business Consultants was recently named one of the 2012 Best Places to Work in San Diego by the San Diego Business Journal.
»POTENTIAL VALUE $500–$2,000
… Collections Services?
TSC Accounts Receivable has provided personalized, innovative collection and total accounts management services since 1992. This local, family-owned business’ management team has combined experience of more than 50 years in the healthcare billing and collection field. SDCMS members receive: • 10% discount on monthly charges SDCMS Member Staff Testimonial: “I came across this agency approximately three years ago when we had to deal with them regarding a different problem. What stood out was how they handled our phone calls. They showed the understanding and compassion it takes when one is dealing with patients who have been overwhelmed with medical debt. Since our field specializes in cardiology, this was important to us. Many patients become stressed with their health issues that turn into financial issues. Shortly after dealing with TCS, we learned that the agency we had been using for 25 years was no longer specializing in medical collections. This was when we made the decision to use TCS and we will never regret the change. The change was a very simple process.” — Betty Szampruch, Billing Manager, San Diego Cardiac Center Medical Group, Which Has Been Using TSC Accounts Receivable Solutions Since 2009
»POTENTIAL VALUE $350–$500
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www.SanDiegoArthritis.com SAN DIEGO PHYSICIAN.org 25
SDCMS
MemberBenefits
Take Advantage of SDCMS and CMA Member Benefits!
26 septem b er 2012
DAY-TO-DAY ASSISTANCE FOR YOUR PRACTICE:
• Access SDCMS’ Physician (and Office Manager) Advocate: In the past year, Marisol Gonzalez, your physician advocate, has solved more than 450 member problems. Marisol can help you get insurance reimbursements, connect you with experts in the field, answer your benefits and membership questions, address your legal issues, support you in finding the answers you need to keep your practice running smoothly, and so much more! Marisol is also available to assist your office manager with his or her practice management questions. • Free Coding Hotline • Free Classified Ads in San Diego Physician and Online at SDCMS.org • Free Attendance at SDCMS’ Seminars and Webinars • Free Attendance at CMA’s Webinars • Free and On-demand Access to All SDCMS Recorded Seminars at SDCMS.org • Free California Emergency Driving Emblem • Payer Contract Analysis With CMA’s Center for Economic Services • Free Access to CMA’s Medical-Legal Library (Formerly CMA ON-CALL) • HIPAA Compliance Assistance • Legal Handbooks, HIPAA Compliance Toolkits, Practice Management Guides, Patient Forms, and More • CMA’s Physician Confidential Line • Become a Certified Medical Coder, Compliance Officer, Office Manager, and Insurance Specialist at a Significant Discount • Ensure You (and Your Office Manager) Have Access to Members-only Content at SDCMS.org • Free San Diego County Physician Mailing List • Access SDCMS Endorsed-partner Expertise to Save Time and Money • Ensure Your Office Manager Is Networking With His or Her Colleagues via SDCMS’ Online Forum, Pre-seminar Networking, and More • Receive Free of Charge SDCMS’ List of San Diego County Pharmacies — Updated Annually
INCREASE YOUR PERSONAL BOTTOM LINE:
• Disneyland Resort Ticket / Passport Discounts • Auto and Homeowner Insurance Discounts From Mercury Insurance Group and Automobile Club of Southern California • Rental Car Discounts From Avis and Hertz
STAY INFORMED:
• Receive a Free Subscription to SDCMS’ Monthly Magazine, San Diego Physician • Receive Free of Charge and Free of Advertising SDCMS’ Biweekly E-newsletter, “News You Can Use” • Follow the Latest Health Policy and Practice Management Stories at SDCMS.org • Follow SDCMS on Twitter, “Like” Us on Facebook, and Watch Our Video Updates on Our YouTube Channel • Sign up to Receive CMA’s Invaluable Publications: CMA Alert: Critical Issues Affecting the Practice of Medicine; CMA Practice Resources: Tips and Tools for Practice Efficiency; Legal Case List: Litigation in Which CMA Is a Party or Has Filed a Brief; Legislative Hot List: CMA Bills and Other Legislation; Regulations Quick List: Regulations Tracked by CMA; and more!
GAIN PROFESSIONAL DEVELOPMENT SKILLS: • Leadership Training Workshops • Advocacy Training Workshops • Media Training Workshops • Join an SDCMS Committee or Commission • Become an SDCMS Physician Leader
official public
diego count y
medic al societ
y May 2012
8,500
Physicians Every Month
Th e DaTa Is Co mIng! e DaTa Is Co mIng sanTh diego co e Th un D ty [specialty] = Not
liSteD By SPeCiAlt
— page 4
Board-certified or
Self-designated Interest
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Area • (specialty) = Nonmember Physician
liSteD AlPhABe
— page 34
tiCAlly
Specialty • See Pages 34–35
for Codes
SDCmS-CmA memBer
— page 148
BenefitS
The Da Ta Is CCoommIn Ta Is Ing!g! ! Th e DaTa Is Co a Th! e D a Ta mIng Is Thee DaTa IsCoCmoIn g ! Th e DaTa IsTh Dang Ta! Is Co mIngm Co mI ! In g! Th e DaTa Is Co mIng
Physician Directory 2012
“Physicians Un ited For
PROMOTE YOUR PRACTICE:
ation of the san
Reaching
a healthy san
!
diego”
A
• Receive a Free San Diego County Physician Mailing List Annually • Create and Manage Your Online Physician Profile at SDCMS.org • Place Free Practice Announcements in San Diego Physician and Online at SDCMS.org • Advertise in San Diego Physician, SDCMS’ Pictorial Membership Directory, and SDCMS’ San Diego County Physician Directory at 50% off Regular Rates • Appear in San Diego Magazine’s Annual “Health Annex” • Become an SDCMS Spokesperson on Topics Within Your Specialty for San Diego County Media
SAN DIEGO PHYSICIAN.org 27
COMMUNICATE WITH YOUR COLLEAGUES AND PATIENTS:
GET PRACTICE MANAGEMENT TRAINING:
• SDCMS Members and Staff Attend Free of Charge All SDCMS Seminars, Webinars, and Workshops: SDCMS conducts approximately 40 seminars and webinars annually with more than 2,000 physicians and office staff attending; examples include Collection Strategies, Medicare Updates, Road to ICD-10, OSHA Updates, Palmetto GBA / Medicare, Treating Patients Right, HIPAA 5010 Changes, Advocacy Training, Media Training, Microsoft Outlook, Leader’s Toolbox, Financial and Legal Life Skills. • Receive Significant Discounts on SDCMS’ Certification Courses • Watch All Recorded SDCMS Seminars at SDCMS.org • SDCMS Members and Staff Attend Free of Charge All CMA Webinars • CME Tracking / Credentialing
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EXCLUSIVE PhySICIan hOME LOan
• Connect, Communicate, and Collaborate With the DocBookMD App for Free: DocBookMD is a HIPAA-compliant ondemand messaging app for smartphones and tablets that includes an up-to-date physician directory, a listing of all local pharmacies, and messaging with images (X-rays, EKGs, wounds). • Appear in and Receive a Free Copy of SDCMS’ Annual Pictorial Membership Directory • Appear in and Receive a Free Copy of SDCMS’ Annual San Diego County Physician Directory
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S an D ie go D ai ly N ew s 2012-2013 Physician Housing Market Special
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San Diego Docto r Buys home Using Specia l Physic ian Mortg age Prescription Real Estate helps Dentist’s family buy with little savings
Physician Mortgage Key Was Access to “Impossible-to-Find” Special home loans for Prescription Real Estate helps its clients with special n and his family. doctors, and that certainly was the case for this Physicia County Medical Society, A fairly new attending physician at San Diego new $1 Million Dollar he only needed $50k for a down payment on his with all wanted at home purchase. He quoted, “All the banks I spoke months of reserve. I least $200k for a down payment, and another 12-18 income. Prescription don’t have that much cash yet, even with my great qualify for this special Real Estate made it easy for me, helping me find & payment made it physician mortgage. Needing only $50k for a down little savings I had, doable, and no reserves were required. I used what from my mom, and we a little bit of my signing bonus, and a small gift of renting for another couldn’t be happier. With 2 young kids, the idea we called Prescription 2 years was depressing to all of us. We’re so glad Real Estate!
28 septem b er 2012
ns, Who $1M Homes Surprisingly in Reach For New Physicia Don’t Have to Rent Any More home, in a modest a is families All Physicians want for their a loan that they good school district, reasonably close to work, and pay PMI. Should be could put very little money down and not have to right? Easier easy for a new attending physician with great income, Real Estate. tion said than done, until they speak with Prescrip for our family, “My wife and I simply wanted to buy a home with their cool and Prescription Real Estate made it super easy us to search with home search tools at their website. They enabled job, price range, filters like school district, distance from my new our search made and square footage. Their technology actually no PMI also came fun.” And his goal of a low down payment and John McConnin, true. “We love helping families and physicians” said McConnin, also a real estate broker at Prescription Real Estate. special financing licensed attorney, said “ I know how important this work with.” is for these young physicians, and they’re great to
McConnin & Company Realty DRE #01445675
★★★
Trust A Common Sense approach to IT Trust us to be your Business Advisor Hardware + Software + Networks Security + Support + Maintenance Ofer Shimrat (858) 569-0300 www.soundoffcomputing.com
San Diego Physician Magazine Advertisers: We Appreciate Your Support! AKT, LLP Alzheimer’s Association BBVA Cooperative of American Physicians Colliers The Doctors Company First Citizens Bank Imaging Healthcare Specialists Medical Billing Connection Medical Speech Solutions Norcal Prescription Real Estate San Diego Arthritis Medical Clinic Soundoff Tracy Zweig & Associates TSC Accounts Receivable University of California, San Diego Health Services Wealth Legacy Group
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SDCMS
MemberBenefits
Make sure you’re taking full advantage of your SDCMS-CMA membership by scheduling a five-minute benefits check-up today! 1) Choose the benefits categories you’d like a check-up in:
Schedule Your 5-Minute Benefits Check-up Today!
❏ Day-to-Day Assistance for My Practice ❏ Increase My Practice’s Bottom Line ❏ Increase My Personal Bottom Line ❏ Gain Professional Development Skills ❏ Promote My Practice ❏ Stay Informed of the Issues ❏ Get Practice Management Training ❏ Tools to Communicate With My Colleagues and Patients ❏ Shape the Issues Critical to the Practice of Medicine ❏ Network With My Physician Community
2) Complete this form and fax it to SDCMS at (858) 569-1334:
Physician’s Full Name
Physician’s Office Manager
Telephone
3) Someone at SDCMS will contact you to schedule your check-up.
Thank you for your membership with sdcms-cma! 30 septem b er 2012
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Dx: Serious risk of lost income Rx: SDCMS disability protection! • Save 10% to 43% • Premiums may be tax-deductible • Own-occupation, sub-specialty contract language Lock in low rates before pending state rate hikes. For your individual quote, call Wealth Legacy Group at 619.370.7472 or visit www.sdcmsdisability.com.
SDCMS
MemberBenefits
Following are SDCMS’ processes and procedures for selecting companies with which we choose to partner to bring to you and your staff those goods and services that you have indicated you want: CHOICE: SDCMS members will, whenever possible, be given a choice of benefits partners, i.e., SDCMS will not normally enter into exclusive relationships.
Policies and Procedures
MEMBER INPUT: Goods and services SDCMS members want and need will be identified and prioritized using secondary research, focus groups, oneon-one interviews, and surveys. NEGOTIATIONS: SDCMS will negotiate with all potential benefits partners to acquire the best possible deals for our members. BENEFITS ACCRUE TO MEMBERS: All contracts will be entered into with the expressed understanding that all financial gain will accrue to SDCMS’ member physicians and not to SDCMS. MEMBER DISCRIMINATION: SDCMS members will receive a better value or a lower cost of goods and services than nonmembers. EASE FOR MEMBER: Little or no work will be required by SDCMS members to take advantage of any and all benefits partners’ goods and services.
32 septem b er 2012
STANDARDIZED VETTING: Benefits partners must have current SDCMS members as customers. SDCMS member feedback will be solicited to ascertain acceptable benefits partners. SDCMS member feedback will be reviewed annually. Benefits partners will be asked for proof of solvency. Benefit partners’ local Better Business Bureau membership status will be queried. MARKET SEGMENT DISCRIMINATION: Market segments will be identified using mode of practice data, and goods and services will be identified for each segment, with the intent of offering comprehensive benefits for each of our member market segments. FEEDBACK AND TRACKING: A feedback tracking system will be implemented for both benefits partners and SDCMS members in order to provide benefit dollar values to SDCMS members. SDCMS members and benefits partners will be routinely surveyed to gauge SDCMS member satisfaction with benefits partners. If you would like to suggest any other policies or procedures, or a specific SDCMS member benefit, please contact Brian Gerwe, your SDCMS director of business development, at (858) 300-2782 or at Brian.Gerwe@SDCMS.org.
BE OUR HERO give access to healthcare for those without!
San Diego County Medical Society Foundation’s Mission Is To Improve Health, Access To Care, And Wellness For Patients And Physicians Through Engaged Volunteerism.
Volunteer for Project Access San Diego Through our flagship program, Project Access San Diego, we have been able to assist over 1.700 uninsured adults in our community to improve their health through access to specialty healthcare services. Join our more than 625 volunteer physicians to provide specialty healthcare services to those who most need our help. You decide how many patients a month or a year you are able to serve. We make your volunteer experience easier and more rewarding, and less taxing to your office staff with comprehensive patient care management, labs, imaging and other ancillary health services. Your consultations will be efficient for you and life-changing for your patients.
Volunteer in Your Pajamas Provide your primary care physician colleagues HIPAA-compliant, web-based patient consultations from the comfort of home or office. eConsultSD increases the capacity of primary care physicians at our community health centers to maintain care of their patients by receiving answers to clinical questions from volunteer specialists. eConsultSD is an easy way for specialist physicians to volunteer when they are not able to provide direct patient care.
Get Involved San Diego County Medical Society Foundation needs you! Attend an event, assist us to recruit fellow physicians, or provide educational opportunities for primary care physicians or medical students. Our first annual Golf Tournament is scheduled for Thursday, February 28, 2013 at Del Mar Country Club; we hope you can join us! Please consider making a contribution to SDCMS Foundation to support our efforts at www.sdcmsf.org, or call us at 858.300.2777.
5575 Ruffin Road, Suite 250, San Diego, California 92123 p: 858.300.2777 f: 858.569.1344 n
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Lawrence Eisenhauer, MD HERO North County OBGYN Dr. Lawrence Eisenhauer has helped numerous Project Access female patients to regain their health over the years, and recently performed four much-needed surgeries -- three in one day! Dr. Eisenhauer’s dedication has helped women who have suffered for years with chronic conditions to improve their health, and get back to work and caring for their families. Elsa B said, “Dr. Eisenhauer was the light at the end of my tunnel. I didn’t know angels existed on earth!” Thank you to all our our more than 625 volunteer physicians -- you are all our heroes!!
FIRST GOLF TOURNAMENT
Our first annual golf tournament, benefitting Project Access San Diego, is set for Thursday, February 28, 2013 at Del Mar Country Club. Golfer fees, including cart, lunch and post-golf reception is $250. To register or for more information, go to sdcmsf.org/ golf/
www.sdcmsf.org
classifieds PRACTICE FOR SALE SAN DIEGO (ENCINITAS) DERMATOLOGY, MOHS, AND COSMETIC SURGERY PRACTICE FOR SALE: Practice address is 477 N. El Camino Real, Encinitas at North Coast Health Center, a large multi-specialty health center. The practice has been at the location for the past 13 years. The seller is a solo, board-certified dermatologist who will be moving on to an academic position. Gross revenue has been in the $930,000 to $1.3 million range over the last four years. The office is about 1,600 square feet and has four exam rooms and two offices, a small lab, and two bathrooms. The practice is located in a populated area comprised of a large skin cancer population, and an affluent population seeking cosmetic procedures. Asking price is $325,000 (including at least $75K in inventory/ equipment). If interested, please email dermmd10@gmail. com. [054] PHYSICIAN POSITIONS AVAILABLE MEDICAL DIRECTOR: The County Psychiatric Hospital needs a full-time medical director. This is a key leadership role in our very physician-friendly, dynamic Behavioral Health system. Facility includes an inpatient unit and a very busy psychiatric emergency unit. Medical director does limited direct clinical care. Required: three years of psychiatrist experience, including one year of managing a psychiatric hospital or multi-disciplinary medical and mental health facility. Competitive salary and excellent County employee benefit package offered. San Diego combines the lifestyle of a resort community and the amenities of a big city. The hospital is centrally located, minutes from many recreational opportunities and great residential communities with wonderful year-round weather. CV can be submitted online at www.sdcounty.ca.gov/hr. For questions, please contact Darah Frondarina, human resources specialist, at (858) 505-6534 or Darah.Frondarina@sdcounty.ca.gov. [072] FAMILY PRACTICE MD FOR URGENT CARE CLINIC: San Ysidro Health Center (SYHC) is currently searching for a family practice MD for our Chula Vista Urgent Care Clinic. Since 1969, SYHC has been providing quality, lowcost, primary healthcare services to South Bay and Central San Diego residents. SYHC offers an extensive array of family-oriented primary healthcare services, including pediatrics, OB/GYN, adult medicine, dental care, and mental health. The family practice MD manages and provides acute, chronic, preventive, curative, and rehabilitative medical care to patients and determines appropriate regimen in specialized areas such as family practice, prenatal OB/GYN, pediatrics, and internal medicine. APPLY ONLINE AT WWW.SYHC.ORG. [071] SOUTHERN CALIF Regional Medical Director (RMD): Your Neighborhood Urgent Care (YNUC) is recruiting two RMDs for its 10 urgent care clinic network in Orange County and San Diego County. BC in emergency medicine or in family practice, internal medicine with urgent care experience required. Management/administrative experience in previous healthcare positions very desirable. Independent Contractor for two years, then equity available. Position is based at the MSO and is 20 hours per week clinical and 20 hours per week quality improvement. Very attractive hourly. Contact ramster@ ynuc.us now! [070] SUPERVISING CHILD PSYCHIATRIST, COUNTY OF SAN DIEGO: BC child psychiatrist to serve as supervising child psychiatrist for Child, Youth and Families (CYF) Behavioral Health and as deputy to the clinical director of the Behavioral Health Division of County of San Diego Health & Human Services Agency (HHSA). Significant administrative / managerial experience required; to provide clinical supervision in a variety of CYF County-operated programs. Applications and CVs must be submitted online at www.sdcounty.ca.gov/hr. For further information please email Marshall Lewis, MD, Clinical Director, at marshall. lewis@sdcounty.ca.gov or call (619) 563-2771, or email Katie Astor, Assistant Deputy Director, at katie.astor@sdcounty.ca.gov, or email Lita Santos, Human Resources, at lita.santos@sdcounty.ca.gov. [068]
COUNTY OF SAN DIEGO: PHYSICIAN-12419307: Salary: $103,376.00–$125,652.80 annually. Serving the citizens of San Diego with excellence. This is a series recruitment that will remain open until the position has been filled. Are you looking for a rewarding career in public health, providing care at the community level in a team environment? An exciting and challenging career as a physician awaits you at the County of San Diego. The Health and Human Services Agency’s Public Health Services is seeking qualified applicants for the position of physician to fill a vacancy in the Tuberculosis (TB) Clinic located at 3851 Rosecrans St., San Diego, CA 92110. As a physician, you will deliver professional medical services in the area of tuberculosis treatment and prevention. Please visit www.sdcounty.ca.gov/hr/ for a complete job description, including essential functions, required education / experience, working conditions, etc. [069] OPPORTUNITY KNOCKS FOR BC/BE PEDIATRICIANS: Live in one of the country’s most desirable locations and practice with a premier San Diego multispecialty medical group! Sharp Rees-Stealy Medical Group is looking for BC/BE Pediatricians. Competitive first-year compensation guarantee, excellent benefits, and shareholder eligibility after two years. Unique opportunity for professional and personal fulfillment while living in a vacation destination. Please send CV to Physician Services, 2001 Fourth Avenue, San Diego, CA 92101. Fax: (619) 233-4730. Email: Lori.Miller@sharp.com. [064] PHYSICIAN — SAN DIEGO COUNTY: Are you looking for a rewarding career in public health, providing care at the community level in a team environment? An exciting and challenging career as a physician awaits you at the County of San Diego. The County has a physician opening in the Public Health Services’ TB clinic located in San Diego (92110). Incumbents will deliver professional medical services related to tuberculosis treatment and prevention. Valid NPI, current California licensure, MD or DO degree, and one year of post-graduate experience required. For more information and to apply, visit www.sdcounty. ca.gov/hr, recruitment #12419307. Open until filled. Contact darah.frondarina@sdcounty.ca.gov for questions on the application process. [063] MID-CAREER PEDIATRICIAN: Great opportunity for a mid-career pediatrician with kind manner and strong entrepreneurial spirit to work FT/PT in small solo progressive practice. This position is a partnership track. Night call is minimal but must be willing to work some Saturdays and evenings to help grow the practice. Nice mix of parents in great school area. Salary DOE. Nice, stable office staff with EMR. Send CV to cvp315@sbcglobal.net. [057] LOOKING FOR PER DIEM PHYSICIAN FOR BUSY URGENT CARE: San Diego North County group looking for per diem physician for busy urgent care. Family medicine physician preferred. Need coverage for two days per week. Malpractice is covered. Please email CV to judy@cassidymg.com or fax to (760) 630-2558, attention Judy. [055] PHYSICIAN AND PSYCHIATRIST NEEDED FOR AMBULATORY CLINIC: Southern Indian Health Council is seeking a FT board-certified physician Mon–Fri, 8:00am– 4:30pm, as well as a PT psychiatrist. Must have current CA medical license, DEA license, ACLS, BLS. We offer a competitive salary, health benefits, vacation, holidays, sick, CME and license reimburse, and malpractice coverage. Forward resume to jobs@sihc.org or fax to (619) 659-3145 or website at www.sihc.org. Contact jobs@sihc.org or HR phone (619) 445-1188, ext. 308 or ext. 307 or HR fax (619) 659-3145. [048] PHYSICIAN NEEDED — FULL- OR PART-TIME SCHEDULES AVAILABLE: Family Health Centers of San Diego is a private, nonprofit community clinic organization that is an integral part of San Diego’s healthcare safety net. Since 1970, our mission has been to provide caring, affordable, high-quality healthcare and supportive services to everyone, with a special commitment to uninsured, low-income, and medically underserved persons. Every member of our team plays an important role in improving the health of our patients and community. We offer an
excellent comprehensive benefits package that includes: malpractice coverage; NHSC loan repay eligibility; and much, much more! For more information, please call Anna Jameson at (619) 906-4591 or email ajameson@fhcsd. org. If you would like to fax your CV, fax it to (619) 8764426. To apply, visit our website and apply online at www. fhcsd.jobs. [046] PRIMARY CARE JOB OPPORTUNITY: Home Physicians (www.thehousecalldocs.com ) is a fast-growing group of house-call doctors. Great pay ($140–$220+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) 279-1212 or email CV to hpmg11@yahoo.com. [037] PHYSICIANS WANTED: Vista Community Clinic, a private, nonprofit clinic serving the communities of North San Diego County, has openings for part-time and perdiem positions. Five locations in Vista and Oceanside. Family medicine, OB/GYN medicine, pediatric medicine. Requirements: California license, DEA license, CPR, board certified, one (1) year post-graduate clinic experience. Bilingual English / Spanish preferred. Benefits: malpractice coverage. Email resume to hr@vistacommunityclinic.org or fax to (760) 414-3702. Visit website at www.vistacommunityclinic.org. EOE/M/F/D/V [035] 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 tailcovered 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) 504-5830 or at venk@gpeds. sdcoxmail.com. Salary $ 102–108,000 annually (equal to $130–135,000 full-time). [778] PRACTICE WANTED WE BUY URGENT CARE OR READY MED-CLINIC: We are interested in purchasing a preexisting urgent care or ready med-clinic anywhere in San Diego County. Please contact Lyda at (619) 417-9766. [008] OFFICE SPACE / REAL ESTATE FULL- AND PART-TIME OFFICE SPACE IN UTC: in 8th floor suite with established neuropsychologists and psychiatrists 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 parking. Contact Christine Saroian, MD, at (619) 682-6912. [862] CLAIREMONT MESA OFFICE SPACE FOR LEASE: Clairemont Mesa Medical Arts Center is a medical office building conveniently located in Kearny Mesa, close to the 15, 163, 52, and 805 freeways. Available for lease September 1, 2012. 520 square-foot suite, currently configured as three room (lobby, exam, and office), located on the second floor. Call Alex at (858) 268-1111, ext. 311, for inquiries and viewing. [066] MEDICAL OFFICE SPACE FOR LEASE: Medical office space of 1,846 square feet located at 15721 Pomerado Road, Poway, CA 92064 in the Gateway Medical Center available for immediate lease. This recently remodeled facility has a shared waiting room, medical records storage area, front desk reception area, three exam rooms, nursing station, private office, shared bathroom. The larger space is shared with an internal medicine group
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. 34 septem b er 2012
and is blocks away from Pomerado Hospital. Imaging is located in an adjacent building. The lease rate is $1.69/SF NNN with a 3% annual increase. The NNNs are currently running $0.73/SF. Tenant will be responsible for pro rata share of utilities and janitorial in addition to NNNs. Great opportunity in this affluent community. Call Angie at (858) 605-9966. [065] OFFICE FOR LEASE SCRIPPS MEMORIAL HOSPITAL MEDICAL OFFICE BUILDING: La Jolla multi-specialty group, excellent referral base, great location, corner office large windows, full- or part-time space available (one doctor retiring). Please call Dr. Shurman cell (858) 344-9024 or office (858) 320-0525. [058] 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] LUXURIOUS / BEAUTIFULLY DECORATED DOCTOR’S OFFICE NEXT TO SHARP HOSPITAL FOR SUB-LEASE OR FULL LEASE: The office is conveniently located just at the opening of Highway 163 and Genesee Avenue. Lease price if very reasonable and appropriate for ENT, plastic surgeons, OB/GYN, psychologists, research laboratories, etc. Please contact Mia at (858) 279-8111 or at (619) 823-8111. Thank you. [836] NEW — EXTREMELY LOW RENTAL RATE INCENTIVE — EASTLAKE / RANCHO DEL REY: Two office/medical spaces for lease. From 1,004 to 1,381 SF available. (Adjacent to shared X-ray room.) This building’s rental rate is marketed at $1.70/SF + NNN; however, landlord now offering first-year incentive of $0.50/SF + NNN for qualified tenants and five-year term. $2.00/SF tenant improvement allowance available. Well parked and well kept garden courtyard professional building with lush landscaping. Desirable location near major thoroughfares and walkable retail amenities. Please contact listing agents Joshua Smith, ECP Commercial, at (619) 442-9200, ext. 102. [006] POWAY / RANCHO BERNARDO — OFFICE FOR SUBLEASE: Spacious, beautiful, newly renovated, 1,467 sqft furnished suite, on the ground floor, next to main entrance, in a busy class A medical building (Gateway), next to Pomerado Hospital, with three exam rooms, fourth large doctor’s office. Ample parking. Lab and radiology onsite. Ideal sublease/satellite location, flexible days of the week. Contact Nerin at the office at (858) 521-0806 or at mzarei@cox.net. [873] SHARE OFFICE SPACE IN LA MESA: Available immediately. 1,400 square feet available to an additional doctor on Grossmont Hospital Campus. Separate receptionist area, physician’s own private office, three exam rooms, and administrative area. Ideal for a practice compatible with OB/GYN. Call (619) 463-7775 or fax letter of interest to La Mesa OB/GYN at (619) 463-4181. [648] BUILD TO SUIT: Up to 1,900ft2 office space on University Avenue in vibrant La Mesa/East San Diego, across from the Joan Kroc Center. Next door to busy pediatrics practice, ideal for medical, dental, optometry, lab, radiology, or ancillary services. Comes with 12 assigned, gated parking spaces, dual restrooms, server room, lighted tower sign. Build-out allowance to $20,000 for 4–5 year lease. $3,700 per month gross (no extras), negotiable. Contact venk@ cox.net or (619) 504-5830. [835] 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] NONPHYSICIAN POSITIONS AVAILABLE NURSE PRACTITIONER WANTED: Nurse practitioner wanted for internal medicine and pediatrics practice in Coronado. Enthusiasm, dependability, and a love of learning are musts! Full-time with benefits. Experience preferred. Please send your resume to CoronadoMedPeds@ gmail.com. [067]
PHYSICIAN ASSISTANT NEEDED: Physician assistant needed on per diem basis for busy urgent care in the San Diego North County area. Hours are evening and/or weekends. Please send CV to judy@cassidymg.com or fax to (760) 630-2558. [056] LOOKING FOR A NURSE PRACTITIONER: Established, busy pain management practice in Mission Valley is looking for a nurse practitioner preferably experienced in pain management or family practice. Knowledge of controlled substance prescriptions and regulations is required. Interpretation of diagnostic tests and the ability to apply skills involved in interdisciplinary pain management is necessary. We offer a competitive salary and benefit package that provides malpractice coverage, CME allowance, as well as an excellent professional growth potential. Please email your curriculum vitae/resume to sdpainclinc@yahoo.com. [052] MEDICAL BILLER NEEDED FOR BUSY PAIN MANAGEMENT CLINIC IN MISSION VALLEY: Must be knowledgeable and experienced with Allscripts Misys. Please email references, contract, and terms to sdpainclinic@ yahoo.com. [053] OB/GYN NURSE PRACTITIONER WANTED FOR BUSY WOMEN’S HEALTH OFFICE IN DEL MAR AREA: This
position conducts annual pap smear exams, deals with all gynecological issues, IUD insertions, as well as obstetric patient weekly appointments. Triage and detailed discussions of lab results. Midwife experience a plus but not required. Ultrasound experience preferred but not required. Position is for Tuesdays and Thursdays, 8:30am to 5:30pm. OB/GYN experience REQUIRED. Ability to keep up with a fast-paced schedule, 18–25 patients a day. Please contact us at cvwh858@gmail.com with resume and salary requirements. [050] PA NEEDED FOR DERMATOLOGY AND COSMETIC SURGERY PRACTICE IN ENCINITAS: Experience in general dermatology a must! Applicant must be knowledgeable in diagnosing and treating common dermatologic conditions, possess excellent interpersonal skills, be a caring and empathetic provider, and possess the highest of ethical standards. Being a team player and having a positive attitude is essential. Please forward resume and cover letter in Word format to dana@doctorlashgari.com. [049] PHYSICIAN ASSISTANT OR NURSE PRACTITIONER: Needed for house-call physician in Coachella Valley (Palm Springs / Palm Desert). Part time, flexible days/ hours. Competitive compensation. Call (619) 992-5330. [038]
Where Are Your Patients Coming From? Each month, every practicing physician in San Diego County receives a copy of this magazine. What better way to ensure they know about your practice? We have advertising packages available at very attractive price points, and member physicians receive 50% off! If your doors are open for business, keep patients coming in with a referral advertisement in San Diego Physician magazine.
Contact Dari Pebdani at 858-231-1231 or at DPebdani@SDCMS.org
SAN DIEGO PHYSICIAN.org 35
SDCMS Member Benefits
GET INVOLVED! Write an Article for San Diego Physician Magazine
Join an SDCMS Committee or Commission
Attend an SDCMS Social
Join SDCMS’ GERM Commission
Become an SDCMS or CMA Physician Leader
Join SDCMS’ Professional Conduct Committee
Join SDCMS’ Editorial Board
Join SDCMS’ Emergency Medicine Oversight Commission
Join SDCMS’ Bioethics Commission
Write a Resolution for the CMA House of Delegates
Help Identify and Elect Candidates That Share SDCMS’ and CMA’s Vision for Medicine and Healthcare
Join a CMA Committee or Council
Email Your Questions to SDCMS@SDCMS.org
Become an SDCMS Spokesperson on Topics Within Your Specialty for San Diego County Media
Send Us Your Thoughts at SDCMS@SDCMS.org
36 septem b er 2012
We Celebrate Excellence – James Strebig, MD CAP member, internal medicine physician, and former President of the Orange County Medical Association.
800-252-7706 www.CAPphysicians.com San Diego orange LoS angeLeS PaLo aLTo SacramenTo
For 35 years, the Cooperative of American Physicians, Inc. (CAP) has provided California’s finest physicians, like Irvine internal medicine specialist James Strebig, 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 11,500 preferred California physicians already enjoying the benefits of CAP membership.
Superior Physicians. Superior Protection. 37
mayapri 2011 SAN DIEGO P HY SICIA N. o rg 37 l 2012 SAN DIEGO PHYSICIAN.org
$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 ]
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License#: 0677182 38 septem b er 2012
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Billing Errors and Omissions Liability
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