April 2015

official publication of SDCMS april 2015

What would medicine look like without SDCMSCMA?

SDCMS Annual Report 2014 page 11 “Physicians United for a Healthy San Diego”

MEDICAL PROFESSIONAL LIABILITY INSURANCE

Our

beats in

Our heart beats in California ‌ and has for almost 4 decades.

Since 1975 NORCAL Mutual has served healthcare professionals throughout the Golden State. Strength, stability and innovative products are just a few reasons why physicians continue to look to us for their medical professional liability insurance. We provide you: Industry-leading claims and risk solutions support 24/7 Full access to our interactive risk management library Flexible coverage options tailored to your needs California is important to us. So is your peace of mind. See how homegrown strength can help protect your practice.

Visit heart.norcalmutual.com or call your agent/broker today.

844.4NORCAL (844.466.7225) Š 2015 NORCAL Mutual Insurance Company

Special mortgage financing for physicians Our special home financing program is designed specifically to meet your needs as a busy physician for the purchase of your primary residence

Low down payment available for purchase prices up to to $1,850,000 Refinances with high loan to value also available No mortgage insurance required Competitive fixed rates available No prepayment penalties or additional lender fees

Corey Weber

Mortgage Banking — Mortgage Banking Officer Phone: 760.405.3575 eFax: 205.524.0695 Corey.weber@bbvacompass.com NMLS #567944 Southern California District 4180 La Jolla Village Dr #530 La Jolla, CA 92037

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.

april

Contents

Volume 102, Number 4

EDITOR: James Santiago Grisolía, MD MANAGING EDITOR: Kyle Lewis EDITORIAL BOARD: Sherry L. Franklin, MD, James Santiago Grisolía, MD, Theodore M. Mazer, MD, Robert E. Peters, PhD, MD, David M. Priver, MD MARKETING & PRODUCTION MANAGER: Jennifer Rohr SALES DIRECTOR: Dari Pebdani ART DIRECTOR: Lisa Williams COPY EDITOR: Adam Elder SDCMS BOARD OF DIRECTORS OFFICERS PRESIDENT: J. Steven Poceta, MD PRESIDENT-ELECT: William T-C Tseng, MD, MPH (CMA Trustee) TREASURER: Mihir Y. Parikh, MD SECRETARY: Mark W. Sornson, MD IMMEDIATE PAST PRESIDENT: Robert E. Peters, PhD, MD GEOGRAPHIC AND GEOGRAPHIC ALTERNATE DIRECTORS EAST COUNTY: Venu Prabaker, MD, Alexandra E. Page, MD, Jay P. Mongiardo, MD, Alt: Susan Kaweski, MD (CALPAC Treasurer) HILLCREST: Gregory M. Balourdas, MD, Thomas C. Lian, MD, Alt: Thomas J. Savides, MD KEARNY MESA: Sergio R. Flores, MD, John G. Lane, MD, Alt: Anthony E. Magit, MD, Alt: Eileen R. Quintela, MD LA JOLLA: Geva E. Mannor, MD, Marc M. Sedwitz, MD, Alt: Lawrence D. Goldberg, MD NORTH COUNTY: James H. Schultz, MD, Eileen S. Natuzzi, MD, Michael A. Lobatz, MD, Alt: Anthony H. Sacks, MD SOUTH BAY: Reno D. Tiangco, MD, Michael H. Verdolin, MD, Alt: Elizabeth Lozada-Pastorio, MD

features

11

SDCMS & SDCMS Foundation Annual Report 2014

AT-LARGE ALTERNATE DIRECTORS Karl E. Steinberg, MD, Jeffrey O. Leach, MD, Toluwalase A. Ajayi, MD, Phil Kumar, MD, Wayne C. Sun, MD, Kyle P. Edmonds, MD, Carl A. Powell, DO, Marcella M. Wilson, MD

12

MICRA • GPCI • Medi-Cal • SGR • Covered California

13

Cal Mediconnect • Scope of Practice • Sunshine Act • Health Plans • ICD-10 • Practice Burdens • Practice Financing • Physician Workforce • CPPPH

14

4

Briefly Noted: Calendar • Welcome New and Returning Members • April Is Donate Life Month • And More …

6

15

BY JOSEPH E. SCHERGER, MD, MPH

16

Seminars & Webinars • Physician Leaders • SDCMS Financials • Your Professional Life • Residents • SDCMS Membership

17

SDCMS Foundation

2

departments

Military • Prescription Drug Abuse • Ebola • Public Health • Office Manager Support

egislator Relations • Your Physician L Advocate • Tangible Member Benefits • Communications • Events & Socials

April 2015

AT-LARGE DIRECTORS Lawrence S. Friedman, MD, Karrar H. Ali, MD, Kosala Samarasinghe, MD, David E.J. Bazzo, MD, Stephen R. Hayden, MD, Peter O. Raudaskoski, MD, Vimal Nanavati, MD (Board Representative), Holly B. Yang, MD

verweight and Obesity: It’s the O Carbohydrates

19 Candidate Statements: 2015–16 SDCMS Board of Directors 26 Physician Marketplace: Classifieds 28

Picasso’s Sketch: It Only Takes a Minute

BY DANIEL J. BRESSLER, MD, FACP

OTHER VOTING MEMBERS COMMUNICATIONS CHAIR: Sherry L. Franklin, MD (CMA Trustee) YOUNG PHYSICIAN DIRECTOR: Edwin S. Chen, MD RESIDENT PHYSICIAN DIRECTOR: Jane Bugea, MD RETIRED PHYSICIAN DIRECTOR: Rosemarie M. Johnson, MD MEDICAL STUDENT DIRECTOR: Spencer D. Fuller OTHER NONVOTING MEMBERS YOUNG PHYSICIAN ALTERNATE DIRECTOR: Daniel D. Klaristenfeld, MD RESIDENT PHYSICIAN ALTERNATE DIRECTOR: Diana C. Gomez, MD RETIRED PHYSICIAN ALTERNATE DIRECTOR: Mitsuo Tomita, MD SDCMS FOUNDATION PRESIDENT: Albert Ray, MD (CMA Trustee, AMA Delegate) CMA SPEAKER: Theodore M. Mazer, MD CMA PAST PRESIDENTS: James T. Hay, MD (AMA Delegate), Robert E. Hertzka, MD (Legislative Committee Chair, AMA Delegate), Ralph R. Ocampo, MD CMA TRUSTEES: Robert E. Wailes, MD, Erin L. Whitaker, MD CMA SSGPF Delegate: James W. Ochi, MD CMA SSGPF ALTERNATE DELEGATES: Dan I. Giurgiu, MD, Ritvik Mehta, MD AMA ALTERNATE DELEGATE: Lisa S. Miller, MD

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.]

Helping your bottom line, one square foot at a time.

JLL Healthcare Practice Group

3 reasons why our clients hire us for their commercial real estate needs: Exclusive specialization We are the only team 100% dedicated to medical office properties in San Diego. Working with a non-medical broker limits your access to valuable market intel, leaving money on the table.

Optimal solutions In a supply-constrained market we can help you identify those hard-to-find opportunities.

Extensive experience Our 35+ years of experience in healthcare real estate assures a painless lease or sale transaction.

Put our unique expertise to work. Contact us today: Paul Braun Managing Director +1 858 410 6388 paul.braun@am.jll.com

Chris Ross Vice President +1 858 410 6377 chris.ross@am.jll.com

Kelly Moriarty Associate +1 858 410 6359 kelly.moriarty@am.jll.com

Leases ▪ Renewals ▪ Sales ▪ Strategic Planning ▪ Demographic & Patient Analysis

/////////Briefly /////////////////Noted //////////////////////////////////////////////////////////////////////// 16th Annual UC San Diego Stroke Conference: Stroke 360 MAY 2 at the Skaggs School of Pharmacy and Pharmaceutical Sciences (cme.ucsd. edu/stroke)

calendar SDCMS Seminars & Webinars SDCMS.org

For further information or to register for any of the following SDCMS seminars, webinars, workshops, and courses, email Seminars@ SDCMS.org.

Work-Life Balance for Physicians (workshop) MAY 2: 9:00am– 12:00pm — hsfronek@ aol.com Workplace Misconduct and Sexual Harassment: Awareness, Prevention, and Mitigation (webinar) MAY 7: 12:00pm– 1:00pm Guidance to Effective Disciplinary and Termination Practices (webinar) MAY 21: 11:30am–1:30pm

Financial & Legal Life Skills for Physicians (workshop) JUN 6: 8:00am– 12:00pm SDCMS White Coat Gala (event) JUN 13: 6:00pm– 11:00pm 2015 ICD-10-CM Code Set Boot Camp (course) JUN 25: 8:00am– 5:00pm The Leader’s Toolkit (workshop) JUL 11–12: 8:00am– 4:00pm & 8:00am– 12:00pm

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.

Social Media Update and Best Practices: Essentials for 2015 (webinar) MAY 28: 12:15pm–1:15pm

Advances in Addiction JUN 6–7 at the Hyatt Regency in La Jolla at Aventine (www. sdpscme.com) Spine Injuries in Sport JUL 15 at Scripps Green Hospital (www. scripps.org/sparkleassets/documents/ sports_medicine_ seminar_2015.pdf) Critical Care Summer Session 2015 JUL 23–25 at Paradise Point Resort, San Diego (cme.ucsd.edu/ criticalcare) Pan-Pacific Biomedical Informatics Training Camp AUG 3–13 at the UC San Diego Biomedical Research Facility II, La Jolla (cme.ucsd.edu/ bioinformatics) Advanced Therapeutic Interventions to Optimize Obesity and Diabetes Care SEP 25–26 at the San Diego Marriott La Jolla (www. scripps.org/events/ advanced-therapeuticinterventions-tooptimize-obesityand-diabetes-careseptember-25-2015)

SDCMS-CMA Membership

Welcome New and Returning SDCMS-CMA Members!

New Members Yvonne J. Ahn, MD Anesthesiology San Diego (858) 565-9666 Ronald E. Cann, MD Psychiatry San Diego (858) 694-3900 Olga Y. Caplin, MD Psychiatry San Diego (619) 692-8750 Matthew F. Carroll, MD Forensic Psychiatry San Diego (858) 694-3900 Thomas R. Coleman, MD, MS Public Health and General Preventive Medicine San Diego (619) 692-8819 Dawn Marie K. De Castro, MD Ophthalmology San Diego (858) 455-6800 David M. Dobos, MD Child and Adolescent Psychiatry San Diego (619) 692-8232 David C. Kunkel, MD Gastroenterology San Diego (858) 657-5088

“

quote of the month

Controversy equalizes fools and wise men in the same way.

And the fools know it.

4

April 2015

”

— Oliver Wendell Holmes Sr., American Physician, Poet, Professor, Lecturer, and Author (1809–1894)

Michelle I. Lozano Camhi, MD Psychiatry San Diego (619) 595-4400 Erica C. Niedbalec, MD Internal Medicine San Diego (619) 713-7899

Ryan A. Salahi, MD Psychiatry San Diego (619) 692-8200 WELCOME RETURNING MEMBERs David W. Fabi, MD Orthopaedic Surgery San Diego (619) 299-8500 Bradley L. Frasier, MD Urology Oceanside (760) 637-2500 Joseph D. Hebreo, MD Nephrology Escondido (760) 745-1551 Melissa R. Lorang, MD Child and Adolescent Psychiatry La Jolla (858) 694-3900 Richard A. Parker, DO General Practice San Diego (619) 229-3922 Ronald A. Zappone, MD Psychiatry La Jolla (619) 823-1697

///////////////////////////////////////////////////////////////////////////////////////////////////

A

pril is National Donate Life Month, a time when Donate Life Month organizations highlight the need for life-saving and life-enhancing organ, eye, and tissue transplants — and that anyone can be a hero and save lives simply by signing up to be an organ, eye, and tissue donor.

That one decision could help the more than 123,000 people waiting for life-saving organ transplants in the United States. More than 22,000 of those people live right here in California.

People like Caleigh Haber of San Francisco. She has cystic fibrosis, a genetic disease that can lead to severe lung disease, which makes breathing very difficult. She is on the transplant waiting list for a new set of lungs.

But there’s no guarantee she’ll get them.

Each day in the United States, 21 people die waiting because the organ they needed did not become available in time. Organs needed for transplant are heart, lungs, liver, kidney, pancreas, or intestine.

Tissue transplants, meanwhile, save and heal lives. Tissues for transplant include cornea, skin, heart valves, bone tissue, tendons, veins, ligaments, and cartilage. More than a million tissue transplants are done each year, and the surgical need for tissue has been steadily rising. Corneal transplants, meanwhile, restore sight to nearly 50,000 people each year.

Despite the vital need, only about 40 percent of adults in California are signed up to be organ, eye, and tissue donors. The facts are: • People of all ages and medical histories can be donors.

• Your medical care and/or funeral arrangements will not be affected by your decision to donate.

• There is no cost to you or your family for donation.

• All major religions support or permit organ donation.

Sign up to save lives by registering as an organ, eye, and tissue donor at www.donateLIFEcalifornia.org or check “YES!” at the DMV every time you renew your driver license or ID.

Practice Management

Contracting

Relocation Management

Credentialing

Technological Advances

Billing Service Business Growth Executive Assistant Financial Management EHR Meaningful Use Support Operational Management Practice Assessment

We can help - absolutely! te

April Is Donate Life Month • Be a Hero • Sign up to Save Lives

Auditing

lutions So Celebrating

Absolu

organ donation

858.256.0351 • www.abs-sol.com

2004 - 2014

“think SDCMS FIRST!” Start by contacting SDCMS at (858) 565-8888 or at SDCMS@SDCMS.org.

SAN DIEGO PHYSICIAN.org

5

P u b l i c H e a lt h

Overweight and Obesity

It’s the Carbohydrates

by Joseph E. Scherger, MD, MPH

Note: The following article does not necessarily reflect the opinions of the San Diego County Medical Society.

The awareness that a low-carbohydrate diet rich in protein and saturated fat resulted in a lower body weight has a long history. In 1927 nutritionist Gayelord Hauser came to Hollywood and helped Greta Garbo, Marlene Dietrich, and other stars stay lean by avoiding sugars and foods made with flour. Hauser published 19 books between 1930 and 1963, the most famous being Look Younger, Live Longer (1950) (1).

6

April 2015

In 1963 The Journal of the American Medical Association (JAMA) published an article from the University of Wisconsin on a novel, low-carbohydrate diet that achieved rapid weight loss (2). A young, obese Manhattan cardiologist named Robert Atkins read the article and tried the diet. He lost his excess weight rapidly and began using it with patients with great success. Atkins appeared on The Tonight Show in 1965, and Vogue magazine did a story on the diet, and it became known as the “Vogue diet” in the 1960s (3). In 1972 Atkins published his first Diet Revolution book, and the very lowcarbohydrate diet rich in fats and protein become known as the Atkins diet (4). Other popular diets followed, calling themselves a “modified Atkins,” such as The South Beach Diet in 2003 (5).

Meanwhile, in the 1970s mainstream medicine realized that lipids were an important risk factor for cardiovascular disease, the top killer in the industrialized world. By a leap of faith and rational thinking more than good science, the mainstream nutrition and medical community blamed dietary saturated fat for causing high cholesterol and launched new recommended diet programs of less fat and more carbohydrates, especially complex carbohydrates

NORTH COUNTY’S NEWEST AND MOST

COVETED MEDICAL CAMPUS VISIBLE 363 FEET linear frontage on Palomar Airport Road (4 3 , 4 9 2 C A R S P E R DAY )

ACCESSIBLE 1 MILE from Interstate 5 ( 2 0 2 , 57 2 H O U S E H O L D S WITHIN 20 MINUTE DRIVE)

S T R AT E G I C North County’s most affluent demographics ( $ 9 8 , 614 AVG H O U S E H O L D INCOME IN A 5 MILE R ADIUS)

6 0 1 0 H i d d e n Va l l e y R o a d , C a r l s b a d , C A 9 2 0 1 1

WE ARE PLEASED TO ANNOUNCE Synovation Medical Group (Pain Management) Urgent Care (Dr. Bryan Doonan) • Carlsbad Imaging Center Great Smiles (Pediatric Dentistry & Orthodontics) • Price-Rite Pharmacy FUTURE TENANTS AT NORTH COAST MEDICAL PLAZA

FOR MORE INFORMATION, PLEASE VISIT TRAVIS IVES Director Lic. # 1889097 858.334.4041 travis.ives@cushwake.com

50,000 SF existing medical office building

39,0 0 0 50,000 SF

proposed build-to-suit opportunity

WWW.NORTHCOASTMEDICALPLAZA.COM

CUSHMAN & WAKEFIELD OF SAN DIEGO, INC. CA License No. 1329963 4747 Executive Drive, 9th Floor San Diego, CA 92121 SAN DIEGO PHYSICIAN.org

7

P u b l i c H e a lt h

The dominant cause and solution to the overweight and obesity epidemic remains hidden in plain sight: It’s the carbohydrates. such as “healthy whole grains.” Starting in 1980, the overweight and obesity epidemic took off with exponential rises in these conditions over the next three decades.

Recent research is showing that the low-carbohydrate diet is largely correct for maintaining a healthy weight (6–10).

Carbohydrates are the main driver of excess body fat by causing fluctuations in blood sugar that increase appetite. Increasing blood sugar causes insulin secretion that drives sugar into cells. What is not burned for energy or stored in the muscles and liver becomes stored fat through lipogenesis.

Body fat is hormonally active and causes the four problems of the metabolic syndrome: dyslipidemia, elevated blood sugar, elevated blood pressure, and overweight/obesity.

There is a genetic contribution to all this, but the ill effects of carbohydrate intake beyond our energy needs are universal.

Excess sugar converted into fat storage reduces LDL particle size and stimulates inflammatory changes in blood vessels, leading to atherosclerosis (6). Replacing fat with carbohydrates, especially grain-based foods, has coincided with an increase in calories consumed (9, 10). Carbohydrates are best obtained from vegetables and whole fruits. Eating more saturated fat and protein reduces hunger and results in fewer calories consumed, the key to the success of lowcarbohydrate diets.

Two academic nutrition scientists, Jeff Volek, PhD, RD, and Stephen Phinney, MD, PhD, have gathered the science around the low-carbohydrate diet in their book for professionals, The Art and Science of Low Carbohydrate Living (9). Their work and that of others has vindicated the approach taken by Robert Atkins that saturated fat should be a mainstay of a healthy diet. Eating saturated fat from natural sources such as tree nuts, avocadoes, eggs, meat, and fish reduces hunger and overall calorie intake,

8

April 2015

resulting in lower body fat.

Volek and Phinney have also triggered a trend among high-performance endurance athletes to move away from carbohydrate loading and sweetened energy drinks.

They show that a ketogenic diet of steady fat burning will improve performance over burning a temporary supply of carbohydrates (11). Humans are not like hybrid cars readily able to convert from one energy source to another; in our case, from carbohydrate to fat burning. If athletes depend on carbs for energy, there is a drop in energy and muscle cramps when they run out. No more pasta before events — eat the steak!

Drink water rather than sweet energy drinks and gels and get necessary salt, fat, and protein during long events such as a marathons

and ultramarathons, triathlons, bicycle races, and hiking.

Men’s professional tennis is a grueling sport, especially in major events that can go to five sets and over four hours. Of the leading male tennis professionals, Novak Djokovic follows a very low-carbohydrate diet and relies on fat burning during performances (12). Interestingly, in the 2015 Australian Open, the semifinal had Djokovic facing defending champion Stan Wawrinka in a match that went five sets.

The score in the final set was Djokovic 6–0.

In the final, Djokovic faced Brad Murray in a four-set match. The score in the final set was Djokovic 6–0. What role did diet play in this success?

My story is revealing. I started running

P u b l i c H e a lt h

marathons at age 29 and was lean and fit with a 32-inch waist. I stopped running long distances after a few years, and, as someone who loved breads and muffins, my waist increased to 36 inches and my weight went to 192 from about 160. At age 46 my total cholesterol was 211 and my HDL cholesterol was only 37. I returned to running marathons and was able to get my weight down to 180 with a total cholesterol of 175 and an HDL of 52. I was happy but my waist was still 36. At age 62 I read Wheat Belly by Dr. William Davis and gave up the grains. In four months my weight was 160, my waist 32, and my total cholesterol was 152 with an HDL of 69. I am running marathons and half-marathons faster than any time in the past 10 years. Best yet, I feel much younger, have very little of the old appetite, and stay awake and alert in the afternoon and even during an evening symphony.

The dominant cause and solution to the overweight and obesity epidemic remains hidden in plain sight: It’s the carbohydrates.

The food industry flourishes on selling foods made with flour and sugar. These food commodities are the easiest to package and store, and hence result in greater

profits. The food industry also funds major health organizations, nutritional research institutes, and federal agencies that provide dietary recommendations, resulting in much inertia to change (13, 14).

Countering the status quo of boxes of high-carbohydrate foods lining our supermarket aisles is a growing worldwide realization that eating the food that nature has provided for millions of years is better for us than the more recent breads and processed foods. The Paleo Diet was introduced in 1975 and is becoming a new fashion whether people understand the nutrition behind it or not (15, 16). French physician Pierre Dukan has been promoting a low-carbohydrate diet for more than 30 years, and the Dukan Diet is increasingly popular in Great Britain and France (17).

Walter Willett of the Harvard School of Public Health has been vocal that fat is not the problem and evidence does not support the recommendation against eating less saturated fat, and that excess carbohydrates are to blame for obesity, diabetes, and other metabolic diseases (20, 21). A growing number of physician innovators are using the evidence about carbohydrates to educate

Scientists tend to ignore research findings that might threaten the existing paradigm and trigger the development of new and competing beliefs.

This is the future you weren’t thinking about 10, or 20, or 30 years ago.

As a financial advisor since 1982, I have the experience, knowledge, and research to help you grow and preserve your wealth. The sooner you start, the better you can manage whatever life has in store. I can help you make it happen. If you’d like to know how, I’d be glad to talk with about your future. There’s no cost and no obligation.

Contact me today so we can begin planning together a better financial future for you.

Barry Masci, CFA, CMT, CMFC, CLU®, CFP® First Vice President – Investments 11512 El Camino Real, Suite 210, San Diego, CA 92130 858-720-2365 • 1-800-395-5901 barry.masci@wellsfargoadvisors.com bmasci.wfadv.com Investment and Insurance Products: NOT FDIC Insured NO Bank Guarantee

MAY Lose Value

Wells Fargo Advisors, LLC, Member SIPC, is a registered broker-dealer and a separate non-bank affiliate of Wells Fargo & Company. © 2013 Wells Fargo Advisors, LLC. All rights reserved. 0514-03415 [74036-v4] A1272 (1194411_372510)

SAN DIEGO PHYSICIAN.org

9

P u b l i c H e a lt h

the public, including William Davis (12, 18), David Perlmutter (19), and Mark Hyman, physician advisor to Bill Clinton’s nutrition advisor who was recently hired by the Cleveland Clinic to lead a new Functional Medicine Institute (20).

Paradigm changes in science and medicine happen slowly. Thomas Kuhn observed that “normal science” is predicated on the assumption that the scientific community knows what the world is like, and scientists take great pains to defend those assumptions. Scientists tend to ignore research findings that might threaten the existing paradigm and trigger the development of new and competing beliefs. Changing a scientific paradigm only happens through discovery brought on by repeated encounters with anomaly (21). The paradigm around what is a healthy diet is changing from a low-fat to a lowcarbohydrate diet rich in natural fats and proteins.

References: 1. Gayelord Hauser. Wikipedia.org. Accessed Feb. 5, 2015.

2. Gordon ES, Goldberg M, Chosy GJ. A New Concept in the Treatment of Obesity. JAMA. 1963;186(1):156-166.

3. Wikipedia, Robert Atkins. Accessed Feb. 5, 2015.

4. Atkins RC. Dr. Atkins’ Diet Revolution. Bantam Books. 1972.

5. Agatson A. The South Beach Diet. St. Martin’s Press. 2003.

6. Bazzano LA, Hu T, Reynolds K, et al. Effects of Low-Carbohydrate and Low-Fat Diets: A Randomized Trial. Ann Intern Med. 2014;161:309-318.

7. Chowdhury R, Warnakula S, Kunutsor S, et al. Association of dietary, circulating, and supplement fatty acids with coronary risk; A systemic review. Ann Int Med. 2014;160(6):398-406.

8. Siri-Tarino PW, Sun Q, Hu FB, et al.

Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr.

2010;91(3):535-546.

9. Volek JS, Phinney SD. The Art and Science of Low Carbohydrate Living. Beyond Obesity, LLC. 2011.

10. Jakobsen MU, Dethlefsen C, Joensen AM, at al. Intake of carbohydrates compared with

Dr. Scherger, 34-year member of SDCMSCMA, is vice president, primary care, and Marie E. Pinizzotto, MD, chair of academic affairs at the Eisenhower Medical Center in Rancho Mirage.

Do you have a patient or family member suffering from alcohol or chemical DepenDency? clark smith, m.D., Director an addiction psychiatry, forensic and pain medicine expert.

ContaCt us today for your free Consultation.

recoveryWorks is reaDy to help.

Halt the damage caused by addiction and cure the underlying causes while developing life skills for future growth.

The RecoveryWorks intensive Outpatient Program includes: › Diagnostic evaluation, individual assessment and treatment plan › After work treatment program › Integrated family treatment program › Affordable treatment, most non-HMO insurance accepted

ECO ERY

858.530.9112

ORKS

recoveryWorkssD.com 10

April 2015

ECOVERY

ORKS

intake of saturated fatty acids and the risk of myocardial infarction: Importance of the glycemic index. Am J Clin Nutr. 2010;91:17641768.

11. Volek JS, Phinney SD. The Art and Science of Low Carbohydrate Performance. Beyond Obesity, LLC. 2012.

12. Davis W. Wheat Belly. Rodale. 2011.

13. Campbell TC, Jacobson H. Whole: Rethinking the Science of Nutrition. BenBella Books, 2013.

14. Minger D. Death By Food Pyramid. Primal Blueprint Publishing, 2013.

15. Voegtlin WL. The Stone Age Diet. Vantage Press, 1975.

16. Cordain L. The Paleo Diet. John Wiley & Sons, 2002, 2011.

17. Dukan Diet. Wikipedia.org, Accessed Feb. 18, 2015.

18. Davis W. Wheat Belly Total Health, Rodale, 2014.

19. Perlmutter D. Grain Brain. Little, Brown and Co. 2013.

20. Townsend A. Cleveland Clinic to open Center for Functional Medicine; Dr. Mark Hyman to be director. Cleveland Plain Dealer. www.cleveland.com/healthfit/index. ssf/2014/09/cleveland_clinic_to_open/ cente.html 21. Kuhn TS. The Structure of Scientific Revolutions. University of Chicago Press. 1962.

Increase Your Referrals PhysiciAns

— page 8

listeD By sPeciA

lty & ZiP coDe

PhysiciAns

— page 44

listeD AlPhAB

eticAlly

san diego county

The annual San Diego County All Physician Directory lists contact information for every physician in the county. It is mailed to all 8,800+ San Diego County physicians free of charge. This digest sized directory is a go-to resource for physicians and their office staff.

All Physician Directory 2015-16 A

SDCMS Members receive 35% off advertising rates. Contact Dari Pebdani today at 858-231-1231 or DPebdani@SDCMS.org

We Permanently Eliminated GPCI

“Physicians United for a Healthy San Diego”

We stopped the Medi-cal Clawback

2014 SDcms Annual Report

We Saved MICRA at the Ballot Box

2014 SDcms Annual Report

WE FINALLY GOT RID OF THE SGR

SAVED MICRA  WE AT THE BALLOT BOX On Nov. 4, 2014, 68% of Californians — 72% in San Diego — voted No on Prop. 46. Never a foregone conclusion, the rejection of Prop. 46 required a massive expenditure of more than $60 million, with CMA’s initial $5 million pledge convincing coalition partners to join and contribute. SDCMS, for its part, worked with local hospital medical staffs and medical groups to alone raise nearly $1 million. In addition, your SDCMS and CMA assembled an exceptional campaign team, built one of the largest, most diverse coalitions in California’s history, conducted extensive polling and focus groups, and ran flawless air and ground games. Ask yourself: What would your practice look like if we hadn’t spent $60 million?

MEDI-CAL • CMA eliminated the 10% Medi-Cal clawback in 2014, saving Medi-Cal providers $42 million.

• CMA held off a 10% across-theboard Medi-Cal cut for three years.

• CMA secured $41 million to provide technical assistance to Medi-Cal providers to implement EHRs and achieve meaningful use.

• CMA created a members-only Medi-Cal Survival Toolkit to help physicians understand the impact the Medi-Cal changes would have on their practices.

• CMA collected Medi-Cal “accessto-care” horror stories to demonstrate Medi-Cal network inadequacy and hindered access to continuous, quality care.

WE PERMANENTLY ELIMINATED GPCI



In 2014 we finally resolved San Diego County’s Geographic Practice Cost Index (GPCI) inequity — returning to San Diego’s physicians the roughly $100 million per year taken from them for more than a decade, equating to $12,500 per year per doctor practice on average! Due to a political compromise, the GPCI’s permanent elimination will be phased in over six years, starting in 2017, but the issue itself has at last been put to rest.

12

March 2015

Drs. Ted Mazer and Bob Hertzka present Congressman Darrell Issa with an honorary SDCMS membership certificate for his work in helping eliminate GPCI.

After a decade of frustration with 17 lastminute postponements and “kicking the can down the road” band-aids, the Senate (92–8) and the House (392–37) overwhelmingly passed HR 2 in April 2015. This bipartisan Medicare SGR Payment Reform and Children’s Health Insurance Program (CHIP) Reauthorization Act will, among other things: • Repeal the SGR and obviate in perpetuity any pending across-the-board Medicare cuts; • Provide 0.5% increases in Medicare each year for four years; • And, in 2019, physicians can choose to participate in one of two payment track options: 1. Fee-for-Service Track: Simplifies and consolidates the existing quality reporting programs, reinstates large bonuses up to 9% and reduces current penalties.

2. Alternative Payment Model Track: Provides 5% bonus payments and allows physicians to develop the new models, such as primary care / specialty medical homes.

HELPING YOU & YOUR PATIENTS NAVIGATE COVERED CALIFORNIA • CMA secured the enactment of SB 964, requiring Medi-Cal managed care plans and insurers offering individual plans through Covered California to provide annual reports to the Department of Managed Health Care (DMHC) about the adequacy of their provider networks and to publicize those reports.

• SDCMS and CMA conducted 14 seminars and webinars on various Covered California topics.

• CMA created a Covered California toolkit and resources webpage, tip sheets for the first four months, a preparing for 2015 changes guide, patient FAQs, a physician participation lookup tool, an understanding the grace period guide, and physician and “Know Your Participation Status” guides.

• SDCMS produced a matrix to help members answer questions like “Am I contracted to see Covered California patients?” and “How do I check my participation status with these plans?”

SDCMS provided Covered California implementation assistance for numerous member practices.

2014 SDcms Annual Report

POLICING THE HEALTH PLANS

MEDICONNECT  CAL RESOURCES

official publication of SDcMS December 2014

Cal MediConnect Is There a DocTor on BoarD?

• CMA secured a court ruling obligating health plans to take responsibility for payment when they irresponsibly delegate risk.

• CMA sponsored AB 2400 to ban socalled all-payor clauses.

• CMA prompted the U.S. DHHS to require the California DHCS to change its payment methodology to ensure California physicians get the full benefit of the ACA primary care increase.

• CMA urged UHC to delay implementation of its premium designation program to allow time to address serious deficiencies.

• At CMA’s urging, Anthem fixed incorrect patient ID cards that resulted in claim denials.

• CMA urged UHC to make changes with its physician rating and tiering program.

“Physicians United for a healthy san diego”

SDCMS and CMA produced San Diego-specific sample letters for patients, conducted four Cal MediConnect seminars and webinars, produced an extensive FAQ document, and SDCMS devoted its December 2014 issue of San Diego Physician to Cal MediConnect: Is There a Doctor on Board?

STOPPING UNSAFE SCOPE EXPANSIONS • CMA defeated an optometry scopeof-practice expansion attempt.

• CMA defeated AB 2015, thereby precluding alternative practitioners such as naturopaths from independently practicing medicine.

DISPUTING SUNSHINE ACT DATA SDCMS and CMA assisted and continue to assist members in disputing incorrect Sunshine Act data on their financial interactions with manufacturers of drugs and medical devices.

ICD-10 RESOURCES FOR MEMBERS • ICD-10 implementation orientation webinar • five pre-recorded ICD-10 planning webinars • eight ICD-10 webinars in partnership with the AlamedaContra Costa Medical Association

MITIGATING PRACTICE BURDENS CMA sponsored AB 1755, signed by the governor, to reduce administrative burdens on providers and health facilities when medical information is breached, while ensuring accurate notification to patients.

PRACTICE FINANCING / REIMBURSEMENT CMA defeated AB 2533, which would have prohibited noncontracted providers from billing for services in excess of in-network reimbursement rates.

official publication of SDcMS April 2014

2013

SDCMS Physician Workforce & Compensation Survey “Physicians United for a healthy san diego”

SAN  MONITORING DIEGO’S PHYSICIAN

WORKFORCE

SDCMS published the results of its sixth biennial San Diego County Physician Workforce and Compensation survey in 2014, a critically important gauge of physician workforce trends in San Diego County that we can take to our legislators.

CPPPH — WORKING TOWARD PHYSICIAN WELLNESS California Public Protection and Physician Health (CPPPH), established in 2009, continued to provide consultation, coordination, education, and network-building for physician providers in 2014, as well as policies and procedures for physician health committees. Regional workshops, including one hosted every four months by the SDCMS Foundation, connect medical staff and medical group wellbeing committee members in 39 of California’s 51 counties. Together with coalition partners, CPPPH has also developed guidelines, including how to address the late career physician, and is working on one about dealing with the disruptive physician. CPPPH will soon be addressing things like burnout that put physicians, their practices, and ultimately their patients at risk. Much more information is available at www.

CPPPH.org.

SAN DIEGO PHYSICIAN.org

13

2014 SDcms Annual Report

official publication of SDcMS May 2014

navy MeDicinein

San Diego “Physicians United for a healthy san diego”

 MILITARY We devoted our May magazine to Navy medicine in San Diego.

FIGHTING PRESCRIPTION DRUG ABUSE • SDCMS hosted a CURES sign-up event on Feb. 28, 2014, signing up more than 60 physicians and saving them valuable time.

• CMA Created a Members-only Resource: “A Physician’s Guide to Implementation of SB 866: The New Standardized Prescription Drug Prior Authorization Form” • Under the aegis of SDCMS, the San Diego and Imperial County Prescription Drug Abuse Medical Task force developed a patient medication agreement (endorsed by SDCMS, HASDIC, and the County of San Diego), saw its Safe Pain Medication Prescribing in Emergency Departments project duplicated in Los Angeles, Ventura, and Orange counties (with awards from the California Hospital Association and National Association of Counties), and helped convince the San Diego Department of Public Health to implement a hassle-free CURES registration system without the notary requirement.

14

March 2015

SDCMS CONVENES  PHYSICIAN

LEADERS TO DISCUSS EBOLA

On Oct. 20, SDCMS convened nearly 100 chiefs of staff, representatives from the County, politicians, and other infectious disease specialists to discuss Ebola, to share preparation plans for an Ebola patient, and to ask questions of each other. SDCMS’ GERM Commission — San Diego County’s infectious disease leaders — continues to address the disease from a clinical perspective.

PROTECTING THE PUBLIC HEALTH • CMA sponsored legislation to require all sugary drink bottles, cans, vending machines, dispensers, and restaurateurs to display a warning.

• CMA joined a coalition seeking to increase the tobacco tax by $2 by the end of 2016.

• SDCMS kept physicians up to date on 2014 outbreaks: influenza in Jan. and Nov., measles in Feb. and March, wound botulism in March, meningococcal disease in April, MERS, pertussis, tattoo-associated skin infections, and mercury poisoning in May, pertussis again in June, chikungunya in July, pertussis again in August, enterovirus D68 in September and October, and dengue in November.

YOUR  SUPPORTING OFFICE MANAGER • SDCMS’ online office manager forum enables member office managers and practice administrators to build a community of mutual support in order to get answers to practice management questions, share best practices, stay abreast of upcoming deadlines, and much more!

• Congratulations to Sheila Hendry, PhD, SDCMS’ 2014 Office Manager of the Year! Sheila was nominated

by Wendy M. Buchi, MD, SDCMSCMA member since 1995, of IGO Medical Group.

• SDCMS published the results of its 2013 SDCMS Medical Office Salary Survey in 2014.

2014 SDcms Annual Report

CULTIVATING  STRONG

LEGISLATOR RELATIONS SDCMS physician leaders, medical students, and staff traveled to Sacramento and Washington, DC, again on several occasions in 2014 to build and maintain strong personal relationships with all of our state and federal legislators.

YOUR SDCMS PHYSICIAN ADVOCATE AT WORK Ask Your SDCMS Physician Advocate: In 2014, your physician advocate, Marisol Gonzalez, solved more than 480 member practice problems and saved them more than $250,000! Examples include prevailing upon CMS to issue a member physician her $12,000 EHR incentive check, pressuring a health plan to issue checks totaling $2,000 owed to a member group, helping a member group having difficulty credentialing a new physician, and ensuring a solo member obtained his 0.5% PQRS incentive.

BRINGING YOU TANGIBLE MEMBER BENEFITS • More than 998 SDCMS physicians saved nearly $354,325 with The Doctors Company, SDCMS’ endorsed professional liability carrier, which offers a 5% members-only discount on professional liability insurance.

• Our Twitter feed continues to deliver a daily treasure trove of healthcare news to physicians’ smartphones.

• SDCMS created, for members only, a line-by-line analysis of Covered California agreements for Blue Shield, Health Net, Molina, and Anthem Blue Cross.

• SDCMS compiled a members-only report of average office and medical staff salaries.

COMMUNICATING TO, FOR, AND FROM PHYSICIANS • 12 Monthly Magazines to 9,000+ Physicians • 26 E-newsletter Blasts (“News You Can Use”) to 9,000+ Recipients

EVENTS  SDCMS & SOCIALS • Our 2014 White Coat Gala installed J. Steven Poceta, MD, as SDCMS president for 2014–15 and recognized Robert E. Peters, MD, PhD, as SDCMS president for 2013–14. More than 200 people attended, including U.S. Representative Susan Davis, Senator Mark Wyland, Assemblymembers Brian Jones and Lorena Gonzalez, and Supervisor Greg Cox. • “Physicians of Exceptional Excellence” — Top Doctors: More than 1,600 physicians participated in the 2014 selection of San Diego’s “Physicians of Exceptional Excellence” and 775 were selected, the largest number of “Top Doctors” ever. The Gala took place on Nov. 1 at the Birch Aquarium, with more than 600 attendees — the largest number of attendees to date.

• SDCMS held three physician mixers in 2014 (April, July, and September) — all rousing successes; the La Jolla social had more than 80 physicians in attendance!

SAN DIEGO PHYSICIAN.org

15

2014 SDcms Annual Report

SDCMS FINANCIALS 6%

Rent: 11% Credit Card/Bank Charges: 1% Insurance: 1% Miscellaneous Expenses: 3% Telephone: 2% Staff Time G&A: 8%

Physician Database

11%

Physician Engagement

13%

Advertising & Sales

SDCMS & CMA SEMINARS & WEBINARS We conducted more than 60 membersonly seminars and webinars in 2014, covering ACOs, Cal MediConnect, contract negotiations, HIPAA, ICD-10, meaningful use, Medi-Cal, Medicare, OSHA, myriad practice management topics, risk management, workers’ compensation, and more!

SDCMS PHYSICIAN

 LEADERS

Infrastructure

Dues

4%

Foundation

Benefits

CMA Commissions

5%

Expenses

income

Foundation

5%

Advocacy

MAKING YOUR PROFESSIONAL LIFE EASIER

RESIDENT PHYSICIANS • SDCMS held its annual all-day “Preparing to Practice” workshop on Feb. 1, 2014, helping almost 100 resident and young physicians establish their post-residency careers.

• CMA was instrumental in securing $7 million for primary care residency slots in the 2014–15 state budget — frustrating the argument that California’s physician shortage should be met by expanding the scope of practice of allied health professionals.

SDCMS offered a number of professional development workshops for members in 2014, including workshops on advocacy training, medical coding, financial and legal life skills, media training, taming Microsoft Outlook, leadership training, and work-life balance.

SDCMS MEMBERSHIP INCREASES FOR THE 13TH YEAR IN A ROW! 2014: 2,961

2012: 2,683

2010: 2,652

2011: 2,670

2008: 2,562

2006: 2,390

2005: 2,195

2003: 2,056

2004: 2,163

GRAND TOTAL: 4,302

2007: 2,419

Affiliate Members: 8 Government Members: 155 Regular Members: 2,785 Leave of Absence Members: 13 2014 TOTAL: 2,961

2002: 2,029

March 2015

8%

12%

Retired Members: 720

SDCMS Physician Leaders

56%

Communication

Student Members: 393 Resident Members: 948 TOTAL: 1,341 Dr. Wailes

Investments

2009: 2,578

Dr. Mazer

15%

26%

22%

2013: 2,813

• Dr. Horacio Rodiles, SDCMS-CMA member since 1973, was appointed to the United States-México Border Health Commission.

• Theodore M. Mazer, MD, was elected Speaker of CMA’s House of Delegates in 2014.

• Robert E. Wailes, MD, was elected vice chair of CMA’s Board of Trustees in 2014.

• UC San Diego’s Commencement and White Coat ceremony processions were led by SDCMS president, J. Steven Poceta, MD. • SDCMS presented at 27 hospital general staff and medical executive meetings in 2014.

• 53 SDCMS physician leaders attended CMA’s House of Delegates in 2014, held in San Diego.

16

17%

Governance

2014 ANNUAL REPORT

Improving Health…

2,798+

22

88%

Patients with Improved Health

Lives Saved

Reduction in Emergency Department Visits

94%

902

9,444

Reduction in Work Days Missed

Surgeries Specialty and GI Healthcare Procedures Appointments

$8.9 Million

in donated care thanks to Physicians, Hospitals, Surgery Centers & Ancillary Healthcare Providers

Changing Lives Since 2008

PROJECT ACCESS

SAN DIEGO PHYSICIAN.org

17

Celebrating Ten

10 Years of Service toOur Community San Diego County Medical Society Foundation

18

March 2015

sdcms elec tions

Candidate Statements 2015–16 SDCMS Board of Directors

Notes: • (Inc.) After Name = Incumbent • Number in Parentheses (#) After Name = Term Length in Years

will continue to evolve … but without us.

I pledge to work on building membership, promoting advocacy, and making San Diego the finest and healthiest city.

OFFICERS

Secretary: Mark W. Sornson, MD (1) — It is a privilege to again ask for your support as I run for secretary of SDCMS. I have served as at-large director for four years, three years as a representative on the Executive Committee, seven times as a CMA delegate or alternate delegate representing San Diego, and two years on the Insurance and Physician Reimbursement Reference Committee for CMA. Previously, I chaired the CMA Young Physicians Section and authored a successful resolution.

Through these experiences I have seen firsthand that when a medical society speaks with a unified voice and builds relationships, we can make a difference. I was a spokesperson for last year’s No on 45 CMA campaign, and it was a true pleasure to be a part of that successful advocacy effort.

When physicians come together, they are listened to. As secretary, I will continue to be a voice for reasoned discussion, representing all physicians. I’ve greatly enjoyed my service on behalf of SDCMS and CMA, and I am honored to ask for your vote to continue.

President-elect: Mihir Y. Parikh, MD (1) — It is a privilege to ask for your support as I run for presidentelect of the San Diego County Medical Society. I have been serving on the SDCMS board for the past nine years, holding various titles along the way, including young physician delegate, secretary, and treasurer. This election cycle I am running for the president-elect position. I believe in the SDCMS mission to uphold the principles behind “Physicians United for a Healthy San Diego.” To be united, we need to have a robust membership of many physicians over many modes of practice over the entire county of San Diego. This large membership will allow us to represent the doctor’s voice in delivering quality healthcare in San Diego. This voice needs to be heard through advocacy and at public health events. In the past nine years, I have clearly seen that we have far greater influence when we speak together than when we opine as individuals. If we cannot carry this influence and demonstrate our relevance, then healthcare

Treasurer: David E.J. Bazzo, MD (1) — I’ve had the privilege to serve on the SDCMS board of directors since 2009.

During this time, I’ve seen what advocacy through organized medicine can accomplish. This past year, the board elected me to serve as its representative to the Executive Committee, allowing me to learn more about the inner workings of our wonderful association.

SDCMS is second to none when it comes to representing the needs and interests of physicians in advocating to optimize our ability to help our patients.

The politics of our state and nation have enormous impact on our capacity to keep our patients healthy, safe, and to keep cost controlled. This could not have been more evident than with the defeat of Prop. 46 (MICRA initiative) last year. These events don’t happen by accident. As with any process, unless you have a seat at the table, your opinion is not heard. Well, through the work of your county and state medical societies, your voices are heard. Your interests are represented.

The members of the board do have influence and work on your behalf to ensure that physicians have a say in the future practice of medicine. I am proud of my membership and position on the board, and view it as an honor to volunteer to help our organization. I ask that you continue to place your trust in me to serve our organization by supporting my election as treasurer. Thank you.

SAN DIEGO PHYSICIAN.org

19

sdcms elec tions

GEOGRAPHIC DIRECTORS La Jolla #1: Geva E. Mannor, MD, MPH (Inc.) (3) — I am honored to be considered as one of your La Jolla representatives to SDCMS. Since 2002, I have been performing oculoplastic surgery in the ophthalmology division at Scripps Clinic Medical Group.

I obtained my MD at Northwestern and an MPH at Harvard, followed by a residency in ophthalmology at Mount Sinai Hospital, New York, and a fellowship at Yale. I have practiced in various types of clinical settings like academic university departments, VA hospitals, British National Health Service (Moorfields Eye Hospital, London, U.K.), and a U.S. HMO. I am aware of the challenges that today’s physicians face. I plan to advocate for my fellow San Diego county colleagues and improve their ability to practice medicine.

Project4:Layout 1

9/22/08

11:22 AM

East County #2: Alexandra (Alexe) E. Page, MD (Inc.) (3) — Serving for three years on the SDCMS board of directors has offered me the chance to build relationships with other San Diego County physicians, understanding and representing their views as a delegate to the California Medical Association. I have used the opportunity to transcend specialty interests and work on a united physician voice defining how healthcare will evolve.

My knowledge and experience in health systems have evolved from serving as a member and now chair of the Health Care Systems Committee of the Orthopaedic Academy (AAOS). But regardless of specialty or practice environment, paradigms of healthcare delivery from patient-centered medical homes, to ACOs, to bundled payments can change the patient-doctor relationship. Physicians can protect the

REGISTRY

&

South Bay #2: Michael H. Verdolin, MD (Inc.) (3)

Page 1

Tracy Zweig Associates A

care we give our patients by proactively defining how these new healthcare models will evolve in our community. Lessons learned through my specialty academy help guide recommendations and direction for all San Diego physicians.

A cum-laude graduate of Harvard Medical School, after residency in New York I joined Kaiser Permanente in San Diego and have practiced orthopaedics here since 1998. As a member of the SDCMS board of directors, I hope to continue communication among physicians of all disciplines to enhance consensus-building and present a stronger front to other stakeholders in the healthcare system.

PLACEMENT

FIRM

Physicians

Nurse Practitioners Physician Assistants

Increase Your Referrals PhysiciAns

— page 8

listeD By sPeciA

lty & ZiP coDe

PhysiciAns

— page 44

listeD AlPhAB

eticAlly

san diego county

Locum Tenens Permanent Placement V oi c e : 8 0 0 - 9 19-9141 or 805-641-9141 FA X : 805-641-9143

t z w e i g@ t r acyzw eig.com w w w.t r acyzweig.com

20

April 2015

The annual San Diego County All Physician Directory lists contact information for every physician in the county. It is mailed to all 8,800+ San Diego County physicians free of charge. This digest sized directory is a go-to resource for physicians and their office staff.

All Physician Directory 2015-16 A

SDCMS Members receive 35% off advertising rates. Contact Dari Pebdani today at 858-231-1231 or DPebdani@SDCMS.org

sdcms elec tions

North County #3: Michael A. Lobatz, MD (Inc.) (3)

North County #1: Patrick A. Tellez, MD, MPH, MSHA, CMO, North County Health Services (3) — One of the main goals of healthcare reform has been to decrease medical costs and the uninsured.

While the ACA has afforded many access to basic primary care, we now face the prospect of having expanded enrollment into the same system we sought to change before having established financing and payment

reforms designed to support sustainability.

Increases in clinical demand and patient volume will naturally increase health expenditures and expose professional reimbursement as a potential expedient solution to fiscal challenges.

Our opportunity is to lead the discussion and implementation of effective management of economic pressures on reimbursement in order to meaningfully impact issues such as contracted physician network inadequacy, physician workforce shortage, and sustainable solutions to payment reform.

Sustaining our Medicare and Medicaid systems as well as our underfunded public health systems will require modification of both financing and delivery of healthcare to meet commonly accepted standards of care and emerging expectations of accountability for quality and service.

While success will require hard work, we, as physicians, are aptly qualified to lead that change. As director, I would be privileged and honored to become part of the team effort to facilitate the Society’s vision for the future.

GEOGRAPHIC ALTERNATE DIRECTORS North County Alternate #1: Neelima V. Chu, MD (3) — I am honored to be a candidate for SDCMS alternate delegate. I am currently practicing endocrinology and metabolism at Sharp Rees-Stealy Medical Group (SRSMG). I have been at SRSMG for four years. Prior to that, I was in private practice for nine years in Chula Vista. I continue to serve as a voluntary assistant professor at UCSD, Department of Endocrinology. I have had the privilege to participate in the Sharp Leadership Academy.

The lessons learned are helping me greatly as the current chief of endocrinology.

I am interested in ensuring that physicians have a voice in the future direction of healthcare and that patients have the ability to access a healthcare system that

Featuring: Daniel Amen, M.D.

REGISTER NOW! Daniel Amen, M.D., popular psychiatrist, nine-time New York Times bestselling author, and PBS television producer

■ ■ ■ ■ ■

Expanded to Four Days Groundbreaking Topics Acclaimed New Speakers CME/CEU/CE Credits Available Early Bird Rate Ends July 31

www.IMMH2015.com

Sign up for our newsletter to stay up-to-date!

SAN DIEGO PHYSICIAN.org

21

sdcms elec tions

can effectively meet both their primary and specialty care needs.

East County Alternate #1: Susan Kaweski, MD (Inc.) (3)

AT-LARGE DIRECTORS #1: Thomas J. Savides, MD (2) — I graduated from UCSD School of Medicine in 1987 and have been a UCSD faculty member in the Division of Gastroenterology since 1993. My clinical specialty is using

advanced endoscopic procedures for management of GI track cancers, pancreaticobiliary disease, and challenging colon polyps. Clinical research interests have included GI bleeding, application of endoscopic ultrasound procedures, combined endoscopic surgical procedures, and pancreatic cystic lesions. I have been active in teaching medical students, residents, and fellows, and served as the training director for the UCSD GI Fellowship Program. I also served in various leadership positions at UCSD, including GI Clinical Services chief, chair of the Health Sciences Faculty Council, and as a member of the Medical Group Board of Governors. In 2014 I became the chief experience officer for UCSD Health System and am responsible for strategy, leadership, and implementation surrounding the improvement of the total healthcare experience of patients, families, providers, and staff. It is my privilege to serve the members of the San Diego County Medical Society.

Is your mom* your bookkeeper? * or spouse, nephew, admin, office manager...

We can help.

High-performance accounting services designed to meet the needs of your medical practice, offering clear financial reporting, fraud protection and privacy.

CoEfficientServices.com 877.292.9684 22

April 2015

#2: Karrar H. Ali, DO (Inc.) (3) — I am honored to run for the board of the San Diego County Medical Society again. As an emergency physician at Sharp Chula Vista Medical Center and full partner with California Emergency Physicians (CEP), I am a change agent who seeks to improve medicine at micro and macro levels for our patients, healthcare providers, administrators, and communities. I hold several committee positions at the hospital that focus on efficiency and team-building, as well as being the advocacy lead at Sharp.

As an emergency physician, I feel the failure of the healthcare system every day, especially after the Affordable Care Act. While Washington and Sacramento have worked in getting Americans coverage, there are still many holes to fill. And until these holes are filled, I feel the despair of patients who have nowhere to turn because

sdcms elec tions

their primary physician is not accepting their plan or that they have to wait until after they die before getting to see a specialist. I feel the frustration of doctors unable to refer their patients or unable to deliver adequate care — with the emergency department being the only hope for helping their patients. The impact of this failure is overcrowded hospitals, stress on healthcare providers, and continued cost-cutting pressures by administrators.

I believe that the only way we can save our healthcare system is for physicians to be informed and involved advocates, both locally and nationally. My goal as a board member is to advocate our position by educating other San Diego physicians and our representatives in Sacramento. I would specifically like to improve emergency services and advocate access to primary care.

I thank you for your support. #4: James (Jim) H. Schultz Jr., MD, MBA, FAAFP, DiMM (3) — Jim Schultz is a family physician who practices at Neighborhood Healthcare, a Federally Qualified Community Health Center serving about 70,000 of the underserved and medically needy. He sees outpatients in Escondido, Pauma Valley, and Temecula, and inpatients as part of the California Emergency Physicians hospitalist program. He has been chief medical officer of Neighborhood Healthcare since 2001, and is currently the medical director of the Council of Community Clinics and of Project Access San Diego.

Prior to his role at Neighborhood Healthcare, Jim was medical director and practicing physician at Graybill Medical Group in Escondido, where he began his professional career in 1988. His goals at SDCMS include fairly representing the interests of the physicians of North County, and bringing in the voice and perspective of those physicians whose practice is predominantly that of the underserved.

He is also a volunteer clinical professor at UCSD in the Department of Family and Preventive Medicine and hosts the Family Medicine Residency PGY-1 Outpatient Gynecology rotation.

#7: Toluwalase (Lase) A. Ajayi, MD (3) — I have been involved with the San Diego County Medical Society since I moved to San Diego for fellowship in 2012, but I have been active in medical organizations since I was a medical student. As a pediatrician, I have previously and currently serve on several executive committees within the American Academy of Pediatricians, and serve as a young physician liaison to the American Medical Association. As a fellowship-trained palliative care physician, I make sure that I am an engaged member of the American Academy of Hospice and Palliative Medicine and serve on several committees.

I am diligent in my work and leadership within the AAHPM, AAP, and AMA because of my dedication to serving as an advocate for patients who are underrepresented and/or who may not be able to advocate for themselves. As a palliative care physician and pediatrician, I am fortunate to be able to work with a large variety of physicians within my different practices.

It would be an honor to have a seat on the board of SDCMS so that I may serve on behalf of all physicians, and I ask for your support. I will be dedicated to you so that we may all continue to be in a position to advocate and provide the best care possible to our patients. I believe progress cannot happen at just one level, but involves collaborating with people at different levels who believe in the continued improvement of healthcare for the patient, the practitioner, and the system.

AT-LARGE ALTERNATE DIRECTORS #2: Steven Chen, MD (1) — It is an honor to be considered for a position on the SDCMS board of directors. Although a recent transplant to San Diego, the importance of organized medicine to our ability to function as a profession is not new to me.

After faculty positions as the chief of breast surgery at UC Davis, and associate program director of the Surgical Oncology Fellowship at City of Hope in Los Angeles, and serving on the board of the county medical societies in Sacramento and Los Angeles, I have recently started an independent surgical oncology practice here with offices in Mira Mesa and Encinitas, with privileges in both the Scripps and Sharp systems.

Having been in academic faculty, an employed surgeon in a foundation model,

TrusT A Common sense ApproACh To InformATIon TeChnology Trust us to be your Technology Business Advisor hArdwAre  sofTwAre neTworks emr ImplemenTATIon seCurITy  supporT mAInTenAnCe

(858) 569-0300

www.soundoffcomputing.com

Endorsed by

SAN DIEGO PHYSICIAN.org

23

sdcms elec tions

*

Voting Ends at Noon on Tuesday, May 5

and now an independent surgeon, I have experienced the breadth of all practice modes and feel that I am well qualified to ensure that the needs of all of these groups are considered in everything that SDCMS does.

I have been fortunate to have served nationally in a number of organizations, including being on the board of the American Society of Breast Surgeons and recently completing terms on the Young Physicians Section Governing Council of the AMA, as well as the executive council of the Young Fellows Association of the American College of Surgeons. I continue to serve on the legislative committees of the American College of Surgeons and the American Society of Breast Surgeons and thus stay up to date on the issues facing the professional practice of medicine.

I fully believe that if we do not defend the profession and act in a professional way, we will lose the right to be a profession. SDCMS and organized medicine are key links to ensuring that being a physician continues to mean being a professional. I ask for your support to allow me to help represent you and your concerns. #3: Erin L. Whitaker, MD (3)

24

April 2015

YOUNG PHYSICIAN DIRECTOR

RESIDENT PHYSICIAN DIRECTOR

Edwin S. Chen, MD (Inc.) (1) — Healthy and happy physicians take better care of healthy and happy patients. In the dramatically changing healthcare landscape, SDCMS provides a meeting place and a launching platform from which we can advocate for ourselves and our patients. New physicians often find themselves immersed in a healthcare world they never imagined. I have had the honor and privilege of serving as the young physician director for the past year, and it has been a wonderful experience. As a young physician who recently started a solo practice, I look forward to collaborating with all of you in sharing our knowledge and experience so that we can better advocate for the medical community and the patients that we serve.

Michael C. Hann, MD (1) — I am a psychiatry resident at Naval Medical Center San Diego (NMCSD), and I am running for the position of resident director. I am a dual-degree graduate of the FIU Herbert Wertheim College of Medicine and FIU Chapman Graduate School of Business in Miami, Florida, where I earned my MD and healthcare MBA. While studying in Miami, I became engaged early on with organized medicine and served on the board of directors for the Dade County Medical Association for three years. I was recognized at the state level with the Florida Medical Association Foundation scholarship for my contributions to organized medicine. Since coming on to active duty, I have completed the Navy’s Officer Development School (ODS), where I served as the division officer for 120 naval officers in training. I was recognized as the honor graduate upon completion of ODS and was further recognized with the George T. Smith Award for Military Leadership. I also continue to be actively engaged at NMCSD, where I currently serve as the house staff council representative for the Directorate of Mental Health, as well as a committee member on the Graduate Medical Education Committee (GMEC)/CLER Pathways Patient Safety Committee. Most recently, I had the privilege of serving as a District I delegate to the CMA House of Delegates in December 2014. I am committed to representing and advocating for resident physicians and would greatly appreciate your support.

YOUNG PHYSICIAN ALTERNATE DIRECTOR Heidi M. Meyer, MD (1) — I am honored to be a candidate for the young physician representative to the SDCMS board.

I am a proud graduate of San Diego County’s medical school at UCSD, where I served as the student delegate to CMA and was mentored by several current and former SDCMS board members. As a resident, I served as the resident member of both the Arizona Academy of Family Physicians and the American Academy of Family Physicians board of directors, which exposed me to the politics of medicine on both a state and federal level.

I firmly believe that all medicine is politics, and to deny this is putting our patients and providers at a grave disadvantage. As a primary care provider, I feel it is part of my duty to serve my community and serve as an ambassador to our patients and fellow providers. Too few of us understand healthcare delivery — at our peril — and it is groups like SDCMS, and its state and national equivalents, that seek to change that. The opportunity to serve on this board is a welcome one.

RESIDENT PHYSICIAN ALTERNATE DIRECTOR Quinn C. Meisinger, MD (1) — I am happy to join the board of directors as a resident representative. I look forward to a productive year.

Accounting

Please support the advertisers who support San Diego Physician When shopping for practice management products and services, be sure to contact these companies first.

Co-Efficient Services (877) 292-9684 bgoodson@coefficientservices.com coefficientservices.com

Alcohol & Chemical Dependency Recovery Works (858) 530-9112 Recoveryworkssd.com

Commercial Real Estate

Cushman Wakefield (858) 334.4041 travis.ives@cushwake.com northcoastmedicalplaza.com

Jones Lang LaSalle (858) 410-6377 chris.ross@am.jll.com us.joneslanglasalle.com/ healthcare

Continuing Education

Integrative Medicine for Mental Health (913)915-5136 info@immh.org www.IMMH.org www.IMMH2015.com

Employment

Tracy Zweig & Associates (800) 919-9141 tzweig@tracyzweig.com tracyzweig.com

Financial Advisors

Wells Fargo Advisors, LLC Barry Masci, First VP – Investments (858) 720-2365 barry.masci@ wellsfargoadvisors.com bmasci.wfadv.com

Human Resources Tri-Net

(888) 874-6388 trinet.com

Insurance

The Doctors Company (800) 852-8872 thedoctors.com/SDCMS Cooperative of American Physicians (800) 356-5672 MD@CAPphysicians.com capphysicians.com Norcal Mutual Insurance Company (877) 453-4486 info@norcalmutual.com heart.norcalmutual.com/ca

Mortgage Banking

BBVA Compass Corey Weber (760) 405-3575 Corey.weber@bbvacompass.com

Practice Management Absolute Solutions (858) 256-0351 kena.galvan@abs-sol.com abs-sol.com/index.html

Technology



Soundoff Computing (858) 569-0300 ofer@soundoffcomputing.com soundoffcomputing.com

Additional information can be found at the Practice Management Resources page at www.SDCMS.org.

SAN DIEGO PHYSICIAN.org

25

classifieds PRACTICE FOR SALE OFFICE OF GENERAL PRACTICE FOR SALE: Please contact Dr. Mary Raiszadeh at (858) 7508984. [329] PHYSICIAN POSITION WANTED LOOKING FOR PART-TIME FAMILY PRACTICE: D. (Doyle) Eugene Johnson, family physician with a wealth of experience, looking for part-time position, preferably in North County. Have been a full-time practicing certified family physician for 50+ years and would like to continue seeing patients part-time. Had one of the largest solo family practices in San Diego for 25+ years. Excellent references! Continually certified in family practice, ACLS, BLS, regularly use computerized records. Will consider locum tenens. Please email d.eugenejohnsonMD@gmail.com with particulars.

[301] PHYSICIAN POSITIONS AVAILABLE OUTPATIENT PRIMARY CARE PHYSICIAN OPPORTUNITY IN VISTA: Optum is excited to announce a full-time, 100% outpatient primary care physician opportunity (Family Medicine or Internal Medicine) in Vista, CA. This position offers a convenient Monday–Friday, 8am–5pm schedule in a well-established and highly respected clinic just three miles from the ocean! Contact Kaitlin Osborn if you, or someone you know, may be interested at Kaitlin_Osborn@optum. com or at (952) 936-3888. [336] PHYSICIAN NEEDED: Seeking a California-licensed physician to cover contrast injections at an imaging center in Imperial County, 2407 Marshall Ave., Suite A, Imperial, CA 92251. Please call (760) 730-3536 for more details, or fax (760) 720-4833. [335] MEDICAL DIRECTOR OPENINGS: Our San Diego County and Temecula facilities provide outpatient substance abuse treatment serving patients afflicted with the disease of addiction specifically to the opioid class of drugs. We have openings for part- or full-time medical director at our San Diego and Temecula facilities. Qualifications: The physician shall be a licensed physician in the state of California with an unencumbered license. The physician is responsible, either directly or through a supervisory relationship with other licensed physicians, physician’s assistant and / or nurse practitioner. Minimum of two years experience with chemical dependency preferred. Excellent communication skills required. SEND RESUMES TO: cenos@crchealth.com. [331]

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) 876-4426. For more information and to apply, visit our website and apply online at www. fhcsd.org. [046a] SEEKING A FOOT/ANKLE SPECIALIST OR HAND SURGEON: Well-established, highly respected, fourphysician group, private practice in San Diego seeking a foot/ankle specialist or hand surgeon. Our group is expanding to meet high volume of cases and planned expansion. Potential opportunity for any established subspecialist looking for a permanent practice location. We have a broad-based primary care referral base, mature EHR, digital X-ray, ultrasound, and DME program. Interested parties, please email your CV in confidence to lisas@sdsm.net. [326] FULL-TIME PRIMARY CARE PHYSICIAN: For a busy, well-established pain management practice in Mission Valley. The candidate must be able to provide compassionate care in a fast-paced environment. Please send CV to alicjasteinermd@hotmail.com. [322] SEEKING PART-TIME PRIMARY CARE / URGENT CARE PHYSICIAN: For a busy, well-established primary care family practice / urgent care medical practice in Pacific Beach. This position could lead to an associate physician position of the practice for the right person. The candidate must be able to provide compassionate care in a fast-paced environment.

Knowledge of musculoskeletal medicine and X-Ray is required. Must be able to suture and have experience with wound care. We have a state-of-the-art medical facility. Please send your CV in confidence for consideration to pbyrnes@andersonmedicalcenter.com.

Compensation: Excellent Pay Rate [317] URGENT CARE PHYSICIAN — Per Diem BC/BE: Arch Health Partners is an award-winning medical foundation affiliated with the Palomar Health System in North San Diego County. Hours: 9:00am–9:00pm.

Send CV to catherine.jones@archhealth.org or fax to (858) 618-5820. [312] GENERAL, FAMILY, OR INTERNAL MEDICINE PHYSICIAN NEEDED IMMEDIATELY: This opening is an independent contractor position. We are a house call practice located in beautiful North San Diego County. We will also provide paid training on our EMR. 8–5, Monday–Friday, 10–12 patients per day, and oncall pager 1 week every 3 weeks, telephone call only.

No rounds or hospital duties. If interested please submit your CV to julie@sandiegomobiledoctor.com. We are very anxious to fill this position, and we look forward to hearing from YOU! No agencies please. [311] FULL-TIME PRIMARY CARE POSITION IN SAN DIEGO: Outpatient only office, no calls, no weekends.

Please send CV to sandiegoprimarycare@yahoo. com. [308]

SEEKING FULL-TIME BC/BE EMERGENCY MEDICINE OR FAMILY MEDICINE PHYSICIANS: SHARP Rees-Stealy Medical Group, a 450+ physician multispecialty group in San Diego, is seeking full-time BC/ BE emergency medicine or family medicine physicians to join our urgent care staff. We offer a competitive compensation package, excellent benefits, and shareholder opportunity after two years. Please send CV to SRSMG, Physician Services, 300 Fir Street, San Diego, CA 92101. FAX: (619) 233-4730. EMAIL: lori. miller@sharp.com. [330]

SEEKING URGENT CARE PHYSICIAN: Busy practice in El Cajon, established in 1982, seeks a parttime physician. Good pay and working conditions along with the potential to become a full-time position. Please send CV to jeff@eastcountyurgentcare. com. [306]

PHYSICIAN POSITIONS AVAILABLE AS WE CONTINUE TO GROW: Full, part-time, or per-diem flexible schedules available at locations throughout San Diego. A national leader among community health centers, 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.

We offer an excellent, comprehensive benefits package that includes malpractice coverage, NHSC loan

BOARD-CERTIFIED PHYSICIANS, PHYSICIAN ASSISTANTS, AND NURSE PRACTITIONERS NEEDED FOR URGENT CARE: Part-time positions available but a full-time opportunity may be offered to the right candidate. Must possess a current California medical license and ACLS certification. Please email or fax CV to (619) 569-2590. Visit www.DoctorsExpressSanDiego.com for more information. [229a]

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.

26

April 2015

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 (619) 992-5330 or email CV to drhunt@thehousecalldocs.com. Visit www.thehousecalldocs.com. [037] PHYSICIANS NEEDED: Internal medicine and family medicine physician positions currently open. Vista Community Clinic is a private, nonprofit, outpatient clinic serving the communities of North San Diego County with openings for full-time, part-time, and per-diem positions. Current CA and DEA licenses required. Malpractice coverage provided. Bilingual English/Spanish preferred. Forward resume to hr@ vistacommunityclinic.org or fax to (760) 414-3702.

Visit our website at www.vistacommunityclinic.org.

EEO Employer / Vet / Disabled / AA [912] SEEKING BOARD-CERTIFIED PEDIATRICIAN FOR PERMANENT FOUR-DAYS-PER-WEEK POSITION: Private practice in La Mesa seeks pediatrician four days per week on partnership track. Modern office setting with a reputation for outstanding patient satisfaction and retention for over 15 years. A dedicated triage and education nurse takes routine patient calls off your hands, and team of eight staff provides attentive support allowing you to focus on direct, quality patient care. Clinic is 24–28 patients per eight-hour day, 1-in-3 call is minimal, rounding on newborns, and occasional admission, NO delivery standby or rushing out in the night. Benefits include tail-covered liability insurance, paid holidays/vacation/sick time, professional dues, health and dental insurance, uniforms, CME, budgets, disability and life insurance. Please contact Venk at (619) 504-5830 or at venk@gpeds.sdcoxmail.com. Salary $ 102–108,000 annually (equal to $130–135,000 full-time). [778] OFFICE SPACE AVAILABLE WOMEN’S HEALTH / WELLNESS OFFICE HAS SPACE AVAILABLE FOR SUBLEASE: Exam room, office, and/or shared staff optional. Fully furnished exam rooms available and ready for use. Location features onsite billing, reception, medical assistants, potential use of in-office procedure room, and a rooftop lounge. If you are interested, please reply with the heading “Space for Sublease” outlining the details of space and/or staff use desired, with your contact information, and we will contact you to set up a showing. Reply to Mrs. Kim at cvwh858@gmail.com. [288] MEDICAL OFFICE SPACE AVAILABLE FOR SUBLEASE/SHARE IN UTC/LA JOLLA AREA: Established orthopedic surgeon seeks tenant to share office space. 4675ft2 in Chancellor Park, near Scripps Memorial Hospital. Completely rebuilt in 2009. Six exam rooms, digital X-ray onsite. Beautiful finishings, spacious waiting room, conference room, break room.

Ample space for support staff and a private office for physician. Available immediately, full or part time.

Ideal for primary or satellite office. Excellent freeway access (1-5 and 805), first-floor suite located off lobby near main building entrance. For further information, please contact Georgana Bradley at (858) 457-0050 or at gbradley@jpbamc.com. [334] CARLSBAD MEDICAL OFFICE FOR LEASE: • Space from 1,000–50,000 SF • Competitive lease rates and TI allowances • Existing tenants include imaging, pharmacy, orthodontics, urgent care, and pain management • Highly visible to over 43,000 vehicles per day along Palomar Airport Road • Interstate 5 is less than a mile away providing access to over 200,000 households within a 20-minute drive • North County’s most affluent demographic with average household income of $98,614 within a 5-mile radius. For further information, please contact: TRAVIS IVES, Cushman & Wakefield, (858) 334-4041, travis.ives@cushwake. com, Lic. # 1889097 [332]

MEDICAL SPACE FOR RENT / LEASE: Approximately 2,000ft2. Available for lease, in best location of Imperial County. Negotiable. Please contact Dr. Maghsoudy at (760) 730-3536. [328] SUBLEASE PART-TIME SPACE ON SCRIPPS LA JOLLA CAMPUS: A beautiful office space is available a few times a week for someone looking for a part-time satellite office or someone who only has clinic a few times a week. We are located in HM Poole building on the campus of Scripps Memorial La Jolla, two-minute walk from the hospital. Office reception, two exam rooms, and a conference room/break room are available. Our staff use is negotiable. Rates will depend on the needs and usage.

Please contact Olga at olgald@sdneurosurgery.com for more information. [325] NORTH COUNTY / LA COSTA-CARLSBAD OFFICE SPACE FOR SUBLEASE: Beautiful, new 2,300ft2 office space available for sublease. Minor procedure room, 5 exam rooms. Lasers available. Located in Bressi Ranch off of El Camino Real. Perfect for dermatology, OB/GYN, wellness / weight loss. Perfect location for North County expansion. Please call Melissa at (760) 707-5090. [318] BANKER’S HILL OFFICE SPACE: Office space available in beautiful, updated Banker’s Hill medical office that also houses a fully accredited ambulatory surgery center. Great opportunity for a plastic surgeon, facial plastic surgeon, oculoplastic surgeon or dermatological surgeon. Office is conveniently located minutes from freeway access and downtown San Diego. Please contact via email at info@drhilinski.com. [313] ALISO VIEJO — 5 JOURNEY: Multi Tenant Medical Building with highly successful medical and dental practices. 2 ground floor medical spaces approx. 2,135 and 2,225 rsf available for lease. $2.90 PSF NNN. Beautifully designed. Tenant Improvement Allowance to customize suite is available. For further information please contact Lucia Shamshoian @ 769-931-1134x13 or Shamshoian@coveycommercial.com. [298] LA JOLLA (NEAR UTC) OFFICE FOR SUBLEASE OR TO SHARE: Scripps Memorial medical office building, 9834 Genesee Ave. — great location by the front of the main entrance of the hospital between I-5 and I-805. Multidisciplinary group. Excellent referral base in the office and on the hospital campus. Please call (858) 455-7535 or (858) 320-0525 and ask for the secretary, Sandy. [127]

plete ultrasound lab on site for scans or studies. Fullday or half-day timeslots. For more information, call Irene at (619) 840-2400. [154] NORTH COAST HEALTH CENTER, 477 EL CAMINO REAL, ENCINITAS, OFFICE SPACE TO SUBLEASE: Well-designed office space available, 2,100SF, at the 477-D Bldg. Occupied by Vascular & General Surgeons. Excellent and central location at this large medical center. Nice third-floor window views, all new exam tables, equipment, furniture, and hardwood floors. Full Ultrasound lab with tech on site, doubles as procedure room. Will sublease partial suite, one or two exam rooms, half or full day. Will consider subleasing the entire suite, totally furnished, if there is a larger group interest. Plenty of free parking.

For more information, call Irene at (619) 840-2400 or at (858) 452-0306. [153] POWAY OFFICE SPACE FOR SUBLEASE: Private exam room or rooms available for one day a week or more. Ideal for physician, chiropractor, massage therapist. Low rates. Email inquiries to kathysutton41@ yahoo.com. [173] POWAY / RANCHO BERNARDO — OFFICE FOR SUBLEASE: Spacious, beautiful, newly renovated, 1,467SF 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] BUILD TO SUIT: Up to 1,900SF 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: Two 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

3998 VISTA WAY, IN OCEANSIDE: Medical office space approx. 2,488 rsf available for lease. Close proximity to Tri-City Hospital with pedestrian walkway connected to parking lot of hospital, and ground-floor access. Lease price: $1.75+NNN. Tenant improvement allowance to customize the suites is available. For further information, please contact Lucia Shamshoian at (760) 931-1134, ext. 13, or at shamshoian@coveycommercial.com. [234] BANKERS HILL PRIMARY CARE / HEALTHCARE PROFESSIONAL & RESEARCH OFFICE SPACE TO SUBLEASE: 50-year established primary care practice and clinical research office, with currently two internists, have space to sublease to another primary care or primary care / subspecialist, or other independent healthcare professional, to help curb overhead and, if primary care, help with acute overflow patients’ needs. Also can provide opportunity to get into clinical research. Contact Jeff at crf@att.net. [265] SCRIPPS XIMED MEDICAL CENTER BLDG, LA JOLLA — OFFICE SPACE TO SUBLEASE AVAILABLE: Vascular & General Surgeons have space available. One room consult office available, with one or two exam rooms, to a physician or team. Located on the campus of Scripps Memorial Hospital, The Scripps Ximed Medical Center is the office space location of choice for anyone seeking a presence in the La Jolla/ UTC area. Reception and staff may be available. Com-

SEEKING PA/NP AND RN: Medical spa in the Del Mar / Solana Beach area is seeking PA/NP and RN. Should have experience with laser hair removal, IPL, CO2 laser, Botox and fillers, and sales. Positive attitude, ability to multitask, perform patient treatment, sales, consultations, effective communicator, work in a team environment, focused on client care, knowledge of lasers and laser theory, quick learner, self motivated. PA/NP will perform consultations and good-faith examinations. Minimum requirements: PA, NP, RN California license. This is a parttime position, 1–2 days a week. Please email résumé / cover letter to synergyamasb@gmail.com or fax to (858) 259-0864. [289] RURAL HEALTH CLINIC MANAGER: Manager will provide management, planning, coordination, and expansion of southern California rural health clinics.

Manager is responsible for supervision of clinic staff, billing procedures, patient services, and regulatory and reporting requirements, including compliance with State and CMS. Previous experience with management of rural health clinic is required. Full time with benefits. Must have at least three years experience in RHC clinic setting and/or BA. Resume to: P.O. Box 3632, El Centro, CA 92244. [333] FNP AND PA POSITIONS AVAILABLE AS WE CONTINUE TO GROW: Full, part-time, or per-diem flex-

ible schedules available at locations throughout San Diego. A national leader among community health centers, 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.

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) 876-4426. For more information and to apply, visit our website and apply online at www. fhcsd.org. [046b] SEEKING MEDICAL ASSISTANT: We are a private practice situated in Encinitas looking to hire a medical assistant. The medical assistant should be flexible and able to float from the front office (administrative area and reception) to the back office area (examination and treatment areas). Some primary duties involve scheduling, registering and rooming patients, taking vital signs and blood tests, keeping the entire office and storage spaces organized, safe, and clean. Requirements include at least three years of work experience in this field with a high school diploma and medical assisting program certificate. Excellent computer knowledge as well as fluent written and verbal communication. Please email ktagdiri@gmail.com. [327] PART- OR FULL-TIME NURSE PRACTITIONER WANTED: Busy pain management practice in Mission Valley seeking a nurse practitioner to work with our growing practice. Please fax CV to (858) 7569012. [323] PART- OR FULL-TIME PHYSICIAN ASSISTANT WANTED: Busy pain management practice in mission valley seeking a physician assistant to work with our growing practice. Please fax CV to (858) 756-9012. [324] SEEKING PHYSICIAN ASSISTANT OR NURSE PRACTITIONER: Seeking PA with experience in dermatology or wellness / weight loss to join busy cosmetic surgery practice in North County. Beautiful office and support staff. Full complement of cosmetic lasers.

Please call Melissa at (760) 707-5090. [319] SEEKING PHYSICIAN ASSISTANT OR NURSE PRACTITIONER: Part-time, with possibility of fulltime, mid-level provider position available in a primary care office in downtown San Diego. This is a wonderful opportunity to learn all aspects of primary care. Prior experience with family medicine, sports medicine, occupational medicine, and/or urgent care is preferred, but new graduates can apply. Must be a certified PA or NP and possess a current California medical license. A DEA license is helpful, but not necessary. Must be comfortable using an EHR system, but will provide training on our specific system.

Wages based on experience. Please email CV to office.mcmc@gmail.com or fax to (619) 232-6012. [315] BOARD-CERTIFIED PHYSICIANS, PHYSICIAN ASSISTANTS, AND NURSE PRACTITIONERS NEEDED FOR URGENT CARE: Part-time positions available but a full-time opportunity may be offered to the right candidate. Must possess a current California medical license and ACLS certification. Please email or fax CV to (619) 569-2590. Visit www.DoctorsExpressSanDiego.com for more information. [229b] NURSE PRACTITIONER: Needed for house-call physician in San Diego. Full-time, competitive benefits package and salary. Call (619) 992-5330 or email drhunt@thehousecalldocs.com. Visit www.thehousecalldocs.com. [152] PHYSICIAN ASSISTANT OR NURSE PRACTITIONER: Needed for house-call physician San Diego.

Part-time, flexible days / hours. Competitive compensation. Call (619) 992-5330 or email drhunt@ thehousecalldocs.com. Visit www.thehousecalldocs.com. [038] SAN DIEGO PHYSICIAN.org

27

poetry and medicine

It Only Takes a Minute No matter what the moment brings It’s you to whom it’s brought Created or delivered Whimsical or fraught The sweet perfume of lovingness The acrid wind of strife It only takes a minute Yet it takes you your whole life

Picasso’s Sketch It Only Takes a Minute

by Daniel J. Bressler, MD, FACP

Introduction As the story goes, Pablo Picasso was approached by a fellow diner at a small restaurant. The woman’s gold necklace and diamond brooch marked her as a woman of substantial wealth. “Pardon me, but aren’t you Pablo Picasso, the great artist?” Picasso gave a quick acknowledgement. “I have a request of you, Mr. Picasso. I would like you to make a sketch for me on this napkin.

And, let me assure you, I will pay whatever you ask — I’m a woman of some means.”

Picasso nodded assent and pulled a fountain pen from the inner pocket of his black jacket. With a few bold strokes, he sketched the café scene, capturing its ambience, a bit of the sidewalk beyond the window, and even a partial profile of the woman. Its economy of line was classic Picasso.

He pushed the napkin across the

28

April 2015

table toward the woman, whose eyes widened with delight. “This is just perfect,” she exclaimed. “I am so grateful.” Pulling out her billfold, she asked, “How much do I owe you for the this?”

Picasso answered without blinking, “100,000 francs.” The woman gasped and repeated the number out loud.

She challenged him, “But the sketch took you less than a minute to create.”

Picasso, smiling now, corrected her.

“No, Madame. This sketch did not take me less than a minute. In fact, it took me my whole life.”

The point of this story isn’t the monetary value of a Picasso sketch. Rather, it is the fact that when we spend many years developing a skill, the simple execution of that skill belies the time that went into its development. This is true for the general surgeon dealing with an intra-abdominal bleed, the psychiatrist talking to a patient intent on self-harm, and the palliative care specialist assisting a family through the grieving process. It is also a truth about every minute for every human being up to and including the last one. Our entire life has always been, and will always be, a preparation for the next moment.

We are always in training for how to be human. We say, “It all comes down to this.” And it does.

Dr. Bressler, SDCMSCMA member since 1988, is chair of the Biomedical Ethics Committee at Scripps Mercy Hospital and a longtime contributing writer to San Diego Physician.

The riddle of behavior How do long-term patterns change?

Abandoning the pills and drink Why now? It seems so strange.

Years hence she’ll quote a phrase you spoke That kept her faith alive It only took a minute Yet it took you your whole life When time is of the essence And every action counts When blood pressure is waning And controversy mounts It’s how you place your sutures And how you wield the knife It only takes a minute Yet it took you your whole life.

You sit down with a family To explain the day’s report You review the string of failures The treatments that fell short To be completely present When loss and blame are rife It only takes a minute Yet it took you your whole life Contemplating suicide Standing on the ledge Accompanied by hopelessness Balanced on the edge Your expert intervention Allowed him to survive It only took a minute Yet it took you your whole life When I’m lying on my deathbed Reviewing past vignettes I hope to eke out one last prayer Of thank yous and regrets Will I hear a chorus of angels Or the whistle of a fife?

It will only take a minute Yet it will take me my whole life.

Success.

It’s what California’s finest physicians strive for... and what CAP can help you achieve.

Since 1977, the Cooperative of American Physicians (CAP) has provided superior medical professional liability coverage and valuable risk and practice management programs to California’s finest physicians through its Mutual Protection Trust (MPT).

As a physician-directed organization, we understand the realities of running a medical practice these days, and are committed to supporting you with a range of programs and services that no other professional liability company offers. These include a 24-hour early intervention program, HR support, EHR consultation, a HIPAA hotline, and a robust group purchasing program, to name a few.

Are You ICD-10 Ready? Get Your “ICD-10 Action Guide” FREE! On October 15, 2015, all medical practices must comply with new, expanded ICD-10 codes. CAP’s ICD-10 Action Guide for Medical Practices has the answers you need to successfully make the transition.

Request your free electronic or hard copy today!

800-356-5672 CAPphysicians.com/icd10now

$5.95 | www.SANDIEGOPHYSICIAN.org

PRSRT STD U.S. POSTAGE

San Diego County Medical Society 5575 Ruffin Road, Suite 250 San Diego, Ca 92123

PAID DENVER, CO PERMIT NO. 5377

[ Return Service Requested ]

DOES YOUR MEDICAL MALPRACTICE INSURER KNOW WHICH DRUGS LEAD TO LAWSUITS IN INTERNAL MEDICINE? THE DOCTORS COMPANY DOES. As the nation’s largest physician-owned

20%

medical malpractice insurer, we have an unparalleled understanding of liability claims

COUMADIN

against internists. This gives us a significant advantage in the courtroom. It also accounts

18%

OPIOIDS

for our ability to anticipate emerging trends and provide innovative patient safety tools to help physicians reduce risk. When your

7%

GENTAMICIN

reputation and livelihood are on the line, only one carrier can give you the assurance that today’s challenging practice environment

KENALOG

5%

demands—The Doctors Company.

To learn more, call our Los Angeles office at 800.852.8872 or visit WWW.THEDOCTORS.COM.

PREDNISONE

5%

DRUGS MOST FREQUENTLY INVOLVED IN MEDICATION-RELATED MALPRACTICE CLAIMS AGAINST INTERNISTS Source: The Doctors Company