January 2016 by San Diego Physician

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Contents

Volume 103, Number 1

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, MD, PhD • David M. Priver, MD MARKETING & PRODUCTION MANAGER: Jennifer Rohr SALES DIRECTOR: Dari Pebdani ART DIRECTOR: Lisa Williams COPY EDITOR: Adam Elder OFFICERS President: William T-C Tseng, MD, MPH (CMA Trustee) President-elect: Mihir Y. Parikh, MD Secretary: Mark W. Sornson, MD Treasurer: David E. J. Bazzo, MD, FAAFP Immediate Past President: J. Steven Poceta, MD

departments 4

riefly Noted: Calendar • B History Thumbnails • Volunteer Opportunities • Welcome New and Returning Members • And More …

features

DCMS 2015 Medical Office S Salary Survey Results Are In!

Congratulations, Deann, SDCMS’s 2015 Office Manager of the Year!

Join SDCMS’s Private Forum for Member Office Managers

BY HEIDI KOCHER, ESQ.

eadership Series: Paul E. Bernstein, L MD, FACS BY Sherry Nooravi, PSYD

educe Technology Risks: 2015’s R Top Three Patient Safety Tips BY CAROL MURRAY, RHIA, CPHRM, CPPS

our SDCMS Physician & Office Y Manager Advocate Is Here to Help!

otlines: A Valuable Tool in H Achieving Compliance

The Power of Our Questions

BY HELANE FRONEK, MD, FACP, FACPH

Physician Marketplace: Classifieds

GEOGRAPHIC and GEOGRAPHIC ALTERNATE DIRECTORS East County: Susan Kaweski, MD (Alt.) • Jay P. Mongiardo, MD • Alexandra E. Page, MD • Venu Prabaker, MD Hillcrest: Gregory M. Balourdas, MD • Kyle P. Edmonds, MD (Alt.) • Thomas C. Lian, MD Kearny Mesa: Sergio R. Flores, MD • John G. Lane, MD • Anthony E. Magit, MD (Alt.) • Eileen R. Quintela, MD (Alt.) La Jolla: Geva E. Mannor, MD, MPH • Marc M. Sedwitz, MD, FACS • Wayne C. Sun, MD (Alt.) North County: Neelima V. Chu, MD (Alt.) • Michael A. Lobatz, MD • Eileen S. Natuzzi, MD • Patrick A. Tellez, MD South Bay: Elizabeth Lozada-Pastorio, MD (Alt.) • Reno D. Tiangco, MD • Michael H. Verdolin, MD AT-LARGE and AT-LARGE ALTERNATE DIRECTORS Lase A. Ajayi, MD • Karrar H. Ali DO, MPH • Steven L-W. Chen, MD, FACS, MBA (Alt.) • Stephen R. Hayden, MD • Phil Kumar, MD (Alt.) • Vimal I. Nanavati, MD, FACC, FSCAI (Alt.) • Robert E. Peters, MD, PhD (Alt.) (Delegation Chair) • Carl A. Powell, DO (Alt.) • Peter O. Raudaskoski, MD • Kosala Samarasinghe, MD • Thomas J. Savides, MD • James H. Schultz Jr., MD, MBA, FAAFP (Board Rep) • Karl E. Steinberg, MD, FAAFP (Alt.) • Erin L. Whitaker, MD (Alt.) • Marci M. Wilson, MD (Alt.) • Holly B. Yang, MD (Board Rep) OTHER VOTING MEMBERS Communications Chair: Sherry L. Franklin, MD Young Physician Director: Edwin S. Chen, MD Resident Physician Director: Michael C. Hann, MD Retired Physician Director: Rosemarie M. Johnson, MD Medical Student Director: Sandeep Prabhu OTHER NONVOTING MEMBERS Young Physician Alternate Director: Heidi M. Meyer, MD Resident Physician Alternate Director: Quinn C. Meisinger, MD Retired Physician Alternate Director: Mitsuo Tomita, MD SDCMS Foundation President: Albert Ray, MD (At-large AMA Delegate) CMA Speaker: Theodore M. Mazer, MD (At-large AMA Alternate Delegate) CMA Past Presidents: James T. Hay, MD (AMA Delegate) • Robert E. Hertzka, MD (Legislative Committee Chair, At-large AMA Delegate) • Ralph R. Ocampo, MD, FACS CMA Trustee: Bob E. Wailes, MD AMA Alternate Delegate: Lisa S. Miller, MD

olitical Veteran Paul Hegyi Takes P Over as SDCMS CEO

20 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.]

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/////////Briefly /////////////////Noted //////////////////////////////////////////////////////////////////////// HISTORY THUMBNAILS

SDCMS’s First President By Ralph R. Ocampo, MD

Community Healthcare Calendar

calendar SDCMS-Cma Webinars and Social

For further information or to register for the following SDCMS-CMA webinar and/or social, contact Jen at (858) 300-2781 or at JOhmstede@SDCMS.org. All Physician Networking Opportunity & Mixer (social) FEB 4: 5–8pm at the Handlery Hotel San Diego in Mission Valley CMA Physician Governance: How to Get Involved in CMA’s Newly Reformed Governance Structure (webinar) FEB 10: 12:15–1:15pm HIPAA Compliance: Key Risks All Physicians Should Know (webinar) FEB 24: 12:15–1:15pm Closing a Medical Practice (webinar) MAR 9: 12:15–1:15pm Medicare Updates 2016 (seminar/ webinar) MAR 10: 11:30am– 1:00pm

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. AAPP 2016 Spring Summit on Private Pay and Concierge Medicine FEB 26–27 at the J.W. Marriott Marquis San Diego Marina. Offering up to 8.5 CME hours, this spring summit will conduct specialized education tracks for private and concierge medicine, direct primary care, and practice formation. You’re invited to meet and learn from a rapidly growing group of private physicians and medical industry professionals. This conference will continue to focus on core private medicine issues that affect and are of interest to all physicians and practices, such as compliance and emerging medical technology. http:// aapp.org UC San Diego Essentials and Advances in Apheresis Therapies MAR 3–5 at the Marriott Mission Valley, San Diego Butters-Kaplan West Coast Neuropsychology Conference APR 7–10 at the Hyatt Regency La Jolla, San Diego

january 2016

David Bancroft Hoffman, MD, founder of our medical society on July 19, 1870, convened Drs. Jacob Allen, Edward Burr, Charles Fenn, Robert Gregg, George McKinstry, and Thomas Stockton for this purpose. In 1879, Dr. Stockton and newcomer P.C. Remondino created the first private hospital (50 beds) at Columbia and F Street, though they had to close it a few years later because of competition from the City Infirmary. It is clear that Dr. Hoffman, who arrived in San Diego on Nov. 8, 1853, was studious and industrious. He became coroner in 1855, passed the bar exam in 1856, became town trustee in 1857, was married in 1858, and subsequently became district attorney, assemblyman, school board trustee, presidential elector, and collector for the port. He wrote the first sanitary report from San Diego, which was published in 1864 in The San Francisco Medical Press. About 30 years ago at a competition for local historians — including Betty Peabody, who won an award for a piece on early women physicians — I had the pleasure of meeting Dr. Hoffman’s granddaughter, then residing in Redlands, Calif. She kindly allowed me to make a photocopy of a locket in her possession that showed Dr. Hoffman in his civil war uniform. Betty Peabody and her husband, a highly respected ReesStealy pulmonologist and historian of that clinic, will figure in future thumbnails. Horton Hall on the Southeast Corner of Sixth and F Streets, the Medical Society’s First Meeting Place

/////////////////////////////////////////////////////////////////////////////////////////////////// giving back

VOLUNTEER OPPORTUNITIES Email Your Physician Volunteer Opportunities to Editor@SDCMS.org SDCMS Foundation Project Access: Volunteer physicians are needed for the following specialties: endocrinology, ENT or head and neck, general surgery, GI, gynecology, neurology, ophthalmology, orthopedics, pulmonology, rheumatology, and urology. We are seeking these specialists throughout all regions of San Diego. Commitment can vary by practice. The mission of the SDCMS Foundation’s Project Access is to improve community health, access to care for all, and wellness for patients and physicians through engaged volunteerism. Help us help the most vulnerable population seek care. For more information, contact Andrew Gonzalez at (858) 300-2787 or at Andrew. Gonzalez@SDCMS.org, or visit www.SDCMSF.org. Help Spread the Message of Health by Making a Brief Presentation in Your Community: Educate children, adults, seniors, and employees on how to improve their lives and take charge of their health through the Live Well San Diego Speakers Bureau. Email Andrew.Gonzalez@SDCMS.org at the SDCMS Foundation to say YES, you will volunteer just one or two times a year, quarterly, or however your schedule allows.

“

Physicians Needed to Mentor UCSD Undergraduates: UC San Diego’s Health and Medical Professions Preparation Program (HMP3) caters to undergraduates in search of career guidance under the mentoring of clinical professionals. They are seeking physicians who can offer shadowing/advising opportunities for these students. For more information, visit hmp3. ucsd.edu. Interested in Becoming a Preceptor for Osteopathic Medical Students? Midwestern / AZCOM osteopathic medical school in Phoenix has third- and fourth-year medical students in San Diego looking for clinical rotations, particularly in pediatrics, psychiatry, general surgery, and OB/GYN. Requirements: Either MD or DO; physicians interested must commit to minimum one four-week rotation per year/or more as desired (2–3 preferable) and to FT hands-on training for each student as is reasonable for the duration of the rotation. Compensation and CME provided. If interested, please contact Dr. Kevin Considine at kconsidine@sbcglobal.net for more information.

Humanitarian Teams Need Medical Volunteers for Haiti: We are looking for physicians and mid-level providers for one-week primary care medical clinics in rural Haiti in February and June 2016. This is a rewarding opportunity to work with the people of Haiti and provide care in a very austere environment in a medically underserved area. Seattle-King County Disaster Team — a U.S.-based nonprofit — has been operating these clinics since 1998. We coordinate all in-country travel and logistics. Please contact Bob Downey at (619) 905-7157 or at labboy@earthlink.net if you are interested in applying. Visit www.skcdteam.org for further information. Physician Volunteer Opportunity: Established in 2011, Flying Samaritans of SDSU provides free healthcare to the underserved community of Ejido Matamoros, Mexico (15 minutes away from the border) through monthly medical and dental clinics (every second Saturday of the month), seeing 60–80 patients/medical clinic and 10/ dental clinic. For details, email FlyingSamaritansSDSU@gmail.com.

New Laws of Interest to Physicians for 2016 The California Legislature had an active 2015, passing many new laws affecting healthcare. In particular, there was a strong focus on healthcare coverage, public health issues, and end-of-life care. For a list of significant new health laws of interest to physicians, email Membership@ SDCMS.org.

The changes in our life must come from the impossibility to live otherwise than according to the demands of our conscience … not from our mental resolution to try a new form of life. — Leo Tolstoy, Russian Writer (1828–1910)

”

SAN DIEGO PHYSICIAN.org

/////////////Briefly /////////////////Noted /////////////////////////////////////////

TrusT

SDCMS-CMA Membership

Welcome New and Returning SDCMS-CMA Members! NEW MEMBERS Ali Aboutaleb, MD Family Medicine San Diego (619) 528-5000 Azzah I. Arikat, MD Internal Medicine El Cajon (858) 499-2706

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Delois J. Bean, MD Surgery of the Hand El Cajon (619) 528-5278 Vi Q. Bowman, MD Infectious Disease San Diego (619) 528-5000 Andrew K. Chen, MD Internal Medicine Escondido (760) 743-0546 Jessica A. Deree, MD General Surgery San Diego (619) 528-5000 Noah J. Friedman, MD Allergy and Immunology San Diego (619) 528-5000 Timothy J. Geraci, MD Infectious Disease San Diego (619) 528-5000 Majid Ghassemi, MD Pathology San Diego (619) 528-5000 Jaganath S. Glassman, MD Psychiatry La Jolla (858) 455-7040 Lisa A. Gleason, MD Clinical Cardiac Electrophysiology San Diego (858) 939-6561 Amit K. Gossain, MD Internal Medicine San Diego (619) 528-5000 Rachel M. Guest, MD Pediatrics San Diego (619) 528-5000

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january 2016

Rachel A. Ireland, MD Pediatrics San Diego (619) 528-5000

Linda Jue, MD Internal Medicine San Diego (619) 528-5000

Shawn M. McHugh, DO Internal Medicine San Marcos (619) 528-5000

Alexander Y. Kim, MD Head and Neck Surgery San Marcos (619) 528-5000

Jeanette M. Morrison, DO Family Medicine Chula Vista (858) 499-2707

Kimberly D. Koppenbrink, MD Internal Medicine San Diego (619) 528-5000

Jennifer S. Mullins, DO Internal Medicine San Diego (619) 528-5000

James C. Kringel, MD Internal Medicine Oceanside (619) 528-5000 David E. Larue, DO Family Medicine San Marcos (619) 528-5000 Brian W. Lee, MD Pediatric Anesthesiology San Diego (619) 528-5000

Carlo H. Niguidula, MD Family Medicine San Diego (619) 528-5000 Ma C. E. Ondrade, MD Internal Medicine San Diego (619) 528-5000 Bhavesh B. Patel, DO Internal Medicine San Marcos (619) 528-7524

Jae K. Lee, MD Internal Medicine La Mesa (619) 528-5000

Jan R. Penvose-Yi, MD Obstetrics and Gynecology Carlsbad (760) 385-8008

Jeffrey A. Lee, MD Neurological Surgery San Diego (619) 528-5000

Laurie D. Publicover, MD Emergency Medicine San Diego (619) 499-2600

Pamela C. Lee, MD Colon and Rectal Surgery San Diego (858) 939-8350

Rebecca S. Ratnam, MD Nephrology La Jolla (619) 528-5000

Wenhui Liu, MD Internal Medicine San Diego (619) 528-5000

Sean M. Ryan, MD Psychiatry La Jolla (858) 694-3900

Charles Lu, MD Cardiovascular Disease San Diego (619) 528-5000

Sammy Shabestari, MD Family Medicine San Diego (619) 528-5000

Michael J. Luskin, MD Emergency Medicine San Diego (619) 528-5000

Leonid Slavin, MD Cardiovascular Disease San Marcos (619) 528-5000

Anita Marlowe, MD Internal Medicine San Diego (619) 528-5000

Jessica L. Stern, MD Emergency Medicine San Diego (619) 528-5000

Kimberly A. Maxon, MD Internal Medicine Carlsbad (619) 528-5000

Carolyn H. Sui, MD Internal Medicine San Diego (619) 528-5000

Kelly S. McAdam, MD Internal Medicine El Cajon (619) 528-5000

Catherine L. Sundsmo, MD Family Medicine Encinitas (858) 499-2708

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Roland El Ghazal, MD Critical Care Medicine (Internal Medicine) Poway (858) 939-6570

Ahmet O. Turek, MD Internal Medicine La Jolla (858) 499-2707

Mark D. Hubbard, MD Family Medicine San Diego (858) 499-2705

Marina Udowenko, DO Family Medicine San Diego (619) 446-1657

Rajiv Jairam, MD Nephrology San Diego (619) 528-5000

Reinier J. Van Tonder, MD Emergency Medicine San Diego (619) 528-5000 Jose C. Vega, MD Emergency Medicine Carlsbad (619) 528-5000 Michael B. Wilson, MD Family Medicine Chula Vista (858) 499-2707 Nadine E. Wilson, MD Internal Medicine San Diego (619) 528-5000 Gang Xu, MD Internal Medicine San Diego (619) 528-5000 Teddy M. Yap, MD Internal Medicine San Diego (858) 499-2600 Corrine A. Yarbrough, MD Internal Medicine San Diego (858) 499-2703 Parviz Yeroushalmi, MD Psychiatry San Diego (619) 692-8232

Renu V. Kaushik, MD Child and Adolescent Psychiatry San Diego (858) 495-4939 Aristotelis T. Laliotis, MD Internal Medicine Del Mar (858) 499-2708

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Alison B. Lynch, MD Family Medicine San Diego (858) 499-2704 Cameron M. McFarland, MD Emergency Medicine San Diego (626) 405-5149 Jeffrey M. Melancon, MD Dermatology San Diego (619) 446-1549 Bishoy Said, MD Ophthalmology San Diego (619) 446-1560 Anthony C. Salazar, MD Emergency Medicine San Diego (619) 528-5000 Jessica K. So, MD Dermatology La Mesa (619) 644-6401

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RETURNING MEMBERS Kelly M. Askim, DO Neurology San Diego (858) 616-8432 Andrew J. Busby, MD Internal Medicine San Diego (619) 528-5000 Brian D. E. Carlos, MD Advanced Heart Failure and Transplant Cardiology San Diego (619) 528-5000

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

SAN DIEGO PHYSICIAN.org

c o m p l i a n c e p r o g r a m s — 8 th i n a s e r i e s

Hotlines A Valuable Tool in Achieving Compliance

by Heidi Kocher, Esq.

Among the critical elements of an effective compliance program are the need to create and implement effective lines of communication and the need to respond promptly to detected or reported offenses. Key to these goals is the implementation of a compliance hotline or similar reporting mechanism. Such hotlines may also be called ethics hotlines, employee hotlines, or whistleblower hotlines. Instituting a hotline, however, may create as much controversy as it serves to solve. Senior management may be reluctant to implement a hotline due to the perceived expense and limited staff to address hotline calls. And — to be completely honest — senior management may not wish to enable staff complaints. A properly implemented reporting mechanism, though, will provide a venue for staff to report valid and serious concerns, while mitigating expense and simple complaining. When most people hear “hotline,” they immediately think a telephone hotline — the most common form. Such a hotline is often accessed by a toll-free number,

january 2016

particularly if the organization has multiple or widely spread locations. For smaller offices or organizations, a dedicated local telephone number may be sufficient. A telephone hotline may either be staffed by an internal department — particularly if the organization is larger — or outsourced to a third-party vendor that specializes in hotlines, or a mix, such as having internal staff handle hotline calls during business hours while having the third-party vendor take after-hours and holiday calls. Whether the call-taker is an employee or a third-party vendor, it is important to note all important details such as names, dates, pertinent account numbers, or other relevant information (1). A distinct advantage to having employees answer or respond to hotline calls is that they are familiar with internal processes and acronyms. In contrast, third-party vendor personnel are usually not familiar with the particular institution, service, or specialty and may not clue in to important follow-up questions. For smaller offices, the hotline often simply goes to a dedicated voicemail that is checked periodically. Even a simple dedicated drop box or mailbox may function as an effective reporting mechanism. A hotline is no longer just telephonic. Many organizations have implemented web-based hotlines and reporting mechanisms, again often using a third-party vendor. Web-based reporting options have the benefit of allowing a completely anonymous report, alleviating some of the concerns of the reporting individual. In addition, these methods often utilize freeform text fields that permit the reporter to provide details in his or her own words, thus often providing key information. In addition, the report form can be set up with drop-down menus to help categorize the reports, and then the data can be exported to an Excel spreadsheet or a database for investigation, resolution, and reporting metrics. Of course, a hotline is useless if employees, patients, and others do not know about it. Accordingly, a key element in implementing a hotline is publicizing it. This can be done via posters at the offices or other sites, including the hotline number on the organization’s website, and disseminating it to employees periodically, such as including a reminder in employee newsletters or other communications to employees. In addition, the hotline should be covered in employee training — both new-hire training and annual refresher training. Regardless of whether the hotline is a telephone line, web-based, or a drop box,

Regardless of whether the hotline is a telephone line, web-based, or a drop box, the reporting mechanism must ensure confidentiality and anonymity, to the extent allowed by law. the reporting mechanism must ensure confidentiality and anonymity, to the extent allowed by law. Only if individuals trust that management takes a report seriously and does not retaliate against suspected reporters will the hotline be successful. This means that first there should be no way to identify the individual making the report unless he or she chooses to be identified. Accordingly, a telephone hotline should not have caller ID or call tracking enabled. Similarly, a web-based reporting mechanism should not collect IP addresses. Second, the individual or department should be perceived to be fair and free of bias. Thus, the compliance or ethics department is often tasked with investigating and responding to allegations. Be aware that reporters may perceive that other departments such as HR or the legal department may be biased, whether this has any basis in fact. Some organizations have taken the step of outsourcing the investigation of an allegation, particularly if it involves sensitive matters, senior management, or large sums of money. The most important element of gaining the trust of potential reporters, however, is to ensure that there is no retaliation against those who do make good-faith reports. Despite a hotline being anonymous, it is often possible to identify the reporter or at least narrow the pool of potential reporters. And, in a surprising number of cases, individuals do identify themselves. In such cases, management must ensure that the individual’s immediate and upper managers do not take revenge for perceived disloyalty. Reported instances of retaliation include giving the suspected reporter a cold shoulder, demotions and docking pay, or moving the reporter’s desk into a broom closet. Suspected reporters have even been suddenly terminated on the flimsiest of grounds after many years of glowing evaluations. News of any such actions will spread through the organization and effectively render inopera-

tive the best of hotlines. To prevent this from happening, senior management must be on guard against instances of retaliation and must be ready to discipline and even terminate anybody who retaliates against a suspected reporter. Finally, the best of hotlines is worthless if there is not timely investigation, escalation if necessary (2), and resolution. Again, if employees or reporters think that a hotline is simply window dressing, they will not bother to risk potential fall-out to make a report. In a related vein, many whistleblower lawsuits start as reports to a hotline that go uninvestigated or unresolved. If you are going to implement a reporting mechanism, you must commit to investigating and resolving any reports. In summary, a compliance hotline is not a difficult or expensive thing to implement if management spends a bit of time upfront thinking through some of these questions and deciding the parameters for the reporting mechanism. These aspects should be documented in a policy or policies addressing implementation of a hotline, investigation of reports and escalation, implementation of corrective actions, and preventing retaliation. Many physicians and healthcare providers have discovered that a hotline can in fact be a valuable tool in achieving compliance. Notes: 1. Note that gathering such information does not violate HIPAA, as there are exceptions for gathering and sharing personally identifiable information for the purposes of healthcare entity operations, healthcare oversight activities, and certain law-enforcement-related activities. 2. Certain subjects should be promptly escalated, within 24 hours — among these would be allegations of falsification of records, fraud, and release of PHI. Management may add other topics. Ms. Kocher is counsel with the law firm of Liles Parker, which has hosted SDCMS’s Certified Medical Compliance Officer (CMCO) certification course. In addition to serving as a chief compliance officer and chief privacy officer, Ms. Kocher has nearly 20 years of experience advising and defending clients on legal and regulatory matters affecting providers of all sizes. Ms. Kocher can be reached at hkocher@ lilesparker.com or at (214) 952-5169. SAN DIEGO PHYSICIAN.org

L e a d e r s h i p — 1 st i n a S e r i e s

Paul E. Bernstein, MD, FACS Medical Director and Chief of Staff, Kaiser Permanente by Sherry Nooravi, PsyD

Dear San Diego Physician Readers, Great leadership and shaping a strong workplace culture are critical to the success of any organization, along with being a role model, “walking the talk,” and seeking to learn from the best practices of others. With that in mind, I’d like to introduce this yearlong leadership series to help you get to know a few of your fellow San Diego County physicians who’ve developed reputations for great leadership. The interviews were conducted by Dr. Sherry Nooravi, an organizational psychologist who not only helps leaders shape motivating workplace cultures, but also studies what leaders of local high-performing organizations are doing right. Her research and insights have been published in the San Diego Business Journal and The Huffington Post, and she was recently recognized as “Trailblazer of the Year” by the National Association of Women Business Owners (NAWBO, San Diego). As you read each interview, consider Dr. Nooravi’s three questions at the end — the “Points to Consider” — and how you can apply the leader’s best practices and advice to strengthen your practice culture. I look forward to learning about these leaders and the best practices of driving an engaging culture with each of you. Paul Hegyi, CEO, SDCMS

Dr. Bernstein, 22-year member of SDCMS-CMA and board certified in head and neck surgery, is chief of staff at Kaiser Permanente in San Diego. The Kaiser network includes more than 500 primary care physicians and 700 specialists, and provides care to more than 600,000 members. Dr. Paul Bernstein can be reached at (619) 5287755 or at paul.e.bernstein@kp.org. Question: What is your leadership philosophy? Answer: I have a hands-on, open-door policy. I believe one should lead by example, from your clinical practice to your work ethic to how engaged you are for your physicians. Influence is communicating well and focusing on patients. Engaging physicians happens by driving patientfocused care, creating a “Yes” culture and a “Yes” philosophy. Our core competency is legacy-inspired excellence. The physicians who started Kaiser Permanente demonstrated early in our history that prevention improves outcomes. Question: What should physicians do to prepare for the future of healthcare?

january 2016

Answer: We must embrace change, as the only thing certain is uncertainty. Abraham Lincoln said the only way to predict the future is to create it. We have many programs that help us serve patients in innovative ways, from (1) Health Everywhere, where our patients choose the care they want, where, when, and how they want it, (2) Health Spot at the County of San Diego campus, where 4,000 of our members can use the futuristic kiosk in the lobby to see a physician in Carmel Valley who can do a “complete” exam using remote biometric measuring instruments, (3) A Mobile Health vehicle with two exam rooms and a lab that is a medical office building on the road, enabling us to care for patients in Ramona and Alpine once a week without having them drive to us, and (4) two Target stores with nurse practitioners and a virtual exam room with biometric equipment to virtually consult with a physician when needed. To help our 1,200 physicians stay connected, we provide them KP iPhones that are fingerprint-protected and allow them to conduct patient business with HIPAAcompliant apps. They can get information via text and can respond and send images. This has helped the engagement of over 1,000 physicians and 21 office buildings. It is easier to communicate back and forth to provide both coordinated and complete care for our patient, specialty, and primary care in one visit. With one click, a physician can text or call the specialist on call. There is no need to play phone tag — and we know who we are talking to. We stay connected and learn from each other. We stay connected through the San Diego County Medical Society to help each other improve overall patient care — not just our own patients, our overall community. We are involved in Project Access San Diego to provide medical care to the uninsured citizens in San Diego County. Question: What advice do you have for young / incoming physician leaders? Answer: Focus on medicine as a profession and not as a job. For a new leader, keep the focus on the patient. It’s about a calling — caring how you make patients feel. When someone leaves your office, it’s how you make them feel that they’ll remember, your compassion. This resonates with our patients and workforce. Get involvement and get teams of physicians who want to work on a variety of aspects of healthcare. Question: What does organizational culture mean to you, and how do you drive it? Answer: Culture builds enthusiasm and

“We must embrace change, as the only thing certain is uncertainty. Abraham Lincoln said the only way to predict the future is to create it.” engagement. Our “Yes” culture centers all of us on our patients and creating excellence. Our history is being a health plan, not a sick plan. We are focused on prevention and keeping our patients healthy. We have an all-staff service event (with all 8,000 staff and 1,200 doctors) teaching our “Yes” culture of patient-centered care — treating the patient the way we and our families would want to be treated. We reinforce the culture at different levels, and I do everything I can, from weekly physician emails that summarize everything (it condenses 60 emails into one) to a weekly three-minute podcast that is sent to our docs’ iPhones. I attend big group meetings, new physician orientations, and weekly breakfast meetings. Our associates go to SCPMG University to learn the history of our organization, patient communication skills, principles of partnership, our board of directors, and how we function as a group. Question: What has worked for engaging your staff that CEOs and leaders in other industries can learn from? Answer: Focus on culture, be a team of colleagues, lead by example, be hands on, and see problems and change as opportunities. Dr. Nooravi is an organizational psychologist and CEO of Strategy Meets Performance, a leadership consulting firm that focuses on helping CEOs of fast-growth companies shape engaging, innovative, and customerdriven cultures through executive coaching and senior team facilitation. She has been named “Trailblazer of the Year” for her research on the best practices of CEOs of high-performing organizations. She can be reached at sherry@ strategymeetsperformance.com or at (312) 286-0325.

Points to Consider

A Yes Culture. What are you doing to create a “Yes” culture to engage both your physicians and patients?

Change Is Coming. What actions are you taking and what behaviors are you promoting to help your team prepare for and drive change?

Driving Culture. What touchpoints do you have to drive the behavior and culture you want to shape (such as staff events, consistent communication, sharing the values of the organization and expectations for patient communication)?

SAN DIEGO PHYSICIAN.org

Where are your patients coming from? Each month, every practicing physician in San Diego County receives a copy of San Diego Physician magazine. What better way to ensure that other physicians know about your medical practice than through a referral advertisement in this highly regarded publication? Advertising packages are available at very attractive price points, and for a limited time SDCMS member physicians receive 50% off by mentioning this ad.

“…patients…get nearly 70% of specialist referrals from their primary care doctors.” “…most experts say referral marketing will only become more entrenched as health care cuts continue.”

Physician referral marketing is on the rise — just read some of the statistics:

“According to one national survey, four in 10 medical office managers flagged referrals from other physicians as the most effective way to attract new patients.”

Contact Dari Pebdani today to get your campaign started. DPebdani@SDCMS.org or 858-231-1231

Overwhelming evidence shows that individuals with PAD are highly sedentary

Seeking Family Medical and Internal Medicine Physicians in Vista and Riverside Position: Full-time, part-time and per diem Family Medicine and Internal Medicine Physicians. Malpractice coverage is provided by clinic. Requirements: California license, DEA license, CPR certification and board certified in family medicine. Bilingual English/Spanish preferred. Send resume to: hr@vistacommunityclinic.org or fax to 760-414-3702

Vista Community Clinic is a private, nonprofit outpatient community serving people who experience social, cultural or economic barriers to health care in a comprehensive, high quality setting.

www.vistacommunityclinic.org EEO/AA/M/F/Vet/Disabled

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Do You Have Patients with Peripheral Arterial Disease?

40 volunteer subjects needed for a 12-week study investigating the effects of interrupting and reducing sedentary behavior on arterial health in individuals with PAD. Please consider providing information to your patients with PAD on this study.

Sedentary behavior increases the risk of chronic disease and premature mortality. The basic message to sit less is realistic but we still don’t know if sitting less can meaningfully improve the cardiovascular health of your patients.

For more information call Steve Laslovich, Principal Investigator at 760.994.3576 or visit our website at:

www.PADActivitystudy.com

R i s k M a n ag e m e n t

• Make certain that your professional liability policy extends coverage to all jurisdictions where you provide services. Medical equipment alarms: Enact policies to ensure alarms are never silenced. A main patient safety risk is alarm fatigue, where too frequent alarms cause providers to override or disable them. When alarms are silenced or eliminated, a significant change in a patient’s condition may go undetected. If there is a resultant harm to a patient, it is extremely difficult to mount an effective defense. The Joint Commission emphasizes policies that can help reduce the risks: • Policies should be in place and communicated to staff to never silence an alarm and should discourage the use of patient-owned medical equipment without alarms in clinical settings. • Any medical device equipped with an alarm should be evaluated annually for preventive maintenance.

EHRs: Ensure that implementation includes thorough staff and provider training. Weaknesses include inaccurate entries that are repeated throughout the record; faulty interfaces between companion systems; greater potential for breaches, resulting in loss of patient privacy; over-reliance on the system by staff, leaving less time to spend with patients; changes in medical record information due to system updates; and difficulty in standardizing the legal medical record for consistency in response to requests for records. To reduce exposure to EHR risks: • Ensure implementation includes thorough staff and provider training. • Establish guiding policies and procedures, and designate an ongoing workgroup or individual to address problems in either support systems or the software itself. • Maintain an ongoing relationship with the vendor to communicate software issues. • Conduct a periodic review of metadata reports that identify name, date, and time of access — a useful way to monitor inappropriate access to the record by staff. • Conduct medical record audits at least quarterly.

Reduce Technology Risks 2015’s Top Three Patient Safety Tips

by Carol Murray, RHIA, CPHRM, CPPS

Although new technologies bring many benefits, they also bring new liability risks, and 2015 could be considered a high-water mark for both new risks and increased prevalence of previously identified risks. The top three patient safety tips of 2015 addressed these risks: Telemedicine: Comply with HIPAA, HITECH, and statespecific laws when transmitting patient health information and follow state licensing requirements. Physicians must be aware of the risks associated with access, such as patient and staff privacy, inaccuracies in self-reporting, and symptoms that may only be caught in person. Additional legal considerations for online interactions — such as licensure

compliance and professional liability coverage for out-of-state interactions — must be addressed for the protection of the physician and the patient. To reduce these liability risks: • Comply with all laws when transmitting all personal health information. Train staff on how to protect and secure your data. • Clearly define proper protocols for webcams and web-based portals. • Use mechanisms to protect the privacy of individuals who do not want to be seen on camera (including staff members, other patients, or patients’ families). • Check practice requirements and legal limitations in states where you anticipate providing care to patients.

Ms. Murray is patient safety risk manager for The Doctors Company. For more patient safety articles and practice tips, visit www. thedoctors.com/patientsafety. SAN DIEGO PHYSICIAN.org

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P e r s o n a l & P r o f e s s i o n a l D e v e lo p m e n t

The Power of Our Questions by Helane Fronek, MD, FACP, FACPh

Rather than asking ourselves, “How can I keep up?” it might be more useful to ask, “What metric do I personally feel reflects my value as a doctor?”

As we walked along the beach, our conversation meandered through many topics: politics, the coming El Niño, and, finally, the questions we ask ourselves. My friend wisely remarked that our lives are generally guided by the questions we ask. My mind immediately went to the questions that physicians frequently ask themselves. “How did I miss this?” “Why did I say that?” “How could I have done better?” Many of us are perfectionists, and the system we train and work in is unforgiving of anything it deems as less than exemplary. Mediocre isn’t allowed in our vocabulary — except, perhaps, in reference to someone else. For this reason, our inner dialogue is frequently peppered with exclamations such as, “How could I have been so foolish?” That is a lose-lose question. We lose when we make one incident representative of all of our behavior, or, worse, of our character. There is an enormous difference between doing something foolish and being foolish. We also lose when we

january 2016

assign a label to ourselves, as if we aren’t able to learn, grow, and change. Each of us has the potential to take an experience and find insight and inspiration in it if we choose to. This type of question deprives us of the endless possibilities inherent in living a human life. Consider the difference if your questions were: • What motivated me to make this choice? • What emotion was I feeling? • What did I need at the time? • What was the outcome I hoped for? • What pattern in my behavior do I see in similar situations? By asking more powerful questions such as these, we can appreciate our generally good intent and have compassion for ourselves when poor judgment or less altruistic motivations influence our behavior. These inquiries will help us discover our unmet needs and uncover the unwritten rules we subscribe to, enabling us to more consis-

tently act as the person we want to become. In healthcare, we are currently paddling furiously in the rapids of one transition after another, trying to keep our heads above water. Regular evaluations of our patient satisfaction scores, meaningful use, and productivity have shifted the focus of our attention from meaningful interactions with patients to the satisfaction of these metrics. Rather than asking ourselves, “How can I keep up?” it might be more useful to ask, “What metric do I personally feel reflects my value as a doctor?” Then decide to keep track of this and let it be a beacon for the type of physician you want to be. And when we see colleagues who are struggling or whose behavior has become indifferent or unprofessional, we might approach them with kindness and ask, “I’ve noticed a change in you. Is there something going on in your life that you’d like to talk about?” So let’s make 2016 a year of kind, compassionate, powerful questions and see how our experience of practicing medicine — and our lives — might change. Dr. Fronek, SDCMSCMA member since 2010, is assistant clinical professor of medicine at UC San Diego School of Medicine and a certified physician development coach who works with physicians to gain more power in their lives and create lives of greater joy. Read her blog at helanefronekmd.com.

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PRACTICE MANAGEMENT

SDCMS 2015 Medical Office Salary Survey 18

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Sample Result Front/Back Office Position

SDCMS Member Physicians and Office Managers:

One-Doctor Office

To receive your free copy of SDCMS’s 2015 Medical Office Salary Survey, email Membership@SDCMS.org. The following positions were surveyed:

Average Hourly Salary

Average Tenure

Responses

E - East County

$16.70

H - Hillcrest

$17.10

J - La Jolla

$19.97

K - Kearny Mesa

$24.31

N - North County

$16.94

NC - North County Coastal

$16.46

S - South County

$15.40

Grand Total

$17.73

$30

$25

Hourly Salary

• Front/Back Office Position for a One-person Office • Front Desk Position • Certification/Insurance/ Pre-authorization Verifier • Surgery/Procedure Scheduler • Data Entry/Clerical Position • Insurance Biller/Insurance Claim Tracker • Patient Collection Representative • IT Tech • Department Lead • Office Manager, 1–3 Doctors, 3–14 Staff • Office Manager, >5 Doctors, >25 Staff • Medical Assistant • Certified Medical Assistant • Licensed Vocational Nurse • Registered Nurse • Physician Assistant • Nurse Practitioner For each position, the data was averaged by geographic region, an overall average was calculated, and a scatter diagram for salary versus tenure is provided. A linear interpolation of all the data is provided as well to give a “best fit” straight-line curve of salary vs. tenure. Thank you to those physicians, office managers, and practice administrators who completed our survey!

District

$20

$15

$10

$5 0

Years Experience

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office manager appreciation

Congratulations, Deann,

Above: (L–R) Jolene Hoeveler, Gloria Palafox, Deann, Dr. Mazer, and Jessica Navarro Right: (L–R) Brian Gerwe, SDCMS Director of Membership Recruitment and Retention, Deann, and Dr. Mazer

SDCMS’s 2015 Office Manager of the Year! 20

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Nominated by Dr. Ted Mazer, 28-year Member of SDCMS-CMA How many doctors can say that their office manager of more than 25 years has not only been critical in the growth and survival of their solo practice, but has been the backbone of the practice even longer than the doctor has been there? How many physicians can emphatically state that their office manager makes their own life in and out of the office both productive and manageable, takes care of making sure that procedures and consults are properly scheduled and approved, performs office testing and oversight as an RN, and keeps the constant day-to-day operations of the practice going, including keeping the rest of the staff happy enough to stay on board with the practice year after year, contributing to the most stable staffing of any practice I know? And how many surgeons can also note that their office manager makes

possible on a scheduling basis the ability of the surgeon to dedicate time to organized medicine through SDCMS and CMA year after year, making sure last-minute schedule changes that require rescheduling of patients and procedures go smoothly and without disruption to the practice and the patients? Frankly, the doctors and patients in San Diego and beyond have benefited from her work in my office, allowing me to work on numerous advocacy issues over the years. I am blessed with being able to say all of these things about my dedicated, professional and yet always friendly — to me and to the patients — office manager, practice administrator and nurse, Deann Cooper, RN! Deann was part of the practice when I moved in, way back in December 1989, and has stayed on to run my practice in so many ways, despite my hectic and ever-changing schedule, being one of the anchors of my practice who has allowed me to care for my patients, in a pleasant environment for my staff and myself, while keeping up with everything from compliance with regulations to bill paying to tax issues. More importantly for SDCMS, she has never faltered in working around the demands I have put upon her and my staff in my work with SDCMS and CMA, often resulting in major scheduling changes, allowing me to pursue my efforts on behalf of organized medicine, doctors, and patients well beyond my own practice. I doubt that too many other office managers would have successfully dealt with the demands put on her both for my practice and my organized medicine involvement over the years, let alone stayed on for two and a half decades to do so. I credit Deann for allowing my practice to flourish, and for allowing me to do what I love with SDCMS and CMA for the past 26 years. My patients credit her with being their guide and hand-holder when planning, scheduling, and following up on surgery. And her dedication to her job and to our patients shines through with her ever-friendly yet professional approach to helping our patients. Many doctors find themselves looking for new staff and office managers on a frequent basis. Not so for me. Deann has been key in this, along with the rest of my staff. My concern is not about always looking for new staff, but how difficult it would be to replace my staff, especially Deann, with anyone as willing and able to do all of the tasks she does in the manner in which she does them. Outstanding office manager to say the least. Indispensable, and maybe irreplaceable on both the professional and personal levels is more accurate. She deserves the honor of being named SDCMS’s outstanding medical office manager, and has for many years!

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

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SDCMS MEMBER BENEFITS

Join Our Invitation-only Private forum for SDCMS Member Office managers SDCMS has created an online forum for our member physiciansâ&#x20AC;&#x2122; office managers and practice administrators. This online forum will enable our valued office managers to build a community of mutual support in order to, for example, get answers to your practice management questions, share best practices, stay abreast of upcoming deadlines, and much more! This is a private, invitation-only forum for the office managers and practice admin-

istrators of current SDCMS member physicians. There you have access to a shared calendar, discussion forums, member profiles, a photo gallery, file storage, and more. We encourage you to upload your photo, complete your profile, and participate! This continues to be a work in progress. If you have any thoughts, ideas, suggestions that might make this a more valuable resource, please let us know at Membership@ SDCMS.org.

To join the forum today, visit sdcmsofficemanagerforum.groupsite.com!

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Your SDCMS Physician & Office Manager Advocate Is Here to Help!

Your SDCMS physician and office manager advocate, Marisol Gonzalez, has been helping member physicians of all practice modes, sizes, and specialties — and their office staff — with their practice management questions for almost 10 years. If you or your office staff have a question or an issue you need help with, feel free to contact Marisol for assistance at (858) 300-2783 or at MGonzalez@ SDCMS.org. For a small selection of the hundreds of questions Marisol received in 2015, and her answers, see the December 2015 issue of San Diego Physician.

SAN DIEGO PHYSICIAN.org

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claims, they get unmatched litigation training tailored to Calif

environment, so they enter the courtroom ready to fight—and

Thank you to the following Join your colleagues—become a member of The Doctors Comp companies for sponsoring the SDCMS Physician CALL OUR LOS ANGELES OFFICE AT 888.53 Networking OR VISIT WWW.THEDOCTORS.COM Opportunity and Mixer

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Thank you to for donating the grand raffle prize — a one night stay plus dinner at A.R. Valentien

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classifieds PHYSICIAN POSITIONS AVAILABLE FAMILY PRACTICE / INTERNAL MEDICINE PHYSICIAN: located in San Diego near the UCSD campus, has been caring for patients of all ages for 27 years, providing comprehensive preventive medicine, illness management, travel medicine, sports medicine, evidence-based chiropractic care, and weight management. We are closely affiliated with Scripps Memorial Hospital and UCSD Medicine. Call responsibilities relatively minor. Hours consistent with healthy work-life balance. This is a real family practice. Board-certified MD and DO physicians interested should contact Tricia/send CV to triciaberkoff@gmail.com. [445] 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 on-call pager one week every three weeks, telephone call only. No rounds or hospital duties. If interested, please email 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. [435] SEEKING FULL-TIME BC/BE OCCUPATIONAL MEDICINE PHYSICIANS: Sharp Rees-Stealy Medical Group — a 500+ physician multi-specialty group in San Diego — is seeking full-time BC/BE occupational medicine physicians to join our staff. We offer a first year competitive compensation guarantee and an excellent benefits package. Please send CV to SRSMG, Physician Services, 300 Fir Street, San Diego, CA 92101. Fax: (619) 233-4730. Email: lori.miller@sharp.com. [441] SEEKING EXPERIENCED, HIGHLY MOTIVATED FAMILY PHYSICIAN: Federally qualified health center (FQHC) clinic site in Linda Vista seeks an experienced, highly motivated family or internal medicine physician with a vision for the future of community medicine. San Diego Family Care operates seven clinic sites in San Diego to serve the primary care needs of our diverse communities. PCMH model operational and EHR system in place. NCQA recognized. Visit our website at sdfamilycare.org. Must have CA license. Competitive salary/benefits with retirement match. Looking for a special doctor, committed to our mission! Send CV to Arthur “Tony” Blain, MD, MBA, FAAFP, Medical Director, at aablain@lvhcc.com or call (858) 248-1509. [440] INTERNAL MEDICINE OR FAMILY PRACTICE PHYSICIAN to provide quality patient care for a full-time practice. The physician will provide outpatient evaluation, diagnosis, and treatment while representing the highest standards for clinical capability, professional education, quality improvement, and overall patient care. The incumbent must hold a current California license and be board certified or board eligible. Located in Liberty Station in Point Loma, we are a fast-paced, primary care clinic that uses Allscripts. Please email CV to erica.christensen@smartcaremd. com. [438]

al practice. Conduct medical diagnosis and treatment of patients, including surgical assist, flexible sigmoidoscopy, and basic dermatology. The incumbents must hold a current California license and be board-eligible; bilingual Spanish/English preferred. Check out a full list of our benefits at www.graybill.org. Send CVs to humanresources@ graybill.org, apply online, or fax to (760) 738-7101. [436/437] PSYCHIATRISTS NEEDED: Full-time or part-time positions available for a well-managed program at San Diego County correctional facilities. Telepsychiatry position also available. Flexible hours with very competitive pay. Send CV to steve@ cpmedgroup.com or call (619) 885-3907. [272] INTERESTED IN BECOMING A PRECEPTOR FOR OSTEOPATHIC MEDICAL STUDENTS? Midwestern / AZCOM osteopathic medical school in Phoenix has third- and fourth-year medical students in San Diego looking for clinical rotations, particularly in pediatrics, psychiatry, general surgery, and OB/GYN. Requirements: Either MD or DO; physicians interested must commit to minimum one four-week rotation per year / or more as desired (2–3 preferable) and to FT hands-on training for each student as is reasonable for the duration of the rotation. Compensation and CME provided. If interested, please contact Dr. Kevin Considine at kconsidine@sbcglobal.net for more information. [408] SPANISH-SPEAKING FAMILY PRACTICE OR INTERNAL MEDICINE: Spanish-speaking family medicine or internal medicine physician for Borrero Medical Group located in south San Diego next to Chula Vista. The practice is growing and needs to hire a new physician. Borrero Medical Group is a well-established practice, 22 years in the community, exceptional office staff. Every member of our team plays an important role in improving the health of our patients. We offer an excellent comprehensive benefits package that includes malpractice coverage, health insurance, competitive and attractive salaries and bonus. If interested, please submit inquiry and CV to rosa10borrero@att.net. [384] PRIMARY CARE JOB OPPORTUNITY: Home Physicians (www.thehousecalldocs.com) is a fastgrowing 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) 9925330 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] OFFICE SPACE AVAILABLE

FAMILY OR INTERNAL MEDICINE PHYSICIAN: Graybill Medical is one of the region’s largest independent, multispecialty groups. We are currently looking for a general family medicine physician (Escondido or Temecula) and an internal medicine physician (Temecula) to provide quality patient care to all ages of patients in a full-time, tradition-

CLASS “A” MEDICAL OFFICE FOR SUBLEASE / SHARE: Great location, well designed beautiful office space available on the first floor. Plenty of free parking on site — 700 Garden View Court, Suite 100, Encinitas. For more information, please contact Annie at (760) 633-1000. [446]

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.

january 2016

$3,500 / 1,701FT2 MEDICAL OFFICE FULLY BUILT OUT: First floor with extensive window line. Two entrances. Excellent highway access. Option for aesthetic practice acquisition available. Easy patient / client parking. 5330 Carroll Canyon Rd. Contact Margaret O’Byrne, MD, at mobyrne61@ gmail.com, (619) 218-8980 (mobile), or (858) 4814888 (office). [444] PSYCHIATRIC OFFICE TO SHARE/SUBLET: Ideal location and opportunity for early career or established psychiatrist seeking a furnished, well-maintained, UTC/La Jolla, class-A office at Regents/LJ Village Drive, close to UCSD/VA and Scripps. Plenty of sunlight streams into this thirdfloor office with waiting room, underground parking, and contemporary art and furnishings. Costs negotiable and could include receptionist services. Most important factor is personal and professional compatibility. Interested? Please email me at karl@karljacobsmd.com. [439] CAMPUS OF SCRIPPS ENCINITAS: One-half of 1,800ft2 office to share in nicest building (320). Available March 1, possibly earlier. Ob-gyn primary, but excellent for aesthetic physician / surgical specialty as it is abutting surgical center. Valet parking, imaging center, perinatology here. Vaginal laser and SculpSure laser presently being used. 220 volt available. Ultra hs Cox internet. New three-year lease with Scripps planned. Call Kristi at (760) 753-8413 for more info. [433] CENTRALLY LOCATED UTC/LA JOLLA MEDICAL OFFICE SPACE and Medicare/AAAASFaccredited surgery center available for sublease starting January 2016. Facility has three examination rooms, physician office space, full operating room, and recovery area. This is an excellent opportunity and location for a busy dermatologic, surgical, ENT, or internal medicine practice. Please contact drmofid@drmofid.com for further information. [425] LA JOLLA (NEAR UTC) MEDICAL OFFICE FOR SUBLEASE OR SHARE: Scripps Memorial medical office building. Great location, steps to main hospital entrance. 9834 Genesee Ave. between I-5 and I-805. Up to four exam rooms and private or shared consult office available. Please call (858) 622-9076 and ask for Jennifer. [394] 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] 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] BUILD TO SUIT: 950SF 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 six gated parking spaces, two entryways, restrooms, lighted tower sign space. Build-out allowance to $10,000 for 4–5 year lease, rent $1,800 per month gross (no extras). 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]

Seeking volunteers for ongoing interventional study investigating the roles of sedentary behaviors and light intensity physical activity on endothelial reactivity and arterial stiffness in individuals with peripheral artery disease. Please contact Steve Laslovich, principal investigator at 760.994.3576

NONPHYSICIAN POSITIONS AVAILABLE PSYCHIATRIC NURSE PRACTITIONER NEEDED: For part-time or full-time work at San Diego County correctional facilities. Flexible hours and very competitive pay. Send CV to steve@ cpmedgroup.com or call (619) 885-3907. [273] ADMINISTRATIVE ASSISTANT NEEDED: Must be detailed-oriented. Know about credentialing. Microsoft Excel, Word. Organizational skills a must. Salary depends upon experience. Send resume to takur01@yahoo.com. [431] 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] MEDICAL EQUIPMENT / FURNITURE FOR SALE CLEARWAVE OFFICE WAITING ROOM CHECKIN KIOSK WITH TABLETOP STAND: (eClinicalWorks Compatible) Decrease wait times, increase collections, and improve financial performance. Liberty Tabletop Kiosk with 17-inch, built-in, all-inone touchscreen computer with privacy filter. Intel Celeron Dual Core, E1500, 202 GHz processor, 2GB RAM, 160GB hard-drive, ID Tech swipe magnetic credit card reader mounted on right side of the screen. Copays and accounts receivable payable upon check-in. Windows 7 OS, LogMeIn Pro2, IE 9, and McAfee. eClinicalWorks kiosk software included. Original cost new $5,199. Sell for only $2,499. Email KLewis@SDCMS.org. [443] EXECUTIVE DESK FOR SALE: Solid wood • no particle board • weight testimony to solid wood • three spacious file drawers • three regular drawers • 6x3x3ft. • custom-made glass cover • $500.00. Call (619) 585-0476. [442] Legal Services Offered

Place your ad here Contact Dari Pebdani at 858-231-1231 or DPebdani@sdcms.org

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Political Veteran Paul Hegyi Takes Over as SDCMS CEO CMA Alum Takes Reins on Heels of Tom Gehring’s Retirement

january 2016

After more than five years with CMA, most recently as its vice president of membership, marketing, and communications, Paul Hegyi took over as CEO of SDCMS on Jan. 1, 2016. The transition comes after longtime SDCMS CEO Tom Gehring announced his retirement. “We could not be happier to have Paul come on board and join our efforts here in San Diego,” says SDCMS president William Tseng, MD, MPH. “During his tenure at CMA, Paul grew statewide membership by more than 15%, and we’re looking forward to the vision and enthusiasm he will undoubtedly bring to San Diego.” Paul started at CMA as a staff lobbyist, covering legislation related to scope of practice expansion for nonphysicians, hospital facility issues, physician aid-in-dying, and prescription drug concerns. He was quickly promoted to serve as vice president of political and external affairs, where he ran CALPAC, CMA’s political action committee. Since 2011, Paul held the role of vice president of membership, marketing, and communications, where he oversaw the reversal of a 20-year decline in membership. “When I took over the membership department, there was a lot of work to do in reversing membership trends,” says Hegyi. “With a rapidly changing healthcare delivery system, physician and patient needs are also

changing. That gave way to new and innovative marketing and membership outreach potential, something I’m looking forward to working toward in San Diego as well. The physicians in the San Diego community have shown a commitment to engaging colleagues and taking big public health issues head on. It’s an honor to have the opportunity to work with such an esteemed group of men and women.” Prior to joining CMA, Paul worked extensively on a number of political campaigns, having consulted directly and through independent expenditures for elections at the local, statewide, and congressional levels. He previously served as chief of staff to Assemblyman Van Tran and in various roles for Congressman Sam Graves (Missouri) and California legislators Tony Strickland, Shirley Horton, and Mark Wyland. “Paul brought tremendous value to CMA as a lobbyist, political director, and membership expert over his tenure here,” said CMA CEO Dustin Corcoran. “Our loss is certainly San Diego’s gain, and while he will be missed, I’m confident he’ll bring the leadership and creativity to SDCMS that he brought here at CMA.” Paul received his MBA from the University of Southern California, where he graduated with honors. He also holds a bachelor of arts degree in government from California State University, Sacramento. Paul can be reached at Hegyi@SDCMS.org or on his cell phone at (916) 215-9842.

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