November/December 2023

NOVEMBER/DECEMBER 2023

Official Publication of SDCMS

Caring for Ourselves Is Caring for Others THE PHYSICIAN WELLNESS ISSUE

Celebrating Independent Physicians

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Editor: James Santiago Grisolia, MD Editorial Board: James Santiago Grisolia, MD; David E.J. Bazzo, MD; William T-C Tseng, MD; Holly B. Yang, MD, MSHPEd, HMDC, FACP, FAAHPM Marketing & Production Manager: Jennifer Rohr Art Director: Lisa Williams Copy Editor: Adam Elder OFFICERS President: Nicholas (dr. Nick) J. Yphantides, MD, MPH President–Elect: Steve H. Koh, MD Secretary: Preeti S. Mehta, MD Treasurer: Maria T. Carriedo-Ceniceros, MD Immediate Past President: Toluwalase (Lase) A. Ajayi, MD GEOGRAPHIC DIRECTORS East County #1: Catherine A. Uchino, MD Hillcrest #1: Kyle P. Edmonds, MD Hillcrest #2: Stephen R. Hayden, MD (Delegation Chair) Kearny Mesa #1: Anthony E. Magit, MD, MPH Kearny Mesa #2: Dustin H. Wailes, MD La Jolla #1: Karrar H. Ali, DO, MPH (Board Representative to the Executive Committee) La Jolla #2: David E.J. Bazzo, MD, FAAFP La Jolla #3: Sonia L. Ramamoorthy, MD, FACS, FASCRS North County #1: Arlene J. Morales, MD North County #2: Christopher M. Bergeron, MD, FACS North County #3: Nina Chaya, MD South Bay #1: Paul J. Manos, DO South Bay #2: Latisa S. Carson, MD AT–LARGE DIRECTORS #1: Rakesh R. Patel, MD, FAAFP, MBA (Board Representative to the Executive Committee) #2: Kelly C. Motadel, MD, MPH #3: Irineo (Reno) D. Tiangco, MD #4: Miranda R. Sonneborn, MD #5: Daniel Klaristenfeld, MD #6: Alexander K. Quick, MD #7: Karl E. Steinberg, MD, FAAFP #8: Alejandra Postlethwaite, MD ADDITIONAL VOTING DIRECTORS Young Physician: Emily A. Nagler, MD Resident: Alexandra O. Kursinskis, MD Retired Physician: Mitsuo Tomita, MD Medical Student: Jesse Garcia CMA OFFICERS AND TRUSTEES Immediate Past President: Robert E. Wailes, MD Trustee: William T–C Tseng, MD, MPH Trustee: Sergio R. Flores, MD Trustee: Timothy A. Murphy, MD AMA DELEGATES AND ALTERNATE DELEGATES District I: Mihir Y. Parikh, MD District I Alternate: William T–C Tseng, MD, MPH At–Large: Albert Ray, MD At–Large: Robert E. Hertzka, MD At–Large: Theodore M. Mazer, MD At–Large: Kyle P. Edmonds, MD At–Large: Holly B. Yang, MD, MSHPEd, HMDC, FACP, FAAHPM At–Large: David E.J. Bazzo, MD, FAAFP At–Large: Sergio R. Flores, MD At–Large Alternate: Bing Pao, MD CMA DELEGATES District I: Steven L.W. Chen, MD, FACS, MBA District I: Franklin M. Martin, MD, FACS District I: Eric L. Rafla-Yuan, MD District I: Peter O. Raudaskoski, MD District I: Ran Regev, MD District I: Kosala Samarasinghe, MD District I: Thomas J. Savides, MD District I: James H. Schultz, MD, MBA, FAAFP, FAWM, DiMM District I: Mark W. Sornson, MD District I: Wynnshang (Wayne) C. Sun, MD District I: Patrick A. Tellez, MD, MHSA, MPH District I: Randy J. Young, MD RFS Delegate: David J. Savage, 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.]

Contents NOV/DEC

VOLUME 110, NUMBER 10

FEATURES

4

Caring for Ourselves Is Caring for Others

By Nicholas “dr. nick” Yphantides, MD, MPH

5

From Spent to Inspired

By Amruti Borad, DO

6

Strategies I Utilized to Cope and Overcome Hardship

By Mitchell P. Goldman, MD, FAAD

8

Learning From and Honoring My Son

By Robert Gillespie, MD

9

Supporting Physician Mental Health and Suicide Prevention

By Laura Hoffman and Christine Yu Moutier, MD

12

UC San Diego HEAR Program: Aiming to Prevent Suicide and Advance Wellbeing Among Healthcare Professionals

By Desiree Shapiro, MD and Sidney Zisook, MD

13

A Peer Support Group for Physician Owners/Managers

By Brooke Resh Sateesh, MD

14

Synergizing Clinician Support with Organizational Wellbeing: One Group’s Journey

By Genevieve Parsons, MD and Kenneth Morris, MD, FAAP

DEPARTMENTS

2

Briefly Noted: Advocacy • Medical Student Tuition Assistance • Drug Prescribing/Dispensing

18

Abracadabra!

By Adama Dyoniziak

19

‘Casino Night Masquerade’ Fundraiser Is a Great Success!

20

What Expectations Will You Let Go Of?

By Helane Fronek, MD, FACP, FASVLM, FAMWA

21

Classifieds SANDIEGOPHYSICIAN .ORG

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ADVOCACY

California Medical Association Announces New Vice President of Political Operations THE CALIFORNIA MEDICAL ASSOCIATION

(CMA) recently announced that Susan McEntire has been named the organization’s vice president of political operations. In this role, she will oversee CMA’s electoral efforts and manage CMA’s political action committee (CALPAC), which supports candidates for state and federal office who share CMA’s goals and vision of the future of healthcare and medical practice.

“Susan has years of experience running and winning campaigns in every corner of the state. She brings a wealth of knowledge as well as keen political instincts gained by navigating complex political landscapes,” said CMA CEO Dustin Corcoran. “She will be a tremendous asset to CMA as we work to improve the healthcare system and provide patients with the high-quality healthcare they deserve.”

McEntire most recently worked as political director for the Assembly Democratic Caucus, where she drew on her decades of experience running field operations and overseeing campaign staff and consultants to elect candidates in districts across the state to the Assembly and worked with the incoming political director on the transition. She previously worked as the director of the Assembly Democratic office of communications and outreach and as statewide field director for the Assembly Democrats.

McEntire has a long history of working in the State Capitol in both the Assembly and the Senate. She has worked for seven different Assembly speakers, served as chief of staff and district director to multiple lawmakers and advised the speaker’s office on elections policy.

“I am thrilled to join CMA at such a pivotal time to support the priorities of our physician members as we head into a critical election year,” said McEntire. “I look forward to assisting physicians as they advocate for greater access to healthcare for all Californians.”

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MEDICAL STUDENT TUITION ASSISTANCE

AMA Foundation Accepting Applications for Physicians of Tomorrow Scholarship Program THE AMERICAN MEDICAL ASSOCIATION

(AMA) Foundation is now accepting applications for the Physicians of Tomorrow Scholarship program, which distributes $10,000 in tuition assistance scholarships to medical students approaching their final year of school. All students may apply for the Physicians of Tomorrow scholarships, regardless of AMA membership status.

The application deadline is Jan. 17, 2024, at 11:59 p.m. CST. The AMA Foundation has had a longstanding tradition of supporting medical students. Since 1950, it has awarded more than $61 million in scholarships. With 12 scholarship categories and a variety of focus areas, including serving those underrepresented in medicine, the AMA Foundation works to recognize a diverse cohort of medical students each year.

DRUG PRESCRIBING/DISPENSING

DEA Extends Telehealth Prescribing Flexibilities for Controlled Substances Through End of 2024 THE U.S. DRUG ENFORCEMENT ADMINISTRATION (DEA) HAS issued a new temporary rule that will extend the ability to prescribe controlled substances based on telehealth patient visits.

While this flexibility was set to end when the federal COVID-19 public health emergency expired in May, DEA had extended the same policies that had been in place during the COVID-19 public health emergency for an additional six months, until Nov. 11, 2023. The latest temporary rule will extend this flexibility through the end of 2024.

DEA received more than 38,000 comments on its proposed telemedicine rules and is working to promulgate a final set of telemedicine regulations by the fall of 2024. According to DEA, the goal of this temporary rule is to ensure a smooth transition for physicians and patients who have come to rely on the availability of telemedicine for controlled medication prescriptions, and allow adequate time for providers to come into compliance with any new standards or safeguards that DEA promulgates in the final rules.

The second temporary rule includes two major provisions, to: 1. Extend, until the end of 2024, the full set of telemedicine flexibilities regarding prescription of controlled medications, in place during the COVID-19 PHE; and 2. Authorize all DEA-registered practitioners to prescribe schedule II–V controlled medications via telemedicine through Dec. 31, 2024, whether or not the patient and practitioner established a telemedicine relationship on or before Nov. 11, 2023.

The California Medical Association (CMA) applauds this extension, which will allow patients to continue to receive safe and effective care via telemedicine. CMA submitted comments on the proposed regulations, urging DEA to ensure that any new rules will not limit access for our most vulnerable patients.

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PHYSICIAN WELLNESS

Caring for Ourselves Is Caring for Others

By Nicholas “dr. Nick” Yphantides, MD, MPH ONE OF THE IRONIES OF LIFE for me as a physician is that at various stages of my career I was not able to care for myself as well as I was caring for my patients. Perhaps some of you can relate to that struggle. If so, you have come to the right place! I must confess that I have been pondering and planning for this edition of San Diego Physician well before the blessing of serving as your current SDCMS president.

I am writing this introductory article on the three-year anniversary of one of the darkest and hardest seasons of my life. Three years ago, in the fall of 2020, I was so desperate that I almost did the unthinkable, and in my compromised place I was distorted in my thinking. For a short period of time I was afraid to get help and admit the extent of my despair because I was so fearful of losing custody of my two precious daughters. While I received amazing physical medical care from my personal physicians, their medical group did not have psychiatrists on staff and when I finally hit rock bottom and was able to at least partially acknowledge how desperate things were for me, I was given a 1-800 number to call. Were it not for Dr. Michael Krelstein, an accomplished local psychiatrist and at the time a colleague of mine who reached out to me directly, I shudder at the thought of what would have happened. Michael made an urgent referral to a local psychiatrist, Dr. David Printz, who was willing to see me that same night and was able

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to intervene and start me on the road to eventual stabilization.

The late Rev. D.T. Niles from Sri Lanka once said that communicating the good news is “one beggar telling another beggar where to get food.”

Well, as a beggar who has been to the edge of the cliff, part of the motivation of this edition is to share where to find the bread! While I had my own unique reasons for getting that far along in my urgency, there are a host of reasons why many of us perhaps are reluctant or perhaps afraid to reach out for help or even admit that we need it. Unfortunately, the stigma even within our profession around mental health and self-care way too often limits us as professionals from seeking needed help ourselves or even acknowledging that we need a break.

Even though we are so fortunate to have the knowledge and skills to effectively diagnose and treat others, it can be so hard to effectively recognize burnout or depression or other challenges in ourselves.

Vulnerability breeds receptivity, so I want to sincerely thank Drs. Amruti Borad, Mitchell Goldman, and Robert Gillespie for openly sharing a bit of their own personal journeys and challenges. I’m so thankful for how they overcame and prioritized their own wellness in turning their own “sorrows into joy.” So grateful to Laura Hoffman and Dr. Christine Yu Moutier, from the American Foundation for Suicide Prevention, for providing a macroscopic perspective and some resources available at the national level. Lots of appreciation to Drs. Desiree Shapiro and Sidney Zisook from UCSD and the article on their “best practice” HEAR program. I’m very grateful to Dr. Brooke Resh Sateesh for her contribution on a peer support group for physician owners and managers. Thankful for Drs. Genevieve Parsons and Kenneth Morris from CPMG for sharing their new and growing efforts within their medical group. Finally, thanks to Dr. Helane Fronek for her thoughtful entry on managing expectations.

Where this goes from here is exciting to consider. More than anything, we hope any of you who may need assistance or support will not hesitate to please reach out. Some of us have discussed the possibility of a town hall forum on wellness in the near future or perhaps a group of us that would be willing to do panel discussions and grand rounds at our local healthcare systems. As we care for ourselves, we can also care for each other. Blessings to you!

From Spent to Inspired

By Amruti Borad, DO

Dr. Nick is President of the San Diego County Medical Society. His professional mission focuses on advocating for those in our community who are in most need through the transformation of population health and more holistic approaches to the planning and delivery of healthcare.

Until March of 2021, he was the first chief medical officer for San Diego County. Currently he is focusing on furthering his mission to address public health and healthcare systems’ challenges to better serve those in most need through a variety of strategic clinical consulting opportunities.

His teenage daughters Veronique and Zoe are the joy of his life and they make their home in Escondido.

I INTERVIEWED FOR MEDICAL school when I was 17 years old. Never in a million years did I think I would seriously consider leaving medicine.

Yes, I had a fleeting moment in medical school where I wanted to leave to become an elementary school teacher.

Yes, I experienced significant selfdoubt and a short bout of burnout in residency, but I still had that fire to achieve the goal of doctor, and no wall was too high to climb.

It was not until approximately six years into practice, one month prior to the first COVID-19 omicron surge, when I thought to myself: “If I have to write one more note, sign one more order, or respond to one more MyChart, I think I might leave medicine.”

I felt it in my bones. I knew it was serious this time. I had all the signs of burnout: emotional exhaustion, a decreased sense of accomplishment, and depersonalization.

Yet I still carried on, thinking I had no choice. Shortly thereafter, I was promoted to clinic medical director and then department wellness director. This brought a renewed sense of purpose and meaning to my physician identity and I felt like I was truly making a difference. This is when I happened to meet a physician coach and decided it was time to invest in myself, learn to be the best leader I could be, and work with them. As I entered into this world of thought work, I realized I was slipping back into burnout, like something was missing. I contemplated leaving medicine, but this time the feeling was more

intense. My wheels started turning — I was curious what else was out there.

I peeked into the world of physician entrepreneurship and real estate. But a part of me knew I still wanted to practice clinical medicine, still take care of patients, and still wanted to be a leader. But how?

The first step was admitting I was a burned out leader. This was the hardest part. I was embarrassed, full of shame for not being able to “handle” rising patient volume and my other responsibilities. What will my superiors, colleagues, staff team, and patients think? But I knew that if I didn’t confront this, if I didn’t discuss this with my leadership team, I would prolong my suffering and never recover, and the real question was: “What will I think if I don’t take care of myself? So, I scheduled a meeting with my boss and with a solution in mind. I thankfully received support to continue my work as a leader and go part-time, but only for six months. I thought this would be enough. Yes, I can recover and then I’ll be good to go.

But I was wrong. I was significantly more effective as a leader and clinician working part-time and I knew I could never go back to what I was doing before. I made sure to continue asking for the possibility of continuing a reduced schedule, but to no avail. So I began to reexplore options, and through an unsuspecting lunch with a friend, found another path — a different organization that supports part-time leadership. I couldn’t have been more excited; however, a part

SANDIEGOPHYSICIAN .ORG

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PHYSICIAN WELLNESS of me also felt disappointed that I had given so much of myself for a cause, and that I had made a difference in my organization at multiple levels, yet I was not “worth” retaining. Ultimately, I was grateful for the level of support I received as I was aware many of my physician colleagues at other organizations were not met with the same sentiment. I also realized the path forward was not to blame someone else but to take responsibility for my part, and develop curiosity and compassion for others and myself — we are all just doing our best.

In the end, as luck would have it, I was offered an opportunity to stay but in concierge medicine. I didn’t know what to think, but something inside of me convinced me to schedule an interview. Perhaps it was the coaching that sparked me to trust my intuition. And it was exactly the right fit for me. It was my way to stay in medicine, a balance between the care for patients and the care for my team and myself, a path I had been looking for, and didn’t know existed.

This was almost one year ago, and since then I found my way back to a fulfilling career in medicine; certified as a life coach with which I started a part-time business coaching medical students and trained physicians to prevent and treat burnout, traverse the various transitions that are a part of the journey of medicine, and reinvigorate their purpose as healthcare professionals, remaining open to all possibilities; I joined a physician mastermind program to ensure that I surround myself with like-minded colleagues, all striving to affect change; and best of all, I get to be a mother for the first time.

I think it’s important to accept that everything in life is 50-50. There are still days when I wonder if I made the right choice, but then I look at all of the gifts I found in the challenges I faced, and express gratitude for the life I have.

If I could leave you with a few words of advice: No one is more invested in you than you are. You are your own life raft. Choose yourself and see the magic unfold.

Dr. Borad is an osteopathic concierge family physician at UC San Diego Health, providing primary care services for ages 5 and up. She was previously a physician leader-clinic medical director, department wellness director, and department COVID-19 lead physician, during which time she developed the skills to make positive changes on a larger scale within the healthcare system and empower healthcare professionals.

After she experienced her own burnout, with the guidance from a physician coach, she transitioned to concierge medicine and then certified as a coach herself, collaborating with medical students and physicians via VORCIS physician coaching to prevent and treat burnout, master transitions, and discover new paths to fulfillment in medicine.

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Strategies I Utilized to Cope and Overcome Hardship

By Mitchel P. Goldman, MD, FAAD SINCE I WAS YOUNG, I HAVE believed in making positive impact for others. At my core I have been fortunate enough to want to share that drive for positivity with others. Of course, I was aware that to become a physician was the journey to both personal and professional growth and success. My goals included not only attaining financial and personal success, but creating a connection and impacting others. I was fortunate enough to marry a beautiful, intelligent woman before starting medical school, where we welcomed two daughters to our new family. Career-wise, I was also fortunate enough to obtain my first choice internship and residency, which I then was able to parlay into joining an outstanding dermatology practice in San Diego.

Life was going exactly to plan. At age 40 I had achieved academic success, written several textbooks, invented and/or helped develop a variety of laser, light, and cosmetic procedures, and became a sought-after speaker both nationally and internationally. Eventually I was elected to being local president of the American Society for Dermatologic Surgery and the American Vein and Lymphatic Society. Finally, after much hard work, my inventions allowed me to pay off my substantial student debt and become financially stable.

Then, my “perfect” world collapsed when my wife left me and we got divorced. I went through a profound depression some would call a midlife crisis. In the depths of my despair, my best friend, Dr. Harve Meskin, a psychologist, recognized that I lacked a non-medical

social circle of friends and support group. He advised me that instead of doing psychotherapy I should do “cyclotherapy.” Cycling was a passion I had in college and medical school, but something I gave up after I moved to San Diego and was hit by a car. I woke up with the paramedics on top of me.

My children were quite young, and when my family told me not to cycle anymore, I listened.

But now that my kids were grown up and on the advice of my friend, I joined the remarkable San Diego cycling community. The Challenged Athletes Foundation was the first organization I joined as they were starting a charity ride from San Francisco to San Diego.

I trained with their members, learned about the help they give to those with physical challenges, and how those athletes overcame their disabilities through organized exercise and friendships. Through this organization and the friendships that I have developed in the cycling community with clubs like

Swamis, Coureur, Wolfpack, and SDBC, I was able to regain my lost self-esteem along with improving my physical and mental health with a renewed passion for living. Participation in teams, charities, volunteer work, and other endeavors outside of medicine have contributed to my renewal and broadened my view of the world.

Now, with my incredible wife, Laura, three amazing children (and two wonderful sons-in-law), two loving grandchildren, and my dog, Otis, I am the happiest I have ever been. My advice to others is to read Man’s Search for Meaning by Viktor E. Frankl to understand that we need to “live as if you were living already for the second time.”

When most of us decide to become a physician, it is because we want to help others. Many of us fall short when it comes to healing ourselves. Allowing our family and occasionally a professional to help us “unlock” and see the bigger picture is frequently what is necessary to cope with the stresses

of our very complex lives.

I have found that while it is difficult for a physician to “heal thyself,” with help from our friends, family, and support groups, we can. My hope is that this message can inspire happiness in your life.

Dr. Goldman graduated from Stanford University School of Medicine, did his internship at UCSD, and dermatology residency at UCLA before returning to San Diego in 1986 to join Richard Fitzpatrick and start Dermatology Associates, then leaving to start Cosmetic Laser Dermatology. He has authored more than 500 medical manuscripts and 13 textbooks concentrating on cosmetic dermatologic surgery, laser surgery, and phlebology.

He recently retired as a volunteer clinical professor of dermatology at UCSD and is presently medical director of Platinum Dermatology Partners, a 400-dermatologist group with offices in California, Arizona, Nevada, and Texas.

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PHYSICIAN WELLNESS

Learning From and Honoring My Son

By Robert Gillespie, MD YESTERDAY I WAS SITTING in my son’s car reflecting on both the many wonderful memories and the painful aftermath of his death; the latter never seemingly far enough away from my thoughts. As I did this, I opened his console to find a stamped verification of his third COVID vaccine. Three weeks later he had taken his own precious life. Just two days before his death, he interviewed for a job but never lived long enough to know that he’d been enthusiastically hired. His calendar was full of scheduled activities. Clearly, his suicide was not planned.

Jayden was initially diagnosed with

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depression at the age of 20, a diagnosis I briefly embraced despite knowing there was more. After a few painful months and a new physician, the correct diagnosis was made. Jayden had schizophrenia — a stigmatized disease that took this beautiful young man to an incredibly dark place.

His infectious personality and creative mind became self-evident very early on. Jayden was always eager to socialize and brought light into any room. At 6, he without hesitation could happily entertain more than 100 guests with his profound wit and innocent humor — qualities that only grew stronger over time. Jayden went on to give both his 8th grade and high school commencement speeches. He was one of three students chosen in California as a Presidential Scholar of the Arts in 2017. This was the apex of a blossoming life filled with receiving honors and praise, while also being a great supportive friend to many and a son truly adored and respected by his parents.

Jayden was a voracious storyteller who deeply cared about others. As a high schooler at Canyon Crest Academy, he began to pursue his dreams of tackling complex social issues through filmmaking. Jayden evolved into a very promising filmmaker while attending Loyola Marymount University — leaving us with several celluloid

examples of what could have been.

Death of a child is the most devastating thing a parent can experience.

My reflection on what I could have done differently is ongoing. Jayden had moved back home and was fully dedicated to extensive therapy. He was candid yet optimistic with others about his condition despite the voices causing him both mental and perceived physical pain. Unfortunately, the wonderful external voices from family, friends, and therapists — nor his earnest desire to get well — could supplant those constant inner voices.

The best way for me to survive this has been to do what comes naturally to physicians — take something not optimal and make it better. Hence, we recently founded the Jayden T. Gillespie Foundation in order to make a positive impact on adolescents and young adults with mental health disorders. We have partnered with RADical Hope Foundation to provide a multi-week program designed to improve mental health, social engagement, and organization among 16- to 18-year-old individuals — with an emphasis on underserved populations.

It is our goal for this to be the first of many community-based programs.

We also held our second annual golf tournament in August supporting Jayden’s Endowment Fund and our newly formed foundation, which was very successful and sold out weeks in advance. Most importantly, our foundation will honor Jayden by making a difference in the mental health of our community and providing a space for people to share their stories — while keeping his alive.

Dr. Gillespie has been a cardiologist with Sharp Rees-Stealy Medical Group for more than 31 years. He is also the founder of the Jayden T. Gillespie Foundation.

Supporting Physician Mental Health and Suicide Prevention

By Laura Hoffman and Christine Yu Moutier, MD SUICIDE IS A SERIOUS PUBLIC HEALTH problem, a complex health outcome, and a leading cause of death in the United States. There is no single cause for suicide, but rather, there are multiple, intersecting factors that come together to create risk.

Among healthcare professionals, research finds elevated suicide risk among certain disciplines, including physicians and nurses. Physicians have higher rates of burnout, depressive symptoms, and suicide risk than the general population.

Troublingly, physicians die by suicide at nearly double the rate of the general population. This is particularly clear for female physicians and likely true for mid to later career male physicians. Physician suicide decedents were less likely to be receiving mental health treatment prior to death when compared with general population suicide decedents.

Physicians report many barriers to seeking mental healthcare, including hesitancy to draw attention to selfperceived weakness, and concerns about reputation and confidentiality. A long history of discriminatory practices related to health professionals’ mental health have led to overwhelming avoidance of help seeking based on fear of negative repercussions to professional reputation, hospital privileging, and medical licensure. These concerns continue to lead to avoidance of treatment, even in the face of lifethreatening health conditions, although there are signals of positive change.

Despite its complexity, suicide can be prevented. Because environmental factors are critical in this mix, the workplace and the culture within the healthcare profession hold great potential for reducing suicide risk factors and providing support. The American Foundation for Suicide Prevention (AFSP) encourages a multi-pronged comprehensive approach to suicide prevention, supporting upstream, midstream, and downstream strategies that are built into the culture of an organization to support change.

Upstream approaches include efforts to increase awareness of mental health and suicide prevention. Examples include ensuring education and resources are promoted such as AFSP’s Talk Saves Lives presentation, and hosting community events, such as AFSP’s Out of the Darkness Walks, that create a sense of connectedness and reduce stigma. For midstream approaches, proactive, anonymous screening programs, such as AFSP’s Interactive Screening Program (ISP) can be utilized to help connect higher risk individuals to mental health sup-

port. An online program utilized by healthcare organizations and in collaboration with their employee assistance program or mental health provider, ISP is an evidence-based practice recognized by the American Hospital Association, the U.S. Surgeon General in a call to action for healthcare workforce burnout, and other national organizations. For downstream approaches following suicide loss, we recommend that all organizations have crisis and mental health resources available that are communicated robustly, as well as postvention policies and crisis response in place proactively. AFSP and partners such the American Medical Association (AMA) and Accreditation Council for Graduate Medical Education (ACGME) provide toolkits to help support organizations in the aftermath of a suicide loss. AFSP also maintains a hub of resources for healthcare professionals.

Doctors who proactively address their mental health are better able to optimally care for patients and sustain their resilience in the face of personal and professional stressors, and mental health concerns such as burnout, depression, stress, and suicide risk. Together, we can create a culture within healthcare that ensures that our healthcare providers know that they are not alone and can connect to the support that they deserve.

Laura Hoffman serves as the director of the Interactive Screening Program (ISP) for the American Foundation for Suicide Prevention (AFSP), where she has been on staff since 2011. Since 2014, she has overseen implementations of ISP at college and university campuses, hospitals and health systems, and workplaces nationwide to connect over 280,000 people to available mental health services. She regularly speaks at national conferences as an expert on comprehensive suicide prevention strategies and programming for the healthcare workforce and college and university students.

Dr. Moutier serves as the chief medical officer for the American Foundation for Suicide Prevention and knows the impact of suicide firsthand. She has dedicated herself to fighting this leading cause of death. For the past decade as CMO at AFSP, Dr. Moutier has been leading a grassroots nationwide movement fueled by science to reduce suicide.

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ORTHOPEDIC SURGEONS Daniel S. Brereton, DO David J. Burnikel, MD Harbinder S. Chadha, MD Tal S. David, MD Pascual H. Dutton, MD John A. Grotting, MD Thomas W. Harris, MD Eric P. Hofmeister, MD Rina Jain, MD Samuel Klatman, MD Michael R. Lenihan, MD Michael P. Muldoon, MD Jonathan J. Myer, MD M. Lucius Pomerantz, MD Jerrick Robker, DO Mark T. Selecky, MD Matthew Shillito, MD Michael A. Sirota, MD James Tasto, MD Scot A. Youngblood, MD

15 Locations Chula Vista | Desert Springs | Encinitas | Kearny Mesa | La Jolla La Mesa | Mission Valley | San Diego | Temecula 10

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H e l p i n g Yo u Ta k e Yo u r B e s t S h o t ORTHOPEDIC SPORTS FELLOWS Bryan D. Bourland, DO Van S. Krueger, MD

PHYSICAL MEDICINE & REHABILITATION Enoch H. Chang, MD Gavin Kolodge, DO

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PHYSICIAN WELLNESS

UC San Diego HEAR Program:

Aiming to Prevent Suicide and Advance Wellbeing Among Healthcare Professionals

By Desiree Shapiro, MD and Sidney Zisook, MD

THE UC SAN DIEGO HEALER EDUCATION Assessment & Referral (HEAR) Program stands as a crucial initiative, placing paramount emphasis on the emotional wellbeing and mental health of healthcare trainees, staff, and faculty within the UC San Diego Health system. This program provides anonymous stress and depression screenings, referrals, education, and support to all members of the UC San Diego Health community. Furthermore, HEAR extends its reach by offering short-term, no-cost, and confidential counseling services tailored specifically for residents and fellows, in addition to facilitating individual “check-in” meetings with certain physician groups.

HEAR plays an indispensable role in the realm of suicide prevention, acknowledging the substantial stress and emotional burdens that often accompany healthcare professions, along with the prevailing culture of medicine that stresses toughing it out in silence and isolation. Recognizing that early identification and intervention are pivotal components of suicide prevention, the program has implemented a web-based screening tool that was initially developed by the American Foundation for Suicide Prevention. This brief, online questionnaire explores various facets of mental health, encompassing prior suicide attempts, emotional states, substance use, eating behaviors, and ongoing mental health treatment. Importantly, all responses to this questionnaire are kept entirely confidential. Beyond merely identifying potential concerns, this tool encourages individuals to seek further evaluation and support, a critical step in preventing suicide. Those interested are encouraged to connect with HEAR counselors who offer personalized referrals to local mental health clinicians and other community resources.

The HEAR Program actively confronts the stigma surrounding mental health issues within the healthcare field,

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fostering an environment that promotes open discussions and mitigates the fear associated with seeking assistance. HEAR hosts Schwartz rounds and other educational talks for attending level physicians, residents, fellows, medical and pharmacy students, and hospital staff. These initiatives raise awareness concerning burnout, depression, and suicide, offering valuable insights into the unique challenges faced by healthcare professionals. By facilitating conversations about available resources and the support necessary to navigate these challenges, HEAR aims to cultivate a healthier and more resilient healthcare workforce. Consequently, this leads to a more motivated and engaged workforce, empowering them to operate at their fullest potential for optimal patient care and outcomes. HEAR strives to foster a culture of compassion and connection where individuals feel at ease discussing their mental health concerns and taking steps to protect their emotional wellbeing.

Here are some testimonials of individuals in our healthcare community who have utilized HEAR: HEAR Team

“I was at a fork in the road that could lead to two dramatically different paths; you helped me pick the longer one, if you get what I mean.”

“ … a lifeline. I felt lost in life, unhappy with my status and direction, despairing at a lack of a foreseeable solution, and ready to accept this as the normal state of affairs.

Despite my outwardly appearing successes, I felt like a failure professionally and personally … I needed help.

… This program started my journey.”

“ … without it, I would not have sought treatment.

Thank you.”

“I am extremely satisfied with the care offered by my HEAR therapist. She is extraordinarily compassionate and has been an essential source of support during the pandemic and through multiple family deaths. I feel so lucky to have her services through HEAR.”

“I have been really enjoying my zoom counseling sessions with my HEAR therapist. I feel like the benefits extend outside of therapy as I am more aware of how am I feeling in certain situations. I also think it has helped me find validation and acceptance for my feelings toward work, rather than blaming myself for burnout and dissatisfaction.”

HEAR TEAM

Dr. Zisook is a distinguished professor of psychiatry, expert researcher, clinician, and educator. Dr. Zisook was director of the UC San Diego HEAR Program for 14 years and now is leading the UC San Diego Peer Support Program for Physicians.

Dr. Shapiro is an associate clinical professor of psychiatry at UC San Diego and new to the HEAR leadership team. Along with being a child, adolescent, and adult psychiatrist, she is also advisor for student wellness at Skaggs School of Pharmacy and Pharmaceutical Sciences and actively involved in medical student teaching.

HEAR COUNSELORS

Rachael Accardi, LMFT, has a master’s degree in marriage and family therapy and is a licensed marriage and family therapist. She has worked at UC San Diego’s HEAR Program as a program counselor for nearly six years. Accardi takes a traumainformed approach to care and is passionate about working and serving UC San Diego Health’s healthcare worker community.

Courtney Sanchez, LCSW, has worked for UC San Diego Health for eight years, and as a HEAR Program counselor for six years. She started her career working for the seriously mentally ill and active-duty

military populations in outpatient psychiatric services before moving to the HEAR Program. She is passionate about mental health in healthcare professionals and finds a lot of meaning in supporting UCSD Health Sciences employees. Sanchez received her master’s degree in social work from San Diego State University.

Julie Kawasaki, LCSW, is a licensed clinical social worker. She has been integral to the HEAR team, providing therapy and referrals for medical residents, fellows, and faculty for three years. In addition to experience in psychedelic therapy, Kawasaki has a variety of experience working in community mental health, substance use/ harm reduction, HIV, and military mental health, including extensive experience treating PTSD.

A Peer Support Group for Physician Owners/ Managers

By Brooke Resh Sateesh, MD AS PHYSICIANS, MOST of us spent years studying the intricacies of anatomy and pathophysiology, then focused on the diagnosis and treatment of disease. Very few of us had the opportunity to take business or leadership classes.

Yet many physicians find themselves running businesses and taking on leadership positions.

As an owner of a private practice, I have found a paucity of professional support in running my business. I always have a colleague to ask a second opinion for medical questions, but I don’t have the same support when it comes to questions like, “When you need to hire a new medical assistant, what is your go-to source?” Or “What is your experience using virtual assistants?” Or “What activities and opportunities do you provide to your staff to improve overall happiness and wellness?”

Since I have been unable to identify such a resource, I have teamed up with Ziksana Consulting, a play-based leadership organization that provides executive coaching as well as training. The Peers at Play for Physicians is a professionally facilitated group coaching experience that focuses on:

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PHYSICIAN WELLNESS • Connecting leaders who are physicians, managers, and/or business owners to develop a professional and personal network.

• Sharing successes and challenges related to business operations, building a culture, billing, medical practices and policies, recruitment and turnover, and personal development opportunities including wellness and leadership skill growth.

• Using a creative and collaborative problem-solving process to generate feasible solutions to complex challenges.

The free introductory meeting will be held at Ziksana Consulting’s office in Hillcrest. following would be the ByThe Shira Abeles, MD overall process and goals for our introductory session: • Physicians get to connect about their practices and share stories of success and challenges.

• Professional facilitation of a creative problem solving process to help participants use new ideas to solve persistent challenges in their businesses.

• Develop closer relationships among physician managers.

Following this introduction, those who find it valuable will continue to meet three additional times under the guidance of Ziksana. After that we will continue to meet in regular intervals to provide support and discuss workplace challenges with or without

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professional facilitation.

Ultimately, having colleagues in similar professional positions who we can turn to for support will improve the success of our practices, which in turn will provide better patient access and care, and, above all, will improve physician wellbeing.

If you are interested in learning more, please email info@ ziksanaconsulting.com.

Synergizing Clinician Support with Organizational Wellbeing One Group’s Journey

By Genevieve Parsons, MD and Kenneth Morris, MD, FAAP

Dr. Sateesh, a board certified dermatologist, was born and raised in San Diego where she graduated from Francis Parker School. She then received her bachelor of arts degree from the University of Pennsylvania, and her medical degree from UCSD School of Medicine. Dr. Sateesh completed her dermatology residency at the University of Maryland. She is the owner of San Diego Family Dermatology located in National City, El Cajon, and Poway, which started as a two-provider, four-staff office, and has grown over the past eight years to 11 providers and more than 50 staff members, and predominantly serves our Medi-Cal population.

NOVEMBER / DECEMBER 202 3

CHILDREN’S PRIMARY CARE Medical Group (CPCMG) is a physicianowned pediatric practice comprising 164 physicians and advanced practice practitioners. CPCMG serves approximately 270,000 patients at 28 sites throughout San Diego and southwest Riverside counties. We accept most commercial payers as well as public health insurance, and take pride in being the largest pediatric safety net provider in the State of California.

Caring for ourselves enhances patient care. Rather than react to fallout from a physician suicide, for example, CPCMG leadership has been proactive in promoting clinician wellbeing and mitigating burnout. Our wellness journey started 10 years ago with the creation of a Balance and Well-Being Committee. As with many contemporaneous fledgling physician wellness efforts, we started by focusing on resiliency, led by the late Dr. Danny Friedland. We miss Danny and are grateful for his legacy of leadership.

In parallel, we strengthened our clinician support resources with the creation of a Peer Support Program called T.L.C. (Talk and Listen Confidentially). This program provides a confidential forum for those clinicians struggling with profes-

widespread geographic distribution of our offices. In 2023, we appointed a chief wellness and leadership officer.

This position will allow CPCMG to concentrate on leadership cultivation and clinician support as we continue to proactively address burnout.

Although we are proud of our work to date, we are not without challenges. Our TLC program has had less uptake than anticipated. We are still searching for ways to enhance our support for clinicians who may be struggling in more significant ways (including with mental health issues). As with any organization, we have had to prioritize our efforts in the context of our global financial structure. Despite these challenges, we look forward to continuing to champion clinician wellness at CPCMG.

sional or personal challenges to contact other CPCMG clinician volunteers trained to listen and support.

Since then, in alignment with the evolution of the national clinician wellness movement, we have recognized the importance of organizational drivers of burnout. We have evaluated ways to address clinician wellbeing more comprehensively based on the three pillars of the Stanford Model of Professional Fulfillment: Culture of Wellness, Personal Resiliency and Efficiency of Practice.

Within this framework, and with the support of leadership at CPCMG, we have made strides in improving efficiency and culture within the EHR and our care teams. These initiatives include: • In collaboration with IT leadership, we empowered our EPIC clinician and IT support teams to create tactics to improve EHR efficiencies, provide our clinicians with in-person EHR coaching (termed “sprints”), and decrease InBasket information redundancy.

• We developed a “Care Team Redesign” strategy to enhance organi-

zational partnerships and promote teamwork. This initiative includes care team huddles and increased collaboration between our physician leadership and practice management teams. The goals are to develop ideal care team models to improve team communication and workflow during visits, implement a team-based approach to InBasket management, and create a patient risk stratification model to identify and provide more time for complex patients.

• Finally, the “Teams First for Patients’ Sake” program encourages clinicians and staff to nurture resiliency and thrive under pressure in the team setting.

As with the rest of the San Diego medical community, the pandemic significantly impacted our clinicians.

When our burnout levels increased in 2021 from our previous historically low levels, we recognized that, in addition to our three major initiatives, our wellness program needed a more robust infrastructure.

Therefore, in 2022 we identified three Regional Wellness Champions to advance our efforts within the

Dr. Parsons is a board-certified pediatrician and fellow of the American Academy of Pediatrics. She has worked as a pediatrician at CPCMG since 2006 and is the lead physician at the Girard office. She has directed and implemented clinician wellness activities at CPCMG since 2013 and was appointed chief wellness and leadership officer in July 2023. She has been a participant in the San Diego County Medical Society Wellness Committee.

Dr. Morris is a board-certified pediatrician and fellow of the American Academy of Pediatrics. He has served as CPCMG’s inaugural chief medical officer for the past four years after a 22-year leadership career in the FQHC environment (North County Health Services/True Care) as a pediatrician, medical director, and champion for clinician wellness initiatives.

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Navigating the Modern Challenges of Sports Medicine Galen of Pergamon (129–216 CE) was a Greek physician who is widely recognized as the first sports medicine surgeon. Although he is best known for being the personal physician to four Roman emperors, his greatest challenge may well have been serving as chief physician to the troop of gladiators in the ancient city of Mysia. The field of sports medicine has come a long way from its humble beginnings, emerging as a specialized field dedicated to enhancing performance, preventing injuries, and ensuring the wellbeing of athletes. In the modern era, advancements in sports science, changing athlete demographics, and an ever-increasing demand for peak performance have created new challenges for the treating physician.

1. TECHNOLOGY INTEGRATION Advancements in technology have revolutionized sports medicine.

Wearable devices such as GPS trackers, heart rate monitors, accelerometers, and eye tracking devices provide real-time data that helps in performance analysis, injury mitigation, and load management. Trendy devices need to be validated with controlled medical evidence (i.e. Q collars). Today’s sports medicine physician needs to understand the relationship between numbers and relevant performance so that this growing amount of data can be used in a constructive way.

2. MENTAL HEALTH SUPPORT Mental health is a critical aspect of athlete wellbeing. Athletes at every level can face stress, anxiety, and depression. The relationship between performance and mental health is well documented but discussing this topic can be difficult for both the patient and physician. Sports medicine professionals now understand the importance of incorporating psychological support into their care plans to address the needs of athletes.

3. ACCESS TO HIGH-QUALITY CARE Access to high-quality sports medicine care is another challenge.

Many amateur and youth athletes do not have the resources or access to top-notch sports medicine professionals, leaving them vulnerable to inadequate care and increased risk of injury. Bridging this gap and making quality care more accessible to all athletes is an ongoing challenge.

4. OVERUSE INJURIES Overuse injuries are becoming increasingly prevalent, particularly in youth sports. The pressure to specialize in a single sport and year-round training can lead to overuse injuries, which may have long-lasting consequences. Sports medicine practitioners must find ways to balance an athlete’s training regimen to reduce the risk of overuse injuries while maintaining performance.

5. FINANCIAL RENUMERATION As today’s athletes push their bodies to unprecedented limits, the financial rewards have never been higher. Economic reward-forperformance is no longer accessible only to professional athletes.

Whether in the form of collegiate scholarships or Name, Image, Likeness (NIL) deals, amateurs can generate enormous sums for their athletic achievements. The pressure to achieve excellence is enormous, and they rely heavily on sports medicine to optimize their performance.

6. AGING ATHLETE POPULATION As the aging athlete population continues to grow, sports medicine professionals must adapt to address the unique needs of older individuals who wish to remain active. As athletes compete at increasingly older ages, their care provider must address the unique challenges that come with aging muscles, tendons, ligaments, and reduced recovery capacity.

7. BIOLOGICS AND REGENERATIVE MEDICINE Although these technologies are in relatively early stages of development, there have been substantial increases in marketing, patient demand, and clinical utilization of biologics, including platelet-rich plasma, bone marrow aspirate concentrate, and other cellderived therapies. Direct-to-consumer marketing of biologics has also proliferated but is largely unregulated, and sports medicine physicians must accurately convey the safety and efficacy profiles of these therapies to patients while simultaneously maintain their understanding of the evolving literature.

CONCLUSION Sports medicine practitioners must continuously adapt to meet the evolving needs of the patient-athlete. By employing technological innovation, collaborating with other specialists, and applying the latest research-driven data, today’s team physician can continue to support each athletes’ goal of high achievement while ensuring their safety and wellbeing.

Synergy Orthopedic Specialists team physicians celebrate the San Diego Legion clinching the Major League Rugby 2023 Western Conference Championship at Snapdragon Stadium in San Diego (L to R: Drs. Tal S. David, Richard Dees, Sean Gao, Andy Grotting) Tal S. David, MD is president of Synergy Orthopedic Specialists and program director of the San Diego Arthroscopy and Sports Medicine Fellowship (ACGME). He is the head team physician for the San Diego Gulls (AHL), San Diego Legion (MLR), and the San Diego Loyal Soccer Club (USL Championship).

For more information or to schedule an appointment with a Synergy Orthopedic Specialists, visit our website www.synergyorthopedic.com or call (858) 412-6080.

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Customized insurance solutions for members The CMA Insurance Program, administered by Lockton Affinity, offers key benefits: Using group purchasing power, CMA members get exclusive, comprehensive coverage at discounted rates.

Unique coverage offerings help safeguard yourself, your loved ones, your business and your livelihood.

Access to newly available Medical Malpractice insurance.

Visit LocktonAffinityCMA.com to schedule a 15-minute call with Lockton Affinity’s dedicated team. Together, we will determine the policies you need to be fully protected.

Info@LocktonAffinityCMA.com | (800) 278-8130

The CMA Insurance Program is administered by Lockton Affinity, LLC d/b/a Lockton Affinity Insurance Brokers LLC in California #0795478. Coverage is subject to actual policy terms and conditions. Policy benefits are the sole responsibility of the issuing insurance company. The California Medical Association will receive a royalty fee for the licensing of its name and trademarks as part of the insurance program offered to the extent permitted by applicable law. Not available in all states.

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CHAMPIONS FOR HEALTH

Abracadabra!

By Adama Dyoniziak

MOST PEOPLE THINK OF MAGIC AS A TRICK …

Abracadabra! Impossible acts put on purely for entertainment. Real magic, though, is not an illusion. Real magic is the feeling when life is transformed from the ordinary to the extraordinary. And not only is it real — it is the very thing that connects us to this world, to one another, to our entire existence.

“The creation of a thousand forests is in one acorn.”

— Ralph Waldo Emerson We each have a purpose — it is magic like a spark within us. Some of us knew it from a young age when we were but an acorn, some of us grew into it when we were adults. Our purpose propels us forward to create a change that leaves a lasting legacy beyond the immediate moment. The satisfaction of fulfilling one’s purpose makes life rewarding and exciting.

Champions for Health works with our dedicated network of physician volunteers, hospitals, surgery centers, nurses, schools, community, private and public partners to improve the health of our community where San Diegans live, work, play, and pray. These individuals have the feeling of believing, of belonging, of getting, of being gotten. The hearts of our volunteers are open and beams of light touch each person with magic. The free services received by participants make a priceless impact! No need to worry about: ER visits; loss of work due to excruciating pain; deciding between paying for food or for a desperately needed medical appointment; being hospitalized due to severe COVID or flu symptoms or complications.

“We make a living by what we get, but we make a life by what we give.”

— Winston Churchill Access to care for all is our mission. Champions for Health is making magic in the world, creating many moments with our compassionate community partners. When I listen to the stories from our physician volunteers and how much working with Project Access patients means to them, I can see that their purpose is being fulfilled: to relieve pain and suffering, to put their multiple medical talents to work, to lift the burden of poverty by removing the barrier to needed consultations and surgery. Our volunteers are making space for the magic to sneak in.

When you support Champions for Health, you contribute

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to the health and wellbeing of thousands of individuals in San Diego. Each of these people shows their gratitude with a smile and a hug because their prayers were answered by helpful angels such as yourself, ready to step up in their time of need.

There are so many ways to help your neighbors … choose the way that works best for you! You can donate once or join our monthly giving program for ongoing support. It’s the end of the year, and stocks and securities can be transferred to Champions for Health. Direct charitable distributions of IRA funds can be contributed up to $100,000. Be on the lookout for Giving Tuesday on Tuesday, Nov. 28 to show your support.

Every day has within it hundreds, even thousands of opportunities to create real magic. But they disappear unless you reach out and grab them. Reach for your magic wand — you too can be a magician and leave this place better than you found it. www.championsforhealth.org/donate.

Adama Dyoniziak is the executive director of Champions for Health.

‘Casino Night Masquerade’ Fundraiser Is a Great Success The annual Champions for Health Casino Night Masquerade fundraiser to benefit Champions’ Project Access San Diego (PASD) and Immunization Programs was a fun time for attendees and a great success. Thank you to Veloce Motors for hosting. Thank you to our other sponsors, and to those who attended and support these important programs to help San Diego County’s medically underserved population.

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PERSONAL AND PROFESSIONAL DEVELOPMENT

What Expectations Will You Let Go Of?

By Helane Fronek, MD, FACP, FASVLM, FAMWA

A PHYSICIAN ATTENDING HER KINDERGARTENER’S

first parent-teacher conference was informed that her child was “behind in her computer skills.” As most caring, highachieving parents, the physician was alarmed. Then, reason prevailed as she realized that children should not be expected to have “computer skills” on entering kindergarten. This former kindergartener is now an academic transplant surgeon.

Clearly, this expectation was arbitrary and unwarranted.

Recently, in a voluntary course examining the impermanence of life and the importance of considering how we want to live until we die, one participant worried that she felt behind on our classwork. The irony was obvious and demonstrated that, even in this deep, spiritual realm, we cannot avoid the pervasive nature of unreasonable expectations.

I shake my head as I recall many expectations I put on myself throughout my life. It felt impossible to say no to anything that was offered or asked of me, and my plate continuously overflowed in an unhealthy way. This was

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compounded by perfectionism, the expectation I share with many physicians that I do everything perfectly. While striving for perfection is important given the consequences of accepting mediocre care or outcomes, perfection is an unachievable goal.

As Danna Faulds wisely comments in her poem Awakening Now, “Perfection is not a prerequisite for anything but pain.”

As we enter the fall season and watch trees shed their leaves, perhaps we can learn this important lesson from nature: good health and the crucial process of renewal require us to let go of things that have come to the end of their lifespan or no longer serve us.

So, take a look at all the things you expect yourself to do. Begin by reviewing your activities and decide which continue to hold meaning for you. Of those that don’t, which will you agree to let go of? That, however, is the more superficial aspect of this process.

What’s more important to consider are the expecta-

tions that underlie many decisions that keep us feeling overwhelmed and not in control of our lives.

Do we expect ourselves to never disappoint anyone?

To perform work as soon as it’s requested, even when we know it can wait until a more convenient time? Are we afraid to set boundaries or say no because we expect ourselves to always be compliant, flexible, and accommodating? Looking at these expectations through the lens of our values can help us find a more compelling and meaningful compass than outdated and destructive expectations that we’ve often unconsciously held on to.

Letting go of expectations we’ve long held can be difficult and painful, as we must redefine ourselves and overcome the fear that our relationships, stature, and confidence may suffer. Yet, through honest exploration of what these expectations compromise in our lives, we find more energy and sense of purpose as we live in ways that reflect what is most important to us.

Dr. Fronek is an assistant clinical professor of medicine at UC San Diego School of Medicine and a Certified Physician Development Coach, CPCC, PCC.

CLASSIFIEDS

PRACTICE ANNOUNCEMENTS PSYCHIATRIST AVAILABLE! Accepting new patients for medication management, crisis visits, ADHD, cognitive testing, and psychotherapy. Out of network physician servicing La Jolla and San Diego. Visit hylermed.com or call 619-707-1554.

VOLUNTEER OPPORTUNITIES PHYSICIANS: HELP US HELP IMPROVE THE HEALTH LITERACY OF OUR SAN DIEGO COUNTY COMMUNITIES by giving a brief presentation (30–45 minutes) to area children, adults, seniors, or employees on a topic that impassions you. Be a part of Champions for Health’s Live Well San Diego Speakers Bureau and help improve the health literacy of those with limited access to care. For further details on how you can get involved, please email Andrew.Gonzalez@ChampionsFH.org.

CHAMPIONS FOR HEALTH - PROJECT ACCESS SAN DIEGO: Volunteer physicians are needed in the following specialties: endocrinology, rheumatology, vascular surgery, ENT or head and neck, general surgery, GI, and gynecology. These specialists are needed in all regions of San Diego County to provide short term pro bono specialty care to adults ages 26-49 who are uninsured and not eligible for Medi-Cal. Volunteering is customized to fit your regular schedule in your office. Champions for Health is the foundation of the San Diego County Medical Society. Join hundreds of colleagues in this endeavor: Contact Evelyn. penaloza@championsfh.org or at 858-300-2779.

PHYSICIAN OPPORTUNITIES PART-TIME CARDIOLOGIST POSITION AVAILABLE: Cardiology office in San Marcos seeking part-time cardiologist. Please send resume to Dr. Keith Brady at uabresearchdoc@ yahoo.com.

INTERNAL MEDICINE PHYSICIAN: Federally Qualified Health Center located in San Diego County has an opening for an Internal Medicine Physician. This position reports to the chief medical officer and provides the full scope of primary care services, including diagnosis, treatment, and coordination of care to its patients. The candidate should be board eligible and working toward certification in Internal Medicine. Competitive base salary, CME education, four weeks paid vacation, year one, 401K plan, no evenings and weekends. Monday through Friday, 8:00 am to 5:00 p.m. For more information or to apply, please contact Dr. Keith Brady at: uabresearchdoc@yahoo.com.

FAMILY MEDICINE/INTERNAL MEDICINE PHYSICIAN: San Diego Family Care is seeking a Family Medicine/Internal Medicine Physician (MD/DO) at its Linda Vista location to provide outpatient care for acute and chronic conditions to a diverse adult population. San Diego Family Care is a federally qualified, culturally competent and affordable health center in San Diego, CA. Job duties include providing complete, high quality primary care and participation in supporting quality assurance programs. Benefits include flexible schedules, no call requirements, a robust benefits package, and competitive salary. If interested, please email CV to sdfcinfo@sdfamilycare.org or call us at (858) 810-8700.

MEDICAL CONSULTANT (MD/DO): The County of San Diego is currently accepting applications from qualified candidates for Medical Consultant-Public Health Services. Vacancies are in the Public Health Services, Epidemiology and Immunization Services Branch (EISB) and Tuberculosis (TB) Control and Refugee Health Branch. Salary: $183,747.20–$204,900.80 annually. An additional 10% for Board Certified Specialty and 15% for relevant sub-specialty.

For job posting information visit https://www.governmentjobs.com/careers/sdcounty?key words=23416202PHS. MEDICAL DIRECTOR, FULL-TIME: FATHER JOE’S VILLAGES: Join us in ending homelessness! We are a dynamic team that runs an FQHC. The Medical Director oversees clinical aspects of the primary care, psychiatry, dental and behavioral health. This position will be a mix of clinic and admin time and will have direct reports (Dental Director, Director of Behavioral Health, and frontline primary care/psychiatry providers). Reports to the Chief Medical Officer, who is responsible for all aspects of the clinic. The Medical Director is a counterpart to the Clinic Director (who oversees admin staff, MA/RN team, billing, PSRs, etc.). See FJV Jobs to apply.

SEEKING MEDICAL DIRECTOR: subcontracted position: 4-8 hours per month Responsibilities: 1. Support case conferences, refractory SUD, co‐occurring conditions, specialty populations. 2. Conduct clinical trainings on issues relevant to staff (e.g., documentation, ASAM Criteria, DSM‐5, MAT, WM, co‐occurring conditions) 3. Provide oversight and clinical supervision. 4. Refer co‐occurring conditions. 5. Lead Quality Improvement functions (e.g., Quality Improvement Projects, clinical team meetings, etc.). 6.

Attend annually 5 hours of continuing medical education on addiction medicine. Required by contract with San Diego County BHS, position is for a Physician licensed by CA Medical Board or CA Osteopathic Medical Board Contact Name: Jennifer Ratoff: e-mail: jratoff@secondchanceprogram.org, phone: 619839-0950 PSYCHIATRIST SPECIALIST: The County of San Diego is currently accepting applications from qualified candidates. Annual Salary: $258,294.40. Note: An additional 10% is paid for Board Certification, or 15% for Board Certification that includes a subspecialty. Why choose the County? 1. Fully paid malpractice insurance; 2. 13 paid holidays; 3. 13 sick days per year; 4. Vacation: 10 days (1-4 years of service); 15 days (5-14 years of service; 20 days (15+ years); 5. Defined benefit retirement program; 6. Cafeteria-style health plan with flexible spending; 7. Wellness incentives. Psychiatrist-Specialists perform professional psychiatric work involving the examination, diagnosis, and treatment of specialty forensics, children/ adolescents and or geriatric patients. This is the specialty journey level class in the series that requires a fellowship or experience in child and adolescent psychiatry or forensic psychiatry. For more information visit our website at sandiegocounty.gov/hr or select this link to go directly to the Psychiatrist Specialist application.

PRIMARY CARE PHYSICIAN: Imperial Valley Family Care Medical Group is looking for Board Certified/Board Eligible Primary Care Physician for their clinics in Brawley & El Centro CA. Salaried/full time position. Please fax CV/salary requirements to Human Resources (760) 355-7731. For details about this and other jobs please go to www.ivfcmg.com.

ASSISTANT, ASSOCIATE OR FULL PROFESSOR (HS CLIN, CLIN X, ADJUNCT, IN_RESIDENCE) MED-GASTROENTEROLOGY: Faculty Position in Gastroenterology.

The Department of Medicine at University of California, San Diego, Department of Medicine (http://med.ucsd.edu/) is committed to academic excellence and diversity within the faculty, staff, and student body and is actively recruiting faculty with an interest in academia in the Division of Gastroenterology. Clinical and teaching responsibilities will include general gastroenterology. The appropriate series and appointment at the Assistant, Associate or Full Professor level will be based on the candidate’s qualifications and experience. Salary is commensurate with qualifications and based on the University of California pay scales.

In-Residence appointments may require candidates to be self-funded. For more information: https://apol-recruit.ucsd.edu/JPF03179 For help contact: klsantos@health.ucsd.edu DERMATOLOGIST NEEDED: Premier dermatology practice in La Jolla seeking a part-time BC or BE dermatologist to join our team. Busy practice with significant opportunity for a motivated, entrepreneurial physician. Work with three energetic dermatologists and a highly trained staff in a positive work environment. We care about our patients and treat our staff like family. Opportunity to do medical/surgical and cosmetic dermatology in an updated medical office with state-of-the art tools and instruments. Incentive plan will be a percentage based on production. If you are interested in finding out more information, please forward your C.V. to jmaas12@hotmail.com.

INTERNAL MEDICINE PHYSICIAN: Healthcare Medical Group of La Mesa located at 7339 El Cajon Blvd. is looking for a caring, compassionate, and competent physician for providing primary care services. We require well-organized and detail-oriented applicants with excellent written and oral communication skills, and excellent interpersonal skills to provide high-quality care to our patients. We provide a competitive salary, paid time off, health insurance, 401K benefits, etc. We provide plenty of opportunities to refine your clinical competency. Our CEO, Dr. Venu Prabaker, has 30 years of teaching experience as a faculty at multiple universities including Stanford, UCSD, USC, Midwestern, Western, Samuel Merritt, Mayo, etc., and will be providing teaching rounds once a week. You will also get plenty of opportunities to attend other clinical lectures at many of the 4- to 5-star restaurants in San Diego. We also have a weekly one-hour meeting for all the staff for team building and to

create a “family atmosphere” to improve productivity and thereby create a win-win situation for all. Visit us at caremd.us.

RADY CHILDREN’S HOSPITAL PEDIATRICIAN POSITIONS: Rady Children’s Hospital of San Diego is seeking board-certified/eligible pediatricians or family practice physicians to join the Division of Emergency Medicine in the Department of Urgent Care (UC). Candidate will work at any of our six UC sites in San Diego and Riverside Counties. The position can be any amount of FTE (full-time equivalent) equal to or above 0.51 FTE. Must have an MD/DO or equivalent and must be board certified/eligible, have a California medical license or equivalent, PALS certification, and have a current DEA license. Contact Dr. Langley glangley@ rchsd.org and Dr. Mishra smishra@rchsd.org.

PER DIEM OBGYN LABORIST POSITION AVAILABLE: IGO Medical Group is seeking a per diem laborist to cover Labor and Delivery and emergency calls at Scripps Memorial Hospital in La Jolla. 70 deliveries/month. 24-hour shifts preferred but negotiable. Please send inquiries by email to IGO@IGOMED.com.

MEDICAL CONSULTANT, SAN DIEGO COUNTY: The County of San Diego, Health and Human Services Agency’s Public Health Services is looking for a Board Certified Family Practice or Internal Medicine physician for the Epidemiology and Communicable Disease Division. Under general direction, incumbents perform a variety of duties necessary for the identification, diagnosis, and control of communicable diseases within the population. This position works closely with the medical and laboratory community, institutional settings, or hospital control practitioners. Learn more here: https://www.governmentjobs.com/careers/ sdcounty?keywords=21416207 KAISER PERMANENTE SAN DIEGO - PER DIEM PHYSIATRIST: Southern California Permanente Medical Group is an organization with strong values, which provides our physicians with the resources and support systems to ensure they can focus on practicing medicine, connecting with one another, and providing the best possible care to their patients.

For consideration or to apply, visit https://scpmgphysiciancareers.com/specialty/physicalmedicine-rehabilitation. For questions or additional information, please contact Michelle Johnson at 866-503-1860 or Michelle.S1.Johnson@kp.org. We are an AAP/EEO employer.

PRIMARY CARE PHYSICIAN POSITION: San Diego Family Care is seeking a Primary Care Physician (MD/DO) at its Linda Vista location to provide direct outpatient care for acute and chronic conditions to a diverse adult population. San Diego Family Care is a federally qualified, culturally competent and affordable health center in San Diego, CA. Job duties include providing complete, high quality primary care, and participation in supporting quality assurance programs. Benefits include flexible schedules, no call requirements, a robust benefits package, and competitive salary. If interested, please email CV to sdfcinfo@ sdfamilycare.org or call us at (858) 810- 8700.

FAMILY MEDICINE OR INTERNAL MEDICINE PHYSICIAN: TrueCare is more than just a place to work; it feels like home. Sound like a fit? We’d love to hear from you! Visit our website at www.truecare.org. Under the direction of the Chief Medical Officer and the Lead Physician, ensure the provision of effective quality medical service to the patients of the Health center. The physician is responsible for assuring clinical procedures are continually and systematically followed, patient flow is enhanced, and customer service is extended to all patients at all times.

PUBLIC HEALTH LABORATORY DIRECTOR: The County of San Diego is seeking a dynamic leader with a passion for building healthy communities. This is a unique opportunity for a qualified individual to work for a Level 3 Public Health Laboratory. The Public Health Services department, part of the County’s Health and Human Services Agency, is a local health department nationally accredited by the Public Health Accreditation Board and first of the urban health departments to be accredited. Public Health Laboratory Director21226701UPH NEIGHBORHOOD HEALTHCARE MD, FAMILY PRACTICE AND INTERNISTS/HOSPITALISTS: Physicians wanted, beautiful Riverside County and San Diego County. High Quality Family Practice for a private-nonprofit outpatient clinic serving the communities of Riverside County and San Diego County. Work full time schedule and receive paid family medical benefits. Malpractice coverage provided. Be part of a dynamic team voted “San Diego Top Docs” by their peers. Please click the link to be directed to our website to learn more about our organization and view our careers page at www.Nhcare.org.

PHYSICIAN WANTED: Samahan Health Centers is seeking a physician for their federally qualified community health centers that emerged over forty years ago. The agency serves low-income families and individuals in the County of San Diego in two (2) strategic areas with a high-density population of Filipinos/Asians and other low-income, uninsured individuals — National City (Southern San Diego County) and Mira Mesa (North Central San Diego).

The physician will report to the Medical Director and provide the full scope of primary care services, including but not limited to diagnosis, treatment, coordination of care, preventive care and health maintenance to patients. For more information and to apply, please contact Clara Rubio at (844) 200-2426 EXT 1046 or at crubio@samahanhealth.org.

PHYSICIAN POSITIONS WANTED PART-TIME CARDIOLOGIST: Dr. Durgadas Narla, MD, FACC is a noninvasive cardiologist looking to work 1-2 days/week or cover an office during vacation coverage in the metro San Diego area. He retired from private practice in Michigan in 2016 and has worked in a San Marcos cardiologist office for the last 5 years, through March 2023. Board certified in cardiology and internal medicine. Active CA license with DEA, ACLS, and BCLS certification.

If interested, please call (586) 206-0988 or email dasnarla@gmail.com.

PSYCHIATRIST AVAILABLE! Accepting new patients for medication management, crisis visits, ADHD, cognitive testing, and psychotherapy. Out of network physician servicing La Jolla & San Diego. Visit hylermed.com or call 619-707-1554.

PRACTICE FOR SALE GASTROENTEROLOGY GI PRACTICE FOR SALE: Looking to expand or move?

Established 25+ years Gastroenterology GI office practice for sale in beautiful San Diego County, California. 500 active strong patient relationships and referral streams. Consistent total gross income of $600,000 for the past couple years; even through pandemic. Located in a professional-medical building with professional contract Staff. All records and billing managed by a professional service who can assist with insurance integration. Office, staff & equipment are move-in ready. Seller will assist Buyer to ensure a smooth transition. Being On-Call optional. Contact Ferdinand @ (858) 752-1492 or ferdinand@zybex.com OTOLARYNGOLOGY HEAD & NECK SURGERY SOLO PRACTICE FOR SALE: Otolaryngology Head & Neck Surgery solo practice located in the Ximed building on the Scripps Memorial Hospital La Jolla campus is for sale. The office is approximately 3,000 SF with 1 or 2 Physician Offices. It has four fully equipped exam rooms, an audio room, one procedure room, one conference room, one office manager room as well as in-house billing section, staff room and a bathroom. There is ample parking for staff and patients with close access to radiology and laboratory facilities. For further information please contact Christine Van Such at 858-354-1895 or email: mahdavim3@gmail.com.

OFFICE SPACE / REAL ESTATE AVAILABLE POWAY MEDICAL OFFICE SPACE FOR LEASE 2/1/2024: Fully built out, turnkey 1,257 sq ft ADA-compliant suite for lease. Great location in Pomerado Medical/Dental Building, next to Palomar Med Center Poway campus. Building restricted to medical/allied health/dental practices, currently houses ~26 suites. Ideal for small health practice as primary or satellite location. Lease includes front lobby, reception area, restrooms, large treatment area, private treatment/exam rooms. Located on second floor, elevator/stair access. Bright, natural lighting; unobstructed views of foothills. On-site parking; nearby bus service. Flexible lease terms available from 3-5 years at fair market rate. Contact Debbie Summers at debjsummers3@ gmail.com (858) 382-8127.

KEARNY MESA OFFICE TO SUBLEASE/SHARE: 5643 Copley Dr., Suite 300, San Diego, CA 92111. Perfectly centrally situated within San Diego County. Equidistant to flagship hospitals of Sharp and Scripps healthcare systems. Ample free parking. Newly constructed Class A+ medical office space/medical use building. 12 exam rooms per half day available for use at fair market value rates. Basic communal medical supplies available for use (including splint/ cast materials). Injectable medications and durable medical equipment (DME) and all staff

to be supplied by individual physicians’ practices. 1 large exam room doubles as a minor procedure room. Ample waiting room area. In office X-ray with additional waiting area outside of the X-ray room. Orthopedic surgery centric office space. Includes access to a kitchenette/ indoor break room, exterior break room and private physician workspace. Open to other MSK physician specialties and subspecialties. Building occupancy includes specialty physicians, physical therapy/occupational therapy (2nd floor), urgent care, and 5 OR ambulatory surgery center (1st floor). For inquiries contact kdowning79@gmail.com and mgamboa@ortho1.com for more information. Available for occupancy projected as February 2024.

LA JOLLA/UTC OFFICE TO SUBLEASE OR SHARE: Modern upscale office near Scripps Memorial, UCSD hospital, and the UTC mall. One large exam/procedure room and one regular-sized exam room. Large physician office for consults as well. Ample waiting room area. Can accommodate any specialty or Internal Medicine. Multiple days per week and full use of the office is available. If interested please email drphilipw@gmail.com ENCINITAS MEDICAL SPACE AVAILABLE: Newly updated office space located in a medical office building. Two large exam rooms are available M-F and suitable for all types of practice, including subspecialties needing equipment space. Building consists of primary and specialist physicians, great for networking and referrals. Includes access to the break room, bathroom and reception. Large parking lot with free parking for patients. Possibility to share receptionist or bring your own. Please contact coastdocgroup@gmail.com for more information.

NORTH COUNTY MEDICAL SPACE AVAILABLE: 2023 W. Vista Way, Suite C, Vista CA 92082. Newly renovated, large office space located in an upscale medical office with ample free parking. Furnishings, decor, and atmosphere are upscale and inviting. It is a great place to build your practice, network and clientele. Just a few blocks from Tri-City Medical Center and across from the urgent care. Includes: multiple exam rooms, access to a kitchenette/ break room, two bathrooms, and spacious reception area all located on the property. Wi-Fi is not included. For inquiries contact hosalkarofficeassist@gmail.com or call/text (858) 740-1928.

PHYSICIAN OFFICE SPACE FOR LEASE: 1500 Sq ft. 3 exam room. Large private office.

Large reception area and patient prep room. New upgraded flooring. Private entrance.

Located in Rancho Bernardo in prime central location. Easy access to interstate 15. Palomar/ Pomerado within 10 min. Security card access during off hours. $2,500/month.

Contact: (619) 585-0476. Ask for Peg. HILLCREST OFFICE TO SUBLEASE OR SHARE: Gorgeous office located across from Scripps Mercy hospital. Office is approximately 2,000 sq. ft. with procedure/effusion room.

Office is fully staffed and looking to add a new provider. We currently have Rheumatology/ Pulmonary/Allergy specialists but can accommodate any specialty or Internal Medicine.

Multiple days per week and full use of office is available. If interested please reach out to Melissa Coronado at Melissa@sdpulmonary.com or call (619) 819-7224.

SUBLEASE AVAILABLE: Sublease available in Del Mar off 5 freeway. Share rent. 2,100 sq ft office in professional building. Utilities included. Great opportunity in a very desirable area. 858-342-3104.

CHULA VISTA MEDICAL OFFICE: Ready with 8 patient rooms, 2000sf, excellent parking ratios, Lease $4,000/mo. No need to spend a penny. Call Dr. Vin, 619-405-6307 vsnnk@ yahoo.com OFFICE SPACE AVAILABLE IN BANKERS HILL: Approximately 500sq feet suite available to lease, includes private bathroom. Located at beautiful Bankers Hill. For more details, please call Claudia at 619-501-4758.

OFFICE AVAILABLE IN MISSION HILLS, UPTOWN SAN DIEGO: Close to Scripps Mercy and UCSD Hillcrest. Comfortable Arts and Crafts style home in upscale Mission Hills neighborhood. Converted and in use as medical / surgical office. Good for 1-2 practitioners with large waiting and reception area. 3 examination rooms, 2 physician offices and a small kitchen area. 1700 sq. ft. Available for full occupancy in March 2022. Contact by Dr. Balourdas at greg@thehanddoctor.com.

OFFICE SPACE IN EL CENTRO, CA TO SHARE: Office in El Centro in excellent location, close to El Centro Regional Medical Centre Hospital is seeking doctors of any specialty to share the office space. The office is fully furnished. It consists of 8 exam rooms, nurse station, doctor office, conference room, kitchenette and beautiful reception. If you are interested or need more information please contact Katia at 760-427-3328 or email at Feminacareo@ gmail.com.

OFFICE SPACE/REAL ESTATE WANTED MEDICAL OFFICE SPACE WANTED IN HILLCREST/BANKERS HILL AREA. Mercy Physicians Medical Group (MPMG) specialist is looking for office space near Scripps Mercy Hospital. Open to lease or share office space, full time needed. Please respond to rjvallonedpm@sbcglobal.net or 858-945-0903.

MEDICAL EQUIPMENT / FURNITURE FOR SALE UROLOGY OFFICE EQUIPMENT AVAILABLE: Six fully furnished exam rooms including tables (2 bench, 3 power chair/table, 1 knee stirrup), rolling stools, lights, step stools, patient chairs. Waiting room chairs, tables, magazine rack. Specialty items — Shimadzu ultrasound, SciCan sterilizer, Dyonics camera with Sharp monitor, Medtronic Duet urodynamics with TDOC catheters, Bard prostate biopsy gun with needles, Cooper Surgical urodynamics, Elmed ESU cautery, AO 4 lens microscope. RICOH MP-3054 printer with low print count. For more information contact: r.pua@cox.net.

NON-PHYSICIAN POSITIONS AVAILABLE RESEARCH SCIENTISTS: (non-tenured, Assistant, Associate or Full level): The University of California, San Diego campus multidisciplinary Organized Research Units (ORUs) https:// research.ucsd.edu/ORU/index.html are conducting an open search. Research Scientists are extramurally funded, academic researchers who develop and lead independent creative research programs similar to Ladder Rank Professors.

They are expected to serve as Principal Investigators on extramural grants, generate high caliber publications and research products, engage in university and public service, continuously demonstrate independent, high quality, significant research activity and scholarly reputation. Appointments and duration vary depending on the length of the research project and availability of funding. https://apol-recruit.ucsd.edu/JPF03713/apply PROJECT SCIENTISTS: Project Scientists (non-tenured, Assistant, Associate or Full level): The University of California, San Diego, Office of Research Affairs https://research.ucsd. edu/, in support of the campus multidisciplinary Organized Research Units (ORUs) https:// research.ucsd.edu/ORU/index.html is conducting an open search. Project Scientists are academic researchers who are expected to make significant and creative contributions to a research team, are not required to carry out independent research but will publish and carry out research or creative programs with supervision. Appointments and duration vary depending on the length of the research project and availability of funding. https://apolrecruit.ucsd.edu/JPF03262/apply OFFICE MANAGER: 1. Hiring, Training, Managing staff on procedures/policies. Monitors continuing compliance and office statistics. Oversee stocking/maintenance of supplies, retail. Equipment/ facilities management. Daily bookkeeping, collections. 2. Ensure smooth/ efficient patient flow with increasing production/collections. 3. Create a friendly environment where patients’ expectations are exceeded, where staff can work together as a team. 4.

Ensure staff working at maximum productivity/efficiency. Salary: $60-70K depending on experience/qualifications. Benefits: health care reimbursement, PTO, retirement, employee discount, bonuses, commission. Contact: info@manageyourage.com ASSISTANT PUBLIC HEALTH LAB DIRECTOR: The County of San Diego is currently accepting applications for Assistant Public Health Lab Director. The future incumbent for Assistant Public Health Lab Director will assist in managing public health laboratory personnel who perform laboratory activities for the purpose of identifying, controlling, and preventing disease in the community, as well as assist with the development and implementation of policy and procedures relating to the control and prevention of disease and other health threats.

Please visit the County of San Diego website for more information and to apply online.

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“As a practicing physician, volunteering for Champions for Health is perfect.”

“The process is simple. You receive medical information in advance to optimize the patient and physician time during consultations. You get to provide state-of-the-art care in top-notch hospitals. I still receive thank you cards from Champions for Health patients I had years ago. It is so rewarding to transform people’s lives.”

— Dr Hernan Goldsztein, Otolaryngologist-Head and Neck Surgeon.

It’s easier than you think to volunteer in your community.

Join us at championsforhealth.org/volunteer/ Join our community of volunteers and provide pro bono specialty medical services in your office through the Champions for Health Project Access San Diego program. We make it easy for you and your office team to provide much-needed medical care to uninsured, low-income adults in our community.