Q4 | Los Angeles Medicine Magazine

OFFICIAL PUBLICATION OF THE LOS ANGELES COUNTY MEDICAL ASSOCIATION

YEARS OF SUPPORTING PHYSICIANS IN LOS ANGELES COUNTY QUARTER 4 2021

FREE PRACTICE RESOURCES FOR ALL CALIFORNIA PHYSICIANS The Cooperative of American Physicians (CAP) understands that a successful practice requires more than just solid protection from medical malpractice lawsuits.

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PUBLISHER Gustavo Friederichsen | gustavo@lacmanet.org EDITOR Sheri Carr | sheri@researchgroupllc.com HEADQUARTERS LOS ANGELES COUNTY MEDICAL ASSOCIATION 801 S. Grand Ave, Suite 425, Los Angeles, CA 90017 Tel 213.683.9900 | Fax 213.226.0350 www.ladocs.org

QUARTER 4 2021

LACMA OFFICERS PRESIDENT | Jeffery Lee, MD PRESIDENT-ELECT | Omer Deen, MD TREASURER | Jerry Abraham, MD SECRETARY | Po-Yin Samuel Huang, MD IMMEDIATE PAST-PRESIDENT | Diana Shiba, MD

2 4

PRESIDENT’S LETTER | Jeffery Lee, MD

LACMA BOARD OF DIRECTORS COUNCILORS-AT-LARGE Richard Seidman, MD | 1 Stacey Ludwig, MD | 1 Karen Sibert, MD | 5 Valencia Walker, MD | 5 Samuel Fink, MD | 6

TRUSTEES & CHAIR DELEGATION Jerry Abraham, MD | CMA Trustee Valencia Walker, MD | Chair of the LACMA Delegation Sion Roy, MD | CMA Trustee Resa Caivano, MD | CMA Trustee

A MESSAGE FROM LACMA CEO Gustavo Friederichsen

STRONGER TOGETHER Celebrating LACMA’s 150th Anniversary

6

COUNCILORS Robert Bitonte, MD, JD | D1 Michael Cao, MD | D2 Stephanie Booth, MD | D3 Heather Silverman, MD | D5 Marc Mendes, MD | D6 Kambiz Kosari, MD | D7 Steven Sawelson, MD | D9 Sharon Jakus-Waldman, MD | D10 Diego Caivano, MD | D14 Nancy Ellerbroek, MD | D17 Lisa Firestone, MD | SCPMG Roxana Yoonessi, MD, JD | SCPMG Troy Elander, MD | SSGPF Muntu Davis, MD | LA County Cristian Rico, MD | AltaMed Atul Nakhasi, MD | 1, YP Councilor Hector Flores, MD | 1, EPC Chair Cecilia Leggett, MD | Resident Councilor Anna Yap, MD | Alt. Resident Councilor Aileen Arevalo | Student Councilor, UCLA

LACMA’s Board of Directors consists of a group of dedicated physicians working hard to uphold your rights and the rights of your patients. They always welcome hearing your comments and concerns. You can contact them by emailing or calling Lisa Le, VP of Operations and Strategic Initiatives, at lisa@lacmanet.org or 213-226-0304.

SUBSCRIPTIONS Members of the Los Angeles County Medical Association: Los Angeles Medicine is a benefit of your membership. Additional copies and back issues: $3 each. Nonmember subscriptions: $39 per year. Single copies: $5. To order or renew a subscription, make your check payable to Los Angeles Medicine, 10755 Scripps Poway Parkway, Suite 615 | San Diego, CA 92131. To inform us of a delivery problem, email editors@physiciansnewsnetwork.com.

Acceptance of advertising in Los Angeles Medicine in no way constitutes approval or endorsement by LACMA Services Inc. The Los Angeles County Medical Association reserves the right to reject any advertising. Opinions expressed by authors are their own and not necessarily those of Los Angeles Medicine, LACMA Services Inc. or the Los Angeles County Medical Association. Los Angeles Medicine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. Los Angeles Medicine is not responsible for unsolicited manuscripts.

LACMA Celebrates with November Member Appreciation Event

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LACMA Unveils Book Commemorating its Storied History & Hopes for the Future

Los Angeles Medicine (ISSN 1533-9254) is published quarterly by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 801 S. Grand Ave, Suite 425, Los Angeles, CA 90017. Periodicals Postage Paid at Los Angeles, California, and at additional mailing offices. Copyright ©2021 by LACMA Services Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. POSTMASTER: Send address changes to Los Angeles Medicine, 801 S. Grand Ave, Suite 425, Los Angeles, CA 90017. Advertising rates and information sent upon request.

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LACMA PRESIDENT

JEFFERY LEE, MD

This year we celebrate the 150th anniversary of the establishment of the Los Angeles County Medical Association in 1871. Our sequicentennial year was one for the history books!

In the early months of 2021, our country and our county continue to be ravaged by the coronavirus pandemic. Los Angeles suffered through the winter as hospitals and ICUs reached capacity, but due to the Herculean efforts of doctors and nurses, we were able to survive the winter, but not without the cost of a great many lives.

LACMA made history as Dr. Diana Shiba, LACMA’s first Asian American female President, continued to push forward with public health initiatives, coordinating with Dr. Muntu Davis, the Health Officer of the LA County Department of Public Health. LACMA continued to promote and provide millions of dollars in PPE to practices across the county.

Thankfully, the dark days of winter were pierced through with light by the arrival of the vaccines in late 2020. LACMA was proud to coordinate with local officials at mass vaccination sites such as Dodger Stadium, Magic Mountain, and Cal State Northridge.

Not only were our doctors volunteering to give vaccinations, but LACMA doctors were also on the frontline of promoting vaccines, especially in disadvantaged communities of color. Our very own Treasurer, Dr. Jerry Abraham, made us proud as he donned a LACMA baseball cap in front of the US Senate to talk about the dire need to get vaccines out and burned the midnight oil getting shots in the arms of local residents.

For a brief moment in the summer, it looked like we had beaten Covid. But the Delta variant arrived and brought with it a significant setback. Indoor masking returned, as did the cases and hospitalizations. LACMA

stepped up its visibility on the need for vaccinations as we co-sponsored billboards with the Patient Care Foundation and LA DPH. These billboards displayed the daily numbers of coronavirus cases, hospitalizations, and deaths to show the imperative of vaccinations.

With additional vaccinations in adults, authorizations for 12 to 16-years-olds, and most recently 5 to 12-year-olds, and the approval of booster shots, we are hopeful that we can reduce and control transmission to a low level in 2022.

Our Health Equity Council continued its meaningful work to address health disparities in communities of color this year. The Race Against Time series included impactful presentations by Dr. Tung Nguyen on “Asian American Health Disparities” and Nicolla Ross of the American Heart Association addressing the “Relentless Pursuit of Equitable Health.” We also hosted a web event with U.S. Rep. Judy Chu and Sonya Harris addressing “AAPI Xenophobia and Equitable Vaccine Distribution.” Dr. Michael Ong was installed as a new tri-chair for the HEC, who replaced Dr. Shiba. In turn, Dr. Shiba established the Public Health Council to promote the physical, social, and mental health of the people of Los Angeles County through advocacy, policy development, and partnership with public health and community-based organizations.

We were grateful to host our Membership Appreciation Event, celebrating 150 years of LACMA. The outdoor gardens at the Huntington Library served as a beautiful

“...I see LACMA striving even higher in 2022 to meet the needs of the physicians in all modes of practices, in all stages of experience...”

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locale for our first in-person event in over a year and a half. Fully vaccinated members who attended were buzzing with excitement, eager to connect once again.

One of the event’s highlights was the guided tours by medical historian Dr. Joel Klein, who curates LACMA’s rare books and printed materials collection. Some of the earliest printed books of anatomy and medicine were on display, helping physicians to see how far we have come in the practice of medicine – books preceding the discovery of blood circulation to currently relevant books on smallpox vaccination. Dr. J. Mario Molina is deserving of special thanks for endowing the curator role for the collection.

The event also included the unveiling of “Stronger Together,” our book commemorating LACMA’s 150th year supporting physicians. The book is filled with wonderful photos, eye-opening history, as well as great stories from LACMA leaders past and present. If you would like your own copy, please reach out to LACMA staff.

The event also highlighted the importance of physician wellness. In the interest of promoting physician wellness, Dr. Kanagaratnam Sivalingam of First Valley Medical Group in the Antelope Valley won a weekend wellness retreat at the Westlake Village Four Seasons. We also announced our partnership with the Dr. Lorna Breen Heroes’ Foundation.

They do extraordinary and impactful work to eliminate the stigma associated with physician mental illness, stress, and depression.

And our work in helping physician practices does not

end there.

As part of our physician wellness initiatives, LACMA has established the Medical Practice Makeover Initiative, committing up to $150,000 to physician practices for grants, practice management consulting, and other resources. Physicians in need can apply for $5000 grants for to use for things such as building a website, IT upgrades, or new staff. Additionally, physicians will have access to a practice management consultant with expertise in helping physicians with workflow, revenue cycle, patient experience, and many other areas. If you are a physician that has found it increasingly difficult to manage your practice efficiently, these resources will help you stay competitive.

As we look to 2022, we know that other issues also loom on the horizon. A November ballot proposition to eliminate MICRA stands as a threat to the practice of medicine. This proposition has the potential to eliminate all caps for non-economic damages, remove limits on attorneys’ fees, and will make personal assets vulnerable to seizure. Defeating this will require a more substantial effort than defeating Prop 46 did in 2014. We will need your help to do that!

To say 2021 was challenging would be an understatement. But I see LACMA striving even higher in 2022 to meet the needs of the physicians in all modes of practices, in all stages of experience, in all parts of this great county. United, we can help each other thrive and raise the profession of medicine!

LACMA CEO

G U S TAV O F R I E D E R I C H S E N

Can One Be Optimistic About the Past?

Research shows that feeling nostalgic about the past will increase optimism about the future. The research examined the idea that nostalgia is not simply a past-orientated emotion, but its scope extends into the future, with a positive outlook. For this reason, I am grateful for the past year, though it was turbulent in the wake of the firestorm in many ways.

In December of 2020, Los Angeles County topped 274 COVID 19 deaths in 24 hours. Today, the death rate is ten. Progress? Yes. Yet, the virus, as we know all too well, is predictably unpredictable. Our physicians have remained on the front lines of care, science, treatment, and accurate information. As relentless the virus and subsequent strains have been, so too is the commitment of doctors to comfort, heal and inform.

Which brings me back to the year that was. LACMA witnessed growth with several Federally Qualified Health Centers, all caring for the most vulnerable to the public health crisis, joining us. First with AltaMed Health Services in late 2019, followed by Clinica Oscar Romero, South Central Family Health Center, Unicare Community Health Center, Angeles Community Health, and St. John’s Well Child and Family Health Center. From a financial perspective, LACMA finished the year in the black, which is a significant achievement with a still-fragile economy. Equally exciting was the commitment to defending MICRA. The LACMA board of directors approved a $300,000 match strategy to motivate local medical staff to contribute to the single most important fight in half a decade. And, to help small medical practices succeed, LACMA launched the unique Medical Practice Makeover Initiative in the form of $5,000 grants and free practice assessments. The grants will be delivered courtesy of the Hyundai Motor Company’s donation of a 2022 Hyundai Palisade.

We continued to expand our portfolio of resources, services, and solutions for our members, adding tech companies that deliver solutions to credentialing, billing, and telehealth challenges. We partnered with the Dr. Lorna Breen Heroes’ Foundation to complement the LACMA MD/DO Lifeline Initiative in support of physician wellness and yes, we celebrated our 150th earlier in November to honor you, our members, along with our member partners and innovators like Dr. J. Mario Molina who endowed the curator role to manage the incredible LACMA Collection at the Huntington Library and Botanical Gardens.

We captured our rich history, the pandemic of 2020 coupled with recent social unrest, and the vision of a bright future in the commemorative book, which is available for all members.

“Stronger Together” is the title of the book but also typifies the consummate professionals who Connecting Los Angeles County work hard every day on behalf With Population Health Insights of our members like Lisa Le, who celebrated her 13th year with LACMA, Noemi Corona, and our Aggregate and synthesize Cohorts consultants: Sheri Carr, Brooke Nicholas, Angelica Donaghy, Identify and Intervene With Henry Rogers, Stephanie High-risk Patients Valencia, Mandy Puliz and the production team of Gabe Zuniga Connect to L.A. County Department and Dennis Chung. Thank you, of Health Services (DHS) TEAM LACMA! Integrate Social Determinants While I’m nostalgic about the of Health (SDoH) Data progress, impacts, and moments of the past year, I’m grateful and optimistic for 2022 and beyond ©2021 Los Angels Network for Ennhanced Services. All rights reserved. to serve you, our members.

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You Take Care of Patients.

We Take Care of You. TO ACCESS AND LEARN MORE VISIT LACMAinteractive.com/MDLifeline

YEARS OF SUPPORTING PHYSICIANS IN LOS ANGELES COUNTY On Saturday, November 6, the Los Angeles County Medical Association celebrated its 150 year history with a Member Appreciation event at the Huntington Library. Art Museum and Botanical Gardens.

More than 200 COVID-vaccinated members, guests and friends gathered together for the first time in nearly two years to commemorate the momentous milestone.

Adding to the excitement of the event was the reveal of Stronger Together, LACMA’s 150th commemorative book, with attendees receiving a special advance copy as they entered the venue.

LACMA staff greeted guests and provided swag bags and give-aways, with one lucky book recipient going home with a complimentary Four Seasons Westlake Village resort package valued at $5,000!

Attendees were also treated to food and drinks, as well as toursof the Ahmanson Reading Room featuring LACMA’s Collection of over 5,000 medical journals, books and artifacts guided by the collection’s curator, Dr. Joel Klein. .

Remarks were brief, with former LACMA president Dr. Diana Shiba welcoming guests and thanking 6 LOS A N G EL ES M ED I CI N E | Q UA RT ER 4 2021

sponsors.

Dr. Jeffery Lee then took to the podium to recognize LACMA partner organizations, the Patient Care Foundation and LACMA Alliance, and past presidents in attendance including Dr. David Aizuss, Dr. William Averill, Dr. Troy Elander, Dr. C. Freeman, Dr. Kenneth Hoffer, Dr. Vito Imbasciani, Dr. George Ma, Dr. Sion Roy, Dr. Robert Bitonte, and Dr. Diana Shiba.

Dr. Lee also recognized Dr. J. Mario Molina who endowed the curator role at the Huntington, and announced that the Molina family donated $10 million to establish the Molina Family Latino Gallery at the National Museum of American History which will be the first Smithsonian Latino Center’s national gallery dedicated to Latino history and culture. The gallery is scheduled to open in May, 2022!

After Dr. Molina received his award, Dr. Lee announced the “Medical Practice Makeover” initiative, “where LACMA will be distributing grants, supplies and even practice transformation assessments at no cost to qualifying practices.”

Dr. Lee also announced LACMA’s new partnership with the Dr. Lorna Breen Heroes’ Foundation. “[T]hey

Top Left: Dr. Diana Shiba delivers welcoming remarks to the fullyvaccinated crowd.

Top Right: Attendees were greeted with a special preview edition of “Stronger Together,” LACMA’s book commemorating its 150 year history serving and supporting physicians.

Center Left: Awards of appreciations for Dr. Molina and the Dr. Lorna Breen Heroes’ Foundation.

Center Right: A visual timeline displayed notable moments in LACMA’s storied history.

Bottom: LACMA physicians, friends and staff enjoying the Huntington Library. Art Museum and Botanical Gardens.

Q UA RT ER 4 2021 | L A D O C S .O RG 7

do extraordinary and impactful work around physician wellness. The foundation is named after Dr. Breen who tragically took her own life in early 2020. The partnership with the foundation will integrate resources, amplify solutions, look at best practices and support policy like the Dr. Lorna Breen Health Care Provider Protection Act, (S. 610 and HR 1667), which unanimously passed the US Senate this past August and aims to reduce and prevent suicide, burnout, and mental and behavioral health conditions among health care professionals.”

Corey Feist, CEO of the Dr. Lorna Breen Heroes’ Foundation was in attendance and shared the tragic story of his sister-in-law, Dr. Lorna Breen and the work the Foundation does in her honor. Also in attendance was one of the Foundation’s board members, Deborah Marcus.

In closing Dr. Lee said, “We look forward to the next chapter in our history and hope you are all a part of it!”

The attendees, representing all corners of Los Angeles County, spent the rest of the afternoon catching up with old friends, making new connections, and enjoying the beautiful surroundings.

It was truly a day of great celebration and appreciation.

Top Left: (L to R) LACMA President Dr. Jeffrey Lee with past presidents Dr. Diana Shiba, Dr. Sion Roy, Dr. William Averill, Dr. Vito Imbasciani, Dr. Troy Elander, Dr. George Ma, Dr. Robert Bitonte, Dr. David Aizuss, and Dr. Kenneth Hoffer.

Opposite Page: Sponsors of the Member Appreciation Event include Presenting Sponsors CAP and CMA along with Advocate Sponsors Mercer and LA Care, Partner Sponsors Lanes, AltaMed and Aledade, and Friend Sponsors LADMC and Blue Shield of California Promise Health Plan.

Fully-vaccinated LACMA members and guests from around Los Angeles County enjoyed reconnecting with colleages and friends.

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11/1/21 4:43 PM

PROTECTING

THE PHYSICIANS OF LOS ANGELES A RECORD OF SUCCESS: Through aggressive political and regulatory advocacy, CMA has positioned itself as one of the most influential stakeholders in the development and implementation of health policy. CMA also gives our physicians direct access to our state’s and nation’s legislative leaders so they can have a direct impact on the practice of medicine in California.

COVID-19: CMA launched and has maintained an ongoing campaign to support and inform physicians during the COVID-19 pandemic. During this time, CMA has distributed more than $100 million worth of PPE at no cost to physician practices across the state to ensure they are able to safely serve the patients of California. CMA also continues to advocate on all fronts to ensure that the interests of physicians and their patients are considered as local, state and federal governments respond to the pandemic.

PHYSICIAN WORKFORCE: CMA is committed to ensuring California is training enough physicians to meet current and future demand. Expanding funding for graduate medical education (GME) to ensure that there are enough residency slots to train physicians in regions where health care services are needed most is one of our top priorities.

“CMA has provided the platform to participate in the advocacy that our patients and practices need on a state and local level.”

Diego Caivano, M.D. Emergency Physician Los Angeles County Member since 2017

LOAN REPAYMENT: CMA’s CalHealthCares program awards $340 million in yearly awards to repay loans for physicians and dentists who agree to see at least 30% Medi-Cal beneficiaries for five years. + Last year, 263 California physicians received a combined total of $55.6 million to pay down student debt. + $40+ million has been awarded to Los Angeles County for physician and dentist loan repayment programs.

QUESTIONS? CMA’s live-person call center is available Monday through Friday during business hours at (800) 786-4262 or via live chat at cmadocs.org.

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GME: CMA’s CalMedForce GME grant program has provided over $114 million to retain and expand GME programs. As of July 2021, 260 California residency programs received awards, representing 546 resident positions. + $16+ million has been awarded to Los Angeles County for primary care and emergency medicine residency programs.

TOBACCO TAX: CMA dealt a resounding blow to the tobacco industry with the passage of Proposition 56, which raised the tax on all tobacco products, including e-cigarette liquids. Prop. 56 will provide up to $2.7 billion in Medi-Cal funding every year. CMA also successfully passed a sweeping series of tobacco control bills – including raising the legal age to purchase tobacco from 18 to 21 and banning the sale of flavored tobacco products – that will undoubtedly save countless California children from a deadly, lifetime addiction to nicotine.

MICRA: CMA and its county societies led the successful fight against the trial lawyers’ Proposition 46 in 2014, in one of the most contentious and high-stakes ballot fights in California history. Had it passed, the ballot measure would have decimated the landmark Medical Injury Compensation Reform Act (MICRA), which has kept access to affordable health care a reality for patients across the state. CMA stalwartly defends this landmark law year after year. MICRA is facing another imminent attack with a ballot measure being pushed by a wealthy out-of-state trial attorney having qualified for the November 2022 ballot. CMA and a broad coalition of coalition of physicians, dentists, nurses, hospitals, safety net clinics, and other health care providers are committed to vigorously fighting this initiative.

PHYSICIAN INDEPENDENCE: CMA is a tireless supporter of physician independence and medical staff self-governance and fights to keep medical decisions in your capable hands.

REIMBURSEMENT ASSISTANCE: Members receive one-on-one assistance from CMA’s reimbursement experts, who have recouped $33 million from payors on behalf of CMA physicians in the past 12 years.

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Access CMA's online health law library with 5,000 pages of information and resources.

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Attend in-person seminars, secure CME or watch on-demand webinars.

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Receive training to advocate for the practice of medicine, public health issues and more.

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CMA and Los Angeles County Medical Association (LACMA) have represented California’s physicians for 165 years as the recognized voice of the house of medicine. Together we stand taller, our combined voices stronger, fighting for the future of medicine and our noble profession.

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LACMA COMMEMORATES

150th Anniversary

WITH A UNIQUE LOOK BACK AT ITS STORIED HISTORY AND VISION FOR THE FUTURE

Los Angeles County Medical Association

STRONGER TOGETHER 150 Years of Physician & Patient Advocacy

with Foreword by

Diana Shiba, MD

TO OBTAIN YOUR COPY CONTACT NOEMI@LACMANET.ORG

CL AS S IF IEDS /J OB B OAR D

The in-depth examination into LACMA’s complicated and impactful past from the late 1800s to the riots of 1992 to the social unrest and public health crisis of 2020 and 2021 and the incredible progress the organization has made over 150 years serving the needs of independent physicians, medical practices, groups, hospitals, health systems, and community clinics. Stronger Together is a tribute to physicians who’ve sacrificed and saved lives as COVID-19 decimated families, communities, and livelihoods across Los Angeles County.

While the book is not another “ode to the past” in the sense of a traditional coffee table reference, it sheds light on LACMA’s impact on racism in medicine, xenophobia, food insecurity, access to care, clean air, health equity, and the organization’s massive response to the pandemic, such as distributing over $12 million in personal protective equipment (PPE) to nearly 2,500 physicians over five days in the summer of 2020.

The book captures the significant progress LACMA has made relative to diversity and inclusion, with the first African American female president, the first Asian American female president, and a seismic shift in how diversity is embraced and celebrated.

For example, not a single word was mentioned about minority physicians in the 1971 (100th anniversary) edition, and the 120th commemorative (1991) book made no mention of Hispanic physicians at all, even though over 3 million Latinos lived in Los Angeles County at the time.

The 150th anniversary edition takes us on a journey from crisis to vivid examples of how the organization helps physicians every day with an eye on progress and hope.

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