May 2015 | Physician Magazine

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REPORTING ON THE ECONOMICS OF HEALTHCARE DELIVERY

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M AY 2015 | TA B LE OF CONT ENT S

Volume 146 Issue 5

6

4

6 AMA President Robert M. Wah, MD,

Is Keynote Speaker at LACMA Event

COVER STORY

8

STUDIES, TRENDS & REPORTS

FROM YOUR ASSOCIATION 4 President’s Letter | Pedram Salimpour, MD

The medical industry is constantly inun-

12 WE NEED YOUR VOTE! Candidate Statements

for LACMA’s 144th Annual Election

pects of practicing medicine, which can

16 CEO’s Letter | Rocky Delgadillo

dated with reports and studies on all asbe confusing and overwhelming for our busy physician readers. We want to make

it easy for you. In this article, we will summarize the latest reports on topics that

are both pertinent and impactful for the success of your ongoing practice.

Physician Magazine (ISSN 1533-9254) is published monthly by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. Periodicals Postage Paid at Los Angeles, California, and at additional mailing offices. Volume 143, No. 04 Copyright ©2012 by LACMA Services Inc. All rights reserved. Reproduction in whole or in part without written permission is prohibited. POSTMASTER: Send address changes to Physician Magazine, 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 9001 7. Advertising rates and information sent upon request.

M AY 2015 | W W W. P H Y S I C I A N S N E W S N E T W O R K .C O M 1

EDITOR

Sheri Carr 559.250.5942 | sheri@physiciansnewsnetwork.com ADVERTISING SALES

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Christina Correia 213.226.0325 | christinac@lacmanet.org Dari Pebdani 858.231.1231 | dpebdani@gmail.com David H. Aizuss, MD Troy Elander, MD Thomas Horowitz, DO Robert J. Rogers, MD HEADQUARTERS

The Los Angeles County Medi-

physicians from every medical

Physicians News Network Los Angeles County Medical Association 707 Wilshire Boulevard, Suite 3800 Los Angeles, CA 90017 Tel 213.683.9900 | Fax 213.226.0350 www.physiciansnewsnetwork.com

specialty and practice setting

LACMA OFFICERS

cal Association is a professional association representing

as well as medical students, interns and residents. For more

PRESIDENT

PRESIDENT-ELECT

TREASURER SECRETARY

IMMEDIATE PAST PRESIDENT

Pedram Salimpour, MD Peter Richman, MD Vito Imbasciani, MD William Averill, MD Marshall Morgan, MD

than 100 years, LACMA has been at the forefront of current medicine, ensuring that its members are represented in the areas of public policy, govern-

LACMA BOARD OF DIRECTORS CMA TRUSTEE

ALTERNATE RESIDENT/FELLOW COUNCILOR

COUNCILOR – SSGPF

COUNCILOR – DISTRICT 9 CMA TRUSTEE

CMA TRUSTEECOUNCILOR – DISTRICT 5

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ment relations and community

ETHNIC PHYSICIANS COMMITTEE REP

relations. Through its advocacy

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efforts in both Los Angeles

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County and with the statewide

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California Medical Association,

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your physician leaders and staff

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strive toward a common goal– that you might spend more time treating your patients and less time worrying about the challenges of managing a practice.

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CHAIR OF LACMA DELEGATION

David Aizuss, MD Erik Berg, MD Robert Bitonte, MD Stephanie Booth, MD Jack Chou, MD Troy Elander, MD Hilary Fausett, MD Samuel Fink, MD Hector Flores, MD C. Freeman, MD Sidney Gold, MD William Hale, MD Stephanie Hall, MD David Hopp, MD Kambiz Kosari, MD Young-Jik Lee, MD Paul Liu, MD Maria Lymberis, MD Carlos Martinez, MD Nassim Moradi, MD TJ Nguyen Ashish Parekh, MD Heidi Reich, MD Sion Roy, MD Michael Sanchez, MD Heather Silverman, MD Andrew Sumarsono Nhat Tran, MD Fred Ziel, MD

LACMA’s Board of Directors consists of a group of 30 dedicated physicians who are 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, Director of Governance, at lisa@lacmanet.org or 213-226-0304.

SUBSCRIPTIONS Members of the Los Angeles County Medical Association: Physician Magazine 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 Physician Magazine, 707 Wilshire Boulevard, Suite 3800, Los Angeles, CA 90017. To inform us of a delivery problem, call 213-683-9900.

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P RES IDEN T ’S LET T ER | P EDRAM S ALIM P OU R, M D

How Do You Say Goodbye to a Friend?

A few weeks ago on a Saturday afternoon I went to visit Dr. Marshall Morgan at home. The place was bright and beautiful and surrounded by objects collected over years of travel with his wife, Jean. Marshall told me he was “really sick.” But he said it with a smirk, a smile even.

It’s hard to pretend away the truth with another doctor. I can’t imagine how many times in his career he had sat where I was. He must have known how I felt. And the man that Marshall Morgan was, worked to make me feel at ease. His roar of laughter at a joke, that incredibly positive and optimistic spirit of his, was still there, admittedly muted by a weakening body. Sitting there, I remembered the first few times I had met him. He was quiet and thoughtful, pensive. I had not thought him a man of bold action. I believed strongly at the time that for the Los Angeles County Medical Association to survive, bold action would be necessary. And I was certain that bold action could only be taken by bold men and women.

How wrong I had been. Over the course of the next several years, it turned out that Marshall, the quiet, pensive, nonboisterous Marshall, was exceptionally inclined toward daring action. He did not get angry or pound the table. I never ever once heard him grandstand. But when it came time to make a move, he was there. Every time. I don’t care how big or bad the adversary, if action was needed, and if resources needed to be directed toward that work, Marshall was supportive.

Dr. Morgan was out front on protecting doctors and our profession, even if that meant placing his own reputation on the line.

Last year doctors were faced with two of the greatest challenges in a generation. One, of course, was MICRA. And the other was Proposition 45. We needed someone to be the face of the profession, the face of doctors. This was no small task. It was a multimillion-dollar state-wide media buy. And it put us in a position to impact or be impacted by a multibillion-dollar industry. People on the other side of the argument were not bashful. And when the call came, Dr. Marshall Morgan put himself out 4 P H Y S I C I A N M A G A Z I N E | M AY 2015

P EDRAM S ALIM P OU R, M D | P RES IDEN T ’S LET T ER

Dr. Morgan with Ronald Busuttil, MD, PhD, Chief of the Division of Liver and Pancreas Transplant in the Department of Surgery at the UCLA School of Medicine.

Pedram Salimpour, MD, with Dr. Morgan, who was the142nd president of the LA County Medical Association.

there. We prevailed. Though we could have been defeated. And it would have been his face. Even in victory, he knew that powerful forces would remember him and his effect. Still, he never wavered.

Because it was the right thing to do for doctors, and for our profession.

During his year as president and mine as president-elect, we met once every three weeks or so for breakfast at the Luxe Hotel in Brentwood. He would tell me what he was struggling with, what I could expect, and give sage counsel. The advice wasn’t high-level stuff you could give to anyone.

The words were for me, helpful and designed for just one person. He had spent the time to think about how best to guide the person sitting in front of him, not just anyone in my position. A lifetime of work had taught Dr. Morgan that the best way to help people is to get to know them, and he did that. It isn’t easy, takes time. But in the end, it is valued, and so deeply appreciated.

The last time I saw him was last week at UCLA, in the ICU. I walked in, masked and gowned, a nurse was attending to him, and Dr. Morgan was sitting upright in his chair. Jean, as always, was there, smiling and filling the room with joy for him. Dr. Morgan looked tired, but not defeated.

I asked the nurse if she knew who that was, referring to the stature of the man. She said that she had been told, “and I recognized him from TV!” The irony was difficult to ignore. In one of the most sophisticated bleeding-edge critical care units in the world sat a man on the brink, one who had saved countless of others’ lives just a few floors below, in the ER. When I told the nurse they had picked him over me because he was far more handsome, he looked right at the young nurse, and he smiled a big smile. Then he looked at me and with the muscular certainty of his gruff voice asked, “Why aren’t you with your little boys? How are you doing?”

He wanted to know how LACMA was doing. He wanted to know how membership growth was going. He wanted to know how I was doing and what I planned to do after my presidency. But he didn’t want to talk about himself. C.S. Lewis said that humility is not thinking less of yourself, but thinking of yourself less. Marshall just thought more of others. Still, his own legacy of academic, then clinical, success cannot be glossed over: Princeton, the Sorbonne, University of Chicago, Phi Beta Kappa, Alpha Omega Alpha, Chief of Emergency Medicine at UCLA, always the best, always gifted. Some saw him as a crack ER doctor; others saw in him the gentle, caring soul of an oldfashioned country doctor. To Dr. Morgan, the two were the same, inseparable. A doctor to him was a doctor. And our profession was the most noble in the world.

If I have enjoyed success in this position, it has been because of his counsel and friendship. I don’t know how you’re supposed to say goodbye to a friend. If you carry on their work, maybe you don’t have to. We will miss you, good friend. I already do.

- Pedram Salimpour, MD, President of the Los Angeles County Medical Association M AY 2015 | W W W. P H Y S I C I A N S N E W S N E T W O R K .C O M 5

Dr. Pedram Salimpour, president of the Los Angeles County Medical Association, Dr. Harlan Levine, chief executive of City of Hope Medical Foundation, Dr. Robert Wah, president of the American Medical Association, Dr. Jinha Park, director of MRI and Radiology Research, City of Hope National Medical Center; and Dr. Steven Rosen, provost and chief scientific officer, City of Hope

AMA President Robert M. Wah, MD, Is Keynote Speaker at LACMA Event “We were honored to host Dr. Wah and inspired by his words and vision for the future of medicine. We look forward to a closer working relationship with the American Medical Association.”

Robert M. Wah, MD, 169th president of the American Medical Association (AMA), was the keynote speaker at a recent event at the Good Samaritan Hospital in Los Angeles hosted by the Los Angeles County Medical Association’s (LACMA) Asian American and Pacific Islander Physicians Advisory Committee. Dr. Wah is AMA’s first Chinese-American president.

During the reception and program, titled “Challenges, Opportunities and the Future of Medicine,” Dr. Wah engaged in a lively exchange with local doctors who voiced concerns about changes in healthcare and the relationship between policy makers in Washington and local leadership.

Jinha Park, MD, co-chair of the Asian American and Pacific Islander Advisory Committee, was instrumental in organizing the event. “The selection of the first Asian-American president of AMA is a historic event in itself. This reception was an opportunity to have a national leader incorporated in a dialogue organized by and for active local AMA chapter physicians.”

Dr. Wah was elected president of the American Medical Association in June 2014. He previously served as chair of the AMA Board of Trustees from June 2011 to June 2012.

“Dr. Wah is an outstanding physician leader whose message of participation in organized medicine as a way of enhancing the profession and ensuring practice sustainability is most welcome,” said Pedram Salimpour, MD, president of LACMA. “We were honored to host Dr. Wah and inspired by his words and vision for the future of medicine. We look forward to a closer working relationship with the American Medical Association.”

Dr. Wah is a reproductive endocrinologist and ob-gyn in McLean, Va., with more than 23 years of

6 P H Y S I C I A N M A G A Z I N E | M AY 2015

military service. He graduated Phi Beta Kappa from the University of Oregon and received his MD from the Oregon Health Sciences University.

He practices and teaches at the Walter Reed National Military Medical Center in Bethesda, Md., and the National Institutes of Health. As division head and vice chairman of the Navy’s largest ob-gyn training program, Dr. Wah was voted Teacher of the Year by his residents. His group started the first military in vitro fertilization program on the West Coast. He has served on the faculties of Harvard Medical School, University of California, San Diego, and Uniformed Services University of the Health Sciences.

A nationally recognized expert in health information technology, Dr. Wah is chief medical officer for Computer Sciences Corporation. He works with public and private agencies using technology to deliver better information for better decisions. He is regularly ranked in Modern Healthcare magazine’s “50 Most Influential Physician Executives” and was featured on the cover of Washington Technology magazine.

Dr. Wah previously served as associate chief information officer for the Military Health System in the Office of the Secretary of Defense. In 2008 Dr. Wah graduated from the Advanced Management Program at Harvard Business School.

Attendees acknowledged that Dr. Wah was compassionate and receptive as the keynote speaker, encouraging physicians to take an active role in enhancing physician and practice sustainability.

Sponsors of the event included City of Hope, City National Bank, Charles R. Drew University of Medicine and Science, Pacific Alliance Medical Center and Korean American Medical Association of Southern California.

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M AY 2015 | W W W. P H Y S I C I A N S N E W S N E T W O R K .C O M 7

THE MEDICAL INDUSTRY IS CONSTANTLY INUNDATED WITH REPORTS AND STUDIES ON ALL ASPECTS OF PRACTICING MEDICINE, WHICH CAN BE CONFUSING AND OVERWHELMING FOR OUR BUSY PHYSICIAN READERS. WE WANT TO MAKE IT EASY FOR YOU. IN THIS ARTICLE, WE WILL SUMMARIZE THE LATEST REPORTS ON TOPICS THAT ARE BOTH PERTINENT AND IMPACTFUL FOR THE SUCCESS OF YOUR ONGOING PRACTICE. THEY INCLUDE THE TOP CHALLENGES PHYSICIANS IN PRIVATE PRACTICE WILL FACE WITH THIS YEAR AND TIPS ON HOW TO TACKLE THEM SUCCESSFULLY PLUS STATISTICS ON HOW ADOPTING TELEMEDICINE AND APPS INTO YOUR PRACTICE CAN HELP RAISE EFFICIENCIES. YOU’LL ALSO READ ABOUT KEY FINDINGS ON THE NEED FOR GREATER COLLABORATION CURB HEALTH RECENT

BETWEEN HOSPITALS, PROVIDERS AND PATIENTS TO CARE COSTS AND LEARN ABOUT THE MOST FINDINGS ON OUTCOMES AND HEALTH FACTORS IN LOS ANGELES COUNTY – AND THE STATE OF CALIFORNIA – AND WHAT THIS MEANS FOR YOUR COMMUNITIES. AND IF YOU’RE WONDERING IF THE CHANGING HEALTH ENVIRONMENT IS TRULY LEAVING MOST PHYSICIANS UNSATISFIED, YOU MAY BE SURPRISED BY THE LATEST REPORTS ON CAREER SATISFACTION.

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TOP 3 CHALLENGES FACING PHYSICIANS IN 2015

A report published by Medical Economics confirms what many physicians and healthcare experts have been predicting with the implementation of the Affordable Care Act. In short, the changing healthcare environment has created substantial challenges for doctors in privatepractice, including staying HIPAA-compliant with the increased use of digital technology, meeting meaningful use requirements and getting paid by insurers. At the same time, everyone agrees that many physicians who confront these obstacles and identify fixes can still have a thriving practice and better their own lives as well as the lives of the patients they serve.

GETTING PAID COMMON REASONS FOR CLAIM DENIALS.

1. The patient is ineligible for services because healthcare coverage ended and the patient failed to show proof of new insurance.

2. The claim form is missing a modifier or modifiers, or the modifier(s) are invalid for the procedure code.

3. A particular service is not covered under the plan benefits or there appears to be a lack of medical necessity.

4. The claim is deficient in certain information such as prior authorization or the effective period of time within which the pre-approved service must be provided for reimbursement to occur.

5. Errors or typos were made collecting pertinent information.

FIXES TO AVOID CLAIM DENIALS

1. Immerse yourself in every detail to submit a “clean” claim and make sure that spelling of patients’ names and other information and billing codes are correct.

2. Avoid even the smallest discrepancies between your records and that of the insurer.

3. Create a pre-billing checklist to prevent errors.

4. Update your ICD-10 system, train your staff how to use it, contact all vendors and health plans about their ICD-10 readiness, beef up your documentation and don’t forget to test your systems.

MEANINGFUL USE According to Bethany Jones and Naomi Levinthal, health IT consultants for The Advisory Board Company, meaningful use continues to be a challenge for doctors this year. As of Jan. 1, eligible professionals will see a 1% cut in Medicare reimbursement for each year they don’t meet meaningful use requirements, with penalties changing from 1% each year to up to 5%. Mastering the technology is the biggest hurdle for many practices. The full-reporting requirement will be tough for many doctors to meet, especially the meaningful use stage 2 (MU2) criteria to have 5% of a practice’s patients view, download or transmit electronic health information through a patient portal to an EHR. • In the MU2 attestation date that CMS has released to date, 70% of attesting eligible professionals have qualified for certain exclusions from the transitions of care requirement, but experts expect a far smaller percentage of professionals to meet the exclusion criteria next year.

• CMS had received more than 44,000 hardship applications from practitioners requesting an extension for MU2 attestation. CMS stopped accepting hardship applications last November.

STAYING COMPLIANT IN A DIGITAL WORLD

Though the chances of your practice being audited for Health Insurance Portability and Accountability Act (HIPAA) violations are slim, keeping patients’ sensitive information secure is getting more complicated. Though HIPAA violations seem more like a large-organization problem, many breaches result from employees being careless or stealing information, which puts smaller practices at risk.

5 SECURITY COMPONENTS TO HELP YOU MANAGE YOUR RISK:

1. Create physical safeguards to your facility and where patient data can be accessed. Examples include installing alarm systems, locking offices and adopting screening systems to avoid secondary viewing.

2. Implement administrative safeguards with a designated security officer, control information access via training staff, create policies and do monthly reviews of activities.

3. Create technical safeguards such as controlling access to electronic health systems with secure passwords, backing up data and virus checks.

4. Create policies and procedures to stay HIPAA-compliant and document security measures.

5. Ensure breach notifications and agreements and update agreements with business associates.

ACCORDING TO HEALTHCARE IT NEWS, MORE THAN 41 MILLION PEOPLE HAVE HAD THEIR PROTECTED HEALTH INFORMATION COMPROMISED IN HIPAA PRIVACY BREACHES, COSTING THE INDUSTRY AS MUCH AS $5.6 BILLION ANNUALLY.

M AY 2015 | W W W. P H Y S I C I A N S N E W S N E T W O R K .C O M 9

TELEMEDICINE ADVANCEMENTS According to a survey of senior healthcare executives, including physician practice groups, released last November by law firm Foley & Lardner LLP, more healthcare providers continue to adopt telemedicine advancements despite reimbursement and regulatory challenges. Among the major benefits that respondents believe telemedicine

THE AFFORDABLE CARE ACT IS PROPELLING TELEMEDICINE

As healthcare providers shift from a feefor-service model to a model based on patient outcomes, which rewards doctors for keeping patients healthy while also asking doctors to share a greater burden of risk, respondents said they feel pressured to create more efficien-

• NINE OUT OF 10 ORGANIZATIONS HAVE ALREADY STARTED DEVELOPING OR IMPLEMENTING TELEMEDICINE PROGRAMS. • 84% SAID THE DEVELOPMENT OF TELEMEDICINE SERVICES IS VERY IMPORTANT TO THEIR SUCCESS. • THE MAJORITY SAID THEY ALREADY OFFER REMOTE MONITORING (64%), STORE AND FORWARD TECHNOLOGY (54%) AND REAL-TIME INTERACTION CAPABILITIES (52%).

• 39% SAID THEY HAVE SERVICES SUCH AS MHEALTH – PATIENT-DRIVEN APPS AND ONLINE PORTALS IN PLACE. can offer doctors are the expansion of a provider’s geographic footprint, the more efficient use of a doctor’s time and significantly fewer barriers to interacting with patients. For the majority of respondents. embracing telemedicine is simply helps them keep their patients healthier.

cies and cut costs. For them, telemedicine is a way to streamline efficiencies and create multiple touch points with patients.

• Half of the respondents said the potential to improve quality of care was the primary motivator for adopting telemedicine.

• 18% were excited about reaching new patients.

Another annual report, published

by Towers Watson, also shows that employers and the government are increasingly recognizing the value of telemedicine.

• According to the 2014 report by Towers Watson, 22% of employers with more than 1,000 employees offer telemedicine consultations as low-cost options to emergency department and primary care visits.

• As of Jan. 15, the CMS added seven new telehealth reimbursement codes, including annual wellness visits and psychotherapy services, recognizing the importance of telemedicine for physicians and health systems to improve the delivery of care.

Reimbursement remains the biggest obstacle to telemedicine adoption. However, obstacles remain.

According to Foley & Lardner, respondents were less confident about telemedicine’s imminent adoption citing reimbursement, regulatory and insurance barriers as the main challenges to getting paid for practicing medicine outside of traditional interactions.

• 41% said they were not reimbursed at all for telemedicine services.

• 21% reported receiving lower rates from managed care companies for telemedicine than for in-person care.

CREATING HEALTHIER PLACES TO LIVE, WORK AND PLAY

The recently released annual county health rankings by the Robert Wood Johnson Foundation and the University of Wisconsin Population Institute showed that LA County had fewer premature deaths than the state average, but overall health outcomes scores were brought down by a higher percentage of residents in poor health and born with low birth weight.

LOS ANGELES COUNTY FINDINGS:

• LA County had an income equality score of 5.3, barely missing the cutoff for most severe income inequality in the nation.

• LA County did worst in clinical care, with lower-than-state-average rates of diabetic monitoring and mammography screening and a higher-than-average number of preventable hospital stays and percentage of uninsured people.

CALIFORNIA FINDINGS:

Twenty percent of the state population under age 65 said they were uninsured; an average of 18% of residents reported fair or poor health; an average of 13% of residents said they had smoked in the last 30 days.

Top-ranking counties for both health outcomes, which represents current aggregate health, and health factors, which estimates how healthy a county is likely to be in the future: Marin County No. 1, Placer County No. 2. The lowestranking county for health outcomes: Sierra County. The lowwest-ranking county for health factors: Imperial County.

1 0 P H Y S I C I A N M A G A Z I N E | M AY 2015

MORE PARTNERSHIPS AMONG HOSPITALS, HEALTHCARE PROVIDERS AND PATIENTS TO CURB HEALTHCARE COSTS ARE PHYSICIANS SATISFIED WITH THEIR CAREERS? According to the 2014 Survey of America’s Physicians, conducted for The Physicians Foundation by Merrit Hawkins, 56% of physicians are pessimistic about the current state of the medical profession.

Younger physicians are more optimistic than older physicians, and female physicians, employed physicians and primary care doctors are more optimistic compared to older physicians, male physicians, practice owners and other specialists, according to the survey.

According to Medscape Physician Compensation Report 2014, specialists who ranked among the highest paid in 2013 reported the lowest levels of job satisfaction.

Anesthesiologists, radiologists and orthopedists were among the highest-paid subspecialists and reported the lowest job satisfaction, according to the compensation survey.

Among the three subspecialists 44% to 47% said they would still choose medicine as a career again if given a chance, compared to 67% of family physicians.

ONLY 32% OF FAMILY PRACTITIONERS SAID THEY WOULD STAY IN THE SAME MEDICAL SPECIALTY. ORTHOPEDISTS RANKED ON TOP OF THE EARNING SCALE WITH AN AVERAGE SALARY OF $413,000 COMPARED TO AN AVERAGE REPORTED SALARY OF $176,000 FOR FAMILY PHYSICIANS. OVERALL, 58% OF PHYSICIANS SAID THEY WOULD CHOOSE MEDICINE AGAIN AS A CAREER. 47% WOULD CHOOSE THE SAME SPECIALTY AND 26% SAID THEY WOULD CHOOSE THE SAME PRACTICE SETTING.

PriceWaterhouse Coopers recently released a report that calls on the need for greater partnerships between hospitals, community organizations and clinics to better coordinate patient care and keep patients from being readmitted.

• According to PriceWaterhouse Coopers, 1% of patients in the United States drive 20% of the country’s healthcare spending.

• Dual eligibles, or patients who

receive Medicare and Medicaid, are some of the biggest offenders often because they don’t get timely treatment for their conditions or don’t keep up with their recovery instructions.

• This year, hospitals, health systems and doctors need to work closer together on finding even more innovative ways to coordinate patient care while simultaneously creating better plans for followup care to include phone calls and in-home care to avoid hospital readmissions.

For more key trends and all the news that’s important to you, turn to upcoming issues of Physician Magazine. Look for the June issue on practice management.

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M AY 2015 | W W W. P H Y S I C I A N S N E W S N E T W O R K .C O M 11

WE NEED YOUR VOTE!

LACMA is holding its 144th Annual Election in June. There is one vacancy each for the positions of Treasurer, Secretary, Councilor-at-Large, Young Physician Councilor, District 14 Councilor and Medical Student Councilor on the LACMA Board of Directors. Proposed changes to the LACMA Bylaws will be voted upon as well. You can expect to receive a voting ballot via email or mail at the end of May, and voting will be performed online.

Please be sure to keep an eye out for your ballot and submit your vote. For additional information about the candidates or the election process, please call Lisa Le at 213-226-0304 or email at lisa@lacmanet.org.

CA NDIDAT ES NOM INATE D F O R TH E O F F I CE O F TR E A S U R E R

C. FREEMAN, MD The Los Angeles County Medical Association deserves a Treasurer who is willing and able to provide strong leadership in the financial life of the organization.

C. Freeman, MD, MBA, is that person. There is nothing glamorous about the job of Treasurer. To enforce following the budget and financial policy can make one unpopular. In addition, being Treasurer does not guarantee that one will ascend to President. Hence, the Treasurer must have fortitude, skills and a desire for the job. Business school training and work experience as a business owner and national award-winning medical director have given me all of these traits. As treasurer in many organizations, I have led several financial turnarounds resulting in greater fiscal strength. This record of success is due to exhibiting the knowledge to understand financial reports and the communication skills to translate financial information and concepts for others. I take the time to learn the nuances of the organization’s finances, restrictions and requirements. When I review financial reports, I ascertain if the financial information is accurate and timely, and note important observations or trends to be highlighted for consideration, just as I have done during LACMA Board meetings.

In partnership with the staff, I work to assure that useful budgets are developed and adhered to, and that budget priorities and decisions reflect the true intentions and objectives of the membership. Being LACMA Treasurer is not likely a glamorous job, but I find the thought exciting. To lend my time and financial skills to work with others who believe in LACMA is bound to be rewarding. The job of Treasurer may not be glamorous, but LACMA deserves a candidate who wants it for the right reasons and can do it well. C. Freeman, MD, MBA, is that candidate.

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WILLIAM K. AVERILL, MD “With ideas that are elemental and strong, uncompromising hard work, and leadership that is at once demanding and sympathetic, Dr. Averill has helped propel LACMA to the strongest position it has enjoyed in over a decade. Dr. Averill’s leadership will help LACMA continue to position itself as the strongest medical association in the State of California and among the most active in the country. It has been a professional highlight to serve on the LACMA board along his side. “ - Pedram Salimpour, MD. I seek your vote for Treasurer of the Los Angeles County Medical Association Board so that I can strive to keep LACMA moving forward and engaged in its important work on your behalf. As a cardiologist, involved daily in direct patient care with a medical practice in Los Angeles County throughout my professional career, I am very familiar with the special challenges and opportunities that we face in our region. LACMA serves an indispensible role, representing doctors for such critical issues as protecting MICRA, preserving patients’ access to their physicians, and intervening when health plans may attempt to inappropriately encroach in medical decision making or deny appropriate reimbursement. Currently a Board officer (Secretary), and a member of the Executive Committee for several years, I am knowledgable regarding our Association’s finances. As Treasurer, I will emphasize efforts to grow our membership, strengthen our balance sheet, and direct resources appropriately, e.g., by reducing LACMA’s office occupancy expenses with annual savings of up to $100,000 per year. With the tradition of leadership set by Dr. Morgan, Dr. Salimpour, and soon Dr. Richman, I am proud to be a member of the LACMA Executive Board. I ask for your vote so that I may continue to serve by representing you as your Treasurer.

CAN D I DAT E S N O MI NAT E D F O R T H E O F F I C E O F S E C R E TA RY

RICHARD BAKER, MD LA County is the largest, most sociodemographically diverse county in the nation.

LACMA should and can be the strongest, most important County Medical Society in the nation.

I seek your vote for Secretary of the Los Angeles County Medical Association Board so that I can assist current and future LACMA leadership in achieving this goal.

Over my 25-year tenure in organized medicine, I have had the privilege of serving as the physician leader across the full spectrum of medicine, including leadership of medical education institutions, major medical research entities, and clinical care organizations/medical groups serving the Los Angeles community. My clinical experience as an ophthalmologist proudly includes almost two decades of service as a front line safety net clinician and clinical educator in South Los Angeles as well as in a small group private practice in Marina Del Rey. I currently

serve as a CMA Trustee, Chairman of the CMA Council of Scientific and Clinical Affairs, and Co-Chair of the LACMA African American Physician Advisory Committee. I have extensive experience both inside and outside LACMA/CMA in successfully engaging with a broad range of physician constituencies and have been actively involved in significantly expanding membership across these constituencies. Equally important, over the last two years I have represented LACMA interests as part of the leadership team that has pushed for transparency and accountability from Covered California and the Health Plans and directly challenged their efforts to exclude private practice physicians, to narrow networks, and to implement intrinsically unfavorable contracting schemes. I am fully committed to building a highly effective organization that focuses upon physician empowerment, advocacy on behalf of our patients, and protection of the public health. We can achieve this goal by becoming relevant to all physician constituencies and modes of practice and by providing real value to all our members.

CAN D I DATES N O MI NAT E D F O R T H E O F F I C E O F C O U N C I L O R - AT- L A R G E

SEC R ETARY CONTI N UE D

NASSIM MORADI, MD I am running for office as the LACMA Secretary. I seek your support in the nomination meeting and discussions with other officers, and I ask for the honor of your vote in the LACMA election. Currently at LACMA, I serve as President of District 10, Chair of Women Physicians Action Committee, Councilor District Southeast/East, and Board Member. I am a LACMA Delegate at CMA, serving on Reference Committees for the past three years and serving on Medical Services Committee. My work in California Society of Anesthesiologists spans over 10 years and now involves serving on several key committees, including Reference Committee, Division of Legislative and Practice Affairs, Committee on Bylaws and Committee on Professional and Public Communication. At Medical Board of California, I serve as Expert Reviewer. I have been a Member of Cooperative of American Physicians Peer Review Committee as well as Harbor-UCLA Medical Center, Volunteer Faculty of the year 2011-2012. These experiences, together with my knowledge of practice management and healthcare economics, has prepared me well for the responsibilities of the Secretary. I want to talk to you about my vision and strategy for guiding LACMA and its members through the turbulence ahead as the Affordable Care Act nears its full implementation. We need to be recognized as physicians who have the educational background and the clinical judgment that distinguishes our profession. We need fair payment for our professional services; we need a Secretary with the experience and the credibility to make our case to the people in Sacramento and Washington who are making the decisions and writing the rules. I pledge to do everything I can to help LACMA carry on the great traditions of Medicine and physician-led patient care. Put me to work for LACMA, and for the great profession of Medicine.

-Nassim Moradi, MD, Diplomate of American Board of Anesthesiology

THERESSIA WASHINGTON, MD “Now that you’ve graduated residency, you know 5% of what you need to practice medicine.” I remember this quote from one of the many books I’ve read over the past couple of years on how to open a private practice – I had no idea how much truth was in those words! Thank God for LACMA! During my brief time of active involvement since graduation, I’ve had the privilege to network with some of California’s most brilliant, successful physicians. I’m now learning the other 95% required to be an outstanding physician by getting involved, attending House of Delegate meetings, serving on numerous LACMA committees and listening humbly while others who have walked my anticipated road share their professional experiences to protect me from avoidable mistakes. As an African-American female phy-

sician who overcame all the obstacles of inner-city Chicago and am now proudly embarking on Private Practice in California, I’m no stranger to fighting hard – failure is never an option. I would like to extend my sense of determination and mindset of hard work to LACMA as Councilor-at-Large.

Now more than ever, physicians must unify, collaborate and fight off the predators who are trying to take over the career field we all struggled so hard to join. We face negative forces from multiple directions attempting to change how medicine is practiced and financed in America. I accept the challenge to continue the fight hand-in-hand with LACMA. It has been my sincere pleasure to thus far serve in the positions of Sergeant-at-Arms and Alternate Delegate with the Los Angeles County Medical Association. I need your vote now for LACMA Councilor-at-Large so I may continue to represent you and your patients in our shared battle to protect the physician-patient relationship. I will work hard for you.

SION ROY, MD My name is Sion “Shy” Roy, and I am a cardiologist at Harbor UCLA. I respectfully ask for your vote to represent you as Councilor-at-Large and continue my service on the LA County Medical Association board. I will bring a tremendous amount of experience if re-elected to the board. I have had the honor of representing our members on the LACMA board since 2012 as both a Resident/Fellow Councilor and a Young Physicians Councilor, and since 2013 I have been on the LACMA executive committee. In 2014, I represented LACMA as a member of the CMA Board of Trustees, and I’m currently the vice-chair for the CMA Committee on Medical Services. Additionally, I was the chair of the CMA Resident/Fellow section from 2012-2014. I’m also active in my community as I teach a health policy class at Santa Monica College and am currently the chair for the Santa Monica-Malibu Unified School District Health and Safety District Advisory Committee. In 2014, I was a very active as a spokesperson for the No on 46 campaign traveling the state for media appearances, in addition to speaking with community groups and fellow physicians. As a board member, I will continue to be a strong advocate for policies that benefit our patients and LACMA members. Additionally, I will continue to advocate for measures that focus on increasing LACMA membership—a strong membership is the backbone for the organization. I am honored to have the endorsement of CMA Chairman of the Board David Aizuss, MD, current LACMA President Pedram Salimpour, MD, and LACMA President-Elect Peter Richman, MD.

CAN D I DATES N O MI NAT E D F O R T H E O F F I C E O F D I S T R I C T 1 4 C O U N C I LO R

JINHA PARK MD, PHD When I began my medical school interviews, many physicians urged me to turn back and find another profession. This was in the early 1990s. We have witnessed tremendous changes during my education and post-graduate training. And, rapid change continues on into our profession as we speak. But the response that I offer is that we need to transform ourselves into vocal advocates for the patients that look to us for healing. What has not changed is the patients’ need for us to help them. If we cannot advocate for them and ourselves, who will? Not the elected officials, insurance companies, nor the hospital or health systems we work with. We must do it and I will help lead that effort. I have made it my mission to engage all the non-physician entities

who now dominate our healing process. We cannot surrender to the changes in delivery without a fight, and with participation in LACMA and organized medicine, we can achieve our goals. As President-Elect of the state chapter of the American College of Radiology, I have been involved with organized medicine for the last five years.

As Co-Chair of the newly formed Asian American Pacific Islander Physicians Advisory Committee, we have invited our sympathetic elected officials and the President of the AMA, Dr. Robert Wah, to provide their insights into the future of healthcare for us. We must build the relationships and effect change in our important roles in the health of our patients. What better way for newly trained and uncertain physicians than to participate in LACMA? I will increase membership from colleagues in my health system and engage others in District 14 to reach new heights in 2015 and beyond.

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CAN D I DAT E S N O MI NAT E D F O R T H E O F F I C E O F YO U N G P H Y S I C I A N CO UNCI LO R

DIST. 14 COUNCILOR CONTINUED

MAHIPAL M. SHAH, MD I am practitioner of orthopedic surgery in Pomona, California area since 1982.

Received MD (MBBS) degree in 1968. Did orthopedic surgery in India. Finished 1972 work and study in orthopedic surgery in the United Kingdom 1973 to 1975. Did orthopedic Residency and Fellowship in New York, NY 1975 to 1980.

Practiced in New York, New York 19801982. Held Chairman of Orthopedic Surgery position at Pomona Valley Hospital 1992-2009. Medical Executive Member Pomona Valley Hospital 1992-2009.

Chair of Orthopedic Surgery San Antonio Hospital Upland, CA 1991-2001.

Chairman of Medical Staff and Executive Committee Chino Valley Medical Center, Chino, CA 1994-1995. Fellow of American Academy of Orthopedic Surgery and Arthroscopy of North America. Diplomate of American Board of Orthopedic Surgery. My goal is to help physicians in private practice and who work in medical groups and hospitals. Need to work with LA County Medical Association and on the state and national levels for recent changes coming in medical fields. I need your support. Thank you.

- Sincerely, Mahipal M. Shah, M.D.

PO-YIN SAMUEL HUANG, MD Early in my training, I thought practice of medicine is simply helping patients with evidence-based medicine. However, as I progressed, I realized that there are many factors beyond the medical sciences that dictate patient care. Oftentimes, these factors are out of the control of the physicians and patients who are directly affected. Through my involvement in LACMA, CMA, and AMA, I have learned the importance of the united voice of physicians advocating for practice of medicine and improvement of our patients’ health. I have advocated for physicians on various issues at the state and national level. Being involved on the board of LACMA will enable me to serve you more effectively as your advocate. After medical school at Keck USC and family medicine residency at Kaiser LA, I have worked closely with a wide variety of specialists right here in LA County. As a primary care physician, I continue to interact frequently with my specialist colleagues. I bring to the table a well-rounded perspective on the practice of medicine with input from physicians in various disciplines. I believe an important way to enhance the health of our patients is through improving the practices of every aspect of medicine. Therefore, I wish to contribute to this process through serving on the board of LACMA. Over the past year, I have voluntarily participated in many open sessions of the LACMA board meetings. I have actively participated in the Young Physician Committee and the Asian Pacific Islander Physician Committee. I learned a lot from the seasoned physicians at these meetings. I would like to step up my involvement and serve as a board member to represent the young physicians and to provide a voice for physicians newly entering the workforce. I humbly ask for your support for the Young Physician Councilor position.

ERICK EITING, MD, MPH, MMM It is with great enthusiasm that I announce my candidacy for LACMA Young Physician Councilor, and I hope to earn your support and your vote.

We are currently at an inflection point. More patients have coverage, but little has been done to improve access to medical care. Our dual-eligible “Medi-Medi” patients get thrown into managed care plans, cutting them off from the doctors who have helped keep their chronic conditions under control for years. Maintenance of certification charges thousands of dollars for tests that do nothing to improve our ability to care for our patients. Rate increases for primary care services get taken away, and our governor threatens to balance the budget by cutting physician pay-

ments even further. All of these stand in the way of what truly matters in medicine: the patientphysician relationship and our ability to provide good medical care. I have extensive experience in organized medicine that I will use to fight for physicians in Los Angeles County. I served as a Councilor for the Medical Society of the State of New York for six years, where I also served as Assistant Commissioner of Medical Education and Assistant Commissioner of Government Relations. I have served on the CMA Board of Trustees and serve on the LACMA Delegation to the CMA House of Delegates. I have also been in the AMA House of Delegates since 2005, where I also served on its Council on Medical Service. Lastly, I serve as the Faculty Advisor for the AMA Chapter at the USC Keck School of Medicine. I believe I can represent you and your needs well, and I hope to earn your support and your vote for LACMA Young Physician Councilor.

-Sincerely, Erick Eiting, MD, MPH, MMM

CANDIDATE S N O M I NATE D F O R TH E O F F I C E O F ME D I CA L S T U D E N T C O U N C I L O R

VAMSI ARIBINDI Every medical student today will on average practice medicine long after most current doctors retire. As medical students, we have perhaps the greatest interest in what the future of our profession looks like. It is my passion to ensure that this future is a bright and happy one—for our patients and for ourselves. I am a rising fourth-year medical student who has been active in organized medicine, first representing USC at the AMA-MSS House of Delegates my first year, serving on two MSS convention committees. In addition, I served as the medical student representative to two CMA standing committees as well. For this past (third) year, I have dedicated my time to learning the craft of medicine above all else. But I anticipate having more time during my fourth year to serve and help shape the future of our great profession. One of my proudest moments thus far was leading students from USC to the California Democratic Party Convention in the hopes of killing Proposition 46. I still remember the feeling as I looked at a room full of doctors united and ready to fight for our profession’s future in this state. I hope to foster and continue that spirit as your elected representative to the LACMA Board. As your representative, my highest priority will be to expand the organization’s presence on medical schools’ campuses, and give our peers more reasons to join us and ensure a vibrant future for our organization. Another prime objective will be to assist medical students interested in health policy and writing resolutions in gaining the support of LACMA and in navigating the new policy process of the CMA.

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MEDICAL STUDENT COUNCILOR CONTINUED

ANDREW SUMARSONO I am the first of my family to be born in the United States and the first to pursue medicine. I attended UCLA for my undergraduate degree and currently attend David Geffen School of Medicine at UCLA. I will be entering my third year of medical school in the summer of 2015. Since starting medical school, I have served as the UCLA Delegate to the American Medical Association’s Medical Student Section, UCLA Delegate to the California Medical Association, and UCLA School Captain for the California GME Campaign. Additionally, I currently serve as the Alternate Medical Student Councilor for the Los Angeles County Medical Association. In this ever-changing climate of healthcare reform, a constant remains: medical students represent the future of medicine. We possess the passion, perspective, and potential to shape the landscape that we will spend our careers in. However, most medical school curricula fail to highlight the importance of policy in the medical profession. Indeed, such material is not even evaluated on any national medical board examination. How can the doctors of tomorrow expect to improve the state of healthcare without the basic understanding of its problems?

It is imperative that my generation, who will inherit the hard-earned victories of previous generations, know how to steward our responsibility well. My goal as the Medical Student Councilor is to substantially increase the number of medical students involved with LACMA. Currently, I am working with the Deans at UCLA to make medical student membership an opt-out process in order to capture every subsequent incoming class. Additionally, we are working on a policy project to garner the interest of the incoming classes toward health policy. I hope to serve as your Medical Student Councilor for the upcoming year to build unprecedented student involvement and interest in the future of healthcare.

FATIMA REYES I respectfully seek your vote for Medical Student Councilor on the Los Angeles County Medical Association Board. I was born in Los Angeles at LAC+USC Medical Center, completed my undergraduate education at UCLA, and now I am a second year medical student at Keck School of Medicine of USC. I am deeply rooted and invested in the health and wellness of Los Angeles and look forward to working for our underserved Los Angeles communities. During my two years as a medical student at Keck School of Medicine of USC, I held leadership roles in the Latino Medical Student Association (LMSA) and Student National Medical Association. Within these organizations, I sought to improve mentorship programs and alumni connections within our medical school. This upcoming year, I have the honor to serve as the Vice President of Mentorship for the LMSA Western Region and will be working closely with the David Geffen School of Medicine of UCLA and Western University as well as all California medical schools to strengthen our LMSA mentorship programs. As Medical Student Councilor for LACMA, I would be honored to help develop LACMA’s mentorship and networking opportunities for medical students in Los Angeles in order to help increase medical student participation.

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M AY 2015 | W W W. P H Y S I C I A N S N E W S N E T W O R K .C O M 1 5

AS S OC IAT ION H AP P ENINGS | LAC M A NEWS

CEO’s LETTER

S P R I N G I S H E R E and LACMA is already starting the flowering season with some very exciting news. We want to congratulate one of LACMA’s outstanding physician members, Dr. Randy W. Hawkins, on his appointment by California Governor Jerry Brown to the Medical Board of California.

The board comprises 15 members, eight physicians and seven public members, and we are honored that one of our own will be representing California’s and Los Angeles’ physicians and their patients.

I echo the sentiments of LACMA’s president, Dr. Pedram Salimpour, who noted that “Dr. Hawkins’ work demonstrates the best of what physicians represent, and the Los Angeles County Medical Association is proud to have Dr. Hawkins’ voice on the Medical Board of California.”

This month, LACMA members will also have the exciting opportunity to hear about the latest trends in this rapidly changing healthcare environment and get the information they need to succeed in this marketplace.

The 18th Annual Western Health Care Leadership Academy on May 29-31 will be held at Loews Hollywood Hotel—in the heart of Hollywood—and feature not only many educational sessions, but also two acclaimed authors.

Malcolm Gladwell, author of “The Tipping Point,” a New York Times bestseller for 400-plus weeks, was named one of the 100 most influential people by Time Magazine and one of Foreign Policy’s Top Global Thinkers.

Special guest speaker Dr. Siddhartha Mukherjee, an oncologist and researcher and Pulitzer Prize-winning science writer, wrote the book “The Emperor of All Maladies: A Biography of Cancer,” a fascinating book that looks into the origins and causes of cancer and its deadly effect on the human body.

This is a great event for physicians in private, group or academic practice as well as those in administrative and management positions.

The new season is just beginning and we are looking forward to more exciting events, information and announcements.

A healthy and happy Memorial Day to you and your families.

We pay our respects to Dr. Marshall T. Morgan, a professor of clinical medicine and chief of emergency medicine at UCLA. Regarded by his colleagues and students as an exceptional educator, physician and friend, Dr. Morgan always put his patients first. I think of Dr. Morgan as a mentor to me. He is a shining example of the power of quiet courage. Dr. Morgan served as president of the Los Angeles County Medical Association in 2013-14 and was a member of the California Medical Association House of Delegates from 200811. We send our condolences to the Morgan family during this very sad time.

Regards,

Rocky Delgadillo Chief Executive Officer

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