O F F I C I A L P U B L I C AT I O N O F T H E L O S A N G E L E S C O U N T Y M E D I C A L A S S O C I AT I O N
A PUBLICATION OF PNN www.PhysiciansNewsNetwork.com
LACMA WELCOMES NEW PRESIDENT
VITO IMBASCIANI, MD I
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“With pesos on hand, we were able to grab a cab and hit the beach.”
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JULY 2016 | TA B LE OF CONT ENT S
O F F I C I A L P U B L I C AT I O N O F T H E L O S A N G E L E S C O U N T Y M E D I C A L
A S S O C I AT I O N
Volume 147 Issue 7
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COVER STORY 12 UNITED WE STAND | As Dr. Imbasciani adds the title
FEATURE
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LACMA Welcomes Its 145th President
More than 200 LACMA members and guests gathered last month to welcome new LACMA President Vito Imbasciani, MD.
of LACMA president to his list of accomplishments, we look at the key issues that will be the focus of his term.
16 WNV and Zika | Protecting Patients as Mosquito Season Begins
FROM YOUR ASSOCIATION 4 President’s Letter | Vito Imbasciani, MD 6 The Ultimate Servant Leader | Gustavo Friederichsen
Physician Magazine (ISSN 1533-9254) is published monthly by LACMA Services Inc. (a subsidiary of the Los Angeles County Medical Association) at 801 S. Grand Avenue, Suite 425, 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,801 S. Grand Avenue, Suite 425, Los Angeles, CA 90017. Advertising rates and information sent upon request.
J ULY 2016 | 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
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specialty and practice setting PRESIDENT
as well as medical students, interns and residents. For more
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
PRESIDENT-ELECT
TREASURER SECRETARY
IMMEDIATE PAST PRESIDENT
Vito Imbasciani, MD William Averill, MD C. Freeman, MD Sion Roy, MD Peter Richman, MD
than 100 years, LACMA has LACMA BOARD OF DIRECTORS
been at the forefront of current medicine, ensuring that its members are represented in the areas of public policy, government relations and community relations. Through its advocacy
RESIDENT/FELLOW COUNCILOR
CMA TRUSTEE
COUNCILOR – DISTRICT 2
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COUNCILOR – SSGPF
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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, your physician leaders and staff strive toward a common goal– that you might spend more time treating your patients and less
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COUNCILOR-AT-LARGE
COUNCILOR – SCPMG
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MEDICAL STUDENT COUNCILOR/USC
COUNCILOR – SSGPF VLGPF TRUSTEE
COUNCILOR-AT-LARGE
Jerry Abraham, MD David Aizuss, MD Emil Avanes, MD Erik Berg, MD Robert Bitonte, MD Stephanie Booth, MD Amanda de la Cerda Troy Elander, MD Samuel Fink, MD Hector Flores, MD Sidney Gold, MD Stephanie Hall, MD Po-Yin Samuel Huang, MD David Hopp, MD Marvin Kaplan, MD Kambiz Kosari, MD Jeffery Lee, MD Paul Liu, MD Maria Lymberis, MD Ashish Parekh, MD Jinha Park, MD Anantjit Singh, MD Stacy Songco Heather Silverman, MD Diana Shiba, MD Nhat Tran, MD
time worrying about the challenges of managing a practice. 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, 801 S. Grand Avenue, Suite 425, Los Angeles, CA 90017. To inform us of a delivery problem, call 213-683-9900. Acceptance of advertising in Physician Magazine 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 Physician Magazine, LACMA Services Inc. or the Los Angeles County Medical Association. Physician Magazine reserves the right to edit all contributions for clarity and length, as well as to reject any material submitted. PM is not responsible for unsolicited manuscripts.
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P RES IDEN T ’S LET T ER | VIT O IM B AS C IANI, M D
“My challenge, which I take up willingly and happily, is to impress on the tens of thousands of physicians in this county... their increasingly great need for the kind of voice that only an all-encompassing organization like LACMA can provide.”
W H A T A T R U E H O N O R to be the new president of the Los Angeles County Medical Association. I am blessed to be among so many who also have chosen a life of healing. It’s hard to imagine being the 145th of anything, and that’s why our work here is so important. LACMA – with its mission of Perseverance, Integrity and Excellence – has been around for a very long time, and will continue well into the future, representing physicians in the largest county in the nation. I owe a great debt of gratitude to many who preceded me, especially presidents numbers 135 to 144 and beyond: Clayton Patchett, Robert Bitonte, Howard Krauss, George Ma, Ralph DiLibero, David Aizuss, Troy Elander, Sam Fink, Pedram Salimpour, Marshall Morgan (of happy memory) and Peter Richman. Until last year, I was the voice — and face — of the medical group at the California Medical Association (CMA) Board and here at LACMA for many years. And that leads me to share a secret. One of my most treasured accomplishments each year was to bring together, at the CMA House of Delegates, the leaders of the Small and Solo Group Practice Forum and the Very Large Group Practice Forum to discuss our respective legislative and advocacy priorities. Yes, we had our differences, but we also discovered we had much more in common. The personal relationships born in those meetings allowed us to help each other where we could — to maximize the good and minimize the pain. What do I hope for LACMA and the year about to start? My challenge, which I take up willingly and happily, is to impress on the tens of thousands of physicians in this county — medical school faculties, hospital staffs, members of groups large and small or those practicing alone — their increasingly great need for the kind of voice that only an all-encompassing organization like LACMA can provide. Regardless of where and how you practice medicine, you cannot do what you need to do for your patients, or for yourself, without LACMA. Every physician needs a voice, an advocate, to speak for him or her, but the exigencies of modern
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medical practice make it increasingly difficult for individual physicians to advocate for themselves or their profession. Difficult because physicians work hard to keep their patients healthy, to document all that they do, to keep current – learning about new drugs and interventional skills, doing required CME and maintaining professional contacts. And they work hard to keep the lights on — by ensuring their compensation covers the overhead and affords a reasonable profit. And now, they even find themselves working hard just to keep their patients. All that hard work leaves precious little time or energy to accomplish that which is equally necessary: No time left to protect the public health, to lobby for sane legislation regarding vaccinations, tobacco, obesity, opioid addiction; No time to protect the profession from unwarranted intrusions into the sanctity of the medical staff, from poorly thought-out expansions of scope of practice, from outright quackery; No time to fight for their ability to keep the doors open by seeking reasonable compensation from federal and private insurers. Historically, in order to do this, physicians have come together to work for the common good: medical staffs, specialty societies, medical school faculties and county medical societies. All of these entities are the constituent parts of the CMA, which is the organized House of Medicine for the entire state. That is why LACMA exists, and has for 145 years: It’s only when many physicians come together, each contributing a little to the greater effort, that great things can be accomplished. So herein lies the challenge: We need to engage the other 90% of physicians in this county who are not members. This includes everybody: The very busy physicians as well as the disaffected and unengaged, young physicians and those who are near retirement, concierge physicians just as much as the public clinic and safetynet physicians, residents and medical students and the professors who teach them. This will be my focus – membership and advocacy – and the focus of our new CEO, Gustavo Friederichsen. I look forward to working with everyone here. We can and we will improve LACMA so that our mission, and our healing presence, can continue in Los Angeles for another 145 years.
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LAC M A C EO | G U S TAVO F RIEDERIC H S EN
T H E U LT I M AT E S E R VA N T L E A D E R While many of us have heard the term “servant leader” often in various healthcare discussions, forums and leadership development settings, I truly believe we have two examples of this timeless concept, first coined by Robert K. Greenleaf in “The Servant as Leader,” an essay that he first published in 1970. One example is aspirational and the other models the behavior each day. “The difference manifests itself in the care taken by the servant-first to make sure that other people’s highest priority needs are being served.“
Some context: In that essay, Greenleaf says, “The servant-leader is servant first… It begins with the natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. That person is sharply different from one who is leader first; perhaps because of the need to assuage an unusual power drive or to acquire material possessions…The leader-first and the servant-first are two extreme types. Between them there are shadings and blends that are part of the infinite variety of human nature.” Greenleaf goes on: “The difference manifests itself in the care taken by the servant-first to make sure that other people’s highest priority needs are being served. The best test, and difficult to administer, is: Do those served grow as persons? Do they, while being served, become healthier, wiser, freer, more autonomous, more likely themselves to become servants? And, what is the effect on the least privileged in society? Will they benefit or at least not be further deprived?“ Greenleaf recognized that organizations as well as individuals could be servant leaders. Indeed, he had great faith that servant-leader organizations could change the world. Which leads me to our two examples. First, LACMA is in the throes of change -- some tumultuous and some caused by what I call “healthy tension.” We are evolving, improving, striving -- a work in progress towards two common goals: relevancy and strength. The second is an individual who possesses a quiet, yet steady demeanor. He has put organization before ego, personal gain behind patient, community and physician benefit. He is the epitome of “servant” and the role model for ‘leader.’ He exudes knowledge and perspective. He has made the most difficult decisions while having clarity of outcome. At the risk of sounding trite during an election year, he embodies temperament in the face of chaos, a steady hand as the waves rock the ship. I wanted to take a moment to give praise when it’s not sought; recognition when it’s not desired. Peter Richman, MD, is more than a general surgeon. He serves the mission, vision and values of our organization. An example to all of us, he could be on call, then surgery, at Facey, in a meeting with healthcare entrepreneurs or leading a board meeting all in the same day. Robert Greenleaf might have coined it some 46 years ago; we have our own role model today. Thank you, Peter!
Gustavo Friederichsen Chief Executive Officer 6 P H Y S I C I A N M A G A Z I N E | J ULY 2016
Join the
LOS ANGELES HEALTH ALERT NETWORK Do you want to be notiďŹ ed about public health threats such as Zika or tainted opioid products? Do you want to receive authoritative information about infectious diseases that may aect your patients?
JOIN LAHAN TO STAY INFORMED! The Los Angeles County Department of Public Health communicates important public health information to health care professionals in Los Angeles County through the Los Angeles Health Alert Network (LAHAN).
All Los Angeles physicians are encouraged to join LAHAN to improve communication during public health emergencies. LAHAN sends health alerts, advisories, and updates on topics such as disease outbreaks, emerging infectious diseases, immunizations, drug shortages and recalls. There are, on average, only 1-2 communications a month and the urgency and target audience are clearly marked. For more information and to see archived LAHAN communications, visit publichealth.lacounty.gov/lahan
Please join this important network. It is a valuable resource to help you serve your patients and to protect the health of the Los Angeles community.
Sign up to become a member of LAHAN by visiting:
publichealth.lacounty.gov/lahan Sign up takes less than 2 minutes. Your contact information will not be shared and you can unsubscribe at any time. J ULY 2016 | 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
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LACMA’S 145TH PRESIDENT
VITO IMBASCIANI, MD, PhD
brings with him an impressive list of credentials, accomplishments and passions More than 200 LACMA physician members and guests gathered at the Bel Air Bay Club on June 23 for the Installation of President and Officers. LACMA’s 145th president, Dr. Vito Imbasciani, who will serve as the president of the Los Angeles County Medical Association for the 2016-2017 year, was honored by speakers and guests at the annual event.
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After a warm welcome from CEO Gustavo Friederichsen and outgoing president Peter Richman, Dr. Imbasciani’s son, Raymond DiSalvo, gave the invocation. Keynote speaker for last Thursday’s installation of officers was John Perez, a former Speaker of the California State Assembly and close friend of Dr. Imbasciani. “It’s great to be with you tonight and to be able to welcome Vito Imbasciani into his new role and to thank him for his many years of service,” Perez began. “Vito has been a friend for years, and I view him to be one of the most compassionate, intelligent and inspirational people I know. And frankly, we’re all pretty lucky to have him in this role.” “This dinner is more than just an installation of your officers,” Perez continued. “It’s a moment of reflection on the work ahead and a moment of reflection on the work we’ve done. “Tonight is all of those things, but it’s also something bigger. It’s a tradition. And for an organization founded in 1871 — 145 years ago —-traditions take on a very special outside importance. They connect us to the past. Traditions open a window to a world that no longer exists so we can take stock of the progress we’ve made and the progress still ahead of us.” Following Perez’s address, Nhat Tran, MD, took to the podium to recognize the winners of LACMA’s Childhood Obesity Challenge, UCLA medical student Tran Do and UCLA undergrad Jonathan Tsang. The title of their winning proposal was “Standing Desks: An Intervention to Reduce Childhood Obesity.” Last November LACMA invited local medical students to propose legislation for adoption by the County of Los Angeles in order to reduce obesity rates among elementary and middle school age children. Former LACMA President Pedram Salimpour, MD, then presented the Lifetime Service Award to Marvin Kaplan, MD, and an award of recognition of leadership, service and dedication to Dr. Richman. Ralph DiLibero, MD, administered the oath of office to Dr. Imbasciani and LACMA’s other new officers. “The honor of serving as the president of LACMA is one of the highest that can be bestowed upon you by your colleagues,” Dr. DiLibero began. “It is a demanding post that requires your clearest thinking, your deepest caring, and your highest ideals. It is possible that you, Vito, will find this both challenging and rewarding.” After Dr. Richman presented Dr. Imbasciani with the traditional gavel and medal, William
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7 PHOTOS: 1. Peter Richman, MD, and Vito Imbasciani, MD. 2. Dr. Imbasciani with son Raymond, husband George DiSalvo, and son Isaak. 3. Dr. Imbasciani with friends and supporters. 4. Dr. Imbasciani with Senator Ben Allen. 5. LACMA CEO Gustavo Friederichsen welcomes the more than 200 members, supporters and guests. 6. The Lifetime Service Award which was presented to Marvin Kaplan, MD. 7. Nhat Tran, MD, with Childhood Obesity Challenge Winners, UCLA medical student Tran Do, and UCLA PhD student Jonathan Tsang.
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Averill, MD, was installed as President-Elect, C. Freeman, MD, as Treasurer, and Sion Roy, MD, as Secretary. Introducing Dr. Imbasciani was Edward Ellison, MD, executive medical director at the Southern California Permanente Medical Group (SCPMG) and a strong supporter of Dr. Imbasciani’s efforts at LACMA and the CMA. Dr. Imbasciani began his speech by thanking Dr. Ellison and former Speaker Perez and acknowledged the support of his family. “Ask anyone who has done this job, or one like it, and they will tell you that it doesn’t happen without the support of one’s family. So I want to publicly thank George and our two sons, Raymond and Isaak, for their love and support over the years that led up to this day.” Dr. Imbasciani acknowledged attendees California state Senator Ben Allen; Howard Fullman, MD, “the medical director of the hospital I have worked in for almost 20 years”; Will Tseng, MD, immediate past president of the San Diego Medical Society; and Darla Holland, MD, presidentelect of the Orange County Medical Association. Dr. Imbasciani shared inspiring stories of his personal, military and medical journeys and spoke eloquently about the importance of bringing physicians together as a unified voice. “What do I hope for LACMA and the year about to start? My challenge, which I take up willingly and happily, is to impress on the tens of thousands of physicians in this county — medical school faculties, hospital staffs, members of groups large and small or those practicing alone — their increasingly great need for the kind of voice that only an all-encompassing organization like LACMA can provide.” Read more about Dr. Imbasciani’s vision for his time as president on the following pages and in his own words in his first monthly letter on Page 4 of this issue.
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14 PHOTOS: 8. Ralph DiLibero, MD, Sion Roy, MD, William Averill, MD, C. Freeman, MD, Vito Imbasciani, MD. 9. David Aizuss, MD, and his wife, Felicia with Howard Krauss, MD. 10. Troy Elander, MD, and his wife, Diane. 11. Sam Fink, MD, and his wife, Beloria. 12. Lifetime Service Award recipient Marvin Kaplan, MD, and Christina Correia with Dr. Imbasciani. 13. Keynote speaker John Perez. 14. Dr. Imbasciani with the LACMA staff, left to right: Deborah Stambler, Tess Richman, Joy Simmons, Lisa Le, Gustavo Friederichsen, Eva Moravcik, Christina Correia, Ellie Tran, Priscilla Alcantara.
Dr. Marvin Kaplan, 2016 Lifetime Service Award recipient, accomplished his undergraduate studies at the University of Illinois – Navy Pier and received his MD from the University of Illinois School of Medicine in Chicago. Dr. Kaplan went on to begin surgical training at the University of Wisconsin, which was interrupted by two active duty years as a general surgeon at Washington and Riverside Air Force Bases. While completing his residency, Dr. Kaplan served as a flight surgeon for a Reserve Air Force unit in Chicago. After spending years dedicating his services to Long Beach and the University of California – Irvine School of Medicine, Dr. Kaplan volunteered his time at Harbor - University of California Medical Center, where he was Chair of the REI Research Foundation. Dr. Kaplan proceeded to work at Long Beach Community Hospital and Long Beach Memorial Hospital, among others, where he supported ER efforts, laparoscopic procedures, placed catheter shunts and fistulas and grafts for renal failures and dialysis. For the last several years, Dr. Kaplan has provided support to surgeons across all surgiPedram Salimpour, MD, presents Dr. Kaplan with the Lifetime Service Award. cal specialties. Dr. Kaplan specializes in general surgery and dedicates his career to the Los Angeles and Orange County areas. Formerly, Dr. Kaplan was an alternate delegate for the American Medical Association as part of the California Delegation, where he contributed to the efforts for organized medicine and participated in committee meetings. Having served five years on various health resolution committees throughout his career, Dr. Kaplan has written many resolutions that aim to assist patients and physicians. Currently, Dr. Kaplan proudly serves as the chair of the Los Angeles County Medical Association Delegation, where he actively evaluates California public health resolutions. Dr. Kaplan is passionate about promoting the health of individuals and supporting public health policies that improve the overall health of the community. Dr. Kaplan is a proud father to four sons and grandfather to six grandchildren. When he isn’t keeping up with his grandchildren, he enjoys reading, gardening and discussing cultural events. J ULY 2016 | 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
UNITED WE STAND BY MARION WEBB
As Dr. Imbasciani adds the title of LACMA president to his incredible list of accomplishments, here are some of the key issues that will be the focus of his term as he plans to serve LACMA and its members with the same type of conviction and passion he has brought to his other posts.
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“That is why LACMA exists, and has for 145 years: It’s only when many physicians come together, each contributing a little to the greater effort, that great things can be accomplished.”
“That is why LACMA exists, and has for 145 years: It’s only when many physicians come together, each contributing a little to the greater effort, that great things can be accomplished.” He noted that while LA County has one of the most diverse populations nationwide with more than 50 ethnic medical society representatives, these groups lack a powerful presence at the political level. “It is my ambition to reach out and create a liaison between each of these groups and LACMA,” Dr. Imbasciani said, adding that all of these organizations require strengthening in terms of their membership. “I am excited to use the many civil and military contacts I have made through 10 years of advocacy serving on the LACMA and CMA boards to engage physicians at the local level to support the efforts of organized medicine to affect public policy,” Dr. Imbasciani said. Dr. Imbasciani also has a long history as an advocate for such key issues as healthcare reform, veteran medical programs, LGBT health and improved public health policy. It is with these causes in mind that Dr. Imbasciani will lead LACMA.
Dr. Imbasciani speaks adamantly about the role of advocacy by medical groups in the protection doctors’ practices, at both the local and state levels. Among his major goals is to unite all California physicians from county and specialty societies under one roof so that all of their voices can be heard loudly and clearly at the legislative level. It would be hard to argue with his insightful analogy as he compares the overwrought physician to a local farmer: “A farmer can’t go to Sacramento every week to argue about irrigation, water rights or pesticides. Everything their sons or daughters stand to inherit requires advocacy at the state level. “The same goes for physicians. We certainly don’t have the time as individuals to protect the public, to battle those who would intrude on our profession, to ensure proper certifications of medical professionals MEDICAL PRACTICE PURCHASES, SALES AND MERGERS as required, to fight against unreasonable CME mandates, or address public policy on vaccinations or compensation for treating the under or poorly insured. “It starts with the county and specialty societies and CMA is the place where they can come together to hammer out differences and speak to the various branches of government Assisting physicians with as one voice.” He stressed the importance of all legal issues for over three decades. doctors in the community to particiFenton Law Group, LLP pate on some level. 1990 South Bundy Drive “County and state societies need Suite 777 to be able to say to legislators not Los Angeles, CA 90025 The brand physicians trust that we represent 2,000 physicians 310.444.5244 www.fentonlawgroup.com in LA, but that we represent 27,000 in LA,” he said.
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Already, Dr. Imbasciani’s advocacy has had significant impact at the state and local levels. As evidenced by his 2015 appointment by Gov. Jerry Brown as secretary of the California Department of Veteran Affairs (CalVet), Dr. Imbasciani is fully committed to the homeless vets here in Los Angeles and around the state. His efforts are contributing to positive results in LA County with a recent Los Angeles Homeless Services Authority survey finding a 30% drop in the number of homeless veterans, from 4,362 in the 2015 count to 3,071 this year. This, according to the report, is in contrast with a 5.7% rise in the remaining homeless population.
A planned project in the city of LA — already dubbed by advocates as a national model for producing large-scale housing for the homeless — is expected to provide hundreds of homeless veterans with apartments. According to an article in The Los Angeles Times from May 27, the city of Los Angeles approved a deal for nonprofit and private developers to convert “nuisance” motels into 500 permanent apartments for homeless vets. Dr. Imbasciani said, “I’m proud our collaboration with the Department of Housing and Community Development and the California Housing Finance Agency developed a wonderful program with strong veteran-centric services from provid-
Colonel Vito Imbasciani is a physician, U.S. Army Medical Corps officer, dedicated community leader, former educator, and LGBT rights advocate who has devoted his life to public service. Preceding his recent election as president of the Los Angeles County Medical Association, Dr. Imbasciani was appointed by Gov. Jerry Brown as secretary of the California Department of Veteran Affairs (CalVet). CalVet serves nearly 2 million California veterans and their families by increasing their access to and utilization of state and federal benefits and services through advocacy and education. With over 28 years of service as an Army surgeon, the CalVet mission is one with deep meaning in Dr. Imbasciani’s life. As president of LACMA, Dr. Imbasciani will lead the more than 2,500 members to fight for physician’s rights while building a stronger, more unified healthcare community in the Greater Los Angeles area. As former state surgeon of the California Army National Guard, Dr. Imbasciani served as the highest-ranking medical officer in the Army National Guard. Dr. Imbasciani volunteered for the military as a resident at Yale-New Haven Hospital. Since that time, he has cared for hundreds of soldiers, men and women, who were wounded on the battlefield through four deployments in two wars. Dr. Imbasciani served in Saudi Arabia in Desert Storm, makeshift encampments in Iraq, the American Hospital in Landstuhl, Germany, and with the Wounded Warriors in Salt Lake City. Dr. Imbasciani’s personal story and lifetime of military service was recognized as an inspiration for President Obama’s repeal of the “Don’t Ask, Don’t Tell” military policy. In order for Vito Imbasciani to serve his country tending to our country’s wounded soldiers, he had to make a deep personal sacrifice, keeping his partner and their two sons a secret. Dr. Imbasciani has dedicated his life not only to the health and well-being of our soldiers in uniform, but to families across Los Angeles and California. He has worked as a practicing surgeon, currently with the Southern California Kaiser Permanente Medical Group, and volunteered as clinical staff at Los Angeles County-USC Medical Center for over a decade. In addition, Dr. Imbasciani serves on the boards of numerous nonprofits and community organizations dedicated to improving quality and access to healthcare throughout California. He has been the recipient of numerous awards and honors for excellence in the practice of medicine, including Exceptional Physician of the Year at Kaiser West Los Angeles Hospital and the Surgeon General’s Excalibur Award for a program he created to improve the health and fitness of soldiers in the Reserves of the U.S. Army. A former professional musician, Dr. Imbasciani also taught music at the University of Florida and Middlebury College prior to becoming a physician. A native of the East Coast, he earned his undergraduate degree from New York State University, his Master’s Degree from Cornell University, and Medical Doctorate from the University of Vermont. He is a former Fulbright Fellow, having studied music in Rome, Italy.
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“I am excited to use the many civil and military contacts I ers with specific experience serving our veterans in need.” CalVet serves nearly 2 million California veterans and their families by increasing access to and use of state and federal benefits and services through advocacy and education. Dr. Imbasciani has long been known for his tremendous efforts to improve public health policy and install healthcare reform. He was also a source of inspiration to President Obama for the 2010 repeal of the military’s “Don’t Ask, Don’t Tell” policy after hearing Dr. Imbasciani’s personal story. An officer in the U.S. Army Medical Corps for more than 28 years and a veteran of two wars, Dr. Imbasciani completed four active duty tours, one to Saudi Arabia (Desert Storm, 1991) and three in support of Operation Iraqi Freedom. Despite his service, he was unable to discuss his gay status throughout his military career and have his husband, George DiSalvo, and their two sons, Raymond and Isaak, onsite upon departure for deployments or returning home from war. Dr. Imbasciani thanks President Obama for his efforts in allowing him to “serve his country openly with his family by his side.”
have made through 10 years of advocacy serving on the LACMA and CMA boards to engage physicians at the local level to support the efforts of organized medicine to affect public policy.”
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WEST NILE VIRUS (WNV) AND ZIKA: Protecting Patients as Mosquito Season Begins RACHEL CIVEN, MD, MPH, AND BENJAMIN SCHWARTZ, MD, ACUTE COMMUNICABLE DISEASE CONTROL PROGRAM, LOS ANGELES DEPARTMENT OF PUBLIC HEALTH. RCIVEN@PH.LACOUNTY.GOV
A S S U M M E R B E G I N S , how can physicians ensure that mosquitos are only a nuisance and not a cause of serious disease? When should messages about preventing mosquito-borne disease accompany other important health protection messages? Widespread concern about Zika – increasing as the Olympics approach – creates an opportunity to get people’s attention, change behaviors, and enhance prevention of all mosquito-borne disease. Here is what physicians in Los Angeles County (LAC) should know.
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CHARACTERISTICS OF ZIKA AND WEST NILE VIRUS (WNV) INFECTIONS AND THE MOSQUITOS THAT MAY SPREAD THEM
Infants of women infected while pregnant Aedes
San Gabriel valley; East LAC
No
Persons currently at risk for infection Risk groups for severe disease
All LA County residents
WNV
ZIKA
Travelers to affected countries
Older adults; persons with reduced immunity to infection
Type of mosquito that can spread infection
Culex
Distribution of the mosquito in LAC
All LAC
Current local transmission in LAC
West Nile Virus (WNV) is endemic in LAC. In 2015, LAC experienced the second most cases since its first large WNV outbreak in 2004. Of 300 reported cases, 232 suffered neuroinvasive infection (e.g., meningitis, encephalitis) and 26 died. Older and immunocompromised individuals are at increased risk. Active older adults who may walk daily and enjoy gardening in an area with WNV-infected mosquitos are at higher risk than those who are less active. Zika poses different risks to a different population: pregnant women. Zika infection is associated with serious birth defects including microcephaly, intrauterine growth restriction, fetal death, and visual and auditory deficits. Mosquito-borne Zika is acquired during travel to countries experiencing outbreaks. Of 17 Zika infected LAC residents, exposure most often occurred in Guatemala (7), El Salvador (4) and Honduras (3). Currently affected countries are listed at http://www.cdc.gov/zika/ geo/index.html. Additionally, sexual transmission of Zika virus has been documented with cases occurring when symptomatic men infected during travel transmit infection to their partner. Zika has been found in semen for over 60 days post-infection; using condoms is protective. CDC recommendations on preventing sexual transmission to women who are or may become pregnant are at http://www.cdc.gov/zika/transmission/sexual-transmission.html. Mosquito vectors differ for WNV and Zika: WNV is transmitted by the dawn/dusk biting Culex and Zika by Aedes, aggressive daytime biters (Table). Though Aedes mosquitos are present in Los Angeles, endemic Zika virus transmission is not, thus Zika currently is prevented by reducing travel-associated infection. Physicians
Yes
should screen pregnant women for upcoming travel to Zika-affected countries and recommend postponing travel until after delivery. If travel cannot be postponed, emphasize rigorous mosquito protection including use of repellents with EPA-approved ingredients which all are safe for pregnant women. Pregnant women also should be counseled about the risk of acquiring Zika from sex partners returning from a Zika-affected country. Mosquito protection and abatement in LAC are crucial to prevent WNV infection and reduce the risk that Zika establishes a foothold and spreads locally. Control of Aedes mosquitos has proved to be challenging; 30 cities and neighborhoods within LAC now have Aedes mosquitos (see http://www.cdph.ca.gov/HealthInfo/discond/Documents/AedesDistributionMap.pdf). Persons at higher risk for WNV should diligently use repellent, particularly at times and places of likely exposure. Encourage habitual protection, just like sunscreen at the beach. As cues, suggest keeping repellent near the front door or on the porch. Reducing mosquito-breeding sites is important for everyone: dump, drain, and discard items where any water may pool. Educational materials for patients can be copied from the LAC Department of Public Health website at http://publchealth.lacounty. gov/acd/VectorZikaClinicians.htm. As summer begins, take the opportunity to share messages and materials, especially for targeted patients, to reduce the risk of WNV and Zika and the serious consequences of infection for them, their families and public health. Please also join the Los Angeles Health Alert Network (LAHAN) to be informed of disease outbreaks and emerging infections such as Zika; visit www.publichealth.lacounty.gov/lahan to join.
J ULY 2016 | 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 17
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PRACTICE FOR SALE
MEDICAL PRACTICE IN ALHAMBRA Solo adult (19+) primary care medical practice in Alhambra, CA. Current physician retiring in 2017 but will stay 3-6 months to assist with credentialing and transition. Patient population is ethically mixed. About 50% are Chinese speaking. Knowledge of Chinese definitely a plus. 2015 net income (not revenue) over $300K. Open M-F only. Asking $250K. For more info email: primarycarepracticeforsale@gmail.com
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APHCV IS NOW HIRING Asian Pacific Health Care, Inc. seeking 3 FT Physicians in Family Practice or Internal Medicine and 1 FT in Pediatric. Los Angeles and San Gabriel areas. Great Benefits. Email us at: HRResume@aphcv.org or fax: 323-660-0935 www.aphcv.org
PHYSICIANS NEEDED
We are an established multidisciplinary medical group looking for additional physicians to join our team, especially those licensed in California! Telemedicine can fit into your schedule whether you have a busy practice or you’re just starting out. You decide the number of days/hours you want, and whether you work from the office or home. To learn more, contact us at
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Prime Van Nuys Location. Two doctor practice (same location 30 years) General Practice, Immigration and Personal Injury. Digital X-Rays. 2800 Sq. Ft./ 13 parking spaces, signage, foot traffic. Contact Corey 818-620-8091
OFFICE FOR LEASE
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Thank You Sponsors The Los Angeles County Medical Association extends our deepest appreciation to the sponsors and supporters of the 2016 Installation Dinner:
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Success. It’s what California’s finest physicians strive for... and what CAP can help you achieve. Since 1977, the Cooperative of American Physicians (CAP) has provided superior medical professional liability coverage and valuable risk and practice management programs to California’s finest physicians through its Mutual Protection Trust (MPT). As a physician-directed organization, we understand the realities of running a medical practice, and we are committed to supporting you with a range of valuable programs and services. These include a 24-hour adverse outcomes hotline, HR support, EHR consultation, a group purchasing program, and payment and reimbursement education and support, to name a few.
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