The Message, October 2011

message THE

A MON T HLY NE WS M AG A ZINE OF SPOKANE COUNTY MEDICAL SOCIETY – OCTOBER 2011

MEDICAL EDUCATION IN SPOKANE: STAYING CURRENT WHILE THE CURRENTS SHIFT COURSE

By Brad Pope, MD SCMS President

M IN MEDICINE IS FOR MENTOR

By George Novan, MD Associate Director, WWAMI Medical Education Program Faculty, Internal Medicine Residency Spokane

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LEARN AT: www.gonzaga.edu/MBAhcm OctoberMORE SCMS The Message Open2

2011 Board of Trustees Brad Pope, MD President Terri Oskin, MD President-Elect Anne Oakley, MD Vice President David Bare, MD Secretary-Treasurer Gary Knox, MD Immediate Past President Trustees: Fredric Shepard, MD Michael Cunningham, MD Paul Lin, MD Randi Hart, MD Gary Newkirk, MD Carla Smith, MD Rob Benedetti, MD Audrey Brantz, MD Louis Koncz, Jr. PAC David McClellan, MD

T a b l e o f C o n t e n ts

Medical Education in Spokane: Staying Current While the Currents Shift Course . . . . . . . . .

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M in Medicine is for Mentor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 A Facetious, Albeit Accurate, Guide to WWAMI Vocabulary . . . . . . . . . . . . . . . . . . . . . 2 Understanding Admission to the University of Washington School of Medicine . . . . . . . . . . . 2 The Spokane Bubble . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Teaching the Teacher . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Advocating for One of Spokane’s Economic Drivers . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Medical Education Expansion: Good for You, Good for Spokane . . . . . . . . . . . . . . . . . . . 9 Enjoying the Broccoli Along With the Grilled Salmon . . . . . . . . . . . . . . . . . . . . . . . . 13 Providence Health Care Offers Continuing Medical Education Category 1 . . . . . . . . . . . . . 13 2011 WSMA Annual Meeting – The New Normal . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Project Access Patient Stories and Provider Appreciation Campaign . . . . . . . . . . . . . . . . 16 When the Commission Calls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Opinion Response to the Future of Medical Care Article . . . . . . . . . . . . . . . . . . . . . . 20 Continuing Medical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Membership Recognition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Positions Available . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24

Spokane County Medical Society Message Terri Oskin, MD, Editor A monthly newsletter published by the Spokane County Medical Society.

The annual subscription rate is $21.74 (this includes the 8.7% tax rate).

Advertising Correspondence Quisenberry Marketing & Design Attn: Jordan Quisenberry 518 S. Maple Spokane, WA 99204 509-325-0701 Fax 509-325-3889 jordan@quisenberry.net

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"Some patients, though conscious that their condition is perilous, recover their health simply through their contentment with the goodness of the physician."

- Hippocrates 460-400 B.C.

All rights reserved. This publication, or any part thereof, may not be reproduced without the express written permission of the Spokane County Medical Society. Authors’ opinions do not necessarily reflect the official policies of SCMS nor the Editor or publisher. The Editor reserves the right to edit all contributions for clarity and length, as well as the right not to publish submitted articles and advertisements, for any reason. Acceptance of advertising for this publication in no way constitutes Society approval or endorsement of products or services advertised herein.

October SCMS The Message Open3

Medical Education in Spokane: Staying Current While the Currents Shift Course

By Brad Pope, MD SCMS President It’s appropriate that I am writing this in September during the proverbial “back to school” period. This month’s magazine is all about the state of medical education in our community. And we’ve got much to celebrate.

I am proud that the Spokane County Medical Society has played such an active role in advocating for a four-year medical school in Spokane. I’ve written throughout the year about how we educated our community with a loud voice about the benefits of offering a full medical education in Spokane. We also brought the issue to the legislature. Once in Olympia, we acknowledged that the economy is surely tough, but that the burden to society will get tougher without more doctors and access to primary care.

Already the medical students who are trained in Spokane are experiencing a different type of education than I did. Tomorrow’s physicians will learn on a multidisciplinary campus alongside nurses, physician assistants, pharmacists, oral hygienists and other health professionals. They will practice collaboratively as part of a team using new technology and care systems.

Many of us weren’t trained in such a setting and have some catching up to do. But while the next generation of physicians and physician assistants will take medicine to exciting new frontiers, I firmly believe that we also need the wisdom of those who have been in practice to make the leap forward practical and useful.

In my 28 years of practicing medicine, one thing I’ve learned is that a physician’s education never stops. While we are learning, we must also lead change in our organizations. Physicians are especially suited to lead change because of our clinical knowledge base which contributes to determining what will be best for our patients.

I wouldn’t have it any other way. Enjoy this month’s articles.

Just a reminder that the upcoming SCMS General Membership Meeting on Tuesday October 18, 2011 will feature L. Gordon Moore, MD speaking on “Maintaining autonomy and improving patient care.” For more information regarding the presentation, please go to the SCMS website at www.spcms.org.

M in Medicine is for Mentor

By George Novan, MD Associate Director, WWAMI Medical Education Program Faculty, Internal Medicine Residency Spokane Fourth year medical students are in the process of applying for residencies. Application packets need letters of recommendation.

As of today, 22 students have asked me to write them a recommendation letter for the upcoming Match (the computerized residency selection process). I agree to their requests but I have a stipulation. I ask them to let me read their personal statements.

Besides knowing the students and wanting to be able to give them suggestions if need be, I have an ulterior motive. I enjoy reading about the influences that have determined their choice of a future field in medicine.

Without giving away names, this is some of what they have written this year. One student did both his first and third years in Spokane.

The compassionate internist with superb reasoning skills who was his clerkship attending imbued the student with hopes of what he might be and so he chose internal medicine. Another student had one of our community's anesthesiologists as her preceptor during her first year of medical school. She wrote how she never forgot the awe as on the first day with him, he showed her how to intubate a patient. A third student had an OB-Gyn preceptor whose energy and positive interactions with patients profoundly influenced her. The student then went on to do her core OB-Gyn clerkship in Spokane and that further cemented her choice. I could go on but I think you get the picture.

"Recent Advances" is a journal article that I have kept since first reading it. It is an essay written by Dr. Michael Lacombe in 1990 and published in the American Journal of Medicine [Am J Med 1990 Apr;88(4):407-408.] It is a fictional account of residents sitting in a cafeteria arguing over what is medicine's greatest achievement.

Not able to agree on which great scientific advance is the one, they turn to an old attending sitting nearby who gives this answer. "The mentor is medicine’s single greatest achievement, though no one set out to invent the idea to win any prize."

The fictional attending continues by reasoning that each teacher in turn has been a student joined to other mentors down through the ages -- with each student-mentor link becoming part of a living grand medical textbook. He concludes by remarking that his mentor figuratively has never left him. His mentor has been at his shoulder ever since -- "I’ve carried my mentor everywhere."

The same applies to me. I still carry my first senior resident as a mentor. I still have my departmental chair and a young ID fellow (both of whom went on to become medical school deans) in my memory as examples for me. UW medical students train in Spokane; from precepting in their first year of school to core clerkships in their third year to electives in their fourth year, our students have their Spokane mentors. Those mentors have influenced the students already. They will carry their mentor with them into the future.

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A Facetious, Albeit Accurate, Guide to WWAMI Vocabulary

By Rachel Safran, MS-4 In 2008 the University of Washington School of Medicine launched a site to train first year medical students in Spokane, marking the expansion of a model for regional medical education already in place throughout the Pacific Northwest. Known among insiders as the WWAMI program, this has allowed 20 students annually to spend their first year of medical school in Spokane, in addition to the dozens of students in the area for clinical rotations during their third and fourth years. The program brings to Spokane a unique opportunity for community-based teaching, as well as some new terminology.

WWAMI Pronunciation: \’hwa-mee\ noun Origin: Derived from the first letter of each of the five cooperating states Washington, Wyoming, Alaska, Montana, and Idaho.

• An enduring partnership between the University of Washington School of Medicine and the states of Wyoming, Alaska, Montana, and Idaho established in 1971 to provide access to publicly supported medical education across the five-state region.

“The WWAMI program is the highlight of training at UW, providing the opportunity for world-class training in a community setting.”

• Compound noun for self-identification designating

a small cohort in a supportive health care community that is eager to engage students in every aspect of patient care.

• Commend, revere, appoint, immerse, honor with the prospect of receiving a personalized education commensurate with, if not exceeding, the quality of training available in Seattle.

“Getting WWAMI’d was the best thing that happened to me in medical school.”

“Talking about board scores and match success, you can’t even tell who was WWAMI’d.”

WWAMI-land Pronunciation: \’hwa-mee-,land\ noun Origin: Late third to fourth year English lengthened from the stem wwami, used to describe clinical training sites outside of the Seattle metropolitan area. ** Sometimes used to imply being distanced from the “mothership” it is more commonly used to connote being at a rotation teeming with one-on-one teaching, hands-on learning, increased access to attendings, and manageable work hours.

• Utopia, location with integrated purpose, supportive environment, community-based site or situation where students more fully participate in their medical training.

• “In WWAMI-land you not only scrub in to the OR, but you’re usually the first assist instead of straining to look over four pairs of shoulders.”

• “I did my Ob rotation in WWAMI-land and did dozens more deliveries than my classmates.

• “If you’re eager to manage your own patients and truly feel like a part of the team, then rank most of your rotations in WWAMIland.”

where a medical student started their training.

“I was a Spokane-WWAMI and had such a phenomenal experience in and out of the classroom that I chose to go back for most of my clinical rotations.”

Derivatives WWAMI’d

Understanding Admission to the University of Washington School of Medicine

By Matt Hollon, MD - Clinical Associate Professor UW SOM and Carol Tietz, MD – Associate Dean for Admission UW SOM

Pronunciation: \’hwa-mēd\ verb [with object] Origin: Mid-first year English lengthened from stem wwami, related to the misplaced and inaccurate notion of being sent away from a central city as an official punishment.

• Forbid, abolish, exile, get rid of, relegate to a decentralized and potentially inferior education.

“I can’t believe I got WWAMI’d to Spokane!”

“I’ve been WWAMI’d - there goes my chance of matching in plastics.”

Current vernacular: The term is now more accurately used to reflect being given the opportunity to begin medical school with

The medical school application process is one of the most competitive of any profession. With the strong interest and competition for medical school positions nationally, there is naturally elation when applicants are accepted at the medical school of their choice and disappointment otherwise.

The University of Washington School of Medicine (UW SOM) works hard to make its admissions process contemporary, fair, transparent, and highly relevant to the Northwest region.

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Continued on page 3

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THE RESULTS

In this article, we provide information about our process and outcomes.

The number of applicants has increased nationally over the last five years from 37,372 in 2005 to 42,742 in 2010 with 44-45 percent of applicants accepted. In 2010, 784 Washington residents applied to medical schools across the United States and 319 matriculated into medical school. Of those Washington residents, 723 applied to the UW and 122 matriculated at UW. 465 Washington applicants did not matriculate at any medical school.

THE ADMISSIONS PROCESS The UW SOM typically receives almost 5,000 applications for 220 positions in each class. Ten positions are reserved for the combined MD/PhD program which receives 250-300 applications annually.

The Admissions Committee consists of University of Washington faculty members from throughout the WWAMI (Washington, Wyoming, Alaska, Montana, Idaho) region as well as medical students and a few members of the non-UW community. The 178 members of the Admissions Committee are responsible for interviewing applicants. The Executive Committee (EXCOM), a subset of the Admissions Committee, is composed solely of faculty members and has 23 members. EXCOM members are responsible for screening applications, interviewing applicants, and voting on whether to accept or reject applicants. Two to three members of the EXCOM screen each application. Applicants who are “screened in” (two positive “screens”) are interviewed between October and March by a panel of three Admissions Committee members. One EXCOM member is part of each interview panel and is the only one of the three panelists with access to the applicant’s grades and MCAT scores. The interviewers assess the applicant’s motivation for a career in medicine, knowledge of the field of medicine and healthcare issues, interpersonal communication skills, and problem-solving skills.

Each EXCOM member presents the applicants he or she has interviewed to the rest of the EXCOM for consideration, discussion, and decision. This presentation includes information from both the written application and the interview. EXCOM members have access to each applicant’s electronic file, which includes summaries of the interview impressions submitted independently by each interviewer. Applicants are accepted (or rejected) on a rolling basis between the end of October and mid-March.

Compared with other states with similar population numbers, the WWAMI states have fewer seats for students who want to go to medical school. Other than the University of Oregon, the University of Washington is the only allopathic medical school in the Pacific Northwest and has a longstanding contract with Wyoming, Alaska, Montana and Idaho, to educate set numbers of residents from those states. Our relatively limited number of medical school seats and the national recognition for the quality of our medical school make the admissions process to UW SOM highly competitive.

Over the last five years, the UW SOM Admissions Committee has typically interviewed between 650 and 850 applicants each year.

Washington applicants may interview in Seattle or Spokane and are compared to other applicants from throughout Washington.

Although the UW SOM receives approximately 3,600 applications from outside the WWAMI region each year, the acceptance rate for these applicants averages just 0.5 percent. The acceptance rate for the WWAMI states, combined, averages 19 percent. In a five–year analysis that compared the acceptance rates of applicants from eastern Washington with those from western Washington, the acceptance rates were not significantly different (19.96 and 19.16 percent, respectively.) Applicants from within the WWAMI region who were not accepted on their first application and choose to reapply are typically accepted at a rate of 20 percent.

October SCMS The Message 3

Continued on page 5

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Every physician needs a good foundation.®

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October SCMS The Message 4

Continued from page 3 Dr. Christopher Watts, an ophthalmology resident in Iowa and son of Spokane OB/GYN Dr. James Watts, entered UW SOM in 2003.

Dr. Watt’s older sister, also a UW SOM graduate, encouraged him to prepare thoroughly for the interview. He and other classmates at Carroll College set up mock panel interviews and he reviewed the UW SOM website on ethical issues in medicine. He notes, “I was prepared almost for interrogation and I had three of the most friendly, personable, engaging interviewers.” Dr. Watts had an excellent interview and was accepted shortly thereafter. He went on to serve as a student member of the admissions committee and advises, “Getting into medical school is competitive – the main thing is applicants need to prepare, be genuine, and demonstrate sincerity and motivation during the interview.”

THE CHARACTERISTICS OF OUR STUDENTS The UW SOM admits the best and the brightest students who have characteristics that national studies have shown are important for future physicians. Our holistic decision-making process considers not only grades and MCAT scores, but also problem-solving ability, communication skills, motivation for and understanding of a medical career, record of service, broad interests and life experiences, and other characteristics. Our mean MCAT score and GPA are at the national average.

Given the commitment necessary to become a practicing physician, medical schools across the country look for applicants who have demonstrable understanding of the day-to-day rewards and difficulties in the life of a physician. This is best gleaned from the observation of doctors while they are seeing patients.

Even pre-medical students who grew up in a family in which one or both parents are physicians benefit from observing the patient-physician interaction. In a series of recent analyses at the UW SOM, the acceptance rate for offspring of physicians was compared to the rate for applicants whose parents were not physicians and found to be identical.

Dr. Katherine Bruya Reed, a dermatologist in Spokane and daughter of Spokane pulmonologist Dr. Timothy Bruya, was accepted to UW SOM in 2000. Reflecting on her admission she says, “I don’t believe I was an extraordinary applicant but I had a lot of direct exposure to different kinds of medicine so when prompted during the interview I knew about healthcare.” Dr. Reed had a personal exposure to medicine through her parents (her mother is an ARNP and nurse educator) however, most of her clinical exposure was through her work as a certified medical assistant in an internal medicine practice. Like Dr. Watts, she went on to serve as one of the student members of the UW SOM admissions committee and participated in applicant interviews.

She says, “All the applicants are outstanding, however you can tell the applicants who have real experience versus a checklist of experience . . . the ones who embrace the experience versus just do the experience.”

Broad life experience can be acquired in numerous ways and is thought to enhance physicians’ cultural competence, empathy, and ability to handle stress. Although we have a special focus on primary care, an applicant does not have to be interested in a primary care career to be admitted to the UW SOM. Students interested in any specialty receive the best training for their future careers. The mission of the UW SOM is to improve the health and well-being of the public. In pursuit of this goal, we are committed to excellence in biomedical education, research and health care. The people of the state and region are served best when graduates of the UW SOM choose a variety of careers that will meet the healthcare needs of our region, recognizing the importance of primary care, clinical specialties and leadership in the biomedical sciences and academic medicine.

Katherine Wysham, the daughter of a Spokane endocrinologist and a Spokane cardiologist, is a third-year medical student at UW SOM. Both through observing her mother’s work as an endocrinologist and her volunteerism at Joslin Diabetes Center in Boston, she developed a strong interest in the chronic care model. This interest backed by her patient care experiences solidified her personal desire to be a physician. She states that she felt really prepared for the interview. When asked by interviewers how she would help a 55-year-old patient with diabetes who has lost hope she says, “I had been in that situation with a patient and when you had that experience interacting with patients that makes you more confident in the interview.” Her advice to future applicants preparing for an interview, “Learn about the program, the philosophy behind UW SOM, and think through the situations doctors face in medicine.”

In summary, the large pool of highly qualified applicants to the UW SOM creates both an enviable and difficult position. The school can easily fill its seats with bright, talented, compassionate people who will make great physicians. Unfortunately, in the process, 80 percent of applicants will not be accepted and they and their families will be disappointed. We have worked hard to make the admissions process transparent and fair.

The Admissions Office strives to put all applicants on an even playing field with regard to the school’s expectations for applicants. The Admissions Office holds town hall meetings each spring and provides detailed information on its website.

For more information and additional helpful links please see http://uwmedicine.washington.edu/Education/MD-Program/ Admissions/Pages/default.aspx and especially http://uwmedicine. washington.edu/Education/MD-Program/Admissions/Applicants/ Pages/AdvicefromAdmissionsDean.aspx. Comments and suggestions are welcome and can be directed to Carol C. Teitz, MD, Associate Dean for Admissions via teitz@u.washington.edu.

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The Spokane Bubble

but has more of a small town feeling that makes one feel welcome and cared about.

By Deb Harper, MD Assistant Dean for Regional Affairs and Rural Health WWAMI Clinaical Medical Education – Eastern & Central WA

This spring I heard the phrase “The Spokane Bubble” for the first time from one of our third year students who had been in the original Spokane first year medical student class in 2008. Several other students with us began agreeing with her.

• Overall, excellent, student-friendly location for clerkships.

What in the world is “The Spokane Bubble”?

• Spokane is a fantastic place to do rotations. I felt very welcome

Most of our 20 entering students in the fall of 2008 did not want to be in Spokane. Seattle was their first choice. But, within less than six weeks, all of them were happy to have been sent here and, in their third year, over a dozen of them chose to spend their entire third year here as Track students. Why? Because of “The Spokane Bubble”.

The students told me they coined this term as a reference to the warmth, welcoming and mentorship they receive from their physician preceptors and the Spokane County Medical Society.

Here are a few of the comments from Spokane students in the past few months: • “I originally chose to spend all of my 3rd year in Spokane because I didn’t want to move somewhere new every 6 weeks.

I had no idea that this would be one of the best decisions of my medical career so far.”

• I have seen as wide a variety of pathology here in Spokane as my classmates have in Seattle but I have been able to take a more active role as a member of the medical team. Spokane has many rotations in which the student works directly with the attending which allows for personalized teaching.

& happy.

• Spokane offers exemplary community-based practices that truly strive to educate and involve medical students. My experience there was wonderful.

• My preceptor was a great teacher, I really enjoyed my day with him. He conducted thorough examinations, took time to teach proper physical exam skills and explained his clinical reasoning.

• The sessions with my preceptor were awesome. I went in the first day expecting an academic shake down, but the teaching style was very KIND yet thorough. My preceptor was great as both a teacher and mentor. I really appreciated how my preceptor was never rushed and took a lot of time to discuss

• This was a great place to do clinical rotations. Thank you for working so hard to give us a wonderful experience.

both the material we needed to cover but also act as a mentor.

• I had a wonderful experience! Thank you to all who made it

• The Spokane preceptors were willing to help us with whatever we needed and it was nice to have MD’s that obviously wanted to make the rotations valuable learning experiences.

• The medical community in Spokane is as advanced as Seattle

possible. I think the Spokane medical community is fortunate to have so many brilliant and caring physicians!

Thanks to all of our great Spokane teaching physicians for your terrific work!

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Teaching the Teacher

By Judy Swanson, MD Faculty Attending, Internal Medicine Residency Spokane Internal Medicine MS3 Clerkship Director Routinely seeing patients with similar problems day in and out can lead to a medical blindness.

You no longer see the person before you; you see a potpourri of data, tests and procedures that need to be discharged before eleven in the morning.

This morning, I take the third year students who rotate on our internal medicine housestaff service on rounds. A patient with COPD is admitted for his third exacerbation this year. As we gather around his bed, he tells a variation of the same old story I know by heart, but this is the first time for many of these students to see and hear the patient talk about his symptoms and effects of his chronic disease. I show the medical students his barrel chest, the intercostal retractions.

I watch how the students respectfully ask him if they can listen to his chest and they listen to the wheezing which I have taken for granted. Their respect strikes a chord within me. I am seeing the patient through a new set of eyes as I remember that sense of awe about the physician- patient interaction. Someone is willing to let you see and touch them in their vulnerable state because they see you as a healer. We thank him and leave the room, continuing our rounds.

The next patient is a pleasant, elderly male who is waiting nursing home placement. He has few active issues and I am wondering what the students can possibly learn by seeing this patient. I look at him closer and now I see the arcus senilis, the seborrheic keratoses and the temporal wasting that I have taken for granted and expect to see in this kind of patient. All the students crowd around, excited about these findings. Encouraged by their response, I look even closer. I now point out to them the Duputryn’s contracture, and have them demonstrate that they know how to elicit a biceps reflex. One student is having difficulty and I show her how to improve her technique by placing a thumb over the tendon. It works, and her pleasure at succeeding is infectious.

It brings back memories of my early attempts to improve my physical exam. As a medical student, I use to practice testing reflexes by using my reflex hammer on my younger brother. My lack of hand eye coordination had always been legendary in my family. I’m sure my brother also remembers my attempts, but perhaps not as fondly; I would strike everywhere on his arm but the tendon. It wasn’t until a kind family practice doctor took pity on my efforts that I learned to test reflexes without fearing I was inflicting bodily harm on an innocent person. Both my brother and I are enduringly grateful for those few seconds of teaching it required.

The WWAMI program in Spokane gives all of us a chance to recapture the moments when we decided to go into medicine and the struggle to obtain the skills necessary to be a physician.

It takes years to develop the history-taking skills and physical exam expertise that community physicians take for granted. Until you watch a student, you don’t appreciate how much you have learned through the years. Apprentices still learn by observing the master at his craft and so it is with the practice of medicine.

And once again, I find myself seeing the person before me.

Advocating for One of Spokane’s Economic Drivers

By Mary B. Verner, Mayor, City of Spokane In the midst of budget problems at all levels of government and impacts on critical services like police, fire, and streets, you might wonder why I’m talking about health care and medical education.

There are a number of answers. Some are obvious. I serve on the Spokane Regional Health District Board, and I am committed to helping our community be healthier.

Since I took office, the City has signed on as a partner for the local Step Up Spokane campaign and the national Let’s Move effort, led by First Lady Michelle Obama. Both are designed to get people more active. We also have supported the creation of community gardens. And, the City has taken other health-related steps, like banning the sale of electronic cigarettes to minors.

Meanwhile, the City of Spokane is one of the area’s largest employers, providing medical benefits to 2,000 employees and their dependents. We routinely engage our employees about healthy lifestyle options. We also are monitoring the entire health care reform debate as we anticipate its local effects.

But, my interest in this area goes far beyond encouraging healthy choices. Healthcare is one of Spokane’s key industry clusters. It is big business for us—a true economic driver that brings goodpaying jobs and visitors, who come here for medical services.

On the academic front, the education institutions within our burgeoning University District on the east end of our city core have a significant academic focus on the health sciences.

Great strides have been made in expanding these educational opportunities in the last year, and we will see both immediate and long-term payoffs for our local, regional, and state economy.

The institutions involved include WSU Spokane, Eastern Washington University, Gonzaga University, Whitworth University, and Community Colleges of Spokane. Other partners include

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Cancer evolves at a rapid speed.

So do our physicians.

They have chosen the fields of oncology and hematology to specialize in and are the region’s leading board certified, fellowship-trained cancer experts. Pushing the limits, they conduct hundreds of clinical trials every year, publish articles for world-recognized scientific journals and customize treatment plans for every patient. Because no two cancers – or patients – are exactly alike.

Meet the physicians of Cancer Care Northwest.

View their full profiles at: cancercarenorthwest.com/doctor-profiles

»

cancercarenorthwest.com

» 509.228.1000 October SCMS The Message 8

comprehensive innovative compassionate integrated

Continued from page 7 the City, Downtown Spokane Partnership, SIRTI, Greater Spokane Incorporated, and other private-sector entities.

The biggest news of the year was an allocation by the Washington Legislature of $35 million to construct the Biomedical and Health Science Building Phase I at WSU Spokane. This building will house a full, 4-year medical school as well as the WSU College of Pharmacy.

A recent analysis suggests that having all four years of medical school in Spokane will eventually create some 9,000 jobs and $1.5 billion of economic impact within our region. The numbers are even greater when you look at the statewide impact.

Also significant is the ability to help address our physician shortage in Eastern Washington and throughout the state. We could see many more medical students in Spokane as early as January 2014.

In addition, 60 new speech and hearing sciences students are attending classes in the District this fall, and we’re anticipating 200 first- and second-year pharmacy students in fall 2012.

Another important component of the expansion of medical education here is the opportunity to develop cutting-edge research that will lead to new technologies and commercialization of those technologies. Gains in patient care and treatment and creating a focus on healthier people and communities are other opportunities.

International District and hospital district, where we anticipate additional student housing, retail amenities and business expansion.

These efforts are overseen by the City-led University District Revitalization Area Project Advisory Committee. The committee will oversee the financial administration and project prioritization in the area, using a mix of local tax revenues and state matching funds.

Ultimately, this is great news for Spokane, which is working mightily to get beyond the effects of the ongoing economic downturn. During 2011, my efforts have been solidly focused on helping the private sector grow and create jobs. Work to expand our medical education offerings and health care industry is a key growth strategy.

Health care is clearly one of our community strengths; we are a regional hub for such services. It just makes sense to advocate for change that will bring us more medical research, expertise, and jobs.

Medical Education Expansion: Good for You, Good for Spokane

By Kevin Dudley Marketing and Communications Coordinator at Greater Spokane Incorporated

So, what happens next?

Construction on the Academic Health Science Center has begun.

WSU and UW are working on curriculum development. Partners who are willing to help our graduates meet their intern and residency requirements are being sought. Participation by local physician practices, hospitals, and clinics is required for this aspect of continuing medical education. We absolutely need this support.

Additionally, we will continue to advocate for the remaining funding needed for the new building, as well as operating funds for all four years of medical studies and the WSU College of Pharmacy. And, the educational institutions will continue work to attract top-notch medical researchers.

The City of Spokane has a distinct role to play in the build-out of the University District. The City is investing significant staff and capital resources to develop the infrastructure that makes our University District a vibrant and integrated development in which talented professionals, staff, and students will learn, work, and live.

Construction is continuing on MLK Way. This new street will divert traffic away from the center of the Riverpoint campus, create a more pedestrian-friendly atmosphere, preserve a corridor for future transit options, and be part of a grand new gateway into Spokane from I-90 to the River and beyond.

So where were we?

Last December, we told you we were reaching out to rural areas to gain support for expanding medical studies at WSU Spokane, gearing up for our annual advocacy trip to Olympia and developing a business plan to meet the long-term needs of the medical community in eastern Washington.

So what’s happened since?

In late January, a delegation of nearly 90 area business leaders traveled to Olympia to, among other things, advocate for money in the capital budget to construct a roughly $70.8 million biomedical building. It will one day be home to four years of medical studies and the WSU College of Pharmacy, not to mention faculty research that can ignite economic activity.

Despite the governor’s proposed budget with no money for the biomedical building, the legislature ended its session allocating $35 million. Our community is thankful for the amount we received, and we’ll continue to advocate and raise the remaining amount. In the meantime, the work goes on.

Representatives from WSU Spokane have been meeting with medical representatives in Spokane and other communities to inform them of this project. A business plan has been adopted and is

We’re also working on plans for a pedestrian and bicycle bridge over the railroad viaduct to improve connections south to the October SCMS The Message 9

Continued on page 11

Riverpoint Rx.pdf

1/20/10

10:55:21 AM

A Personalized Approach to Your Health Riverpoint Pharmacy is one of the few remaining pharmacies that can still offer customized medications through pharmaceutical compounding.

We can provide: • Individualized strengths, combinations and flavorings • Specialized dosage forms such as topical gells and slow release capsules • Sterile compounds such as preservative-free eye drops, injectibles and custom nebulizer solutions • Veterinary compounding Our specially trained pharmacists also offer personalized consultations in: • Nutrition evaluation and planning for improved health • Bioidentical Hormone Replacement Therapy for men and women • Review of medications and supplements • Pain management options for chronic pain and special needs

R iverpoint P

H

A

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M

A

C

Y

Your treatment. Custom designed.

(509) 343-6252 | 528 E. Spokane Falls Blvd. #110 www.riverpointrx.com

October SCMS The Message 10

Continued from page 9 currently being utilized by a Steering Committee working to support the development of the health science campus at Riverpoint.

The next step is to secure operating funds and private donations in order to expand the program and add second-year students – bringing all four years of medical studies to Spokane – and then to increase the total number of students admitted to the Spokane program.

By 2013, we hope to have the first class of 20 second-year students in Spokane.

The WSU College of Pharmacy will also be moving its first- and second-year students from Pullman to Spokane, joining medical students in the new building. Third- and fourth-year pharmacy students already study in Spokane. Efforts are also underway to expand the number of residency slots in graduate medical education – and key factor in retaining our area talent.

More students entering our community makes way for a future of great economic growth, as they purchase housing, buy groceries, go out to dinner, buy lattes, order pizza, go to the movies, buy gas and lots more.

So what does all this progress mean? With more students in Spokane, the economic benefits are nice enough. But with more students also comes more opportunity for physicians to train the future workforce.

“Having students and teaching sort of elevates the game, if you will, for practicing medicine,” said Ken Roberts, WWAMI Spokane Director. “If you have students in your clinic and you’re responsible for educating them on how to do one thing or another, you automatically pay more attention to those things that you’re doing.”

Dr. Brad Pope, president of the Spokane County Medical Society and District Medical Director at Group Health Cooperative, shares that view.

More students in Spokane, coupled with a greater number of residency slots, will increase the chances of a graduate staying in the area to practice.

Roberts said the Spokane County Medical Society informally surveyed physicians in Spokane and found that many current physicians are interested in teaching. Those who currently teach indicated they want to teach more.

That’s a powerful message when it comes to advocating for more operating funds to introduce a second year of medical studies and accept more students.

“So the question we have is, how many more physicians do we have in town who are really interested in teaching but are not teaching yet?” Roberts asks. “What’s our capacity?”

Last year, a $24,000 grant from the Empire Health Foundation allowed WSU Spokane to implement faculty development sessions to help physicians learn about teaching. Roberts said one session is complete, with more coming up in October and January.

“That will help address some of those anxieties or lack of confidence some doctors have,” Pope said.

Being able to improve quality care and being part of something this transformative can only be a positive. Helping educate today’s students will aid in reducing the severe physician shortage in our region. It will also help improve quality care, as more patients will be treated by physicians with a background in interdisciplinary health studies. There are also opportunities for physicians to engage in research with university faculty.

Of course, students are only as good as their mentors – the physicians.

“I have met some of the most dedicated and talented and engaged medical educators that I would put on par with anyone I’ve ever met in my career,” he said.

“If you’re exposed to students as you’re doing work as a physician, it kind of keeps you on your toes,” he said. “You feel like, ‘oh, well I’m supposed to be a mentor to this person. I’m supposed to know more than they know. I’m going to keep up with things.’”

The biggest issue is this: there’s a shortage of doctors in our region. An aging population and an aging workforce mean a higher number of physicians will be needed to meet our region’s medical needs.

“If someone moved to this area, is on Medicare and don’t have any existing relationship with a primary care doctor in this town, they’re going to find it very difficult to find a primary care physician in town who will accept them as a new patient,” Pope said.

October SCMS The Message 11

We’ll come to you because we care.

“For over 40 years we’ve provided the best home healthcare to the Inland Northwest, and today we're ranked as one of Medicare's elite agencies in the country. No wonder over 95% of our clients would recommend us. Call me personally to see why we're the right choice for you and your clients."

– Mike Nowling President Family Home Care & Hospice

Call Today 509.473.4900 www.familyhomecare.org October SCMS The Message 12

Enjoying the Broccoli Along With the Grilled Salmon

By Tom Schaaf, MD Medicine is both an art and a science—and medicine evolves all the time. Lately we are experiencing promising changes in basic science and innovation in the ways we deliver care. Part of our job is to stay current on the advances. If we practice solely what we learned in medical school, even if that was just five years ago, we won’t deliver the best medical care.

As physicians and physician assistants, we’re on the receiving end of a fire hose of information about new therapies and delivery system redesign. I find it time-consuming to filter what’s useless or misinformation. It goes without saying that continuing medical education (CME) should be evidence-based. Even better, CME shouldn’t be funded by drug companies who can influence content, even when they aren’t directly paying the instructors.

That’s why Group Health Cooperative joined several health care organizations to support the Spokane Society of Internal Medicine in its effort to offer CME without drug-company support. These supporters include Providence, Deaconess Medical Center, Valley Hospital, Inland Imaging, PAML, Rockwood Clinic and Physicians Insurance.

Many of us would prefer to get our medical updates in Maui.

Regardless of where we get it, today’s practitioners need two types of CME to survive in today’s health care environment.

First, we always need new, evidence-based clinical information.

The science changes and so should our practice.

Then there’s the second type: CME that prepares physicians for the future of healthcare.

Topics such as the medical home model and care management are critical to understand if we want to give our patients the best, safest and most cost-effective care possible. National health policy is another.

Patient safety is also a timely topic. In the past two decades, doctors and health care organizations have become more transparent and committed to patient safety, which may require a culture and behavioral shift and buy-in from physicians.

Shared decision-making is yet another area of interest. New evidence-based videos and tools have emerged to support doctors and empower patients when they face a decision about a diagnosis that offers several proven treatment options.

Finally, we are all swimming in new health care technology whose potential is promising and powerful.

They are good for you and vital to better patient care, but we’d honestly prefer a serving of grilled salmon (or that conference in Maui). Although these subjects may not make you salivate on first impression, I am convinced that they will improve our medical care and health care system in the long term, while making our patients happier.

Now that we are fully immersed in fall activity, I encourage you all to attend a seminar, forum or conference on one of these topics.

Find one in Maui if you want. Once you taste it, you’ll be glad you tried it.

Tom Schaaf, MD, is the assistant medical director for Group Health Cooperative’s Eastern Washington/North Idaho District. Boardcertified in Family Medicine, Dr. Schaaf has practiced at Group Health in Spokane since 1992, and founded its hospitalist program in 1997.

Providence Health Care Offers Continuing Medical Education Category 1

By Alex Shuford, Ph.D. Providence Health Care’s CME Coordinator Continuing Medical Education (CME) is an important facet of medical education for health care professionals and an integral part of Spokane’s rich learning environment as it increasingly becomes an academic medical hub. All physicians, nurses, mid-level providers, PAs or CRNPs are welcome to any of the Providence Health Care CME programs or conferences.

Providence Health Care is accredited by the Washington State Medical Association (WSMA) to provide CME1 activities.

Washington State physicians must complete 200 hours of CME every four years and at least 80 hours must be CME 1. CME 1 activities at PHC for 2011 include Cardiovascular Grand Rounds, Genetics Grand Rounds, Ortho Trauma Case Conferences, Pediatric Grand Rounds, Pediatric Surgery Case Reviews, Psychiatry Grand Rounds, Stroke Education, Stroke/Neurology Case Conferences and Women’s Grand Rounds. In addition to these regularly scheduled series, PHC hosts weekly tumor boards, special course offerings, and is a joint sponsor of the statewide Surgical Care and Outcome Assessment Program (SCOAP) as well as the Clinical Outcomes Assessment Program (COAP).

In compliance with the Washington State Medical Association (WSMA) and the Accreditation Council for Continuing Medical Education (ACCME) mandates, PHC is careful to keep CME 1 education free from “commercial interests” and requires anyone in a position to influence the content of an educational activity to disclose all relevant financial relationships.

I jokingly call this category of CME as the “broccoli” topics.

October SCMS The Message 13

Continued on page 14

Continued from page 13 Many of PHC’s CME activities are held at the urban campuses of Providence Sacred Heart Medical Center and Providence Holy Family Hospital and are often recorded using Mediasite or available by Telehealth. To see a full calendar of CME 1 events including dates, times and locations, please visit our website at https://cme.shmc.org and click on the CME Schedule tab.

Several Saturday afternoon speakers addressed issues regarding Information Technology and Making Integration Work (John Kenagy’s slides are available at info@johnkenagy.com). Please check out photos from the Annual Meeting at our SCMS website at www.spcms.org.

THANK YOU to all the Spokane County Medical Society (SCMS) members who participated.

The CME Program can also award CME 1 credit for services you are already providing. Do you teach medical students or residents? Are you part of Performance or Quality Improvement work? Have you been invited to present at Grand Rounds or other CME event? You may be eligible to receive CME 1 credit for these activities.

If you have ideas for an educational CME 1 event or would like to learn more about the PHC CME program including joint sponsorship to promote your educational program, please contact Providence Health Care’s CME Coordinator: Alex Shuford, Ph.D. at 509.474.3391 (M - F, 8:00 - 4:30) or email alexandra. shuford@providence.org.

2011 WSMA Annual Meeting – The New Normal

Dr. Dean Martz (outgoing WSMA President) addressing the House of Delegates and Dr. Brian Seppi (WSMA Board member)

The WSMA Annual Meeting was held in Spokane this year and before it got started, there was a Friday afternoon CME, “Medical Practice Transformation: Charting Your Course”, sponsored by WSMA and Physicians Insurance. If you weren’t able to attend you can check out the program On Demand through the WSMA. The Saturday morning meeting focused on the reference committees and the work related to resolutions and preparation for the House of Delegates (HOD) meeting on Sunday. Drs. Brad Pope and Courtney Clyde served on Reference Committee C that heard testimony on various resolutions. Dr. Terri Oskin helped with the credentialing process for the HOD. Other Spokane County Medical Society members in attendance included Drs. Gary Knox, Jeff Snow, Fredric Shepard, Anne Oakley, Russ Oakley, Audrey Brantz, Michael Cunningham, Beth Peterson, Rod Trytko, Deb Harper, Dean Martz, Brian Seppi, Nick Fairchild and PA-C Lou Koncz.

Spokane Delegates at the WSMA Annual Meeting

Dr. Dean Martz, who served ably in the Presidency for 2010-2011, passed on the gavel to Dr. Doug Myers from Clark County (both had inspiring comments about leadership in Medicine). Dr. Deb Harper was given a bound collection of WSMA written materials to remember her dedicated work as she leaves the WSMA Board after serving her last term as Past-President and Chair of the Executive Committee, among other significant accomplishments.

The WAMPAC luncheon featured Stuart Elway, PhD, who spoke about the political landscape in both Washington and Washington D. C.

Eastern Washington Caucus breakfast attendees

October SCMS The Message 14

When it comes to your special delivery, we’ve got you covered.

We believe new moms and babies should be surrounded with comfort and care. That’s why we bring you:

• Suites designed so mom and baby can remain in the same room throughout their stay • Spacious suites with cozy amenities, a private bath and accommodations for an overnight guest • Trained OB nurses plus a Special Care Nursery for infants with more complex medical needs • Support for all types of birth plans, from natural to planned C-sections • A waiting room exclusively for families of OB patients

To schedule a tour of The Birthing Center and Special Care Nursery at Valley Hospital, call (509) 473-5475.

To find an OB physician based in the Valley, visit www.spokanevalleyhospital.com/physicians.

12606 East Mission • Spokane Valley

P e r s o n a l i z e d OB C a r e . R i g h t H e r e .

October SCMS The Message 15 53203_VHMC_OB_7_5x10c.indd 1

1/14/11 5:01 PM

Project Access Patient Stories and Provider Appreciation Campaign

I am attending college at SCC to study electrical maintenance. Money is really tight and my situation arose unexpectedly. An onset of vision problems led to needing an MRI scan. Project Access provided this MRI at Inland Imaging. The scan showed a one-inch large tumor at the front of my brain (pituitary tumor).

By Lee Taylor Director, Project Access Spokane November is Project Access Provider Appreciation Month.

Beginning in October, and continuing through November, Project Access will be doing as much as possible to publicly thank the providers who have so generously donated medical services to the low income uninsured residents of Spokane County. This update next month will be dedicated to the Provider Appreciation Campaign.

This month we want to share two stories that were provided by Project Access patients. We hope you will enjoy reading these stories and we hope that they will help deepen your understanding of the huge impact the generous donations of services have on our community.

Project Access is one of those miracle blessings that a person rarely experiences. I am receiving costly diagnostic tests and medical help that would have been impossible without Project Access.

Even my regular doctor could not effectively help since my true state of health was unknown without these tests.

This led to assembling a team of surgeons, Dr. Martz and Dr. Cruz, at Sacred Heart. The surgery went well, but a follow-up MRI is yet to be done so we don’t know if the whole tumor was removed. Words cannot express my gratitude for the outstanding medical field we have here in Spokane. I am beyond impressed with the care I received.

Thank you.

Russ Bower September 8, 2011 If you would like to learn more about Project Access please call me at 220-2651 or email me at lee@spcms.org.

Project Access is a wellspring of hope and help. And all freely given. Donated time, energy, skills and resources.

The estimated cost of it all is staggering. There are no words good enough to express my humble heartfelt gratitude for all the dedicated caring people that make all this possible for myself and all the many others that are being helped.

May God richly bless all of you with Project Access.

Theresa M. Bennett May 27, 2011

October SCMS The Message 16

A Multidisciplinary Approach to Improving Quality of Life Physical Medicine & Rehabilitation Psychology

Physical Therapy

Interventional Spine Pain Medicine EMG/NCS Jamie Lewis, MD Patricia Fernandez, PsyD Brandon Byquist, DPT

Phone: 509.464.6208 Fax: 888.316.1928 Spokane, Washington October SCMS The Message 17

Fellow SCMS Members: The SCMS Peer Review Committee has the task of reviewing activity by the Washington Medical Quality Assurance Commission involving members. Over the past several years there have been a significant number of investigations regarding professionalism. The Peer Review committee has provided information designed to educate us about these issues and how to avoid having MCAQ ”knock on the door”. We trust this has been helpful!

The following article was written by an attorney with MCAQ to provide understanding about their mission and the process involved when a complaint is received. Having talked to individuals who have had to go through this journey, I know how stressful and punitive it seems. If you do get “a call”, please know that there is due process available to you. The Peer Review committee members are available to discuss this further if you wish.

Michael Metcalf MD Peer Review Committee Chairman

When the Commission Calls

By Tom Fain Member Fain Anderson VanDerhoef, PLLC Darrel Royal used to have a saying about a forward pass: “Three things can happen, and two of them are bad.” The same saying applies to an investigation by the Medical Quality Assurance Commission – three things can happen, and two of them are bad. An investigation can lead to either: 1) closure (good), or 2) a Stipulation to Informal Disposition (bad), or 3) a Statement of Charges (really bad).

You have to cooperate – but so do they. Whenever an MQAC investigation is undertaken, a physician has a duty to cooperate

with the investigation, including a duty to provide information to the Commission. A failure to cooperate can even lead to its own sanctions. HOWEVER, because state disciplinary proceedings are quasi-criminal in nature, the physician has a constitutional right to consult with an attorney, and a legal right to know what the allegations are, before he has to respond to questioning.

Investigations are always serious business. To appreciate the seriousness of the disciplinary process, look at the sanctions the Commission is authorized to take, including restriction, suspension or revocation of your license. No sanction is without consequence. With the multitude of provider plans funding reimbursement, the consequences of any discipline may be significant. Some plans provide for a termination of credentials for any sanction, while others may limit termination to specific sanctions such as revocation or suspension. These same concerns may arise with credentialing for hospital privileges, employment by your group, or even your board certification.

Notice. Most (but not all) investigations start with written notice.

But the notice doesn’t tell you what the investigation is about. The notice will even tell you that you are free to submit a response at this time. DON’T! Instead, wait until you know the issues.

Investigations then progress to either: a) an inquiry letter asking for a written explanation, or b) a personal visit from the investigator.

The Inquiry Letter. If you get an inquiry letter, it will inform you of the nature of the complaint.1 This is your chance to tell your story.

Tell it wisely. The quality of your response is largely determinative of what steps the Commission takes next. Before submitting a response, you should review the entire chart of the patient(s) involved, consult counsel (and maybe even a colleague) and consider conducting a literature search to support your decisions.

Your response can have even farther-reaching effect. SHB 1403 went into effect July 22, 2011 to require that copies of your reply to an inquiry letter be provided to the complainant.

October SCMS The Message 18

Continued on page 20

FAMILY Now providing comprehensive HOME prosthetic and orthotic patient care for adults and children CARE VALLEY ORTHOPEDIC

Spokane Valley 509-922-5040 Coeur d’Alene 208-765-3080 Sandpoint 208-265-0100 Post Falls—Opening November 2011 For more information and practitioner profiles, go to www.kpoidaho.com

We’re with you and your patients

Every Step of the Way

October SCMS The Message 19

Continued from page 18 Not only can the MQAC use a poorly drafted response against you in a disciplinary proceeding, but the complainant can use your response against you in a medical malpractice case.

The Interview. If the investigator drops by for a visit, it is not just a social call. He has reviewed the file, and everything the complainant has said about you, long before the visit. You, on the other hand, probably haven’t seen the patient for quite some time, and have little recollection of the care or issues involved.

Now is not the time to demonstrate your skills at extemporaneous speaking. If you haven’t already done so, get a lawyer now.

Politely inform the investigator that you do want to cooperate, but that you also want a reasonable opportunity to consult with counsel and review the allegations and chart before responding.

Otherwise, listen – don’t talk. If the investigator has not by now presented you with a letter outlining the allegations to which you are to respond, now is the time to ask for it (he has it with him).

Then, set up an appointment in the near future that provides you with an opportunity to review the records, meet with counsel, and adequately prepare for the interview.

But lawyers cost money. True. However, most professional liability policies provide coverage for legal expenses associated with disciplinary proceedings. Some have deductibles, some have caps, some are direct pay, and some are reimbursement. If your lawyer doesn’t mention this to you, be sure to mention it to him.

If your insurance company prefers a certain lawyer, find out why. If you prefer someone else, insist on the right to use him or her. It is your license at stake, not theirs.

Tom Fain is a member of the Seattle law firm Fain Anderson VanDerhoef, PLLC, a Fellow in the American College of Trial Lawyers, and an Advocate in the American Board of Trial Advocates. Tom has tried cases in state and federal courts and administrative agencies. He has represented hundreds of health care professionals over the past 35 years, and tried their cases before civil juries, professional disciplinary boards, hospital fair hearing panels and provider plan panels. The firm’s attorneys deal extensively with professional liability and disciplinary matters on a daily basis. The firm website is www.favfirm.com.

1The actual complaint may not be provided with the inquiry. If it is only paraphrased, the actual complaint should be requested. It is not exempt from disclosure. The DOH sometimes does not agree with this position, but (in my humble opinion) they are wrong.

Reprinted with permission from the Washington Healthcare News.

Opinion Response to the Future of Medical Care Article

By John McCarthy, MD I feel a need to respond to Dr. Rice’s opinion about the future of medical care in the last issue of The Message. I don’t feel a need to respond to the controversial proposal that all physicians should be on salary though I imagine some of my colleagues might. Last year, I had the opportunity to work with George on a presentation regarding the future of medicine and found him to be thoughtful, attentive to his audience, and clearly invested in healthcare for patients.

In spite of that, I think his lack of appreciation for Family Medicine as a Specialty is ill informed and worthy of discussion. Dr. Rice writes, They (family physicians) should be incorporated into the mix of pediatricians, internists or gerontologists. I think, in today’s advanced medical care it would be extremely hard to be a “jack of all trades.” Many family physicians do not have hospital privileges and do not do obstetrics or surgery today.

While I appreciate the idea that some people will be better served or prefer being seen by a Pediatrician, an Internist, or a Geriatrician, I believe it ill conceived to suggest that this should be a cornerstone of good medical care. There are certainly different issues which we face as we age but I believe to base a healthcare system on this would be misguided. I think it a mistake to de-value the contribution family physicians (who are trained across the age spectrum) offer to the health of this nation.

I do not think of myself or my family medicine colleagues to be “jack(s) of all trades.” Rather, I consider family physicians to be the providers of choice for the majority of health issues for the majority of the population, providing continuity and collaborating with our valued specialty colleagues. Furthermore, I suggest that Dr. Rice is correct in stating that this is inherently “extremely hard” and (I would add it takes an excellent physician to do this job well).

Additionally, the impact Family Medicine Physicians make in the rural arena is profound. If we were to remove Family Physicians from Washington State, approximately 2/3 of our counties would be or become Health Professional Shortage Areas (HPSAs). See the following link from the Graham Center for an interactive map. http://www.graham-center.org/online/graham/home/toolsresources/maps/maps/hpsamaps.html. I am certain that Dr. Rice was not suggesting this transition away from Family Physicians occur overnight; but rural America is not adequately populated by Pediatricians at this time and outpatient General Internists are a valued, and rare entity in both urban and rural arenas. There are reasons this evolution has occurred and a re-working of the health care system might be able to address this issue.

Continued on page 21 October SCMS The Message 20

Continued from page 20 Finally, I must add a personal note. I look forward to my family physician, Jim Bingham, MD continuing to provide excellent care for me and my family. I would be disillusioned if my children “graduated” from his care and had to seek another physician when they turn 19 or I had to transition when I turn 65. Dr. Bingham has a contextual relationship with my children, my wife and me. It would be a shame to “age out” of that relationship. When I become a geriatric patient (I am not sure that is a chronological age phenomenon), I look forward to continued excellent care by Dr. Bingham, and if need be, a referral to one of my highly valued specialty colleagues for whatever needs I have developed.

Continuing Medical Education Endocrinology Update 2011: 3.0 Hour(s) of Category I CME credit, sponsored by the Spokane County Medical Society. We will be honored to hear from Dr. Irl Hirsch from the University of Washington regarding Updates on Diabetic Issues. Conference held on October 6, 2011 at the Deaconess Health and Education Center. Contact Jennifer Anderson at (509) 325-5010 or email jennifer@spcms.org for more information.

Interactive Teaching Skills, a WWAMI Spokane Faculty Development Workshop presented by Judith L. Bowen, MD, FACP, professor of medicine at Oregon Health & Science University.

Approved for 2.5 CME Category 1 and sponsored by Providence Health. Registration is free and includes dinner. Save the date for October 6 from 5:30 p.m. to 9:00 p.m., venue in Spokane to be announced. For more information contact Marlene Maurer, 509-3587795 or mamaurer@uw.edu. This is the 2nd in an ongoing series.

Previous attendance not required. Grant funded by Empire Health Foundation.

The Columbia Basin Medical Conference (15 AMA Category 1 Credit Hours) will be held on November 4 & 5, 2011 in Moses Lake.

For more information visit www.russocme.com or email russocme@ gmail.com.

The Long Acting Opioid Conference (8 AMA Category 1 Credit Hours). The conference will be in Spokane on October 21, 2011 and Kennewick on November 18, 2011. For more information visit www. russocme.com or email russocme@gmail.com.

Caduceus Al Anon Family Group – Meets every Thursday evening from 6:15 pm until 7:15 pm at 626 N. Mullan Road, Spokane, WA. Non-smoking meeting for spouses and significant others of Healthcare Providers who are in recovery or who may need help seeking recovery. Facilitated 12 Step Al Anon Format. No dues or fees. Contact 509-928-4102 for more information.

Physician Family Support Group — Physicians, physician spouses or significant others, and their adult family members share their experience, strength, and hope concerning difficult physician family issues which may include medical illness, mental illness, addictions, work-related stress, life transitions, and relationship difficulties. The meetings are on Tuesdays from 6:30 pm – 8 pm at Sacred Heart.

Format: 12 Step principles for everyone, confidential and anonymous personal sharing; no dues or fees. Contact Bob or Carol at 509-6247320 for more information.

Humanity In Clinical Care - A Psychoanalytic View of Prejudice, Its Many Faces: Why Is Prejudice So Problematic in a Physician’s Mind? Presented by Salman Akhtar, MD (Internationally acclaimed psychoanalyst and author; Professor of Psychiatry, Jefferson Medical College, and Director of Psychiatric Outpatient Services, Thomas Jefferson University Hospital, Philadelphia, PA) at The Marcus Whitman Hotel and Conference Center, 2nd and Rose Street, Walla Walla, WA. Friday, October 28 2011 12:15 pm. to 3:00 pm Lunch included. CME II, 2 hours. Participants will learn to confront their own biases and prejudices and improve their ability to provide humane clinical care. No cost. The Lectureship is funded through donations from the medical community of Walla Walla as a loving memorial to Dr. James E. McClellan. PRE-REGISTRATION IS REQUIRED. Space is limited. Email Carole Alexander at cralexander@charter.net for more information.

Membership Recognition for October 2011 Thank you to the members listed below. Their contribution of time and talent has helped to make the Spokane County Medical Society the strong organization it is today.

40 Years Peter C. LaRowe, MD

10/12/1971

30 Years

Meetings, Conferences and Events

Michael O. Henneberry, MD

10/27/1981

10 Years

Institutional Review Board (IRB) – Meets the second Thursday of every month at noon at the Heart Institute, classroom B. Should you have any questions regarding this process, please contact the IRB office at (509) 358-7631.

F. Jane Durcan, MD

10/1/2001

Elizabeth C. Ho, MD

10/1/2001

October SCMS The Message 21

In the News Glen Stream, MD Elected as AAFP President The American Academy of Family Physicians (AAFP) announced that Dr. Glen Stream assumed the role of president of the academy.

Stream, a family physician, spent three years as an AAFP board director and one year as president-elect. At Rockwood Clinic, he has served as a board member, chief privacy officer and medical director of information services. He currently is the practice's chief medical information officer.

As president of the AAFP, Stream advocates on behalf of family physicians and patients nationwide to inspire positive change in the U.S. healthcare system. Stream was elected to his position by the AAFP's Congress of Delegates.

InCyte Pathology Announces the Expansion of Its Oncology Diagnostic Services InCyte Pathology welcomed hematopathologist, Ayumi I. Corn, M.D., to its growing cancer diagnostic division. InCyte Pathology’s hematopathologists work closely with area oncologists to decide the best treatment for patients with diseases of the blood, bone marrow and lymph nodes.

Prior to joining InCyte Pathology, Dr. Corn was a hematopathologist at Integris Baptist Medical Center in Oklahoma City, OK. She recently moved to the Spokane area with her husband and three children and will begin working at InCyte Pathology in early October. Dr. Corn is board certified in hematology, anatomic and clinical pathology. She graduated from the University of Oklahoma College of Medicine and completed her residency at the University of Oklahoma Health Sciences Center and St. Joseph’s Hospital and Medical Center.

“InCyte Pathology is excited to have Dr. Corn on board,” explains InCyte Pathology’s Chief Medical Director, David Hoak, M.D. “Dr. Corn trained with one of the nation’s premier hematopathologists, Dr. Kathryn Foucar, and completed subspecialty training in flow cytometry, bone marrow, lymph node and molecular pathology. She will be a valuable asset to oncologists and their patients throughout the Inland Northwest.”

Claudette Kenmir Named Vice President, Eastern Regional Office, at Physicians Insurance A Mutual Company Physicians Insurance A Mutual Company has announced that Claudette Kenmir has been named Vice President, Eastern Regional Office. Kenmir has relocated from Denver, where she was vice president and regional general manager at Liberty Mutual Group/ Safeco Insurance. Before her position in Denver, she was vice president and national sales center leader of Safeco Insurance Companies in Liberty Lake, Washington.

“Claudette Kenmir has extensive experience in personal and commercial lines growth and profitability,” says Mary-Lou Misrahy, President and CEO. “Her leadership skills, strong ties to the region, and dedication to customer service will enable us to best serve existing Physicians Insurance members and increase membership of physicians, clinics and hospitals in Eastern Washington and Idaho.”

Kenmir earned her bachelor of business administration degree in finance from Eastern Washington University. She began her insurance career at Fireman’s Fund Insurance Company in Spokane in 1986.

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The following physicians/physician assistants have applied for membership, and notice of application is presented. Any member who has information of a derogatory nature concerning an applicant’s moral or ethical conduct, medical qualifications or such requisites shall convey this to our Credentials Committee in writing 104 S Freya St., Orange Flag Bldg #114, Spokane, Washington, 99202.

PHYSICIANS

Patel, Yashma R., MD Neurology Med School: J.J. M. Medical College, India (2001) Internship: Flushing Hospital Medical Center (2004) Residency: SUNY at Sunny Brook (2007) Fellowships: SUNY at Sunny Brook (2008), (2009) Practicing with Rockwood Clinic since 9/2011

Borgnes, Erik M., MD Diagnostic Radiology Med School: Wayne State U (1992) Internship/Residency: St. Joseph’s Hospital (1997) Practicing with Radia Inc., PS since 3/2009 Chaganur, Kavitha, MD Internal Medicine Med School: Vijayanagar Institute of Medical Sciences, India (2004) Internship/Residency: Internal Medicine Residency Spokane (2012) Practicing with Providence Sacred Heart Medical Center Hospitalist beginning 4/2012 Corn, Ayumi I., MD Anatomic/Clinical Pathology Med School: U of Oklahoma (1994) Internship/Residency: U of Oklahoma (1997) Residency: St Joseph’s Hospital and Medical Center (2000) Fellowship: U of New Mexico Health Sciences Center (2005) Practicing with InCyte Pathology beginning 10/2011 Corn, Todd D., MD, PhD Internal Medicine Med School: U of Oklahoma (1997) Internship/Residency: Mayo clinic (2000) Practicing with PPS PSHMC Hospitalist beginning 10/2011 Edgehouse, Kristin A., DO Pediatrics/Pediatric Hematology/Oncology Med School: Philadelphia College of Osteo (2004) Internship/Residency: Oregon Health and Science U (2007) Fellowship: Stanford U (2010) Practicing with Judy Felgenhauer, MD, PS, Sacred Heart Children’s Hospital beginning 10/2011 Fishman, Michael S., MD Diagnostic Radiology Med School: Ohio State U (1987) Internship: U of Colorado Health Sciences Center (1988) Residency: U of California, San Diego (1992) Fellowship: U of California, San Diego (1993) Practicing with Radia, Inc., PS since 1/2010

Schillinger, David S., MD Emergency Medicine Med School: Drexel U (1983) Internship: Crozer Chester Medical Center (1984) Residency: Shands Jacksonville Medical Center (1986) Practicing with Hospital Physician Partners (Valley Hospital) beginning 10/2011 Srikureja, Wichit, MD Gastroenterology Med School: Loma Linda U (1997) Internship/Residency: Mayo Clinic (2000) Fellowship: Loma Linda U (2004) Practicing with Providence Adult Gastroenterology beginning 11/2011

PHYSICIANS PRESENTED A SECOND TIME Eggers, John R., MD Obstetrics and Gynecology Med School: Loma Linda U (1985) Practicing with Obstetrix Medical Group of Washington, Inc., PS beginning 10/2011 Hannon, Elena M., MD Obstetrics and Gynecology Med School: U of Colorado (1995) Practicing with Obstetrix Medical Group of Washington, Inc., PS beginning 10/2011 Heller, Stephanie A., MD Pediatrics Med School: Oregon Health and Science U (2002) Practicing with Deaconess Medical Center since 9/2011

Kalisvaart, Jennifer L., MD Pediatrics Med School: Baylor College of Medicine (2004) Internship/Residency: U of California, Los Angeles (2008) Practicing with Sacred Heart Children’s Hospital beginning 11/2011 Lyko, Adam A., MD Endocrinology Med School: Loma Linda U (2001) Internship: Jerry L. Pettis VA Medical Center (2005) Residency: Loma Linda U (2004) Fellowship: Cedars Sinai/West LA VA Program (2011) Practicing with Rockwood Clinic, PS beginning 10/2011

McManus, Shea E., MD, MPH Internal Medicine Med School: Tulane U (1994) Internship/Residency: U of North Carolina (1997) Practicing with Hospital Specialists PLLC (Holy Family) beginning 12/2011

Jones, William B., MD Diagnostic Radiology Med School: U of Washington (1981) Practicing with Radia Inc., PS since 10/2009 Karambay, James J., MD Emergency Medicine Med School: Albany Medical College (2008) Practicing with Valley Hospital Emergency Dept. since 9/2011 McGree, Kathren E., DO Family Medicine Med School: Touro U College of Osteo (2008) OB Fellowship with Family Medicine Spokane since 9/2011

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Continued from page 23 Olson, Soren L., MD Orthopaedic Surgery Med School: U of Washington (2004) Practicing with Northwest Orthopaedic Specialists since 9/2011 Rezvani, Laghaieh, MD Diagnostic Radiology Med School: Mashad U, Iran (1970) Practicing with Radia Inc., PS since 10/2009 Zherebtsov, Monica, MD Pediatrics Med School: UMDNJ- Robert Wood Johnson Medical School (2004) Practicing with Pediatric Gastroenterology since 9/2011 POSITIONS AVAILABLE OUTREACH CLINIC AT HOUSE OF CHARITY – This is an opportunity to volunteer and bring to the underserved in our community first line medical care. We need one or two more doctors to help us. We see the homeless, predominantly, two afternoons each week. Join four Board MDs and twelve RNs to rotate once or twice monthly in an excellent, well-equipped clinic with pharmacy. If you are completely retired, the state will pay for your medical license and malpractice. For more information and to sign up, call Dr. Arch Logan, Medical Director, at (509)326-0255 or Ed McCarron, Director of the House of Charity, at (509)624-7821.

PROVIDENCE PHYSICIAN SERVICES is recruiting for BE/BC Pediatricians to join us in Spokane, the urban center of spectacular eastern Washington. Excellent opportunity to join a collegial, physician-led medical group affiliated with the region’s most comprehensive and caring hospitals. Providence offers generous hiring incentives, competitive compensation, comprehensive benefits and flexible work arrangements to fit individual needs.

Contact: Mark Rearrick, mark.rearrick@providence.org, (509) 4746605, www.providence.org/physicianopportunities.

PEDIATRIC HOSPITALISTS OPPORTUNITIES - If you would like the opportunity to participate in the growth of our pediatric services at Deaconess and Valley Medical Centers, please consider joining our multi-disciplinary team. We need two more pediatric hospitalists to complete our team and participate in a flexible schedule. You will be working with nurses with many years of pediatric expertise. You will be part of a team of hospitalists providing 24-hour coverage/365 days per year. Please contact Evelyn Torkelson Director, Physician Recruitment, at torkele@empirehealth.org for more details.

EASTERN STATE HOSPITAL PSYCHIATRIST - ESH is recruiting for a psychiatrist. Joint Commission accredited, CMS certified, state psychiatric hospital. 287 beds. Salary $161,472 annually with competitive benefits and opportunity for paid on-call duty. Join a stable Medical Staff of 30+ psychiatrists, physicians and physician assistants. Contact Shirley Maike, 509.565.4352, email maikeshi@ dshs.wa.gov. PO Box 800, Medical Lake, WA 99022-0800.

SPOKANE REGIONAL OCCUPATIONAL MEDICINE (SROM) has an opportunity for a physician. Our treatment approach takes a comprehensive view that encompasses the medical, psychosocial and functional outcomes of the injured worker and follows best practices as defined by Washington State L&I’s Center of Occupational Health and Education (COHE). SROM is affiliated with Valley Hospital and Medical Center, Deaconess Medical Center and Rockwood Clinic. This affiliation provides exceptional administrative support, offers state of the art diagnostic services’ improving our ability to diagnose and treat, and a referral system that is unmatched. For more information contact Evelyn Torkelson, physician recruiter at (509)473-7374 or email at torkele@ empirehealth.org.

QTC MEDICAL GROUP is one of the nation’s largest private providers of medical disability evaluations. We are contracted through the Department of Veterans Affairs to manage their compensation and pension programs. We are currently expanding our network of Family Practice, Internal Medicine and General Medicine providers for our Washington Clinics. We offer excellent hours and we work with your availability. We pay on a per exam basis and you can be covered on our malpractice insurance policy.

The exams require NO treatment, adjudication, prescriptions to write, on-call shifts, overhead and case file administration. Please contact Gia Melkus at 1-800-260-1515 x5366 or email gmelkus@ qtcm.com or visit our website www.qtcm.com to learn more about our company.

PRIMARY CARE INTERNIST WANTED (Pullman) - Immediate opportunity for BE/BC primary care internist to join a privately owned, multi-specialty, physician practice. Palouse Medical offers a competitive employment package, guaranteed first year salary, comprehensive benefits and partnership potential. Dedicated to delivering quality care, we are proud to offer an extensive array of patient services and on-site laboratory and imaging departments.

We can’t wait to introduce you to the communities that we love and serve. Call Theresa Kwate at (509) 332-2517 ext. 20 or email tkwate@palousemedical.com. Contact us today and discuss your future at Palouse Medical!

PROVIDENCE SACRED HEART CHILDREN’S HOSPITAL (Spokane, WA) is seeking a BE/BC Pediatric Hospitalist to join our inpatient team. Be part of an exceptional care-team serving children from four inland Northwest states. Work closely with the Pediatric Trauma Center, general pediatric unit, PICU, NICU (level III), and Pediatric Surgery known for exemplary care. Strong crossspecialty support, state-of-the-art equipment and technology, and wonderful quality of life in sunny eastern Washington. Competitive compensation and excellent benefits package, including relocation.

Sacred Heart Medical Center and Children’s Hospital has 623 beds, a medical staff of more than 900 and a service area population of about 1.5 million. The children’s hospital alone includes more than 90 pediatric sub-specialists. Learn more: Mark Rearrick, Providence physician recruiter, (509) 474-6605, mark.rearric@providence.org, www.providence.org/physicianopportunities.

PHYSICIAN OPPORTUNITIES AT COMMUNITY HEALTH ASSOCIATION OF SPOKANE (CHAS) Enjoy a quality life/work balance and excellent benefits including competitive pay, generous personal time off, no hospital call, CME reimbursement, 401(k), full medical and dental, NHSC loan repayment and more. To learn more about physician employment opportunities, contact Toni Weatherwax at (509)444-8888 or hr@chas.org.

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Northpointe Medical Center Located on the North side of

Continued from page 24 CONTRACT BACK-UP PHYSICIAN 4 + HOURS/MONTH Octapharma Plasma is hiring a Contract Back-Up Physician in our Spokane, WA Donor Center! This position requires just 4 hours per month. GENERAL DESCRIPTION Provide independent medical judgment for issues relating to donor safety, health and suitability for plasmapheresis and immunization. Provide federal and international mandated training and supervision of donor center medical staff to assure compliance with applicable laws. We provide on-the-job training. WHO IS OCTAPHARMA PLASMA? Octapharma Plasma, Inc. is dedicated to improving the health and lives of people worldwide. OPI owns and operates plasma collection centers critical to the development of life-saving patient therapies utilized by thousands of patients globally.

Learn more at www.OctapharmaPlasma.com! APPLY TODAY! Apply today by sending your resume/CV to Careers@ OctapharmaPlasma.com!

WANTED... NURSE PRACTITIONER FOR NORTH SIDE FAMILY PRACTICE OFFICE. Looking for a dynamic & energetic NP with 3 years practice experience (preferably in family medicine). 30-35 hours/week, one weekend call every 3 months. Communication skills and concise charting skills a must! Send resumes to: lfisher@inwhealth.net.

REAL ESTATE

Luxury Condos for Rent/Purchase near Hospitals. 2 Bedroom Luxury Condos at the City View Terrace Condominiums are available for rent or purchase. These beautiful condos are literally within walking distance to the Spokane Hospitals (1/4 mile from Sacred Heart, 1 mile from Deaconess). Security gate, covered carports, very secure and quiet. Newly Remodeled. Full appliances, including full-sized washer and dryer. Wired for cable and phone. For Rent $ 850/month. For Sale: Seller Financing Available. Rent-to-Own Option Available: $400 of your monthly rent will credit towards your purchase price. Please Contact Dr. Taff (888) 930-3686 or dmist@inreach.com.

For Sale: 17718 E Linke Rd, Greenacres WA $649,900 Elegance redefined featuring a custom-built rancher and horse property situated on 5 breathtaking acres. For you over 3,800 sq feet, opulent master bedroom, formal dining, open floor plan & a gourmet kitchen. For your horses a 56’ x 48’ metal show barn, heated tack room, 12x12 wash area, 11 matted stalls, mechanical horse walker. Everything to accommodate you & your equestrian needs. Offered by John L Scott Real Estate – John Creighton at (509) 979-2535. For a virtual tour www.tourfactory.com/709316.

Spokane, the Northpointe Medical Center offers modern, accessible space in the heart of a complete medical community. If you are interested in locating your business here, please contact Tim Craig at (509) 688-6708. Basic info: $23 sq/ft annually. Full service lease.

Starting lease length 5 years which includes an $8 sq/ft tenant improvement allowance. Available space: *Suite 210 - 2286 sq/ft *Suite 209 - 1650 sq/ft *Suite 205 - 1560 sq/ft *Suite 302 - 2190 sq/ft

For Lease 3700 sq ft of second floor space in a new 18,900 sq ft building available. It is located just a few blocks from the Valley Hospital at 1424 N. McDonald (just South of Mission). First floor tenant is Spokane Valley Ear Nose Throat & Facial Plastics. $22 NNN. Please call Geoff Julian for details (509) 939-1486 or email gjulian@spokanevalleyent.com.

Sublease: Furnished Medical Office Space ~ Need immediate space for one or more north Spokane care providers? This shared suite is ready for occupancy; all furniture and exam room equipment included. Two exam rooms, one provider office, one nurse’s station and shared surgery suite, medical records storage area, reception and waiting area. 963 sq ft total, original lease $23/sq ft; will negotiate lower rate. Excellent location in a fullservice medical building with lab and full radiology services. For more information, call (509) 981-9298.

South Hill – on 29th Avenue near Southeast Boulevard - Two offices now available in a beautifully landscaped setting. Building designed by nationally recognized architects. Both offices are corner suites with windows down six feet from the ceiling.

Generous parking. Ten minutes from Sacred Heart or Deaconess Hospitals. Phone (509) 535-1455 or (509) 768-5860.

North Spokane Professional Building has several medical office suites for lease. This 60,000 sf professional medical office building is located at N. 5901 Lidgerwood directly north of Holy Family Hospital at the NWC of Lidgerwood and Central Avenue.

The building has various spaces available for lease from 635 to 6,306 usable square feet available. The building has undergone extensive remodeling, including two new elevators, lighted pylon sign, refurbished lobbies, corridors and stairways. Other tenants in the building include, pediatricians, dermatology, dentistry, pathology and pharmacy. Floor plans and marketing materials can be emailed upon request. A Tenant Improvement Allowance is Available, subject to terms of lease. Please contact Patrick O’Rourke, CCIM, with O’Rourke Realty, Inc. at (509) 624-6522 or cell (509) 999-2720. Email: psrourke@comcast.net.

MEDICAL OFFICES/BUILDINGS

OTHER

Good location and spacious suite available next to Valley Hospital on Vercler. 2,429 sq ft in building and less than 10 years old. Includes parking and maintenance of building. Please call Carolyn at Spokane Cardiology (509) 455-8820.

Closing OB/GYN practice – For sale 2 exam tables, 1 electric exam table (like new), colposcope, non-stress test machine, speculums, metal filing cabinets, office supplies, waiting room chairs and bookcases. Call 747-6600 for more information.

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St. Luke’s Rehabilitation Institute Information Resource Management (IRM) Northwest MedStar Northwest TeleHealth health@workTM Community Health Education & Resources (CHER) Center of Occupational Health & Education (COHE)

At INHS collaboration drives everything we do.

Through innovative health care technology, education and patient care solutions, INHS is reaching out to the region and creating tomorrow’s health care − today.

Health Training Network Northwest MedVan Spokane MedDirect Center of Philanthropy

Inland Northwest Health Services (INHS) is a non-profit corporation in Spokane, Washington providing collaboration in health care services on behalf of the community and its member organizations Providence Health Care and Empire Health Foundation.

AD

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PRSRT STD

SPOKANE COUNTY MEDICAL SOCIETY - ORANGE FLAG BUILDING 104 S FREYA ST STE 114 SPOKANE, WA 99202

U.S. Postage

PAID

Spokane, WA Permit No. 512

ADDRESS SERVICE REQUESTED

Printed on GP Spectrum® Paper: Certified by the Sustainable Forestry Initiative. Please recycle.

WINE MAKER’S DINNER SERIES 3 HORSE RANCH VINEYARDS OCTOBER 6TH, 2011 AT 6 PM SPRING VALLEY VINEYARDS NOVEMBER 3RD, 2011 AT 6 PM $65 A PERSON Join us for an exclusive wine maker’s dinner on the deck prepared by Chef Adam Hegsted and his staff. Serving a locally inspired nine-course meal, paired perfectly with a selection of alluring wines.

Space is limited.

Purchase tickets at the casino ticket sales booth or Enoteca.

Get two $25 dining credits, plus two $50 EPC credits, and top it all off with a one-night stay in our brand new hotel wing.

Both guests must be Rewards members. Based on deluxe room double occupancy and availability. Available 7 days a week. Expires one year from purchase date.

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