The Message, April 2012

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A MON T HLY NE WS M AG A ZINE OF SPOKANE COUNTY MEDICAL SOCIETY – APRIL 2012

Spokane Four Years of Medical Education – A Reality!

By Terri Oskin, MD SCMS President

UW School of Medicine Launches Curriculum Renewal Initiative Let’s Keep It Real As Our Practices Change

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April SCMS The Message Open2

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

2012 Officers and Board of Trustees Terri Oskin, MD President Anne Oakley, MD President-Elect Bradley Pope, MD Immediate Past President David Bare, MD Vice President William Keyes, MD Secretary-Treasurer Trustees: Robert Benedetti, MD Audrey Brantz, MD Michael Cunningham, MD Karian Dierks, MD Randi Hart, MD Louis Koncz, PA-C Shane McNevin, MD Gary Newkirk, MD Fredric Shepard, MD Carla Smith, MD Newsletter editor – Anne Oakley, MD

Spokane Four Years of Medical Education – A Reality! . . . . . . . . . . . . . . . . . . . . . . . 1 Pacific Northwest University- College of Osteopathic Medicine Update . . . . . . . . . . . . . 2 Riverpoint Academy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 UW School of Medicine Launches Curriculum Renewal Initiative . . . . . . . . . . . . . . . . . 5 Medical, Business Community Lead Way in Supporting Second-Year Medical Education . . . . 6 MD and PA Training in Spokane . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Health Information Exchange Panel: Regional Projects . . . . . . . . . . . . . . . . . . . . . . 7 Let’s Keep It Real As Our Practices Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Growing Medical Student Interest in Spokane Training . . . . . . . . . . . . . . . . . . . . . . 9 Covering the Sidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Essay Winner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Working with the Underserved: A Vital Part of My Medical Education . . . . . . . . . . . . . 13 CME Planning Committee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 A Successful Match for WWAMI Spokane . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Physician Leadership Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Inland Imaging and SCMS Host Mammogram Party . . . . . . . . . . . . . . . . . . . . . . . 17 In the News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Meet Travis Prewitt and Brad Desormeau of UBS: The Prewitt Group . . . . . . . . . . . . . . 20 Meetings, Conferences and Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 WWAMI Celebrates 40th Anniversary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 You Can Now Apply to Washington’s Workers’ Comp Medical Network . . . . . . . . . . . . 23

Spokane County Medical Society Message 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 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.

IDEA Clinic: A Dental Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Membership Recognition for April 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 New Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 FYI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Positions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Classifieds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30

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April SCMS The Message Open3

Spokane Four Years of Medical Education – A Reality!

By Terri Oskin, MD SCMS President It’s hard to believe it’s already spring as I just finished shoveling what I hope is the last snow of the season!

Winter is the time we make our annual trek to Olympia and Washington, DC to meet with our legislators. In January I joined members from across the state for the Washington State Medical Association Legislative Summit in Olympia. Along with Keith Baldwin, Anne Oakley, Brian Seppi, Courtney Clyde and Tom Schaaf, we met with our legislators in the state Senate and House. Discussions included the need for more physicians in Spokane and rural areas and we asked lawmakers to continue funding graduate medical education in Spokane. Feeling that the mood in the capital was right (it is an election year), we again briefed legislators about the need for tort reform and about the financial hardship to physicians if interpreter reimbursements from the Medicaid system were cut.

We also advocated for the volunteer retired physicians program. The program provides malpractice insurance to retired physicians who volunteer their time, providing medical care to low-income patients.

For a cost of $240,000 this program provides $84 million of free medical care annually throughout the state. Also on our agenda, we encouraged our lawmakers to preserve funding for the Basic Health Plan and Critical Access hospitals.

In February I attended the yearly National Advocacy Conference in Washington, DC sponsored by the American Medical Association.

Due to our budget cuts at home, I was the only representative from Spokane (down from our usual three) and the only representative from Washington State east of the Cascades.

The keynote speaker for the conference was Marilyn Tavenner, acting COO for CMS. During the Q&A session she heard an earful regarding the financial hardship and inefficiencies that practices will incur to meet the present implementation deadline of October 2013 for International Classification of Diseases, 10th Edition (ICD-10).

The next day, a press release from Health and Human Services Secretary Kathleen Sebelius was issued stating, “We have heard from many in the provider community who have concerns about the administrative burdens they face in the years ahead. We are committing to work with the provider community to reexamine the pace at which HHS and the nation implement these important improvements to our health care system. “ Over the next two days we met with each of our US representatives and senators. Of course, the Sustained Growth Rate (SGR) mess was at the top of our agenda. We observed broad bipartisan agreement that tying reimbursement schedules to the SGR is a flawed formula.

Most of our lawmakers even went on record as saying the cuts will never go through. However, still no one has posed any replacement

plans. One of our talking points focused on the Overseas Contingency Operations budget. This is money already in the budget but not spent to fund the wars in Iraq and Afghanistan. With the withdrawal of troops, this money will not be needed. We asked lawmakers to consider shifting the surplus of funding to offset the debt already accumulated in payments to physicians because of the flawed SGR formula. Our representatives thought this was a novel idea, but alas, made no commitment to support it.

During our stay in Washington, Congress did announce it was going to delay this year’s scheduled 27 percent cut to Medicare payments until January 2013. This is great news, but again, as the end of the year approaches we will all be left in limbo unless another fix to the program is put in place.

Another hot topic legislatively is the need to continue funding graduate medical education. Representative Cathy McMorris Rodgers and Senator Maria Cantwell have been strong advocates, especially with our needs in Washington State. Cathy McMorris Rodgers shared a new bill she drafted. She is proposing six pilot programs focused on placing medical residents in rural settings.

I am not forgetting that this month’s The Message is actually about higher education and Spokane’s four-year medical education experience. Greater Spokane Incorporated President and CEO Rich Hadley is confident the remaining funding for the Biomedical and Health Sciences Building at WSU Spokane will be approved this year. The first year of second-year medical students is slated to start the fall semester of 2013 along with the continuing first-, third- and fourth-year classes.

Curriculum planning for the new medical school is in full swing.

The Research Leadership Group has pledged nearly $1 million for faculty recruitment and start-up costs. The Academic Planning and Biomedical Research groups will have their plans in by May 15.

On March 23, we will participate in the Graduate Medical Education Summit being held in Spokane to discuss how we can expand residencies in Spokane. Look for an update in next month’s issue.

One final note - Recently I had a thoroughly enjoyable time with local third- and fourth-year medical students at an annual panel discussion hosted by Providence Sacred Heart Medical Center and sponsored by the Spokane County Medical Society. Students took the opportunity to ask medical colleagues about their specialties, lifestyles and more. An excellent turnout of students asked poignant questions about what their future life could be like. I enjoyed talking personally with students and heard repeatedly how wonderful their experiences are in Spokane. Students appreciate the one-to-one time with mentors and said they gained experience far superior to what they had in Seattle.

It was delightful to meet young individuals, non-biased and full of opportunity, as they head into their future. I encourage you to meet with these young adults through preceptorships and mentoring programs. Contact Deb Harper at djharper@u. washington.edu to get connected. After all, that optimistic feeling and those pivotal encounters, that is what great medical education is all about!

April SCMS The Message 1

Pacific Northwest UniversityCollege of Osteopathic Medicine Update

day administration throughout the core sites and works with Dr. Robert Sutton on residency development throughout the Pacific Northwest. Dean Robyn Phillips-Madson, DO, MPH and others on the team visit all sites regularly. A strong team on campus is available to offer additional administrative assistance to students and faculty at the core sites.

By Lynda K Williamson, D.O.; A.B.F.M. Regional Dean-Spokane

The 42-acre campus includes offices in the Iron Horse Lodge, classrooms, student study space, lounge and kitchen facilities in the Cadwell Student Center and lecture rooms, clinical skills offices, faculty and staff offices, laboratory space for research, osteopathic manipulation, simulation and gross anatomy are located in the Butler-Haney Hall. This spring, construction will result in the addition of a 300+ seat auditorium, that can be divided into two smaller lecture halls, and additional office space.

Graduation of the Inaugural Class: On May 12th, 69 osteopathic physicians will graduate from Pacific Northwest University’s College of Osteopathic Medicine (PNWU-COM). The inaugural Class of 2012 began two years of coursework in Yakima in 2008, with a subsequent two years of clinical rotations at one of 16 core rotation sites throughout the Pacific Northwest. Spokane is a core clinical site and is host to 14 current students in their 3rd and 4th years of training. Those students are under the supervision of Spokane Regional Dean, Lynda Williamson, D.O. Over 45 physicians in the Spokane area medical community helped to develop the skills and talents of members of the inaugural class. The University is grateful to the dedicated PNWU-COM adjunct clinical faculty (preceptors) who train and inspire students and who have given constructive feedback to contribute to the development of those students and the University’s programs. In today’s busy practice climate, precepting medical students is truly a labor of love and demonstrates a high level of professional commitment.

The Mission of PNWU-COM is to increase the number of primary care physicians serving in rural and underserved areas of the greater Pacific Northwest. The method behind the mission is to choose Northwest students and train them as close as possible to where they are from. Because residency location in large part determines where a physician ultimately practices, PNWUCOM has been actively developing residency programs in the Northwest. Currently, 294 students are enrolled in four classes with 90% from the Northwest and approximately 50% from Washington State. The inaugural class’s final residency match statistics will not be available until mid-March, but it appears that 61% of the inaugural class have indicated they will seek to The Leadership: Keith Watson, DO, has been chosen as PNWU’s new president. Dr. Watson received his Doctorate of Osteopathic Medicine (DO) degree from the Texas College of Osteopathic Medicine in 1975 and completed an internship and general surgery residency at Tulsa Regional Medical Center (now Oklahoma State University Medical Center) in Tulsa, OK. He also completed a surgical oncology fellowship at the University of Texas System Cancer Center, MD Anderson Hospital and Tumor Institute. He currently is the Senior Associate Dean at Ohio University Heritage College of Osteopathic Medicine, and will begin serving as president July 1, 2012.

The Clinical Rotations Team consists of Dr. Juan Acosta, Interim Director of Clinical Rotations, handling student and physician related matters; Dr. Anita Showalter, Assistant Dean of Clinical Sciences, working with faculty development and curriculum; Nicki Flood, MBA, Director of Regional Sites, who leads the day-to-

Full accreditation for PNWU-COM will be completed with the inaugural Class of 2012’s graduation. To learn more about the College of Osteopathic Medicine’s program or to become involved in training future colleagues please visit the actual campus in Yakima, the virtual campus on-line (www.PNWU. org) or meet with Spokane Regional Dean, Lynda Williamson, DO (dr.lynda@live.com). Spokane’s physicians (PNWU Adjunct Clinical Faculty) are helping to meet the healthcare needs of Spokane County and the greater Pacific Northwest’s underserved communities by teaching these new physicians.

Surgical Specialists of Spokane is Pleased to Welcome Dr. Janet Abadir, M.D., FACS Dr. Janet Abadir, M.D., FACS Dr. Abadir is a board certified general surgeon. Dr. Abadir received her medical degree from Robert Wood Johnson Medical School and completed her residency at The University of California Irvine Medical Center.

Dr. Abadir is board certified by the American Board of Surgery and is a Fellow of the American College of Surgeons and a member of the Association of Women Surgeons.

Dr. Abadir is currently accepting new patients.

To refer a patient or schedule a consultation, call Surgical Specialists of Spokane at 509.747.6194

April SCMS The Message 2

Riverpoint Academy Igniting Passion, Producing Innovators

By Matt Miller CTE Director This fall the Mead School District will launch a new opportunity for students to spend their final two years of high school on the Riverpoint campus in downtown Spokane. Riverpoint Academy will open its doors in September 2012 to 75 juniors, featuring learning that blurs the line between high school and college.

Collegiate partners include WSU, EWU and the Community Colleges of Spokane. Students will have the chance to take college courses for credit on campus and engage in oncampus programs in health sciences, design, technology and entrepreneurship.

Located in the Innovate Washington Building, 665 N. Riverpoint Blvd., Riverpoint Academy’s mission is to apprentice students in the art of learning through inquiry, creativity, critical thinking, responsibility and leadership. The Spokane science, technology, engineering and entrepreneurial community will partner with Riverpoint Academy to infuse real-world learning and exposure to career pathways by providing internships, mentorships, job shadows and guest speakers. Students will grapple with realworld challenges.

STEM+ open house (January2012) showcased students currently involved in the STEM+ programs, as well as opportunities that are available for students in STEM+ fields.

The Academy will have a STEM+ focus. Danette Driscoll, the newly named principal of Riverpoint Academy, says course work will “combine science, technology, engineering, math and entrepreneurship in the way we find those disciplines linked in the world of work and innovation. The Academy will challenge students to apply their knowledge and creativity toward solutions and to gain experience and skill that positions them well for future careers.”

For more information about the Riverpoint Academy visit www. riverpointacademy.org.

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UW School Of Medicine Launches Curriculum Renewal Initiative

interprofessional commitment and other areas that advance our mission of improving health.

The vision committee will complete its work over the next three months and make final recommendations in early May. In the meantime, a steering committee for the curriculum renewal process will be convened soon to plan and begin the ongoing work of curricular change.

Dear Colleagues: In 1999-2002, the UW School of Medicine conducted a comprehensive, time-limited curriculum review. The review led to a number of changes, including an outstanding new program—the Colleges—that has been highly praised by our students and faculty and is emulated nationally.

Last year, I charged a committee to complete another year-long review of our medical school curriculum. The committee performed extensive research into curricula nationally and talked with hundreds of faculty, staff, students and others about our curriculum. The committee’s final report identified both strengths and challenges. While we have an excellent medical school and produce outstanding physicians for the future, the findings of this report indicate a clear mandate for change.

The committee identified several major areas for curricular improvement, including the need to enhance active learning in the preclinical curriculum and to increase integration within each year and across years. Among other areas identified for change were: increasing flexibility for students in their curricular choices and schedules, providing additional time for earlier career exploration, and expanding focus on critical thinking, information management and lifelong learning.

Due to the ongoing, rapid change in medical knowledge and a constantly shifting healthcare environment, the committee recommended that a continuous curriculum renewal process be initiated rather than a time-limited process.

Today, Ellen Cosgrove, vice dean for academic affairs, Suzanne Allen, vice dean for regional affairs, and I are very pleased to announce the launch of the UW School of Medicine curriculum renewal. I have charged a vision committee, chaired by Wylie Burke, UW professor and chair of the Department of Bioethics and Humanities, to envision a plan for our curriculum renewal.

This committee will work over a short period of time, using the curriculum review committee’s final report as a foundation, to develop the organizing principles and larger theme(s) of the curriculum as we move into a continuous curriculum renewal process.

Widespread involvement of faculty, staff and students is essential to the success of the curriculum renewal. Today, a website was launched that describes activities and findings to date. This site will be updated regularly with new information about activities and progress of the curriculum renewal and will provide one of several venues for providing feedback. There will also be many opportunities to participate on committees and work groups; please let Ellen Cosgrove (ellencos@uw.edu) or Suzanne Allen (suzaalle@uw.edu) know if you would like to be involved.

We have an enormous and very exciting opportunity to shape the future direction of our medical school’s curriculum. This is a chance for faculty, staff and students to work together and develop educational models that best serve our students and support our mission of improving the health of the public. While the work will not always be easy—change is never easy—it will position UW Medicine and the WWAMI Program to lead the nation in thoughtful and meaningful innovation in the best interests of patients, students, faculty, staff and our community.

Please join me in welcoming this opportunity to work together on behalf of developing the best possible medical education program.

Sincerely,

Paul G. Ramsey, M.D. CEO, UW Medicine Executive Vice President for Medical Affairs and Dean of the School of Medicine, University of Washington (Reprinted by permission)

I have asked the vision committee to develop themes and organizing principles that reflect and take advantage of the unique strengths and foci of the UW School of Medicine, such as the WWAMI program, global health, UW Medicine’s commitment to patient safety and quality, translational research preeminence, April SCMS The Message 5

Medical, Business Community Lead Way in Supporting Second-Year Medical Education in Spokane

By Doug Nadvornick The process of bringing medical education to Spokane – and now shepherding it through a growth phase – has been a collaborative one, involving higher education, business, civic and medical leaders.

For 40 years, the University of Washington School of Medicine and Washington State University have been partners in the WWAMI program, the UW’s five-state medical education consortium that also includes Wyoming, Alaska, Montana and Idaho.

For nearly all of those years, Spokane physicians have taught third- and fourth-year medical students in the city’s hospitals and doctors’ offices. In 2008, the two universities added firstyear medical instruction on the Riverpoint Campus. More doctors became involved; some transferred from the clinic to the classroom to mentor the next generation of physicians.

“A WWAMI medical education program in Spokane that includes the option of training in Spokane for all four years is the catalyst for creating new and sustained growth for the entire region,” said Scott Morris, Avista’s chairman, CEO and president. “The Spokane business community strongly supports this initiative and is ready to collaborate to make it happen.”

Private fundraising ongoing The $2.95 million needed for the start-up of second-year medical education is coming from several groups. The legislature allocated $600,000 for medical education expansion. The universities are also committing additional money from their budgets. The Empire Health Foundation has pledged $850,000.

The rest will be covered by the private sector. Once the secondyear program is up and running, the two universities will seek legislative support to continue operating it.

For several months, members of the Academic Health Science Center Resource Leadership Group – chaired by Marty Dickinson and Tom Quigley – have quietly met with leaders of Spokane’s most prominent companies. Their goal is to raise $1.45 million. As of March 6, they had $600,000 in signed pledges and are waiting on another $500,000 in commitments. They hope they can finish their campaign this spring.

Business leaders in Spokane have also played a major role in the growth of medical education in the Lilac City. Not only did business leaders advocate for the first-year classes, they’ve also worked to find resources to improve the facilities and expand the capacity for more students.

“The response from the business community has been tremendous,” said fundraising co-chair Marty Dickinson. “While there are many more conversations to have, we appreciate how this initiative has been embraced by the leaders in this community and we want to make sure that everyone has an opportunity to participate should they so desire.”

Last year Greater Spokane Incorporated (GSI) and members of the Spokane County Medical Society played an important role in convincing lawmakers to allocate half the money needed for a new Biomedical and Health Sciences Building on the Riverpoint Campus. It is WSU’s top capital budget priority. The new building will be the home for WWAMI medical education and a consolidated WSU College of Pharmacy, which is currently split between Spokane and Pullman. This year, business leaders are back in Olympia trying to secure the rest of the funding.

Part of the allure for business is the prestige involved with Spokane offering a full four years of WWAMI medical education.

The WWAMI program is known throughout the nation as a landmark regional education program. Another part of the allure is the potential economic impact, as spelled out by Tripp Umbach. The economic consultant projects Spokane’s Academic Health Science Center will have a huge fiscal impact as health sciences programs and research grow at Riverpoint.

Now, with the support of GSI, the business community and others, the UW School of Medicine and WSU are working on a two-year pilot project that would allow second-year medical instruction to start in Spokane as early as fall 2013. That would mean a WWAMI medical student could complete all of the first two years of medical school without having to take the traditional second-year detour to Seattle.

“When Marty and I were approached to lead the fundraising effort to raise the remaining $1.45 million, we felt the business community would again rise to the occasion,” said fundraising co-chair Tom Quigley, “especially given the project return on investment of $2.1 billion annually when the Riverpoint Campus has fully matured.”

While the fundraising continues, preliminary discussions are starting about the development of an innovative second-year curriculum that aligns with the curriculum offered in Seattle. WSU scientists as well as clinicians hired by UW to teach will participate in educating the second-year students.

April SCMS The Message 6

MD and PA Training in Spokane

By Ben Arthurs (UW School of Medicine) and Kali Arthurs (MEDEX Physician Assistant Program) We frequently meet people who can’t understand how or why we train in Spokane, as students of the University of Washington.

At this point our response is pretty well rehearsed. We tell them about the WWAMI medicine and MEDEX physician assistant programs, and how the UW offers regional training. We share how standardized tests hold students throughout the region accountable for the same benchmarks. Finally, we brag about choosing to train in Spokane, and how it actually enhances our professional training.

The two of us began with didactic training at Spokane’s WSU Riverpoint campus. We felt fortunate to have studied in such beautiful facilities with state of the art technology. Taking our courses there offered the advantage of training amongst a small group of students. As a result we built friendships with colleagues and faculty. The close-knit community fostered a unique environment, where program directors were responsive to student driven changes and instructional models weren’t set in stone for the sake of tradition. Ultimately, we think our training was as strong as that offered in Seattle, and came with a personable touch.

Clinical training in Spokane offered an equally rich learning environment. We both benefitted from extensive one-on-one mentorship that often comes with clinical rotations in the area.

This brought opportunities for active participation in patient care and procedures, on par with the best available to UW students.

Collectively, we performed biopsies, assisted in surgeries and helped deliver babies under guidance of willing preceptors.

Overall, we found Spokane’s medical community receptive and eager to teach, making for a top notch learning experience.

Training in Spokane also offered other perks. Compared to Seattle, the city offers a low cost of living, little traffic and equally amazing outdoor recreation. From a research standpoint, Ben had the opportunity to publish several papers with the Radiation Oncologists at Cancer Care Northwest. At WSU, Kali helped run the Healthcare Team Challenge, providing a collaborative experience with students from the MD, PA, RN, pharmacy and several therapy disciplines. We both volunteered at the studentrun House of Charity clinic, a rewarding opportunity to help the homeless. These are just a few examples of the extensive extracurricular opportunities that make Spokane great.

Overall, we are thrilled to have had the opportunity to train at the University of Washington, and equally proud to have done so in Spokane. Training in the close-knit community brought us friendship amongst classmates, faculty and preceptors, many of whom we hope to work alongside in the future. It’s a unique

place where teachers push us to excel and welcome us to join them for dinners, jogs and ski runs. We found Medical and PA school challenging and at times stressful, but the uniquely supportive and collegial environment in Spokane made for an overwhelmingly positive experience. We thank Spokane’s healthcare professionals and educators for their outstanding contributions to our education and look forward to following in their footsteps as clinician-teachers.

Health Information Exchange Panel: Regional Projects A Pre-Conference to the Critical Access Hospital Conference, March 12, Spokane, WA Co-Sponsored by the SCMS and the CAHN

By Keith Baldwin, SCMS CEO Sue Dietz, Director of the Critical Access Hospital Network (CAHN), moderated a panel of presenters: Darin Neven, M.D., discussing the Emergency Department Information Exchange (EDIE), Consistent Care, and the WA DOH Prescription Monitoring Program (PMP); Peter Gelpi, CEO, Clarity Health Services; Jac Davies, Director, Beacon Community of the Inland Northwest (BCIN), INHS and a representative of the North Idaho Health Network (NIHN), Coeur d’Alene, ID. Each of the presenters quickly described their particular project and tried to succinctly identify how this would affect the patient and providers involved.

Darin Neven, M.D. talked about the web based system that would allow ED physicians to communicate at the time of service the necessary information about prior ED visits, medications, care plans and other diagnostic testing to improve the care of patients, especially high utilizers of ED services. The benefit to the patient and provider is having relevant information at the time of service.

Peter Gelpi noted the benefits of a system for managing “transitions” for providers and patients that involves admission and discharge information between physician offices and hospitals, including ED transfers. The system can also be used to handle other transitions of care across the continuum of care. The key for the patient and provider is the “accountability” that the system brings to the transactions between individuals in the care system.

Jac Davies discussed the ability of the BCIN and Virtual Lifetime Electronic Record (VLER) to enable health information sharing for service members, veterans and providers using the BCIN system.

Jac noted that Orion had been chosen as the Health Information Exchange (HIE) tool to allow the BCIN to measure the results of sharing information, educating, providing care coordination and other services to providers to improve the management of Type I Diabetes patients.

April SCMS The Message 7

Continued on page 9

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Continued from page 7 The BCIN has the ability to share much more information about patients as part of an integrated record as the project moves to maturity. Prevention of the many potential medical complications associated with Type II Diabetes is the most important benefit of the system.

The NIHN called NIHNConnect is focused in developing a system of integrated care for the five hospitals and associated providers in the network in northern Idaho. They have chosen the MobileMD HIE to help communicate and share information across the system of providers. The implementation of MEDITECH 6.0 at two hospitals in the region has slowed the process of implementation. Several task forces are working on system and clinical issues necessary to the process. The most important aspect of this system is to create better communication among all the providers, physicians and hospitals in order to provide improved care to patients.

A number of Spokane physicians were in attendance and noted the important aspects of each system and their relevance to the current environment where, more than ever, we need to have the ability to “share patient information” in order to improve the health of populations, improve the experience of care for the patient and reduce the per capita cost of care.

Let’s Keep It Real As Our Practices Change

By Tom Schaaf, MD, Group Health Cooperative Recently Group Health Physicians held its annual meeting where we discussed physician practice in the changing health care world.

So what’s changing? We talk around it a lot, but here’s how I see it: Financing: Clearly there is no source of new money to pay for rising health care costs. No government arm or employer has the extra cash to maintain the current system much less continued medical cost inflation.

Waste: We know there’s a lot of waste in the system— procedures done to patients that don’t bring measurable value to patients’ lives. Much of that waste is born out of the fee-for-service world where we pay for care on a per-widget basis.

Given these facts, what might health care look like in the future? Two scenarios are frightening: severe price controls or real rationing. Nobody wants to see this happen. The better alternative is to create health care systems that improve care for populations and deliver comprehensive care to individuals, and that are reliable and patient-friendly. This alternative needs to occur in the context of systems rather than one-off models, or we won’t achieve the reach and scale needed to be affordable.

As physicians we have to maintain our leadership. We can’t play the victim and just accept things as they are. The first step we can take is to have a clear picture of reality. We can’t just dig our heels in and blame others such as the lawyers, hospitals, and insurance companies; and most of all we can’t blame our patients.

We must recognize our position in health care and partner with physicians and other clinicians who share the same vision to create new care systems.

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Continued from page 9 At Group Health Physicians, our vision focuses on identifying what our patients need and getting it to them—in ways that are satisfying for patients and gratifying for us. People talk about making Primary Care “sustainable”, but it really has to be satisfying to physicians. We can’t just be paying our bills. We need to reconnect with our vision for why we went to medical school.

As medical leaders, we can look at our patients’ needs and work with our colleagues (RNs, pharmacists, etc.) to create a medical system where together we share and give patients what they need, and avoid the things that don’t improve their lives. Few organizations actually pull this off; I consider Group Health and Kaiser to be two systems that are aggressively pursuing this vision.

Physicians must buy into a shared vision. At Group Health our doctors are committed to getting it right and improving over time. If there’s any secret sauce in how Group Health operates, it’s that we look for our flaws and weak spots and we push toward the vision of the best care for all of our members. The most critical part of this is our ability to acknowledge our failures and the reality of our environment and persistently move forward.

I think we can learn something from Admiral James B. Stockdale, one of America’s most revered war heroes. During the Vietnam War, he was taken prisoner and endured seven years in the infamous Hanoi Hilton. There, Stockdale led the resistance against Vietnamese propaganda and organized a system of behavior and rules governing prisoner behavior. These rules (unity over self) gave prisoners a sense of hope and empowerment that many credited with helping them to survive. Admiral Stockdale said that the difference between him and the prisoners who died was that he had a vision for survival and making it through, but not a false hope about how easily or quickly. The prisoners who folded in on themselves had unrealistic visions for getting out.

We’ve got to get real about our changing medical practices. We have the opportunity to work together and create new health care systems that can be both satisfying for patients and gratifying for doctors.

Tom Schaaf, MD, is the assistant medical director for Group Health Cooperative’s Eastern Washington/North Idaho District.

Board-certified in Family Medicine, Dr. Schaaf has practiced at Group Health in Spokane since 1992, and founded its hospitalist program in 1997.

Covering the Sidelines

By Ed Reisman, MD - Family Medicine Spokane Group Health- Activity, Sport & Exercise Medicine and Barbara Brandon, DO - Family Medicine Spokane Sports Medicine Fellowship-Asst Director Covering the sidelines of contact and collision sports at the high school level is a rewarding and often enjoyable experience, but requires preparation and understanding roles. As a sideline physician your primary goal is to manage emergencies on the playing field and evaluate injured athletes for return to competition. The sideline of a game is a difficult place to practice medicine. You are expected to evaluate the injured athlete, make the proper diagnosis, treat the condition and determine if it is safe for the athlete to return to play as quickly as possible. This often takes place in front of hundreds of spectators on an athlete dressed in uniform and sometimes bulky protective equipment without the benefit of further tests.

A sideline physician must possess a fundamental knowledge of emergency care regarding sporting events and be familiar with musculoskeletal injuries and medical conditions that affect the athlete. The primary care or orthopedic physician is uniquely qualified to fulfill this role due to their basic knowledge and training. In addition, they should be enthusiastic, available and interested in helping the school and community. Understanding the sport, perhaps by prior participation, allows you to prepare for the sport specific injuries or emergencies. There is an opportunity for primary care (family medicine, internal medicine, emergency medicine, pediatrics and physical medicine and rehabilitation) and orthopedic physicians to continue their medical training by completing a sports medicine fellowship.

Spokane has a number of sports medicine specialists who can be an additional resource to the physicians providing care at sporting events. Family Medicine Spokane offers a 1 year accredited Sports Medicine Fellowship to family medicine physicians who are then eligible for a Certificate of Added Qualification (CAQ) in Sports Medicine.

As the leader of the sports medicine team at a game, the sideline physician should know and appreciate the roles of the athletic trainer and emergency medical services. The athletic trainer serves a pivotal role in communication due to their frequent interaction with the athletes and coaches. A certified athletic trainer (ATC) is trained to diagnose, manage and rehabilitate musculoskeletal injuries and other common conditions among athletes. Thus, they play a critical role in the initial on the field evaluation of an injured athlete. The ATC also has a working relationship with the coach, athletic director and sometimes even the parent, and can often help relay information from the physician. The role of emergency medical services (EMS) is to support the ATC and sideline physician and to transport injured players when requested.

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Continued from page 10 On game day it is best to arrive early and introduce yourself to the emergency medical services, visiting team’s medical personnel and let your school’s athletic trainer know of your arrival as they may have athletes to be seen prior to playing. A sideline physician should consider carrying their own “medical bag” of supplies. It should be stocked with items needed to treat common injuries or medical conditions that might be encountered on the field of play for that sport. This can be coordinated with the athletic trainer and the supplies they may have on the sidelines. During the game be alert to the action—you will be in a unique position to witness the mechanism of injury which can aid in the clinical evaluation. A key thing to remember is that you can become involved in the action that can extend off the field into the sideline area, so it is vital to pay attention. For injuries that occur on the playing field, the athletic trainer should be the first, and typically the only, responder. The sideline physician may take a few steps onto the field to be visible if the athletic trainer should signal for physician or EMS assistance. It is appropriate for the sideline physician to be involved immediately in emergencies involving loss of consciousness, spinal or head injury, deformity from fractures or dislocation or in sports where there is an injury clock such as wrestling.

Same day return-to-play decisions are the most difficult action for the sideline physician. Emergencies often trigger known protocols; a torn ACL may be a severe injury, but the decision about return to play is simple. It is the minor injuries that present the greater challenge to the sideline physician. Same day return-to-play criteria are subjective, but should include these considerations: »» Will clearance to play be safe for the injured athlete and what are the risks and consequences of further injury? »» Will clearance be safe to other players when the treatment involves wearing a hard splint? »» Will the athlete be able to compete effectively or could loss of performance put others at risk? »» Will continued play affect healing and later ability to perform?

Sometimes having the injured player attempt some sport specific tests on the sidelines can help in the return to play decision process. The ATC and physician may discuss the return of an athlete to a game, but the physician makes the final decision.

The sideline physician should understand their medical liability risk and should have adequate malpractice insurance for coverage of sporting events. A written memorandum of understanding with the school or event that defines responsibilities and level of coverage expected is highly recommended. Game injuries should be documented and include a description of the injury, initial examination along with treatment and follow up instructions and to whom these were communicated. Good Samaritan laws exist, but are not always straightforward when

applied to sport coverage. For example, the Samaritan laws apply when you are present as a spectator and suddenly there is an emergency or urgent injury and you respond. However, any verbal understanding or compensation such as accepting a Team Shirt, imply that you have a prearranged role at the event and thus a responsibility to provide care and the Good Samaritan laws will not apply. It is recommended that you clarify this with your malpractice insurance to assure the proper coverage.

Coverage of sporting events provides a rewarding experience with unique challenges and responsibilities to the physician on the sidelines. Many thanks to the physicians and athletic trainers that provide support for many of the Spokane area high schools. Working together we can improve the care and safety of our student athletes and provide for successful sports coverage. Further information can be found in the Team Physician and Sideline Preparedness for the Team Physician consensus statements located on the American Medical Society for Sports Medicine website at AMSSM.org. For further questions, please feel free to contact the authors.

Essay Winner Dr. Dan Jensen, transitional resident, is the winner of the “On Becoming A Physician” essay. The event is sponsored annually with the generous support of the Shikany Endowment and judged by the Spokane Humanities Committee. Residents from all of the Spokane residencies are invited to participate. Dr. Jensen received a cash prize and was honored at the Spokane Society of Internal Medicine’s annual scientific meeting in February.

Congratulations Dan!

Primum non nocere

By Daniel Jensen, MD Transitional Year Resident 2011-2012 The patient before me was a complicated mess. On rounds, I would try to sum him up in one complete, frequently-bordering-on-runon, sentence, “This is a 67-year old male with no available next of kin with a history of metastatic pancreatic cancer, multiple CVAs resulting in dysarthria and Parkinson’s disease who presented in the ED three days ago with respiratory distress secondary to volume overload. (Breathe) He has been diuresed with 80 of Lasix TID without much response…”

To a freshly-minted third year medical student, just walking into this patient’s ICU room had been overwhelming, let alone having responsibility for him. This gentleman was truly near the end and it seemed like everybody, except for me, was willing to admit it. Don’t misunderstand me, I knew he was sick. Sicker than sick. But my growing medical knowledge didn’t keep my emotions from trying to deny that his Final Discharge Summary was likely only days away.

Coming to this realization was especially difficult because in my short time on the wards, I had not yet had a patient die under my care.

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Continued on page 13

Continued from page 12 "I hope he doesn’t die," I would tell my wife at home after telling her a HIPAA-compliant version of the patient’s story. "I'm not sure how to deal with that."

"What do you think the patient wants?" she would ask.

"I don't know. He can’t really talk."

"Well, have you tried asking him?"

I was taught in medical school that physicians are entrusted to be present during the most intimate, personal events of others’ lives. Being involved with birth, death—things for which only family and clergy are usually present—was the special privilege of a physician. I had never had a direct conversation with a patient about death. I had practiced “delivering bad news” to other medical students in small group sessions earlier in medical school, but I had never actually done it with a patient. “Pretendtelling” my best buddy from medical school that he was going to “die” seemed a far cry from actually delivering such news to a real patient. The thought of talking about the end of life with my real, flesh-and-blood patient seemed foreign and intimidating. I wondered if I would ever be comfortable with talking to patients about death. Would it just be a matter of time? If so, when was I going to start learning? Intellectually, I knew I had to go through my “first time,” and there was no other way around it. My patient surely had to know he was going to die, right?

“Good morning! How are you today?” I smiled brightly as I entered his room the next morning, obviously overcompensating for my nervousness. “I hope you got some rest. I was looking at your labs this morning and noticed that we need to give you some potassium…” Like a child learning to walk, I stumbled along for several minutes, attempting several times to build the courage to approach this difficult subject. Finally, the elephant in the room gave a sigh of relief when I said, “Sir, things aren’t looking very good for the long term. I am not sure anyone has asked you this, but what would you like us to do to help?” I half-avoided the question with my hesitant euphemisms, but I was certain he understood the meaning of my question. I held my breath and offered my pen so he could write a response. Trembling, his hand struggled to grip my pen as he wrote. The ball point glided gently across my paper, mimicking the Brownian path a molecule of oxygen might take across a room. Seconds turned into minutes as I sat by his bedside, and finally, he closed his eyes and rested his one functional hand on his chest, indicating that he was finished. Taking the pen, I saw a thin, Parkinsonian handwriting, seemingly illegible.

What was meant to have been written was masked by a billion nerve misfirings, leaving only a gentle scribble.

Examining the paper closely, however, recognizable letters emerged, and a word suddenly jumped out of the page. “Stop.”

Stop? Stop what? Treating you? Helping you? Is that what you want me to understand? I blinked, trying to clear both my eyes and mind, hoping to read it differently the second time. “Stop.”

I looked over at the patient, who met my gaze. I could see tears

streaming from his face, tears that seemed to say, “I’m tired and in pain. I have some regrets, but I’ve had a good life. I have fought hard and it is time for me to go.” My own tears welled up inside, and as I fought to quarantine them, they replied, “But we can’t just let you go! I need you to keep trying!” His eyes gently chided in return, “You will be fine and so will I. Thank you for taking care of me. Ours will be the last friendship I made in life and I will always be grateful for it. Please let me go.” With that he closed his eyes to rest.

I now think back to the words, “Primum non nocere—First, do no harm,” and realize that it was at this early moment in my path toward physician-hood that I first understood the poignant significance of this phrase. Our role as physicians is to relieve suffering. Sometimes the way to accomplish this is by allowing death to intervene.

Later that day, I passed him in the hall while he was being transferred to the inpatient hospice. I asked the nurse to stop for a moment so I could say goodbye. I tried to meet his tired eyes with mine and smiled while grasping his hand, trying my best to reassure him. Everything will be okay. As much as I was trying to convince him, I knew I was also trying to convince myself. He looked into my eyes reassuringly and squeezed my hand. I know.

He died only hours later due to respiratory failure.

Working with the Underserved: A Vital Part of My Medical Education

By Jacob Casey WWAMI 1st Year Medical Student Saturday mornings means waking up extra early for my day at the student-run free clinic at the House of Charity. With my hospital ID affixed to my new white coat, I make my way out the door for a delightful morning walk through Browne’s Addition and downtown Spokane on my way to Division and 3rd. I have a lot to think about along the way. Over the past few weeks I’ve had the pleasure of getting to know the intricacies in 1st year classes such as cell physiology, biochemistry and histology. Yet nothing has given me more difficulty then grappling with the patient interview. My lack of skill comes into sharp relief while bumbling my way through the patient load at the House of Charity.

Winter Saturday mornings are chilly. Crossing Monroe, then Wall Street gives me ample opportunity to reflect upon the Free Clinic’s role in my medical education. It is there at the clinic, where the homeless and underserved come for shelter and access to resources that are otherwise denied to them, that compassion and empathy become primary learning objectives. It is there where I learn that a substantial component of a successful patient interview is immaterial.

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CME Planning Committee

Continued from page 13 This knowledge cannot be gleaned from textbooks. Instead, I would argue that experience with those who rely upon the role of the clinician in this particular setting is the most important part of my medical education. I want to repeat that again: working with the underserved is a vital part of my medical education.

Along the way I cannot help but notice a group of protesters that gather in front of the Spokane Club on my way to work. I don’t envy their continual exposure to the elements, but I do admire their tenacity. Somewhere during my education, prior to entrance into medical school, I learned the power of subversive activity.

Those who change history rarely act within the system, but rather work outside it for change. The fruit seller who lit himself on fire in Tunisia ignited a series of revolutions across the Middle East. Republicans in the Boston Harbor threw tea overboard in an act of defiance. Similarly, the Saturday Clinic and free clinics across the country for that matter are examples of subversive institutions. They are subversive because they go against the norm of healthcare in our country -- that those with money and access to insurance should get the best care.

I work at the Free Clinic not because of my desire to add an item to my resume. No. I work there because it is a form of direct defiance and protest against what I see as a dangerously unfair system. In the past few years, the gap between people who can afford proper healthcare and those who cannot has substantially widened. I choose to be on the side that believes that all individuals, regardless of ability to pay, should have access to excellent care. I am also similarly encouraged by the volunteer physicians that staff the clinic -- their dedication is what I seek to emulate in my future career. I work in the hope that I take business away from healthcare institutions that rely on continual growth, and therefore continual profit. I have never felt comfortable with that idea of monetary profit in connection with the services I hope to one day provide. Instead, much like a successful patient interview, the profit should be immaterial -- it will be measured in the general health of the public.

Clinical Performance Improvement Network: Learning Session CMS Partnership for Patients – The Washington Hospital Engagement Network Sponsored by SCMS in conjunction with WSMA, Puget Sound Health Alliance and Washington Academy of Family Physicians

By Jennifer Anderson, CME Coordinator The Mission of the Spokane County Medical Society is to promote and provide leadership in the art and science of medicine.

Furthermore, the Society strives to improve and preserve the health of the citizens in our community. SCMS implements its mission through many different means. One of the methods we use is to implement a planned and comprehensive continuing medical education program for physicians.

The Spokane County Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) through the Washington State Medical Association (WSMA) to sponsor CME activities for physicians an. The SCMS CME Committee reviews and monitors AMA PRA Category 1 CME activity compliance with ACCME Essentials and Standards for both directly sponsored and jointly sponsored activities. The Committee is chaired by Clint Hauxwell, MD and members consist of Bruce Becker, MD; Don Coerver, PA-C; N. Roger Cooke, MD; V. Patrick Hughes, MD; Guy Katz, MD; Melanie Lang, MD; Mary Noble, MD and Kim Thorburn, MD. It is the goal of the committee to initiate, evaluate and accredit high quality continuing medical education programs that reflect our local and regional physicians’ educational needs both for primary care and specialty care. The committee’s overriding principle is to improve healthcare quality by enhancing the medical knowledge, skills, and clinical performance of participants while ensuring that the programs are never influenced by commercial interests.

The Spokane County Medical Society is pleased to offer ongoing CME opportunities to local and regional physicians and physician assistants. Since the CME Committee is not allowed to plan programs it was decided to set up a CME Planning Committee.

The committee is tasked with planning and implementing our first day-and-a-half CME symposium in September. Providing a program of this length allows for a larger number of CME credits to be offered and a decreased cost per CME credit for attendees.

The planning committee for the fall symposium is still evolving.

At this time the following members have agreed to serve: Robert Benedetti, MD; Bob Bray, MD; Clint Hauxwell, MD; Eric Johnson, MD; David McClellan, MD; Gary Newkirk, MD and Brian Seppi, MD. This symposium will focus on several primary care needs, as well as some cross-specialty topics. SCMS hopes to make this fall symposium an annual event. Other 2012 CME events include a Pain Management program on May 3, 2012 and a Moderate Conscious Sedation course in the fall of 2012.

April 25 5:30 – 7:30 p.m.

For more information see page 20 Meetings, Conferences and Events

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Providence Spokane Heart Institute proudly welcomes Andrew Boulet, MD, FACC and Michael Ring, MD, FACC.

PROVIDENCE SPOKANE CARDIOLOGY Cardiologists available 24-hours-a-day for consultation and patient transfers at 1-888-447-8349. phc.org

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Providence Spokane Cardiology and the Providence Spokane Heart Institute are pleased to welcome Andrew J. Boulet, MD, FACC, and Michael E. Ring, MD, FACC, to our Spokane clinic and the Heart Institute. Drs. Boulet and Ring have been providing excellent cardiac care to patients throughout our community for many years and we are pleased to have their expertise as part of the Heart Institute.

To schedule an appointment, call 509.455.8820 or 800.755.5857.

A Successful Match for WWAMI Spokane

By John McCarthy, MD Assistant Dean for Regional Affairs UWSOM A little less than four years ago, 20 medical students from the UWSOM started their medical education in Spokane at the Riverpoint campus. Just recently we found out what happened to those students as the match results were announced. The questions we wanted answered were: »» Was it a wise investment of state dollars to attempt to add medical students to the Spokane community? »» What is the benefit of having more medical education in Spokane? »» As those students transition to residency, will our community benefit?

The answer is an unequivocal yes! On the day of match, it appears that our community will retain four of those students or 20% of the entering class. The other students have matched in specialties not available here or for different reasons, they did not enter the match this year. In addition, we have been able to attract students from Pullman who did most of their third/fourth year training here. The bottom line is that the outcome predicted with respect to growing physicians locally with commitments to the community and region is coming true.

Internal Medicine Residency Spokane has landed three firstyear Spokane students who will be enjoying their training here.

The linkages are great. This is in contrast to 2008 when no UW graduates matched with IMRS. Family Medicine Spokane (FMS) Residency matched with one Spokane student and two Pullman students. This is in contrast to 2008 when no UW students matched with FMS. SCMS’s student representative, Jordan Storhaug, will be staying with the Family Medicine Spokane Residency.

There is of course a call to action here. We need a greater variety of residencies in the community in order to accommodate the desires for our students to stay local. As we move forward with medical education growth in Spokane, we need to be working with the leaders in different specialties to develop Graduate Medical Education opportunities in the region. At that time, we will have completed the goal of allowing students with ties to eastern Washington to complete the vast majority of their medical education here.

Rachel Safran – Internal Medicine Residency Spokane Program Jon Anderson - Internal Medicine Residency Spokane Program Liz Stuhlmiller – Family Medicine Spokane Residency Program Jordan Storhaug - Family Medicine Spokane Residency Program Lacie Bland – Internal Medicine Residency Spokane Program Stephanie Gering - Family Medicine Spokane Residency Program

Physician Leadership Resources Books A link for any of the resources listed can be found at the SCMS website (www.spcms.org) Leadership Resources tab.

Getting Change Right In Getting Change Right, Seth Kahan challenges us to approach organizational change in a whole new way. Presenting a critical shift from the old mindset of coming up with a good idea, and then pushing it through with mandates, he shows that the way to successful, authentic change today is through engagement – the need to connect to people, to listen as much as to share ideas, and to involve as many key people as possible in the realization of their goals.

Clinical Integration: A Road Map to Accountable Care With the Federal legislation regarding Accountable Care Organizations finalized and commercial payers following suit, Clinical Integration: A Roadmap to Accountable Care by Bruce Fareau, MD; Ken Yale, DDS, JD; J.M. Bohn and Colin Konschak offers timely updates on key changes affecting the industry as clinically integrated networks (CIN) and accountable care organizations (ACO) emerge.

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Inland Imaging and SCMS Host Mammogram Party On the evening of February 22, Inland Imaging and SCMS hosted a Mammogram party for our female physicians and members of Inland Imaging. Students from the Inland Massage Institute provided chair-massages and the Varicose Vein Center offered free vein screenings. There was plenty of food and drinks for everyone to enjoy and time to visit with colleagues.

Thank you to Dr. Florence Gin for arranging the party.

Drs. Amy Henkle and Flo Gin (Inland Imaging Radiologists)

Drs. Terri Oskin, Beth Peterson and Flo Gin

Drs. Terri Oskin and Mary Badger enjoying massages from the Inland Massage Institute students.

April SCMS The Message 17

Update in Pain Management 2012 Category I CME sponsored by SCMS

May 3 Evening workshop at the 2012 Primary Care Update Read more information on page 20 Continuing Medical Education

Nicholas Rajacich, MD WSMA President Elect US Representative Cathy McMorris Rodgers Douglas Myers, MD WSMA President Bruce Andison, MD WSMA Assistant Secretary Treasurer Terri Oskin, MD SCMS President

In the News SCMS and WSMA Leadership Take Advocacy to Capitol Hill  In February Spokane County Medical Society President Terri Oskin, MD and WSMA President Doug Myers, MD, President-Elect Nick Rajacich, MD, and Assistant Secretary-Treasurer Bruce Andison, MD met with all members of our congressional delegation (and/or their staff) to advocate for full repeal of the Medicare Sustainable Growth Rate (SGR) formula, support for adequate Graduate Medical Education (GME) funding and amelioration of the impact of the October 2013 implementation of the new ICD-10 coding system (International Classification of Diseases, 10th Edition). Also available on the SCMS website at https://picasaweb.google.com/ SCMSmembers/AMA2012NationalAdvocacyConference.

Terri Oskin, MD SCMS President Douglas Myers, MD WSMA President Bruce Andison, MD WSMA Assistant Secretary Treasurer US Senator Maria Cantwell Nicholas Rajacich, MD WSMA President Elect Jennifer Hanscom, WSMA Associate Executive Director/Chief Operating Officer

Bruce Andison, MD WSMA Assistant Secretary Treasurer Douglas Myers, MD WSMA President US Representative Norman Dicks Nicholas Rajacich, MD WSMA President Elect Terri Oskin, MD SCMS President

Nicholas Rajacich, MD WSMA President Elect Douglas Myers, MD WSMA President US Representative Jay Inslee Bruce Andison, MD WSMA Assistant Secretary Treasurer Terri Oskin, MD SCMS President

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Continued from page 18 Election into Alpha Omega Alpha Internal Medicine Residency Spokane is proud to congratulate Drs. Jeremy Graham (faculty) and Dinesh Ratti (senior resident) on their election into Alpha Omega Alpha (AOA). These talented physicians were nominated by the U WA students and/or faculty. While AOA emphasizes leadership and scholastic achievement, additional factors include ethical standards, fairness in dealing with colleagues, demonstrated professionalism, potential for achievement in medicine and a record of service to school and community.

InCyte Pathology

Quality Diagnostics

for over 50 years

Election to AOA is an honor signifying a lasting commitment to scholarship, leadership, professionalism and service. AOA is a lifelong honor and membership in the society confers recognition of a physician’s dedication to the profession and art of healing.

Please congratulate these two fine physicians on this outstanding achievement.

Health Sciences University Names New President The Board of Trustees at Pacific Northwest University of Health Sciences has named D. Keith Watson, D.O. as its new president.

Dr. Watson is the senior associate dean for academic affairs at the Ohio University Heritage College of Osteopathic Medicine in Athens, Ohio and the chief academic officer for the Centers for Osteopathic Research and Education—an entity overseeing 90 Graduate Medical Education programs in 26 training institutions.

Dr. Watson received his Doctorate of Osteopathic Medicine (DO) degree from the Texas College of Osteopathic Medicine in 1975 and completed an internship and general surgery residency at Tulsa Regional Medical Center (now Oklahoma State University Medical Center) in Tulsa, OK. He also completed a surgical oncology fellowship at the University of Texas System Cancer Center, MD Anderson Hospital and Tumor Institute.

He has been an American College of Osteopathic Surgeons member since 1980.

Dr. Watson is married to Maureen Clothier, DO, who is an internist with a special interest in geriatrics. They have three children, Laura Merz of Alexandria, VA, Karen Watson at the University of Cincinnati, and James Watson who will soon attend Ohio State University.

InCyte Pathology provides expansive subspecialty expertise in all areas including: Dermatopathology, Gastrointestinal Pathology, Gynecologic Pathology, Hematopathology, Oral and Maxillofacial Pathology, Renal Pathology, Placental Pathology and Urologic Pathology.

For advanced diagnostic services, please contact us at 888.814.6277 or visit our website at www.incytepathology.com.

Dr. Watson is slated to begin on July1, 2012, and will replace Interim President Lloyd Butler, DO. Dr. Butler will continue with the university in the Office of University Advancement.

PNWU College of Osteopathic Medicine welcomed its inaugural class of 75 students in 2008. Currently, a total of 294 students are enrolled.

On May 12, 2012, the College of Osteopathic Medicine will hold its first commencement exercises for the Class of 2012 before these young physicians start their residencies. Dr. Watson will be participating in the ceremony along with Dr. Butler and the Dean of the College of Osteopathic Medicine, Robyn Phillips Madson, DO, MPH.

Proudly serving Northwest physicians and their patients for over fifty years

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Meet Travis Prewitt and Brad Desormeau of the UBS: The Prewitt Group - An SCMS Community of Professionals Partner

Self-introduction We are Travis Prewitt and Brad Desormeau, co-founders of The Prewitt Group at UBS, a nationally recognized Wealth Advisor in Medical Economics.

How long have you been in Spokane?

Brad was assigned to Fairchild AFB in 2000 after his return from South Korea.

Travis has lived here most of his life. He had been a professor at Whitworth University then left to start his career in wealth management over 30 years ago.

What service do you provide for professionals?

We act as an expert resource to professionals in the community with regards to financial information, wealth management, liability management and estate issues.

What makes your organization stand out as a “good” partner?

The truth is that when it comes to Financial Advisors, planners, brokers etc. there are really only three things that distinguish the "good" from the others. One is intellectual capital. Our team is nationally recognized as one of the top advisors in the country, more than once now, in Medical Economics. Our firm has global resources available to us as well and we have as many capabilities and as much knowledge as any. We have a planning based approach. We tell folks, "Prescription without diagnosis is malpractice." Our process takes some time before we ever suggest any type of action on investments or liabilities. It is the quick idea, the product first talk, the idea from a friend at work that are where people get hung up or lose money. The second thing is cost. We believe in being up front and transparent when it comes to fees. We discount costs to less than half of the national average. Lastly, there is the topic of communication and relationship.

This is where we excel. Our clients talk with us monthly. We have a schedule with them where they know when we're calling and it is a standing meeting where our staff keep them reminded of the calls and appointments. We keep our clients names and information extremely private. The only exception is those physician, CPA and attorney clients that ask to be used as a reference for our practice.

We use our resources to try and work with the Medical Society to recruit and retain quality physicians to the community. We are constantly brainstorming with clients, other professionals and the Medical Society staff on how to best host an event, provide an opportunity, and overall enhance the experience for the medical folks in our community.

What is your thinking about the Spokane area medical community?

Simply put…the best! Not only has our families received unbelievable care. In our experience some of the best docs in the world are right here in Spokane. We have physicians and specialists around the country as clients and a lot of them started in this area and say it is one of the best kept secrets in medicine. I would also note the medical managers and staff as well. Some of those folks are amazing and we consider them essential in how our community prospers.

Visit our updated website • View "The Message" Online

• Legislative updates

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• Membership information

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-Information about credentialing, committees, bylaws, etc.

-The online medical library is a SCMS membership benefit.

• CME information -Topic and dates for upcoming CME courses April SCMS The Message 20

Continuing Medical Education Promoting Healthy Families (Practice Management Alerts from the American Medical Association ) is designed to help physicians successfully talk about healthy behaviors with their adult patients in a way that may spark—and help sustain—positive changes for the whole family. The continuing medical education activity includes a video module, a detailed monograph and patient handout. These activities have been certified for AMA PRA Category 1 CreditTM. For more information www.ama-assn.org.

Update in Pain Management 2012 This 2.75 hour AMA Category I CME seminar is sponsored by the Spokane County Medical Society.

This activity has also been reviewed and is acceptable for up to 2.75 Prescribed credits by the American Academy of Family Physicians.

This conference is one of the evening workshops at the 2012 Primary Care Update and will be held on May 3, 2012 at the Red Lion Inn at the Park. Contact Jennifer Anderson at 509.389.6264 or email jennifer@spcms.org for more information.

Chronic Opioid Therapy Join Group Health and Spokane area healthcare providers for a CME program focused on Group Health’s guideline-based approach to managing the challenges of chronic opioid therapy. We will demonstrate treatment techniques for handling difficult situations and describe how we risk-stratify patients and track the development of care plans to comply with new state guidelines and other changes in our practice. Wednesday, April 11, 2012, 6:00–8:30 p.m. The Davenport Hotel, 10 South Post Street, Spokane Complimentary (includes parking and buffet dinner) Information and registration: cmetracker.net/GHC/Catalog Questions call 509. 241.7146. This activity has been approved for AMA PRA Category 1 Credit™ Primary Care Update (Preconference Thursday May 3) Conference begins Friday, May 4 – Saturday, May 5, 2012 Red Lion Hotel at the Park, 303 W. North River Drive, Spokane Now in its 29th year, this well-established update is a tremendous opportunity for physicians and other health professionals to choose from more than 20 CME sessions and workshops designed specifically for primary care practitioners. This activity has been reviewed and approved for up to 23.25 Prescribed credits by the American Academy of Family Physicians. For more information call 509.358.7640 or e-mail ahec@ wsu.edu. Online Brochure & Registration: http://extension.wsu.edu/ ahec/Pages/PCU2012.aspx.

Yakima Valley Medical Conference 15 AMA Category 1 Credits April 13 & 14, 2012 - Yakima, WA More information visit www. russocme.com or contact Melissa at russocme@gmail.com or 509.431.0718 Pain management Update for the Primary Care Provider April 21, 2012 Saturday – Doubletree Guest Suites, 16500 Southcenter Parkway, Seattle, WA 8 Category 1-A AOA Approved CME Credits Learn effective management for patients with chronic non-cancer pain. The credits qualify towards exemption to the state rule to consult a pain specialist if exceeding the 120 MED (morphine equivalent dosing) cap for chronic non-cancer pain patients. For more information or to register go to www.woma.org.

Meetings, Conferences and Events 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.

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 509.624.7320 for more information.

End-of-Life Ethics Conference to be hosted by Hospice of Spokane - Ethical decisions at the end of life provide a point where factors that influence end-of-life care such as finances, laws, values, culture and technology converge. This conference examines the ethical issues and dilemmas that emerge at the end of life. The conference is hosted by Hospice of Spokane and will be held on Wednesday, April 25 from 10:15 am to 2:00 pm at the Lincoln Center, 1316 N. Lincoln, Spokane. For more information or to register, visit www.hospiceofspokane.org or call 509.532.6731. Discussion will include topics such as artificial nutrition and hydration, palliative sedation, surrogate decision-making and the ways that ethical issues at end of life can sometimes create moral distress and influence the grief reactions of families.

CMS Partnership for Patients: The Washington Hospital Engagement Network Clinical Performance Improvement Network: Learning Session Spokane County Medical Society Meeting – April 25, 2012 – 5:30-7:30 PM Deaconess Health and Education Center – 910 West 5th Avenue, Spokane – Room 268 Dinner will be served at 5:30 PM and the program will run from 6:00 to approximately 7:30 PM At the completion of the webinar, participants will be able to: 1. Identify the priority goals of the Partnership for Patients Initiative and the national target reductions expected in hospital acquired conditions and preventable readmissions. 2. Identify the lead participants in the Washington Hospital Engagement Network and the roles each will play in achieving the above target reduction objectives. And 3. Identify the role community physicians are expected to play in reducing preventable hospital readmissions by scheduling timely post-discharge visits and medications reconciliation. For more information or to register call Michelle Caird at 509.325.5010 x25 or michelle@spcms.org

April SCMS The Message 21

1972. Later that year, Dan and Bonnie relocated to Fairchild Air

In Memoriam

Force Base (FAFB).

During his enlistment in the United States Air Force at FAFB

Thomas A. Marr, MD

Dan trained as a Flight Surgeon and practiced in Obstetrics and Gynecology. This began his life's work and passion of caring for

Thomas A. Marr passed away on February 21, 2012. He was born in Grafton, ND on April 18, 1927. He was raised by his parents, Arthur and Vivian Meagher in Park River, ND.

mothers and bringing children into the world. Dan began his private medical practice in 1979 and delivered 6532 babies, falling just short of his personal goal of 7000 due to his forced early retirement in April of 2011. He loved to teach and enjoyed having medical students and nursing students rotate through his office.

After his service in the Navy for two years, Tom pursued his dream of becoming an internal medicine physician and graduated from the University of Minnesota Medical School in 1953. He had an internship at Harborview and a fellowship at the VA Hospital in Seattle. During his residency, he met and married Ardis Graham and started a family. In 1959, the family moved to Spokane, WA, where Tom began his internal medicine practice at Rockwood Clinic. In 1961he started the Kidney/Dialysis Center at Sacred Heart Medical Center. By

Dan was always willing to share his knowledge and experience.

Survivors include his loving wife Bonnie Phillips, his daughters Laura Harper (Brian), Lisa Westbrook (Alan), Lydia Myers (Brian) and Leah Southard (Bradley), his brother Thomas Phillips (Barbara), his nephews Stacey Phillips (Lindsey) and Todd Phillips, and great nephews William Phillips and Pierce Phillips.

He will truly be missed.

1962, Dr. Marr pioneered with Drs. Loren Gothberg and Richard Steury in establishing the Artificial Kidney Center and the creations of peritoneal dialysis. These innovations changed thousands of patients' lives. In 1996, he retired from his medical career. In 1997, he married his loving partner and friend, Sue Ann DeSmeth. They spent the last 15 years traveling the world, enjoying golf, playing cards, spending time with family and friends, and settling in their home in Sun Lakes, AZ.

Ralph Dean Luther, MD On January 03, 2012 Ralph Dean Luther passed away at home in Rancho Mirage, CA. His only child, Joan, and his son-in-law, Ken Young, were by his side. His beloved wife, Mary, predeceased him by 6 years. Dean was born July 01, 1915 in Ligonier, PA. Dean was the last survivor of the six children of Crystal and Dick

Tom is survived by his devoted wife of 15 years, Sue Ann DeSmeth Marr; his sons Stephen Marr (Cyndi), Michael Marr (Sharon) and by his daughters, Theresa Marr Gusregan (Dan), Judy Marr-Gusky (Paul), Katie Marr and Mary Marr Lenz (Mark).

Tom had 13 grandchildren and five great-grandchildren. In addition, he is survived by Kathy DeSmeth Lundberg (Steve); Matthew Lundberg (Zoe), Krista Lundberg Davis (Leon), and John DeSmeth. Tom was preceded in death by his sister Katherine Meagher, his parents Arthur and Vivian Meagher, his wife Ardis and his sister Mary Jean Meagher Grossinger.

Luther. He moved to California with his uncle, Dean Luther and attended UC Berkeley. He returned to Pennsylvania to attend Temple Medical School where he met another medical student, Mary Joan Queeney. The sweethearts married after medical school. When Dr. Luther was stationed to Gorgas Hospital, the Pacific Rim Army Medical Surgery for the severely wounded during WW II, they took their infant daughter, Joan Queeney Luther, with them to live in Panama for the next three years.

When they returned stateside, a debate about where to settle down ensued. Dr. Mary wished to live in Florida; Dr.

Daniel G. Phillips, MD

Dean wished to move to Alaska. Dr. Dean was an avid fly fisherman and game hunter from the ages of 8 to 90. The final

On January 03, 2012 Dr. Daniel G. Phillips passed away. He was born on August 02, 1943 in Augusta, GA to Thelma Louise Campbell and Samuel Lee Corley. After the death of his father, his mother remarried and Dan was adopted by Mervin Thomas Phillips.

Dan was a proud graduate of the University of Georgia (1964).

He met his wife, Bonnie Ellen Davis, in the summer of 1962 while working at Eugene Talmadge Memorial Hospital where Dan and Bonnie worked as Nursing Assistants. Dan and Bonnie were married June 4, 1966 and enjoyed 46½ years of loving marriage. He proceeded on to medical school at the Medical

compromise was to settle in Spokane, WA where Dr. Luther practiced Orthopedic Surgery with the Rockwood Clinic, while Dr. Mary taught nursing for Sacred Heart Nursing School and went on to become Director of The Spokane County Health Department.

Dean fly fished and hunted happily for many years in the Pacific Northwest. The couple enjoyed social life, golf and tennis at the Hayden Lake Country Club; and in 1975 bought a winter home in Rancho Mirage, CA. They had the pleasure of traveling the world with their friends.

College of Georgia and graduated in 1968. Dan completed his residency in Obstetrics and Gynecology at Emory University in

April SCMS The Message 22

WWAMI Celebrates 40th Anniversary

In future years, L&I will invite other provider types and out-of-state providers to join the network. Until then, they can continue to treat injured workers without joining.

On March 22 various Spokane educational, business, community and medical well-wishers joined together to celebrate WWAMI’s 40th Anniversary. Started in 1972, WWAMI has collaborated to advance regional excellence in medical education and meet physician workforce needs in rural and underserved areas.

During the celebration Matthew Hollon, MD, Clinical Associate Professor University of WA School of Medicine was presented the 1st Spokane Track Teacher of the Year award by Deb Harper, MD, Assistant Dean for Regional Affairs and Rural Health, WWAMI Clinical Medical Education. Congratulations to Matthew Hollon, MD!

“We want every great health-care provider in the state to be part of our network,” said Beth Dupre, L&I’s Assistant Director for Insurance Services. “Your patients are counting on your participation. I urge you to apply early, so we can have credentialing completed before the network launches.”

After the network launches, injured workers will be able to see a non-network provider, but only for the initial office or emergencyroom visit. They must then choose a network provider for ongoing care. L&I will help workers locate a network provider.

How the application process works • Providers can apply at www.JoinTheNetwork.Lni.wa.gov. You have the option of applying online through Provider Source (using your OneHealthPort account) or on paper.

• Throughout 2012, L&I will be reaching out to current L&I providers to invite them to apply, one region at a time. However, current and new providers (of the types listed above) may apply to the network at any time.

• All current providers for L&I must re-apply, including participants in the Centers for Occupational Health and Education (COHE).

Even though you may have been an L&I provider for years, we have limited information about you — not enough to add you to the network.

What does the application include?

Our application process is similar to other insurers. We have made it easy for you with only three parts to the application.

• Washington Practitioner Application • L&I Network Provider Agreement

Elizabeth Stuhlmiller, M4; Luis Manriquez, M3; Hannah Qualls, M4; Matthew Hollon, MD, Winner of 1st Spokane Track Teacher of the Year; Stephanie Gering, M4; Benjamin Arthurs, M4; Collette Inaba, M3; Katie Mackay, M4; Mallory Beale, M3; Ricky Martin, M3 and Rachel Safran, M4

You Can Now Apply to Washington’s Workers’ Comp Medical Network

• Statewide Payee Registration and W-9 tax information Enrollment through delegation?

If your practice is in a health-care organization qualified to credential providers on behalf of L&I, we may be able to work with that organization to enroll you. Please contact us for information at 360.902.6810.

What are the network standards?

The network standards are modeled on those used by most health plans. The standards are described in new administrative rules, effective Feb. 3, 2012. To develop the standards, L&I worked closely with a special advisory group made up of provider, worker and employer representatives.

By the Washington State Department of Labor & Industries The Department of Labor & Industries is now accepting applications for the statewide workers’ compensation medical network that will launch in 2013. Network providers will care for injured workers covered by L&I as well as by self-insured employers.

Beginning January 2013, the following medical providers that practice in Washington State must be in the network to treat injured workers beyond the initial visit: physicians, chiropractors, naturopathic physicians, advanced registered nurse practitioners, physician assistants, podiatric doctors and surgeons, dentists, and optometrists.

Background The medical provider network is part of historic legislation passed in 2011, Substitute Senate Bill 5801, to improve workers’ outcomes following injury. In addition to creating the network, the legislation expands access to the state's Centers of Occupational Health and Education (COHEs). L&I will also develop incentives for network providers who use best practices for occupational health. For more information on the COHE expansion, best practices, and incentives, visit www.Lni.wa.gov.

April SCMS The Message 23

Continued on page 24

Continued from page 23 What happens if you choose not to apply, or are not accepted into the network?

You can apply at a later date, but processing your application could take longer. A delay could impact your ability to care for your patients.

If you do not become part of the network, any injured workers in your care will need to move to a network provider not later than January 1, 2013.

Questions?

A list of common questions about the network is available at www.

ProviderNetwork.Lni.wa.gov. If you don't find your answer there, please contact us: Email: ProvNet@Lni.wa.gov or 360.902.5140.

Stay informed Sign up for L&I’s Provider Newsletter — it’s fast and easy. Go to http://www.Lni.wa.gov and search for “Provider listserv”.

IDEA Clinic: A Dental Home

By C. William Britt, Jr., MD In January, 2012, Spokane dentist Dr. Tyler Shoemaker treated the first patient of the IDEA Clinic!

When CHAS terminated its volunteer program, area dentists had no place to volunteer to help the poor. Recognizing the unmet need particularly for adult care, Drs. Mark Paxton, Jim Sledge, Dale Ruemping, Sue Weishaar, Amir Ganji, and Ryan Love began meeting seven years ago to plan a clinic controlled by the Spokane District Dental Society (SDDS) that would provide facilities for dentists in every field to volunteer and deliver the same quality of care as in their private offices while offering a sliding fee scale based on income and household size.

The concept of the Inland Northwest Dental Expanded Access Clinic emerged. When they asked the SDDS to create a foundation for the purpose of securing grants to equip the IDEA Clinic, Dr. Otto Stephens immediately donated $10,000 and the SDDS, $120,000. Dr. Paxton has served as the SDDS Foundation’s President and Drs. Ganji and Weishaar as Board members since its inception. Patrish Brady was the Executive Director until February when Sherri Lynch assumed the interim position.

The Foundation partnered with the Yakima Valley Farm Workers Clinic to locate the IDEA Clinic at the YVFWC’s Riverstone Dental Clinic (RDC) in the Northeast Community Center. The IDEA Clinic has six operatories fully equipped for contemporary 4-handed dentistry, 2 consultation rooms, an operating suite, a dental lab, and office space for a Clinic Coordinator and the Foundation Executive Director. Bids were submitted recently for equipping the operating suite. The Clinic shares the RDC’s reception and waiting areas, computer and telephone systems, sterilization facility, and digital x-ray unit.

Equipment and supplies for the IDEA Clinic have been purchased with grants of $192,000 from the Washington Dental Service Foundation and $250,000 from the Murdock Foundation. Other grants include $40,000 from the Empire Health Foundation, $20,000 from Providence Health Care, $1,000 from the Williams Foundation, and an additional $25,000 from the SDDS. Donations, totaling $10,700, have been received from 82 individual members of the SDDS. Dr. Paxton, Foundation President, indicated that acquisition of a microscope for endodontic procedures and a 3-dimensional CT scanner for certain surgical, endodontic and orthodontic cases with funds from future grants is projected.

At present, patients are scheduled for the IDEA Clinic by the RDC and complete a screening assessment for fee determination. Fees range from very little to the full charge, but all patients will pay something for their care. 30 dentists have been credentialed to work at the Clinic, a number projected to reach 100 by the end of the year. A dental assistant is working there 3 days each week.

When the Clinic is fully operational, the Foundation plans to employ a Director of Dental Services to develop treatment plans and triage each patient to the appropriate provider. The general dentists and specialists, who volunteer some with their office staff, will perform the needed procedures.

Recognition of the Foundation’s mission is growing. Organized by Dr. Brooke Cloninger, the 2012 fundraising event was supported by the Spokane business community and raised more than $70,000!

Dr. Mark Koday, Director of the YVFWC’s 9 dental clinics in Washington and Oregon, indicated that the collaboration between the RDC and the IDEA Clinic allows RDC patients in need of specialty care to be referred to a clinic with a full complement of specialists and a sliding fee scale. Dentists volunteering at the IDEA Clinic provide specialty education to the RDC’s general dentists and general dentistry residents. Drs. Koday and Paxton anticipate the Clinic to join with the RDC in training students of the Dental Hygiene Program at EWU and the Regional Initiative in Dental Education (RIDE), a UW program for dental education locally.

Dr. Koday stated, “The public health, education, and private sectors working together give us far greater capabilities than we can provide on our own,” and sees the joint venture with the SDDS Foundation as a model for partnering with dental societies in other regions.

Speaking for the Foundation as President-Elect, Dr. Amir Ganji explained, “If the parents go to the dentist only when they are in pain, the children will go only when they are in pain. We want to offer families a dental home. After we treat the acute problem, we want to give them the care they need and break the cycle.”

Congratulations to the SDDS, its Foundation, and these visionary leaders and donors. Spread the word: The WELCOME mat is out!

April SCMS The Message 24

SAVE THE DATE! Senior Physicians Golf Tournament Thursday 17 May 2012 11:30 a.m. Lunch 1:00 p.m. Shotgun Start Manito Golf Course

Awards ceremony immediately following Special thanks to Waterbrook Winery and Nike Golf for supporting the tournament.

Everyone is welcome to join in the fun!

Membership Recognition for April 2012 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.

30 Years Stuart J. Fealk, MD

4/27/1982

Russell C. Roundy, MD

4/27/1982

20 Years Patrick T. Beaulaurier, MD

4/15/1992

Eric B. Leavitt, MD

4/15/1992

David M. Maccini, MD

4/15/1992

Russell N. Oakley, MD

4/15/1992

Thomas F. Prenger, MD

4/15/1992

Thomas P. Schaaf, MD

4/15/1992

10 Years

In Memoriam

John T. Tran, MD

Cornelius E. Hagan, Jr., M.D. Born in Brooklyn, NY on September 13, 1911 to Dr. Cornelius E. Hagan and Katharine Lucina (Durrenberger) Hagan, Cornelius E. Hagan, Jr. passed away on February 23, 2012. He entered the University of Virginia on September 1929 and later graduated from the Medical College of Virginia on May 28, 1935. He married Lydiellen Munsell in Colorado on August 21, 1934.

He did his internship and surgical residency at Englewood Hospital, Englewood, NJ and his internship and residency at Columbia Presbyterian Hospital, NYC. He became a Certified Otolaryngologist in 1960.

Dr. Hagan was an otolaryngologist at the Truesdale Clinic in Fall River, M.A. in 1940.

He obtained his private pilot’s license in January of 1941.

He entered military service on January 21, 1943 and was assigned to Ft. George Wright, Spokane. He was Discharged October 19, 1956 and settled in Spokane.

Dr. Hagan was in private practice of Otolaryngology until his retirement in 1978. He was an avid flyer, golfer, photographer and traveler.

April SCMS The Message 25

4/1/2002

The following physicians and 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 Bell, John W., MD Diagnostic Radiology U of Utah (2006) Internship: Sacred Heart Medical Center (2007) Residency U of Utah (2011) Fellowship: U of Utah (2012) Practicing with Inland Imaging Associates, PS 7/2012

DeMars, Patrick D., MD Anesthesiology Med School: U of Minnesota (1981) Internship/Residency: Naval Regional Medical Center (1984) Fellowship: Naval Regional Medical Center (1987) Practicing with Shriner’s Hospital for Children 3/2011

Lee, Thomas K., MD, PhD Anatomic Pathology Med School: The George Washington U (2006) Internship/Residency: Johns Hopkins U (2009) Fellowship: Stanford U Medical Center (2010) Practicing with Pathology Services (Deaconess) 4/2012 Magee, William T., MD Orthopedic Surgery Med School: Louisiana State U (2002) Internship/Residency: Oregon Health & Science U (2007) Fellowship TRIA Orthopaedic Center (2008) Practicing with Rockwood Main Clinic 4/2012

Ray, Erik S., MD Diagnostic Radiology Med School: Chicago Medical School (2001) Internship/Residency: Rush U Medical Center (2006) Fellowships: Johns Hopkins (2007), Rush U Medical Center (2008) Practicing with Radia, Inc. 5/2012

PHYSICIANS PRESENTED A SECOND TIME

Cheek, Andrew G., MD Ophthalmology Med School: Loma Linda U (2007) Internship: Kettering Medical Center Residency: U of Maryland/Maryland General Hospital (2011) Fellowship: West Virginia U Eye Institute (2012) Practicing with Spokane Eye Clinic 8/2012

Gopaluni, Srivalli, MD Medical Oncology/Hematology Med School: Gandhi Medical College (2002) Internship: Gandhi Hospital (2003) Internship/Residency: SUNY Upstate Medical U (2006) Fellowship: SUNY Upstate Medical U (2012) Practicing with Cancer Care Northwest 7/2012

Nelson, Kelly M., DO Family Medicine Med School: Des Moines U (2005) Internship/Residency: Doctor’s Hospital (2008) Practicing with Rockwood Liberty Lake Clinic 5/2012

Abadir, Janet S., MD Surgery Med School: Robert Wood Johnson Medical School (2000) Practicing with Surgical Specialists of Spokane 4/2012 Baker, Drostan G., MD Family Medicine Med School: St. Matthews U (2009) Practicing with Rockwood Liberty Lake Clinic 8/2012 Call, Jason A., MD Radiation Oncology Med School: Medical College of Wisconsin (2007) Practicing with Cancer Care Northwest 7/2012 Conklin, Alissa, MD Obstetrics and Gynecology Med School: Southern Illinois U (2008) Practicing with Rockwood OB/GYN Center 8/2012 McCarthy, Anne Marie, MD Pediatrics Med School: St. George’s U (2004) Practicing with Providence Medical Group Hawthorne 2/2012 Monday, Kimberly E., MD Neurology Med School: Baylor College of Medicine (1992) Practicing telemedicine with Providence Medical Group - Stroke and TIA Center 1/2012 Nakave, Abhijeet, MD Internal Medicine Med School: Seth GS Medical College, India (2003) Practicing with Apogee Physicians 4/2012 Sharp-Saunders, Jennifer L., MD Pediatrics Med School: Baylor College of Medicine (1998) Practicing with Rockwood Liberty Lake Clinic 6/2012

Nackos, Jeffrey S., MD Diagnostic Radiology Med School: U of Utah (2006) Internship: Deaconess Medical Center (2007) Residency: Integris Baptist Medical Center (2011) Fellowship: U of Wisconsin (2012) Practicing with Inland Imaging Associates, PS 7/2012

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April SCMS The Message 26

FYI

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Reminder: Prescriptions Must Have Two Signature Lines

PHYSICIAN ASSISTANTS Boice, Nicole C., PA-C Physician Assistant School: U of California, Davis (2011) Practicing with Spokane Obstetrics & Gynecology, PS 2/2012 Lukes, Janie D., PA-C Physician Assistant School: U of Washington, Medex Northwest (2011) Practicing with Heart Clinics Northwest, A Division of Kootenai Medical Center 1/2012

PHYSICIAN ASSISTANT PRESENTED A SECOND TIME Garcia, James L, PA-C Physician Assistant School: U of Washington, Medex Northwest (2009) Practicing with Providence Health Services dba NW Heart and Lung Surgical Associates 2/2012

Health care prescribers are reminded that the Board of Pharmacy law requires every written prescription have two signature lines at the bottom of the prescription. RCW 69.41.120 requires: • All written prescriptions shall have two signature lines at opposite ends of the bottom of the form. Under the line at the right side shall be clearly printed the words “DISPENSE AS WRITTEN”. Under the line at the left side shall be clearly printed the words “SUBSTITUTION PERMITTED”.

• The practitioner must communicate instructions to the pharmacist by signing the appropriate line.

• For oral prescriptions, the practitioner or the practitioner’s agent must tell the pharmacist whether a therapeutically equivalent generic drug may be substituted.

• Pharmacy Board inspectors have found a significant number of prescriptions--many generated electronically-that lack two signature lines. The Board urges practitioners to ensure that clinics, particularly those using EMRs, comply with this requirement. A pharmacist may refuse to fill a prescription that does not meet these requirements.

During the Month of April April is National Sexual Assault Awareness Month National Crime Victims’ Rights Week is April 22-28 April 16 is National Healthcare Decisions Day. Please consider discussing and completing Advanced Directives as a gift to those who love you!

April SCMS The Message 27

POSITIONS AVAILABLE 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.

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.

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, oncall 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!

FAMILY MEDICINE SPOKANE Immediate opening with Family Medicine Spokane (FMS) for a full time BC/BE FP physician who has a passion for teaching. FMS is affiliated with the University of Washington School of Medicine. We have seven residents per year in our traditional program, one per year in our Rural Training Track and also administer OB and Sports Medicine Fellowships. This diversity benefits our educational mission and prepares our residents for urban & rural underserved practices. We offer a competitive salary, benefit package and gratifying lifestyle. Please contact Diane Borgwardt, Administrative Director at 509-459-0688 or e-mail at BorgwaD@ fammedspokane.org.

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!

PREMIER CLINICAL RESEARCH, an independent dedicated research facility here in Spokane with 20 years of research experience is looking for a Pediatrician to be a part of our physician network for future studies. For more information please contact: April Gleason, Director of Business Development, (509) 390-6768, premierclincalresearch@gmail.com.

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 cross-specialty 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 subspecialists. Learn more: Mark Rearrick, Providence physician recruiter, (509) 474-6605, mark.rearric@providence.org, www.providence.org/ physicianopportunities.

PROVIDENCE HEALTH & SERVICES is building its Urgent Care presence in Spokane. We are recruiting for BE/BC Urgent/ Immediate Care physicians and advanced practice providers (nurse practitioners and physician assistants welcome to apply). This is a great opportunity to join a growing employed medical group in beautiful eastern Washington. The exceptional Providence care team is implementing a system-wide standardized EHR and providers benefit from shared best practices and robust clinical and business support. Providence already operates hospitals, residency programs and numerous primary care and specialty clinics in Spokane.

Competitive compensation and excellent benefits package, including relocation. Learn more: Mark Rearrick, Providence physician recruiter, (509) 474-6605, mark.rearrick@providence.org, www.providence.org/ physicianopportunities.

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Continued from page 28 SPRINGDALE COMMUNITY HEALTH CENTER ARNP or PAC N.E. Washington Health Programs (NEWHP) has an immediate opportunity for an excellent Physician Assistant (certified) or Nurse Practitioner with Family Practice experience to join our Springdale Community Health Center located in rural Springdale, WA. This position is for Family Practice outpatient care; urgent care experience is a plus but not required. NEWHP offers competitive compensation, comprehensive benefits. . NHSC eligible site. EOE and provider.

Application Deadline: Until filled. Send resume to: N.E. Washington Health Programs Attn: Human Resources PO Box 808 Chewelah, WA. 99109 or electronically to desirees@newhp.org.

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.

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.

MEDICAL OFFICES/BUILDINGS 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 full-service medical building with lab and full radiology services. For more information, call (509) 981-9298.

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.

Northpointe Medical Center Located on the North side of 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 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.

Clinical Space for Lease - Built in January 2011. 1128 sq ft, four exams rooms, two administrative offices, one office with a counter (electronic bar for laptops, etc.), restroom, reception area and waiting room. Rates are negotiable. Interested parties contact Sharon Stephens at Bates Drug Stores, Inc. 3704 N. Nevada, (509) 489-4500 Ext. 213 or Sam@batesrx.com.

Office space located at 1315 North Division. This location is two miles north of downtown Spokane and just west of Gonzaga and the university district. It consists of 902 sq. ft. and rents for $1015 per month plus 20% of the building Avista and City of Spokane bills. The rest of the building is occupied by a physiatry and pain management medical practice. The space would be ideal for an ancillary medical, chiropractic or therapeutic clinic. Parking is ample and convenient.

The space has a nice waiting area and receptionist-enclosed area, with several office, storage or exam rooms. Call (509) 321-2276 for more information or for a showing of your ideal location.

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Medical Director and Physician Airway Heights Corrections Center (AHCC) SALARY: UP TO $172,920 ANNUALLY PLUS EXCELLENT BENEFITS PACKAGE* The WA State Department of Corrections Health Services Division is seeking highly motivated individuals for the critical roles of Medical Director and Physician for our Airway Heights Corrections Center (AHCC) located 10 miles west of Spokane, WA. The Medical Director is responsible for directing the healthcare programs and services at the facility.

The Medical Director and Physician are responsible to: • Supervise and participate in medical treatment of consulting physicians and other providers.

• Perform diagnosis and treatment of diseases and injuries of patients at the institution.

• Work in collaboration with others to ensure staff and resources are in place to provide offenders with appropriate and timely medical services consistent with established standards.

• Create a work environment that values high ethical standards, emphasizes safe, high quality medical care, nurtures teamwork and encourages activities which lead to continuous improvement.

The successful candidates will have: · Valid license to practice medicine and surgery in the State of Washington (or the ability to obtain prior to employment). · Completion of an approved residency program. · Board certified or board eligible. · Possess strong interpersonal skills and experience in directing medical operations. · Exceptional communication skills with the ability to communicate orally and in writing with a variety of individuals ranging from correctional administrator and staff, health care professionals to patient advocates and other laypersons.

Compensation Package* Your paycheck is just part of your total compensation. Employees also have access to an outstanding benefits package to include medical, dental, vision, and retirement plans. We also provide TORT claim coverage.

Mission Our mission is to provide medically- necessary health care that promotes wellness.

Vision We are a team of committed professionals supporting successful re-entry through a patent focused integrated system of care.

To apply: For questions or to apply, email your resume and a letter of interest to Jamie.robinson@doc.wa.gov or call (360) 413-5435.

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GONZAGA MBA In Healthcare Management

Because Better Business Means Better Care

MBA & MACC PROGRAMS

Gonzaga is committed to developing innovative and ethical leaders with the ability to think criticially about the current challenges facing the healthcare industry. Structured for working professionals, our program is delivered online and on weekends. Classes are designed to give healthcare managers the business skills to make a difference.

RSVP at www.gonzaga.edu/mbahcm

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

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