The Message, December 2012

message THE

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

A TRIBUTE TO MY PARENTS

By Terri Oskin, MD SCMS President

Spokane County Veteran Services The Spokane Veterans Home Veterans as Medical Students Virtual Lifetime Electronic Record (VLER)

welcome home

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December SCMS The Message Open2

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

A Tribute to My Parents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Spokane County Veteran Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 The Spokane Veterans Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Veterans as Medical Students . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Virtual Lifetime Electronic Record (VLER) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Washington State Veterans Cemetery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Elections, Economic Forecasts and the Future of Medicine . . . . . . . . . . . . . . . . . . . . . . 7 Medical Student Jacob Casey’s Research Project . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Spokane Prescription Opioid Task Force (SPOTF) . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 INHS Serves Up Daily Eating and Exercise Guidelines in Five Easy-To-Digest Steps . . . . . . . . 10 For Your Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Physician Leadership Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Membership Recognition for December 2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Continuing Medical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Meetings/Conferences/Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 In The News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

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: Lisa Poole 518 S. Maple Spokane, WA 99204 509-325-0701 Fax 509-325-3889 Lisa@quisenberry.net

New Physicians and Physician Assistants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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Positions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Classifieds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

"As

we express our gratitude, we must never forget that the

highest appreciation is not to utter words, but to live by them."

John Fitzgerald Kennedy

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.

December SCMS The Message Open3

A Tribute to My Parents

By Terri Oskin, MD SCMS President As the seasons change and we move from autumn to winter, signaling the end of the year, so too is my term as SCMS president coming to an end. December is also a time for holidays, family and reflection. In this, my last letter, I would like to tell you about two very special people in my life that helped shape me into who I am today - my parents.

As some of you know, my mother past away this past year and my father four years prior. I was truly blessed to have both of my parents as part of my life well into adulthood. But it is also true that nothing prepares you for their loss. My parents were both born from immigrants, who came over with nothing from Poland. My dad’s father became a business man owning a butcher shop and tavern, not the best businesses to be in during the 1920’s and 1930’s in Chicago and my mother’s dad was a laborer who worked as a casket maker. Things were tough for both families during the depression.

My mother dropped out of high school to help support her family and my father worked in the family meat market along with his three older brothers.

Following the attack on Pearl Harbor, my father, just as so many others, was called to serve his country. He served as a medic in the Army and was stationed in the Pacific Arena, New Guinea and the Philippines to be exact. He never talked much of the war except to tell us of his antics and about the people. Not the “enemy” but the locals. I heard many times through the years his two favorite stories.

About how he was busted from private first class to private for coiling up a dead python and placing it at the entry to the officers’ tent and for throwing beer bottles through the air, which apparently sounded just like air raid sirens. But the story I never heard, until many years later, was how my dad earned a Bronze Star Medal for rescuing a soldier, who was shot, from the battlefield. Or that his unit received orders they were to head to Japan and were actually on the ship making their way when they received word of the beginnings of peace talks. Japan had surrendered. After the war he returned to Chicago where he resumed his role of butcher extraordinaire in the family business. Sometime later he met my mother at a picnic. She was giving her number to my father’s friend, and my dad being the ladies’ man he was, wrote it down as well just in case.

She was quicker and more accurate than anyone who challenged her brain power over their use of a calculator. But when we were young she put those skills aside to be home raising her three kids. To help make ends meet, she worked as a waitress on the weekends at a banquet hall. It was not all bad with her gone because the leftovers were great! I don’t know how much leftover wedding cake I ate during those years.

We didn’t have a lot of money when I was growing up, but I never knew that. What I do know we had was plenty of love and encouragement. Education was on the top of my mother’s list. It was so important to her that we were given the opportunity to achieve our full potential in life. Both of my parents wanted nothing more than for their three children to have a better and easier life than they had. They encouraged us to learn as much as possible and to never accept mediocrity. Sundays were filled with trips to museums, zoos, arboretums and even a Cub’s game on Ladies’ Day. Sunday night always included a family dinner followed by gathering around the TV for Mutual of Omaha’s Wild Kingdom. What my parents gave me were the building blocks to succeed in life no matter what the field or the challenge.

From my dad I learned compassion and empathy and maybe his sense of humor; from my mom perseverance and discipline. From both I received love, wisdom and encouragement. I think my parents would be proud of their achievements and have successfully accomplished their dreams to provide the most wonderful life for their children.

Wishing you all a very wonderful and safe holiday season!

My mother was the second of four siblings and the oldest girl. She dropped out of high school to help support her family, but never lost her zest for education. She attended night classes too so that she could graduate and continued her night studies to become a bookkeeper. There was never anyone quicker or sharper with numbers than my mom.

December SCMS The Message 1

Spokane County Veteran Services

All eligibility requirements are identified in RCW 73.08.005 and RCW 41.04.007.

By Chuck Elmore, Director

The poor economy and high unemployment rate have caused a tremendous growth in the number of Veterans we serve annually. In 2007, our office saw about 4600 customers in need of financial aid; by 2010 that number had risen to over 6500 Veterans, an increase of over 41 percent in just three years. This year we expect to exceed 6350 customers in need of financial assistance, a drop of about 2% over the high in 2010. This decrease is due in part to the improving economy and unemployment situation. Many Veteran service organizations in the community provide assistance to Veterans but we are often the one organization that lies between those Veterans and homelessness.

Spokane County Veteran Services provides emergency financial aid for eligible Veterans and their immediate families. This program has been in existence since 1952 (60 years) and was brought about by RCW 73.08.010. This Revised Code of Washington requires all 39 counties in the state to establish emergency financial relief programs for indigent military Veterans, including the National Guard and Armed Forces Reserve. The program was originally known as the “Veterans Aid Bureau” and the office administered the “Soldiers and Sailors Relief Fund.” Funding for the Veteran Services Relief Fund is mandated by RCW 73.08.080 and comes from a small portion of each county’s property tax revenue. We are also required by law to have an over-sight committee made up of representatives from nationally chartered Veteran Service Organizations (VFW, DAV, American Legion, etc.). The committee meets twice per year to review our services and funding availability.

Our office has a full-time staff of five County employees, including a Director, two Veteran Service Officers, a Staff Assistant and one Office Assistant. We have also been fortunate to acquire two VA Work Studies Staff (paid for by the Department of Veterans Affairs Work Study program) to assist with data base input and customer service. Our primary focus is to provide qualified Veterans and their families with financial aid for food, transportation, utilities and rent. Our financial assistance is not an on-going entitlement. It is for severely low-income, emergency situations. The basic qualifications for eligibility are: oo Must provide proof of Honorable Discharge from military service (DD214). oo Must provide proof of residency in the State of Washington for a minimum of 12 months and must be a current resident of Spokane County. oo Must provide proof of income at the time of application income (tax returns, pay stubs, DSHS, VA and Social Security award letters, etc. for all members of the household). Income must be less than 150% of the poverty level established by the Department of Health and Human Services.

Our organization provides other services as well to Veterans. We can assist a Veteran with procurement of military service records needed to file a claim with the Department of Veterans Affairs. We make referrals to other community service organizations (SNAP, Salvation Army, VOA, etc.) for additional assistance, as needed, and we conduct a winter clothing drive in early fall every year to collect coats, hats, gloves, etc. for the homeless Veterans in Spokane County.

Our dedicated staff participates on many local boards and programs such as the Eastern Washington Veterans Task Force, FEMA – Emergency Food and Shelter Program, Spokane Regional Homeless Governance Council Evaluation and RFP Review Committee, and the Spokane County Veterans Court and Veterans Forum established by District Court Judge Vance Peterson.

If you know of Veterans in Spokane County who are struggling on a limited income and in need of financial assistance, please refer them to our office. New clients are seen between 8 – 10am daily or by appointment. We ask that all Veterans call first before coming to the office so we can instruct them on what documents to bring on their first visit. Spokane County Veteran Services is open Monday – Friday from 8am - 3:45pm and we are located at 1102 W. College Avenue, one block south of the County Courthouse. If you have questions, please give us a call at (509) 477-3690.

December SCMS The Message 2

The Spokane Veterans Home

By Brian Teed Superintendent The Spokane Veterans Home (SVH) provides responsive medical and supportive care to veterans who are no longer able to provide for themselves. We are a Medicare and Medicaid certified facility. SVH staff is not depleted due to a drop in census. Our Medical Director visits patients on a daily basis coming to the facility twice a day and an on-call physician is available on weekends. While the norm on State Surveys is about 11 citations, we are proud to say we received 2 minor citations on our 2012 DSHS Survey.

»» Reside in Washington State; »» Or be the spouse or widow of an eligible veteran.

»» Physical Therapy »» Occupational Therapy »» Speech Therapy »» Recreation Activities »» Social Services »» Volunteer Programs »» Nutritious Meals

»» Served at any time, in any branch of the United States Armed »» Received an honorable discharge;

»» Medical Director (visits patients twice a day)

»» Hospice

Applicants must meet the following criteria for admission:

Forces including National Guard;

The applicant’s goal can be either rehabilitative care with plans to move back into the community or long-term residence. In addition to Medicaid certified 24-hour nursing care, no-cost medical benefits and pharmacy services, the homes offer the following supportive services:

»» Community Involvement »» Religious Programs »» Transportation »» Laundry »» Beauty & Barber Services The Spokane Veterans Home is located at 222 East 5th Avenue.

For more information call (509) 344-5770

December SCMS The Message 3

Veterans as Medical Students

By Doug Nadvornick Health Sciences Communications Coordinator WSU Spokane

After finishing his five-year military stint, Larson returned to Spokane and then enrolled at Washington State University to study neuroscience. He chose to attend medical school in Spokane and pursue a career in neurosurgery.

A handful of the 100 first-year University of Washington medical students who have studied in Spokane since the first-year medical program began in 2008 are military veterans.

Joe Wolf – who studied in Spokane in 2010-11—credits his time as a Washington Army National Guard captain in Iraq for steering him to medical school.

“I remember one day when one of my soldiers was injured and I took him to the Baghdad E.R.,” Wolf said. “He was severely injured with a crushing injury. One of the surgeons there brought him through it all and, at the end of that experience, I decided I wanted to be one of those guys (surgeons).” Wolf won a Bronze Star for his service in Iraq.

Joe Wolf at the Saturday morning clinic at the House of Charity, one of the outreach opportunities that Spokane medical students have, checking out a tattoo of a younger patient.

When he returned to the U.S., he decided to pursue a career in rural medicine. He was accepted for the UW medical school’s TRUST (Targeted Rural Underserved Track) program for students who want to work in medically-underserved areas. He was matched with a clinic in Chelan, where he spent several days throughout his first year learning under the direction of a preceptor.

Two members of the current first-year class in Spokane are also military veterans. One is a former Army lieutenant and graduate of Gonzaga University.

The other, Erik Larson, is an Alaska native who moved to Spokane during his teenage years. He enlisted in the Air Force as a reconnaissance airman and Arab linguist and spent a year deployed in Qatar.

Joe Wolf presenting a case to the preceptor at the House of Charity Clinic. The other student is Aimee Gough, who did many of her third- and fourth-year clinical rotations in Spokane.

December SCMS The Message 4

Virtual Lifetime Electronic Record (VLER)

How Can You Help?

By Nicole Stewart Director of Marketing & Communications Inland Northwest Health Services (INHS)

If you provide care for Veterans or Service Members in your office and would like an account to access the VLER system, please email trainVLER@inhs.org to schedule a 10-minute tutorial.

More than half of all active duty Service Members and Veterans receive a portion of their care from private facilities. Securely sharing certain parts of their electronic medical record helps reduce the paper hassle and allows private health care providers to make more informed decisions about the care people receive.

Spokane is one of seven pilots in the nation collaborating with the United States Department of Defense (DOD) and the Department of Veterans Affairs (VA) to participate in the Virtual Lifetime Electronic Record (VLER) initiative, allowing private selected health care providers secure access to medical history summaries of Veterans and Service Members. It’s a national initiative to share health information among the DOD, VA and other federal and private providers over a secure network known as the eHealth Exchange (formerly known as the Nationwide Health Information Network).

The VLER mission is to create a consolidated, coherent, consistent view of electronic health, benefit and personnel records, and make this view reliable and available to authorized service providers, Service Members, Veterans and their families.

In collaboration with Inland Northwest Health Services (INHS), Spokane VA Medical Center and Fairchild Air Force Base, physicians have access to patient information that once was not available for Veterans and Service Members through the VLER system.

“More than 5,500 active military personnel are stationed at Fairchild Air Force Base, thousands of Veterans and their families call the greater Spokane region home,” said Tom Fritz, CEO of INHS. “We are honored to work with VA and the Department of Defense to build on a nationally-recognized health information network to provide an even more efficient health information delivery system.”

What Data Is Available?

The VA is currently sharing the following medical information with VLER Health approved providers: • Allergies • Health Problems • Outpatient Medications • Some Blood Test Results (Chemistry and Hematology) • Immunizations

In order to see key elements of a Veteran patient’s electronic record, your patient must be enrolled in the VLER system. Participation for Veterans is voluntary and free. To enroll, Veterans can visit local VA health care facilities, go online at to http://www.spokane.va.gov/ VLER.asp or call 1-877-771-VLER (8537).

Spokane is home to many Veterans and Service Members. This is our opportunity to further support their overall health care by participating in VLER.

Washington State Veterans Cemetery

By Travis Potter Acting Director

What is VLER?

• Vital Signs

In the future, other documents such as doctors’ notes and discharge summaries may be available for sharing between the VA and participating VLER health providers.

For many years the veterans on the east side of Washington State recognized the need for a Veterans Cemetery in their area.

Many individuals, groups and Veteran Service Organizations spent countless hours lobbying and promoting the need for the facility. Finally, their dedication and hard work came to fruition.

In 2009 The Washington State Department of Veterans Affairs began construction on the Veterans Cemetery in Medical Lake.

The project was a partnership between the Washington State Department of Veterans Affairs and the Federal VA. The grand opening was held on Memorial Day of 2010 and the first military honors service was held a week later.

The initial construction consisted of the infrastructure and buildings, as well as the landscaping and areas that are used for interment. The facility offers several options for interments including casket burial and three choices for cremation. The cremation interment options include columbarium niches, in-ground inurnment and a scattering garden. As these initial developments begin to fill up additional areas will be constructed. It is anticipated there is sufficient space for the cemetery to continue developing new areas for over a century.

Eligibility for interment at the State Veterans Cemetery mirrors National Veterans Cemetery eligibility requirements. In general, U.S. veterans discharged under conditions other than dishonorable and their spouses and dependent children are eligible.

To date over 1250 individuals have been laid to rest at the Washington State Veterans Cemetery.

Continued on page 7

December SCMS The Message 5

Help Us Keep Families Together When Life Unravels....

Gabby and Stephania were both rushed to Spokane earlier this year after being diagnosed with Acute Lymphnode Leukemia. Strangers when they arrived at the Ronald McDonald House, the two have become close friends, bonding over a common medical battle and a deep love of all things that sparkle. Their moms are grateful for the girls’ friendship, and for the empathy and support they have found at the “House that Love Built”.

This holiday season, 22 families will find themselves far from home, but thanks to Spokane’s Ronald McDonald House, they will have each other.

You can give the gift of togetherness to families like Gabby’s and Stephania’s by supporting RMHC Spokane at www.rmhcspokane.org/donate.

Your gift helps our families heal together. Thank you.

December SCMS The Message 6

Continued from page 5 Not only was it the hard work and dedication of the community that enabled the development of the cemetery, but their continued generosity and support has also played a major role in the cemetery’s continued success. The community supports the cemetery in many ways including financial donations as well as donations of time and expertise.

Generous financial donations have been given, which enabled the facility to make special improvements as well as host public events.

One of the major improvements was an electronic reader board that directs visitors to services being held and also allows the cemetery to provide information on significant events or messages. Thanks to the community two majestic eagle sculptures were installed that now stand guard at the entrance gates. Contributions have been made to numerous Eagle Scout projects including the Avenue of Flags, Honor Guard Walkway, Scatter Garden and others. Many offerings have also lead to improved landscape features such as trees and shrubs.

Special events held at the cemetery such as Memorial Day, Missing in America Project and Wreaths Across America are largely funded by the community. Because of the generosity of the community, those projects and events have been made possible.

Community support of the cemetery is also shown by the charitable donations of time made by individuals, groups and organizations. A Cemetery Advisory Board consisting of seven members volunteer their time to provide advice and assistance. When the cemetery provides a military honors service volunteer groups and individuals play essential roles. Individuals, groups, businesses and organizations regularly contribute their time, resources and expertise for special events and maintenance and landscape projects. The facility and the service we provide is enhanced and fortified by these examples of selflessness commitment to the cemetery and our veterans.

Because of the patriotic commitment and continued support of the community, The Washington State Veterans Cemetery will be honoring veterans and serving their families for many decades to come.

To learn more about the cemetery, please visit the website at www. dva.wa.gov and follow the cemetery link.

Elections, Economic Forecasts and the Future of Medicine

By Keith Baldwin, CEO, SCMS It’s not a fairy tale, the elections are over and the truth or lies will now be replaced by what - action, more rhetoric, prognostications or the “fiscal cliff?” We don’t actually get to pick, is the correct answer. I recently followed the election returns, as many of you did, and I am still not sure that the elections have changed much for medicine.

Some might say that the election outcomes are a “mandate” for continuing healthcare reform; others believe it is a complicated voter demographic involving fewer voting white male Caucasians and others think it is just more of the same. No matter your persuasion, we must deal with the realities of continued implementation of the Affordable Care Act; benefit exchanges, reimbursement changes and an even greater emphasis on the triple AIM. Will the SGR formula be corrected, will CMS significantly reduce reimbursement for treating Medicare patients and will the greater emphasis on increased payment for and use of primary care increase quality and reduce cost?

There are some things that we do know. Dr. John Mitchell and Dr. Grant Forsyth, both locally known and respected economists, recently spoke to a large (800+) audience at the “2013 15th Annual GSI Economic Forecast, Preparing for the New Normal.” Several issues seem clear from their national and local perspectives. Housing and jobs are improving, albeit slowly, with incentives from low interest rates partially created and maintained by federal policy makers.

What is troubling is that the median household income has actually declined by 11% from 2004 to today and now it sits at approximately $49,000. That means that half of the population in WA State, in this case, has incomes below that amount. How will those households pay for their healthcare in the future? A great question! The looming problem is what people are calling the “fiscal cliff;” a combination of a number of income and payroll taxes that were deferred and that now will go back into place on January 1, 2013 along with continuing and significant budget shortfalls for local and state governments. Unless those taxes are reversed, they could create a financial tsunami and drive us into another recession or worse.

So there are no “Tooth Fairies” according to John Mitchell. There is no such thing as free care and the rich aren’t going to bail us out of the debt crisis. The recovery will continue to be slow, higher investment returns will necessitate taking greater risk and the future does look brighter, IF we don’t go over that “fiscal cliff.” In the meantime, there will be so much happening in healthcare that will continue to be influenced by the Triple Aim (improving the experience of care, improving the health of populations and reducing per capita costs of health care). The SCMS is striving to provide leadership in this tsunami of change. Become involved and engaged!

December SCMS The Message 7

COLUMBIA MEDICAL ASSOCIATES

Diagnostic Excellence

is currently seeking a BC/BE Internist to join

Spanning the State

our Northside Internal Medicine Group in Spokane, Washington to meet our increased service utilization. We are a group of over 40 physicians providing comprehensive medical care to families and individuals of all ages within the Spokane region. The position offers the following: • Flexible schedules and outstanding teams make this opportunity worth exploring.

• Competitive Salary and Generous Benefit Packages • Conveniently located only two blocks from Holy Family Hospital • Established relationship with local hospitalist group for admitting, rounding, and discharge

Our physicians are committed to maintaining the health and well being of all their patients through preventive care measures and working closely with community specialists.

Our new partnership with Group Health and collaborative care models ensure patients have access to the best care in Spokane.

Two premier laboratories have joined forces to deliver progressive diagnostics and patient care to the Northwest.

InCyte Pathology and Eastside Pathology have entered into a merger agreement.

The merger will create a northwest regional pathology practice where physicians and hospitals can access 36 board certified pathologists with expertise in 27 disciplines and subspecialties.

To apply or inquire for further information please contact: Nancy Longcoy, Physician Recruiter Longcoy.n@ghc.org; Ph: 206-448-6132

Learn more by visiting www.incytepathology.com or calling 509.892.2700

Proudly serving the greater Spokane healthcare community since 1957

December SCMS The Message 8

Medical Student Jacob Casey’s Research Project

“This project has given me greater fluency when it comes to understanding research and applying it to my clinical practice,” Casey said.

Though Casey doubts he’ll pursue research as a career right out of medical school, he says it could be an option later in his career.

By Doug Nadvornick Health Sciences Communications Coordinator WSU Spokane Some medical students agonize about which specialty path to follow as doctors. For others, the choice is an easy one.

Second-year medical student Jacob Casey falls in the middle of the spectrum. He hasn’t picked a specialty yet, but powerful seeds were planted with his summer Medical Student Research Training Program (MSRTP) research related to chronic kidney disease (CKD).

While studying in Spokane last fall Casey approached Washington State University (WSU) nursing assistant professor Kenn Daratha about collaborating on summer research. Casey had taken Daratha’s class on evidence-based medicine and read the professor’s research about the medical complications and outcomes for patients hospitalized with CKD. Daratha and his colleague, Dr. Katherine Tuttle, a Spokane nephrologist/researcher agreed to mentor Casey. The medical student formulated his own research question: other than heart failure and sepsis, what are the other complicating factors for CKD patients?

Casey conducted a medical literature review and, together, the two organized a database that included hospital patient information for more than 26,000 Washington residents (names excised) with CKD. Through the summer Casey used statistical software to analyze the data and identify a variety of complications that lead to longer hospital stays, readmissions within 30 days after discharge or even death.

“Skin ulcers were a significant issue for many patients,” Casey said. “I never would have thought of that, but they brought many patients back to the hospital within 30 days of their release.”

“This study was unique in that it used data from actual hospital patients, not people who volunteered for a clinical trial. It gives us useful real world results,” Tuttle said.

This fall Casey has created a poster describing his research and written a paper that he plans to submit to a medical journal.

He has been invited to present his paper at the Western States Medical Research Forum in Carmel, California in January. He was also invited to attend the American Society of Nephrology annual conference in San Diego with Daratha and Tuttle.

“This project has not only helped him (Casey) to think about nephrology as a possible career choice, it makes him more competitive in applying for fellowships after medical school,” Daratha said. “Even more important, it cements in his mind the benefits of using evidence when he cares for patients.”

Spokane Prescription Opioid Task Force (SPOTF) Law Enforcement Panel Discussion

By Keith Baldwin, CEO, SCMS The alarms were going off, literally (it helps to enter the correct after hour’s door), at the Spokane Regional Health District the other night (November 8) as the SPOTF attendees listened to an expert panel from community law enforcement agencies. The panel members answered a set of questions for the audience and related their respective experience and comments about combating the heroine/prescription opioid problem in Spokane and its environs.

The panel members included »» Spokane County Sheriff, Ozzie Knezovich »» Spokane Police Department, Operations Bureau, Major Frank Scalise »» Spokane County, Senior Deputy Prosecutor, Jim Kaufman »» Resident Agent in Charge, Mark Haigh, Drug Enforcement Administration, Spokane Resident Office »» United States Attorney for the Eastern District of WA, Michael C. Ormsby Keith Baldwin acted as the moderator and introduced each panel member with a short explanation by the panelists of the agency they represented. Keith then asked the panel members a number of questions developed by physician members of the SPOTF. The presentation was concluded with written questions submitted by the audience as part of a Q&A session. The moderated questions included: 1.

2.

How can the medical community work better with law enforcement and prosecuting attorneys to address drug seeking behaviors that are clearly criminal activity (distinct from difficult patient behavior)?

What are the parameters for breaking the confidentiality of the patient/provider healthcare interface when “what seems to be criminal activity or a perceived illegitimate purpose for the visit” occurs between a patient and provider?

December SCMS The Message 9

Continued on page 10

Continued from page 9

of prescription drugs on the streets in our community. As much as half the supply may be coming to the community

3.

4.

5.

It is not infrequent that a pharmacist notes that a patient has altered a prescription and the pharmacist has appropriately refused to fill the prescription. Since this is a criminal act, what would be the most appropriate action to hold the patient accountable for his/her actions other than refusing to fill the prescription? (Legally what can be done and should be done?)

When an assumed accidental overdose of a narcotic analgesic(s) results in a death, what is the policy for evaluating and processing the scene? Is there information that is obtained that might be given back to providers that could help them understand the circumstances of those deaths?

The purpose of the SPOTF was to bring to light for the medical community the extent of the opiate problem and our role in appropriate use. Have you noticed any decrease in opioid related criminal activity in the last year since the SPOTF activity or do you still see the need for the medical community to do more? If you think we as a medical community should being doing more, what is your perception of what that would be?

It isn’t possible to provide a transcript of all the presenters’ remarks here although there were some significant themes that came from the panel’s conversation. Here are a few of those themes: »» It is everyone’s social responsibility to report ANY incident that seems to point to the misuse of prescription drugs to law enforcement. Initially it may only lead to law enforcement intelligence but that could make a significant difference in deterring inappropriate use or in actually reducing the potential for a crime later. Every panelist thought that reducing future inappropriate behavior or preventing it through “awareness and education” were the best approaches to keeping everyone safe from criminal activity. »» It is very important when you are a witness to any potential criminal activity to TAKE NOTICE of even the smallest issues and include them in the process of reporting incidents. Reporting in a timely manner is very important as the activity may involve multiple sites or incidents. Pharmacists should always report, in as much detail as possible, any fraudulent activity related to tampering with or forging a prescription for pain medications.

Those offenses will be prosecuted. »» It was noted how valuable and successful the Drug Court

from sources outside our area. And, there is the possibility of activity by gangs and production by organized crime of pain medications in our community. »» Medical providers can receive information about a patient’s death through the autopsy (a pubic record), manner and cause of death, from the Medical Examiner, to help with understanding of the use and/or abuse of controlled substances by patients. »» It can’t be emphasized enough that it takes EVERYONE in the community to combat illegal activity and prevent the misuse of prescription drugs!

INHS Serves Up Daily Eating and Exercise Guidelines in Five Easy-To-Digest Steps

By Adrian Rogers The Spokesman-Review (reprinted by permission) It’s no secret that eating healthy food and working up a regular sweat prevent obesity – or that preventing obesity can help prevent chronic illnesses including diabetes, heart disease and stroke.

Health advice comes from all directions – doctors, media, friends, school, work. Sometimes, said Emily Fleury, a director at Inland Northwest Health Services (INHS), we get so much advice about staying healthy – and sometimes seemingly conflicting advice – that many people file it in their minds as junk mail. They ignore it all.

That’s why INHS and other organizations behind the two-year-old Step Up and Go program created a program that distills eating and exercise advice into easy-to-digest bites. The 85210 program offers five daily guidelines – one per digit – for preventing obesity.

Mostly in its beginning stages, 85210 is making a few appearances – on TV spots, on posters on workplace billboards, in a proclamation

by Spokane Mayor David Condon last month that fall 2012 is “Step Up and Go for ‘85210’ season.” Organizers plan to spread the message throughout the community, targeting day cares and schools, work sites and healthcare facilities.

is in Spokane as an alternative to simply prosecuting and incarcerating people with addictions. »» Clearly, the provider community needs to be diligent about NOT over-prescribing prescription pain medications and using best practices to reduce the use of opioids in all settings including

“Somebody that’s trying to prevent heart disease is going to tell you something different than somebody that’s trying to prevent cancer, and they’re going to tell you something different from somebody who’s trying to prevent diabetes,” Fleury said.

the Emergency Departments, to relieve pain after surgery (acute and outpatient) and in oral health.

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»» It is also true that in the last year there has been an explosion December SCMS The Message 10

For Your Information

Continued from page 10 “But really they’re all speaking the same message. They want you to improve your nutrition, they want you increase your exercise.”

The program places Spokane among more and more communities nationwide where health advocates are working to create and disseminate simplified, streamlined information about obesity prevention, Fleury said. The 85210 program is based on a childhoodobesity prevention program in Portland, Maine, among the oldest efforts of its kind and one that’s been proven to improve residents’ body-mass indexes, a standard measure of obesity.

The trend stems partly from financial shrewdness among nonprofit organizations and others aiming to educate residents and reduce obesity – they’re putting their “little pockets of money” together to create a unified message, Fleury said.

It’s also born from a belief among health advocates that when the same easy-to-follow advice comes from multiple sources, people are more likely to incorporate it into their lives. The 85210 program focuses on five aspects of daily life: sleep, diet, recreational screen time, exercise and sugary drinks.

In the next two years, the program will focus on children. Part of that effort: working with other organizations to provide training and other resources for day care facilities in Spokane County and five surrounding counties. Those efforts will be funded by a $930,000 federal grant.

The 85210 program is the newest campaign by Step Up and Go, an obesity-prevention group founded in 2010 as Step Up Spokane.

It changed its name to include people from elsewhere in the region, said Dr. Hal Goldberg, a Spokane cardiologist and the group’s founder. Step Up and Go is run out of INHS offices but also has backing from Premera Blue Cross, Providence Sacred Heart Medical Center and others.

Step Up and Go serves as a central resource for local fitness-related events and health information, Goldberg said. But it’s also supposed to hold up a mirror to the community: Two-thirds of Spokane County residents are overweight or obese, reflecting national rates.

When you’re overweight but see that lots of other people are, too, you might figure you’re OK, Goldberg said. There’s no motivation to change.

“Well, if this is the norm, it’s not a healthy norm,” Goldberg said.

In 2009, nearly 29 percent of Spokane County residents were obese, based on their body-mass index. Another 35 percent were considered overweight.

“As trends go, people in the overweight category keep going up,” Fleury said. “People who are in healthy category tend to stay there, people who are overweight and people who are in the really obese category tend to go up as well. We want to change that.”

U.S. Set to Sponsor Health Insurance

By Robert Pear – NY Times The Obama administration will soon take on a new role as the sponsor of at least two nationwide health insurance plans to be operated under contract with the federal government and offered to consumers in every state.

Ronald F. Pollack of the consumer group Families USA sees potential benefits, and problems, with the multistate insurance.

These multistate plans were included in President Obama’s health care law as a substitute for a pure government-run health insurance program — the public option sought by many liberal Democrats and reviled by Republicans. Supporters of the national plans say they will increase competition in state health insurance markets, many of which are dominated by a handful of companies.

The national plans will compete directly with other private insurers and may have some significant advantages, including a federal seal of approval. Premiums and benefits for the multistate insurance plans will be negotiated by the United States Office of Personnel Management, the agency that arranges health benefits for federal employees.

For the complete story go to: http://www.nytimes.com/2012/10/28/ health/us-to-sponsor-health-insurance-plans-nationwide.html New National Survey Shows Exchange Negotiations Difficult A new survey explores interactions between health insurers and providers about health insurance exchanges. The survey may shed some light on conversations happening here in Washington State as the Washington HealthPlanFinder is developed. The executives surveyed were from other states that are on an exchange implementation timeline similar to Washington State’s. Of the more than 100 hospital executives who responded to the survey: »» 62 percent have begun conversations with payers about participation in the exchanges, »» 54 percent said those conversations included a discussion of reimbursement rates, »» 62 percent said existing commercial rates are the right starting point for exchange network payment rates and 26 percent said "somewhere between commercial and Medicare rates” was appropriate, and »» 56 percent said they would have to make substantial cuts to operating costs or "do something drastic" if Medicaid-level rates prevail for the exchange networks while 11 percent said they would likely decline to participate or simply "go out of business."

The survey, commissioned by ReviveHealth and conducted by Catalyst Healthcare Research, found hospital executives are very concerned about the rates being offered to care for people who buy their health benefits through an exchange. Complete survey results are available for download from ReviveHealth. (Chelene Whiteaker, chelenew@wsha.org)

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

Books "Dear Governor: About The State of Reform" by Aaron Katz, Principal Lecturer of Health Services and Global Health, UW School of Public Health is a collection of voices from across the health care spectrum, from four states: WA, OR, ID and AK. Dear Governor, The pioneers who drafted the Washington State Constitution were public health experts. No, really. As far as we know, none of the 75 delegates to the Constitutional Convention of 1889 was an epidemiologist, but their words – “It is the paramount duty of the state to make ample provision for the education of all children” (Article IX) – show they understood that an educated public is fundamental to a healthy society. Today, we have a large body of research to support their wisdom.

How far we’ve strayed. Since 2009 we‘ve slashed nearly $5 billion from K-12 and higher education, jeopardizing the health and well-being of a generation of children and threatening to condemn a stellar system of public colleges and universities to a future mediocrity.

This is shameful and avoidable. The next governor can do two things to reverse the harm and improve the health of all Washingtonians – make the case for additional tax revenues to support a quality educational system and redouble state efforts to reign in health care costs, which have the effect of crowding out education in the state budget.

The case for higher taxes is simple. U.S. Supreme Court Justice Oliver Wendell Holmes said it best: “Taxes are the price we pay for a civilized society.” State government needs adequate income to provide a quality education system as well as meet other expectations we have as citizens, yet we’ve been increasingly starving it for the past 20 years through tax limiting initiatives and tax loopholes. We need a governor who will reverse this course.

Health care is more complicated.

State health care spending is increasing for two reasons. First, as employer-sponsored health insurance has eroded – the Great Recession has accelerated an existing long-term trend – Medicaid and other statefunding health insurance programs have filled the gap. Second, the broader health care system is inherently inefficient and inflationary. So, for example, during the recession, even as the annual increase in overall national health care spending has dropped below 4%, the lowest in 50 years, prices of health care goods and services have risen much faster.

What the state pays for health care is largely a product of those price increases; that is, state government is largely a “price taker.”

Still, the State of Washington has been one of the most active states in seeking efficiencies in its regulation and purchase of health care services. It moved most acute care Medicaid beneficiaries into managed care plans in the 1990s, the vast majority of Basic Health clients are served by two highly managed plans, it has an aggressive Medicaid drug purchasing program and has been an innovator at trying to find efficient and effective ways of serving the most difficult patients, those with multiple, chronic diseases. Certainly, more can be done along all these lines, but it’s safe to say the potential to “save” money in state-purchased health care does not reach into the billions of dollars – a few hundreds of millions, perhaps, but not billions. And it is billions in savings that are necessary if Washington is to again become a leader in public education and if the economic burden of high health care costs on families and businesses is going to be eased.

The federal Affordable Care Act lays the groundwork for fixing the system, but it didn’t go far enough; it did not include proven mechanisms to control health care spending. The experiences of many Western industrialized countries provide us with two basic models that will allow us the reign in health care spending.

First is what we might call the “public agency” model – like transportation or law enforcement, state government would pay for health care or health insurance for all its citizens with a budget set and controlled by the Legislature. Funding would come from some combination of taxes and user fees (that is, premium shares, copayments, etc.). This is the model used by Canada and the United Kingdom, among others.

The second approach is the “public utility” model. Here, rather than financing health care for everyone, the state sets up strong regulations of the health insurance industry so that it competes in ways that promote access, efficiency, and quality. Think electricity or water, markets in which private enterprise can add value but not at expense of anyone’s basic needs. Germany and the Netherlands have health care systems based on this “public utility” model.

We need a governor who will set aside economic theories that don’t work in the real world of health care in favor of time-tested policies that do. These two evidence-based models provide the next governor with the opportunity to lead us toward real health care reform and, therefore, toward rebuilding our education system, the paramount duty of state government and the key to a healthy population.

Sincerely, Aaron Katz For more information go to: http://stateofreform.com/deargovernor-alan-yordy-peacehealth/dg-cover-perspective-v2

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Continued from page 13 “Healing Leadership, A Survival Guide for the Enlightened Leader” by Steven J. Geske and Howard R. Hansen “Are you a healing leader?” Steven Geske and Howard Hansen talk a lot about chronic anxiety in their book. They note that, “instead of being uncomfortable with being uncomfortable, if we address chronic anxiety head-on we become comfortable with being uncomfortable. That’s sort of a mouth full but it really is about being resourceful from within and addressing culture and relationships. Only those that are emotionally mature can manage through chronic stress and create a healing environment.

This involves self-care. Learn more about the book at http://www. amazon.com/Healing-Leadership-Survival-Enlightened-Leader/ dp/1468148451/ref=sr_1_2?ie=UTF8&qid=1352762415&sr=82&keywords=healing+leadership

Membership Recognition for December 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.

20 Years Jeffrey B. Butler, MD

12/11/1992

10 Years Jeffrey D. Bunn, MD

12/11/2002

Lewis J. Meline, MD

12/11/2002

SAVE THE DATE Spokane Society of Internal Medicine’s 64th ANNUAL MEETING The 64th annual Update in Internal Medicine will be held at the Spokane Convention Center on February 22, 2013.

Mark your calendars!

This year’s meeting features internationally renowned back pain expert, Dr. Richard Deyo, as well as medical humanities leader, Dr. Robert A. Schwab. Other topics include updates in rheumatology, women’s health, palliative care and drug therapy, with focused sessions on COPD, GERD and anemia.

For further details of the meeting and updates please see the SSIM website http://www.spokanesocietyim.org/.

If attending the SSIM meeting don’t miss the SSIM-ACP kickoff event on Thursday evening. We will provide an update on ACP activities regionally and nationally and offer a short session on advancing to fellowship in the College prior to hearing an entertaining talk from Dr. Schwab.

All in all, the SSIM meeting will be an amazing opportunity for both hospital-based and office-based internists, as well as other specialists and primary care providers, to hear updates on a broad range of areas relevant to the care of the adult patient. As this year’s meeting will be held on Friday only, for those traveling to Spokane, consider making an extended weekend out of it by visiting one of the five major ski areas (Schweitzer Mt., Silver Mt., 490 North, Mt. Spokane and Lookout Pass) within a two hour drive from downtown Spokane

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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.

Rockwood Health Systems Breast and General Tumor Boards: These tumor boards are jointly sponsored by Rockwood Health Systems and the Spokane County Medical Society. Tumor Boards will be held weekly September – December 2012. Each Tumor Board is worth 1.0 Category I CME credits. For more information please contact Sharlynn M. Rima CME Coordinator at SRima@ rockwoodclinic.com.

Update in Internal Medicine 2013: This seminar is jointly sponsored by the Spokane Society of Internal Medicine and the Spokane County Medical Society. 9.25 AMA Category 1 Credits. Conference will be held on February 22, 2013 from 7:00 a.m. – 6:00 p.m. at the Spokane Convention Center. For additional information please contact Jennifer Anderson at (509) 448-9709 or email spokanesocietyim@gmail.com.

Meetings/Conferences/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.

WSMA & UW Physician Leadership Course Offered in Spokane Spring 2013 - WSMA/UW Physician Leadership Course is a comprehensive leadership skills development program that offers ten weeks of interactive hybrid distance learning specifically designed for physicians. The course is based on UW MHA and Certificate of Medical Management curriculum. Eight weeks of online assignments and group work is bookended by two in-person weekend meetings, allowing physicians to develop their leadership skills in a convenient manner without needing to take significant time away from their practice or personal lives.

The 40-hour course focuses on Leadership and conflict management, Strategic planning and management, Safety and quality management, Finance and Communication and advocacy. Our next course will be offered spring 2013 in Spokane. In-person dates are March 8 and 9 and May 10. Between March 9 and May 10 the course is conducted online. The course is limited to 30 individuals. Tuition for WSMA members is $2,000 and non-member tuition is $2,550. To apply for the spring 2013 course, send your CV, a letter of interest and a letter of recommendation before January 1, 2013 to Jennifer Hanscom at jen@wsma.org.

AMA Webinars to Cover Pain Management, Avoidance of Prescription Misuse - A new AMA webinar series will offer stateof-the-art education to help physicians develop skills to manage patients with persistent pain while prescribing opioid drugs safely and effectively.

The free 12-part series kicked off with a webinar on responsible opioid prescribing on November 1. Part of the Prescribers' Clinical Support System for Opioid Therapies collaborative led by the American Academy of Addiction Psychiatry, this webinar series will cover a range of important topics related to the intersection of pain management, opioid prescribing and substance abuse, including addiction. Each webinar will be archived for on-demand viewing.

Pain is one of the most common reasons patients seek medical attention in the United States, as more than 100 million Americans are burdened by chronic pain, according to a 2011 report by the Institute of Medicine. In recent years, the use of prescription opioids for managing persistent pain has increased substantially. At the same time, the country has seen a deeply concerning increase in prescription drug abuse, unintentional overdoses and deaths linked to prescription drugs.

The AMA continues to work with state and national legislators and other groups to combat prescription drug abuse while ensuring patients get the medications they need. Visit the AMA's Web page on prescription drug abuse and diversion at ama-assn.org/go/ stopdrugabuse to learn more.

Intensive Care Management Services for Patients with Multiple Chronic Conditions - Wednesday, December 5, 2012 from 12:15 until 1:15 PM Clinical Performance Improvement Network – WEBINAR This webinar continues the CPIN series on specialized programs that promote intensive care management services for patients with multiple chronic conditions. The Washington State Department of Health is currently launching a statewide, multi-year program to assist medical practices in their transformation to Patient Centered Medical/Health Homes (PCMHH). This includes assisting practices in developing programs to treat high-risk patients in a more costeffective manner through targeted care management services and linking to those community-based organizations providing these same services. The webinar will present practical steps on how to create and sustain these programs in a way that significantly improve patient care outcomes by focusing intensive outpatient care on highrisk persons with multiple chronic conditions.

Physician members of WSMA may register online at www.wsma. org/foundation/CPIN/ Anyone can register by sending an e-mail titled CPIN Dec 5 to kho@wsma.org with the following items: Name, Phone, Clinic/Group Name and Number of Participants. Free for all physicians, medical group staff, or other care providers. $75 for nonclinical participants.

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Get the treatment you deserve by choosing your Private Banker at watrust.com

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Continued from page 18 Spokane Guild of the Catholic Medical Association- Meets second Wednesday of each month at 6 PM at Providence Sacred Heart Medical Center Administrative Board Room in Administration on the Main Floor. All are welcome. For inquiries contact Phil Delich, MD at (509) 465-1554 or e-mail at delichphil@gmail.com.

Upcoming Aging and Mental Health Conference, March 8, 2013 Friday, March 8th, 2013 8:00 a.m. to 5:00 p.m. The purpose of this conference is to raise awareness of the issues involved with mental health and older adults, as well as provide concrete tools for assessment and intervention. Mark your calendars now. More details to follow. For more information contact Jamie McIntyre, MSW Aging and Long Term Care of Eastern Washington Assistant Planner/ Title V Coordinator (509) 458-2509 x211.

medical professionals and active medical and non-medical professionals to provide back up support in emergencies and non-emergencies, provide public health education, support to the American Red Cross, hospitals, emergency medical services, mental health, public health and the Department of Emergency Management.

During the past years the focus has been on organizing, mobilizing and training two MRC E WAÂ Teams, Alpha and Bravo.

They are now looking for an equal number of back up team members for support. For more information, contact Dave Byrnes, MRC coordinator, at dbyrnes@spokanecounty.org.

In The News On Oct 24, 2012 Capt. Robert Tosatto, HHS/OSH, Director of the Medical Reserve Corp presented Robert Cross, MD with the "Founding Father of MRC Eastern Washington" award at the Awards Dinner.

Established in September 2003, the Eastern Washington MRC is comprised of members of public health, retired

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Visit the Walk Shoppe for a great selection of Danskos

| 3707 S. Grand Blvd. Suite. A Spokane (509) 747-2161

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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 Atkinson, Marie D., MD Neurology Med School: Wayne State U (2002) Internship: Grace Hospital (2003) Residency: Detroit Medical Center (2007) Practicing with Providence Epilepsy Center 01/2013

PHYSICIANS PRESENTED A SECOND TIME Kwon, Jun-Beom, MD Internal Medicine Med School: George Washington U (2006) Practicing with Apogee Physicians 08/2009 Pakkianathan, Stephen J., MD OBGYN Med School: Loma Linda U (2007) Practicing with Northwest OBGYN 10/2012 Parker, Pamela D., MD OBGYN Med School: Jefferson Medical College (1990) Practicing with CHAS 01/2013 Wilson, Jonathan J., DO Family Medicine Med School: Des Moines U (2008) Practicing with Deer Park Family Care Clinic 02/2012

Fang, Chunhui, MD Internal Medicine Med School: Beijing Medical U-China (1999) Residency: Jacobi Medical Center (2011) Practicing with Apogee Physicians 01/2013

PHYSICIAN ASSISTANT

Gomez Torres, Jeisa Y., MD Internal Medicine Med School: Universidad Autonoma de Guadalajara Mexico (2004) Internship: Santa Rosa Hospital (2003) Residency: Ramon Ruiz Hospital (2011) Practicing with IPC of Washington/Holy Family Hospital 12/2012

Owens, Gabriel P., PA-C Physician Assistant School: U of Nebraska (1999) Practicing with Providence Spokane Cardiology 11/2012

Pounds, Denise R., MD Family Medicine Med School: Saint Louis U (2008) Residency: Swedish Medical Center (2011) Practicing with Group Health 09/2012

Houchin, Charles R., PA-C Physician Assistant School: MEDEX Northwest/U of Washington (2012) Practicing with Rockwood Clinic 10/2012

Shibley, Eric R., MD (aka Choudhury Shiblee Nomany) Internal Medicine Med School: Sir Salimullah Medical College-Bangladesh (2002) Residency: Meharry Medical College (2010) Practicing with Apogee Physicians 01/2013

Lang, Gregory R., PA-C Physician Assistant School: U of Washington (2012) Practicing with Inland Cardiology Associates/Rockwood Clinic date pending

PHYSICIAN ASSISTANTS PRESENTED A SECOND TIME

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POSITIONS AVAILABLE 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, on-call shifts, overhead and case file administration. Please contact Gia Melkus at (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!

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 by sending your resume/CV to Careers@ OctapharmaPlasma.com!

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.

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 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.

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.

PHYSICIANS NEEDED FOR WORKERS COMPENSATION EXAMS Let us help you get started in earning additional professional income!

We are an established I.M.E. practice currently looking for Active Practice and Board Certified Orthopedic and Neurological Doctors, to perform Workers Compensation Exams. Located just minutes away from Rockwood Clinic in North Spokane, we offer a flexible schedule in a helpful, working environment. Previous experience performing Workers Compensation Exams is not required. Please contact Lorraine Stephens for further information at (509) 484-0380.

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.

MEDICAL DOCTOR (MD/DO) (PRN openings in Spokane, WA) Physicians needed to perform physicals and health screenings at a non-commercial medical facility. MD/DO must have a current active, license from any state, available 1 to 3 mornings a week.

Send CV to or call: Gil: (210) 424-4008 meps@thi-terra.com EOE

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Continued from page 24 NORTHWEST MEDICAL SPECIALTY EVALUATIONS - Physicians wanted for medical disability exams in our Spokane office. Excellent pay. Work is low stress with minimal paperwork and no ongoing patient care responsibilities. We can schedule around your availability seven days per week. For more information call (509) 588-7340.

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 fullsized 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: 16909 N Triple Butte Court, Colbert, WA $789,000 Beautiful home, custom built in 1996 by Copeland Design and Construction. Situated on five wooded acres with two seasonal ponds and 220 feet of river frontage along the Little Spokane River.

Idyllic country living but only 5 minutes from the Wandermere Shopping Center and only 10 - 15 minutes from Holy Family Hospital.

There are 4 bedrooms, a library, a formal dining room, an open kitchen with eating area, great room, rec room, sun room, 2 full baths, a guest bath, mud room, laundry room, a 3-car attached garage and a greenhouse with fenced-in garden, covered front porch, large back deck with hot tub and a patio of cobblestones. Views from the back deck look over the Little Spokane River wetlands. Call Dr. Edward Petruzzello at (509) 879-3770. No realtors please.

MEDICAL OFFICES/BUILDINGS 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 receptionistenclosed area, with several office, storage or exam rooms. Call (509) 321-2276 for more information or for a showing of your ideal location.

OTHER Ten (10) adjustable rolling physician stools, teal - $35.00 each, all in great condition. For more information contact Colleen Kins at Internal Medicine Residency (509) 744-3965 or email Colleen.Kins@ Providence .org.

Went into partnership - no longer need the following items: CIRC BOARD & CLAMPS Circumstraint circumcision board $50. Gomco circumcision clamps (sizes 1.1, 1.3, 1.45) $20ea size. Everything like new. EKG & SPIROMETER - $200 WelchAllyn, Schiller AT-10 EKG and Spirometer. Low use. Maintained/inspected/serviced by Sacred Heart Engineering. Comes with 14 reams of additional paper, Spirometry calibration syringe and 50 disposable spirometry mouth pieces. Original manuals included. AUTOCLAVE - $2000 Midmark, M9 UltraClave, Steam Sterilizer/Autoclave. Low use, ideal condition.

Maintained/inspected/serviced by Sacred Heart Engineering. Comes with assortment of sterilization envelopes, sterilization wraps and confirmation tape along with 6 bottles of Speed-Clean, Autoclave cleaning solution. Original manual included. All equipment located in Spokane Valley. Email shellymanson@comcast.net for purchase, pictures and/or questions.

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Serving the Medical Community for over 30 years, Fery’s will gladly cater your next breakfast, lunch, or dinner meeting We can accommodate any size and budget!

To schedule, call: 509-458-5234 or e-mail: feryscatering@gmail.com 421 S. Cowley Spokane, WA 99202

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

PRSRT STD U.S. Postage

PAID

Spokane, WA Permit No. 512

ADDRESS SERVICE REQUESTED

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

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