The Message, May 2014 by Spokane County Medical Society

2014 Officers and Board of Trustees

Table of Contents

David Bare, MD President Matt Hollon, MD President-Elect

President’s Message: Health and Health Care: The Mood of a Nation . . . . . . . . . .

Anne Oakley, MD Immediate Past President

In-Depth Interview: Brian C. Tryon, MD: A Man of Many Interests . . . . . . . . . . .

Health Sciences: Teaching Physician-Teachers Some New Tricks . . . . . . . . . . .

J. Edward Jones, MD Vice President Gary Newkirk, MD Secretary-Treasurer Trustees Charles Benage, MD Audrey Brantz, MD Karina Dierks, MD Elizabeth Grosen, MD Clinton Hauxwell, MD Louis Koncz, PA-C Frank Otto, MD Fredric Shepard, MD Carla Smith, MD Brian Tryon, MD Newsletter Editor – Matt Hollon, MD

Guest Column: End of Life: Preparing the Documents . . . . . . . . . . . . . . . . 7 Hospice of Spokane Opens Hospice House in North Spokane . . . . . . . . . . . . . 9 Membership Recognition for May 2014 . . . . . . . . . . . . . . . . . . . . 10 HHS Mandate and Religious Freedom Lecture Invitation . . . . . . . . . . . . . . 11 Doctors Without Borders Recruitment Information Session . . . . . . . . . . . . . 11 2013 Physician Citizen of the Year Award . . . . . . . . . . . . . . . . . . . 12

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Spokane County Medical Society General Membership Meeting . . . . . . . . . . . 13 Spokane County Medical Society The Message A monthly newsletter published by the Spokane County Medical Society. Advertising Correspondence SCMS Publications Attn: Daniel Klemme 518 S. Maple Spokane, WA 99204 509-343-0123 Fax 509-325-3889 Daniel@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.

Providence Health Care: Creating Tomorrow’s Success Today . . . . . . . . . . . . 15 Guest Column: Obstetrics in Sierra Leone: Bottoms Up . . . . . . . . . . . . . . . 17 SCMS Foundaton: A Hot Spotters Success Story… Interrupted . . . . . . . . . . . . 19 Group Health: Medical Centers Earn Highest Recognition Status for NCQA Medical Home . . . 21 Spokane-Jecheon Sister City Association Trip to South Korea . . . . . . . . . . . . 22 New SCMS Members . . . . . . . . . . . . . . . . . . . . . . . . . 23 Classified Ads . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Meetings / Conferences / Events / Continuing Medical Education . . . . . . . . . . . 25 Positions Available . . . . . . . . . . . . . . . . . . . . . . . . . . 26

“I am determined to be cheerful and happy in whatever situation I may find myself. For I have learned that the greater part of our misery or unhappiness is determined not by our circumstance but by our disposition.” –Martha Washington

President’s Message

broken promises for assurance to be the

what was learned in the Kettering Foundation

those workers they cover with insurance.

correct answer. So upgrading institutions to

study to the specifics of Health Care Reform.

They are the ones who are paying for these services. They have been able on the West

a better format with systemic reform wasn’t it. But it was also clear that Americans

First I am aware, as I think most of you

side of the State to give score cards to health

hadn’t given up on the country. They believed

are, that the health care institution

care organization who have been caring

that the core issue was a misplaced moral

is being persuaded by incentives to

for their workers and covered lives and

compass. Greed, lack of compassion for

establish Accountable Care Organizations,

incentivized them by allow transparency to all

one another and too little regard for others’

accomplishing Meaningful Use with electronic

who care to ask: “Who gives the best care,

dignity were several of the values most often

medical records and forming Patient Centered

at the lowest price and works at keeping our

quoted as missing in our society. So they

Medical Homes for Primary Care practices.

workers healthy?” I think this will be eye

concluded that it needed to start in the hearts

Through the Federal government all of this,

opening and a stimulus to take some first

of all Americans to get back to our previous

from the top down, has helped stimulate

steps perhaps through perhaps a task force

morality and through individual and small

“programs for change” based on best

sponsored by SCMS.

group efforts we might be able to find our way

practices and the effort for more efficient,

back to a country of which we can be proud

affordable, quality care. In our own health

Hopefully in this we can begin by not asking

and have an end to the wackiness and rules

care institution then most changes have not

what institutions can do in solving Spokane’s

of engagement that were understandable

been of the workers for the people but for

health care problems of the region, but what

to everyone. People looking to their fellow

the bean counters and a bigger piece of the

can we do as individuals and as members of a

citizens then, seemed to be their answer to the

federal pie.

great medical society? How can we, with the knowledge of our strengths and weakness,

fix. Neighbors, neighborhoods, regions within

HEALTH AND HEALTH CARE: THE MOOD OF A NATION By David Bare, MD

the expansion of special interest factions,

of the things they value require sacrificing

communities where advised to be the point

Don Berwick, the former CEO of the Institute

brainstorm our way to innovative solutions

of action where good change could begin

of Healthcare Improvement, advised that the

that will begin the process of improvement?

to take place and trust could be nurtured

solution to the health care crisis could not

I would also suggest that much of this will

until there was reestablishment. Americans

be mandated from the top down but must

involve the citizens of the Spokane region

may be moving beyond their expectations of

be solved at the local level since at least

as we stimulate and motivate them (many of

institutions to look at their expectations of

currently every community will do best in

whom are our patients) to a higher level of self

themselves. It is from this starting point that

reform of their local communities where their

efficacy which will of itself result in helping meet the Triple Aim.

all vying for their particular purposes and

over some other things that they might hold

I want to leap into the whole issues of Health

particular strengths and weaknesses can be

goals. Additionally, the American public has

dear. It was clear from this research that

Care Reform.

delineated. This seems to fit perfectly into the

It would be an

become disenchanted with the institution of

most individuals had lost trust and respect for

understatement to

government and has started looking beyond

many of our institutions, which for most, had

If you’ve had a chance to read previous

suggest that any

political party boundary lines, searching for

been the bedrock of their security. Hospitals,

articles I’ve written for The Message you

So here’s what I’d like to propose. Let us,

once again with the various institutions that

discussion about the

solutions to complex problems related to the

banks, educational institutions, government

understand that there is no arguing that the

members of the SCMS, begin to look at the

are there, in the most basic understanding

future of health care

administration of health care.

on all levels and those institutions of labor

health care industry needs to be reformed.

local scene regarding health care here is the

of who they are, for the good of our people.

from which we earn a living were now

You also know that I believe we (providers)

Spokane region. Let’s focus on our strengths

Hopefully they can see our effort and we can

and our weaknesses using the criteria of

see theirs. We can make this a change from

SCMS President

has the potential for becoming contentious,

mood or the American populace as well.

The other part of this is to bring all of us along to a point of working with and forging trust

not only amongst the ranks of our esteemed

A fascinating study sponsored by the

suspected. In this study two basic questions

are a huge part of that industry and with

colleagues but also throughout the public

Kettering Foundation and conducted by

needed to be asked.

proper leadership coming from our ranks

improving population health, improving the

“me” to “us” and realize that group effort

sphere. Although I will limit my discussion in

Richard Harwood has done some very

we can make a credible impact for good in

patient’s experience of care and reducing the

composed of individual efforts is far better

this rendering mainly to health care, we are

insightful work that helps clarify the mood

“Do citizens just want more efficient and

this process of improvement. You also have

per capita cost.

than individual effort on its own.

all aware that there is a much deeper current

of the American public. The format of this

effective institutions? Or do they want

been informed of the efforts to begin these

of discontent that runs through our nation in

research is one of the key things that make

more control in their own hands to shape a

reforms starting at the institutional level with

A meeting with Washington’s Health Care

If this has motivated you to get involved I urge

many areas. Focusing primarily on American

this study so unique. They used citizen forums

future they find increasingly dangerous and

the obvious need for compliance from all the

Alliance to discuss these very issues is

you to contact us at the SCMS email and web

health care, most people would agree that

in which deliberations and dialogue took

uncertain?” It became clear through the

moving parts of the system including all of

scheduled. This is a conglomerate of

portal to let use know in what way and in what

businesses and other agencies (some

time frame you might be willing to serve and

the system has entered a state of paralysis

place. It was more than a place to make wish

process that it was not enough for institutions

us, who care for patients. So if I can assume

due to an absence of clear direction. This

lists and complain. They were encouraged to

to assure citizens they would take care of

that what evidence I previously presented

governmental, some private) that have a big

share ideas to better health and health care

lack of uniform guidance has contributed to

confront the tensions that occur when some

the problems. There had been way too many

was convincing then we can move on to apply

stake in the Triple Aim for their workers or

for the future of Spokane. n

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In-Depth Interview By Bonny Laugher

grasses, evidence of seasons of standing

will be able to interface the data collected

SCMS Accounting Assistant

water covering the fields. For most people, the

about the moisture levels of the fields with

acquisition of a property with so many problems

special software that will be able to make

The bucolic image of a pastoral cattle ranch

would be totally overwhelming. For the Tryons,

decisions about how irrigation channels on

is fast becoming a relic of a simpler past as

working toward the creation of a self-sustaining

the property should be manipulated to allow

families and small operations struggle to survive

cattle ranch was a challenge they readily

for optimal irrigation of the land. Essentially,

and hold onto their ranches in the face of

accepted and embraced.

within four to five years, the majority of the

large-scale corporate cattle ranching. However,

BRIAN C. TRYON, MD: A MAN OF MANY INTERESTS From Cattle Ranching To Neuroradiology

irrigation processes on the cattle ranch will be

innovative and entrepreneurially-minded

One of the Tryonsâ&#x20AC;&#x2122; primary goals for the cattle

individuals, such as Dr. Brian Tryon and his wife

ranch was to improve the way in which the

Holly Tryon, are working to stem this tide.

pasture fields were irrigated. Traditionally,

In addition to managing the irrigation channels

the ranches in the Rogue Valley are irrigated

on the property more effectively, their

On a cool morning, coal-colored steers lazily

by flooding. In the past, there was no reliable

sensitivity to the environmental impact of

bend and chew tender grass in a verdant field.

way to gather feedback about the moisture

ranching practices on the natural waterways

The rising sun makes its gradual climb over

levels of the soil. This meant the fields were

meant the Tryons knew they would have to

the valley, cutting through the fading mist as

often flooded with too much water, resulting

improve the condition of the stream flowing

dew glistens amongst the blades of grass like

in the unwanted growth of unproductive

through their property. A protected waterway,

tiny mirrors of light. A stream gurgles noisily

and non-nutritious weeds, unsuitable food

the stream provides spawning grounds for fish

nearby, the winter run-off quickening the pace

sources for cattle. Additionally, each ranch

to lay their eggs. Working with the Jackson Soil

of the current as it laps against the thin trunks

along the main irrigation canal was assigned

and Water Conservation District, the Tryons

of fledgling Alder trees, digging their roots into

a specific timeframe for irrigation. To control

created a 50-ft buffer around the stream. To do

the muddy banks of the brook in defiance of the

or manipulate the flow of water during the

this, they had to remove extensive amounts of

rushing water. Tucked in the Rogue Valley in

timeframe, it could mean that someone would

blackberry brambles that lined the banks of the

southwestern Oregon, the Tryonâ&#x20AC;&#x2122;s cattle ranch

need to be monitoring the progress of the water

waterway. In Oregon, blackberries can be an

is a prime manifestation of what can happen

across the fields, possibly even in the middle of

invasive weed, crowding out other vegetation,

when technology is effectively partnered with

the night, a hugely inconvenient undertaking.

forming thick tangles of thorns and developing

sustainable cattle ranching best practices.

Alternative means of irrigation were cost-

dense root structures, making them incredibly

prohibitive so the Tryons needed to find a way to

difficult to eradicate. Once the blackberries

improve the flood irrigation system in place.

were removed, the Tryons planted fast-growing

Dr. Tryon, a Board-Certified Neuroradiologist working with Radia, Inc. PS as the Medical

Dr. Tryon wearing typical ranch wear

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completely automated.

Alder trees to protect the banks of the stream,

Director at Deaconess Hospital, purchased the

Utilizing research and technological

followed by a planting of native bushes to

Oregon cattle ranch with his wife Holly, a civil

developments from Oregon State University,

help preserve the soil and prevent erosion.

engineer with a background in environmental

the Tryons decided to implement a field

This natural buffer creates an appropriate

science, approximately six years ago. As with

monitoring system. Field monitors provide

environment for fish but also provides a

many ranches in the area, the condition of the

information about the volume of water in

measure of protection from any byproducts of

property had largely remained untouched as

the soil which can, in turn, be used to shift

the cattle ranch. The Tryons also refrain from

the ranch was passed down from family to

the flow of water from a fully irrigated field

using any pesticides in their ranch operations

family, generation to generation. Impenetrable

to a less saturated area. The availability of

as part of their commitment to environmentally-

hedges of thorny blackberry bushes crowded

measurable data provides feedback about the

sound ranching practices.

out the banks of the stream running through the

soil conditions which can also be correlated

property. Dilapidated stables with crumbling

to the quantity or yield of the growing fields,

Extending the modernization plans of the

and likely hazardous electrical and irrigation

providing key information for determining

cattle ranch to the actual structures on

systems exhibited the typical character of

best irrigation practices for optimal grass

the property, the Tryons determined that a

improvements executed throughout the years.

yields. In the process of wiring their ranch

complete overhaul of the stables would be

Non-nutritious weeds choked out desired

for wireless remote monitoring, the Tryons

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facilitate remote monitoring of the stables. In

Dr. Tryon went to night school to learn more

necessary. The existing stables displayed

the near future, they expect an indoor riding

about ranching and farming practices and

signs of “cribbing” and animal-inflicted

area to be completed and also anticipate

is also a member of the Oregon Cattleman’s

destruction, possibly signifying that livestock

that they will begin boarding horses with the

Association. He has spent considerable time

housed in the run-down building may have

assistance of a horse trainer, all activities

with more seasoned ranchers, such as Charlie

experienced stress from being sheltered

that will contribute to their goal of making the

Boyer of Long Mountain Farm, who shared their

there. It was also apparent that components

cattle ranch self-sustaining.

wealth of experience and knowledge about

of the electrical and irrigation systems

what works and what doesn’t work in cattle

would require a complete overhaul to bring

The effort and education required to transform

ranching. Spending time on local ranches, Dr.

them up to code. Before undertaking such

a cattle ranch into a self-sustaining enterprise

Tryon continues to practice his skills to become

a substantial remodel, the Tryons looked at

is not insubstantial. Together, the Tryons have

a better horseman and cattleman.

best practices for stable design, layout, and

managed to increase their number of cattle

construction to ensure optimum comfort and

from 40 to 125 Black Angus steers and their

Dr. Tryon’s interest in ranching and farming

safety for the animals that would eventually

main growing field yield by at least 125%.

is long-standing and originates from his

be stabled within the structure. Additionally,

Although the Tryons benefit from Holly’s

childhood and relationship with his father. The

they looked at technological improvements

background in environmental science and

youngest of five children, Dr. Tryon is the son

that would add to the ease and efficient use

engineering, they have both spent a great deal

of a World War II and Korean War veteran.

of the buildings, such as cameras that would

of time learning about ranching best practices.

One of the original Mustang Men in the U.S. Marine Corps, his father nurtured in him a love of the outdoors through frequent time outside that often included horse-packing and backpacking trips in the Sierra Nevadas. His dad was an orphan who grew up on a boys’ ranch in Denver, Colorado. Even as an adult, Dr. Tryon’s father never lost his love of ranching and farming and fostered this same appreciation in his son. After retirement, Dr. Tryon’s father had hoped to return to ranch life but debilitating Rheumatoid Arthritis prevented him from ever realizing this dream before he died. With his wife’s support, Dr. Tryon’s efforts to improve their cattle ranch and make it a self-sustaining and successful endeavor is a way for him to honor his father and remember the unique and close relationship they shared. Brian C. Tryon, MD received his Doctor of Medicine from Drexel University in May 2000 at Philadelphia, Pennsylvania. He completed his Internship at Drexel University Hospitals and his Residency in Diagnostic Radiology at Drexel University College of Medicine in June 2005. In June 2006 he completed his Fellowship in Neuroradiology at the University of Texas Southwestern Medical Center and Parkland Hospitals in Dallas, Texas. Dr. Tryon is a member of the Spokane County Medical Society Board

Dr. Tryon working on fence posts

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Health Sciences

TEACHING PHYSICIAN-TEACHERS SOME NEW TRICKS By Doug Nadvornick,

about new federal cholesterol guidelines.

A neonatologist said when a nurse calls him at

WSU Medical Sciences

Another wondered about how he could

home with a question about a baby, he asks to

explain the nuances of psoriatic arthritis.

have the phone placed near the baby so he can

What is the best way to teach medical students

listen to them. So the doctor decided to use

and/or resident doctors about, say, psoriatic

They discussed a variety of presentation

that as a teaching tool. He plays the sounds of

arthritis or new federal cholesterol guidelines?

methods, from roleplaying to “expert”

babies recorded over the phone for students

interviews. The physicians pondered social

and residents to help them discern healthy

If you like traditional methods, you might

media uses, scavenger hunts, and even an

babies from sick ones.

write an outline, create a few Powerpoint

old technique used by pioneering broadcast

slides and give a lecture. But lectures aren’t

journalist Edward R. Murrow that he entitled

Othello physician Randy Bunch said his strategy

always effective ways to impart information,

“This I Believe,” in which a person writes and

for teaching first-year medical students who

says Lynne Robins from the University of

reads a short essay based on a closely-held

come for month-long summer visits is to get them

Washington School of Medicine.

personal belief. “This I Believe” has been

involved in research projects that might have

revived and used in recent years on National

some application at his practice.

Robins and her colleague Chris Surawicz recently led

After the workshop, some attendees

a group of 90 doctors in a

said it was a useful exercise.

workshop aimed at giving physician-teachers new tools

“The discussion with others with

to engage their students.

different backgrounds gave rise to

The event was held in the

great ideas,” wrote one physician on

auditorium of WSU Spokane’s

a follow-up evaluation form.

new Pharmaceutical and “I cannot be an effective educator without

Biomedical Sciences Building.

interactive learning,” wrote another. “We can’t just mind meld When asked what they would likely

students with what we want them to know,” Robins said. We have to help them develop their

Spokane physicians learn about new methods for engaging students during a workshop at WSU Spokane.

do differently in their practice as a result of what they had learned that

Public Radio programs.

evening, one wrote, “Try to teach the students

Some of the new teaching methods are already

the way they like to learn instead of the way I

To “stretch your imaginations and show you new

in use in Spokane doctors’ offices and medical

like to teach, or at least compromise.”

teaching methods”, as she put it, Robins split

school classrooms.

own ideas and thinking skills, she said.

Another wrote: “Engage students

the participants into groups of six-to-eight and gave each set of doctors a deck of cards, which

One doctor in Hollon’s group said he used

more emotionally and create learning

offered different options for engaging students.

roleplaying to teach his residents about

experiences rather than ‘teaching’.”

hospital billing techniques. It’s effective and

Another promised to “put more mental

In one group, Dr. Matt Hollon dealt the cards

fun, he said; the students really got into it.

energy into prep time with students.”

to six colleagues. They thumbed through

Another physician opined that roleplaying

them and discussed the relative merits of

could be useful in teaching about arthritis by

Workshop organizers say they were surprised

the teaching strategies. One physician was

using different scenarios to expose students to

and pleased by the strong physician turnout.

interested in how she could tell st udents

patient points of view and treatment options.

They hope to hold other events later on. n

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Guest Column

END OF LIFE: PART 1 PREPARING THE DOCUMENTS By Valerie Logsdon, MD

view the necessity, to plan for death.

ADVANCE DIRECTIVES

Hospice of Spokane

So, how does one plan to die? Planning for

The advance directive is simply a

death is not much different than the planning

combination of the Living Will and Durable

Let’s take a poll…how many of you have, in

that takes place before a birth. What are your

Power Of Attorney (DPOA).

the past year, either completed or reviewed

goals? How do you want to be treated? Where

your will, your living will, and your durable

would you like to die? What gives your life

The health care directive or “living will”

medical power of attorney?

quality? What are your fears? Of course, things

is a legal document that specifies wishes

do not always go as planned, but by planning

at the end of life should one be unable to

Unfortunately, even among this well educated

we pave the way to achieve our goals, in this

communicate them. In Washington state,

medical audience, more than 40% have not.

case perhaps, a dignified death.

this only applies if one has a terminal condition where life-sustaining treatment

Yet dying is one thing we all have in common. I have yet to meet the person not destined to

Most have heard about advance directives,

would only prolong the dying process.

die. In 2012, for the first time in history, over

but few have actually prepared them. In

Most living will forms are limited in their

2.5 million people died in the US; the number

one survey, 60% said that making sure their

breadth of coverage and are vague. They

of deaths is not the only change. In the early

family is not burdened by tough decisions

typically do not incorporate wishes regarding

1900’s the average life expectancy was 50

is extremely important, yet 56% had not

day-to-day-care, placement options, and

years. With high childhood mortality, those that

communicated their end of life decisions.

treatment options. They also are always

became adults could live into their 60s. And

80% said that if seriously ill, they would want

open to interpretation, even when the

then, we typically died quickly from infections

to talk to their doctor about end of life care,

terminal nature of the illness is clear. Most

and diseases. Thanks to improved sanitation,

yet 7% had had those conversations. 82%

importantly, they apply only if an individual

antibiotics and other medical interventions,

said it was important to put those wishes in

has a terminal condition and cannot

a child born today has an average life of 78

writing, yet only 23% did. What is wrong here?

communicate her/his wishes.

years (women still outlive men, but the gap is

Why are we so reluctant to talk about death?

narrowing). Our medical miracles have been

Perhaps we are simply superstitious; talking

A durable power of attorney for health care

wondrous. Despite these advances, we cure

about it will make the worst happen (knock on

(DPOA) is a legal document that allows one

only a few illnesses. Instead, we prolong the

wood…). The place to begin to change these

to appoint a person to act as a health care

experience of living with chronic disease. More

statistics is in our practices. And the time

agent: someone authorized to consent to,

than 90 million Americans live with at least

to have these conversations is before crisis

stop or refuse most medical treatments. Once

one chronic illness. Less than 10% of us will

occurs. Conversations about end of life are

appointed, this agent can speak on your behalf

die suddenly. Chronic disease has become the

easier when death is seen as a future event,

anytime you are unable to make your own

norm. And with it has come the ability, and in my

not an imminent one.

medical decisions, not just at the end of life.

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Pick your DPOA appointee well. The person

resuscitated, if a crisis occurs and EMS

• The appointed guardian

should know you well as they are not legally

services are called, they are generally

• The DPOA

bound to follow your advanced directives.

required to resuscitate and stabilize until

• The spouse or registered domestic partner

They are charged to act in good faith and

the patient is brought safely to the hospital.

• Children of the patient >=18 years old

should be able to represent your wishes,

This includes CPR/intubation. We have

• Parents of the patient

respond to unexpected changes in your

addressed this in Washington through

• Adult brothers and sisters of the patient.

condition and base decisions on YOUR

the use of the Physicians Order for Life

feelings regarding care. It is a good idea to

Sustaining Treatment form (POLST). The

The surrogate should use substituted

appoint someone that thinks/feels like you.

POLST converts a person’s wishes into a

judgment; determine whether the patient,

If you hope for comfort at the end of life, do

physician/ARNP/PA-C’s order. It covers

if competent, would have consented to

not pick someone that believes in redemptive

the topics of CPR, medical Interventions

the procedure. When that is not clear, the

suffering. By creating a DPOA, you do not

and, optionally the use of antibiotics and

surrogate should determine what is in the

give up any authority or choice. As long as

medically assisted nutrition. It is portable

patient’s best interest.

you remain capable, your consent must be

across all medical settings. Once signed,

obtained for medical care. The decisions

it remains valid through time. It should be

Please consider discussing these issues

can be emotionally difficult. Make sure that

reviewed periodically and most certainly

even with young healthy adults. Some of

the person you choose is willing and has the

should reflect the current wishes of the

the most difficult decisions occur when a

strength to be up to the task.

patient. A capable person may void the

young person becomes incapable. Dying

form at any time.

can be a stressful time for everyone. It can,

Every state recognizes a Living Will

however, be accomplished with love and

and DPOA. Washington state does not

In the absence of an advance directive,

dignity. Asking those that we love to make

require that either of these documents be

our state law allows surrogates to make

difficult decisions without our guidance is

notarized. However, other states do.

medical decisions for incapable individuals.

most certainly NOT an act of love.

Despite the existence of a living will

There is a priority list that determines the

expressing a person’s wish to not be

decision maker:

I use the following resources: For statistics:

Invested in Your Comfort and Your Care

www.cdc.gov/nchs/fastats/death.htm

Hospice of Spokane’s first priority is patient care so our patients can focus on what’s important to their lives.

www.pewforum.org/2013/11/21/views-onend-of-life-medical- treatments

“I knew that once we got to the Hospice House, I could just be with my mom. It was the best choice we ever made.” – Kristie, daughter of Hospice of Spokane patient

For Advance Directive forms: www.wsma.org/advance.directives www.ghc.org/all-sites/images/ healthAndWellness/pdf.values-worksheet. pdf A great website for your patients (and you): http://theconversationproject.org n

Northeast Washington’s only nonprofit hospice, providing care and support for terminally ill patients and their families since 1977.

Comfort. Dignity. Peace of Mind. 509.456.0438

hospiceofspokane.org

SPOK ANE COUNT Y MEDICAL SOCIE T Y |

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MEMBERSHIP RECOGNITION FOR MAY 2014

Hospice of Spokane

Thank you to the members listed below. Their contribution of time and talent has helped to make the Spokane County Medical Society

From left to right – Gina Drummond, RN, MSN, CEO of Hospice of

the strong organization it is today.

Spokane; Bob Bray, MD, Medical Director; Jim Edwards, MSW,

40 Years

Chaplain and John Bjorkman, CPA, AEP, Board Chair

40 Years Norman J. James, MD

5/28/1974

30 Years Berdine S. Bender, MD

5/24/1984

Scott C. Edminster, MD, FACEP 5/24/1984

In 2012 we inadvertently missed listing our

Donald A. Schmutz, MD

3/17/1972

Gordon E. Larson, MD

5/12/1972

A Henry Reisig, MD

6/22/1972

Glen W. Ruark, MD

7/1/1972

Gary T. Wandschneider, MD

7/1/1972

Parviz Partovi, MD

7/11/1972

James F. Conaty, MD

10/24/1972

Michael A. Judd, MD

10/24/1972

Lowell T. Mouser, MD

12/19/1972

Emeritus physicians. Below are the physicians’ names that should have appeared in 2012.

30 Years

We apologize for the oversight.

Gary E. Cantlon, MD

1/26/1982

Robert Hander, MD

1/26/1982

Halford B. Holte, MD

1/26/1982

60 Years Ralph Berg, Jr., MD

9/19/1952

Russell C. Roundy, MD

4/27/1982

William E. Anderson, MD

11/13/1952

Michael E. Ryan, MD

9/28/1982

Richard H. Hempstead, MD

11/13/1952

Michael J. Kraemer, MD

10/26/1982

Mark E. Williamson, MD

11/30/1982

50 Years

HOSPICE OF SPOKANE OPENS HOSPICE HOUSE IN NORTH SPOKANE

Victor E. Castleberry, MD

1/11/1962

20 Years

Hampton W. Irwin, MD

1/11/1962

Susan J. Tewel, MD

6/17/1992

Alden R. Parker, MD

1/11/1962

W. John Chapman, MD

10/28/1992

Fred K. Viren, MD

2/15/1962

Richard R. Stacey, MD

5/6/1962

10 Years

Jacob W. Meighan, MD

6/5/1962

Julian Bindler, MD

11/13/2002

House Increases Capacity for Specialized Care in Homelike Setting By Tamitha Anderson, APR

When it comes to patients’ and their

the comfort and care that are unique

Hospice of Spokane, Director of Development

families’ special needs when facing the final

to a Hospice House setting,” said

& Communications

chapter of life, only a Hospice House is built

Gina Drummond, RN, MSN, CEO of

specifically to meet those needs. A Hospice

Hospice of Spokane. “Opening this

On April 11, 2014, Hospice of Spokane opened

House offers a safe harbor; it is a place

second House will allow us to serve

its second Hospice House to patients and

where families can leave the caregiving

more people who need this special

began serving patients on April 14. Located

duties to staff and focus on being with their

kind of care.”

just off Division on Spokane’s north side, the

loved ones.

13,000 square foot Hospice House North was

For more information regarding

designed based on the hospice philosophy of

“Since opening our first Hospice

Hospice of Spokane please call

holistic care and constructed specifically for

House in 2007, more than 2,700

(509) 456-0438 or visit the website

patients who are near the end of life.

patients in our community have felt

at hospiceofspokane.org/. n

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Our business is turning them into realities. We do this by helping our clients plan and manage their financial resources. Fee-only.

For a complimentary consultation or brochure, call: Greer Gibson Bacon, CFP® (509) 838-4175 or (888) 864-8827 assetplanning.com

SPOK ANE COUNT Y MEDICAL SOCIE T Y |

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2013 PHYSICIAN CITIZEN OF THE YEAR AWARD Congratulations

and still serves as Okanogan County’s public

to Dr. John F.

health officer. During his medical career,

McCarthy, recipient

McCarthy has been a small business owner,

of the Spokane

part of a multi-specialty group and an

County Medical

employee of a large primary care practice.

Society Physician Citizen of the Year

Dr. McCarthy is the WWAMI clinical

Award for 2013. Dr.

coordinator for Eastern and Central

McCarthy received

Washington. He instructs first-year medical

JAMBO!

the award at the Spokane County Medical

students at WSU Spokane’s Riverpoint

Society’s General Membership meeting

campus, works as residency faculty for

on April 17, 2014 at the Red Lion Hotel at

Family Medicine Spokane and provides

the Park.

patient care as an urgent care physician

humanitarian Spokane-based

in Spokane. He is a past president for the

nonprofit that is committed to

He is a native Washingtonian, born in

Washington Academy of Family Physicians

Spokane. He spent his formative years in

and past delegate to the American Academy

Tacoma. Dr. McCarthy has his Bachelor

of Family Physicians.

Partnering for Progress is a

ensuring that residents of the Kopanga/Giribe community in

of Science from Santa Clara University,

western Kenya have improved

a Master of Counseling Psychology from

Dr. Darryl Potyk nominated Dr. McCarthy and

Gonzaga and his medical degree from

wrote “I believe that John is worthy of this

access to health care, clean water,

University of Washington. He completed his

award as he has demonstrated excellence in

sanitation and education. We have

residency in family medicine in 1993 with an

many different ways for his profession and his

emphasis on rural medicine. He worked for

community. The sum total of his contributions

14 years in Tonasket (a community of 1,000

in a variety of areas, rather than any single

Clinic in Giribe. Some of the

in Northern Washington), performing full

accomplishment makes him worthy of this

spectrum family medicine, including operative

award. Through his direct contact with

common diseases include malaria,

obstetrics and emergency room staffing. He

medical students and residents, Dr. McCarthy

was also the medical director for Okanogan

has inspired and has been a superb role model

Home Health and Hospice’s Hospice program

for many young physicians. “

recently partnered with the Ogada

water borne illness, GYN diseases, malnutrition, as well as the diagnosis and treatment of HIV. A team of providers will travel to Kopanga to

HHS MANDATE AND RELIGIOUS FREEDOM LECTURE INVITATION We are fortunate to have David

Hospital, because they treat patients of all

Please invite your family and friends

DeWolf, Professor at Gonzaga Law School,

faiths, may lose their conscious exemption.

to join us for this informative lecture

and an expert on the First Amendment,

When one considers that Catholic hospitals

and hopefully a lively discussion.

discuss the impact of the HHS mandate on

provide 16% of health care in the United

Admission is free, but donations

religious healthcare institutions. The issue

States, while other Christian hospitals

to defray the printing costs will be

is much broader and complex than simply

provide at least another 5-6%, it becomes

accepted. The lecture is sponsored

providing contraceptives.

clear that the impact on the delivery of

by the Catholic Medical Association

healthcare will be significant.

and will be held on Wednesday, May

Human and Health Services has changed

14, 2014 at 6 PM, at Sacred Heart

the definition of a religious institution. Under

The timing for the lecture is apropos,

the new ruling, hospitals such as Sacred

as the Supreme Court deliberates

Heart Medical Center and Holy Family

on Kathleen Sebelius v. Hobby Lobby.

SPOK ANE COUNT Y MEDICAL SOCIE T Y |

Auditorium, 20 West 9th Avenue. n

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provide primary care on October 11

SAVE THE DATE

– 18, 2014. We are in need of medical providers, optometrists and dentists

Spokane County Medical Society Presents

Medicine 2014

the above are also needed for the February 2015 trip February 20-28. If you would like to volunteer please contact Stacey Mainer, co Founder,

Friday—September 26, 2014

mainer20@gmail.com or call

8:00 a.m. to 5:00 p.m.

(509) 951-2437.

Red Lion Hotel at the Park

Watch for more details!

SPOK ANE COUNT Y MEDICAL SOCIE T Y |

for the October trip. Educators and

–Asanti Sana

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Guest Speaker: Mack Dryden Comedic Motivator and Emcee

“He GENERAL was a BIG hit! Everyone was rolling in the aisles with laughter.” SPOKANE COUNTY MEDICAL SOCIETY MEMBERSHIP MEETING

Live Happy, Laugh Loud

An evening filled with laughter, good food, entertainment by Mack Dryden, conversation

As a comedian he’s performed on dozens of TV shows, including The Tonight Show with both Johnny Carson and Jay Leno. As an actor he’s appeared in several movies and on many TV shows, including JAG and a recurring role as a judge on ABC’s The Guardian. Before becoming an entertainer, he was an award-winning journalist and a black belt karate champion.

with colleagues and lots of prizes – that was the setting for the Spokane County Medical Society’s General Membership meeting held on Thursday, 17 April, 2014 at the Red Lion Hotel at the Park.

MEAL CHOICES SERVED WITH SALAD, BREAD, DESSERT AND COFFEE/TEA

Double Cut Pork Loin Chop

Name_______________________________________________ Pork Chicken Vegetarian

Chicken Oscar

Name_______________________________________________ Pork Chicken Vegetarian

Served with apple bourbon mustard glaze, smashed red potatoes and fresh vegetable Boneless skinless breast of chicken topped with Dungeness crab, asparagus and béarnaise sauce with saffron rice and fresh vegetable

Vegetarian

Chef’s choice

SCMS

Orange Flag Building 104 S. Freya St., Ste. 114 Spokane, WA 99202 (509) 325-5010 Fax (509) 325-5409

very special thank you to our sponsors. PRIZES AFOR DRAWINGS PROVIDED BY THE FOLLOWING SPONSORS:

The Prewitt Group Northland Team

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Providence Health Care

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Guest Column

OBSTETRICS IN SIERRA LEONE: BOTTOMS UP

wrapped in blankets and given to the mother

going limp. I could feel the pulse in the

compressing. Still nothing. The mother was

to hold until the baby dies. Shortly after she

umbilical cord and it was very slow. I put

wailing, watching us, helpless. And then the

delivered another patient delivered a baby

some traction on the baby’s hips while

baby gasped. It wasn’t much and it didn’t last

that weighed only 750 grams but that baby is

having the mom pull her knees as close to

long but it was enough to give us hope and

somehow still alive. Perhaps it was further

her chest as possible to try and give the

we kept working, all the while watching the

along and just stunted in growth so maybe

baby more room but the baby was stuck.

baby’s dusky blue color start to lighten and

The day started off busy and stayed that

That got the day off to a rousing start.

its lungs are more developed than most 750

way. My first patient was a 22-year-old

It seemed like the door into labor and

gram babies but the likelihood of it living

I’ve heard horror stories about babies that

a pinkish color. When the baby opened its

woman who had had four pregnancies,

delivery never closed after that. I’ve

more than a day or two isn’t very high.

deliver up to the head and then get stuck

eyes and started crying everyone in the

delivered three babies, and all had died

started to become desensitized to

but that’s one of those things you always

room just looked at the person next to them,

before the age of two. She had delivered this

dead fetuses, it’s so common here. The

I got to bed around 2:00 AM and slept for

think will never happen to you. But here

eyes wide in something like disbelief. I

baby at home over 36 hours before. The baby

baby is already dead in easily one out

a couple of hours but then got an urgent

it was happening. Out of options, I did the

think when you’re used to seeing babies die

was doing well but she had not delivered the

of five of the patients we see. During a

phone call from labor and delivery. I still

only thing I could do and reached up into

watching one come back from the dead is

placenta and had started hemorrhaging.

typical month in the US you might see

have trouble understanding the nurses

the mother and found that both arms were

especially miraculous. The mother started

an occasional fetal death but it isn’t

sometimes and this was one of those

trapped above the baby’s head. Picture

crying and chanting something, the nurses

She had to walk an hour and a half to the

common, at least not where I practiced,

instances so I just got over to labor and

someone with their arms over their head

regained their brusque attitudes, and within

nearest clinic to get an ambulance to take

and most of these babies died before

delivery as quickly as I could and found a

getting ready to dive into water and you’ll

a minute or two the baby was screaming its

her to the hospital. When she arrived she

labor started. In contrast almost all of the

patient who had just arrived by ambulance,

understand how the baby got stuck. The two

lungs out.

was only semi-conscious, covered in blood

fetuses that die here occur during labor.

pushing, with the baby’s buttocks halfway

arms combined with the head just couldn’t

and her hemoglobin was only 3.1. I think I’ve

It is understandable that in a referral

delivered. This was her first baby and

get through the mom’s pelvic bones. I was

It could’ve gone either way. I hope that I

mentioned that a low, normal hemoglobin for

center such as this that there would be

MSF OBGYN Stephen Torres

based on the size of the baby’s buttocks, it

able to get one finger past the mom’s pelvic

don’t someday have to tell a story like that

women in the US is at least 12 or 13 so she

a higher rate of complications since any

Fifty-eight-year-old Doctors Without

wasn’t a small kid. There wasn’t time to get

bones and hooked around the baby’s right

but with a different ending. I’ve looked

was dangerously low. We approached her

woman who wasn’t complicated would

Borders/Médecins Sans Frontières (MSF)

her back for a Caesarean so I got my hat,

arm near the elbow and tried to pull the arm

back over everything that happened and

family to donate blood but they all refused

have delivered somewhere else. But I’m

OBGYN Stephen Torres previously worked

mask, eye shields, apron, gown, and double

down, bending it at the elbow but it wouldn’t

I just don’t see what could have been

and I finally came to understand that they

beginning to understand why the mothers

with Native Americans in the Indian Health

gloves on in record time and prepared for a

move. I really don’t know how much time

done differently. Perhaps if she had come

are Jehovah’s Witnesses, who believe that

don’t react with grief the way they do back

Service for three years after completing

breech delivery. I felt pretty calm thinking

had passed by then. It may have only been

in sooner we would have taken her for

receiving blood products will keep you out of

home. I think they go into the pregnancy

his training, then spent the next 22 years in

optimistically, “What could go wrong?”

a couple of minutes but it seemed like an

a Caesarean but around here a breech

heaven, even though the patient was not.

understanding that the chances of having

Well, everything apparently.

eternity. Not really giving it much thought

presentation isn’t necessarily an indication

but knowing that if something didn’t happen

for a C-section. I alerted the pediatrician to

The baby delivered up to its hips pretty

quickly to improve the situation the baby

keep an eye on the baby’s right arm but even

easily. Mom pushed again and the baby

would die, I pulled as hard as I could on that

if it’s broken, and I suspect it is, that seems like a reasonable price to pay.

private practice in the state of Arkansas.

a bad outcome are not low so their

then turn into a mottled pale and then finally

He retired from private practice in 2012 and

Fortunately the patient was amenable to

hopes to spend the coming years working

receiving blood over the objections of her

with MSF in areas of need.

family (and they were pretty angry at us,

Last night after midnight I had a patient

delivered the umbilical cord. That’s when

arm. I felt a pop, am pretty sure I broke its

convinced that we were condemning her to

come in with severe polyhydramnios–way

Stephen’s first mission with MSF was at the

the clock starts ticking in my head. From that

arm, but it finally moved and I was able to

eternity in hell) and we were able to find blood

too much fluid around the baby. As a result

Gondama Referral Center in Bo, Sierra Leone.

point on the baby’s umbilical cord is being

get it down past the head into the vagina.

I was so hyped up on adrenaline after that

to give her. I took her to the OT and after a

she went into labor early and delivered a

This is a referral hospital for pregnancy

compressed between the baby’s skull and

The other arm came more easily since some

that I never went back to sleep. I’m on call

really difficult 45 minutes was able to get the

malformed baby, stillborn. It only weighed

complications and for pediatrics. Sierra

the mom’s pelvic bones, effectively cutting

of the pressure had been released with the

again tonight but wanted to wait until the

placenta out but during the entire time she

850 grams, about 2 pounds, so even if it

Leone has one of the highest maternal death

off the delivery of oxygen to the baby. We

removal of the right arm and after that the

electricity comes back on at 11:00 AM (20

continued to lose blood. Her hemoglobin after

had been alive there would have been no

rates in Africa.

had mom keep pushing but the baby didn’t

baby’s head came out easily. But the baby

minutes ago) and the fan starts working

the procedure, even after the transfusion, was

attempt to keep it alive. The policy here is no

budge. I remember Dr. Quirk, a maternal-

was as limp as a rag and I could no longer

again to try to get some sleep. I’ve been here

3.0 and we didn’t have any more blood to give

resuscitation on babies weighing less than

MSF has played a large role in reducing

fetal specialist and the man I learned the

feel a pulse in the umbilical cord.

three weeks now and that’s a little hard to

her. We’ll keep looking for blood but in the

1000 grams. That’s what most babies weigh

those numbers but access to health care for

most from during my residency, saying of

meantime she’ll need to stay in the hospital

at about 28 weeks along in the pregnancy,

pregnant women and children continues to

breech deliveries vaginally: “Keep your

We moved the baby over to the resuscitation

here but in other ways it feels like I’ve been

until her blood counts have improved. She

12 weeks early. The hospital doesn’t have

be a problem.

hands off until the baby has delivered up

table and started resuscitating the baby. I

here a long, long time.

needs help just to get up to go to the bathroom

the resources to keep these babies alive.

to the scapulas (basically just below the

used the bag and mask to force air into the

and now her family is angry at her and refuses

There are no ventilators, they don’t have the

This blog is being published retrospectively.

shoulders).” I kept that in mind and tried to

baby’s lungs while the nurse started chest

- See more at: http://www.

to assist her. I can’t help but wonder what life

nursing staff they would need, and there

Read more from Stephen’s blog:

avoid trying to help the mom by pulling on

compressions. Nothing. We rolled the baby

doctorswithoutborders.org/news/article.

is going to be like for her when she goes home,

is no other place to refer these babies to.

http://blogs.msf.org/stephent/

the baby until another minute passed and

to the side and massaged its back, slapped

cfm?id=7104&cat=field-blogs#sthash.

still ostracized by her family.

When these babies are born alive they are

the baby, who had been kicking, started

its feet, and then continued bagging and

suI4HsSr.dpuf n

SPOK ANE COUNT Y MEDICAL SOCIE T Y |

expectations aren’t high.

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believe. In some ways it feels like I just got

SPOK ANE COUNT Y MEDICAL SOCIE T Y |

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Spokane County Medical Society Foundation his frequency in the emergency department,

red flags for a lot of landlords. This was the

Support and Stability End

which he visited thirteen times in July,

case at the low-income housing facility into

Unfortunately, grant funding for the work

four times in August and thirteen times in

which we had hoped to get Ethan. Great

with Ethan ended on December 31. Sarah

September — on track to rack up 120 visits

efforts were made to demonstrate that

made sure that he understood our case

over the course of a year.

Ethan deserved a chance given the length of

management would be ending and made

time passed since those convictions. Still,

contact one last time on New Year’s Eve

The Hot Spotters Group Intervenes

his application stalled for weeks and was

day. We all had high hopes based on the

The Hot Spotters work with Ethan began

ultimately denied.

incredible turnaround that had occurred.

arranged for him to have a mobile phone

This defeat prompted Ethan to search for an

At some point in February, Ethan took off for

provided by House of Charity. This allowed

apartment on his own. He had hoped to get

Yakima. We know this for a couple of reasons:

efficient care coordination by enabling

out of downtown because he thought that

First, because we found out that he had

us to reach Ethan without having to track

trouble waited around every corner, but he

basically abandoned his apartment, which

him down on the streets or wait for him to

found an affordable, livable apartment on

had apparently become a revolving door for

arrive in the ED late at night. Sarah Bates,

3rd Avenue. We facilitated the process by

rowdy, inebriated young people; also, because

SCMSF Community Health Worker, met with

paying a security deposit and two months’

he began to show up in the emergency

Ethan, assessed his needs, and arranged

rent in advance and helped Ethan move in on

departments at Yakima Regional and Memorial

for him to stay at the Days Inn temporarily

Thanksgiving. House of Charity staff made

Hospitals — five times in February and twelve

while we worked on a long-term housing

a referral to the Community Warehouse for

times in March. Dr. Neven had noted the

solution. She continued to check in with him

furniture and basic living items but with

Emergency Department Information Exchange

approximately three times each week, using

a waiting period of about a month, Sarah

(EDIE) system, requesting that Sarah be

grant funding to help with some of his basic

donated an air mattress, some pots and

contacted any time Ethan turned up in an

needs such as a coat and a Grocery Outlet

pans, a lamp and other basic necessities to

emergency department. We have received

card for food.

get Ethan settled.

many of these notifications,

One of the things Sarah discovered right

During the months of October, November,

We have also received some nearly

away was that Ethan did not realize he was

December and January, Ethan visited the

unintelligible voice messages from Ethan

enrolled in Medicaid. He thought that the

emergency department just once — on track

asking for our help to return to Spokane to

only benefits available to him were through

to make only three ED visits over the course

get back on track, but as I finish this article

the Veterans Administration and as a result

of a year. That is a 97.5% drop from his usage

on the afternoon of April 16, Ethan has

he was not connected with any primary

before our intervention started.

already been in both of Yakima’s emergency

toward the end of September. Dr. Neven

A HOT SPOTTERS SUCCESS STORY… INTERRUPTED By Jim Ryan

anywhere from 30 to 100 times per year,

the emergency departments. This caught the

SCMS Foundation, Patient Care Coordinator

usually by way of police, fire or Emergency

attention of Dr. Darin Neven, a Providence

Medical Services escort. In addition

Sacred Heart Medical Center Emergency

The Spokane Hot Spotters group continues

to the Medicaid and charity care costs

Department (ED) physician and a member

to coalesce and evolve rapidly as an

associated with the services, there exists

of the Hot Spotters leadership team, who

increasing number of community providers

the potential for diversion of resources

suggested that we immediately get involved

unite around the basic premise that

away from more traditional emergencies

in working to stabilize Ethan.

together we can break a vicious cycle.

such as fires and heart attacks. This

A cycle that has resulted in excessive

all adds up to an undue burden on the

Ethan’s cycle basically involved getting

and costly overutilization of emergency

community at-large and creates a multi-

extremely intoxicated and then calling an

services by a small number of highly

leveled incentive to fix the problem of over

ambulance to take him to the emergency

complex individuals who have been

use by a limited number of individuals.

department where he could count on a

resistant to traditional methods of health and social service delivery.

sandwich and a bed in which to sleep it off. The experience of one of our earliest

Ethan was technically homeless at the time

clients, whom we’ll call “Ethan,” starkly

due to the fact that the place he called home

The population served by the Hot Spotters

demonstrates the efficacy of this type of

was actually a bedbug-infested apartment

program is comprised of individuals who

intervention. In mid-2013, Ethan was new to

not fit for human habitation. He avoided his

go to hospital emergency departments

Spokane and immediately began frequenting

apartment like the plague, as evidenced by

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departments today...before noon.

care or behavioral health providers. This discovery allowed us to connect Ethan with

It is important to note that at no point was

needed mental health and primacy care

Ethan even asked to be sober. Certainly,

Ethan would be the first to tell you that

serviced provided by Providence’s Internal

we make a habit of promoting and gauging

our assistance was what stabilized him

Medicine Residency Spokane and Frontier

interest in treatment but it was not a

for a short period of time. He would also

Behavioral Health.

prerequisite for our involvement and we

tell you that his backslide began when we

have no reason to believe that Ethan ever

had to sever our services due to funding

Securing housing for Ethan proved to be

stopped drinking heavily. The primary goal

constraints. It is clear that housing

difficult. Ethan has social security income

was to stabilize Ethan’s basic living situation

combined with case management was the

sufficient to afford a suitable apartment

and thus substantially curb his excessive

key to keeping Ethan out of the emergency

but some past legal troubles made the

use of emergency services — and to that

departments and that the relatively low cost

situation more complex. He had a couple of

end, the outcome of our work with Ethan

of that assistance represents a vast savings

20-30-year-old felony convictions that raised

vastly exceeded our expectations and goals.

over the alternative. n

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Group Health

SPOKANE-JECHEON SISTER-CITY ASSOCIATION TRIP TO SOUTH KOREA

SEPTEMBER 13 - 21, 2014, MAXIMUM OF 20 PEOPLE Expected cost: $3,600 per person, which includes round trip airfare from Spokane, hotels, and most meals. Note: we have been fortunate to get a very good group airfare for this trip: $1,120 for adults, and $1,050 for seniors (age 60 and over). That is included in the total. In order to receive this airfare, participants must make a $100 deposit with the travel agency by May 15. Booking after that date may be possible if the tour is not full, but the airfare will be higher, and will depend on fares at the time of booking. Please contact us when you are ready to make a

GROUP HEALTH MEDICAL CENTERS EARN HIGHEST RECOGNITION STATUS FOR NCQA MEDICAL HOME Group Health’s 25 Medical Centers across

most widely adopted medical home model

them every opportunity to have the best

Washington state recently received the

in the country.

possible health,” said Claire Trescott, MD,

highest recognition status (Level III) for

Group Health’s medical director of Primary

Patient Centered Medical Home (PCMH)

“The NCQA’s 2013 PCMH Recognition

from the National Committee for Quality

standards emphasize the use of systematic,

Assurance (NCQA). This award recognizes

patient-centered, coordinated care that

“It’s very rewarding for the organization

the vital role clinicians and practices play

supports access, communication and

to achieve this goal and earn the highest

in delivering high-quality, patient-centered

patient involvement,” said NCQA President

possible recognition from a prestigious

care that is built on evidence-based,

Margaret E. O’Kane. “The NCQA patient-

national accreditation organization

nationally recognized clinical standards and

centered medical home is a model of 21st

like NCQA.”

advances quality.

century primary care that combines access,

The patient-centered medical home is

Care Services.

teamwork and technology to deliver quality

This three-year recognition was awarded in

care and improve health.”

December 2013 and is the second time Group

a way of organizing primary care that

Health has earned the honor.

emphasizes care coordination and

This recognition shows that Group Health

communication to transform primary care

Medical Centers have resources to provide

NCQA officials recently hosted a media

into what patients want it to be. Medical

patients with the right care at the right time.

briefing about its 2014 PCMH Recognition

homes can lead to higher quality and

standards, which launched March 24 and

lower costs, and can improve patients’

“We created our patient-centered medical

include changes affecting the advantages

and providers’ experience of care.

home model to meet or exceed the needs

and requirements. For more information,

NCQA’s PCMH Recognition program is the

and expectations of our patients, and to give

visit www.ncqa.org. n

SPOK ANE COUNT Y MEDICAL SOCIE T Y |

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deposit, and we will put you in touch with the travel agent. Costs are based on two people per room. Room rates for single occupancy will be higher. This trip has been planned to give participants an opportunity to learn about Korean traditional alternative medicine. With this in mind, participants will attend the Oriental Medicine Bio-Expo that Spokane’s sister city, Jecheon, hosts once every four years. The trip also includes three days in the modern city of Seoul, South Korea’s capital and business hub, which will give participants a feeling for modern Korea.

Tentative Itinerary (There will be changes) Saturday, Sept. 13 Depart Spokane for Seoul (Alaska Air to Seattle; Korean Air nonstop to Seoul)

historic site and Semyung University Medical School. Check into Cheongpung Lake Hotel. Dinner at the hotel.

Sunday, Sept. 14 (Evening) Arrive at Incheon International Airport (ICN), the airport for Seoul, and transfer to hotel.

Friday, Sept. 19 Visit Jeongbang Buddhist Temple and Korean Cultural Complex (folk village). Lunch. Cruise on Cheongpung Lake. See monorail tourist attraction. Dinner.

Monday, Sept. 15 Sightseeing in Seoul, including familiarization with the Seoul subway. Visit historic Gyeongbok Palace, National Folk Museum, Jogyesa Buddhist temple, Gahoe-Dong traditional neighborhood, Insadong Arts District. Tuesday, Sept. 16 More sightseeing in Seoul, including Sejongno Boulevard, Kyobo Bookstore (one of the world’s largest bookstores), Cheonggyecheon Stream, South Gate Market, and the tony MyeongDong shopping district. Wednesday, Sept. 17 Sightseeing in Seoul – Free Time for visiting other places as individually desired. These could include the National Museum, Itaewon Shopping District, Namsan Tower, East Gate Fashion Market, and other places. For those who wish, it may be possible to book a tour to the DMZ. (DMZ tours must be booked at least 48 hours in advance.) Thursday, Sept. 18 Morning departure for Jecheon, a two-hour bus ride from Seoul. We will stop en route at a typical Korean highway rest stop (hyugyeso), and at the Baeron Catholic Martyrs Sacred Site. Lunch in Jecheon, meeting with the mayor, visit Uilimji

Saturday, Sept. 20 Visit Korean traditional healing center and Oriental medicine weight-loss spa. Lunch. Sightseeing at Jecheon Bio-Expo, including official opening ceremonies. (The Bio-Expo is an exposition focusing on alternative medicine practices, including traditional herbal medicines, acupuncture, massage, other manipulation techniques, etc.) Sunday, Sept. 21 Morning departure from Jecheon for travel to Incheon Airport (ICN), with sightseeing en route, as time allows. Late afternoon departure for Spokane, arriving in Spokane in late afternoon of the same day (Sunday, Sept. 21), due to the difference in time zones. Note: Seoul is best experienced on foot; participants should take tennis shoes or other comfortable shoes for walking. Sandals and flipflops are not advised. If you have questions about the trip, or want to make a preliminary reservation, please email spokanewees04@yahoo.com

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New SCMS Members 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 to the Spokane County Medical Society, 104 South Freya Street, Orange Flag Building, Suite 114, Spokane, Washington, 99202.

PHYSICIANS

Hecker, Susan, MD Internal Medicine Med School: U of Washington (2007) Internship: U of Utah (2008) Residency: U of Utah (2010) Joined CMA Northside Internal Medicine Marks, Lacey, MD Obstetrics/Gynecology Med School: Boston U (2007) Internship: Phoenix Integrated Res. Program (2008) Residency: Phoenix Integrated Res. Program (2011) Joining Rockwood OB/GYN Center 09/2014 Grace, Travis, MD Emergency Medicine Med School: Florida State U (2010) Internship: U Medical Center South Nevada (2011) Residency: U Medical Center South Nevada (2013) Joining Northwest Pacific Emergency Physicians (Deaconess) 07/2014 Barker, Jessica, MD Obstetrics/Gynecology Med School: U of Texas (2010) Internship: Temple U Hospital (2011) Residency: Temple U Hospital (2014) Joining Rockwood OB/GYN Center 10/2014

Meredith, David, MD Pathology Med School: U of New Mexico (2009) Internship: U of New Mexico (2010) Residency: U of New Mexico (2013) Joining Cellnetix Pathology 07/2014 Aldred, Jason, MD Neurology Med School: U of Tennessee (2003) Internship: Oregon Health & Science U (2004) Residency: Oregon Health & Science U (2007) Joined Northwest Neurological, PLLC

PHYSICIANS PRESENTED A SECOND TIME

Reed, William F., MD Internal Medicine Hospitalist Joined The Hospitalist Co. (Holy Family) Rabe, Jacob B., MD Emergency Medicine Joining Valley Hosp Emerg. Dept. (Hospital Physician Partners) 08/2014 Mueller, Anthony R., MD Emergency Medicine Joining Valley Hosp Emerg. Dept. (Hospital Physician Partners) 08/2014 Allred, Jared J., MD Orthopedic Surgery Joining Rockwood Sports Medicine & Orthopedics Center 09/2014 Mickelson, Joseph D., MD Family Medicine Joining Rockwood Hospitalists 08/2014

PHYSICIAN ASSISTANTS PRESENTED A SECOND TIME Wagner, Aaron, MD Radiation Oncology Med School: Loma Linda U (2009) Internship: Providence Sacred Heart (2010) Residency: U of Utah, Huntsman Cancer Ctr (2014) Joining Cancer Care Northwest 07/2014 Gourley, Brett, MD Hematology/Oncology Med School: Oregon Health & Science U (2008) Internship: U of Minnesota Med. Ctr (2011) Residency: U of Minnesota Med. Ctr (2014) Joining Rockwood Cancer Treatment Center 08/2014

Bachmeier, Brad J., PA-C Physician Assistant Joined PMG – Orthopedics Beardslee, Donna L., PA-C Physician Assistant Joined Rockwood Hospitalists

SPOK ANE COUNT Y MEDICAL SOCIE T Y |

EASTERN WASHINGTON PHYSICIAN HEALTH COMMITTEE (EWPHC) EWPHC is a “quick call” to find assistance

Assistance is available to you in the following areas: 

Marital and Family Issues



Death of a Spouse or Family Member



Drug/Alcohol Misuse

This commi�ee, a fusion of the former SCMS commi�ee and one including members of medical staﬀs of Community Health Services and Providence Health Care Hospitals, meets quarterly to educate ourselves about physician health issues, review u�liza�on and sa�sfac�on with the Wellspring Employee Assistance Program (EAP) and plan ac�vi�es, programs and resources to address needs in those areas.



Lawsuit Educa�on and Support

Some of the guiding principles of the commiƩee are:



MQAC/OSTEO Board Issues





Boundary Issues

The medical profession and healthcare community should foster physician well‐being





Disrup�ve Behavior

A sense of community with one’s peers is vital to personal well‐being



Elder Care



Assess the changes in the healthcare environment



Prac�ce Management

Physician Commi�ee Members (Name and Contact Informa�on) Jim Shaw, Chair 710‐3151 Barry Barnes

255‐6557

Michael Metcalf

927‐4102

Paul Russell

954‐4989

Steve Brisbois

953‐3798

Michael Moore

747‐5141

Robert Sexton

624‐7320

Andi Chatburn

624‐2313

Mira Narkiewicz

889‐5599

Tasca Snow

565‐4000

Deb Harper

443‐9420

Sam Palpant

467‐4258

Alexandra Wardzala

990‐1938

Michael Henneberry

448‐2558

Tad Pa�erson

939‐7563

Hershel Zellman

993‐4274

Greg Loewen

844‐8476

Rod Peterson

944‐5781

Caduceus Al Anon Family Group ‐ Meets every Thursday evening from 6:15 pm un�l 7:15 pm at 626 N. Mullan Rd., Spokane, WA. Non‐smoking mee�ng for spouses and signicant 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 informa�on. Physician Family Alanon Group ‐ Physicians, physician spouses or signicant others and their adult family members share their experience, strength and hope concerning diﬃcult physician family issues. This may include medical illness, mental illness, addic‐ �ons, work‐related stress, life transi�ons and rela�onship diﬃcul�es. We meet Tuesday evenings a�er 6pm. The format is structured by the 12‐Step Alanon principles. All is conden�al and anony‐ mous. There are no dues or fees. To discuss whether this group could be helpful for you, contact Bob at (509) 998‐5324.

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SPOK ANE COUNT Y MEDICAL SOCIE T Y |

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Classified Ads REAL ESTATE RIVER FRONT AND ACREAGE, 3300FT², 4 BEDROOM HOME FOR LEASE (OR SALE) $1,850/MONTH. Close in but feels like the country. Four bedroom, three and ½ bath, master suite with corner jetted tub and large walk-in closet, open living and dining area with great views and gas fireplace, family room with wood stove, attached two-car garage and detached two-place carport. Forced air natural gas furnace. Large multilevel deck and patio looking toward river. Wooded acres on the Little Spokane River with private trails, sandy beach and swimming hole. Plentiful wildlife. School bus comes to front drive. Mead school district. Close to Whitworth, shopping and freeways but very quiet and secluded. Cable hookup. Grounds are river irrigated. First and last plus cleaning deposit. Utilities not included. No indoor pets. $150/month grounds maintenance fee if you choose not to do it yourself. Contact Scott (509) 435-7099. For photos go to Craig’s list - http://spokane. craigslist.org/apa/3984125910.html. ONE OF COPELAND’S BEST NORTH SIDE HOMES on over fifty acres with meadows, trees, complete privacy and gorgeous views. This home offers contemporary living at its best featuring four bedrooms, four bathrooms, three-car garage, hard rock maple floors, cabinets and built-ins, three balcony decks plus a patio with water feature. The second level has a distinctive master suite with custom built-ins, large walk-in closet, lovely master bath with lowboy toilet and bidet, a large sitting room with built-in shelving, raised gas fireplace and extraordinary views! The main floor great room boasts granite, stainless appliances, oversized pantry and very functional laundry suite with chute. Superefficient geothermal heating and cooling affords economical year ‘round comfort. Twenty minutes from Holy Family Hospital. Mead schools! $665,000 Call Marilyn Amato at (509) 979-6027.

COMFORTABLE THREE-BEDROOM HOME IN QUIET NEIGHBORHOOD FOR RENT. Good storage in kitchen, gas stove, dishwasher, refrigerator, washer/dryer and fireplace. Comes furnished or can negotiate. Close to Hamblen Grade School, Sac Middle School and Ferris High School. Three bedrooms, three baths, large living room, family/TV room, master bedroom has private bathroom, two-car garage. Large windows in living room look out into large fenced yard with automatic sprinkler system (front and back). Snow blower and lawnmower provided. Call (408) 594-1234 or (509) 993-7962. LARGE SECOND OWNER CUSTOM BUILT EXECUTIVE HOME with unparalleled views of Liberty Lake and Spokane Valley on five acres available for sale or lease. Custom hardwood floors and woodwork throughout, cherry office shelves, cathedral ceilings, central air, three car garage, brick porch, tile roof, large deck, three fireplaces, four bedrooms, four bathrooms, formal dining room, large kitchen, large eating room and den. Walk out basement, wood stove, kitchen and bathroom. Large 30’ x 100’ pole barn with separate utilities, two phase power, three twelve-foot overhead doors. 30 x 60 sports court. Large animals allowed. Water rights included. 4Kw grid interactive, portable battery backup solar system available. Offered for $600k or for lease $3250, no pets/ smokers. Seller is a real estate broker at (509) 220-7512.

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 medical office spaces available for lease from 635 to 10,800 contiguous usable square feet. and has undergone extensive remodeling, including two new elevators, lighted pylon sign, refurbished lobbies, corridors and stairways. Other tenants in the building include urgent care, family practice, pediatrics, dermatology, dentistry, pathology and pharmacy. Floor plans and marketing materials emailed upon request. A Tenant Improvement Allowance is available, subject to terms of lease. Contact Patrick O’Rourke, CCIM, CPM®with O’Rourke Realty, Inc. at (509) 624-6522, mobile (509) 999-2720 or psrourke@comcast.net.

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. PHYSICIAN FAMILY ALANON GROUP: Physicians, physician spouses or significant others and their adult family members share their experience, strength and hope concerning difficult physician family issues. This may include medical illness, mental illness, addictions, work-related stress, life transitions and relationship difficulties. We meet Tuesday evenings after 6 p.m. The format is structured by the 12-Step Alanon principles. All is confidential and anonymous. There are no dues or fees. To discuss whether this group could be helpful for you, please contact Bob at (509) 998-5324.

POSITIONS AVAILABLE 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 Psychology, Psychiatry, Physical Medicine and Rehabilitation, Family Medicine, Occupational Medicine, 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 Maggie Dillon directly at (909) 978-3548 or mdillon@qtcm.com or visit our website www.qtcm.com to learn more about our company. ESTABLISHED SPOKANE CLINICAL RESEARCH COMPANY is seeking primary care and specialty physicians interested in serving as Principle Investigators or as Sub-Investigators. There is an opportunity to assume an on-going research portfolio and to join new studies that are opening in the spring of 2014. For more information, contact Dalyn Boehm or John Driscoll at Premier Clinical Research at (509) 343-3710 or research@premierclinicalresearch.com. PHYSICIAN (OB/GYN AND URGENT CARE) OPPORTUNITIES AT COMMUNITY HEALTH ASSOCIATION OF SPOKANE-Spokane Locations (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 CHAS Human Resources at (509) 444-8888 or hr@chas.org. Visit our website to learn more and to apply www.chas.org.

PROVIDENCE FAMILY MEDICINE RESIDENCY SPOKANE - Immediate opening with Providence Family Medicine Residency Spokane (PFMRS) for a full- time BC/BE FP physician who has a passion for teaching. PFMRS 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 Linda Barkley, Program Assistant at (509) 459-0688 or Linda.Barkley2@providence.org. FULL-TIME LICENSED PHYSICIAN ASSISTANT (PA) wanted for expanding clinic in Spokane, Washington. Currently patients are seen four days per week, Monday through Thursday, 8 a.m. to 5 p.m. Approximately 24 patients per day. This could expand into five days a week in the future. No call, weekends or holidays. Fabulous benefit package offered, including vacation and CME benefits. Starting salary depends on experience. Submit resume and cover letter to Kris Norton, Office Manager Inland Neurosurgery & Spine Associates, P.S. 105 W 8th Ave, Ste. 200 Spokane, WA 99204 or knorton@neuroandspine.com. SPECTRUM HEALTHCARE RESOURCES has an immediate opportunity for a civilian Family Practice Physician at Fairchild Air Force Base. This contract position offers: Full-time; Outpatient setting; Monday through Friday, 7:30am to 4:30pm; Manageable patient load (20-25 per day) and Shared on-call responsibilities (mostly telephone consulting). The position will have the following requirements: Current and unrestricted medical license; Successful completion of a family medicine residency; Board Certified by the ABFM or AOBFP; BLS, ACLS, PALS and Ability to work in a team setting. Contact Spectrum recruiter Lisa Paska for more information at Lisa_Paska@ spectrumhealth.com or (314) 744-4107.

PROVIDENCE MEDICAL GROUP (PMG) – Eastern Washington is recruiting for an excellent Family Medicine physician to join our care team in Spokane Valley, a scenic suburb of Spokane. Full-time opportunity with our growing medical group in what will be a large, state-of-the-art medical ambulatory center (construction completion target is spring 2014). No OB. Outpatient only. Competitive compensation and comprehensive benefits. PMG – Eastern Washington is our physician-led network of more than 450 primary and specialty care providers in multiple clinic locations in Spokane and Stevens County. PMG partners with some of the region’s most advanced hospitals: Providence Sacred Heart Medical Center & Children’s Hospital, Providence Holy Family Hospital, Providence Mount Carmel and Providence St. Joseph’s Hospital. Contact Mark Rearrick at mark.rearrick@providence.org or (509) 474-6605 for more information. BC/BE PEDIATRICIAN WANTED, SPOKANE The State of Washington Division of Disability Determination Services seeks a BC/BE pediatrician to perform contract service in our Spokane office. Contract services include the evaluation of physical impairment severity from medical records and other reports, utilizing Social Security regulations and rules of law. Medical consultants function as members of the adjudicative team and assist staff in determining eligibility for disability benefits. Reimbursement: $65/hour base; potential for $68/hour for high productivity. Interested physicians should contact Chief Medical Consultant Dr. Gene Profant at (360) 664-7454 or Spokane Office Manager David Bennett at (509) 329-2508. This position reviews interesting cases; teaching is thus an integral function. Hours are quite flexible. MID-LEVEL OPPORTUNITIES AT COMMUNITY HEALTH ASSOCIATION OF SPOKANE-Family Practice ARNP and Physician Assistant needed in Spokane, WA and Moscow, ID. 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 CONTINUED ON NEXT PAGE

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Classified Ads repayment and more. To learn more about employment opportunities, contact CHAS Human Resources at (509) 444-8888 or hr@ chas.org. Visit our website to learn more and to apply www.chas.org. We are looking for a COMPASSIONATE AND SKILLED FAMILY/INTERNAL MEDICINE PHYSICIAN/ FINAL YEAR RESIDENT For our growing clinic in the Olympic Peninsula. This setting provides a place and all the resources for setting up your own private practice in a complete turnkey manner with regulatory and administrative matters taken care of professionally. The organization is physician led and takes care of physicians very well. We would expect the new physician to start with some urgent care hours and slowly transition to a full time private practice primary care. Candidates signing up in during their residency are eligible for a $1000 per month stipend for the remainder of their residency. For further details, please call (509) 414-6390. PROVIDENCE MEDICAL GROUP (PMG) – Eastern Washington has immediate opportunities for BE/BC Family Physicians to join our expanding primary care team in Spokane, eastern Washington’s largest city. Newborns to geriatrics, no OB. Excellent compensation and benefits. PMG – Eastern Washington is our physician-led network of more than 450 primary and specialty care providers in multiple clinic locations in Spokane and Stevens County. PMG partners with some of the region’s most advanced hospitals: Providence Sacred Heart Medical Center & Children’s Hospital, Providence Holy Family Hospital, Providence Mount Carmel and Providence St. Joseph’s Hospital. Contact Mark Rearrick at mark. rearrick@providence.org or (509) 474-6605 for more information. NORTHWEST MEDICAL SPECIALTY EVALUATIONS SEEKS BOARD ELIGIBLE / BOARD CERTIFIED PHYSICIANS FOR SSI EXAMINATIONS. Flexible hours. No call or ongoing patient care responsibilities. This is an excellent way to supplement your clinical income. Call (509) 588-7340 for more information, or email kcave@nwmse.com

MANN-GRANDSTAFF VA MEDICAL CENTER in Spokane has immediate opportunities for Psychiatrists, Emergency Medicine Physicians, Internists, and Hospitalists and an immediate opening for a Director of the Emergency Department. Recruitment incentives and Education Debt Reduction Incentives may be available. Please contact Rodney Gile (509) 434-7590 (Rodney.gile@ va.gov) or Robyn Highbarger (509) 434-7393 (Robyn.Highbarger@va.gov) for specific information about positions. PHYSICIAN-BE/BC FAMILY MEDICINE - General Full Time, Spokane, WA Columbia Medical Associates (CMA) is a multispecialty medical group with more than 40 clinicians in 12 locations throughout the Spokane, Wash. region. The providers of CMA are dedicated to providing patient-centered, evidencebased medical care for the 70,000 patients the organization serves each year. CMA employs 200 health care professionals and accepts all types of insurance. CMA is a subsidiary of Group Health Cooperative and its physicians are employees of Group Health Physicians. Benefits include: Full malpractice indemnification, medical/ dental/vision benefits, 401(k), 4 weeks paid vacation, CME, long-term disability, long-term care benefits. Competitive salary offered. Spokane is located on the eastern side of the state. Its unique location provides year round activities including skiing, hiking, boating and kayaking. Small town charm, pleasant neighborhoods, affordable housing and a highly rated school system make Spokane a great place to live and an unparalleled place to raise a family. Columbia Medical Associates is an Equal Opportunity Employer committed to a diverse and inclusive workforce. Interested candidates may send a CV to Jessica Billings at billings.j@ghc.org. PHYSICIAN WANTED NATIVE PROJECT/ NATIVE HEALTH CLINIC – Consider joining a growing, innovative, community health clinic in Spokane, WA. NATIVE offers patient-centered care in a medical home that provides medical, dental, mental health, chemical dependency and preventative health services in a multi-disciplinary

SPOK ANE COUNT Y MEDICAL SOCIE T Y |

practice model and needs a Family or Internal Medicine physician. Physician benefits include competitive salary and excellent medical, dental and life insurance benefits, 401(k), paid licenses and CMEs, I.H.S. and NHSC loan repayment and signing bonus. At NATIVE’s beautiful facility, we serve people of all ethnicities, income levels, ages and medical or behavioral health needs. For more information contact Dylan Dressler, Clinic Manager, at (509) 483-7535 or our website at www.nativeproject.org for the complete job description. N.E. WASHINGTON HEALTH PROGRAMS LOON LAKE COMMUNITY HEALTH CENTER is seeking a family practice ARNP or PA-C. The ideal candidate will enjoy working with a medical team that is dedicated to the mission of NEWHP and have the ability to work autonomously. The Loon Lake clinic is nestled in the rural area of Loon Lake in N.E. Washington State. The area allows for the recreational enthusiast who enjoys, skiing, hiking, hunting, fishing, snowshoeing, horseback riding and any other outdoor event that you desire. Competitive salary and benefits. N.E. Washington Health Programs is also a NHSC/State student loan repayment eligible site. Please send resume to NEW Health Programs/Attn: HR DTR/PO Box 808/Chewelah, WA 99109 or email to: vickien@newhp.org. EOE & Provider

OTHER Medicinal Cannabis and Chronic Pain Provider Survey The State of Washington Attorney General’s office has granted researchers from the University of Washington an opportunity to develop and deliver a comprehensive CME program for health care providers regarding the scientific basis, clinical applications, and legal ramifications for using medicinal marijuana to treat chronic pain. To inform the development of the training and to collect information about current beliefs and practices around medical marijuana, the researchers are inviting healthcare providers in Washington state to complete a one-time 10- minute anonymous survey. Consider sharing your perspective. For more information and to respond to the survey, visit http://adai.uw.edu/mcacp/.

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PLASTIC SURGERY 41% NEUROLOGICAL SURGERY 39% URGENT CARE 38% NEUROLOGY 36% PATHOLOGY 33% CARDIOVASCULAR SURGERY 32% ORTHOPEDIC SURGERY 32% UROLOGICAL SURGERY 32% GENERAL SURGERY 31% RADIOLOGY 30% EMERGENCY MEDICINE 30% OBSTETRICS AND GYNECOLOGY 29% FAMILY PRACTICE 29% OPHTHALMOLOGY 28% INTERNAL MEDICINE 27% PULMONARY DISEASES 26% GENERAL PRACTICE 26% GYNECOLOGY 24% PEDIATRICS 24% GASTROENTEROLOGY 21% PSYCHIATRY 20% PHYSICAL MEDICINE & REHAB. 18%

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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. 307

ADDRESS SERVICE REQUESTED

Please Recycle

Spokane County Medical Society members and significant others are invited to enjoy a summer evening cruise aboard The Serendipity on the Spokane River This is a great opportunity to meet your colleagues.

Thursday, July 17 Cruise starting at Templin’s Marina Boat loading starting at 6:00 p.m. Embarking promptly at 6:30 p.m. Returning at 9:00 p.m. Heavy hors d’oeuvres * Wine and other refreshments Limited space available—RSVP to michelle@spcms.org

Thank you to our sponsor!

The Prewitt Group