The Message, December 2011

message THE

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

A Year of Progress and Change

By Brad Pope, MD

Three partners.

One focus: your health.

Introducing Rockwood Health System.

It’s the new name of the very healthy partnership

between Deaconess Hospital, Rockwood and Valley Hospital. For office visits, a trip to the E.R., surgery – or nearly anything you need – we’ve got you covered, with more than 40 locations throughout the Inland Northwest. Rockwood Health System: Working together for a healthier life.

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

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

2011—A Year of Progress and Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Spokane County Medical Society 2011 Priorities and Activities - an Update . . . . . . . . . . . . . 2 What Will SCMS Look Like in 2012? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Be Involved – Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Dental Clinics Collaborate with Spokane EDs to Help Low Income Patients . . . . . . . . . . . . . 4 The Evolution of Medical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 AMA Interim Meeting 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Project Access – Reflecting About This Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 In the News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Membership Recognition for December 2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 FYI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Continuing Medical Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Meetings, Conferences and Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 New Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

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

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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

2011—A Year of Progress and Change

Health weighed in on the issue and required professional boards to apply new rules for managing non-cancer chronic pain.

By Brad Pope, MD It’s been a fast-paced year and suddenly I find myself writing my final president’s column.

Back in January our members expressed how SCMS should devote its time and resources. You asked us to focus on increasing access to primary care and expanding our medical school. You wanted SCMS to play a role in improving hospital relations and strengthening legislative relationships. You agreed that SCMS plays a fundamental role in promoting professionalism.

Here’s a quick recap of our progress on those fronts:

Access to care and medical education With the economy stalled and unemployment still high, many Spokane families struggled to maintain their health coverage.

In January, SCMS sent a delegation to Washington, DC, and to Olympia, advocating for lawmakers to preserve funding for health programs that serve the uninsured. We also continued to operate Project Access, providing healthcare to low-income, uninsured Spokane County residents. Thanks to all of you who have volunteered your time to provide this safety net.

We also worked upstream to expand access to primary care by supporting a four-year medical school in Spokane. Many SCMS members championed the cause at the state legislature, which allocated $30 million toward the school. In October, Spokane successfully broke ground on the new building, jumpstarting our future.

Improving hospital relationships and professionalism Collegiality between providers has been a hot button issue this year. Over the past year, our community’s largest healthcare systems have consolidated with the plan of becoming integrated delivery systems. Their aim is to better manage costs and improve quality for populations of patients.

Many physicians and physician assistants have been swept up in their current and contemplated professional future. Will they continue to stay in private practice or will they join a larger health system? In which setting are they more likely to thrive professionally and give the best care?

SCMS’s approach to improving hospital relationships has been to bring diverse providers together on common ground issues.

Chronic Opioid Therapy (COT) is one initiative for which I am especially proud. The issue impacts our patients, our practices and society. Washington State has one of the highest rates of prescription narcotic overdose death in the country. For many doctors, prescribing opioid drugs to patients poses a dilemma— and yet patients with chronic, nonmalignant pain deserve to have their pain managed. This summer Washington’s Department of

SCMS convened the medical community to develop a communitywide approach to coordinating care for those patients. We asked primary care, emergency physicians, dentists and other professionals in a variety of disciplines to advise on the information that should be recorded in a shared medical record through MEDITECH. Providers from different healthcare systems collaborated to develop a better approach to this common problem.

We made great strides. Today Spokane providers in any setting can log in to MEDITECH to verify whether their patient is on COT and learn how to get the details of their patient’s pain management agreement. We’ve also outlined the information that should be included in a standard pain agreement, which is available to any clinic or provider as a resource. Visit SCMS’s website for the agreement and for instructions on using MEDITECH . Thank you to Dr. Gary Knox for chairing the committee, as well as Drs. Mary Noble, Lynda Williamson and David Bare for their leadership.

It’s rare when all providers can agree on a community approach to care, yet that’s precisely what we did. I am optimistic that SCMS will find more common ground and opportunities to promote collegiality and trust in each other.

A final note on legislation In partnership with the Washington State Medical Association, SCMS continues to monitor the nation’s Joint Select Committee on Deficit Reduction (Supercommittee), which is charged with finding $1.2 trillion in deficit reductions over a 10-year period.

Without Congressional action, Medicare rates will be cut nearly 30 percent on January 1, 2012.

Many doctors could find these rates to be unsustainable, jeopardizing access to care for Medicare patients. For that reason, we continue to lobby our legislators to work toward a permanent fix to the Sustainable Growth Rate (SGR) physician payment formula.

In closing, I want to thank our CEO Keith Baldwin and his staff who perform at an exceptional level of professionalism. To reduce our administrative overhead costs, they made some difficult adjustments this year with skill and competence. I have also been very impressed by the Board of Trustees and our members. It’s been a pleasure to serve all of you. The investment of my time and energy in the role of SCMS President has paid off handsomely as I have personally grown and gained new wisdom as a physician leader. I am grateful for having had the experience of working with so many fine professional leaders in this great community we have built for ourselves. I invite and encourage you to become involved in molding SCMS’s future in whatever way you can.

December SCMS The Message 1

Spokane County Medical Society 2011 Priorities and Activities - an Update

By Keith Baldwin SCMS CEO Judging from the activity on our SCMS calendar, the length of the Executive Committee (EC) and Board of Trustees (BOT) agendas and the fact that we did more, with less staff time, this year compared to last year, it was a busy and productive year for SCMS, Project Access and the Medical Library staff. The SCMS physician leadership spent extra time with additional task force and priority related meetings such as the GSI/WSU/UW Medical School Steering Committee and the Spokane Prescription Opioid Task Force. The SCMS and Project Access convened a number of other physician groups for discussions including Oncologists who discussed PET reimbursement and pre-authorization with DSHS/ Medicaid, the BOT talking about whether to consider membership for Advanced Registered Nurse Practitioners; and, the four hospital Emergency Department Medical Directors creating a dialogue with Medicaid about the three visit limit for Medicaid patients in the ED. The Informatics Committee was engaged in a number of IT topics involving meaningful use, Health Information Exchanges (HIE) and the Beacon Community of the Inland Northwest (BCIN) project. The CME Committee had discussions leading to fewer but expanded program activity for 2012. The Grievance Committee is still considering whether a process to accept third party “complaints” related to high volume or high dose physician prescribers of opioids is appropriate for SCMS action.

Staff continue to improve the quality of the newsletter through engaging physicians and physicians for contributions based on our annual editorial calendar. The staff also provide a collaborative credentialing process with the hospitals in town that makes it much for efficient for new physicians entering the community.

We worked hard to develop and provide new social events for physicians throughout the year to encourage collegiality.

The Priorities for 2011 focused on a number of issues • Increase access to Primary Care, • Expand to a four-year Medical School and increase Graduate Medical Education (GME) capacity in Spokane, • Create bridges on common issues to improve Hospital Relationships, • Strengthen Legislative Relationships for Advocacy, and • Enhance Professionalism through leadership in medicine.

Your physician leadership was active in all those areas. The SCMS advocated, with the Washington State Medical Association (WSMA), at the local, state and federal level, to maintain reimbursement for a number of programs that were slated for significant budget cuts e.g. the Medicaid Interpreter program.

That advocacy continued as budget shortfalls were significant at state and federal levels. A new Project Access Director improved operations and incorporated a rigorous program for finding medical homes for patients so they can maintain better health.

This is more efficient for the specialists, who volunteer their services, because they know that patients have been appropriately referred for care. Significant recognition for the physician volunteers and hospitals was being carried out in October and November of 2011 to support this worthwhile program for lowincome uninsured adults.

Countless hours have been spent by many physicians to advocate for and support the development of the four-year medical school in Spokane. A new health sciences building is being built to house the complete Pharmacy program, the WSU/UW Medical School and labs for research. Physicians who go to medical school and residency in the same community have a 70% chance of staying in that community to practice medicine. This will significantly improve the recruitment and retention of primary care physicians in our region.

We convened meetings and conversations with physicians and hospitals on a number of issues including Medicaid reimbursement in Oncology, Imaging and Emergency Department visits. The Spokane Prescription Opioid Task Force is another great example of many stakeholders coming together to foster open communication and an ongoing dialogue on community-wide issues. The convener role for SCMS has also involved the Empire Health Foundation, the Spokane Regional Health District, Inland Northwest Health Services (INHS), Medicor users and others, in productive conversations involving a variety of different interest groups. The goal is to keep avenues of communication open on issues of community-wide interest.

The SCMS is again this year asking physicians in Spokane County to support their Medical Society, so this work, and so much more, can continue and be enhanced in 2012.

What Will SCMS Look Like in 2012?

The Art and Science of Prognosticating: Likely Future Course of Something

By Keith Baldwin SCMS CEO I sometimes enjoy listening to the futurists. They always seem a little over confident, although they do show some good and elaborate trending, and in the end, they are helpful when it comes to looking into the future. It is very difficult to predict the future though it might be interesting to try to weave some themes together. First, let’s see what we do know.

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December SCMS The Message 2

Continued from page 2 What we do know about 2011 might lead us to some conclusions about 2012. What did we hear from our members? We were told, from a survey in May 2011, that the following would be “Priorities” for our members in 2012:

2012 PRIORITIES (in no specific order of importance) • Patient Access to Care (Physician Workforce/ Uncompensated Care) • Expand UW Curriculum to Four Years in Spokane • Physician Reimbursement/Payment Reform/SGR • Collegiality/Professionalism/Leadership Development • Physician – Hospital Relations/Medical staff Issues/

Physician Employment and Contracting ONGOING EMPHASIS • Informatics (EMR/EHR/HIE/Meaningful Use/ COE/ICD-10) • Pain Management/Opioid Use/Abuse • Demonstration Projects Regarding Medical Liability Reform

It is a pretty comprehensive list of issues that needs attention in some fashion (see The Message article entitled “Spokane County Medical Society 2011 Priorities and Activities – an Update”).

Some of the issues are recurring, e.g. Medical Liability Reform.

On the other hand, physician payment reform is an issue that hasn’t peaked yet and is a reflection of the Patient Protection and Affordable Care Act (PPACA) and its implementation leading up to significant changes in 2014 if the Accountable Care Organization (ACO) activity and the individual mandate come to fruition.

We also heard from non-member physicians (298 were sent out and 43 responded) in another survey, asking why they chose not to join membership organizations. The majority listed the cost of membership, financial issues in their medical practice and the perceived value of membership not always being equal to the dues request. Other reasons listed included disagreeing

with a position statement and preferring to pay dues at only one membership organization. The cost to address membership organization issues, at least for some physicians, outweighed the importance of having an organization advocate for them and organized programs for their use.

If you separate out all the issues that SCMS members can’t control or maybe even influence, such as: • A Supreme Court decision on the PPACA Individual Mandate, • Reductions in reimbursement from Medicare and Medicaid, that also came with new regulatory requirements, • The results of the US Debt Reduction Super Committee • A Washington State budget shortfall to be addressed by a 2011 special session that will primarily have to address higher education and healthcare program reductions, and • Many new ACA, Preferred Provider Medical Health Model (PPMHM) and ACO demonstration and pilot projects, that even CMS must be wondering what is going on.

Then consider the following that you could have affected: • Meeting meaningful use criteria on your Electronic Medical Record (EMR) that should have already earned you extra reimbursement, • Qualifying for eRx or at least filing for an exemption as an alternative, • Started planning for the ICD-10 conversion, • Attending a faculty development session so you can help teach the expanded class of new medical students at the WSU Spokane WWAMI program, • Determining the best governance or ownership model for your group or yourself individually, and deciding whether to stay independent and maybe contract with an ACO, affiliate with a system of care or become part of an employed arrangement.

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Continued from page 3 Now, if we take all that into account, it might be hard for anyone to know where to start predicting what will happen in 2012. An alternative for SCMS might be to engage in a Strategic Planning process to help understand the needs of the membership, how and what resources we can deploy to impact those needs, and determine if the Medical Society is the place to do that. A Strategic Planning process, with your input and participation, could be a much more reliable and constructive process than prognosticating. I hope you will consider having a part in determining the SCMS future. It seems a worthy effort. Please watch for additional information on the Strategic Planning process at the SCMS.

Be Involved – Lead

By Clay Elrod, DO In my previous career in nuclear power we had strict procedures to dictate all that we did. The government oversight and regulations were never-ending. We were constantly under the threat of being unfunded. Having your career in the hands of someone who may or may not understand what they are regulating but only responding to the political pressures of their constituents is unnerving.

I vowed to take control of my career and to act instead of being acted upon. I learned that you can lead or you can follow. If you want a say in the direction of your profession, then you need to be involved…you need to lead. After nine additional years of preparation for medical school, Transition Year and part of my residency, I find myself in a similar situation…no control over the direction of my profession.

As an Ex Officio on the Spokane County Medical Society Board of Trustees, I have been able to witness and participate in the direction of our profession locally. I have been able to lead, not follow. I have been able to act instead of just being acted upon.

I may not always agree with the direction, but I know my concerns are heard, addressed and debated, making the course of action more palatable.

Physicians are, by definition, proactive people. If you want your voice heard, then get involved. I encourage you to take ownership of your profession and join your local, state or national organization. Have your voice heard and guide our profession through these new and tumultuous times.

Thank you for the opportunity to serve.

Dental Clinics Collaborate with Spokane EDs to Help Low Income Patients

By Darin Neven, MD Spokane Emergency Physicians Low-income patients who present to Spokane Emergency Departments (ED) in need of acute dental care will now find it easier to see a dentist. Collaboration among the four Spokane EDs and the dental clinics at Community Health Association of Spokane (CHAS) Clinics and the Riverstone Clinic has created a protocol for referring ED patients with acute dental pain to receive prompt dental care. The protocol, available on the Spokane County Medical Society website, outlines a procedure for referring patients from the ED to those dental clinics. The protocol clarifies that acute dental evaluation and treatment which often includes radiographs and extraction or filling are still covered by Washington Medicaid for acute dental pain.

The minimum fee required upfront for each clinic is listed in the protocol as well as an estimate for a dental extraction at each clinic so patients paying out of pocket can anticipate the cost.

CHAS and Riverstone dental clinics have agreed to see patients referred from the ED usually within 48 hours. The protocol encourages the use of non-narcotic pain medicine and no more than 48 hours of prescription opioid pain medicine if clinically indicated. The Spokane Prescription Opioid Task Force has also been addressing the dental care issue.

A process to track patients who do not show up for dental appointments and communicate that information back to the ED was created as result of the collaboration. When a patient does not show for a dental appointment, that information is entered into the patient’s MEDITECH Patient Care Inquiry (PCI) record. The ED physician can look in MEDITECH PCI and see on the bulletin section, located on the right side of the screen when the patient’s record is opened, that the patient did not attend the scheduled dental appointment. That information can help identify patients who are not genuinely interested in dental care and may be presenting to the ED with an agenda to receive prescription opioids while also providing the opportunity for the ED provider to stress dental follow-up care. Because the ED cannot provide definitive care for any dental condition it is important that low-income patients obtain the appropriate dental follow-up care. This protocol is the first of many expected to be produced from a collaboration among the medical directors of the four Spokane emergency departments that was created to find creative solutions to referring low-income patients for care from the ED. More low-income patients are seeking primary care from Spokane emergency departments.

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Continued from page 4 Without appropriate follow-up care those patients were observed to return to the ED in worse condition. Special thanks go out to the CHAS Dental Clinics and the Riverstone Dental Clinic for working with the EDs to treat patients in need. More creative solutions similar to the collaboration are needed to deal with anticipated budget cuts to Medicaid and the economic downturn.

This work was supported by the Empire Health Foundation.

Therefore, in addition to the 30-35 hours of sitting through lecture per week that students face, they need to read an additional 35 hours to get through the assigned readings once.

This subject matter is not easy stuff. It has to be chewed upon, digested and incorporated into a workable knowledge base.

Those 70 hours per week are not close to what they need to do to try to comprehend the subject matter.

Delivery of this heavy dose of basic science is further hampered by having minimal clinical experience in the early years. We can't sustain our present two and two approach -- the first two years being preclinical and heavy into the basic sciences while the last two years devoted to clinical training.

The Evolution of Medical Education

By George Novan, MD Associate Director, WWAMI Spokane Evolution might not be the right word. Maybe the word should be revolution. It's coming, but I can't for sure tell you exactly when or what. The way we teach will change. It has to. We can't sustain the current system analogized as learning by drinking from a fire hose.

In the September 2011 issue of Academic Medicine, Klatt and Klatt co-authored an article entitled "How Much is Too Much Reading for Medical Students? Assigned Reading and Reading Rates at One Medical School." The study occurred at Mercer University School of Medicine in Savannah, GA. The authors calculated the total amount of reading assigned during 71 weeks in 12 modules of the preclinical basic science curriculum.

Faculty assigned 29,239 pages of reading across the modules.

That comes out to 411 pages of reading per week. Averaging approximately 12 pages of reading per hour, it would take a student 35 hours to do the weekly reading just once. Whether comprehension would occur is difficult to say.

Medical schools nationwide have revised or are in the process of revising their curricula. The University of Washington School of Medicine is no exception. It has started on the process. We await the new curricular model that will emerge with optimism.

As physicist Neils Bohr said: "Prediction is very difficult, especially about the future." Realizing that, I'm willing to take that risk. This is what I see might be some of the changes to come our way.

Classic lecture hours will plummet. Hours spent in active learning in small tutorial groups will increase. After ingraining general basic principles, teachers will choose more clinically relevant and focused reading assignments. They will pick prototypical, clinically relevant examples to begin the layered accumulation of more in depth knowledge with each subsequent exposure to the subject. Clinical work will begin in the early years and basic science will be reinforced in the later years. Interprofessional education and training will increase so that it is part of training in school rather than being experienced for the first time in the workplace.

The next phase of medical education for us is going to be interesting and exciting.

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December SCMS The Message 6

AMA Interim Meeting 2011

By Rodney L. Trytko, MD, MBA Washington Delegate The AMA House of Delegates met in mid-November. The meeting comes at a time when great change is occurring in health care. Despite the acuteness and importance of many the issues, this meeting highlighted the ability of a diverse group of physicians from all over the country and from every specialty to collaborate and develop effective policy. It was a very productive and positive meeting.

At the opening session, AMA leadership announced its clear intention to improve the AMA Value Equation to physicians. The components of this equation are: 1. Voice of physician organizations 2. Forum for direct personal engagement 3. Provide expertise for managing practices and valuable resources 4. Source of research, education, career support and

practice enhancement 5. Authoritative advocate for physicians to Washington DC,

the courts and the public No other physician organization has the strength or national scope to effectively advocate for all physicians. Current events clearly demonstrate the need for a strong and active AMA. At the meeting, hundreds of resolutions and reports were carefully considered and discussed. The following were certainly among the most important:

AMA structure and membership The AMA is looking to dramatically change its membership model in order to significantly increase its membership. The status quo is not sustainable. An Alternative Membership Project is currently seeking options for improving the alignment of member benefits, implementing a more focused set of activities across the organization, and creating a mutually beneficial and transparent partnership with states and specialty societies. Dr Komorow from Washington State is on the committee. The committee’s report is due at the 2012 annual meeting.

In addition, a new emphasis on employed physicians is being developed. The AMA will seek to become the lead association for employed physicians by establishing an employed physicians division. This division will provide services such as contract review, employee-employer relation services and mediation.

The AMA will also establish an employed physicians section and ensure that such physicians are adequately represented on the Board of Trustees.

Health care reform Health care reform is certainly the primary issue facing organized medicine today.

Physician payments are under attack from all sides and threatening our ability to care for patients. The AMA is seeking the following: 1. A full repeal of the flawed sustainable growth rate

formula (SGR) 2. Medical liability reform 3. Five years of stability adjusted for inflation in order

to develop a new delivery system, including appropriate

physician payment reforms 4. Medicare private contracting Medicare private contracting has been a long-standing policy of the AMA. Promoting the Patient Empowerment Act (H.R 1700) is explicitly part of the AMA Strategic Plan and will continue to receive the full support from our advocacy team and grassroots network.

Finally, the AMA will support the open marketplace model for state health care exchanges in order to increase competition and maximize patient choice, and the involvement of state medical associations in the legislative and regulatory processes concerning state health insurance exchanges.

Physician led, team based care While the AMA recognizes that non-physician providers are a valuable component of the physician-led health care team, we will continue to advocate that physicians are the best qualified by their education and training to lead the health care team. Certain invasive procedures should only be performed by physicians. The AMA will also oppose calls by the Institute of Medicine and other organizations to expand the scope and remove barriers of nonphysician providers, especially in the area of primary care.

Physician autonomy The AMA will continue to support the unfettered right of physicians to exercise their personal and professional judgment in voting, speaking and advocating on any matter regarding patient care, the profession, health care and the medical staff.

The exercise of independent medical judgment should be incorporated into all physician employment and independent contractor agreements, and medical staff bylaws.

The AMA will also oppose current proposed Medicare hospital conditions of participation rules that would eliminate the medical staff’s oversight role of peer review and credentialing.

Other issues Patient navigators are increasing in prevalence because many patients need assistance in managing an increasingly complex health care system. The AMA believes that navigators should foster patient empowerment, ensure direct communication with Continued on page 9

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One of the Top in the Nation.

Right Down the Street.

It might sound simplistic but it’s true.

By focusing on quality care for patients and doing what’s right, we have received national recognition. The Joint Commission recognizes Valley Hospital for achieving excellence in performance on its accountability measures during 2010 for Pneumonia and Surgical Care.

Out of 3,099 hospitals submitting accountability measure data to The Joint Commission, Valley Hospital was the only in Spokane and one of only five in Washington to meet or exceed the target rates of performance for 2010.

So what does our being a top performer in using evidencebased care mean for you? Peace of mind in knowing that our local care is tops in the nation.

Top Performer on The Joint Commission Key Quality Measures 2010

Find out more at our website: SpokaneValleyHospital.com.

Pneumonia Surgical Care

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• Collaborating with community clinics to improve efficiency of the application and referral process and

the patient’s medical team, refrain from clinical activities, fully disclose their training and conflicts of interest, and be free of bias.

Drug shortages have become an increasingly problematic issue.

The AMA will support the recommendations of the 2010 Drug Shortage Summit, support drug shortage legislation (e.g.

H.R. 2245 and S. 296), and call on the FDA to require drug manufacturers to establish plans for continuity of supply of vital medications and vaccines.

maximize the number of patients we serve • Working with the Spokane ED Medical Directors and Empire Health Foundation to increase capacity for referrals to other providers so patients are treated in the most appropriate setting to maximize quality of care and minimize cost.

• Working with other Project Access organizations in Washington State to quantify the savings of referrals to Project Access from the EDs

Project Access – Reflecting About This Year

• Convening medical community leaders to explore gain sharing compensation program options with Medicaid and other payers • Quantifying the community costs of patients who

By Lee Taylor Director, Project Access Spokane

are treated through the Project Access program and identifying the savings compared with the costs of

This was a year of transition and preparation . . . transition in leadership and staffing . . . preparation for demonstrating community value, which we will need to do in order to ensure ongoing revenue.

The Project Access team is mostly new. The new team members support our staff nurse and program manager, Cathy Kirsner, and our volunteer medical director, Dr. Val Logsdon. They have been with Project Access for several years. The Therapeutics committee, the volunteer physicians who help us establish referral protocols, remains consistent and strong. The medical screening of clients referred by the community clinics to our network of specialty providers is one of the most valuable roles of Project Access. Our medical team is the reason our donors of specialty medical services can be confident that the Project Access patients show up at the scheduled time, following correct protocols, with the appropriate tests completed, making the visit with the specialist as efficient as possible.

The current team members bring a new level of expertise and skills to Project Access. Margie Locher is our patient coordinator who sets appointments and counsels the clients. Margie is the reason we have a no-show rate of only 5%. She is also the reason that patients show up with an attitude of appreciation.

Sarah Bates is our operations specialist. She helps us work more efficiently and measures the outcomes of our work. She is also our communication specialist, improving the way we communicate with providers and clinics and thanks our providers throughout the year.

And then there is the preparation. We have been creating valuable partnerships in the medical community and working to quantify the value of the work we do. Here is a short list of this work underway:

treatment in the EDs due to treatment delay or avoidance We are confident that those partnerships and the resulting collaborative work will lead to expanded roles for Project Access.

Our organization has completed an important transition and is well positioned for valuable roles in improving access to medical care for residents of Spokane County.

We truly appreciate the support from the medical community and the huge donation of medical services from hundreds of providers and organizations. We also appreciate the support from our community-at-large. Project Access continues to receive significant funding from the cities in Spokane County because they understand the value of the investment in our service.

We are honored to provide these important services to our community. If you would like to learn more about Project Access please call me at (509) 220-2651 or email me at lee@spcms.org.

In the News Congratulations to Internal Medicine Residency Spokane Residents Three residents were selected for presentations at the Washington Chapter American College of Physicians Scientific Annual Meeting in November. Drs. Eric Allen, Aparna Padmaraju and Dinesh Ratti gave outstanding presentations and skillfully fielded questions from the audience. They also participated in a rousing game of Medical Jeopardy, competing with the other three internal medicine residencies in the state. Dr. Padmaraju will be representing Spokane in the resident medical jeopardy competition at the National ACP meeting in New Orleans in April.

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

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Your treatment. Custom designed.

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

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Continued from page 9

Kevin Sweeny, MD Joins Providence Health Care Kevin Sweeny, MD has joined Providence Health Care as the Chief Medical Officer – Physician Services. In his new role at Providence, Dr. Sweeny will work closely with the Providence Medical Group – a group of more than 170 physicians and mid-level providers. In addition, he will have responsibility for overseeing PHC’s relationships with physicians and hospitals throughout the region, as well as the development of specific clinical programs at Sacred Heart Medical Center and Holy Family Hospital. Dr. Sweeny also will head up recruiting new physicians to Providence and the Spokane community.

Dr. Sweeny graduated from Gonzaga University with a Bachelor of Arts degree in 1978. He received his medical degree from the University of Washington and completed residency training at the University of California, Davis, at Scenic General Hospital in Modesto, California. He is Board Certified in Family Practice and is a Certified Physician Executive of the American College of Physician Executives.

“The greatest and most important benefit is providing patients the assurance that their breast biopsy results are accurate,” explains Dr. Hoak. “Patients can feel confident that the clinician’s treatment decisions will also be accurate and effective.”

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

20 Years James T. Doyle, MD Diane L. Rubin, MD Glen R. Stream, MD

12/11/1991 12/11/1991 12/11/1991

10 Years Svetlana F. Cox, MD Florence M. Gin, MD Jeanne M. Hassing, MD Jennifer A. Troiano, MD

12/12/2001 12/12/2001 12/12/2001 12/12/2001

David Hoak, MD Receives College of American Pathologists Certificate of Recognition InCyte Pathology’s Laboratory Medical Director, David C. Hoak, M.D., recently received the College of American Pathologists (CAP) Breast Predictive Factors Testing Advanced Practical Pathology Program Certificate of Recognition. Designed for pathologists with intermediate or higher skill level in breast predictive factors testing, this selective training program covers the accurate performance and interpretation of breast cancer predictive factors in accordance with the guidelines of the American Society of Clinical Oncology and the College of American Pathologists (ASCO/CAP).

The College of American Pathologists is the leading organization of board-certified pathologists, serving patients, pathologists and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine. CAP advanced training programs focus on providing pathologists with practical skills, tools and techniques for implementation in their laboratories to ensure more effective results for patients, as well as compliance with current laboratory guidelines. A majority of Dr. Hoak’s training was on the performance and interpretation of prognostic and predictive factors such as estrogen receptor (ER), progesterone receptor (PgR), and Human Epidermal growth factor Receptor 2 (HER2) in breast cancer diagnostic pathology.

These factors determine the clinical course of disease for the patient and their suitability for specific treatments. Given the critically important implications that these factors have in terms of subsequent selection of therapy and ultimately the clinical outcomes for a patient, ensuring testing accuracy is a high priority for InCyte Pathology.

In Memoriam NORMAN L. RUBENS, MD After a heroic fight with cancer Norman L. Rubens passed away on September 29, 2011. He was raised in the pacific northwest, attended the University of Oregon, served in WWII, and subsequently graduated from the University of Oregon Medical School in 1952. After he completed a medical surgical residency in San Francisco, he practiced medicine in the Hillyard area of Spokane, WA. Loved by patients and his peers he generously gave his time to the medical community, including service for the Board of Directors of Medical Service Corporation for many years, the Board of Directors of the Spokane County Medical Society, and as President of the Holy Family Hospital Medical Staff.

Norman loved adventure and new experiences, including water sports, snow skiing, archery and jogging. He was a man with an enormous heart and positive view of life who cherished time with family and friends.

He is survived by his beloved wife of 60 years Shirley (Tucson); his children, Craig and wife Gloria Rubens (Seattle), Debra Rubens (Spokane), Dave and wife Debbie Rubens (Spokane), and Larry and wife Michelle Rubens (Knoxville) and six grandchildren. He was preceded in death by a grandchild, Michael Rubens (Knoxville).

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FYI

In Memoriam

Rockwood Health System Links IDS Partners - Deaconess

ROBERT S. JOHSNON, MD

Hospital, Rockwood Clinic and Valley Hospital Two years ago Deaconess Medical Center, Valley Hospital and Medical Center, and Rockwood Clinic joined forces to transform healthcare in the community with the development of an Integrated Healthcare Delivery System (IDS).

The IDS will be known as the Rockwood Health System. Each facility will continue to use its own name first, while adding the Rockwood Health System name to signage, advertising and other communications.

Group Health Cooperative Wins Top Medicare Rating for Quality and Service Group Health Cooperative’s Medicare Advantage HMO plans received five stars for 2012, the highest rating from the Centers for Medicare & Medicaid Services (CMS). The plan earned the prestigious five 5-star ratings for both medical and prescription drug coverage. Through the Medicare Star Quality Rating System, CMS assigns scores of one to five stars to Medicare plans based on 53 quality measures across five categories that include staying healthy, managing chronic conditions, member satisfaction, customer service and pharmacy services.

Robert Seedoff Johnson, MD "Bob" passed away October 23, 2011 in Spokane after a brief battle with kidney cancer and a very full life. Bob, a full-blooded Swede and the only child of Carl O. Johnson and Thorborg E. Seedoff, was born January 9, 1923 in Rockford, IL where he spent his childhood. He was a Lutheran graduate of the University of Notre Dame. He attended Northwestern School of Medicine, in Chicago, IL under the U.S. Army's GI Bill. He completed his medical internship at St. Luke's Hospital in Chicago. Bob married the love of his life, Marjorie Louise Ferm, in 1947. He served as a captain general medical officer in post WWII Japan. Upon his return to the U.S., he finished his Internal Medicine residency at the VA Hospital in Minneapolis.

Bob was one of the first Internal Medicine specialists in Spokane and a pioneer in the early days of Rheumatology.

He started medical practice in 1952 at the Spokane VA Hospital and then joined Associated Internists. He retired in 1989 after 37 years of service to this community. He was a founder and past president of the Spokane Society of Internal Medicine and president of the Northwest Rheumatism Society.

Bob is survived by his wife of 64 years, Marjorie; children Dr. Stephen G. Johnson (wife Jean, sons Gregory, Timothy, and Eric); Dr. Mark A. Johnson (wife Dr. Janine, sons Karl, Peter, and Nicolas); Mary J. Perry (children Sarah Etter and Matthew), and Paul E. Johnson (wife Linda, daughter Lisa Neel); and two great grandchildren Noah Johnson and Hazel Etter. Preceding him in death was his son-in-law, Dr. James Perry.

He will be fondly remembered by all the people whose lives he touched.

Visit our updated website • View "The Message" Online

• Legislative updates

-Full current and past issues available

-Connect with SCMS on Facebook and stay informed

• Membership information -Information about credentialing, committees, bylaws, etc.

• Connect to Medicor -The online medical library is a SCMS membership benefit.

• CME information -Topic and dates for upcoming CME courses

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Cancer evolves at a rapid speed.

So do our physicians.

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

Meet the physicians of Cancer Care Northwest.

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

»

cancercarenorthwest.com

» 509.228.1000 December SCMS The Message 15

comprehensive innovative compassionate integrated

Continuing Medical Education STD Update - The Spokane Regional Health District and the Seattle STD/HIV Prevention Training Center sponsored two-day STD Update course January 19 and 20 at St. Luke’s Rehabilitation Institute in Spokane. This course provides participants with training in the most recent advancements in the epidemiology, diagnosis and management of viral and bacterial STDs, and was designed for clinicians in the Spokane area who diagnose and treat patients with sexually transmitted infections. CMEs and CNEs are available.

Presentations will be conducted by several notable figures including Dr. Jeanne Marrazzo, current Medical Director of the Seattle STD/ Sexually Transmitted Diseases/HIV Prevention and Training Center, and Dr. Devika Singh, Internal Medicine Physician of Seattle, Washington. The cost to register is $100. Seating is limited and pre-enrollment is required by January 10. CME: The University of Washington School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The University of Washington School of Medicine designates this educational activity for a maximum of 13.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Please visit www.seattlestdhivptc.org for online registration and payment information. Any additional questions can be directed to Alexandra Hayes, Health Program Specialist at the Spokane Regional Health District at 509-324-1635 or ahayes@spokanecounty.org.

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.

WSMA & UW Physician Leadership Course - In partnership with the University of Washington Graduate Programs in Health Administration, and UW Professional and Continuing Education, the WSMA is offering a 40+ hour interactive hybrid distance learning course that will focus on leadership and conflict management, strategic planning and management, safety and quality management, finance, and communication and advocacy. This combination of face-to-face and online learning will enable physicians to begin developing and honing their leadership skills in a convenient manner without needing to take significant time away from their practice or personal lives. This course is made possible through a grant from the Physicians Foundation. The course will be led by Dr. Ed Walker. The course will be held March 30-June 8, 2012. The application deadline is January 1, 2012. During the spring 2012 course, the in-person classes will be held March 30 and March 31 at the Riverpoint Campus in Spokane, WA. Course participants will then have eight weeks of online instruction and interaction, finishing with a third in-person session and closing ceremony on June 8 at the Riverpoint Campus in Spokane. The course is limited to 30 physicians. The tuition for the course is $2000 for WSMA members and $2550 for non-members.

The WSMA designates this live activity for a maximum of 24 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The WSMA designates this online enduring material for a maximum of 16 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This enduring material activity, WSMA/UW Physician Leadership Course Online, has been reviewed and is acceptable for up to 16 Prescribed credits by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of participation in the activity. To apply for participation in the Spring 2012 course, please send your letter of interest, CV and a letter of recommendation to Jennifer Hanscom at jen@wsma.org.

Seattle WSMA address is 2033 6th Ave, Suite 1100, Seattle, WA 98121.

If you have any questions about the WSMA/UW Physician Leadership Course, please contact Jennifer Hanscom at the WSMA Seattle office (206) 441-9762 or 1 (800) 552-0612 (jen@wsma.org).

Strategies for Managing Chronic Pain in Primary Care - CPIN WEBINAR: Tuesday, December 6, 2011 – 12:15 to 1:15 p.m. Managing chronic pain in ambulatory care settings is extremely challenging. In addition to the concerns about safety, abuse and addiction risk, and effectiveness in long-term chronic pain treatments, new legislative requirements, evolving guidelines, and co-morbid patient conditions makes this subject a difficult challenge for many primary and specialty care providers. This webinar will give physicians practical advice on how to meet these many challenges. This webinar is intended as a clinical overview of the topic and is not designed to meet the specific CME training requirements for Washington HB 2876 compliance.

Presenter David Tauben, MD, a University of Washington clinical associate professor and director of medical student education in pain medicine, in a joint appointment with the Department of Anesthesia and Pain Medicine and the Department of Medicine. At the completion of the webinar, participants will be able to identify major causes of chronic pain for patients treated in primary care settings, identify treatment options available and the key criteria for selecting the most appropriate treatment choice and identify criteria for evaluating treatment success and for changing treatments, dosage and duration appropriately. CPIN is a collaborative effort of the WSMA Foundation for Health Care Improvement, the Puget Sound Health Alliance, and the Washington Academy of Family Physicians.

All sessions are free for medical groups, physicians and all other care providers. There is a fee of $75 for all others. This activity has been approved for AMA PRA Category 1 Credit™ and also AAFP Preferred CME credit. Register online at www.wsma.org/CPIN OR send the following information in an e-mail titled CPIN Dec 6 to kho@wsma.org: Name; Phone; Clinic/Group; and Number of Participants

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Meetings, Conferences and Events

E-prescribing Narcotics Webinar – Stay on top of the rules

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

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

and regulations of e prescribing and the future opportunities for eRx of narcotics. There will be implementation in 2012 of this topic, especially since Washington State has already adopted the DEA rules on the subject that were created in 2010, but there are many steps for providers, hospitals and pharmacies to make that happen.

February 21, 2012 Noon – 1 p.m. SCMS Conference Room. Limited registration. Call (509) 325-5010 for more information.

Questions about registration: call Kesley Howard at (206)956-3020 or kho@wsma.org Questions about content or CPIN: call Lance Heineccius at (206) 9563657 or Lance@wsma.org

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

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

$

3

OFF

CODE: DOCTOR Now you c an have premium pizza crusts delivered straight to your door! www.rizzutospizzanight.com December SCMS The Message 18

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

PHYSICIANS

We’ll come to you because we care.

Knorr, Roberta L., MD Pediatrics Med School: Universidad de Montemorelos, Mexico (1983) Internship: Loma Linda U (1984) Residency: White Memorial Medical Center (1986) Fellowship: Loma Linda U Medical Center (1988) Practicing with CHAS beginning 1/2012 Louie, Helen, MD Obstetrics and Gynecology Med School: Medical College of Pennsylvania (1994) Internship/Residency: UMDNJ, Robert Wood Johnson U (1998) Practicing with Deaconess Perinatal Services beginning 2/2012 O’Halloran, Elizabeth K., MD Family Medicine Med School: Duke U (2003) Internship/Residency: Duke U Medical Center (2005) Residency: Oregon Health and Science U (2007) Practicing with Providence Medical Group – Hawthorne beginning 12/2011

“For over 40 years we’ve provided the best home healthcare to the Inland

Walkes, Jon-Cecil M., MD Surgery/Thoracic Surgery Med School: U of California, Los Angeles (1996) Internship/Residency: Baylor College of Medicine (2007) Fellowship: Baylor College of Medicine (2003) Practicing with Deaconess Hospital beginning 3/2012

Northwest, and today we're ranked as one of Medicare's elite agencies

PHYSICIANS PRESENTED A SECOND TIME Dinglasan, Catherine J.C., MD Family Medicine Med School: U of East Ramon Magsaysay Medical Center, Philippines (2000) OB Fellowship with Family Medicine Spokane beginning 1/2012 Reyta, Virginia D, MD Pediatric Medicine Med School: Far Eastern University (Philippines) (1993) Practicing with Rockwood Clinic beginning 1/2012

in the country. No wonder over 95% of our clients would recommend us. Call me personally to see why we're the right choice for you and your clients."

– Mike Nowling President Family Home Care &

PHYSICIAN ASSISTANT

Hospice

Gutshe, Christian J., PA-C School: U of Washington, Medex NW (2011) Practicing with Radia Inc., PS beginning 12/2011

PHYSICIAN ASSISTANT PRESENTED A SECOND TIME Sassone, Justin W., PA-C School: Eastern Virginia School of Medicine (2011) Practicing with Rockwood Clinic since 10/2011

Call Today 509.473.4900 www.familyhomecare.org December SCMS The Message 19

POSITIONS AVAILABLE HOSPITALIST: FIND YOUR PASSION HERE - Isn’t it Time for Something Better? Group Health Permanente, the Northwest’s premier multi-specialty group, is currently seeking a BC/BE Hospitalist to join our Spokane team. Group Health is dedicated to providing innovative and patient-centered care to communities throughout Washington. Physicians will round on and care for Group Health patients in the hospital setting for a 100% Hospitalist opportunity. Affordable housing, highly rated schools and year round activities, Spokane is an unparalleled place to raise a family. A flexible schedule, generous benefits and competitive salaries make this an opportunity worth exploring. For additional information or to submit your CV, please contact Nancy Longcoy at longcoy.n@ghc. org or Office: 206-448-6132; Cell: 206-612-7731 PROVIDENCE PHYSICIAN SERVICES is recruiting for BE/BC Pediatricians to join us in Spokane, the urban center of spectacular eastern Washington. Excellent opportunity to join a collegial, physician-led medical group affiliated with the region’s most comprehensive and caring hospitals. Providence offers generous hiring incentives, competitive compensation, comprehensive benefits and flexible work arrangements to fit individual needs.

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

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.

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 1-800-260-1515 x5366 or email gmelkus@ qtcm.com or visit our website www.qtcm.com to learn more about our company.

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.

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! 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.

PROVIDENCE SACRED HEART CHILDREN’S HOSPITAL (Spokane, WA) is seeking a BE/BC Pediatric Hospitalist to join our inpatient team. Be part of an exceptional care-team serving children from four inland Northwest states. Work closely with the Pediatric Trauma Center, general pediatric unit, PICU, NICU (level III), and Pediatric Surgery known for exemplary care. Strong cross-specialty support, state-of-the-art equipment and technology, and wonderful quality of life in sunny eastern Washington. Competitive compensation and excellent benefits package, including relocation. Sacred Heart Medical Center and Children’s Hospital has 623 beds, a medical staff of more than 900 and a service area population of about 1.5 million. The children’s hospital alone includes more than 90 pediatric sub-specialists. Learn more: Mark Rearrick, Providence physician recruiter, (509) 474-6605, mark.rearric@providence.org, www. providence.org/physicianopportunities.

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

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REAL ESTATE

MEDICAL OFFICES/BUILDINGS

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

Good location and spacious suite available next to Valley Hospital on Vercler. 2,429 sq ft in building and less than 10 years old.

Includes parking and maintenance of building. Please call Carolyn at Spokane Cardiology (509) 455-8820.

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

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

Starting lease length 5 years which includes an $8 sq/ft tenant improvement allowance. Available space: *Suite 210 - 2286 sq/ft *Suite 209 - 1650 sq/ft *Suite 205 - 1560 sq/ft *Suite 302 - 2190 sq/ft Sublease: Furnished Medical Office Space ~ Need immediate space for one or more north Spokane care providers? This shared suite is ready for occupancy; all furniture and exam room equipment included. Two exam rooms, one provider office, one nurse’s station and shared surgery suite, medical records storage area, reception and waiting area. 963 sq ft total, original lease $23/sq ft; will negotiate lower rate. Excellent location in a full-service medical building with lab and full radiology services. For more information, call (509) 981-9298.

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.

Continued on page 23

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Continued from page 22 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 ediatricians, 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.

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.

Give your family the ultimate Christmas present that will last a lifetime: Beautiful Lake Coeur d'Alene home with beach on quiet bay with scenic views year round.

•

3 Bedrooms, Sleeping Loft, 2 1/2 Bath, Modern Kitchen with a View

• Large double garage, maintenance free wrap-around

•

deck, large storage area for beach supplies, large dock Year round access

• Located on southwest side of the lake (Covehaven area) • Easy access to Spokane and Coeur d'Alene

Call 509 432 1158

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PRSRT STD

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

U.S. Postage

PAID

Spokane, WA Permit No. 512

ADDRESS SERVICE REQUESTED

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

NO BO

W!

OK

Value $295

Get two $25 dining credits, plus two $50 Extra Play Cash credits, a one-night stay in either of our hotel wings, plus an additional $20.12 in EPC per person.

Available December 2011 – March 2012, 7 days a week, excluding holidays and event nights.

Not valid with other offers. Max two stay-n-play packages per month per guest.

Both guests must be 18 yrs or older and a Rewards members to receive EPC. Limited availability. Based on deluxe room double occupancy.

1 800 523-2464 | CDACASINO.COM |

/CDACASINORESORT

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