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PLUS: SFMMS LEADERSHIP ELECTION INFORMATION VOL.90 NO.8 October 2017
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IN THIS ISSUE
SAN FRANCISCO MARIN MEDICINE October 2017 Volume 90, Number 8
Health Care Advocacy FEATURE ARTICLES 10 Lessons Learned: Successful Medical Students & Resident Campaigns Beth Griffiths, MD
12 Health Care Advocacy: Becoming an Active Participant Q&A with Andrew Bindman, MD 14 Advocacy: More Opportunities Than You May Think Pratima Gupta, MD
MONTHLY COLUMNS 4
Membership Matters
7
President’s Message Man-Kit Leung, MD
9
Editorial Gordon Fung, MD, PhD, and Steve Heilig, MPH
34 Medical Community News 34 Classified Ads 34 Upcoming Events
SFMMS 2017 Leadership Election Information; Pages 16 to 33
SAN FRANCISCO
MARIN MEDICAL SOCIETY
Editorial and Advertising Offices: San Francisco Marin Medical Society 2720 Taylor St, Ste 450 San Francisco, CA 94133 Phone: (415) 561-0850 Web: www.sfmms.org
SAVE THE DATE: SFMMS 150th Anniversary Celebration & Gala March 15, 2018 | St. Francis Yacht Club, San Francisco, CA In 2018, SFMMS will celebrate its 150th Anniversary. Save the date for a celebration not to be missed! More information and registration will be available soon at https://www.sfmms.org/events.aspx. Sponsorship opportunities available—contact Erin Henke at ehenke@sfmms.org or (415) 561-0850 x268.
MEMBERSHIP MATTERS Activities and Actions of Interest to SFMMS Members California Physicians Stand with Dreamers
SFMMS Awards Inaugural Community Service Awards at General Membership Meeting More than seventy SFMMS members attended the General Membership Meeting held at the Golden Gate Yacht Club on September 11, 2017. SFMMS President-Elect John Maa, MD, and Supervisor Malia Cohen each received the inaugural SFMMS Community Service Award for their efforts in protecting public health. CMA President, Ruth Haskins, MD, shared remarks about physician wellness and the importance of alliances in supporting the medical profession. Attendees, including physicians, residents and medical students, mingled with each other and with SFMMS leaders.
First and Second Year UCSF Medical Students ‘Mix’ with SFMMS Leaders The UCSF chapter of the AMA/CMA hosted a mixer recently to introduce SFMMS leaders to first and second year medical students interested in health policy. SFMMS leaders shared their perspectives on how to shape public health policy through participation in organized medicine. We thank UCSF medical student liaisons Omar Mesina and Andrew Lin for organizing this enlightening and interactive event.
AMA President Meets with SFMMS and UCSF Leaders
American Medical Association President, David Barbe, MD recently met with SFMMS and UCSF leaders to share information about current AMA projects of interest to the SF medical community. UCSF School of Medicine Professor and Vice-Chair of Dermatology, Jack Resneck, Jr., MD attended and is currently the Chair-Elect for the AMA’s Board of Directors. 4
The Trump Administration recently announced it would end the Deferred Action for Childhood Arrivals (DACA) program, which currently protects nearly 800,000 young undocumented immigrants from deportation. More than a fourth of “Dreamers” reside in California, and Congress has been asked to craft replacement legislation within the next six months. In response, California Medical Association (CMA) President Ruth E. Haskins, M.D., stated: “. . . our nation’s health care system has the largest percentage of foreign-born and foreign-trained workers of any industry in the country. Already facing a national shortage of physicians and other health care professionals, revoking DACA could also undermine patient care and disrupt medical schools and hospitals for decades to come. We urge Congress to support solutions that don’t needlessly punish young Americans, preserves patient access to care, alleviates our nation’s physician shortage and supports health care workforce diversity.” Read more at http://bit. ly/2wVJFEU.
Physicians Report Anthem Not Complying with AB 72 Interim Payment Rules
The CMA has received reports from physician offices that Anthem Blue Cross is not paying the “interim payment” as required under the recently effective law (AB 72) limiting out-of-network billing for covered, non-emergent services performed at an innetwork facility. The new law requires fully insured commercial plans and insurers to make “interim payments” to non-contracted physicians for non-emergent services performed at in-network health facilities, and places limitations on the ability of physicians in such circumstances to collect their full billed charges. If your practice has received an incorrect payment from Anthem or any other payor related to the new law, CMA wants to hear from you. Practices can contact CMA at (888) 401-5911 or via email at economicservices@cmanet.org. For more information, visit www. cmanet.org/ab-72.
Experiencing a Delay in Workers’ Compensation Utilization Review Decisions? File a Complaint
The California Division of Workers’ Compensation (DWC) has finalized regulations to ensure that utilization reviews (UR) are conducted in compliance and within specified timeframes. CMA encourages physicians experiencing delays in the receipt of workers’ compensation UR decisions to be diligent in submitting complaints to DWC to highlight organizations that fail to meet the timely review standards. Physicians who find that UR is not being done according to the regulations can complete the UR complaint form and email it with a description of the issue to DWCManagedCare@dir.ca.gov. Indicate “UR Complaint” in the subject line. More information on filing workers’ compensation complaints can be found on the DWC website - https://www.dir.ca.gov/dwc/. For more information, see CMA On-Call document #7310, “Utilization Review,” (http://bit.ly/2xvIjkW) which provides an overview of California statutes and regulations regarding UR applicable to workers’ compensation insurers and self-insured employers.
SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
CMA Urges CMS to Further Reduce MACRA Administrative Burdens The CMA recently submitted comments on proposed 2018 changes to the Medicare Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Though not perfect, the Centers for Medicare and Medicaid Services (CMS) has listened to physician feedback and has made changes that will significantly reduce the administrative burdens on physicians, particularly for small and rural practices. Under the proposed rule, 2018 will be another transition year like 2017. This means that physicians who report only one quality measure in 2018 can avoid all penalties in 2020. Highlights of the proposed rule can be found at http://bit.ly/2h2ldI8. CMA will be working closely with the American Medical Association (AMA) and CMS to monitor the QPP’s effect on physician practices, the physician-patient relationship and access to care.
California State Loan Repayment Program Now Accepting Applications
The California State Loan Repayment Program (SLRP) application cycle for 2017 is now open. The program assists with the repayment of educational loans for health care professionals who work in underserved areas of California. Grant recipients must commit to two-year, full-time or four-year, half-time service agreement to provide direct patient care in a primary, dental or mental health Health Professional Shortage Areas (HPSA) in California. Awardees must be currently employed or have accepted employment at a SLRP Certified Eligible Site that is willing to match the state award amount, dollar for dollar. Grant recipients may receive up to $50,000, though service years and award amounts may vary from year to year based on federal requirements and the amount of the provider’s debt. The program is federally funded through a grant from the U.S. Health Resources and Services Administration Bureau of Health Professions National Health Service Corps and is administered by the State of California’s Office of Statewide Health Planning and Development (OSPHD). Interested parties can apply online through CalREACH at http://bit.ly/2wVopPD. For more information, visit the OSHPD website at http://bit.ly/2jlxQT5.
JOIN OR RENEW YOUR MEMBERSHIP TODAY!
When you join the San Francisco Marin Medical Society, you join more than 2,000 members in San Francisco and Marin who are actively protecting the practice of medicine and defending public health. Working together with you, SFMMS unites physicians to champion health care initiatives and innovation, advocate for patients, and serve our local medical community, including physicians of all specialties and practice modes. We cannot do this alone. Join SFMMS/CMA Today to Receive fifteen Months of Membership for the Price of 12 - Starting October 1, 2017, new members who join paying full 2018 dues, will receive the remaining months of 2017 membership for free. Join today to start receiving your benefits. Visit www.sfmms.org/membership for more information about SFMMS membership and benefits, or to join online. Renew Your Commitment to Medicine; Renew Your SFMMS Membership Today - Make sure you continue to receive the benefits of SFMMS and CMA membership by renewing today. Full dues-paying members enjoy a 5% Early Bird Discount* if your renewal is received by December 15, 2017. There are three easy ways to renew your dues: 1. Mail/fax your completed renewal form when you receive it in the mail; 2. Renew online at www.sfmms.org with your credit card; or 3. Enroll in Easy Pay Automatic Dues Renewal Plan** (quarterly installments) by contacting SFMMS at (415) 561-0850 or membership@sfmms.org. *5% Early Bird Discount applies to 2017 full dues-paying members only who are renewing at the same level for 2018; renewal form and payment must be received by December 15, 2017. **Easy Pay Automatic Dues Renewal Plan (quarterly installments) is available to full dues-paying members only; renewing members receiving the Early Bird Discount are not eligible for Easy Pay. WWW.SFMMS.ORG
October 2017 Volume 90, Number 8
Editor Gordon Fung, MD, PhD Managing Editor Steve Heilig, MPH Production Editor Amanda Denz, MA Copy Editor Amy LeBlanc, MA EDITORIAL BOARD Editor Gordon Fung, MD, PhD Obituarist Erica Goode, MD, MPH Michel Accad, MD Erica Goode, MD, MPH Stephen Askin, MD Shieva Khayam-Bashi, MD Toni Brayer, MD Arthur Lyons, MD Chunbo Cai, MD John Maa, MD Linda Hawes Clever, MD David Pating, MD SFMS OFFICERS President Man-Kit Leung, MD President-Elect John Maa, MD Secretary Brian Grady, MD Treasurer Kimberly L. Newell, MD Immediate Past President Richard A. Podolin, MD MMS Officers President Peter Bretan, MD President-Elect Michael Kwok, MD Secretary/Treasurer Naveen Kumar, MD Immediate Past President Jeffrey Stevenson, MD SFMMS STAFF Executive Director and CEO Mary Lou Licwinko, JD, MHSA Associate Executive Director, Public Health and Education Steve Heilig, MPH Associate Executive Director, Membership and Marketing Erin Henke Executive Assistant/Office Manager Maria Vega Membership Coordinator Mina Yoo SFMMS BOARD OF DIRECTORS Larry Bedard, MD Charles E. Binkley, MD Peter Bretan, MD Irina deFischer, MD Nida Degesys, MD David T. Duong, MD Benjamin L. Franc, MD Steven H. Fugaro, MD Robert A. Harvey, MD Imran Junaid, MD Naveen Kumar, MD Michael Kwok, MD Raymond Liu, MD Todd A. May, MD Jason Nau, MD Dawn D. Ogawa, MD Stephanie Oltmann, MD Ray Oshtory, MD David R. Pating, MD William T. Prey, MD Justin P. Quock, MD
Monique D. Schaulis, MD Michael C. Schrader, MD Lori Selleck, MD Dennis Song, MD Jeff Stevenson, MD Winnie Tong, MD Matt Willis, MD Joseph W. Woo, MD Albert Y. Yu, MD
CMA Trustee Shannon Udovic-Constant, MD AMA Delegate Robert J. Margolin, MD AMA Alternate Gordon L. Fung, MD, PhD
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PRESIDENT’S MESSAGE Man-Kit Leung, MD
The Value of Membership - For You, Your Patients, and Our Community It’s simple economics: What is the return on investment (ROI) of membership? As with most financial transactions, the choice to consume a specific good or not is generally made by weighing the perceived value gained against the cost paid. The decision to join your county and state medical associations is no different: membership must prove its worth. There was a time when the value of membership in organized medicine was largely unquestioned. In the early 1950s, three-quarters of all physicians were members of the American Medical Association (AMA) along with their county and state societies. This was a time when doctors found significant value in these organizations which were able to deliver goods relevant to physicians’ needs. These medical associations served as a repository of educational resources, provided practice support, and offered a sense of community with other physicians. Much has changed since then. According to a 2016 survey, membership in AMA has dropped to about one in four doctors. While over 61 percent of those surveyed indicated they are still members of their state medical associations, much less than half (41 percent) reported being members of their county medical societies. In an even more disturbing trend, younger physicians (defined as those less than forty-six years old) were less likely to join their county medical societies compared to older doctors (28.5 percent vs. 48.4 percent). There are a number of reasons contributing to the decline in membership in traditional medical organizations. Specialty societies have largely supplanted county and state medical associations as resources for relevant medical education. Additionally, physicians are increasingly becoming employed and may find less value in practice support services and networking opportunities offered by medical societies. Finally, more and more doctors are interacting via internet and identifying with communities online, foregoing the need to socialize in person. The consequence is that today’s physicians are organizationally fragmented. In order to regain relevance, county and state medical associations must adapt and deliver a new set of goods applicable to the doctors of today. At the San Francisco Marin Medical Society (SFMMS), while we continue to provide resources for practice management such as our recent MACRA/MIPS assistance program, we also offer leadership and advocacy training which are particularly attractive to physicians who are employed or belong to large groups. Furthermore, for members who want to interact digitally, we host online forums via our website. When members want to meet in person, we continue to organize social events at venues such as art galleries, muWWW.SFMMS.ORG
seums, and restaurants to reinforce our sense of community. Of particular note is the SFMMS Investment Interest Group which meets regularly to discuss strategies for financial management for physicians at all career stages. Finally, we publish nearly monthly issues of our journal San Francisco Marin Medicine which keeps all members up to date on newsworthy events in the San Francisco and Marin medical communities. Ultimately, though, SFMMS’ biggest value lies in its political advocacy capabilities and close relations with policymakers. Because we represent the most diverse population of physicians, including doctors from all specialties and modes of practice, legislators continue to look to SFMMS and the California Medical Association (CMA) for input on healthcare policies. Recent legislative victories include defending the cap on MICRA, increasing funding for Medi-Cal, and taxing sugarsweetened beverages. Even coalitions of specialty groups cannot match the depth of organized medicine’s diversity and breadth of influence. SFMMS and CMA continue to be the best means for physician political voices to be heard. Besides ROI, there is another economic principle to bear in mind when considering membership in SFMMS/CMA. That concept is called a “positive externality,” which is defined as a benefit enjoyed by a third-party as a result of a transaction. For example, when an individual receives a vaccination, that individual not only decreases the risk of contracting a disease but also decreases the risk of others becoming infected. Similarly, participation in organized medicine is a positive externality because not only do individual members gain a political voice to advocate for health care issues which are personally relevant, but the rewards of these advocacy efforts are also enjoyed by all physicians and their patients. Especially as the debate on healthcare reform rages on, the nation’s public in general benefits from hearing the voices of their trusted doctors. The ROI of your membership in organized medicine extends beyond you—it includes value to all of your colleagues, patients, and society as a whole. Man-Kit Leung, MD, is an otolaryngologist in private practice in San Francisco and president of the San Francisco Marin Medical Society. He welcomes correspondence at mleung@ sfmms.org.
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EDITORIAL Gordon Fung, MD, PhD, and Steve Heilig, MPH
THE PROUD SFMMS ADVOCACY TRADITION We live in trying times. But then, judging from historic writings going back centuries, even millennia, people have always felt that way about their times. Perhaps the pace and scale of human action makes things seem more urgent now, especially when severely clashing worldviews are tossed into the mix. As the SFMMS nears its 150th birthday in 2018, we will be looking at some of the history of this organization, founded by a handful of Gold Rush era physicians. Their primary goals were to promote the building of some good local hospitals, provide for good medical education on this remote West Coast outpost, weed out some of the rampant wholly fake physicians hanging out shingles everywhere, and have a place to do what we now often refer to as “networking.” They succeeded in some of these aims, likely far beyond their most hopeful dreams. The hospitals they founded evolved into such august institutions as UCSF and Stanford Medical Centers. Their educational and “peer review” activities were then the only game in town. The early meetings, insofar as there are any records left (medical society buildings, early on, seemed to have a tendency to burn to the ground like other local structures), were lively affairs. And before the 1800s end, the SFMS was being asked to bring expertise to local public health issues such as what to do about the health impacts of opium dens. In our more modern era, the SFMS, now SFMMS, has been a leader among medical societies on many issues. See the concise summary list on page 14 of this issue to get an idea of the scope of activities; you can read that some of the original vision still pertains, but has evolved and broadened considerably. At our recent annual meeting, CMA President Ruth Haskins, MD, praised the SFMMS as the most active, impactful county association she’d ever seen. This reflects not only our local action but our policy impact on the state, via CMA, and even nationally via AMA. It is safe to say that more CMA and AMA policy has come out of SFMMS than from any other local association. And also that, on many topics, our advocacy has led those much larger and often more conservative organizations to take on more leading, even progressive positions than they likely would have otherwise. Of this we are very proud. A significant trend occurring over the past few years that adds value and impact to our advocacy tradition is the increase in medical students and residents involved in our efforts. It has always been said that during legislative visits the students and residents have the major focus and attention of the legislators. Their perspective as young adults who are just entering the field and learning about it first hand without WWW.SFMMS.ORG
any economic incentives but pure scientific focus and patient oriented motives articulate the case for change the best. Legislators and staff listen more intently and know that the relationships they build with these young advocates can be highly productive for better public health. At SFMMS, we are fortunate that UCSF Students and residents have demonstrated a significant interest and have worked to establish their own interest group to meet and further engage with the medical society, the CMA, and AMA. We are also excited that the chair of the medical student section for the CMA and the AMA and the Resident delegate for the AMA are members of the SFMMS delegation to the CMA, and active on the Council of scientific and public health affairs as well as the Health Care reform Task Force of the CMA. One of them also was a legislative aide for a state representative before medical school. These are definitely our future leaders and have the ear of the legislators. True advocacy involves taking some risks. Our positions are always, as much as possible, “evidence-based,” reflecting the latest best scientific and public health knowledge. But sometimes our leadership feels the need to go a bit beyond that, and take what might be seen as a more “political” stance. One recent example was when SFMS wrote a letter to the AMA strongly opposing their endorsement of Dr. Tom Price as a nominee for United States Secretary of Health and Human Services, as there were just too many problems with that nomination. We took some flak for that. It is unseemly to say “We told you so,” so we will just conclude by noting that, much more often than not in our long history, this medical association has been shown to be on the best side of issues. We thank all of you who have, and will, join in. Editor and cardiologist Gordon Fung, MD, PhD, is clinical pro- fessor of medicine at UCSF with a practice in consultative general clinical cardiology, and is medical director of the Electrocardiography Lab at Moffit/Long Hospitals and of the nation’s first UCSF Asian Heart & Vascular Center located on the Mount Zion Campus. He is a former SFMMS President. Steve Heilig, MPH, is director of public health and education for the San Francisco Marin Medical Society.
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Health Care Advocacy
LESSONS LEARNED Successful Medical Student & Resident Campaigns Beth Griffiths, MD, MPH “What is the best way for me to get involved politically?”
Since last November’s election, I have been asked this question frequently by fellow residents, medical students, and even attendings. Many have never been
politically active, but now realize the many ways in which politics influences the health care we deliver and feel a new sense of urgency to get involved. As an internal medicine resident who, prior to entering medicine, worked in the U.S. House of Representatives and the California State Assembly, I learned lessons of successful effective legislative advocacy from the other side, so to speak. I solidified these lessons later as a medical trainee successfully advocating for policy change, largely through involvement in my county medical societies, the California Medical Association (CMA) and the American Medical Association (AMA). My hope is that these lessons will serve those with a newfound interest in legislative advocacy on behalf of their patients.
Advocacy is a team sport
With an already very demanding day (or day-and-night) job, it is nearly impossible for any trainee or most practicing physicians to meaningfully impact legislative advocacy without collaborating with others, either within an existing organization or by creating a new one. For most, joining an existing organization will be more practical, given the significant demands of creating a new one. When choosing an existing organization to work with, I consider the organization’s effectiveness, my alignment with the organization’s goals, and my ability to affect change within the organization. These considerations will often have to be weighed against each other, and anyone interested in advocacy must determine how comfortable they feel working within a more powerful organization with which they do not completely align. That said, I find that many of my colleagues underestimate their ability to create change within an existing organization. For example, I have spent considerable time working within the AMA, although I do not agree with every position the organization has taken. But I have frequently been impressed by the power of trainees to shape the organization. This year, trainees have been instrumental in efforts to ensure the AMA strongly opposes block grants for Medicaid and repeal of the Affordable Care Act (ACA). However, there are times when building a new organization can be very important. The most successful examples are organizations that are built when a new issue arises or becomes timely, such as when medical students created White Coats for Black Lives (WC4BL) to support the broader Black Lives Matter movement. 10
All politics are local While advocating for major national health reform is perhaps the most glamorous of advocacy work, I have found my impact to often be more significant on the local level. Thousands may be engaged in a big ticket item, rendering the impact of one person small. But paying attention to more local issues allows trainees with limited time and experience to effect significant change. As one example, the model for the ACA was the development of a plan for universal health insurance in Massachusetts. Advocates knew that the political climate would not allow for passage of national health reform at the time, but by focusing their efforts on state-based advocacy they designed the blueprint for the eventual passage of national health reform. Similar opportunities will likely exist in California in the coming years.
Learn from, and collaborate with, the professionals
As trainees, none of us has time to track all of the major health issues before a legislature or form relationships with all the requisite lawmakers. That is the role of lobbyists. While grassroots activism is a key ingredient to successful advocacy, I have yet to make any significant policy change without relying on lobbyists. When I led a group of medical students advocating for state-based primary care residency program funding in California, calling and visiting lawmakers was important, but our campaign would have failed without the help of CMA’s team of lobbyists, who understood the budget process and advocated for our cause on a consistent, frequent basis.
Stories matter more than statistics
As physicians, we strive to make evidence-based decisions, but in politics dramatic stories more often spark change. I have seen this lack of evidence-based decision making frustrate me and my colleagues, but the power of the story in politics can also be a great source of power for clinicians, who can share their patients’ stories. Learning this lesson can dramatically change how we speak with politicians. The #KeepAmericaCovered organization of UCSF trainees advocating against ACA repeal has focused heavily on sharing patient stories with lawmakers. Similarly, when I lobby legislators or give testimony at legislative hearings, in addition to citing statistics, I always highlight patient stories to make my point.
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Take advantage of opportunities for incremental change, and keep going. This is the final and perhaps the most important lesson I have learned from mentors who have worked at the intersection of policy, politics, and advocacy for decades. When I worked in Congress during the passage of the ACA, I knew senior staff members who had worked unsuccessfully for decades trying to pass universal health insurance. Rather than give up, they pushed for incremental advances and prepared as they waited for a window of opportunity, when they finally persevered. My hope is that last November’s election and subsequent efforts to repeal the ACA have inspired more of my medical trainee and physician colleagues to become and stay involved in advocacy. Our patients’ access to care as well as their health and well-being depend on our willingness to become advocates on their behalf.Weshould look no further than examples of our own colleagues’ successes to learn essential lessons and, most importantly, to be inspired about our own chances for successful legislative advocacy.
The San Francisco Marin Medical Society is proud to recognize our member and California Medical Association delegate,
DR. PRATIMA GUPTA,
Beth Griffiths is a third year resident in internal medicine at UCSF. This article was modified from Dr. Griffiths’ original article, which was published in the New England Journal of Medicine in June 2017.
for receiving the CMA’s 2017 Compassionate Service Award for her dedication to direct care and advocacy for underserved patients.
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Health Care Advocacy
HEALTH CARE ADVOCACY Becoming An Active Participant Q&A with Andrew Bindman, MD 1. What/when was your first impetus to become active in health policy? Did this start in your residency training, or afterwards? I developed an interest in public health and health policy at a young age. My father was a clinical psychologist with a public health degree who was active in the administration of public community mental health clinics and programs around Boston. When I went to medical school it was always with the intention of combining an interest in medicine and public health. I was fortunate to be able to come to University of California, San Francisco (UCSF) for my residency where I found role models for this type of career within the Division of General Internal Medicine. After my residency in internal medicine, I developed my skills in health policy as a researcher through the Robert Wood Johnson Clinical Scholars Program at a combined UCSF-Stanford site. I did my training during the early days of the HIV epidemic. I was exposed to and impressed by the partnership between UCSF and the San Francisco Department of Public Health at San Francisco General Hospital. I found this to be a really unique and effective academic and community based partnership. So while I had come to UCSF thinking I would return home to Boston afterwards, when I got the opportunity after my training to join the UCSF faculty at San Francisco General Hospital I found it too good of an offer to leave. I’ve now been on the faculty at UCSF for thirty years.
who are also rigorous investigators who are using evidence from research to improve care. Steve encouraged me to translate the knowledge I was gaining from research to serve as the basis of evidence-based policy.
3. Many physicians are trained for clinical care and research, but not public advocacy. What is your ‘elevator speech’ to show them that advocacy can be rewarding?
I would not describe myself as an advocate but rather as an information broker. I am involved not only in the process of generating new knowledge through the process of research, but also in disseminating that knowledge to those involved in the policy process so that evidence can be used to inform decision-making. In general, I do not think that the research community does enough to ensure that its work is disseminated in a way in which it can constructively influence the policy process. I emphasize this aspect of the research process in my teaching with trainees. I also try to inspire trainees by acknowledging how important and rewarding it can be to connect with and help one patient at a time, but also to point out that through policy it is possible to affect literally millions of lives in a positive way as was case with the Affordable Care Act (ACA).
2. Who were particularly influential mentors and what special advice did they share?
4. What were some of the more memorable events/accomplishments/challenges in your career in advocacy?
UCSF had and continues to have some of the most influential health policy academics in the country. During my training, I received mentorship from Phil Lee who twice served as the Assistant Secretary for Health with the U.S. Department of Health and Human Services as well as the Chancellor at UCSF. He established the Institute for Health Policy Studies (IHPS) which houses health policy researchers from many departments across UCSF’s School of Medicine. I became affiliated with IHPS when I joined the faculty at UCSF and this exposed me to several key members of the UCSF health policy community including Hal Luft, Jon Showstack, and Drummond Rennie who helped me to establish my career. I was also fortunate to be surrounded by my affiliation with IHPS with other early career faculty members, such as Kevin Grumbach, who had a shared interest in health policy. Another key figure at UCSF who I continue to turn to for advice today is Steve Schroeder. Steve was the Chief of the Division of General Internal Medicine when I came to UCSF and he later became the President of the Robert Wood Johnson Foundation. Steve built the Division of General Internal Medicine at UCSF which to this day and in each of its hospital sites has faculty who are not only gifted clinicians and teachers but
Far and away the most significant health policy related activity I have been involved with was the passage of the ACA; after all, this legislation has already increased insurance coverage by more than twenty million people. I did this as a part of a Robert Wood Johnson Foundation supported Health Policy Fellowship. For the fellowship, I relocated to Washington, DC for a year and became part of the staff of the Energy & Commerce Committee chaired by Congressman Henry Waxman within the House of Representatives. In that role, I was involved in drafting language related to the ACA, particularly provisions related to the Medicaid program, or what we call Medi-Cal here in California. I was given the opportunity to be a part of this influential Congressional Committee because I had a long-standing interest in and knowledge of the Medicaid program as a clinician at San Francisco General Hospital and as a researcher who had published numerous studies evaluating Medicaid policies. While I take great pride in what the ACA has accomplished I was disappointed that I was not as successful as I hoped in ensuring higher reimbursement for Medicaid providers. As a part of the ACA, we were able to get a two-year increase in Medicaid reimbursement for primary care practitioners, but based on my experience as a
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SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
provider and from research I have done for many years on the topic in California, I think access to care for Medicaid patients requires a sustained level of reimbursement that is at least comparable to that provided in the Medicare program.
5. What suggestions/tips might you have for students and others who might be considering becoming active in policy advocacy?
As a physician, one has a platform from which to be a valuable information broker who can help policymakers understand the complex world of health care delivery. Physicians are uniquely capable of describing the challenges they see in providing patients with effective care. I sought a career as a health services researcher because I wanted to be able to systematically assess the validity of my anecdotal experiences in clinical care in a way which I thought would make them more meaningful for policymakers. I have found that to become valuable as an information broker, one needs to become an expert on a topic and to develop relationships with policymakers by being available in an on-going way. Also, when involved in the policy process, it is important to be mindful of the social responsibility and not to abuse the privilege by putting self-interests ahead of patients’ interests. Doing so undermines one’s credibility and runs the risk that physicians will be viewed as just another interest group.
6. What recommendations do you have for faculty who might be interested in the mid-career RWJF fellowship program?
It is my sense that the protracted debate at the federal level regarding health care legislation has increased physicians’ interest in learning more about the health policy process. For those who wish to get directly involved, fellowships such as the one I participated in sponsored by the Robert Wood Johnson Foundation provide outstanding service learning opportunities. There are several such programs which provide health professionals with an entrée into federal health policy. These programs vary in their policy focus, duration, and level of prior experience. The Robert Wood Johnson Foundation Health Policy Fellowship is broad based in its health policy focus. It targets individuals who are mid-career and who have demonstrated a potential to be leaders in academia, professional organizations, community-based organizations, or some other health care stakeholder group. I learned an enormous amount about the policy process, not only from the immersion into Congress but also from my peer group. This program requires a commitment of a year working in Washington, DC, but it is a tremendous opportunity and for many a life changing experience.
Andrew Bindman, MD, is Professor of Medicine, Health Policy, Epidemiology and Biostatistics, at the University of California San Francisco (UCSF). He is also a senior advisor in the Office of the Assistant Secretary for Planning and Evaluation within the U.S. Department of Health and Human Services where he works on issues related to the health care workforce, graduate medical education, and Medicaid.
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SFMMS ADVOCACY ACTIVITIES AN ADVOCATE FOR PATIENTS, PHYSICIANS, AND THE COMMUNITY As the only medical association in San Francisco and Marin to represent the entire spectrum of medical specialties and interests, the San Francisco Marin Medical Society (SFMMS) has been a champion for community health issues since its inception in 1868. Our policymaking efforts through collaborations with state/national medical and political leaders, as well as articles in our awardwinning journal, have given us a reputation for being influential far beyond the Bay Area. The SFMMS agenda and activities continue to focus on the community and the following areas of involvement.
UNIVERSAL ACCESS TO CARE: With ongoing, vigilant efforts to preserve programs and prevent cuts in Medi-Cal reimbursement, SFMS leaders have long advocated that everyone should have access to quality medical care. SFMS additionally joined in the lawsuits to preserve the Healthy San Francisco program, a curriculum designed by those (including our own representatives) serving on the Mayor’s Task Force. SFMS advocated for, and even helped create, community clinics dating back to the original Haight-Ashbury Free Clinics in the 1960s, and, more recently, argued for preservation of the Affordable Care Act’s best features.
ANTI-TOBACCO ADVOCACY: SFMS advocates were instrumental in the banning of tobacco smoking in San Francisco restaurants, an accomplishment that was ahead of the rest of the state and nation. SFMS advocated for many policies, including ever-stronger protections from secondhand smoke, higher taxes on tobacco products, and the removal of tobacco products from pharmacy settings. SFMS later signed onto an amicus brief in support of upholding San Francisco’s law banning the sale of tobacco in pharmacies. SFMS actively worked to pass legislation to tax tobacco products in order to provide additional funding for Medi-Cal.
HIV PREVENTION AND TREATMENT/HEPATITIS B:
Having been among the first to push for legalized syringe exchange programs, appropriate tracking and reporting processes, optimal funding, and more, the SFMS was, naturally, at the center of medical advocacy for solid responses to the AIDS epidemic in the 1980s. SFMS is a partner in the Hep B Free program in San Francisco and helps educate physicians and patients on the prevention and treatment of hepatitis B.
SUGAR TAXATION AND HEALTH: SFMS has long been on record combating overconsumption—and marketing—of sugar and soda, especially where young people are concerned. To help prevent and battle obesity and other associated ills, SFMS has not only endorsed the broad coalition, but is also at the forefront of instituting a landmark local tax on soda with revenue marked for health needs. We have authored policy on this issue for the California Medical Association (CMA) as well. SCHOOL AND TEEN HEALTH: SFMS helped establish and
staff a citywide school health education and condom program, removed questionable drug education efforts from high schools, worked on improving school nutritional standards, and provides medical consultation to the San Francisco Unified School District 14
school health service. SFMS has authored a resolution allowing minors to receive vaccines to prevent Sextually Transmitted Infections (STIs) without parental consent.
END-OF-LIFE CARE: SFMS leaders have developed numerous
policy and educational efforts to improve care toward the end of life, including promulgation of the Physician Orders for Life-Sustaining Treatment (POLST) medical order. The SFMS was instrumental, after decades of advocacy, in getting the CMA to remove its blanket opposition to physician-assisted dying and to thus allow for legalization of that in 2016.
ANTIBIOTIC RESISTANCE: SFMS leaders have presented na-
tional meetings and policy on this topic, including the American Medical Association’s first statement on antibiotic overuse in agriculture and numerous subsequent efforts.
ENVIRONMENTAL HEALTH: SFMS’ many efforts include establishing the Collaborative on Health and the Environment, a nationwide educational network on scientific approaches to environmental factors in human health, and advocating for reduced exposure to mercury, lead, and air pollution.
REPRODUCTIVE HEALTH AND RIGHTS: SFMS has been a state and national leader in advocating for women’s reproductive health and choice, including access to all medical-indicated services. ORGAN DONATION: SFMS has been the vanguard in seeking improved donation of organs to decrease waiting lists and deaths due to the shortage of organs through educating the public and proposing new policies regarding consent and incentives for organ donation.
OPERATION ACCESS: SFMS is a founding sponsor of this local organization which provides free surgical services to the uninsured, and has provided office space, volunteers, and funds.
DRUG POLICY: SFMS has been a leader in exploring and advocat-
ing new and sound approaches to drug abuse, including some of the first policies regarding syringe exchange, medical cannabis, and treatment instead of incarceration. We were integral in the development of CMA’s landmark report on decriminalization and regulation of cannabis, and even in creation of the official subspecialty of Addiction Medicine.
MEDICAL ETHICS: SFMS has developed and promulgated forward-looking policies and approaches regarding end-of-life care, patient directives, physician-assisted dying, and other topics of interest to patients, physicians, policymakers, and the general public.
PARTNERSHIPS: SFMS works closely with many local specialty and health organizations such as the San Francisco Department of Public Health, Health Commission of San Francisco, San Francisco Emergency Physicians Association, San Francisco Pediatric Council, San Francisco Community Clinic Consortium, West Bay Hospital Conference, Chinese Community Health Care Association, and others.
SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
Health Care Advocacy
ADVOCACY More Opportunities Than You May Think Pratima Gupta, MD You may think you don’t have opportunities for advocacy, but consider a time where you saw something was not right or got so frustrated with the challenges a patient was enduring. When were you motivated enough to do something and change the situation? When did you care so much or were bothered
enough to do something about it? The American Medical Association defines advocacy as action by a physician to promote social, economic, educational, and political changesthat ameliorate the suffering and threats to human health and well-being that he or she identifies through his or her professional work and expertise. I am often asked by physician colleagues and parents alike, “How can you do this to your children?” regarding my many varied endeavors from politics to volunteer global health. My response is simple: How could I NOT do this to my children? We are often overwhelmed, and I know the last thing we want is one more thing to do, but I am suggesting that we make advocacy a habit. Patient stories are one of the most powerful tools we have in our medical arsenal, especially if we take the time to jot down relevant de-identified details. During my first Lobby Day where we met with legislators and their staff in Sacramento, they were riveted by the plight of our patients. I was nervous and stumbled over my words, but they were humbled by the fact that we, as busy doctors, took time out of our clinical duties to speak on behalf of our patients. We make time to read journal articles, mentor students, and attend CME conferences despite everything else happening around us. Advocacy on behalf of our patients and our profession is part of our duty to ensure equitable health care for all. Advocacy consists of developing the abilities and advantages that you already have and is not as daunting as it seems. As physicians, we have the innate skills required to be advocates: patient stories, credibility, technical and scientific knowledge, access to and understanding of research, and experience with advocating for individual patients. We have high public trust and can ground our advocacy in evidence. Involving residents and students is essential to provide them with the educational experience of advocacy and opportunities to familiarize themselves with the political issues of their local communities and beyond the hospital walls. Many resident physicians are too exhausted from their hectic schedules to engage in policy making, and many residency programs do not offer opportunities for engagement in political advocacy. However, these young physicians are uniquely poised on the front lines of health care delivery and will be most affected by current WWW.SFMMS.ORG
policy changes. Preventing physician burnout is a core priority for many organizations and professional societies. If our professional actions (work) clash with our personal morals, a devastating consequence can be frustration, apathy, and a loss of one’s purpose. The constant demands that we face as physicians can make us lose sight of why we chose this rewarding profession. The simple act of being an advocate and speaking up for those who have entrusted you with their health can reignite the spark and fan the flames of professional satisfaction. As our California Medical Association President Dr. Ruth Haskins recently wrote, “We derive professional satisfaction and personal rejuvenation through moments like these, where we can use our knowledge and wisdom to support and heal individuals of all backgrounds and cultures . . . We physicians are viewed as community leaders, woven into the fabric of our culture: societal pillars who have the ability to motivate and the means to promote diversity through health, healing, and communication.” In summary, physicians are effective and sought-after advocates. There are many opportunities where we can collaborate with colleagues for strategic advocacy—a learnable skill that builds upon our existing physician aptitude. Despite the challenges, we should stick with it, because in the long term, we are speaking the truth as doctors. As physicians, we are blessed with great privilege and with privilege comes great responsibility. So, I challenge you to put down this magazine and your cup of coffee/glass of wine, close your eyes, and ask yourself: Are you living your life & spending your time in alignment with your values? Pratima Gupta is an Obstetrician/Gynecologist practicing in San Francisco who was awarded the California Medical Association’s Compassionate Physician Award for 2017. She is currently the Volunteer Medical Director of St. James Infirmary and the third Vice-Chair of the San Francisco Democratic Party. In her spare time she likes to tickle her five-month-old, bicycle with her fouryear-old, and run through Golden Gate Park.
OCTOBER 2017 SAN FRANCISCO MARIN MEDICINE
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SLATE OF CANDIDATES SFMMS 2017 Election Pursuant to the San Francisco Marin Medical Society Bylaws Article X Section 2—Nominations, the Nominations Committee renders in writing the following slate of candidates for the 2017 SFMS election. This slate was read at the September 11, 2017 General Meeting, at which time the SFMMS President called for additional nominations from the floor.
2018 Officers | Term 2018
For SFMMS President-Elect Kimberly L. Newell Green, MD For SFMMS Secretary Benjamin Franc, MD, MS, MBA For SFMMS Treasurer Brian Grady, MD For SFMMS Editor Gordon L. Fung, MD, PhD, FACC, FACP (Incumbent Editor)
SFMMS Board of Directors
Term: 2018 to 2020 Seven candidates to be elected to the SFMMS Board of Directors: Alice Chen, MD, MPH Michael C. Lubrano, MD, MPH Stephanie Oltmann, MD (Incumbent Director) William T. Prey, MD (Incumbent Director) Michael Scahill, MD, MBA Michael C. Schrader, MD, PhD, FACP (Incumbent Director) Eric C. Wang, MD Matthew D. Willis, MD (Incumbent Director) Albert Y. Yu, MD, MPH, MBA (Incumbent Director)
SFMMS Nominations Committee
Term: 2018 to 2019 Four candidates to be elected to the SFMMS Nominations Committee: Francis J. Charlton Jr, MD James L. Chen, MD Diana Coupard, MD Michael K. Kwok, MD Todd A. May, MD
American Medical Association Delegate Term: 2018 to 2019 Robert J. Margolin, MD (Incumbent Delegate)
American Medical Association Alternate Delegate Term: 2018 to 2019 Gordon L. Fung, MD, PhD, FACC, FACP (Incumbent Alternate Delegate)
NOTES
District VIII (SFMMS) California Medical Association (CMA) Trustee Term: October 2018 to October 2021 Shannon Udovic-Constant, MD, FAAP (Incumbent Trustee)
SFMMS Young Physicians Section (YPS) Alternate to the California Medical Association House of Delegates Term: 2018 to 2019 Jaclyn B. Taub, DO Priyanka K. Wali, MD
For SFMMS Delegation to the California Medical Association House of Delegates Term: 2018 to 2019 The candidates receiving the highest number of votes will serve as Delegates; the rest will be Alternate Delegates or on the wait list. The President-Elect automatically becomes one of the Delegates according to the SFMMS Bylaws: Ameena T. Ahmed, MD, MPH (Incumbent Delegate) Larry A. Bedard, MD, FACEP, FIFEM (Incumbent Alternate) Roger S. Eng, MD, MPH, FACR (Incumbent Delegate) George A. Fouras, MD (Incumbent Alternate) Zarah Iqbal, MD, MPH Naveen N. Kumar, MD (Incumbent Alternate) Michael K. Kwok, MD (Incumbent Alternate) Man-Kit Leung, MD (Incumbent Delegate) L. Alison McInnes, MD, MS Joann (Josie) E. Moschella, DO Stephanie Oltmann, MD (Incumbent Alternate) Michael C. Schrader, MD, PhD, FACP Jeffrey L. Stevenson, MD Matthew D. Willis, MD Joseph W. Woo, MD
2017 President-Elect, John Maa, MD, automatically succeeds to the office of President. 2017 President, Man-Kitt Leung, MD, automatically succeeds to the office of Immediate Past President.
Member voting will take place ONLINE ONLY. In order to place your vote, we must have your email address in our database. Please provide us with your email address if we don’t already have it by emailing mvega@sfmms.org. Paper ballots are NO LONGER mailed. Please look for a special email from SFMMS on October 23 with detailed information regarding the online voting process, as well as the link to the online ballot.
Your online vote must be cast by 5 PM, Monday, November 13, 2017. Please see candidate biographies and statements on the following pages.
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CANDIDATE BIOGRAPHIES President-Elect
Secretary
BRIAN GRADY, MD
BENJAMIN FRANC, MD, MS, MBA
KIMBERLY L. NEWELL GREEN, MD
Pediatrics
Treasurer
Nuclear Medicine/ Molecular Imaging
Urology
Current Job Positions and Hospital and Teaching Affiliations
Pediatrician, Kaiser Permanente; AssociateClinical Professor, UCSF.
Professor, Department of Radiology and Biomedical Imaging, University of California, San Francisco. I provide clinical care at all UCSFaffiliated campuses (UCSF, ZSFG, VA). As a member of the UCSF Center for Healthcare Value within the Institute for Health Policy Studies, my research focuses on increasing value in cancer care.
Urologist, Golden Gate Urology; active medical staff member at California Pacific Medical Center (CPMC) and CPMC/St. Luke’s, St. Mary’s Medical Center, St. Francis Memorial Hospital, and Seton Medical Center.
SFMMS: Board of Directors 2016-2017; Executive Committee 2016-2017; Board Liaison to the UCSF Medical Staff 2015-2017; CMA: Council on Medical Services. PAST: CMA: Council on Information Technology. Sierra Sacramento Valley Medical Society: Delegate to the CMA HOD; Member of the Medical Review and Advisory Committee.
SFMMS: Secretary 2017; Executive Committee 2015-2017; Board of Directors 20142017; Liaison from St. Luke’s Medical Staff to the SFMMS 2013-2016; CMA Council on Health Professions and Quality of Care, 201617.
Having trained at University of California, San Francisco (UCSF), worked in the community at San Francisco General Hospital (SFGH) and at several private practice offices, and now being in practice at Kaiser San Francisco, I have had experience with a range of medical settings and care delivery systems in this city. Having been asked to participate in a two year “Emerging Leaders” Leadership Education Program, I have since held several local and regional leadership positions at Kaiser Permanente, including Chief Healthcare Innovation Officer, Chief of Physician Health and Wellness, Department Technology Lead, and Continuing Medical Education (CME) Coordinator.
American College of Radiology–Member Economics Committee, Government Relations Committee, Coding and Nomenclature Committee; California Radiological Society, Secretary. Society of Nuclear Medicine and Molecular Imaging–Member Government Relations Committee; Past President Northern California Chapter. Experience in private practice, community health, and academic health system settings. Managed operations, personnel and resources in inpatient and outpatient clinical enterprises. Leadership roles held at Sutter Medical Group, Radiological Associates of Sacramento Medical Group, and UCSF.
Currently serving as the Secretary/Treasurer MEC Seton Medical Center; former president of the CMA Resident Physician’s Section.
More than ever in these turbulent times, physicians must work to shape how medicine evolves so we can continue to take exemplary care of our patients and attain professional satisfaction. I would be honored to continue to help lead this group of committed physician leaders for the benefit of the entire community.
I am proud to serve SFMMS members. As an officer, I aim to extend the value and visibility of SFMMS in the evolving regional healthcare and health policy environments. I will seek new opportunities for advocacy, physicianled healthcare reform, and public education to support SFMMS initiatives and ideals.
I am very grateful to be considered for this position. My colleagues have been such a great support to me in my practice, and I would be honored for the opportunity to repay through service to the SFMMS.
SFMMS/CMA Committees or Offices
SFMMS: Treasurer 2016-17; Secretary 2015, Board of Directors 2012-2014, Executive Committee 2014-present, Nominations Committee 2010-2011.
Additional Relevant Experience
Why Are You Interested in Serving?
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OCTOBER 2017 SAN FRANCISCO MARIN MEDICINE
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CANDIDATE BIOGRAPHIES Editor Editor
Board of Directors ALICE CHEN, MD, MPH
GORDON L. FUNG, MD, PHD, FACC, FACP
MICHAEL C. LUBRANO, MD, MPH
Incumbent Editor
Also Candidate for AMA Alternative Delegate and CMA Delegation
Cardiovascular Diseases
Internal Medicine
Anesthesiology
(applying for Chronic Pain Fellowship)
Current Job Positions and Hospital and Teaching Affiliations
UCSF Medical Center, Active Attending; Chinese Hospital, Associated. UCSF School of Medicine, Clinical Professor of Medicine. Director, Cardiac Services, Asian Heart & Vascular Center, UCSF Medical Center at Mount Zion, Director, ECG Laboratory, UCSF medical center.
Chief Medical Officer, San Francisco Health Network. Professor of Medicine, University of California San Francisco. Primary care physician, Richard H Fine People’s Clinic, Zuckerberg San Francisco General.
Resident Physician, Department of Anesthesia & Perioperative Care, University of California San Francisco (UCSF) School of Medicine.
SFMMS: Editor, 2011 to present; Executive Committee, 2011 to present; Past President. CMA: Delegate since 2000 (Chair since 2014); Member of Council of Scientific Affairs 20042015; Council of Scientific Affairs and Public Health 2015 to present; Council of Delegation Chairs since 2015.
SFMMS Nominations Committee 2017-2018.
SFMMS PAC Board (current), SFMMS Membership Committee (current), CMA Council on Science and Public Health (current), CMA RFS Chair (2 terms, past).
None.
I have served medical students and now residents in dozens of local and nationally elected policy positions over the past few years. This includes Delegate of the AMA Resident and Fellow Section (RFS) and Chair of the AMA RFS Delegation to the AMA HOD. I am also on the Resident Component Governing Council for the American Society of Anesthesiologists as well as the Board of Directors of the American Society of Interventional Pain Physicians.
Why Are You Interested in Serving?
Current board member of the San Francisco General Hospital Foundation, board secretary/treasurer of Health Access Foundation, and board secretary of the National Council of Asian Pacific Islander Physicians. Past board member of the California Pan-Ethnic Health Network and the DentaQuest Foundation. Past physician leadership positions at SFGH include Chief Integration Officer, Director of eReferral, and Medical Director of the General Medicine Clinic. Significant work in physician advocacy focused on coverage, access, immigrant health and disparities.
Medicine is changing faster than ever by every perspective. We have on the Editorial Board strived to bring some of these changes to you with stories from the most knowledgeable experts and those actively involved in the dynamic process. I have been honored to serve as your Editor over the past years. The challenge of transmitting the updates and at time history of medicine has been the highlight of my professional career and service to the SFMMS. I ask your vote to continue in this position.
SFMMS’ policy priorities are very much aligned with the public and population health needs of our City. In the context of the recent efforts to repeal and replace the ACA, physician engagement and advocacy on behalf of our patients and community are more critical than ever. As a member of the SFMMS board of directors, I would welcome the opportunity to learn from SFMMS members, staff, and directors, and to contribute my experience and expertise.
None.
SFMMS/CMA Committees or Offices
Additional Relevant Experience
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SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
STEPHANIE OLTMANN, MD,
WILLIAM T. PREY, MD
Incumbent Director
Incumbent Director
MICHAEL SCAHILL, MD, MBA
Also a candidate for CMA Delegation
Family Medicine
General Psychiatry and Sleep Medicine
Pediatrics
Current Job Positions and Hospital and Teaching Affiliations
Solo practice for thirty-one years; Associate Staff at California Pacific Medical Center.
Medical Director, Virta Digital Diabetes Reversal Clinic. Clinic Instructor, Stanford Neonatology. Pediatric Leadership for the Underserved at UCSF.
SFMMS Board 2015-2017; Executive Committee 2015; SFMMS PAC Secretary/Treasurer 2016-2017; Alternate Delegate to CMA House of Delegates 2015-2017; Young Physician Section Delegate to CMA House of Delegates 2014, Alternate Delegate to CMA House of Delegates 2013.
SFMMS: Board of Directors 20152017/2014/2011-2012; CMA: Alternate Representative in the late 1980s.
None.
Co-Chief and Chief in family medicine residency program at North Shore–LIJ Health System, Glen Cove, NY; Resident Delegate to the Congress of Delegates for the NY State Academy of Family Physicians during second and third year of residency.
I have had several administration positions during my years of practice, including being the Acting Medical Director of the St. Mary’s Hospital Sleep Disorder Center, Psychiatric Director of the Children’s Hospital Eating Disorders Center, and Medical Director/Chief of Staff of the Ross Psychiatric Hospital. These experiences have taught me the importance of teamwork, focused goals, and creative problem solving.
MBA, Stanford. Lead and organize several medical business and technology networking groups. President and Social Chair of Stanford Graduate Rugby Club.
I have learned a great deal about the local politics and complex realities that organized medicine has to face in the Bay Area during my tenure on the Board. The Board’s evolving positions on topics such as the sugar tax, the right to a humane death, protecting the availability of medical insurance and access to mental health treatment are of particular interest. As a physician with offices in San Francisco and Marin County, I celebrate, and have been supportive, of the recent merger of the two medical societies. I see exciting times ahead as our medical society remains at the forefront of protecting and improving the practice of medicine, both in the Bay area and the larger world beyond.
The support of a vibrant community of colleagues is key to every generation of practitioners. The Society is in an exciting period of adaptation to meet this need amid changing technologies and platforms of communication. I would be honored to be a part of that evolution.
Primary Care Physician at One Medical in San Francisco (starting 10/2017); Previously at Dignity Health Foundation Group, St. Mary’s Medical Center, and USF Student Health Center. SFMMS/CMA Committees or Offices
Additional Relevant Experience
Why Are You Interested in Serving?
Serving as a Board member is a privilege and a great opportunity to participate in and learn about grassroots politics and policy-making. In a time of significant changes in health care and of rapidly evolving technology, I am excited to continue engaging in the process of health care policy.
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CANDIDATE BIOGRAPHIES Board of Directors MICHAEL C. SCHRADER, MD, PHD, FACP
ERIC WANG, MD
MATTHEW D. WILLIS, MD Incumbent Director
Incumbent Director
Also a candidate for CMA Delegation
Also a candidate for CMA Delegation
Internal Medicine
Radiology
Public Health
Current Job Positions and Hospital and Teaching Affiliations
Private practice, internal medicine; Fellow, American College of Physicians; Clinical Professor of Medicine, UCSF Volunteer Clinical Faculty; Instructor, Inpatient Medicine CPMC 2000-11; Instructor, UCSF Foundations of Patient Care Preceptor 1998-2016; Instructor, UCSF Longitudinal Care Experience 20122016. UCSF Volunteer Clinical Faculty Advisory Board 2016-present. Community Action Committee Saint Francis Memorial Hospital 2016-present.
Private Practice Radiologist and medicolegal consultant; practices at Chinese Hospital, Seton Memorial Hospital, and imaging centers.
Public Health Officer, County of Marin. Guest Researcher, U.S. Centers for Disease Control and Prevention. Adjunct Professor in Public Health, Dominican University of California.
SFMMS Board of Directors 2015-2017. SFMMS Executive Board 2017. SFMMS PAC 2017.
None.
Marin Medical Society Board Member (201517); SFMMS Board of Directors 2017.
I trained to be a physician-scientist but decided my true path was clinical medicine. I have always participated in teaching the next generation of physicians. I currently serve on the UCSF Volunteer Clinical Faculty Advisory Board. I am president of a small, independent physician practice. I have experience in clinical practice quality and served previously on the Subcommittee on Congestive Heart Failure Outcomes and the Atrial Fibrillation Clinical Pathway Committee at UCSF/Mt Zion.
Member of Medical Executive, Medical Staff Nominations, Physician Improvement, Spine Surgery, and Multidisciplinary committees, and chair of the Emergency Department Flow Committee at Chinese Hospital. Member of Chinese Community Health Care Association Finance Committee and Claims Review Committee evaluating malpractice claims for the Cooperative of American Physicians.
California Conference of Local Health Officers (CCLHO) Executive Board. Health Officers Association of California Legislative Committee. CCLHO Health Equity Committee co-chair. State of California Opioid Workgroup.
Medicine faces many challenges today. We must fight to protect the rights of patients and doctors. Patients deserve affordable and available care. Physicians deserve to be independent and serve patients the best we know how. Women’s health. Skyrocketing health costs. Support for scientific research. Support for the independent practice of medicine. Physician job satisfaction. These problems should be acted on by physicians to benefit patients.
I have always been passionate about serving and educating the underprivileged, but recent events have reinforced the need to serve and defend not only our community of patients, but also our community of physicians. I welcome the challenges to come, and look forward to advocating for both.
The SFMMS can lead the way in supporting health and wellbeing for all in our region. I’m excited to add my voice as a health officer, physician and epidemiologist to make sure public dialogue and policies are grounded in evidence, and informed by the firsthand experience of physicians.
SFMMS/CMA Committees or Offices
Additional Relevant Experience
Why Are You Interested in Serving?
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SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
SFMMS Nominations Committee ALBERT YU, MD, MPH, MBA
FRANCIS J. CHARLTON JR, MD
JAMES L. CHEN, MD
Incumbent Director
Family Medicine
Internal Medicine
Orthopedic Surgery
Current Job Positions and Hospital and Teaching Affiliations
Chief Health Information Officer, San Francisco Department of Public Health; Clinical Professor, UCSF Department of Family and Community Medicine; Attending Physician, Family Health Center, Zuckerberg San Francisco General Hospital and Trauma Center.
Solo Private Practice Primary Care Internal Medicine, Active Medical Staff and Core Clinical Faculty Internal Medicine Residency Program St. Mary’s Medical Center.
I am in private practice and founded Advanced Orthopaedics & Sports Medicine Inc. I am the Director of the San Francisco Sports Medicine Fellowship. I serve as Clinical Faculty at UC San Francisco and teach residents. I have privileges at all four hospitals in San Francisco.
SFMMS Board of Directors, 2015–2017; Additional Relevant Experience SFMMS Executive Committee, 2016–2017.
Various committees/boards during the 1980s and 90s.
I have previously served on the Nominations Committee for San Francisco Medical Society.
Board of Directors, National Council of Asian Pacific Islander Physicians 2014 –2017; Past President and Secretary, NICOS Chinese Health Coalition; Past Vice Chair, UCSF Department of Family and Community Medicine; Past Chief, UCSF Family Medicine Service; Past Medical Director, UCSF Lakeshore Family Medicine Center and SFDPH Chinatown Public Health Center; Past Chief Medical Informatics Officer, SFDPH Ambulatory Services.
Born and raised in San Francisco by a native SF Mom and a fifty-year SFMMS member General Practitioner Dad, myself a physician in SF for forty years, who has been in and worked collaboratively with physicians on staff at every SF hospital still in operation (in addition to many more physicians and several hospitals that are no longer with us).
None.
Universal access to quality health care remains incomplete. In the current discourse, patients are at risk of losing such right and benefits. SFMMS has always advocated for progressive policies. I would be honored to continue working with committed physicians to promote and protect the health of all San Franciscans.
I owe it to the SFMMS to participate because of all it’s done for me, my family, and my patients throughout my lifetime.
I am interested in bringing new physicians into the medical society. I feel it is important to unify all physicians in our geography so we can mobilize and prepare for upcoming changes in healthcare.
SFMMS/CMA Committees or Offices
Additional Relevant Experience
Why Are You Interested in Serving?
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CANDIDATE BIOGRAPHIES SFMMS Nominations Committee DIANA COUPARD, MD
MICHAEL K. KWOK, MD
TODD A. MAY, MD
Also a candidate for CMA Delegation
Internal Medicine
Internal Medicine
Family Medicine
Current Job Positions and Hospital and Teaching Affiliations
I am an Internal Medicine primary care provider for One Medical Group in the Inner Sunset. I also present the National Rounds clinical information to our North Residential District offices each quarter.
Internal Medicine private practice - both inpatient and outpatient (Kwok Internal Medicine, Inc.). Active Medical Staff - Marin General Hospital. Courtesy Medical Staff - Novato Community Hospital.
Chief Medical Officer, Zuckerberg San Francisco General Hospital; Primary Care Physician, Family Health Center, ZSFG; Hospitalist Attending Physician, ZSFG; Professor, Family & Community Medicine, University of California, San Francisco.
Member of MMS/SFMMS continuously since 1992. Board of Directors Marin Medical Society 1994-1996, 2012-May 2017; Secretary/Treasurer MMS 2013-2015 & President elect 2016-May 2017. Executive Committee of SFMMS May 2017 - present. Board of Directors SFMMS May 2017-present. Alternate Delegate to CMA House of Delegates 2014-present.
SFMMS: Board of Directors 2014-2017, ZSFG Liaison to the SFMMS Board of Directors during term as Chief of the Medical Staff at ZSFG 2009-11. Through my service with the SFMMS, I have come to greatly appreciate the importance of this society in consistently advocating for the best interest of our patients.
Marin General Hospital Strategic Planning Committee 2015-present. Novato Community Hospital (NCH) Board of Directors 19982006 (Finance Committee, Nominations Committee, Executive Committee; Secretary of the Board). NCH Medical Staff: Vice Chief of Staff 1997, Secretary/Treasurer 19951996 & 2005-2011; Chairman Pharmacy & Therapeutics Committee 1993-1996; Quality Review Committee 1992-2011 & Medical Committee 1992-2011, Medical Executive Committee for eleven years. Marin Physician Hospital Organization Board of Directors 1997-1999; Chaired Marin PHO Committee on Physician Recruitment & Retention.
I have been closely involved with clinical operations at ZSFG for the last twenty years, in both primary care and inpatient services. I have assumed several substantial leadership roles at the ZSFG campus.
Identifying and encouraging physicians to participate in organized medicine is essential to Medicine as a profession. I am honored to contribute and participate in this process.
This is a critical time in health care, requiring collaboration among our city hospitals and medical groups, as well as concerted advocacy for our patients and the integrity of our profession. The strength of our society is diversity, in all ways, and I will bring this principle to the Nominations Committee.
SFMMS/CMA Committees or Offices
None.
Additional Relevant Experience
Prior experience with SFMMS includes: Elected to board of directors for two terms (1997 and 2000); Medical Review and Advisory Committee member (1994-2000); Peer Review and Ethics Committee member (1994 –2000); Managed Care Task Force (1998-2000); Nominations Committee, 1998
Why Are You Interested in Serving?
After private practice then time off for child rearing, I am now practicing medicine at One Medical Group. I look forward to helping integrate our organization into the larger SF/ Marin medical community, so we can become a part of the dialogue in problem solving health care delivery for our community. 22
SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
American Medical Association Delegate
American Medical Association Alternate Delegate
ROBERT J. MARGOLIN, MD
District VIII SFMMS California Medical Association (CMA) Trustee
SHANNON UDOVICCONSTANT, MD, FAAP
GORDON L. FUNG, MD, PHD, FACC, FACP
Incumbent Delegate
Incumbent Editor
Incumbent Trustee
Also Candidate for Editor
Internal Medicine and Geriatrics
Cardiovascular Diseases
Pediatrics
Current Job Positions and Hospital and Teaching Affiliations
Primary Care Practice in Internal Medicine; Chief, Division of Internal Medicine at CPMC; Vice Chief of Staff of the Medical Staff at CPMC; Chair of the Credentials Committee at CPMC; Board of Directors, Medical Insurance Exchange of California; Associate Clinical Professor, UCSF.
See bio under Editor
Kaiser Permanente Pediatrician; Associate Clinical Professor, UCSF Department of Pediatrics; Short-Term Director from San Francisco to the Permanente Medical Group (TPMG) Board.
SFMMS/CMA Committees or Offices
AMA: Delegate to the House of Delegates; CMA: Past Member of the Board of Trustees, Past Chair of the Audit Committee, Past Chair of CALPAC; SFMMS: Past President, Past Chair of the Delegation.
SFMMS: Board consultant 2015-present; Immediate Past President 2014, President 2013, President-Elect 2012, Treasurer, 2011, Board of Directors 2007–10 (Executive 2007–present, Bylaws 2007), SFMMS PAC Board 2006–present (Chair 2009–10, Secretary/Treasurer 2007–08); CMA: Trustee Oct. 2012-Oct. 2018, CMA House of Delegates 2010–13 (Alternate, 2008–09), CALPAC Board 2011–present, CMA Young Physician Section Executive Committee, atlarge member 2003–05, CMA Council on Legislation member 2010–present.
Additional Relevant Experience
I have spent much of the past twenty-five years in leadership roles in our medical society and the CMA.
Why Are You Interested in Serving?
I have greatly enjoyed my role as your AMA delegate for the past ten years. I believe I have the experience, perspective, energy, and desire to continue to advocate for physicians and their patients and thus ask that you reelect me to serve as your AMA delegate. WWW.SFMMS.ORG
Additional Relevant Experience
Why Are You Interested in Serving?
Over the past five years, I have served as an alternate delegate from the San Francisco Medical Society and CMA to the AMA. The experience has been highly stimulating and provocative. Representing San Francisco and California in one of the largest organized medicine institutions and facilitating our impact on the practice of medicine in America was just aweinspiring. The AMA is involved in every aspect of medical care from the training of students and residents to the regulation of the medical practice including ethical practice and government reimbursement. Over the past year during the active process of merging with Marin Medical Society to the SFMMS, I am invigorated to represent this larger thoughtful group at the AMA. I seek re-election as alternate delegate to continue the great work that we are doing at SFMMS to the national level.
I serve on three medical boards: CMA, SFMMS, and The Permanente Medical Group (TPMG). I have extensive experience in health care policy and advocacy as a delegate to the CMA House, and a member of the CALPAC Board. I am a direct and effective communicator, also skilled at developing coalitions with other physicians. It is my priority to facilitate engagement across the CMA Why Are You Interested in Serving?
I am proud to be from the SFMMS, with its history of bringing forward important policies that have shaped CMA. I want to continue to serve SFMMS for the CMA to be what San Francisco/Marin’s physicians want it to be. I will work to preserve the profession of medicine so that it is a career that I would want my children to pursue.
OCTOBER 2017 SAN FRANCISCO MARIN MEDICINE
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CANDIDATE BIOGRAPHIES SFMMS Young Physicians Section (YPS) Delegate or Alternate to the CMA House for 2017
JACLYN TAUB, DO
SFMMS Delegation to the California Medical Association House of Delegates
PRIYANKA WALI, MD
AMEENA T. AHMED, MD, MPH Incumbent Delegate
OB/GYN
Internal Medicine and Obesity Medicine
Internal Medicine and Preventive Medicine
Current Job Positions and Hospital and Teaching Affiliations
OB/GYN Physician at Kaiser Permanente San Francisco working with OB/GYN residents and UCSF medical students. SFMMS/CMA Committees or Offices
None.
Additional Relevant Experience
Attending physician in outpatient primary care at Baywest Family Health Care. Hospital Affiliation - St. Luke’s Hospital; Clinical Instructor - Dartmouth Giesel School of Medicine, Stanford School of Medicine; Ketogenic Educator for DELISH Trial at UCSF.
Adult Medicine, Kaiser Permanente San Francisco Medical Center; Chief of Complementary and Alternative Medicine; Assistant Clinical Professor, Department of Epidemiology and Biostatistics, UCSF.
None.
CMA Delegate 2014-2017; Former SFMMS PAC Board Member.
Radio program on KFOG: “Things You Wish You Could Ask Your Doctor But Are Afraid To, ”a program designed to educate the general public about medical issues. Medical writer for healthline.com - routinely feature articles and videos about general medical topics. Stand-up comedian - perform worldwide.
I completed a fellowship in social epidemiology, through which I developed a keen interest in how political and social factors affect health. This background has demonstrated to me how important policy is in shaping health and health care. I’ve had the privilege to volunteer with Physicians for Human Rights in Central Asia, the Middle East, and South America, working to end human rights abuses and create mechanisms for accountability.
Our current healthcare system and representation is inadequate. Many physicians are fed up under the current model, which has devastated the once sacred physician-patient relationship. With my background in teaching and public speaking, I believe I am the right person to uniquely represent our organization in future legislative changes.
I look forward to serving San Francisco’s physicians as a leader and advocate. I would be honored to work with my colleagues to shape policy to improve health in San Francisco.
Additional Relevant Experience
I have been on several committees in my residency program to help improve patients’ experience, such as improving the bereavement process and also emergency simulation drills and training. I would like to get more involved with the political aspects of healthcare.
Why Are You Interested in Serving?
I am interested in becoming the Young Physician Delegate to become more involved with the politics affecting our health care system now and in the future. During these changing times, I believe it is important for physicians to play an active role in shaping our system. 24
SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
LARRY A. BEDARD, MD, FACEP, FIFEM
ROGER S. ENG, MD, MPH, FACR
GEORGE A. FOURAS, MD
Incumbent Alternate
Incumbent Delegate
Incumbent Alternate
Emergency Medicine, Medical Legal Consultant, Administrative Medicine
Radiology
Child and Adolescent Psychiatry
Current Job Positions and Hospital and Teaching Affiliations
President, Golden Gate Radiology Medical Group; Chief of Radiology, Chinese Hospital.
Mental Health Psychiatrist, Los Angeles County Dept. of Mental Health, Children’s System of Care/ Countywide Services.
SFMMS: President 2015; Director 2009–12; Executive 2010–11, 2013-2016; Board consultant 2017-present; PAC 2011–present; Nominations 2011; CMA: Chair, Council on Membership, Governance and Bylaws 2016-present; Board of Trustees 1997–98, 2003–07; Delegate/Alternate Delegate 1995–present; Young Physicians Section, Chair 2001–02; IT Committee, Chair 2004–08; Committee on Nominations 1997–98, 2003–07; Long-Range Planning Committee 2003–07; Chair, CMA Website 2006–07; Health Care Finance Technical Advisory Committee 2004; Committee on Medical Service 1998–99; CMA House of Delegates 2012 Reference Committee C Chair (partial list).
SFMMS Consultant to Board 2013-present; Immediate Past President 2012; President 2011; President-Elect 2010; Secretary 2009; Director 2003-2008; Executive Committee 2003-2011; SFMMS PAC 2004-present (Chair 2015-2016 /2007-08); Physician Membership Services, 2003-present; CMA Delegate, 2010-2015; CMA Alternate Delegate 2016-2017/2007-2009/ 2000-2002.
I am serving my fourth elected term on the Marin Healthcare District (MHD) Board of Directors. During my terms MHD has separated from Sutter Health and established Marin General Hospital as an independent, full service community hospital. We have established eleven Primary Care Clinics and are building a new $534 million addition. I have learned valuable lessons on how to transition from volume to value and from independent small/solo practice to a hospital integrated or affiliated practices.
AMA offices: AMA Delegate 1996–97; AMA-RPS Delegate 1995–97; AMA-YPS Delegate 1998–99 (Vice Chair, CMA YPS delegation); Related medical affiliations: President, California Radiological Society 2014; Treasurer, San Francisco Bay Radiological Society; Chinese Community Health Care Association IT Committee 2006–present; Carestream Physician Advisory Board 2005–present; American College of Radiology, Councilor, 2008–present; Chinese Hospital, Medical Executive Committee 2004–2010.
Past President, Nor Cal Regional Organization of Child and Adolescent Psychiatry; Co-chair, Adoption and Foster Care Committee for the American Academy of Child and Adolescent Psychiatry.
Throughout my career I have always enjoyed medical advocacy and medical politics. I have served as President of CALACEP and ACEP. As a Delegate or Alternate for more than thirty years, I have authored many resolutions. I enjoy the debates and the camaraderie and friends at the House.
Participating in our local medical society is both a privilege and a professional responsibility. I will continue to represent our diverse membership and public health initiatives at the state level.
The SFMMS delegation has been one of the most influential groups in the CMA. It has been an honor to participate and to encourage younger physicians to become engaged in organized medicine. I hope that you will allow me to continue to serve the SFMMS in the future. Thank you for your support.
Marin Healthcare District (MHD) Board of Directors; MHD, Chair Finance and Audit committee; Delta V Bio, Medical Legal Consultant. SFMMS/CMA Committees or Offices
I have been a Delegate or Alternate Delegate to the CMA House of Delegates for more than thirty years representing CALACEP in the Specialty Delegation and District X. I served one term on the CMA Board of Directors
Additional Relevant Experience
Why Are You Interested in Serving?
WWW.SFMMS.ORG
OCTOBER 2016 SAN FRANCISCO MEDICINE
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CANDIDATE BIOGRAPHIES SFMMS Delegation to the California Medical Association House of Delegates ZARAH IQBAL, MD, MPH
NAVEEN N. KUMAR, MD
MICHAEL K. KWOK, MD
Incumbent Alternate
Incumbent Alternate
Also a candidate for Nominations Committee
Pediatrics
Interventional Radiology
Internal Medicine
Current Job Positions and Hospital and Teaching Affiliations
UCSF Pediatrics Resident, PGY-1, Pediatrics Leadership for the Underserved (PLUS).
Chief of Interventional Radiology at Kaiser Permanente, San Rafael.
See bio under Nominations Committee
SFMMS/CMA Committees or Offices
CMA Medical Student Section, Vice Chair of Policy, 2014-2015; CMA Medi-Cal subcommittee, 2015-2016; CMA delegation to AMA, delegate, 2015-2017. Created electronic matrix for delegation to keep track of resolutions.
SFMMS Board of Directors 2017-19; Marin Medical Society Secretary/Treasurer 2017; Alternate Delegate to CMA House of Delegates 2016-17.
MPH in health policy, Harvard T.H. Chan School of Public Health, Class of 2016. American Academy of Pediatrics, Section on Pediatric Trainees (SOPT). AAP delegation to AMA, 2017 - current. Policy Intern, Office of Massachusetts Representative Christine Barber, 2015-2016.
None.
Additional Relevant Experience
Why Are You Interested in Serving?
Since my first CMA meeting, I have realized that advocacy work is core to my purpose as a physician. My involvement in organized medicine and my health policy focus during my MPH has led me to develop a unique perspective and skill set in health policy and advocacy. As an SFMMS delegate, I hope to use this skill set to advocate for patients and physicians. 26
This is a great opportunity to represent our physicians in the house of organized medicine and make our voice heard.
My experience in Hospital leadership and governance, Medical Staff leadership and governance, Physician peer review and Medical Society leadership provide me a broad perspective on the practice of medicine and health policy issues. I feel I can be an effective voice and represent my physician colleagues at the CMA House of Delegates.
SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
L. ALISON MCINNES, MD, MS
MAN-KIT LEUNG, MD
JOANN (JOSIE) MOSCHELLA, DO
Incumbent Delegate
Otolaryngology – Head & Neck Surgery
Psychiatry
Family Medicine
Current Job Positions and Hospital and Teaching Affiliations
Adult Psychiatrist; Founder Ketamine Therapy for Depression Program, Department of Psychiatry Kaiser Permanente; Associate Clinical Professor of Psychiatry, University of California San Francisco
La Clinica de Salud, Kaiser SF Mission Bay; Assistant Professor of Family and Community; Medicine, Family and Community Medicine Residency Program, UCSF/ZSFGH; Clinical Instructor, Family Medicine Residency Program, Salinas, CA; Clinical Instructor, Touro University, College of Osteopathic Medicine, Vallejo, CA; Teaching Faculty, Planned Parenthood, Mar Monte (Bay Area Affiliate).
SFMMS: President, President-elect, Treasurer, Secretary, Board of Directors, Executive Committee, PAC (former Vice Chair), Nominations Committee, Chinese Hospital liaison to SFMMS; CMA: Delegate and Alternate Delegate to HOD, CMA At-Large Delegate to Council on Legislation.
None
None
St. Francis Memorial Hospital Board of Trustees, Asian American Medical Group Board of Directors.
As the Regional Medical Director for Ketamine Therapy for the last 2.5 years, I held two major CME conferences to educate psychiatrists from Kaiser Permanente and the community about the utility of ketamine therapy and other fast acting antidepressants. I established an international coalition of physician-researchers to promote this work. I coordinated activities at eight different medical centers within Kaiser and other major medical centers including UCSF. I am good at educating and building coalitions.
Chief Resident, Natividad Family Medicine Residency Program 2004-2005; Advisory Board Member, Training/Education in Abortion for Comprehensive Healthcare 2005-present; RHEDI Director, Natividad Residency Program 2006-2012; Union representative, Union of American Physicians and Dentists 2011-2014; Harvard School of Public Health: Program in Community Health Center Management 2012.
Some of the most efficacious medicines for illnesses like depression and PTSD are being derived from psychedelic drugs. There is resistance to the use of these medicines out of fear of their abuse potential thus advocacy and education are needed to ensure they will be available to those in need.
My main interests in serving in HOD are to serve as a voice for underserved Californians and to continue to be a voice for people on the margins. I began my career in the MontereySanta Cruz area with farmworkers and now in SF with immigrants and sexual minorities. I am committed to bringing awareness and inclusion of these populations to the work of the HOD.
Private practice in small group; affiliations with Chinese Hospital, St. Francis Memorial Hospital, CPMC, St. Mary’s Medical Center.
SFMMS/CMA Committees or Offices
Additional Relevant Experience
Why Are You Interested in Serving? Why Are You Interested in Serving?
It has been a great honor to serve as an officer of SFMMS the past few years. I hope to continue my service to our membership as a delegate to the CMA House of Delegates and help craft CMA policy consistent with our common values.
WWW.SFMS.ORG
OCTOBER 2016 SAN FRANCISCO MEDICINE
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CANDIDATE BIOGRAPHIES SFMMS Delegation to the California Medical Association House of Delegates STEPHANIE OLTMANN, MD
MICHAEL C. SCHRADER, MD, PHD, FACP
Incumbent Alternate
JEFFREY L. STEVENSON, MD
Incumbent Alternate
Also a candidate for Board of Directors
Family Medicine
Also a candidate for Board of Directors
Internal Medicine
General Practice, Primary Care
Current Job Positions and Hospital and Teaching Affiliations
See bio under Board of Directors
See bio under Board of Directors
Private practice; Solo practice; Medical staff Marin General, Novato Community Mills-Peninsula Hospitals.
SFMMS/CMA Committees or Offices
Immediate Past President Marin Medical Society 2017; SFMMS Board of Directors and Executive Committee 2017; PAC 2017; Currently Alternate Delegate; Former CMA Work Comp Technical Advisory Committee (TAC).
Additional Relevant Experience
Working with legislators, professional groups, CMA, private. MEDICAID-MEDI CAL (GOALS): 1.Taxpayer’s default health care. 2. Eligibility; remove penalties for working. 3. Efficiency-infrastructure improvements; expedite qualifying, treatment, payment. EHR IMPROVEMENTS (Goals): 1.Physician intuitive, expedited. 2.CURES intuitive. 3.Interoperability resolution with CMA leadership; revoke EHR certification if fails interoperability tests like “I need a patient record CD, now”. 4.Time of service authorization. 5.Secure core medical data. End proprietary ransom. WORKERS COMP: 1.SB 563-1160 (Pan-CMA); payor MD responsible for utilization review. Goal; medical director board seat. 2.Improve efficiency; 28:1 Premium: Paid Medical. OTHER: 1.Lobbied extra time reimbursement: 99358 Bill It
Why Are You Interested in Serving?
Serving as a delegation member is a privilege and a great opportunity to participate in and learn about grassroots politics and policymaking. In a time of significant changes in health care and of rapidly evolving technology, I am excited to continue engaging in the process of health care policy.
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None.
Quality of care, practice survivability.
SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
MATTHEW D. WILLIS, MD
JOSEPH W. WOO, MD
Also a candidate for Board of Directors
Public Health
Emergency Medicine
Current Job Positions and Hospital and Teaching Affiliations
See bio under Board of Directors
SFMMS/CMA Committees or Offices
Staff Physician, Chinese Hospital ER; CEO, Asian American Medical Group; Medical Director, Chinese Community Healthcare Association. SFMMS Board of Directors 2017-2019 / 2010–2015; SFMMS PAC Board
Additional Relevant Experience
Former Medical Director Chinese Hospital ER; Former Chief of Medical Staff, Chinese Hospital.
Why Are You Interested in Serving?
Thank you for the opportunity to serve. I find myself in a unique position in my career as a practicing physician, administrator, and SFMMS Board member. From this perspective, I embrace the chance to shape policy and tackle the pressing issues that face our doctors and patients. SFMMS physicians have always been leaders at all levels of organized medicine and with your vote, I look forward to carrying on this honored tradition. WWW.SFMMS.ORG
OCTOBER 2017 SAN FRANCISCO MARIN MEDICINE
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CURRENT DELEGATION MEMBERS LAWRENCE CHEUNG, MD, FAAD, FASDS
GORDON L. FUNG, MD, PHD, FACC, FACP
MIHAL L. EMBERTON, MD, MPH, MS Incumbent Alternate
Incumbent Delegate
Delegation Chair; Incumbent Delegate
Also a candidate for Editor and AMA Alternate.
Dermatology
Family Medicine
Cardiovascular Diseases
Current Job Positions and Hospital and Teaching Affiliations
Solo private practice with volunteer teaching responsibility at UCSF.
Adult and Family Medicine Senior Physician, the Permanente Medical Group; Clinical Teaching Faculty, UCSF.
See bio under Editor
SFMS/CMA Committees or Offices
SFMMS: Board Consultant, 2016-17; Immediate Past President, 2015; President, 2014, President-Elect, Treasurer, Secretary, Board of Directors, Political Action Committee, Membership Committee. CMA: House of Delegates and current member of the Council on Science and Public Health. AMA: Delegate At Large representing the CMA.
Delegate to CMA House, 2015-2016; Alternate Delegate, 2013-2014; 2017
I have been very active at the local level (SFMMS), state level (CMA) and national level (AMA) on a variety of issues including preserving modes of practice (specifically solo and small group) as well as public health policy (tobacco control, soda, obesity epidemic and health care disparity).
When my wife was denied health coverage in 2008 by my employer, despite my Public Policy Masters in Public Health, it took six weeks of emotional collaboration with multiple stakeholders, both in the hospital and community, before we were finally granted spousal benefits. This experience has stimulated my passion for social justice and also prompted my participation on multiple LGBTQ and Diversity Committees, where I continue to refine leadership and advocacy skills.
Additional Relevant Experience
Why Are You Interested in Serving?
SFMMS was an invaluable organization for me when I started my solo practice eleven years ago and continues to be a resource for me today. The Society serves as my only local advocate and the CMA serves as my only state advocate in matters of public health, patient safety, and physician advocacy. With the looming changes occurring in the profession of medicine, I feel that it is not just a privilege but a duty to make the Society a relevant organization for future San Francisco physicians.
30
I would like to continue to improve the practice of medicine and the delivery of care from the policy side, where changes can improve the overall health of Californians as well as the lives of physicians. It is an honor to represent my SF colleagues in the House of Delegates.
Why Are You Interested in Serving?
I ask for your support to represent you at the California Medical Association House of Delegates (HOD). San Francisco is a unique community that has a finely honed process to make a significant impact in health policy at the local, state, and national levels. We have also been rising to the challenge of working within the new format of the CMA for yearround resolutions and a shortened HOD. Your delegation over the years has demonstrated success in developing and supporting resolutions that have impacted key areas of our practice, from environmental health issues to public health issues with healthy lifestyles and neighborhoods to streamlining the way for patients to get their prescriptions. No one person can have the expertise required in all these areas. So the collaborative/team effort to bring these issues to the CMA and many to the AMA requires all members of the delegation to pitch in. I look forward to working with this team of delegates to bring San Francisco’s expertise and issues to the state and the nation.
SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
PRATIMA GUPTA, MD
JOHN LANDEFELD, MD, MS
Incumbent Delegate
Incumbent Alternate
Obstetrics and Gynecology
Internal Medicine Resident
JOHN MAA, MD Incumbent Delegate
General Surgery
Current Job Positions and Hospital and Teaching Affiliations
Kaiser Permanente Senior Physician; Volunteer Assistant Professor at UCSF; Medical Director St. James Infirmary (free clinic in SF for sex workers and transgender individuals).
Internal Medicine - Primary Care resident (PGY-1) at UCSF-SFGH.
SFMS/CMA Committees or Offices
SFMMS PAC 2016; Delegate to CMA House of Delegates 2017; Alternate Delegate 2015-2016.Recipient of the 2017 CMA Compassionate Physician Award. Additional Relevant Experience
Vice-Chair of the San Francisco Democratic County Central Committee; American College of Ob/Gyn District IX Legislative Committee member; Board of Directors of California Family Health Council; Member of SF Mayor’s Anti-Human Trafficking Taskforce; former member of Board of Directors for Physicians for Reproductive Choice and Health.
SFMS/CMA Committees or Offices
Alternate Delegate to CMA House of Delegates 2017.
Why Are You Interested in Serving?
As San Francisco’s first-ever elected medical doctor, I believe that health and public service extend beyond the doors of my clinic and hospital. The social determinants of health such as education, nutrition, transportation, and environment must be incorporated into our priorities at SFMMS and CMA. Physician advocacy is an important part of my medical philosophy, as I consistently use my voice as a physician to fight to ensure reproductive rights for all men and women in the U.S. and abroad. In addition, I am committed to cultivating and empowering others to achieve success. Through my many years of medical training and practice, I have mentored many undergraduate and medical students, residents, and colleagues. My mentorship approach involves a discussion around the individual’s goals (both immediate and long term), envisioning the best and worst case scenarios, and making a roadmap about how to achieve success. I like to continue to do regular check-ins with my mentees to explore their path, their strategy, and allow them to stray as long as they continue to keep their end goal in sight. We must be our own support network. WWW.SFMS.ORG
Additional Relevant Experience
Prior to medical school, I was a political organizer working on Barack Obama’s first presidential campaign. During medical school, I spent a year as a non-voting board member of LifeLong Medical Care, a community health center in the East Bay. I have also conducted public health and health policy research on topics including digital health, patient safety, social determinants of health, and the health of marginally housed individuals. Why Are You Interested in Serving?
As an intern in internal medicine building a career in public health and primary care, I am eager to bring a Primary Care Physician trainee’s perspective on front-line care in safety net settings to service at SFMMS.
Chair, University of California Office of the President Tobacco Related Disease Research Program; Marin General Hospital, General and Trauma Surgery; Chair of the American Heart Association Western States Affiliate Advocacy Committee. Selected as (415) Top Doctor by Marin Magazine, a San Francisco SuperDoctor in 2012 and 2013, and the 2016 American Heart Association (AHA) Physician Volunteer of the Year. SFMMS: President-Elect 2017; Secretary, 2016; Board of Directors, 2012-2015; Executive Committee, 2014-2017/2012-2013; AMA, 1991-present; CMA Specialty Society Delegate and Member of the Subcommittee on Professional Liability; Awarded SFMMS David Perlman Award for Excellence in Medical Journalism in 2013; San Francisco Medicine Magazine Editorial Board, 2012-present. Past President, American College of Surgeons (ACS) Northern California Chapter; Recipient of the 2013 ACS Ellenberger Award for Excellence in State Advocacy; Nominated for the White House“Champion of Change for Prevention and Public Health” 2013; Named a “Top 20 people making a difference in healthcare in America” 2009; Current Member of AHA Board of Directors and Past President, San Mateo, 2004-2005; Commendation for Tobacco Control Advocacy by the San Francisco Board of Supervisors in 2014; Recipient of the California Chronic Care Coalition 2016 Star of Advocacy Award. I would be honored to serve on the SFMMS Delegation with the vision to improve the overall health of the public in San Francisco (and beyond) by leading scientific, public policy, and research efforts to strengthen the future practice of medicine, and promote quality patient care through advocacy.
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CURRENT DELEGATION MEMBERS ROBERT J. MARGOLIN, MD
RICHARD A. PODOLIN, MD, FACC
ANDREA M. WAGNER, MD
Incumbent Alternate
Incumbent Delegate
Incumbent Delegate
Internal Medicine and Geriatrics
Cardiology
Emergency Medicine
Current Job Positions and Hospital and Teaching Affiliations
Primary Care Practice in Internal Medicine; Chief, Division of Internal Medicine at CPMC; Vice Chief of Staff of the Medical Staff at CPMC; Chair of the Credentials Committee at CPMC; Board of Directors, Medical Insurance Exchange of California; Associate Clinical Professor, UCSF.
I am in private practice with one partner (Remo Morelli, MD) and affiliated with St. Mary’s Medical Center.
Director of Outside Hospital & Emergency Operations and Emergency Prospective Review Program (EPRP) for Northern California; Staff Physician, Emergency Medicine, Kaiser Foundation Hospital, San Francisco.
AMA: Delegate to the House of Delegates. CMA: Past Member of the Board of Trustees, Past Chair of the Audit Committee, Chair of CALPAC. SFMMS: Past President, Past Chair of the Delegation.
SFMMS: Immediate Past President 2017; President, 2016; President-Elect, 2015; Secretary, 2014; Board of Directors, 2009-2013; Executive Committee, 2012-2017; Nominations Committee, 2017/2009; Delegate to CMA House, 2015-2017; Alternate Delegate, 2014. Additionally, for many years I served as delegate to the CMA from the California Chapter of the American College of Cardiology
Delegate to CMA House, 2015-17; Alternate Delegate, 2012-2014.
I served as Chairman of the Quality Committee at St. Mary’s Medical Center for four years, and then as Chief of Staff for four years. I have been President of the San Francisco Heart Association and a District Councilor for the California Chapter of the American College of Cardiology. For two years I served as Chairman of the Board of the St. Mary’s Medical Center Foundation, and currently, I serve as Chairman of the Community Board of St. Mary’s Medical Center.
Board of Directors, California Chapter of the American College of Emergency Medicine, June 2006–June 2012; Counselor, American College Emergency Physicians, 2006-2015; Committee Member, Government Affairs Committee California American College of Emergency Physicians (ACEP), 2006-2016.
In this period of fundamental change in our health care system, physicians need to align to advocate for their profession, their patients, and their community. The strength of the SFMMS and the CMA will directly affect the viability of medical practice and the vitality of health care in San Francisco
I would like to continue in my role in the SFMMS delegation to the CMA House of Delegates. We play a critical role for our Medical Society in crafting and promoting policy resolutions. Thank you for your support.
SFMS/CMA Committees or Offices
Additional Relevant Experience
I have spent much of the past twenty years in leadership roles in our medical society and the CMA.
Why Are You Interested in Serving?
I have greatly enjoyed my role as your CMA delegate for the past twenty years. I believe I have the experience, perspective, energy, and desire to continue to advocate for physicians and their patients and thus ask that you reelect me to serve on your CMA delegation.
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SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
Once the new SFMMS Charter is approved, all members of the delegation will have to be approved, so the following delegation members, whose current term does not expire until 2018, will also need to be reelected to serve out their current term through 2018: AMY E. WHITTLE, MD Incumbent Alternate
Pediatrics Assistant Clinical Professor of Pediatrics, University of California, San Francisco; Medical Director, Multidisciplinary Assessment Clinic; Medical Director, San Francisco Medical-Legal Partnership, both at Zuckerberg San Francisco General; Course Director, Physician in Community & Behavior and Development rotations, UCSF Pediatric Residency. Alternate Delegate to CMA House, 2015-2017; SFMMS Nominations Committee, 2014-2015.
I served as State Governmental Affairs Committee Representative for Chapter 1 of the California American Academy of Pediatrics (AAP) from 2011-2016. This committee determines advocacy priorities and then reviews state legislation relevant to these areas and determines AAP advocacy strategies. I am also co-chair of the Chapter 1 AAP-CA Advocacy Committee, which coordinates advocacy around pediatric health policy issues at the local, state, and national levels. My prior experience in advocacy led me to become interested in serving as a delegate to the CMA House of Delegates. My past experience in evaluating legislation and policy will serve me well in the task of reviewing resolutions and helping to form the SFMMS positions.
WWW.SFMMS.ORG
Lawrence Cheung, MD, FAAD, FASD (Incumbent Delegate) Mihal L. Emberton, MD, MPH, MS (Incumbent Alternate) Gordon L. Fung, MD, PhD, FACC, FACP (Incumbent Delegate) Pratima Gupta, MD (Incumbent Delegate) John Landefeld, MD, MS (Resident) (Incumbent Alternate) John Maa, MD (Incumbent Delegate) Robert J. Margolin, MD (Incumbent Alternate) Richard A. Podolin, MD, FACC (Incumbent Delegate) Andrea M. Wagner, MD (Incumbent Delegate) Amy E. Whittle, MD (Incumbent Alternate)
A Time for Physicians to Lead Peter N Bretan, Jr., MD, FACS
It is a distinct honor to have served as CMA Trustee as well as four separate terms as President of the Marin Medical Society in the past twenty years. By participating in the development of healthcare policy
through these types of leadership, we enable our profession of medicine to remain physician-led in these most volatile times. We have an opportunity to better the trajectory of healthcare for our patients, but it will take teamwork and experience. It is my intent to serve the CMA and our profession of medicine at the highest level possible for the benefit of our patients as President Elect of the CMA. Formulation of good healthcare policy by our CMA recently has enabled our forty-five thousand Physicians to provide better care for their patients, but going forward it will required innovative strategies in this new era of polarizing legislative agendas. The doctor-patient relationship is sacrosanct, and even as an ultra-specialist in transplant and urologic surgery, I believe that patients are best cared for close to their Primary Care Physicians and families. That is why after a successful urban centered academic career, I now deliver rural care to six different northern California counties, and ten different hospitals and clinics covering a two hundred mile radius. These experiences enabled me to effectively serve as the chief or Urology or Surgery at three of those hospitals, as well as their CMA/AMA OMSS representative for the past seventeen years. With dwindling rural physicians’ population being accelerated by impending programs of the Medicare Access & CHIP Reauthorization Act (MACRA), the Meritbased Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs), our profession requires representation by leaders with credible experience and the ability to debate and educate our legislators. That is why I have taught a HCP course in medical school to help produce an army of educators to our elected officials. It is this potential that makes our students and residents the most important members of our CMA; they are our future of the practice of medicine, our profession. That is why have been teaching them for the past thirty years of my career. That is why I bring thirty to forty students each year to medical missions, seeing over eight thousand patients and performing more than a thousand lifesaving surgeries in less than a week—not just to show them how to save lives, but most importantly, that every life is precious. We are all life savers! Please join me in these vital efforts. OCTOBER 2017 SAN FRANCISCO MEDICINE
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MEDICAL COMMUNITY NEWS CPMC Edward Eisler, MD California Pacific Medical Center is once again ranked as a top hospital in California and San Francisco by U.S. News & World Report, ranking number twenty-seven (out of 412) in the state. While the U.S. News & World Report recognizes CPMC as high-performing in chronic obstructive pulmonary disease colon cancer surgery, heart failure and knee and hip replacement, we are proud of the entire suite of services we offer. CPMC’s Forbes Norris ALS Research and Treatment Center, headed by Sutter Pacific Medical Foundation physician Dr. Robert Miller, was selected to participate in a high-profile Phase 3 trial for amyotrophic lateral sclerosis (ALS) cell therapy along with Massachusetts General Hospital. The trial, led by BrainStorm Cell Therapeutics of Hackensack, NJ, is proceeding through advanced stages of planning after receiving a $15.9 million grant from the California Institute for Regenerative Medicine. The Phase 3 trial plans to enroll two hundred
UPCOMING EVENTS
2017 Institute for Medical Quality (IMQ) Medical Staff Conference
October 26, 2017 | Embassy Suites SFO (Gateway) Hotel, South San Francisco This one day course will address the critical challenges facing medical staff and is designed for physicians, hospital leaders, medical staff directors, credentialing specialists and quality improvement professionals. For more information or to register, visit http://bit.ly/2gZTD22.
Mastering the Art of Disclosing an Unexpected Outcome (offered twice)
November 7, 2017, 6-9pm | Hospice by the Bay, 17 East Sir Francis Drake Blvd, Larkspur, CA November 14, 2017, 6-9pm, SF location | TBD When an unexpected outcome occurs, a discussion explaining what happened can help prevent a negative patient response and can actually improve patient trust and reduce the risk of a lawsuit, yet few physicians have been trained in this specialized set of communication skills in how to effectively manage these difficult conversations. With this in mind, MIEC has created an interactive workshop that examines the elements of providing a timely and effective disclosure when an unexpected outcome occurs. This three-hour evening workshop is free to SFMMS member physicians. More information and registration will be available soon at https://www.sfmms.org/events.aspx.
patients. The trial will further research on a therapy, called NurOwn, that converts stem cells into a cell type which secretes a variety of proteins designed to treat the ALS disease. The earlier Phase 2 trial showed promising results with forty percent of subjects experiencing an improvement of at least fifty percent in post-treatment.Sutter Health is planning a partnership with a start-up called Qventus at two dozen of its California hospitals and thirty of its pharmacies in the coming months. The project involves alerting pharmacists when patients need a change in medication—an example might be a transition from injectable Tylenol to a cheaper oral alternative—or require extra support in how to take their meds. A second effort nudges providers to move patients more efficiently through surgery centers to prevent delays. This would allow doctors, nurses and pharmacists to focus on the patients with the most complex needs who need more help, and reduce expensive, unnecessary treatments.
CLASSIFIED ADS Medical and dental space 2,000 sf and up in newly upgraded Pacific Vision Foundation building at 711 Van Ness Ave, SF. Ford Griswold, Bayside Realty Partners, 415-990-7004 or fgriswold@baysiderp.com.
For Sale: ENT/Derm Equipment
Otic, Nasal & Oral Instruments, Mirror Warmers, Stapedectomy Set, Lighted. Surgical Loupes, Power table, Mayo Stands, Small Oxygen Tank, Laryngoscope, Over 40 Lipsuction Cannulas, IV Stands, Defibrillator, Instrument Trays, New Tulip Liposuction Set. Call Dr. Parnell (415) 271-1720.
Medical Office
250 sf medical office at 350 Bon Air Road with reception area and ample parking. $1400. Anne-Marie 415-955-7050
Medical Office
599 Sir Francis Drake, window office with high ceilings, 2 exam rooms, private restroom and reception area. Anne-Marie 415955-7050
SAVE THE DATE: SFMMS 150th Anniversary Celebration & Annual Gala
In 2018, SFMMS will celebrate its 150th Anniversary. Save the date for a celebration not to be missed! Come together with many of the Bay Area’s most influential stakeholders in the medical community to celebrate SFMMS’ 150 years of physician advocacy and camaraderie. Ticket information will be available online soon at www.sfmms.org and invitations will be mailed in January. Sponsorship opportunities are available – contact Erin Henke at ehenke@sfmms.org or (415) 561-0850 x268. 34
SAN FRANCISCO MARIN MEDICINE OCTOBER 2017 WWW.SFMMS.ORG
Donate Blood. Save Lives. To make an appointment, call us at 1-888-393-4483 or visit www.bloodcenters.org
San Francisco Marin Medical Society 2720 Taylor St, Ste 450 San Francisco, CA 94133
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REASONS TO JOIN CMA AND YOUR COUNTY MEDICAL SOCIETY
TOGETHER WE ARE STRONGER
HEAD SEAT AT POLICY TABLE
California Medial Association (CMA) and its county
Through aggressive political and regulatory
medical societies have represented California’s
advocacy, CMA and its county medical societies
physicians for 160 years as the recognized voice
are positioned as one of the most influential
of the house of medicine. Together we stand taller
stakeholders in the development and implementation
and stronger as we fight to protect patients and
of health policy.
improve the health of our communities. We are a we do wouldn’t be possible without the support of
COLLABORATE WITH COLLEAGUES
members like you.
CMA and its county medical societies bring together
dominant force in health care – but all the great work
SHAPE THE FUTURE OF MEDICINE Members receive direct access to our state and
physicians from all regions, specialties and modes of practice through leadership, collaboration, social and educational events, and community service.
national legislative leaders to influence how medical
PROMOTE PUBLIC HEALTH
care is provide today and in the future.
From tobacco use and obesity to prescription drug
PROTECT THE PROFESSION Your membership affirms your commitment to the medical profession and ensures physicians remain in control of the practice of medicine.
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abuse and vaccinations, your membership dollars support forward-thinking public health advocacy to improve the health of Californians.
PROTECT MICRA CMA staunchly defends the landmark Medical Injury Compensation Reform Act (MICRA) year after
Members receive one-on-one assistance from CMA’s
year, saving each California physician an average of
reimbursement experts, who have recouped $13
$75,000 per year in professional liability insurance
million from payors on behalf of CMA physicians in
premiums.
the past seven years.
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STAY IN THE KNOW CMA and its county medical societies produce
CMA and its county medical societies provide many
publications to keep you up to date on the latest
opportunities to get involved, including opportunities
health care news and information affecting the
to volunteer, serve on a committee, council or board,
practice of medicine in California.
and shape the future of the medical profession.
Join or renew your membership today! www.cmanet.org/join Questions? Contact our Member Service Center at (800) 786-4262 or memberservice@cmanet.org. 01.23.2017