LEARNING TO HEAL TRAINING TO SERVE
Decision Medicine Western Health Care Leadership Academy Member Benefits Update Fall 2015 FALL 2015
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YOU WORK TO PROTECT YOUR PATIENTS. We work to protect you.
AS A PHYSICIAN, you probably know better than anyone else how quickly a disability can strike and not only delay your dreams, but also leave you unable to provide for your family. Whether it is a heart attack, stroke, car accident or fall off a ladder, any of these things can affect your ability to perform your medical specialty. That’s why SJMS/CMA sponsors a Group Long-Term Disability program underwritten by New York Life Insurance Company: • Benefits not tied to a practice, giving you more flexibility with potential career changes
LEARN MORE ABOUT THIS VALUABLE PLAN TODAY! ——————————————————
Call Mercer for free information, including features, costs, eligibility, renewability, limitations and exclusions at:
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800.842.3761
• High monthly benefits up to $10,000
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• Protection in your medical specialty for the first 10 years of disability With this critical protection, you’ll have one less thing to worry about until your return. SPONSORED BY:
UNDERWRITTEN BY:
OR SCAN TO LEARN MORE!
New York Life Insurance Company New York, NY 10010 on Policy Form GMR
69974 (9/15) Copyright 2015 Mercer LLC. All rights reserved.
Mercer Health & Benefits Insurance Services LLC • CA Ins. Lic. #0G39709 777 South Figueroa Street, Los Angeles, CA 90017 • 800-842-3761 CMACounty.Insurance.service@mercer.com • www.CountyCMAMemberInsurance.com
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SAN JOAQUIN PHYSICIAN
FALL 2015
VOLUME 63, NUMBER 3 • SEPTEMBER 2015
Decision Medicine 2015
{FEATURES}
12 32 44 52 FALL 2015
{DEPARTMENTS}
2015 WESTERN HEALTH CARE LEADERSHIP ACADEMY
20 IN THE NEWS
LEARNING TO HEAL TRAINING TO SERVE
42 YOUNG PHYSICIAN & LIFETIME
San Joaquin General Hospital’s Residency Program
DECISION MEDICINE
Investing in the future of San Joaquin Health Care
MEMBER BENEFITS
New faces and Announcements
ACHIEVEMENT AWARD DINNER Photo Spread
50 ICD-10
Resources
58 PUBLIC HEALTH
Injuries: Preventable, Not Accidental
62 PRACTICE MANAGEMENT:
Committed to Improving Quality Health Care
65 NEW MEMBERS
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PRESIDENT John Zeiter, MD PRESIDENT-ELECT Moses Elam, MD PAST-PRESIDENT Ramin Manshadi, MD SECRETARY-TREASURER Kwabena Abudofour, MD BOARD MEMBERS Raissa Hill, DO, Grant Mellor, MD, Dan Vongtama, MD, Alvaro Garza, MD, Mohsen Saadat, DO, Clyde Wong, MD, George Savage, MD, Phillip Yu, MD, Peter Garbeff, MD
MEDICAL SOCIETY STAFF EXECUTIVE DIRECTOR Lisa Richmond MEMBERSHIP COORDINATOR Jessica Peluso
SAN JOAQUIN PHYSICIAN MAGAZINE EDITOR Lisa Richmond EDITORIAL COMMITTEE John Zeiter, Lisa Richmond, Mike Steenburgh
COMMITTEE CHAIRPERSONS DECISION MEDICINE Kwabena Adubofour, MD LEGISLATIVE Jasbir Gill, MD COMMUNITY RELATIONS Joseph Serra, MD PUBLIC HEALTH Alvaro Garza, MD SCHOLARSHIP LOAN FUND Janwyn Funamura, M.D.
CMA HOUSE OF DELEGATES REPRESENTATIVES Robin Wong, MD, Lawrence R. Frank, MD,
MANAGING EDITOR Lisa Richmond CREATIVE DIRECTOR Sherry Lavone Design CONTRIBUTING WRITERS James Noonan, John Zeiter, MD, Alvaro Garza, MD, MPH, Todd Davenport, PT, DPT, OCS, Brandon Piasecki THE SAN JOAQUIN PHYSICIAN MAGAZINE is produced by the San Joaquin Medical Society
James R. Halderman, MD, Roland Hart, MD, Grant Mellor, MD, Kwabena Adubofour, MD,
SUGGESTIONS, story ideas or completed stories written
Gabriel K. Tanson, MD, Ramin Manshadi, MD
by current San Joaquin Medical Society members are welcome and will be reviewed by the Editorial Committee. PLEASE DIRECT ALL INQUIRIES AND SUBMISSIONS TO: San Joaquin Physician Magazine 3031 W. March Lane, Suite 222W Stockton, CA 95219 Phone: 209-952-5299 Fax: 209-952-5298 Email Address: lisa@sjcms.org MEDICAL SOCIETY OFFICE HOURS: Monday through Friday 9:00 AM to 5:00 PM Closed for Lunch between 12pm-1pm
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FALL 2015
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Letter From The Executive Director
STAFF REPORT
THE VALUE OF MEMBERSHIP I love Fall- back to school, cooler weather and everything pumpkin! But, at SJMS it also means a very busy summer season has come to a close. We successfully completed our 2015 Decision Medicine program in July. These students are truly a bright spot in our summer. Thank you to our generous financial sponsors Health Plan of San Joaquin and Kaiser Permanente, local community partners and our member physicians for your continued support! You can get a glimpse in to this year’s program on page 44 .
LISA RICHMOND
Fall also means a new group of Residents at San Joaquin General Hospital in surgery, internal medicine and family medicine. At SJMS, we believe strongly that these residents are our future and we want to do everything we can to support and welcome them to our community while encouraging them to get involved in organized medicine. To that end, we offer complimentary membership to all residents. It is so exciting to see the number of residents that are retained to San Joaquin County. I know you will enjoy reading the feature on these wonderful programs! Finally, Fall kicks off of our annual membership campaign! Membership not only provides you with personal benefits, but opens a wide array to services to your practice managers and staff as a whole. Additionally, we at SJMS and CMA, hope you truly appreciate the extensive lobbying and advocacy that takes place every day in Sacramento and in Washington D.C. on your behalf. The last year has been very successful with Governor Jerry Brown signing SB277 in to law, eliminating the personal belief exemption from mandatory vaccinations for all public school children, the passing of the Medicare SGR Payment Reform Act, and we cannot forget the defeat of Prop 46! Please take the time to review your full slate of benefits on page 52. Please SAVE THE DATE for our annual Holiday Party on Thursday, December 10 at Stockton Golf & Country Club. It is always a nice time to gather with friends and colleagues as we celebrate the holiday season! All the Best,
Lisa Richmond
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We believe in 98.6 degrees.
Being a good doctor is about more than practicing good medicine. It’s about preventing illness. Being proactive. Taking the time to really listen. And giving our patients the personalized care they deserve. So, to all doctors, we’d like to say thanks. Because of you, a healthier life for everyone is as normal as 98.6.
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For more information, visit us online at kp.org/centralvalley SAN JOAQUIN PHYSICIAN
FALL 2015
A message from our President > John Zeiter, MD
Is the Sky Really Falling? Nearly 200 years ago, Just Matheis Thiele published the earliest version of an Old Danish folk tale about a chicken who believes the sky is falling after an acorn falls on his head. Versions of this story go back more than 25 centuries, but they are all united by the themes of fear, hysteria, and misconception. The chicken’s minted phrase “The sky is falling!” has come to represent the common idiom that disaster is imminent. In the many versions of this fable, the sky, of course, does not fall, but what ensues may be far worse: mass hysteria follows the chicken’s warning, and in the end, the chicken and all the other fowl he convinces are invited into the fox’s lair to be eaten. As of late, pessimism and hysteria have clouded the distinguished profession we have all upheld. How long do we, as physicians, have to endure endless attacks on our profession from government, insurance companies, and lawyers? Are we being transformed from “physicians” to nameless and indistinguishable “providers”? How will we be affected by the predicted mass shortage of physicians by 2025? Will healthcare reform and decreasing reimbursements continue to threaten already diminishing scales of physician compensation? When are the progressively intrusive and many times unproductive rules and regulations, including EHR, going to stop? I will try to address some of these heavily weighted questions; however, I am tired of all this doom and gloom. Therefore, I will focus on the brighter aspects of medicine emphasizing that we should revel in the light at every tunnel and stay clear of following Chicken Little down that foxhole! With the help of the CMA and the hard work of many individual physicians, Proposition 46 was defeated (67-33%). After a decade of battling huge Medicare cuts, both the House (392-37) and the Senate (92-8) overwhelmingly passed the Medicare SGR Payment Reform Act. Two huge wins for the hard working and dedicated legions of physicians! These victories emphasize the importance of not only physicians working together
ABOUT THE AUTHOR John H. Zeiter, MD is the managing partner of Zeiter Eye Medical Group and a Volunteer Clinical Professor at the UC Davis Eye Center. Dr. Zeiter is currently President of the San Joaquin Medical Society.
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A message from our President > John Zeiter, MD
with lobbyists to fight for our profession, but also the value we receive from our membership dues paid to the SJMS, the CMA, and our specialty organizations who are all battling the regulators for us. Currently there are bills in Congress for stalling ICD-10 implementation, for Meaningful Use EHR Reform, for Medicare RAC Audit Reform, and for increased Graduate Medical Education Funding. Physicians are consistently in the top 3 most prestigious and respected professions in nearly every poll. Firefighters, policeman, judges, and university professors all continue to show the utmost respect to our profession. We have undergone an incredible amount of education and training, and despite the mass amount of medical information available on the internet, we still hold a skillset that the layperson does not possess. For these years of training and medical expertise, we have earned the trust and the faith of patients, both healthy and ill. I don’t recall ever hearing a patient call me “provider Zeiter” or even “Mr. Zeiter”. Built on uncompromised dedication to an art and an oath, we are and should always be “physicians” to our patients. If the insurance companies want to call us providers, so be it. This title does not diminish the quality of care we will continue to provide. Despite all the obstacles our profession must tackle, medical school applications in the U.S. are at an all-time high. The candidates are incredibly intelligent, well-rounded and enthusiastic despite anticipated student debt, decreasing reimbursements, and the press’ pessimistic view of medicine. Medical schools have done a remarkable job at increasing the number of students, in both MD and DO programs, as well as international graduates that want to
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come here to train. Although lack of funding has contributed to a shortage of residency training positions, bills currently in Congress could increase the number of residency slots by 15,000 in the next five years. Geographic location plays a large role in physician supply and demand, and the SJMS Decision Medicine Program for local high school students encourages these budding physicians to return to our area when their medical education is complete. In addition, the “Family Business” article in the San Joaquin Physician 2014 Winter issue listed more than 70 physicians who returned to our county to serve the community from which they came. I believe it is our responsibility as physicians to encourage both our own children and interested young adults to consider pursuing the noble practice of medicine. In making important decisions about vocation, our youth need to consider cost of living and the scales of compensation. The median income of an individual living in the U.S. appears to correlate with their level of education: high school graduate--$32,000; bachelors--$52,000; masters--$67,000; PhD--$76,000; professional degree (DDS, JD)--$125,000. The annual average income of a primary care physician is close to $200,000 and for specialists, $285,000. Could most doctors have chosen a different career path and made more money in Silicon Valley or on Wall Street? We all know the answer to that question, but I would bet that the majority of physicians could not imagine choosing a more fulfilling career than medicine. In Medscape’s 2015 survey, approximately 50% of both primary care physicians and specialists feel that they are fairly compensated, and 70% said they would choose the
same career path if they could change history. In addition to the growing issues of physician compensation, we must also address the increasing demands placed on physicians by the government. No matter how much physicians object, the Electronic Health Records mandate is not going away. After several years of disbelief, protest, and procrastination, we implemented EHR in 5 offices (36 exam rooms) in 2011. It was painful, of course—expensive equipment, time consuming training, obtrusive to patient dialogue, and every other awful thing you’ve heard or experienced. Four years later….no more chart transportation between offices, no more lost charts, no more dictation, simple e-prescribing, complete documentation for coding and billing, remote access, and $144,000 per provider from CMS. EHR has definitely changed the manner with which we practice medicine; however, in no way has it kept us from providing excellent care to every patient. Although it seems as if our profession is being pelted by acorn after acorn, we must not run nor should we cave into fears that the sky is falling. In fact, I would argue that being a physician remains among the most exciting and fulfilling professions and that there has never been a better era in which to practice medicine. Science and technology will continue to flourish, and during a young physician’s life, we will likely see innovation and advancement in the treatments of every disease. So let’s embrace our profession together, support the organizations that are helping to fight our battles, encourage students to pursue a career in healthcare, and stop the Chicken Littles from propagating impending disaster.
FALL 2015
MIEC Belongs to Our Policyholders!
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The 2015 Western Health Care Leadership Academy was held in sunny Hollywood at the end of May, bringing Tinseltown a little star power of its own.
Western Health Care Leadership Academy brings star speakers, hundreds of physicians to Hollywood
The 18th annual event drew more than 570 participants, with guest speakers including bestselling author Professor Dave Logan; Congressman Ami Bera, M.D.; Pulitzer Prize-winning author Siddhartha Mukherjee, M.D.; Congressman Michael Burgess, M.D.; and New York Times bestselling author Malcolm Gladwell. >>
Western Health Care Leadership Academy - 2015
Malcolm Gladwell talks problem solving Bestselling author Malcolm Gladwell spent his talk illustrating the difference between two conflicting types of problems: mysteries and puzzles.
The first keynote speaker, New York Times bestselling author Malcolm Gladwell, told attendees that being a good physician often requires being a good “mystery solver.” Puzzles and mysteries are two different types of problems, Gladwell said—a distinction first articulated in 2007 by national security expert Gregory Treverton. According to the theory, puzzles occur when there is not enough information to solve a problem. Mysteries, on the other hand, arise when there is more than enough
information. Tackling a mystery thus becomes a matter of sifting through the abundance of data, rather than uncovering new information to reach a conclusion. “This is a crucial distinction because we live in a world [where] most of our institutions and most of our disciplines and most of our expectations and regulations and such are set up on the expectation that what we face are puzzles,” Gladwell said. “And [Treverton] says, ‘look, we don’t face puzzles anymore. The signature problems of the modern world are all
mysteries.’” Gladwell applied the distinction to historical events, stating that the Cold War was a puzzle propelled by a general lack of information, but the 9/11 attacks were a mystery that occurred in the wake of information overload. However, the distinction can also be applied to medicine, he said. In past generations, a doctor was a collector of information. Now, a doctor has to be an analyst of information. Modern physicians must take a different approach to solving the information-laden problems of
Western Health Care Leadership Academy - 2015
today, and that requires good judgment and understanding, he explained. In other words, it requires being a good mystery solver. “Now here’s the question,” Gladwell said, looking over the crowd of physicians. “Does the world treat you as puzzle solvers, or does it treat you as mystery solvers?” Gladwell added that the physician’s role today is “infinitely more complicated” and demands more than checking boxes and solving algorithms. So does the doctor-patient relationship, he said. “We, and by ‘we’ I mean all patients, are terrified,” Gladwell said. “We’re entering a world we don’t understand, that is full of all kinds of questions we didn’t know existed four or five years ago. We want to walk into an office and have someone talk to us and look us in the eye and reassure us and give us guidance and understanding and nurturing and support.” Gladwell’s presentation drew rapt attention throughout his 40-minute segment and received high praise from those who attended the Western Health Care Leadership Academy, an event spearheaded by the California Medical Association. In the end, he emphasized the need for physicians to stand up for themselves and say that the nature of their profession has changed. “You need to stand up to the world and say, ‘we’re not dealing with a puzzle anymore,’” Gladwell said. “We’re dealing with a mystery.”
“We, and by ‘we’ I mean all patients, are terrified. We’re entering a world we don’t understand, that is full of all kinds of questions we didn’t know existed four or five years ago. We want to walk into an office and have someone talk to us and look us in the eye and reassure us and give us guidance and understanding and nurturing and support.” - Malcolm Gladwell
Attendees hear cancer presentation from Pulitzer Prize-Winning author Siddhartha Mukherjee, M.D. Discoveries about cancer have led to a better understanding of the enigmatic disease, but according to Pulitzer Prize-winning author Dr. Mukherjee, that understanding is merely the tip of the iceberg.
Siddhartha Mukherjee, M.D., an acclaimed hematologist and oncologist, touched on what he called the three realizations of cancer before leaving the audience to ponder the question: “What does our theory of cancer tell us today?” “There is no other human disease that we know of that has this level of diversity and complexity,” he said, standing in front of the Ray Dolby Ballroom at the Loews Hollywood
Hotel. “Every patient’s cancer is his or her own cancer.” Cancer is one of the oldest diseases known to man, despite some contemporary beliefs that it is mostly derived from present-day sources, Dr. Mukherjee said. It is one of the major problems of this century, and innovation in every aspect of cancer medicine is desperately needed to help fight the disease. Deciphering cancer physiology, in
particular, is also vital to understanding the ailment, he said. “We will not move through the barrier of cost, of care, of any of the barriers that currently surround cancer medicine unless we complete this project,” Dr. Mukherjee stated. Dr. Mukherjee noted that there have been three revelations regarding cancer through the course of history. The first was that cancer is a disease of the cells, but eventually scientists discovered
Western Health Care Leadership Academy - 2015
Save the date: 2016 Western Health Care Leadership Academy to feature Karl Rove and Donna Brazile
that it is also a disease of genes and genomes — that is, it also involves multiple genes. These insights have been critical to understanding the nature of cancer, he explained. But again, more effort needs to be made to understand its physiology. Dr. Mukherjee said it is the current and next generations who will need to helm this imperative project. “It is the job of our generation to figure out how to make sense of the entire physiology, and by physiology I mean the human being that has cancer, his or her interactions with his or her particular environments, his or her particular exposures, and then deliver a complete new system of cancer medicine,” he said. Dr. Mukherjee is the author of the 2010 Pulitzer Prize-winning book The Emperor of All Maladies: A Biography of Cancer, which was also the basis for a Ken Burns-produced documentary that aired on PBS earlier this year.
“We will not move through the barrier of cost, of care, of any of the barriers that currently surround cancer medicine unless we complete this project.” - Siddhartha Mukherjee, M.D.
www.westernleadershipacademy.com
Check your calendar and save the date for the 2016 Western Health Care Leadership Academy, to be held in San Francisco May 13-15, 2016, at the Hilton Union Square. The opening session will feature a preview of the 2016 presidential election and its impacts on health care. Speakers for this session include Karl Rove, former Deputy Chief of Staff and Senior Advisor to President George W. Bush, and Donna Brazile, Al Gore’s campaign manager and Democratic National Committee Vice Chair. Physicians and nurses, medical practice managers and other health care professionals will find this program will help you prepare for changes affecting your profession, your practice and your economic future. Stay tuned for more information.
One of only 11 California health plans to achieve NCQA Accreditation for its Medi-Cal HMO line of business.
The National Committee for Quality Assurance (NCQA) recently awarded Health Plan of San Joaquin (HPSJ) a Three-Year Health Plan Accreditation for its Medicaid/HMO line of business. The official award recognizes HPSJ as “accredited for service and clinical quality that meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement.”
Lakshmi Dhanvanthari, MD Chief Medical Officer FALL 2015 Health Plan of San Joaquin
Our recent accreditation from NCQA is especially gratifying in that it acknowledges both the quality of care that HPSJ offers to members through our network, as well as the hard work by our providers, together with HPSJ staff, to attain this level of unique national recognition.
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In The News
IN THE
NEWS Lodi Health-Adventist Health Affiliation Completed
After nearly two years of negotiations and recent approval by the California Attorney General, Lodi Health officially becomes part of Adventist Health today. Adventist Health donated $2 million to the Lodi Memorial Hospital Foundation and will invest at least $98 million in Lodi Health to make significant additional capital improvements. In addition, Adventist Health will implement a new, state-of-the-art electronic medical records system. Employees and patients of Lodi Health have already begun seeing changes; the Adventist Health logo has been added to select signage and information is appearing on both organizations’ websites. Lodi Health employees will begin participating in orientation forums starting Tuesday to learn more about Adventist Health’s mission, purpose and history. What remains the same is Lodi Health’s commitment to its community and employees. The nonprofit organization has served the community of Lodi, California for 62 years. Both Lodi Health and Adventist Health are committed to preserving the health care services provided by 191-bed Lodi Memorial Hospital, 15 clinics, several outpatient centers, an adult day care center and a child care center. Lodi Health’s existing leadership also remains in place as does its local governing board. “As part of Adventist Health, we look forward to using new tools and resources to continue providing strong, high quality healthcare to our community,” said Joe Harrington, Lodi Health President and CEO. “We’re celebrating today!”
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Providing staff, physicians, and patients with relevant & up to date information
Wolcott Named President & CEO of Lodi Health
Daniel Wolcott has been named president & CEO of Lodi Health (LH), which joined Adventist Health in May, according to Bill Wing, Executive Vice President/Chief Operating & Strategy Daniel Wolcott Officer of the health system. Wolcott will assume his new role in early August, working in conjunction with current President and CEO Joe Harrington to achieve a smooth transition until Harrington’s retirement later this year. Wolcott comes to LH from Greeneville, Tennessee, where he served as President and CEO of Takoma Regional Hospital. During his time there, Wolcott grew hospital net revenue by more than 40 percent, established a board quality and safety committee, and developed a relationship with Debusk College of Medicine for the hospital to be a core rotation site for third-year medical students. “Daniel’s strong background in community relations will be instrumental in transitioning Lodi Health into the Adventist Health family,” said Wing. “He brings a history of quality and safety as well as financial strength.” Before working at Takoma Regional Hospital, Wolcott served as vice president & administrator at Florida Hospital Memorial System from 2004 to 2009. While there, he initiated a 30-minute door-to-doctor guarantee in the Emergency Department, which was a first in Adventist
FALL 2015
In The News
Health System and achieved more than 95 percent success. He also grew the employed physician group from 24 physicians in 2004 to 45 physicians in 2009. “The board members and I have been impressed that throughout Daniel’s career, he has been involved in the various communities he has worked in, and we look forward to him joining the Lodi community,” said Steven Crabtree, board chairman of LMH. “He served on the board of the Hospital Alliance of Tennessee and has successfully engaged board members and community leaders to facilitate transitions and build trust.” Wolcott received an MBA in finance from Georgia State University in 2001 and a Bachelor of Business Administration in Marketing from Southern Adventist University in 1997. He and his wife, Cynthia, have four children: Peter, Joshua, Seth, and Sarah.
counties. Dr. Millar received his undergraduate degree from Brigham Young University in Provo, Utah, and his medical degree from the University of California, San Francisco. He came to Kaiser Permanente in Steven Millar, MD 2004 and has worked at the Tracy Medical Offices since the outpatient clinic opened in January 2005. He speaks Spanish and also Kekchi, a little-known language he learned while living in Guatemala for several years. Kaiser Permanente Physician Group Earns International Accolade for Leadership Development
Patricia Gooch, RN, CENP Patricia “Pidge” Gooch, RN, CENP, Appointed Chief Nursing Officer for Kaiser Permanente in the Central Valley
Gooch oversees nursing care, quality, and service standards at Kaiser Permanente Manteca Medical Center and Kaiser Permanente Modesto Medical Center. She is a 1989 graduate of Ann May School of Nursing in Neptune, New Jersey. Prior to coming to Kaiser Permanente, Gooch was the Chief Nursing Officer of Doctors Hospital in Manteca. She is a member of the American Organization of Nurse Executives, and holds a national certification in executive nursing practice. Pediatrician Steven Millar, MD Appointed Chief of Health Promotion for Kaiser Permanente in the Central Valley.
In his new role, Millar oversees health and wellness activities within Kaiser Permanente and through various community initiatives in Stanislaus and San Joaquin
FALL 2015
The Permanente Medical Group (TPMG), a physician-led medical group serving Kaiser Permanente members in the Central Valley, is the only organization in North America to receive a major award at a recent global leadership conference. The “Making a Difference” award, presented by global consulting firm Lee Hecht Harrison at a conference in San Diego, recognized the medical group for its highly successful program to build leadership capability of physicians. Led by Moses Elam, MD, the physician-in-chief of TPMG, the leadership program was started in 2010 to equip physicians with the skills needed to effectively lead change and drive critical innovations that enhance quality and safety. “Our intent was to build the leadership capability of physicians to help lead people through significant change,” said Dr. Elam. “We partnered with Lee Hecht Harrison, the leaders in this field, to co-design the program, which is now the cornerstone in the success of TPMG Central Valley in building the leadership capability of physicians.” More than 80 physicians have graduated from the program, and many of them have been promoted into the role of chief of their respective departments. “TPMG physicians are applying leadership skills to solve real business challenges, with a laser focus on health
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In The News
IN THE
NEWS to meet the market’s demand for safe, innovative, customized care,” said Gary Halverson, Talent Development Coach at Lee Hecht Harrison. The other winning projects were awarded to programs in Spain, Brazil, France, Australia and India. TPMG physicians in the Central Valley Service Area are the medical providers for Kaiser Permanente members in Stanislaus and San Joaquin counties. Christopher Neuman Awarded Brown University’s Executive Master of Healthcare Leadership
Christopher “Chip” Neuman, Area Finance Officer for the Central Valley Service Area of Kaiser
Christopher Neuman Permanente, received the prestigious Executive Master of Healthcare Leadership (EMHL) from Brown University’s School of Professional Studies at the 250th graduation ceremony in May 2015. Neuman joins an elite group of high-profile
executives from across the health industry who are transforming healthcare by addressing the compelling challenges of access, quality and sustainability. Neuman completed a Critical Challenge Project entitled, High Utilizer Management. With this project, Neuman transferred knowledge and skills acquired in the program, and created an innovative, sustainable solution with immediate, tangible benefits for his organization. At Kaiser, Neuman provides bestin-class service to 250,000 insured members in the Central Valley through four hospitals and manages more than $1 billion in revenue. He serves as a member of the board of directors for the Stanislaus County Business Alliance. Neuman is a
HAVE SOMETHING TO SHARE? We welcome submissions to our In-the-News Section from our community healthcare partners. We prefer Word files and .jpg images and may edit for space restrictions. Send your files to lisa@sjcms.org one month prior to publication (February 1st for the Spring issue, May 1st for the Summer issue, August 1st for the Fall issue and November 1st for the Winter issue).
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In The News
resident of Ripon, CA, and graduate of UC Berkeley. Brown University’s Executive Master of Healthcare Leadership program is an accelerated program of intense study focused on leading transformative change in healthcare. Graduates lead in the clinical, corporate, and public sectors and promote outstanding health care for patients as well as financial health for their organizations. Health Plan of San Joaquin (HPSJ) Earns NCQA Accreditation
The National Committee for Quality Assurance (NCQA) has awarded to HPSJ a Three-Year Health Plan Accreditation for its Medicaid/ HMO line of business. The award recognizes HPSJ as “ACCREDITED for service and clinical quality that meet or exceed NCQA’s rigorous requirements for consumer protection and quality improvement.” It was earned after a substantial and lengthy review of the health plan’s quality initiatives and service delivery processes. HPSJ is now one of only 11 California health plans to achieve this accredited distinction for its Medi-Cal HMO line of business. This is HPSJ’s first attempt for NCQA accreditation which impacts all areas of the community-based, not-for-profit plan. HPSJ CEO Amy Shin said, “This NCQA accreditation is especially gratifying in that it acknowledges both the quality of care that HPSJ offers to members through our network, as well as the hard work by all providers,
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together with HPSJ staff, to attain this level of unique national recognition.” Health Plan of San Joaquin’s Pharmacy Residency Program
Since 2006, HPSJ has had as a pillar of its pharmacy department a nationally accredited managed care residency program. With accreditation from the American Society of Health-System Pharmacists and Academy of Managed Care Pharmacy, this is a 12-month program that offers next generations of professionals’ opportunities to learn to balance access, quality, and cost, as well as develop their personal and professional leadership. There are only 38 such residency programs in the U.S. Applicants come from all over the U.S. and residency graduates are in senior leadership roles throughout the country. As the Stockton Record recently reported, “Three former Health Plan residents are working for the agency now, including Johnathan Yeh, Director of Clinical Programs; Jonathan Szkotak, the current director of Pharmacy; and Pharmacist Brenda Ng, the most recent graduate of the program.” NhuAnh Le has begun her pharmacy residency which will take her into 2016 and the program’s tenth anniversary.
Jennifer Medina Medina, who started with HPSJ in 1998, is now heading a major initiative focused on the organization’s customer-centric brand. “Health Plan of San Joaquin has a longstanding commitment to our local communities. I bring a deep understanding of our community needs and lead our marketing team with new and traditional strategies that continue to yield measurable results.” She said, “HPSJ’s membership is now at 315,000 – a third of that growth since the Affordable Care Act implementation in January 2014.” “Over her years at HPSJ, Jennifer has had key roles in customer service, project management, and marketing,” said David Hurst, HPSJ Vice President for External Affairs. “She has a strong working knowledge in all these operational areas, as well as a consistent and strong commitment to the communities throughout our service area.”
Health Plan of San Joaquin Appoints Marketing Director
Health Plan of San Joaquin Appoints Chief Financial Officer
Jennifer Medina has been appointed HPSJ Marketing Director and now oversees creative and marketing services, outreach, enrollment and member engagement efforts, and digital media for the public health plan.
Michelle D. Tetreault is now HPSJ’s Chief Financial Officer. She has extensive senior leadership experience in fiscal operations for communitybased health plans. “I bring collaboration and cohesion to the transparent financial operations SAN JOAQUIN PHYSICIAN
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In The News
IN THE
NEWS of accountants, analysts, planners and coordinators, all focused on our stewardship of the resources with which we are entrusted.” ICD-10 is Coming-October 1, 2015
Michelle D. Tetreault of growing public health plans,” said Tetreault. She sees as her mission, “to capitalize on the strengths of our finance team so that we can continue expanding HPSJ’s capacity to serve the fast-growing membership brought to us by the Affordable Care Act and expanded Medi-Cal.” Tetreault, who relocated to the Central Valley and HPSJ’s headquarters in French Camp, previously was Director of Fiscal Operations and Interim Chief Financial Officer for Neighborhood Health Plan of Rhode Island. “Michelle has a well-earned reputation within the healthcare industry as a strong financial manager with extensive strategic and tactical experience,” said HPSJ Chief Executive Officer Amy Shin. “Our finance division, which Michelle now leads, includes a team
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As Central Valley providers have been preparing for the October 1st transition from ICD-9 codes to ICD-10, Health Plan of San Joaquin (HPSJ) has been working to support all the medical practices that are part of its provider network. Those practices, whether large or small, are encouraged to continue reaching out with their questions to the Provider Services Department of this community-based, not-for-profit health plan, at (209) 942-6340. National Safety Month: NORCAL Mutual Provides Tips for Pain Management and Opioid Prescribing
The National Safety Council recently released a warning that prescription opioid painkillers account for more drug overdose deaths than heroin and cocaine combined. The Centers for Disease Control and Prevention reports that the amount of prescription
painkillers prescribed and sold in the U.S. has nearly quadrupled since 1999. The warnings are included as part of the 2015 National Safety Month campaign. In recognition of this safety awareness month, NORCAL Mutual Insurance Company, the ninth largest medical professional liability insurance provider in the nation, offers tips related to pain management and opioid prescribing. Physicians need to be especially careful when managing chronic pain with opioid medications. Medical practices often seek risk management advice when they suspect a patient is misusing prescription medications, is not complying with treatment, or when the patient is making unreasonable demands for more opioids. If a patient suffers harm as a result of opioid medication use, a physician may find himself or herself the target of a lawsuit alleging negligent treatment of chronic pain, says NORCAL Mutual’ s Senior Risk Management Specialist Josh Hyatt. To help enhance patient safety and reduce risk of opioid dependency, NORCAL Mutual cautions physicians to: • Recognize the signs of potential
FALL 2015
In The News
drug addiction and diversion • Apply risk management best practices that support sound pain management principles to improve patient safety and increase defensibility in the event of a claim • Consider implementing pain medication agreements • Follow pain management guidelines • Utilize and refer to specialists when appropriate Hyatt adds, “It’s important to establish a treatment plan and goals as early as possible in the treatment process. Physicians should also engage the patient in education around the risks of opioid therapy.” NORCAL Mutual has a team of risk management specialists available to assist policyholders assess their practice and help identify any potential pitfalls that may arise. Pain management and opioid prescribing is one of the many topics that NORCAL Mutual risk management specialists present throughout the country. Dameron Hospital Upgrades CT System to Improve Patient Safety
To improve clinical and operational capabilities and reduce radiation dose in CT imaging, Dameron Hospital is upgrading its existing CT scanning system with the Toshiba VeloCT console. According to Bradley Reinke, MD, Vice President of Medical Affairs and Chief Medical Officer of Dameron Hospital, the VeloCT console includes dose reduction technology and dose management tools, making exams safer for patients. The new console also offers
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advanced hardware that produces faster exams, improving the clinical and operational capabilities of the unit. “The VeloCT console allows our facility to utilize the most advanced CT technologies without purchasing an entirely new system,” explained Dr. Reinke. “We will be able to generate 128 slices per rotation which effectively doubles our current image quality. The faster imaging speed also helps us increase workflow and bring new and more advanced imaging studies to our patients. This takes us to the next level of imaging technology.” “Dameron Hospital is in the process of upgrading a number of diagnostic and therapeutic imaging systems,” said Dameron Hospital President and Chief Executive Officer Lorraine Auerbach. “As part of our commitment to delivering the highest levels of care and service, we want to give our physicians and patients access to the industry’s best CT solutions, which supports the delivery of the best patient care available. This is another step towards realizing our vision of becoming the hospital of choice in the Central Valley.” ThermiVa Now Available at California Skin and Laser Center
California Skin and Laser Center now has available the ThermiVa vaginal rejuvenation system. This noninvasive radiofrequency device painlessly delivers precisely controlled heat for the treatment of vulvovaginal laxity. A series of three twenty to thirty minute treatments induces new collagen growth and
reproducibly results in vaginal tightening and shrinkage of the external genital tissues. Frequently there is improvement in vaginal dryness and a reduction or complete elimination of urinary frequency and urine leakage with exercise. Patients have reported increased sexual satisfaction and orgasms after treatment, as well as reduced discomfort from the rubbing of tight clothing. This non-destructive treatment produces no down time and has no significant side effects. It can replace expensive surgical and destructive laser treatments.
Sakimura and Barzaga
Dah and Hatton San Joaquin Women Physicians Group
The San Joaquin Women Physicians Group met on June 22, 2015, at the home of Dr. Harjit Sud for a summer supper featuring British and Indian High Tea and other
SAN JOAQUIN PHYSICIAN
25
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In The News
tempting homemade delicacies from around the world. Those attending included Drs. Grace Barzaga, Linda Sakimura, Patricia Hatton, Naju Dah, Janwyn Funamura, Raissa Hill, Richelle Marasigan, Poonam Doogal, Lily Pang, Christine Bell, Daksha Vaid, Thu Var Myint, Trinh Vu, and Sudevi Thaker. (Our apologies if you attended and your name was not included). Any female physicians who are interested in joining us for our gatherings can contact Dr. Linda Sakimura at LKawaguchi@comcast. net or contact the Medical Society at 209-952-5299. We will be meeting again on Friday, December 4, 2015, and we look forward to seeing others there! Berberian European Motors Breaks Ground at Their New Trinity Parkway Location
Berberian European Motors broke ground at their new location on Trinity Parkway in Stockton, just off of I-5 and Eight Mile Road. In Spring 2016, they will be moving from their current location on West Lane in Stockton. In the meantime, you can now take advantage of their wonderful selection of new and pre-owned cars. Whether you want a new S-Class, which delivers comfort and value like only a Mercedes-Benz can, or a new CLA, which starts at $31,500* MSRP, Berberian European Motors is here for you and Mercedes-Benz of Stockton will continue the legacy of excellence. With this move comes several changes. The dealership will no longer be named Berberian European Motors, but will instead unveil a fully-branded Mercedes dealership: Mercedes-Benz of Stockton. They are also hiring for a number of positions
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found at:berberianmotors.com/ careers. Stay up to date with Berberian and follow the progress of the new dealership on Facebook, Instagram, and Twitter. *Excludes all options, taxes, title registration, $925 transportation charge and dealer preparation fees
children working out on the farms or family businesses and put education on the back burner, but my father made education for his children a priority and would always say that it was something no one could ever take away from you.”
Pacific Homecare Services Celebrates 10-Year Anniversary & the Impact of Hispanic Business Women
Pacific Homecare Services (“PHS”), a Stockton, CA based in-home care provider, is celebrating its 10-year anniversary. President Leticia Robles started PHS a decade ago out of a spare room in her home. PHS now provides services to more than 20 counties and has branch offices in Sacramento, East Bay, and Sonoma. They are a non-medical, in-home care agency dedicated to providing service to individuals of all ages that require assistance with basic living skills. They serve senior citizens, veterans, developmentally disabled children and young adults, postoperative individuals, and even new mothers. As a multi-lingual care provider, their services include everything from meal planning and preparation to personal care and assistance to shopping and errands. Leticia Robles is the epitome of the American Dream; she is the embodiment of all the qualities that people admire in the world of business. Mrs. Robles is the youngest of 9 and the daughter of immigrants who came to the U.S. over 50 years ago. Leticia’s family was in farming and she was raised on the San Joaquin Delta. “Many Hispanic families had their
Kevin Rine, MD
Peter Garbeff, MD Recognizing Physicians with Humankindness
Each quarter, St. Joseph’s Medical Center recognizes physicians in the community that go beyond clinical excellence to deliver healing with compassion and kindness, also known as humankindness. Most recently, Dr. Kevin E. Rine, Dr. Peter J. Garbeff, Dr. Sanjeev K. Goswami, and Dr. Irving Christopher Hudlin, were recognized by their patients and peers for listening, explaining, and displaying genuine kindness to their patients. St. Joseph’s invites you to nominate physicians practicing humankindness at St. Joseph’s or in the community to receive recognition.
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As a member of the San Joaquin Medical Association, you’re privy to an exclusive benefit—Financial Center Credit Union membership for you and your staff ! In a time when the safety and soundness of funds is at the forefront of everyone’s minds, Financial Center membership is the perfect prescription for peace-of-mind. Voted Best Of San Joaquin, Financial Center is the most trusted credit union in the Valley. Time and time again, we offer our members the lowest rates on their loans as well as the safest place to save their money. Follow the doctor’s orders and call us today. And don’t forget to pass this message onto your staff – they (and their wallets!) will thank you.
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In The News
Sanjeev K. Goswami, MD
Stroke Association,” said Don Wiley, President and CEO of St. Joseph’s Medical Center. “The certification provides us with the opportunity to highlight the exceptional stroke care we provide as well as to continually strive to advance our care even further.” St. Joseph’s will be able to display The Joint Commission’s Gold Seal
of Approval® for their Advanced Certification for Primary Stroke Centers and The American Heart Association/American Stroke Association’s Heart-Check mark. Displaying The Gold Seal of Approval® and the Heart-Check mark signifies that St. Joseph’s meets the highest standards of care for stroke victims and is committed to providing high
Chris Hudlin, MD Call (209) 467-6486 or email Catherine.Swenson@dignityhealth. org for more information. St. Joseph’s Awarded Advanced Certification for Primary Stroke Center
The Joint Commission, in conjunction with The American Heart Association/American Stroke Association, recently recognized St. Joseph’s Medical Center with Advanced Certification for Primary Stroke Centers. St. Joseph’s underwent a rigorous onsite review wherein Joint Commission experts evaluated compliance with stroke-related standards and requirements, including program management, the delivery of clinical care, and performance improvement. “We are pleased to receive advanced certification from The Joint Commission and the American Heart Association/American
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quality, safe and effective treatment to patients experiencing stroke. St. Joseph’s Launches New Lung Screening Program
St. Joseph’s Medical Center has recently launched a Lung Cancer Screening Program aimed at finding lung cancer in its early stages, when it is not only treatable, but often curable. Lung cancer is the most common cause of cancer-related death for men and women, outnumbering colon, breast and prostate cancers combined. Individuals aged 55-74 years old with a history of smoking or over 50 with a family history of lung cancer, may qualify for St. Joseph’s Lung Cancer Screening program, the only one of its kind in San Joaquin County. Lung cancer screening is now covered by Medicare Part B and all major insurances. Screenings are available by referral from a primary care physician and patients can also opt to pay for the screening out of pocket for a nominal fee. To find out more about this information call 209.939.4526. St. Joseph’s Designated an ACR Breast Imaging Center of Excellence
St. Joseph’s Women’s Imaging Center has been designated a Breast Imaging Center of Excellence by the American College of Radiology (ACR). To receive this designation, St. Joseph’s underwent a rigorous review process to insure that the Women’s Imaging Center met nationally accepted standards. With this award, the ACR recognizes that St. Joseph’s Women’s Imaging Center has earned accreditation in mammography, stereotactic FALL 2015
breast biopsy, and breast ultrasound (including ultrasound-guided breast biopsy). Peer-review evaluations, conducted in each breast imaging modality by board-certified physicians and medical physicists who are experts in the field, have determined that this facility has achieved high practice standards in image quality, personnel qualifications, facility equipment, quality control procedures, and quality assurance programs. St. Joseph’s Women’s Imaging Center, located at 3439 Brookside Road, provides complete imaging services including digital mammography, breast ultrasound, stereotactic biopsy, and bone density testing.
Maggie Park, MD Maggie Park, MD, Appointed as Medical Director of California Children’s Services
Dr. Maggie Park is pleased to join the San Joaquin County Public Health Services as the Medical Director for CCS (California Children’s Services). Dr. Park is a board-certified pediatrician with 13 years of clinical experience. She has practiced general pediatrics at San Joaquin General Hospital, Ventura County Medical Center, and most recently at Community Medical Centers, where she served as their Pediatric Associate Medical Director. She is also proud to serve as a commissioner for the First 5 San Joaquin Commission. In addition
to overseeing the CCS program, Dr. Park is excited to have the opportunity to be a part of the public health effort focusing on preventing disease and promoting health and well-being for the pediatric population of San Joaquin County. The American Cancer Society’s Annual ‘Making Strides Against Breast Cancer’ Walk Scheduled for October 11 in Stockton
On Sunday, October 11, The American Cancer Society is hosting its fourth annual Making Strides Against Breast Cancer at San Joaquin Delta College. The event is a 5k walk that honors survivors, provides information and raises funds for the Society’s breast cancer services as well as research toward preventing, curing and treating breast cancer. These services include “Look Good, Feel Better,” which provides those undergoing treatment with free wigs and makeup tips and “Reach to Recover,” where newly diagnosed breast cancer patients are paired with survivors to help them through their journey. Additionally, the Society funds groundbreaking research, which has led to advances such as Herceptin, Tamoxifen and the use of mammography as the standard in breast cancer detection. Those interested can form teams or walk as individuals. Since there is no registration fee, participants are encouraged to fundraise. For more information please visit http:// MakingStridesWalk.Org/Stockton, e-mail: StocktonCAStrides@cancer. org or call 209.941.2677.
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SAN JOAQUIN GENERAL HOSPITAL
Learning to Heal Training to Serve
Story By l James Noonan
The three residency programs at San Joaquin General Hospital’s French Camp campus have provided top-level physician training for decades. Along the way, they’ve also help create a pipeline of physicians in an area of the state where they’re sorely needed.
For physicians that complete their residency at San Joaquin General Hospital, however, it’s also likely their first introduction to a community, one to which they’ll be providing much-need care over the course of their careers.
For most physicians, the residency experience is a seminal moment in their medical training.
At least that’s what the statistics say.
San Joaquin General Hospital > Physician Training
“
When students come here, they tend to stay here. It’s something we’re very proud of.
“
Sheela Kapre, M.D “We’ve got a fairly long history of retaining our residents,” said Sheela Kapre, M.D., San Joaquin General Hospital’s longtime Director of Graduate Medical Education. “When students come here, they tend to stay here. It’s something we’re very proud of.”
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While data from almost any residency program would suggest that physicians generally tend to settle down in the area where they complete their training, San Joaquin General has made physician retention a major focus of their program, an effort that goes a long way in a medically underserved area of the state. >>
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In fact, with a track record that boasts an average of somewhere between 30 and 40 percent of graduates from the hospital’s internal medicine, family medicine, and surgical residency programs continuing to practice in San Joaquin County over the past decade – some of the hospital’s programs retain as many as 60 percent of graduating residents – one could argue that San Joaquin General has done more to increase access to care than nearly any of other institution in the Central Valley. Given the high level of need seen in communities around San Joaquin General’s French Camp campus, it’s easy to understand why retaining physicians is a cause for celebration. According to California’s Office of Statewide Health Planning and Development, an overwhelming majority of San Joaquin County is designated as “medically underserved.” In most areas of the county, the ratio of 34
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physicians to patients is less than one for every 3,000 residents. Adding to the problem is the fact that much of the county’s population scores poorly when it comes to health factors such as obesity and smoking rates, while a large portion also falls well below the federal poverty line. In short, the residents of San Joaquin County and the surrounding Central Valley need physicians – and they need them badly. For those heading up San Joaquin General’s residency program, addressing this shortage has become something of a calling. “The underserved populations are our mission. We want to make sure we’re here for them. We want to make sure we can provide them with quality care,” Kapre said. Each year, the hospital’s physician training program has the opportunity to train and develop 24 new residents – eight in each of its three programs – with the hope that
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San Joaquin General Hospital > Physician Training
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Saadat’s internal medicine program, meaning that high-caliber candidates are readily available. Saadat attributes at least part of that high level of demand to major strides made been by the hospital in recent years. In 2013, San Joaquin General Hospital was designated a level three trauma center, making it the only such facility serving the more than 700,000 residents of San Joaquin County. The hospital also became a Joint Commission-certified stroke center in 2012, the product of months of comprehensive training undergone by hospital staff. “This has all elevated the profile of our programs dramatically,” Saadat said. While advancements and accreditations can go a long way toward getting graduating medical students to show interest in San Joaquin General, those inside the program believe it is the high level of hands-on instruction, which delicately balances resident interaction with quality patient care, that gets them to stay in the region full-time. “When I was a resident, it was the dedication to both patient care and teaching that kept me here,” Saadat said. “That dedication has never changed.” Kapre echoes this sentiment, noting that at San Joaquin General, residents are not simply observers in the process, but are asked to participate in the delivery of care from day one. “The reason I stayed on as faculty is that the training was very hands-on,” she said. While providing an opportunity
for freshly-minted M.D.s and D.O.s to provide hands-on care certainly makes for a more involved and enjoyable training experience, it also requires an increased level of attention from the hospital’s attending physicians, Kapre explains. “When I was training, you had a few attending physicians making rounds. That was the way that academics
“
The underserved populations are our mission. We want to make sure we’re here for them. We want to make sure we can provide them with quality care.
“
they will eventually set up shop in the region after completing of their training. Trends in the medical field suggest that this is often the case. “Nationally, it’s a well known fact that where you train is where you stay,” said Mohsen Saadat, D.O., who oversees the hospital’s internal medicine residency program. When it comes to understanding why residents might choose to stay in San Joaquin County after their training, Saadat and Kapre have somewhat of a unique point of view on the matter, having both completed their residency at San Joaquin General. “Three years is long time,” Saadat said, in reference to length of the hospital’s residency programs. “You start a family here. You tend to become attached to the community.” While convenience and a growing attachment to one’s surroundings can, at least in part, explain San Joaquin General’s high rate of resident retention, both Saadat and Kapre note that other, special steps should also receive a good deal of the credit, chief among them being the very manner in which physician training is conducted. “For starters, we try to attract local candidates,” Saadat said. “When you’re local, when you have roots in the county, you will want to come back.” Fortunately, San Joaquin General’s residency programs don’t have much of a recruitment problem. This past year, hundreds of graduating medical students applied for one of only eight available spots in
Sheela Kapre, M.D.
went,” she said. “Today, nothing is
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San Joaquin General Hospital > Physician Training
“
When I was a resident, it was the dedication to both patient care and teaching that kept me here. That dedication has never changed.
“
Mohsen Saadat, D.O.
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done blindly. Patient safety has become a big focus of what we do. If we can’t provide safe care, and we can’t provide quality care, we’ve got a problem.” As is the case which much of medicine, the manner in which “hands-on” care is being delivered today differs greatly than what was seen in the past. Kapre notes that residents currently training at San Joaquin General gain experience not only in bedside care, but also in the hospitals state-of-theart telehealth program, which is used to provide a high level of care to residents of the more rural parts of San Joaquin County and the Central Valley as a whole. “Take dermatology, for example. We’re able to receive an encrypted image from a clinic in area and make an assessment remotely,” Kapre said. “That makes things really easy, but it also gives the residents training in an area that they might not have otherwise received.”
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San Joaquin Medical Society and CMA Members Enjoy: Vast CMA Resources:
Serving the counties of San Joaquin, Calaveras, Alpine, and Amador
“My Membership provides me a Voice in Sacramento and Washington DC.” Thomas McKenzie, MD
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San Joaquin General Hospital > Physician Training
This ability to serve patients, particularly those living in more rural communities, is a growing trend, and areas lacking adequate access to care have become some of the earliest adopters of this technology. Kapre notes that San Joaquin County’s current physician shortage also opens up some unique opportunities to retain San Joaquin General’s graduating residents. In more rural areas of the county, there has been a concerted effort to increase access through the establishment of Federally Qualified Health Centers, she explains. These clinics, which receive reimbursement from the federal government, not only help increase access to care in areas where it’s sorely needed, but also created a demand for physicians. “We’re trying to put clinics in place to serve those populations. When we look at our at-risk populations, what we’re seeing is really just a lack of preventative care,” Kapre said. “These clinics provide a way not only to provide that care, but also help keep residents in the community.” While all of the steps taken by San Joaquin General to help retain residents certainly do their part, both Kapre and Saadat note that the sense of community in San Joaquin County and the Central Valley are also play a large role in decision making process. “Early on, we try to get them involved in the community-based projects,” Saadat said. “Being a resident is hard. You’re working
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so hard, and you don’t have time for many things, so getting them involved in their community provides a structure that people like to work within.” Once they’ve been immersed in their community, history has shown that most residents find it to be a place they want to be – one they
would like to spend their career serving. “That feeling of ‘I’ve done a good job, and I’m excited to go to work every morning,’ leads to continuity in practice.” Kapre said. “We want residents be here long enough to feel that sense of community.”
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Young Physician & Lifetime Achievement
Award Dinner
Lifetime Achievement Award: Dr . Javad Jamshidi
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Young Physician Award: Dr . Steven Billigmeier
FALL 2015
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SAN JOAQUIN MEDICAL SOCIETY’S
DECISION MEDICINE PROGRAM
2015
BY: BRANDON PIASECKI, 2015 DECISION MEDICINE FACILITATOR
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INVESTING IN THE
FUTURE
OF SAN JOAQUIN HEALTHCARE:
DECISION MEDICINE 2015
“I think becoming a doctor is the closest that we can become to being real superheroes in our world today…” replied one of the Decision Medicine candidates to Dr. George Khoury’s final interview question: “why do you want to become a doctor?” There was more than a brief moment of stunned silence from the Decision Medicine interview panel comprised of three physicians, Vanessa Armendariz, and me, more than enough intimidating adults to strike nervous chords in the average high school student. We all exchanged glances at each other after that response, outwardly maintaining our professional demeanor, but inwardly we were all celebrating, mentally pumping our fists, thinking “Yes! We have another one!” We had similar thoughts and reactions to 23 other confident, composed candidates, inspired to pursue medicine for many reasons, from witnessing family members’ battle cancer to a desire to bring diversity to high-specialized medical fields like cardiothoracic surgery. But there was a common theme that linked all 24 Decision Medicine’s students’ reasons for becoming a doctor someday: the desire to serve humbly and impact the lives of those who need healing. As with every year, the application process was extremely selective. With over 120 qualified applicants, those 24 students that were selected showed exceptional ability and were all well-rounded in many ways excelling not only in academics, but music, sports, and leadership activities. The 2015 participants had an average GPA of 4.2 and represented 15 different high schools across five different cities in San Joaquin County.
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Decision Medicine > 2015
DAMERON HOSPITAL: HEMATOLOGY LECTURE, FORENSIC PATHOLOGY PRESENTATION, BLOOD TYPING ACTIVITY, HOSPITAL TOUR: PATHOLOGYINFORMATION TECHNOLOGY- CORE LAB
KAISER PERMANENTE: MOCK DIAGNOSIS ACTIVITY WITH PHYSICIANS, HOSPITAL TOUR, SIMULATED BIRTH AND Q&A WITH PHYSICIANS
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Throughout the two weeks, the students were challenged physically and mentally as they were exposed to various specialties in medicine. The nine-hour days were balanced to include informational lectures from various hospital departments, question and answer sessions with physicians, residents and medical students, as well as interactive hands-on activities. From pig heart dissections to analyzing and typing their own blood, students learned so much that they probably would not have had the opportunity to experience outside of this program. Decision Medicine kicked off with a teambuilding day in which students participated in rope course activities and icebreakers, which really set a tone of camaraderie for the rest of the two weeks. They toured Shriners Children’s Hospital Sacramento and played with children recovering from treatment. With the help of St. Joseph’s Medical Center and the American Red Cross, they were able to become both CPR and First Aid Certified. Thanks to San Joaquin General Hospital, this year marked the first year that all 24 students were able to observe a surgery. They were able to observe an ACL surgery, colonoscopy, laparoscopic cholecystectomy, and a thrombectomy. They also were able to go on rounds with the Residents and attending Doctors and see what their day-to-day jobs are like. It was an experience they will not soon forget! The program has evolved significantly since its inception from Dr. Adubofour and Dr. Khoury back in 2001, due to the continued support from our financial partners Health Plan of San Joaquin and Kaiser Permanente, community partners, and dedicated physicians. The growth is evident both in increase in applicants and the increasing number of volunteer mentor physicians. The shadowing experience was a huge success on both sides, with the physicians expressing their passion for inspiring and molding future doctors and
FALL 2015
Decision Medicine > 2015
HPSJ HEALTH CAREERS SCHOLARSHIPS DECISION MEDICINE STUDENTS HONORED HPSJ Chief Medical Officer Lakshmi Dhanvanthari, MD, presented the first two HPSJ Health Careers Scholarships of $2,500 each to Decision Medicine 2015 graduates Margarito Meza and Daniela Pantoja at the July 26 ceremony at Stockton Golf and Country Club. Dr. Dhanvanthari said, �With this award we recognize your outstanding academic achievements and the commitment you have already demonstrated to service in communities in San Joaquin and Stanislaus counties. We have faith in the potential you have shown and we join with your family, teachers, and friends to support your efforts as you pursue your health career higher education goals.� Mr. Meza will attend UCLA in the fall. Ms. Pantoja will attend UC Davis.
students really being impacted by the relationships they developed with these role models. Although the program is only two weeks in duration, the San Joaquin Medical Society commits to serving as a resource to the students throughout their journey to pursuing a career in medicine. The goal of the program has always been to expose high achieving students to the field of medicine in hopes that they return to practice in San Joaquin County. This was reiterated throughout the program and reinforced at the concluding celebration banquet. Our keynote speaker this year, Dr. Steven Millar of Kaiser Permanente, delivered an inspirational address to the aspiring physicians and their families that resonated with everyone in the room. He gave the students (and parents!) 10 tips for success to FALL 2015
achieve their goals of becoming physicians, all stemming from the theme of practicing medicine because you love to serve others, not yourself. The attitude of self lessness permeated the program from start to finish, and the closing message could not have been more fitting.
Some of the students will be the first in their families to attend college and many of them have not had previous exposure to the medical field. This program enables students to talk with a diverse group of physicians that may have similar backgrounds, whether they went to high school locally, are an underrepresented minority, or overcame various life obstacles. These connections and mentoring opportunities are often life-changing and truly valuable to the students because it shows that our medical community is invested in their future. With everything this program has given these students, they truly are on their way to becoming superheroes, and we are all excited to watch them as they pave their path toward becoming exceptional physicians!
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(209) 823-7190 48
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FALL 2015
Decision Medicine > 2015
SAN JOAQUIN GENERAL HOSPITAL: SURGERY OBSERVATION, HOSPITAL TOUR, Q & A SESSION AND ROUNDS WITH RESIDENTS
PHYSICIAN SHADOWING: PERSONAL MENTORING WITH SJMS MEMBERS
VENTURE ACADEMY: TEAM BUILDING ACTIVITIES AND ICE BREAKERS
2015 DECISION MEDICINE STUDENTS Samuel Bankole
Health Careers Academy
Daniel Barajas
Bear Creek High School
Johanna Bedoy
Tracy High
Celeste Buenrostro
Saint Mary’s High School
Leonardo Carrillo
Ronald E. McNair High School
Andre Codner
Stockton Collegiate International School
Madeline Guajardo
Stockton Collegiate International School
Carrie Hang
Cesar Chavez
Sheila Ho
Millennium High School
Ashley Hoang
Bear Creek High School
Lovepreet Kaur
Sierra High School
Annah Khan
Benjamin Holt Preparatory Academy
Delaney Lund
Lodi High School
Kira Maszewski
Cesar Chavez High School
Ellen Nguyen
Tracy High School
Daisy Osana
Edison High School
Kunal Patel
Lincoln High
Nikhil Pothuru
John C. Kimball High School
Martin Sandoval
Franklin High School
Caroline Stelzer
Stockton Collegiate International School
Crystal Torres
Health Careers Academy
Randy Yan
Benjamin Holt College Preparatory Academy
Joyce Zamorano Sanchez
Millennium High School
Catherine Zhang
Lincoln High School
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CMA Works with CMS to Mitigate Medicare ICD-10 Disruptions CMA PUBLISHES With implementation of the ICD-10 code set just around the corner, many physicians have been understandably wary about the transition and the potential for payment disruptions and claims processing errors that could interfere with patient care. Fortunately, the California Medical Association (CMA) – working closely with the American Medical Association (AMA) and other medical associations – has secured provisions that will ease this transition, particularly for physicians in practices with limited resources. Thanks to CMA advocacy, the Centers for Medicare & Medicaid Services (CMS) recently announced that it will provide a one-year grace period during which it will allow for flexibility in the Medicare claims payment, auditing and quality reporting processes as the medical community gains experience using the new ICD-10 code set. The ICD-10 implementation date of October 1, 2015, has not changed.
ICD-10 TRANSITION GUIDE CMA has published the “ICD-10 Transition Guide” to help practices of all sizes successfully make the switch to the new ICD-10 coding system. The guide will answer frequently asked questions and includes CMA’s “ICD-10 Transition Preparation Checklist” to
THE CHANGES ANNOUNCED INCLUDE:
help ensure the transition is
CLAIM DENIALS: Medicare review contractors will not deny claims based solely on the
a smooth one. The guide is
specificity of the ICD-10 diagnosis code as long as a valid code from the right family of
free to members-only at
codes is used. Moreover, physicians will not be subject to audits as a result of ICD-10
www.cmanet.org/icd10.
coding mistakes during the grace period. QUALITY REPORTING: Physicians also will not be penalized under the quality reporting programs for errors related to the additional specificity of the ICD-10 diagnosis code, again as long as a code from the correct family of codes is used.
ICD-10
ICD-10 What
ADVANCE PAYMENTS: If Medicare contractors are unable to process claims within established time limits because of administrative problems, such as contractor system malfunction or implementation problems, advance payment may be available to keep resources flowing to physician practices. ICD-10 COMMUNICATION CENTER: CMS will set up a communication center to monitor the implementation of ICD-10 in an effort to quickly identify and resolve issues related to the transition. As part of the center, CMS will have an ICD-10 ombudsman to help receive
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and triage physician and provider issues. For the latest ICD-10 news and updates, see CMA’s ICD-10 resource page at www.cmanet.org/icd10.
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FALL 2015
2015 ICD-10-CM Code Set Boot Camps DISCOUNTED
ICD-10 EDUCATION AND TRAINING FOR MEMBERS
Recognizing that health care providers need help with the transition, CMA, AMA and CMS are also working to make sure physicians and other providers are ready for the October 1, 2015, transition to the new ICD-10 code sets. CMA, in partnership with its local county medical societies and the California Medical Group Management
Association, is offering two-day ICD-10 code set seminars around the state. The two-day boot camps include 16 hours of intensive general ICD-10 code set training, along with hands-on coding exercises. To view the available dates and locations, visit CMA’s ICD-10 event calendar at www.cmanet.org/aapc-icd10. In addition to the two-day code set boot camps, CMA has negotiated deep discounts on other ICD-10 training courses through AAPC. For details, visit www.cmanet.org/aapc.
Sav eu
2015 ICD-10-CM Code Set Boot Camps p to
CMS and AMA will also be offering webinars, educational articles and national provider calls to help physicians and other health care providers prepare for the transition. For more information, see CMS’s ICD-10 provider page at www.cal.md/cms-icd10 and AMA’s ICD-10 web page at www.cal.md/AMAICD10.
$40
0!
Learn to code for ICD-10-Clinical Modification (ICD-10-CM) and prepare for the ICD-10 Proficiency Assessment. Training is led by a certified AAPC instructor and is provided onsite in a classroom format. Conducted over two days, attendees will receive 16 hours of intensive general ICD-10 code set training along with hands-on coding exercises.
WHAT’S INCLUDED:
TRAINING FOCUSES ON:
• 16 CEUs
• ICD-10 format and structure
• AAPC ICD-10-CM Code Set Course Manual
• Complete in-depth ICD-10 guidelines
• AAPC ICD-10-CM Code Set Draft Book
• Nuances found in the new coding system, with coding tips
• AAPC Online ICD-10-CM Proficiency Assessment (Required for current AAPC CPCs to maintain their credential)
• Access to AAPC’s Online ICD-10-CM Assessment Training Course through December 31, 2015
PRICING: • $399 for CMA members & members’ staff • $499 for CA-MGMA members • $599 for non-members
LOCATION/DATES
*Comparable AAPC ICD-10 Boot Camp Costs $799
Santa Maria . . . . . June 8-9
San Jose . . June 30-July 1
Sacramento . . . .July 15-16
Modesto . . . . August 12-13
Fresno . . . . . . . June 15-16
Redlands . . . . . . . .July 7-8
Roseville . . . . . August 4-5
Redding . . . . August 24-25
Napa. . . . . . . . . June 18-19
Los Angeles . . . . . .July 8-9
Stockton. . . . August 10-11
Eureka . . . . . August 26-27
Irvine . . . . . . . . June 23-24
Santa Rosa. . . . .July 13-14
San Diego . . . . June 25-26
Torrance . . . . . . .July 14-15
(French Camp)
*Dates and locations subject to change. Please check www.cmanet.org/AAPC-ICD10 for updated information and new boot camps being added.
REGISTER: CALL (800) 786-4262 OR VISIT WWW.CMANET.ORG/AAPC-ICD10 INFORMATION: CALL JULI REAVIS AT (916) 551-2046 OR EMAIL JREAVIS@CMANET.ORG
For more information about CMA, please visit: www.cmanet.org
SIGN UP FOR ICD-10
For more information about these and other CMA member discounted course offerings from AAPC, please visit: www.cmanet.org/AAPC
NEWS ALERTS The CMA website allows registered users to create custom content alerts on the topics that are of interest to you. Once signed up, you will be notified any time there is new content posted in one of your areas, including ICD-10 issues. To sign up, go to www.cmanet.org and visit your account dashboard, click on “My Alerts,” then select “ICD-10.”
For more information about CMA, please visit www.cmanet.org or call 800.786.4262 SAN JOAQUIN PHYSICIAN 51
FALL 2015
Members-Only Benefits
Contact CMA Today! When you join CMA, you hire a powerful professional staff to protect the viability of your practice. By protecting your practice from legal, legislative, and regulatory intrusions, your CMA membership lets you focus on what’s really important: your patients.
1-800-786-4262 www.cmanet.org/ groupdiscounts
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Members can offset the price of their annual dues when using CMA membership services and discounts. Thanks to CMA’s group buying power, members receive deep discounts on everything from magazines to office supplies to insurance products. From auto insurance to retirement plans, CMA’s discount programs will save you time and money. Many CMA members save more than their annual dues!
Legal Services CMA On-Call: CMA’s health law library, CMA On-Call, has over 5,400 pages of up-to-date legal information on a variety of subjects of everyday importance to practicing physicians. Accessible to members at www.cmanet.org/cma-on-call or by calling 800.786.4262. Legal Services: CMA’s legal department provides members with information and resources about laws and regulations that impact the practice of medicine. While CMA staff cannot provide physicians with individual legal advice, our health law information specialists, with the support of CMA legal counsel, will help you find legal information and resources on a multitude of health-law related issues. Call 800.786.4262.
FALL 2015
San Joaquin Medical Society > Member Benefits 2015
Professional Development
Practice Management
CME Tracking/Credentialing: CMA’s Institute for Medical Quality certifies CME activity for credentialing purposes to the Medical Board of California, as well as to hospitals, health plans, specialty societies, and others. CME Certification is $33 a year for CMA members, $57 for nonmembers. IMQ, 415.882.5151 or www.imq.org.
CMA Reimbursement Help Center: Trouble getting paid? In the past five years, CMA’s practice management experts recouped over $10 million from payors on behalf of physician members. CMA provides members and their staff with FREE one-on-one assistance with individual practice management, reimbursement, and contracting related issues. Reach CMA’s practice management experts at 888.401.5911.
CMA Webinar Series: CMA’s webinar series gives physicians the opportunity to watch online presentations on important topics of interest and interact with legal and financial experts from the comfort of their homes or offices. The webinars are free to CMA members and their staff. All of our webinars are also archived for on-demand viewing at any time in our resource library. There are currently more than 100 archived webinars on topics ranging from HIPAA, to health reform, to coding, billing, and compliance. www.cmanet.org/webinars. CMA Seminar Series: Experts from CMA’s various centers travel to local county medical socities throughout the state, holding live seminars for members and their staff on a variety of issues. Contact your local county medical society for more information. ICD-10 Training: The transition to ICD-10 will take strategic planning and considerable preparation. CMA has partnered with the largest and most respected coding organization, AAPC, to provide our members with a complete suite of ICD-10 solutions at steeply discounted rates. Visit www.cmanet.org/aapc for more information. Certified Professional Coder Program: CMA members and their staff receive big discounts on Certified Professional Coder (CPC) training and certificates from AAPC. AAPC’s CPC credential is the gold standard for medical coding in physician office settings. Contact your local county medical society for more information.
FALL 2015
CMA Payor Contract Analysis: CMA members have free access to objective written analyses of major health plan contracts at www.cmanet.org/ces. Each analysis is designed to help physicians understand their rights and options when contracting with a third party payor, as well as which contract provisions are prohibited by California law.
Publications CMA produces a number of publications to keep members up to date on the latest health care news and information affecting the practice of medicine in California. Subscribe to any of these newsletters online at www.cmanet.org/newsletters. CMA Alert: CMA’s bi-weekly e-newsletter provides up-to-date information on many issues of critical importance to California physicians. CMA Practice Resources (CPR): CMA’s free monthly e-mail bulletin from CMA’s practice management experts that focuses on critical payor and health care industry changes and how they directly impact the business of a physician practice. Each issue includes tips on reimbursement and contracting related issues along with information on the latest practice management news. CMA’s Press Clips: CMA’s daily news roundup, provides a quick but meaningful overview of the day’s health care news.
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Insurance Mercer Insurance Services: As the primary insurance advisor for CMA and its affiliated county societies, Mercer offers a wide variety of sponsored insurance plans and services for members. With health care reform impacting members as employers, you need to be speaking with a knowledgeable advisor to consider your medical plan offerings, in or out of the health exchange, for yourself, your employees and your dependents in the months and years ahead. Designed to cover a multitude practice and personal insurance needs the CMA-sponsored insurance plans include disability, group life, workers’ compensation, employment practices liability (with access to employment counsel included), and dental. Members also have access to personal insurance concierge services to help with your insurance planning. More information on Mercer’s sponsored benefit program can be found at www.countyCMAmemberinsurance.com or call 800.842.3761. Auto and Homeowners Insurance: Discounted auto and homeowners insurance for CMA members. Mercury Insurance Group, 888.637.2431 or visit www.mercuryinsurance.com/cma.
Other Supplies and Resources Medical Waste Disposal and Regulatory Compliance: EnviroMerica offers CMA members heavily discounted medical waste removal and regulatory compliance services. Through EnviroMerica, CMA members can protect themselves from regulatory fines, receive compliance consultations and properly dispose of medical waste at a fraction of the cost charged by competitors. Find out more at www. enviromerica.com or by calling 650.655.2045.
PHYSICIANS SERVICE BUREAU TELEPHONE EXCHANGE
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DocBookMD: CMA members are eligible for a free download of the DocBookMD smart phone app, which allows them to securely send messages directly from their iPad, iPhone and Android devices. Find out more at www.docbookmd.com or by contacting your county society. Physician Practice Websites: Mayaco Design and Marketing offers CMA members deeply-discounted website design services for their practices starting at $1,250. Contact Mayaco at 209.957.8629 or visit www. mayaco.com for more information. HIPAA Compliance: PrivaPlan offers CMA members discounted rates on HIPAA privacy and security compliance resource kits custom tailored
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San Joaquin Medical Society > Member Benefits 2015
to California’s regulations. Find out more at www.privaplan.com. StaplesAdvantage: Save up to 80% on office supplies and equipment from Staples, Inc. Visit www. cmanet.org/groupdiscounts to access the members-only discount link. COLA: COLA is a physiciandirected organization whose purpose is to promote excellence in laboratory medicine and patient care through a program of voluntary education, consultation and accreditation. This member benefit provides a 15 percent savings on COLA’s Laboratory Accreditation Program and its educational products and services. CMA members also
FALL 2015
receive free online support and a complimentary basic quality lab course and may be eligible for a discount on AAFP and ACP proficiency testing programs. Visit www.cmanet.org/groupdiscounts to access the members-only discount code. MedicAlert: MedicAlert is a nonprofit foundation with over 50 years of lifesaving experience identifying and providing vital medical information to emergency personnel for over 4 million members worldwide. CMA members and their patients save $10 on new adult enrollments and $2.95 on Kid Smart Enrollments. www.medicalert.org/cma or 800.253.7880.
Security Prescriptions: Get 15% off tamper-resistant security prescription pads and printer paper. www.rxsecurity.com/cma. php. Magazine Subscriptions: 50% off subscriptions to hundreds of popular magazines, with a best price match guarantee. Visit Subscription Services Inc. at www.buymags.com/cma or call 800.289.6247. Car Rentals: Save up to 25% on car rentals for business or personal travel. Members-only coupon codes are required to access this benefit. Get your code at www. cmanet.org/groupdiscounts or call 800.786.4262.
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Public Health
Update
ALL CALIFORNIALICENSED PHYSICIANS Authorized to prescribe Schedule II, III, or IV controlled substances Must be registered to access CURES 2.0 (the Controlled Substance Utilization Review and Evaluation System) With the Department of Justice By January 2016. The Medical Board of California can assist. For more information: http://www.mbc.ca.gov/
Injuries: Preventable, not Accidental Alvaro Garza, MD, MPH, and Todd E Davenport, PT, DPT, OCS
Injuries remain the leading cause of death for everyone between the ages of one to 44 years and the third leading cause of death overall in the United States. They are substantial contributors to morbidity and health care costs each year. This evidence led to identifying injury reduction as a leading indicator of Healthy People 2020 (HP2020) in the U.S. This article reviews select aspects of injuries in San Joaquin County and makes recommendations for healthcare providers to help reduce drug poisoning.
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Injuries are thought by many to be “accidental” outcomes that occur by chance, “something that could happen to anyone,” or “being in the wrong place at the wrong time.” However, far from being unfortunate “accidents,” there are specific related circumstances that can be addressed; risk factors that can be substantially reduced. To better understand these factors, injuries are characterized by intent: purposeful intentional injuries and “accidental” unintentional injuries. Intentional injuries are further classified as self-inflicted or assault-related.
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The national HP2020 objective for total injury deaths rate is 53.7 per 100,000 population; in comparison, the San Joaquin County rate during 2013 (the latest data available) was 54.8. The unintentional injuries of poisoning and motor vehicle “accidents” were the top two most common causes of all injury-related deaths in San Joaquin County (Table). The HP2020 objective for assault-related deaths is 5.5 per 100,000, and the San Joaquin County rate was 7.1 in 2013. This difference translates to 11 assault-related deaths in San Joaquin County that would have been prevented if the HP2020 goal was met. The incidence rate of assault-related deaths in San Joaquin County was
also 48% higher than in the State of California as a whole. Firearm assaults accounted for almost 90% of all assaultrelated deaths in our county. The distribution of injuries in San Joaquin County varies by socioeconomic status (i.e., by level of education) and race/ethnicity, pointing to important disparities. There was an inverse relationship between level of education and the incidence of all deaths among residents in 2013. For example, injury-related causes of death for residents with baccalaureate or graduate degree were mostly unintentional or self-inflicted, whereas assault related deaths were more likely to occur in individuals with education levels involving ‘some college’ or less.
Top Five causes of injury-related deaths in San Joaquin County, 2013 All
Unintentional
Self-Inflicted1
Assault-Related*
1
Unintentional Poisoning (14.2)
Poisoning (14.2)
Firearm (4.1)
Firearm (6.1)
2
Unintentional Motor Vehicle Accidents2 (11.9)
Motor Vehicle Accidents (11.9)
Hanging/Suffocation (3.5)
Cut/Pierce (0.1)
3
Firearm Assaults (6.1)
Falls (4.0)
Poisoning (1.6)
---
4
Firearm Suicides (4.1)
Drowning (1.6)
Cut/Pierce (0.6)
---
5
Unintentional Falls (4.0)
Burns (0.9)
Jump (0.4)
---
(1) Parenthetical values are crude incidence per 100,000 people based on 2010 Census estimates. (*) Includes all injuries not classified as “Other” (2) Combines all classifications of motor vehicle accidents. Source: California Department of Public Health. Injury: Leading Cause of Death Among Persons Ages 1-44, U.S.
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The most common cause of injury-related death among Black and White residents of San Joaquin County was unintentional poisoning during 2013. However, the rate difference between race groups was 13.5 per 100,000, accounting for seven extra deaths among Black residents compared to White. By contrast, the incidence of fallrelated injury deaths was almost 10-fold less among Black residents of San Joaquin County compared to White, accounting for 12 extra fall-related deaths among White residents. Motor vehicle “accidents” were the most common cause of injury-related deaths among Latino and Asian/Pacific Islander residents, with very similar racestratified incidences.
Opioid Poisoning Drug overdose is a leading form of poisoning, with opioids as the primary listed drug for hospitalizations and ER visits. The U.S. Centers for Disease Control and Prevention (CDC) recently reported on the growing use of heroin nationally, with the greatest increases in women and people with private insurance and higher incomes. The strongest risk factor for heroin use is a prescription opioid use disorder. From 1999 to 2013,
Injury: Leading Cause of Death Among Persons Ages 1-44, U.S.
Source: Centers for Disease Control and Prevention
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the amount of prescription opioids dispensed in the U.S. nearly quadrupled. Although we do not have San Joaquin County specific data, it is reasonable to consider that we have a similar phenomenon happening here. The American Medical Association has recently called for physicians to help stop the opioid overdose epidemic. In the healthcare community, prevention of such addiction calls for healthcare providers to pay attention to and improve opioid prescribing practices. Practitioners can analyze patient prescription-drug history and make better informed decisions before prescribing opioid painkillers. To assist with this, we remind you of the Controlled Substance Utilization Review and Evaluation System (CURES 2.0) and that state law requires CURES registration by all practitioners authorized to prescribe controlled substances by their DEA registration. More information is available at the Medical Board of California, http://www.mbc.ca.gov/. Highly recommended to help prevent opioid overdose is the “Opioid Overdose Toolkit: Information for Prescribers” by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) that includes information on the opioid antagonist naloxone. It can be found (and downloaded) at http://store.samhsa.gov/shin/content//SMA14-4742/ Toolkit_Prescribers.pdf. Also useful is the website “Prescribe to Prevent” at http://prescribetoprevent.org/. A local resource is the San Joaquin County Substance Abuse Services at http://www.sjgov.org/OSA/. Each clinician has an important role to play in injury risk reduction in our County. Every patient consult, but especially if an injury-related visit, can and should serve as a teachable moment, even for the busiest physician. For example, encourage use of seat belts, car seats, and bicycle helmets; discourage use of firearms; counsel on reducing home fall hazards and on safe disposal of expired medications. As healthcare professionals, we do all have important roles and responsibilities to prevent injuries in our communities and reduce their impact on our lives. After all, Injuries are preventable.
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practice manager Free to SJMS/CMA Members!
resources
The Office Manager’s Forum empowers physicians and their medical staff with valuable tools via expert led educational sessions from industry professionals who are committed to delivering quality health care. For more than 130 years, the San Joaquin Medical Society (SJMS) has been at the forefront of current medicine, providing its physician’s and their staff with assistance and valuable practice resources. SJMS is proud to offer the Office Manager’s Forum, a monthly educational seminar designed to enhance the healthcare environment with professional development opportunities while providing solutions to some of the challenges that come from managing a practice. Attendees gain knowledge on a broad array of topics related to the field of medical staff services, office management, billing and coding, human resources, accounting and back office support. The Office Manager’s Forum is held on the second Wednesday of each month from 11:00AM – 1:00PM at Papapavlo’s in Stockton and includes a complimentary lunch. Attendance is always FREE to our members. Non-members are welcome and may attend for one month at no cost to experience one of the quality benefits that comes with Society Membership ($35.00 thereafter). Registration required. For more information or to be added to the mailing list email Jessica Peluso, SJMS Membership coordinator, at Jessica@SJCMS.org or call (209) 952-5299.
SEPTEMBER 9TH 2015:
“ARE YOUR EMPLOYEES CLASSIFIED PROPERLY” 11:00AM to 1:00PM
Improper classification of employees can result in significant wage claims and penalties for a business. This seminar will address proper classification of independent contractors versus employees and exempt versus non-exempt employees. ~Velma Lim & Jamie Bossuat- Kroloff, Belcher, Smart, Perry & Christopherson
OCTOBER 14TH 2015: “TBD” 11:00AM to 1:00PM
ARE YOU READING CPR? CPR contains the latest in Practice Management Resources, Updates and Information.
May 2012
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NOVEMBER 11TH 2015: “STEPS TO REDUCE BAD DEBT” 11:00AM to 1:00PM
Ana Molina~ CB Merchant Services Collections Manager with over 30 years accounts receivable and collection experience and is directly responsible for compliance and training of collection personnel.
DECEMBER 9TH 2015: “MEDICARE UPDATES 2016” 11:00AM to 1:00PM
Join us for our annual Medicare Update workshop for physicians and office staff. This 2 hour seminar will cover relevant information about current, future and proposed changes for the coming year.
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