Summer 2015 by San Joaquin Medical Society

FROM THE

GROUND PLUS: Young Physician Award Recipient San Joaquin Golf Tournament Wrap Up and more! Summer 2015 SUMMER 2015

SAN JOAQUIN PHYSICIAN

A ﬁnancial safety net for you—

AND THE ONES YOU LOVE 10- AND 20-YEAR LEVEL TERM LIFE No matter where you are in life, SJMS Group Level Term Life Insurance benefits can be an affordable solution to help meet your family’s financial protection needs. Mercer and SJMS leveraged the buying power of your fellow members to secure dependable and affordable life insurance benefits at competitive premiums from ReliaStar Life Insurance Company, a member of the Voya® family of companies.

With quality life insurance beneﬁts extended at competitive rates, you’ll rest easy knowing you’ve provided coverage for your loved ones through the Group 10-Year and 20-Year Level Term Life Plans.

As a member, you can conveniently help protect your family’s financial future with the Group 10-Year and 20-Year Level Term Life Plan. It features: • Benefits up to $1,000,000 • Rates that are designed to remain level for 10 or 20 full years* • Benefit amounts that never change during the level term period provided premiums are paid when due

See For Yourself: Get more information about your Group 10-Year and 20-Year Level Term Life Plans, including eligibility, benefits, premium rates, exclusions and limitations, and termination provisions by visiting www.CountyCMAMemberInsurance.com or by calling 800-842-3761. Sponsored by:

Mercer Health & Benefits Insurance Services LLC • CA Ins. Lic. #0G39709 777 S. Figueroa Street, Los Angeles, CA 90017 • 800-842-3761 • CMACounty.insurance.service@mercer.com • www.CountyCMAMemberInsurance.com * The initial premium will not change for the first 10 or 20 years unless the insurance company exercises its right to change premium rates for all insureds covered under the group policy with 60 days’ advance written notice. The County Medical Associations & Societies receives sponsorship fees for insurance programs that offset the cost of program oversight and support member benefits and services.

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VOLUME 63, NUMBER 2 • JUNE 2015

Legislative Day 2015

{FEATURES}

12 24 32 42

CMA

{DEPARTMENTS}

Legislative Advocacy Day

16 IN THE NEWS

ROOTS RUN DEEP

47 CONGRESS PASSES MEDICARE PAYMENT

Dr. Steve Billigmeier Young Physician Award Recipient

FROM THE GROUND UP

New faces and announcements

REFORM AND ELIMINATES SGR

51 SENATE PRESIDENT PRO TEM DELIVERS KEYNOTE SPEECH

Dr. Javad Jamshidi Lifetime Achievement Award Recipient

52 PUBLIC HEALTH

SAN JOAQUIN GOLF TOURNAMENT

56 PRACTICE MANAGEMENT:

beneﬁtting The First Tee of San Joaquin and Decision Medicine

TB in San Joaquin The key to improving patient outcomes

59 NEW MEMBERS 61 IN MEMORIAM

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PRESIDENT Ramin Manshadi, MD PRESIDENT-ELECT John Zeiter, MD PAST-PRESIDENT Thomas McKenzie, MD SECRETARY-TREASURER George Savage, MD BOARD MEMBERS Raissa Hill, DO, Moses Elam, MD, Grant Mellor, MD, Dan Vongtama, MD, Alvaro Garza, MD, Kwabena Adubofour, MD, Mohsen Saadat, DO, Clyde Wong, MD

MEDICAL SOCIETY STAFF EXECUTIVE DIRECTOR Lisa Richmond MEMBERSHIP COORDINATOR Jessica Peluso

SAN JOAQUIN PHYSICIAN MAGAZINE EDITOR Lisa Richmond EDITORIAL COMMITTEE Ramin Manshadi, Lisa Richmond, Mike Steenburgh

COMMITTEE CHAIRPERSONS

Vanessa Armendariz

MRAC F. Karl , Gregorius, MD

MANAGING EDITOR Lisa Richmond

DECISION MEDICINE Kwabena Adubofour, MD

CREATIVE DIRECTOR Sherry Roberts

ETHICS & PATIENT RELATIONS to be appointed LEGISLATIVE Jasbir Gill, MD COMMUNITY RELATIONS Joseph Serra, MD PUBLIC HEALTH Alvaro Garza, MD SCHOLARSHIP LOAN FUND Janwyn Funamura, M.D.

CONTRIBUTING WRITERS James Noonan, Ramin Mashadi, MD, Alvaro Garza, MD, MPH, Julie Vaishampayan, MD, MPH, George Khoury, MD.

NORCAP COUNCIL Thomas McKenzie, MD THE SAN JOAQUIN PHYSICIAN MAGAZINE

CMA HOUSE OF DELEGATES REPRESENTATIVES

is produced by the San Joaquin Medical Society

Robin Wong, MD, Lawrence R. Frank, MD, James R. Halderman, MD, Roland Hart, MD,

SUGGESTIONS, story ideas or completed stories

Grant Mellor, MD, Kwabena Adubofour, MD,

written by current San Joaquin Medical Society

Gabriel K. Tanson, MD, Ramin Manshadi, MD

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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Confidence The feeling you have when you are affiliated with Hill Physicians. Diego Ferro, M.D.

Hill Physicians provider since 2013. Uses Ascender preventive care reminders, RelayHealth online communication tools and Hill inSite to review eClaims and eligibility.

At Hill Physicians, we continue to improve upon coordinated care, with remarkable results. We provide the tools and support that practices need to be financially successful and improve the coordinated care experience for their patients. Our advantages include: • Fast, accurate claims payments • Free eReferrals, ePrescribing and online doctor-patient communications • Experienced RN case management for complex, time-intensive cases • Deep discounts on EPM and EHR solutions to help you meet the federal mandate • Easy preventive care and disease management reminders for patients • Extensive health resources that boost patient engagement • High consumer awareness that builds practice volume That’s why 3,800 independent primary care physicians, specialists and healthcare professionals have joined Hill. Feel confident in the future of your practice and your patients by affiliating with Hill Physicians Medical Group.

For more about the advantages of affiliating, visit HillPhysicians.com/JoinUs.

Hill Physicians’ 3,800 healthcare providers accept HMOs and many PPOs from Aetna, Anthem Blue Cross, Blue Shield, CIGNA, Easy Choice, Health Net, Humana, SCAN, San Francisco Health Plan, United Healthcare WEST and Western Health Advantage. Medicare Advantage plans in all regions. Medi-Cal in some regions for physicians who opt-in.

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Letter From The Executive Director

STAFF REPORT

IT’S ALL ABOUT BALANCE We are all trying to achieve it-work/life balance. It can be tricky to have a successful career and also be present for our family. As a working mom, I know I wake up each day and wonder how it’s all going to happen- work, meetings, baseball games, music lessons, swim practice, etc. Some days it feels impossible to balance it all and more importantly, do it well. I have always loved the quote “never get so busy making a living that you forget to make a life.” I believe this issue is filled with stories that are reflective of physicians taking the time to “make a life.”

LISA RICHMOND

Recently, SJMS sponsored the San Joaquin Women Physician’s Group luncheon organized by Dr. Grace Barzaga and Dr. Janwyn Funamura. It was fun to see the interaction between the young women physicians and the more seasoned veterans of our community as they shared the history of the group as well as tips and tricks for being successful physicians, wives and moms. The ladies are looking to revive this group and meet more frequently. See the In the News section for more details and contact information. Along those lines, SJMS held its 6th Annual Golf Tournament benefitting The First Tee of San Joaquin and SJMS’s Decision Medicine Program. It was a beautiful day of golf, relaxation and fellowship at Elkhorn Golf and Country Club. The funds generated for Decision Medicine will secure the charter bus which transports students to San Francisco for the grand finale of the program where they dissect pig hearts with cardiothoracic surgeons, tour various medical facilities and end their day with dinner at Pier 39. This day is always a highlight for the students! We appreciate all of the support from those who came out to golf and/or donated to the event. Please see Dr. Khoury’s article and pictures from the event. We are looking forward to honoring our Lifetime Achievement and Young Physician Award recipients, Dr. Javad Jamshidi and Dr. Steven Billigmeier at our annual membership dinner on Sunday, June 14 at Stockton Golf & Country Club. These men are excellent examples of how to effectively balance their busy practices with giving back to their community, while never losing sight of their number one priority- FAMILY! You will find a wonderful feature on each physician towards the middle of this issue. Please find additional details about this event in the enclosed advertisement. I hope to see you there! I am so excited to announce that Vanessa Armendariz, Community Relations Manager and 2005 Decision Medicine Alumni has been accepted to the University of Kansas School of Medicine, which begins this June! We will miss her so much, but know we will see her back in San Joaquin County as a practicing physician. Finally, with Vanessa’s departure and the facilitation of our Decision Medicine program this summer, the office hours will vary and may be closed at times. Please give us a call before coming by to insure we are open. Thank you for your patience through this transition. All the Best,

Lisa Richmond

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A message from our President > Ramin Manshadi MD, FACC

Year in Review: Past, Present and the Future I have had the privilege of leading the San Joaquin Medical Society, (SJMS) for the past year. It has been a tumultuous year for physicians at the national, state, and the local level. We continuously battled at the front lines while holding steady at our back lines as well. We fought for what we believed in and never conceded. We were united and remained focused. I believe our perseverance is best described by a quote from President John Quincy Adams. â&#x20AC;&#x153;Patience and perseverance have a magical effect before which difficulties disappear and obstacles vanish.â&#x20AC;? We have defined such perseverance by maintaining a steadfast purpose in our work in spite of difficulty, obstacles, or discouragement. We prevailed over the trial lawyers at the state level and defeated Proposition 46 that would have adversely affected all physicians and increased health care costs and reduced access to our patients. For years at the national level, we educated our legislators about the SGR flaw and it finally paid off. After decades of uncertainty, annually or even every few months we faced the threat of 20%-30% across the board Medicare cuts. Finally, this year, Congress unanimously voted to end the SGR method of payment. For the next year(s) we no longer need to be anxious that when Congress convenes our fate on the subject will be in their hands. President Adams would have been proud of us.

ABOUT THE AUTHOR Board Ramin Manshadi MD, FACC is President of the San Joaquin Medical Society and is a Board-Certified Cardiologist

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SAN JOAQUIN PHYSICIAN

A message from our President > Ramin Manshadi MD, FACC

The medical field has been and right away. If you are already a membership. Our financial position will always be a noble profession. We member, I would ask you to reach is solid and the overall outlook looks have all been trained to be healers-not out to your colleagues and friends excellent. politicians or business professionals. who are not and persuade them to We were able to achieve this Yet, by the virtue of our training we join. Additionally, please consider through your continued support. have positively affected history. Let donating to the California Medical When we asked you to get involved us recall the early life of President Associationâ&#x20AC;&#x2122;s PAC (CALPAC). Your to educate your patients about the James Knox Polk. As a young man donations to CALPAC will always be consequences of Proposition 46, you he was stricken with a severe urinary used wisely to advance the voice of delivered. When we asked you to call stone that caused recurrent issues and medicine which will ultimately help on Congress and push to repeal the infections that eventually required us deliver the best possible care to our flawed SGR, you responded. When we surgery. Dr. Epharim McDowel patients who place their full trust in asked you to donate to CALPAC, you performed a successful surgery I say farewell, but I will continue to march and saved his life. He eventually became alongside you, the SJMS board, and with the the President of United States incoming President, Dr. John Zeiter. Dr. Zeiter defeating Henry will bring his vast background knowledge from Clay. Polk wanted to annex Texas and managing Zeiter Eye Medical Group to our expand the United States west to the leadership team. Pacific Ocean. On the other hand, Clay wanted a smaller country model. It our hands. For example, Dr. Richard kindly opened up your wallets. You was because of the successful surgery Pan, a prominent Pediatrician, and have conquered and will continue to and the advances in medicine that we State Senator is leading the physicianâ&#x20AC;&#x2122;s conquer. Simply stated, we are battle are now living in Stockton, California, charge for us and has sponsored the tested for the future. United States. Had Clay won, it would all-important vaccination legislation I say farewell, but I will continue to have been Stockton, California, that will keep communicable diseases march alongside you, the SJMS board, Mexico. in check and prevent outbreaks of and with the incoming President, Dr. Times have changed since President diseases. John Zeiter. Dr. Zeiter will bring his Polk was a teenager. Physicians now Over the year, our Board was vast background knowledge from need to be healers AND politicians. united and focused, and it has been managing Zeiter Eye Medical Group We need to be proactive. We need a privilege to work with them. We to our leadership team. Please join to be the Chef and not the Cook. have representatives from nearly me in welcoming him as the new We need to support our organized every major medical organization President of SJMS. medicine efforts at the local, state, in the county. Our thoughts have and national level. If you are not always been focused and to make members, please call SJMS to join decisions that would benefit the entire

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LEGISLATIVE ADVOCACY DAY POLITICAL PANEL SPEAKS ON MEDI-CAL, PHYSICIAN WORKFORCE AT CMA LEGISLATIVE ADVOCACY DAY

The importance of ensuring access to care for Californians and possible policy solutions, including increasing the physician workforce and expanding health care technology, were key topics during a panel discussion at the California Medical Association’s (CMA) annual Legislative Advocacy Day on April 14. The panel, composed of Assembly Health Committee Chair Rob Bonta, Assembly Business and Professions Committee Chair Susan Bonilla and moderator CMA Senior Vice President Janus Norman, delved first into California’s ongoing implementation of the Affordable Care Act (ACA).

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“Providing accessible high-quality health care to as many Californians as possible is my goal and something I’m very passionate about,” Bonta said. “I believe that health care is a right, not a privilege, and is for everyone – not just for the few.” Bonta noted two challenges to this goal, including ensuring those who are covered can truly access providers when they need to, as well as reducing the number of people without coverage. “While we’ve made great strides in reducing the number of uninsured in California, there are still significant numbers who are uninsured – 3 million this year,” Bonta said, adding that California’s significant undocumented population – estimated at 1 million – also doesn’t receive coverage under the ACA. To help resolve these challenges, Bonta authored AB 366, which would restore a cut made to Medi-Cal reimbursement rates and raise those rates to Medicare levels. Also on Tuesday, that bill passed unanimously through the Assembly Committee on Health. Bonilla discussed the need to avoid a “false promise” by fully funding Medi-Cal, as well as the need for “robust and reimbursable telehealth” services. She also emphasized the need to resolve California’s physician shortage. “It’s really a waste of California resources to have medical students that then have to leave the state because we aren’t going to be able to find a [residency] spot for them,” she said. “We want them to stay in California.” Bonilla concluded the panel by asking physicians to stay involved in the policymaking process. “What does the profession need? The answers need to come from you,” she said. “These are all issues that we really rely upon your input in order to make wise polices that are actually going to work.”

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COMMITED TO OUR COMMUNITY Health Plan of San Joaquin works to improve the health of our community by providing over 300,000 individuals throughout San Joaquin and Stanislaus with access to high-quality healthcare through our Medi-Cal Program. Our teams of dedicated professionals are committed to supporting local physicians in their delivery of care by developing programs that reinforce treatment plans, educate members about their conditions and provide them tools to stay healthy. Our commitment extends to locally-developed programs with financial support of Decision Medicine, a program where high school seniors interested in medical careers are inspired to pursue their dreams through first-hand experiences in addition to scholarship funding reserved for students in our area who demonstrate high academic achievement and a passion for medicine. Linked in By fostering strong relationships with physicians throughout the Central Valley for almost 20 years, Health Plan of San Joaquin continues to improve the lives of those in our community.

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SAN JOAQUIN PHYSICIAN

In The News

IN THE

NEWS Kaiser Permanente Receives Prestigious Accreditation for Breast Cancer Care

Kaiser Permanente in the Central Valley has been granted full, three-year accreditation by the National Accreditation Program for Breast Centers for the integrated health system’s high standards and positive outcomes in treating patients with breast diseases. Accreditation by the national program, known as NAPBC, is administered by the American College of Surgeons and awarded to programs that have voluntarily committed to provide the highest level of quality breast care, and that undergo a rigorous evaluation process and review of their performance. “We are extremely pleased that such a prestigious accreditation program has recognized that our patients receive the best possible care at our facilities,” said Moses Elam, MD, the physician-in-chief for Kaiser Permanente in the Central Valley. “The accreditation also validates that our physicians, nurses and staff are extremely competent and compassionate caregivers.” During the accreditation process, Kaiser Permanente’s breast center program demonstrated compliance with standards established by the NAPBC for diagnosing and treating patients with the full spectrum of breast disease. The accreditation standards require proficiency in the areas of leadership, clinical management, research, community outreach, professional education, and quality improvement. Breast center programs accredited by the NAPBC provide comprehensive care, including a full range of state-of-the-art services; a multidisciplinary team approach to coordinate the best treatment options; and information and access to ongoing clinical trials and new treatment options.

SAN JOAQUIN PHYSICIAN

Providing staff, physicians and patients with relevant & up to date information

San Joaquin General Hospital Physician Residents Receive National Honors

Two of San Joaquin General Hospital’s Internal Medicine residents have been honored by the American College of Physicians as “Young Achievers in Medicine” this year. The two resident physicians in Internal Medicine are Masoud Ghaemmaghami, M.D. and Mehvish Mahmood, M.D., both now completing their residency program at San Joaquin General Hospital under the guidance of Internal Medicine Department Chair and Program Director, Dr. Mohsen Saadat. The two young physicians recently traveled to Boston and were honored at the American College of Physicians’ National Internal Medicine Meeting. The American College of Physicians is a national organization of medical internists and physician specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across a wide spectrum from daily health to complex illnesses. On behalf of the national competition for this recognition, Steven Weinberger, M.D., F.A.C.P., Exec V.P. and C.E.O of the ACP said, “This group of early career internists demonstrates academic excellence and represents the best of what the future of Internal Medicine holds.” San Joaquin General Hospital currently has 24 Internal Medicine residents. “I am proud of the national recognition of Drs. Ghaemmaghami and Mahmood from the ACP. It’s an example of the knowledge and dedication of our resident physicians to providing the highest level of medical care for local County residents,” said David Culberson, C.E.O of San Joaquin General Hospital. San Joaquin General Hospital’s Internal Medicine Residency Training Program is affiliated with the University of California, Davis School of Medicine. The educational experience graduating physicians receive at San Joaquin General is designed to be challenging, rewarding, and intellectually stimulating. “The two nationally honored

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In The News

physicians are an excellent example of the quality of our resident physicians,” added Culberson. Dr. Masoud Ghaemmaghami completed his undergraduate studies in the field of Neurobiology and Behavior at Cornell University, New York, where he was involved in several research projects, including student health services. Under the supervision of Professor Daneshvar, a writer and a visiting scholar at Cornell, he translated “Our Town,” a famous English play, into Farsi in 2006. After completing his medical education at St. George’s University in 2012, Dr. Ghaemmaghami joined San Joaquin General Hospital’s Internal Medicine Residency Program where he is currently a third year resident. Since his internship, Dr. Ghaemmaghami has shown a passion for critical care bed side ultrasonography. Dr. Ghaemmaghami He has been published and has presented several posters and clinical vignettes at American College of Physicians and most recently at the World Congress on Ultrasound in Medical Education held in Portland, Oregon in October 2014. Dr. Ghaemmaghami has made several lifesaving diagnoses based on his skills in critical care ultrasonography and has been recognized by the Emergency Department and the Internal Medicine Program on multiple occasions for his skills and knowledge in critical care ultrasonography. Dr. Mehvish Mahmood completed medical school at King Edward Medical College of Pakistan where she was awarded the Gold Medal in Ophthalmology and Silver Medal in the field of Internal Medicine. Dr. Mahmood was the coordinator for a case control study on lifestyles and diseases associated with cancers of upper GI tract as a joint research project between Kagoshima University, Japan and King Edward Medical University, Pakistan. After graduating from medical school, Dr. Mahmood completed an internship in Cardiac and Vascular Surgery at Mayo Hospital in Pakistan. After completing her USMLE

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Step I and II with exceptionally high scores, she joined San Joaquin General Hospital’s Internal Medicine Residency Program in July 2013 where she is currently a second year resident. Coping with the busy life of a Dr. Mehvish Mahmood medical resident and achieving academic excellency leaves very little time for her to enjoy her hobbies of cooking, baking, painting and participating in debate. In addition to English, Dr. Mahmood is also fluent in Hindi, Punjabi and Urdu. Dr. Mahmood is an exceptional resident and will continue to thrive in her last year of residency with a graduation date of June 2016. A Healthy Workplace Initiative For Employees – Health Plan of San Joaquin (HPSJ) Partners With San Joaquin General Hospital (SJGH)

Health Plan of San Joaquin (HPSJ) announced today almost 200 staff participated in its first-ever National Walking Day event held in partnership with San Joaquin General Hospital (SJGH) on April 1. The event, held to support the American Heart Association’s National Day of Walking, also marked the opening of a series of walking paths set up on the neighboring HPSJ and SJGH campuses, as part of new efforts to encourage staff to make walking a daily habit. “As healthcare professionals, staff at Health Plan of San Joaquin and San Joaquin General Hospital care for others while often neglecting their own health,” said HPSJ Health Promotion/Cultural & Linguistics Manager Jenny Dominguez, MPH / MBA. “As part of new efforts to encourage staff to make walking a daily habit, we joined together on April 1st – with a ribbon-cutting to kick-off a selection of new walking paths on the adjacent campuses, and then with HPSJ and SJGH staff heading out on the one-mile path.” Additional paths through the adjacent campuses have also been established for employees to walk, including for staff at Mary Graham Children’s Shelter and the VA Stockton

SAN JOAQUIN PHYSICIAN

In The News

IN THE

NEWS Heart disease is this country’s No. 1 killer. But by exercising for as little as 30 minutes each day, the risk can be reduced. The American Heart Association recommends walking, which offers many benefits – even for healthcare pros.

National Walking Day Clinic, who were also invited to participate in the April 1st kick-off walk. After remarks by Pam Benziger, local American Heart Association Executive Director, Dr. Mohsen Saadat, DO, SJGH Internal Medicine Program

Director, Dr. Lakshmi Dhanvanthari, MD, HPSJ Chief Medical Officer, and HPSJ’s Dominguez, warm-up stretches were led by “Carl the Trainer” from Pure Form PFT (Stockton) who donated his time.

Tawhid R. Gazi, MD, joins Lodi Health as Medical Director of Gastroenterology and Interventional Endoscopy

Tawhid R. Gazi, MD, has joined Lodi Health. He is the new medical director of gastroenterology and interventional endoscopy and practices at Lodi Health Physicians Plaza Surgical Care. Dr. Gazi is board-certified and fellowship-trained in internal medicine and gastroenterology. He is a graduate

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).

SAN JOAQUIN PHYSICIAN

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In The News

Tawhid R. Gazi, MD of Tufts Medical Center in Boston, where he also earned his bachelor of science with Summa Cum Laude status. Most recently, Dr. Gazi has practiced interventional gastroenterology at Northbay Medical Center in Fairfield. Prior to that, he was Chief of Gastroenterology at Providence Health Center in Waco, Texas (20112013), Director of Digestive Diseases at St. Mary’s Hospital in Decatur, Ill. (2010-2011) and Chief of Endoscopy at Lake Grandbury Medical Center in Grandbury, Texas (2006-2010). When he is not taking care of his five children, Dr. Gazi and his wife enjoy playing golf and tennis. Dr. Gazi’s office is located at Lodi Health Physicians Plaza Surgical Care, 999 S. Fairmont Ave., Ste. 100, in Lodi, 209.334.8514. Dr. Gazi is now taking patients and most insurance is accepted. He is fluent in English and Spanish. Foundation Commits to Purchase DaVinci Surgical Robot

The Lodi Memorial Hospital Foundation Board of Directors recently committed to purchase a

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new DaVinci Surgical Robot Model Xi for Lodi Health. “We have talked with our donors and they agree that this new technology is so important to our patients that the $2,000,000 price tag is definitely worth it”, stated, Wayne Craig, Executive Director. The DaVinci Xi will allow new types of surgical procedures like bariatric, colorectal and thoracic surgery that the current DaVinci Si cannot. Our success with the original DaVinci Robot has been exceptional placing Lodi Health in the top 10% in the nation and one of the few hospitals in the area with seven robot-certified surgeons. The collaboration of these seven surgeons plus other medical staff including Dr. Fahey, Chief of Surgery,

to help with this acquisition and become part of the Robotics Team that is changing the practice of medicine and bringing the best care to our community. To make a contribution or learn more details please contact Wayne Craig, at 209-339-7630. Doctors Hospital of Manteca is Recognized for Outstanding Record in Patient Safety – Awarded an “A” in Fall 2014 Hospital Safety Score

Doctors Hospital of Manteca was honored with an “A” grade in the Spring 2015 Hospital Safety Score, which rates how well hospitals protect patients from errors, injuries and infections. The Hospital Safety Score is compiled under the guidance of the nation’s leading experts on patient safety and is administered by The Leapfrog Group (Leapfrog), an independent industry watchdog. The first and only DaVinci Surgical Robot hospital safety rating to be peer-reviewed in the Journal of has yielded exceptional results for our Patient Safety, the Score is free to the patient population. public and designed to give consumers “Our patients will benefit the most…” information they can use to protect states Dr. Param Gill who performs themselves and their families when over one hundred surgeries each year. facing a hospital stay. The Minimally Invasive Procedure “I am deeply grateful to our dedicated (MIS) procedure used by the DaVinci team of employees, physicians, Robot reduces hospital time and and volunteers for their sustained recovery time to 50% of traditional efforts to ensure the safety of our surgeries and thus considerably patients,” said Nicholas Tejeda, Chief reduction in pain. Back to work times Executive Officer at Doctors Hospital are often 75% less than open surgical of Manteca. “These individuals procedures. have worked tirelessly to identify The Foundation is asking our donors opportunities for improvement,

SAN JOAQUIN PHYSICIAN

In The News

IN THE

NEWS implement action plans to achieve those goals, and closely monitor our progress. Of course, we understand that patient safety is a journey, rather than a destination. Indeed, this most recent recognition represents the fourth straight measurement period that Doctors Hospital of Manteca has earned the top ranking. We will continually strive to improve our performance and provide our community with a safe hospital that delivers a high level of clinical care and customer service.” “Patient safety needs to be a 24-7 priority for hospitals, as errors and infections are all too common and often deadly,” said Leah Binder, president and CEO of The Leapfrog Group, which administers the Hospital Safety Score. “We commend the ‘A’ hospitals, including Doctors Hospital of Manteca, for helping us to raise the standards of health care nationwide, and demonstrating that they’ve made the well-being of patients a top priority.” Health Plan Of San Joaquin (HPSJ) Appoints New Customer Service Director

Health Plan of San Joaquin (HPSJ) today announced that, after a nationwide search, Mike McCarns 20

SAN JOAQUIN PHYSICIAN

Mike McCarns has been appointed as Director of Customer Service, effective March 2, 2015. McCarns has over 20 years of healthcare-related call center and customer service management experience. McCarns, who is relocating to the Central Valley and HPSJ’s headquarters near Stockton, previously was Executive Director at Cognosante (Nashville, Tennessee) where he managed the overall performance of a large scale, multi-channel, healthcarerelated contact center. Prior to Cognosante, his experiences included over five years as Program Director of Customer Service at ICF International in Virginia, where he managed both inbound and outbound call centers with over 900 agents. McCarns

began his career on the healthcare side, graduating from Chemeketa Community College (Oregon) as an Emergency Medical Technology/ Technician (EMT Paramedic). “Mike has had an extensive customer focused career having managed several large customer contact centers,” said HPSJ chief executive officer Amy Y. Shin. “Even more, we are impressed with his focus on providing premier customer service through our premier customer service representatives. He’s not only experienced and accomplished, but also he is genuinely enthusiastic about the mission we share – providing our members with a fantastic customer experience.” HPSJ Chief Joins California Association Board With Focus On Health Systems Quality Improvements

Health Plan of San Joaquin CEO Amy Shin has joined the board of the California Health Care Safety Net Institute (SNI), the research and quality improvement affiliate of the California Association of Public Hospitals and Health Systems (CAPH). As CAPH’s quality improvement partner, SNI designs and directs programs that accelerate the spread of innovative practices among California’s public

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In The News

Amy Shin hospitals, public clinics and beyond. Shin said “our work on behalf of the diverse communities of San Joaquin and Stanislaus counties mirrors SNI’s mission to make sure more people – especially those most affected by health disparities – receive effective, efficient and respectful health care regardless of their ability to pay.” Under her leadership, HPSJ has grown to 300,000 members. Her 20 years of progressive Medicare, Medicaid and commercial managed care leadership experience includes serving as Chief Administrative Officer at On Lok – founder of the pioneering PACE (Program of All Inclusive Care for the Elderly). HPSJ Health Careers Scholarships Program – Collaborative Expansion Launched for 2015

Identifying the challenges in the Health Plan of San Joaquin (HPSJ) Service Area regarding provider capacity and the limited number of new clinicians coming into the region, in 2009 HPSJ launched the Health Careers Scholarship Program to encourage graduating high school students with interests in medical professions as they

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pursue higher education. For 2015, they have again refined the Health Careers Scholarships, their prime scholarship program, by creating partnerships with seven local agencies offering specialized education and support for students who are working toward a health career here in the Central Valley. San Joaquin Medical Society’s Decision Medicine is proud to be one of the seven partners, along with Delta College - Nursing Program, Health Careers Academy High School, UOP School of Pharmacy, Health Careers Academy - Grace M. Davis High School, Modesto Junior College Nursing Program, and CSU Stanislaus School of Nursing. Later this summer, SJMS will join with HPSJ leaders to present awards to two of our 2015 Decision Medicine graduates. HPSJ CMO Lakshmi Dhanvanthari, MD, said, “With this program we can reinvest the limited resources of our health plan in our community, collaborating with these schools to encourage and support the next generation of doctors, nurses and pharmacists.” St. Joseph’s brings Vein Viewers Technology to Patients

St. Joseph’s Medical Center has adopted an innovative medical device called VeinViewer®, which allows medical professionals to visualize a patient’s vasculature in HD and in real-time. The digital image is projected directly onto the surface of the patient’s skin. VeinViewer has been shown to increase the rate of first-stick success by up to 100 percent, decrease medically unnecessary PICC lines by greater than 30 percent and increase patient

Valleri Gammon

Valleri Gammon, the first Health Careers Scholar to receive HPSJ support and encouragement for each year of her academic career. The recent CSU Stanislaus School of Nursing honors graduate has been hired by Doctors Hospital of Manteca as a Circulating Registered Nurse. She looks forward “to being a mentor to future HPSJ Health Careers Scholars.” satisfaction by 100 percent. St. Joseph’s is proud to be among the first to bring this new technology to patients in our community. St. Joseph’s Foundation purchases Penguin Warmers for Neonatal Intensive Care Unit

With the help of generous donors, St. Joseph’s Foundation of San Joaquin purchased nine Penguin Milk Warmers to be used for patients in the Neonatal Intensive Care Unit. The Penguin Warmer is designed to warm pumped breast milk to maternal body

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PUT THE TOP DOWN IN A NEW CONVERTIBLE

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E U R O P E A SUMMER N M O2015 TORS

In The News

temperature. The warmer protects the feedings from hot spots and plastic extractables while preserving the valuable nutritional properties of the breast milk/formula. St. Joseph’s Medical Center has a 22bed Community Level III NICU to care for newborns who need intensive medical attention. As a certified BabyFriendly Hospital, St. Joseph’s offers a caring environment combined with advanced technology and highly skilled doctors, nurses, and therapists to provide specialized care. St. Joseph’s Launches Diabetes Patient Navigator Program

St. Joseph’s has implemented a new Diabetes Navigator Program to help guide and support patients living with diabetes. The Diabetes Navigator Program is free and open to those who are newly diagnosed, as well as individuals in need of additional support managing their condition. St. Joseph’s Diabetes Navigator Program can help connect your patients to: • A team of health educators, nurses and pharmacists, who are ready to provide support • Informative workshops to help empower your patients to take control of diabetes • Local, peer-led diabetes support groups • Information about clinical diabetes management services, provided in close collaboration with physician (service by referral only). St. Joseph’s team of health educators and specially trained pharmacists work closely with patients to maximize the effectiveness of their treatment and pursue a healthier lifestyle. If you’re interested in learning more

SUMMER 2015

about this program, please call our Diabetes Navigator at 209.944.8355 for more information or visit StJosephsCares.org/Diabetes. For other patient navigation support, you can reach our Cancer Navigator at 939.4526 and our Heart Navigator at 467.6540. Hybrid Suite Coming to St. Joseph’s Medical Center

The award winning Heart & Vascular Institute at St. Joseph’s Medical Center will be opening a new Cardiac Hybrid Suite, with the capability to transform from a cardiac catheterization lab to an operating room in a matter of seconds, with cutting-edge technology and tools. The Hybrid Suite will be our region’s first to combine the very best medical expertise of St. Joseph’s cardiac specialists with state-of-the-art technology. The room will feature an imaging system on a robotic arm with ultrasound capabilities, CT imaging, angiography, and more to provide intricately detailed pictures of the heart and blood vessels—all of which help us pinpoint any areas of concern and accurately diagnose and treat cardiovascular disease. St. Joseph’s Foundation of San Joaquin will be hosting a farm-totable style event called Farm to Heart, to help raise funds to bring this much needed technology to our region. The event will be held on June 13 at the Lincoln Farmhouse and will feature dinner, cocktails, live music and an auction. For tickets or more information, please call 209.467.6347.

San Joaquin Female Physicians Luncheon

San Joaquin Female Physicians Group met at Confucius Church on April 16, 2015. It was attended by a dozen female physicians. The luncheon was coordinated by Dr. Janwyn Funamura pediatrician and Dr. Graciela Barzaga PM&R specialist and was sponsored by the San Joaquin Medical Society. Dr. Pat Hatton OB/GYN shared the history of the group pioneered by Dr. Dora Lee and upon her demise other doctors continued her legacy. “Join

our group of lady doctors who really understands the issues in your life. Make connections, make friends, relax and enjoy music, food, games and have fun”. The next gathering will be at the house of Dr. Harjit Sud on Monday, June 22 from 6pm - 8pm. For more information please contact Lisa Richmond at 209952-5299 or Lisa@sjcms.org. Available Space to Lease for Medical Office:

For Medical office in Weber Ranch Professional park, 1801 East March Lane, Stockton, CA; call today at 209951-8830 or 951 83 95; 1367 sq. ft. fully finished ready to move in with 4 exam rooms, Doctor’s Chamber with separate bath room. Manager’s room, work station for MAs, Patient’s bath room, storage room, and Reception (waiting room).

SAN JOAQUIN PHYSICIAN

SUMMER 2015

A deep connection to his family, his community and his profession are what makes Dr. Steve Billigmeier the San Joaquin Medical Societyâ&#x20AC;&#x2122;s Young Physician of the year.

ROOTS RUN DEEP Story by: James Noonan

Dr. Steve Billigmeier has always cared about roots. Growing up, his family was dependent upon them -- cherry tree roots, walnut tree roots and pear tree roots -- for their livelihood, relying on the annual harvest of their family farm to make a living.

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SAN JOAQUIN PHYSICIAN

As an adult, a different set of “roots” became important, the kind that keep a man and his family ingrained in the community that they’ve long called home. For Billigmeier, these roots, both literal and figurative, lay in Linden, Calif., a community that his family has called home for five generations, and one that he continues to serve on a near-daily basis. “Everybody is here,” he said, noting he currently lives only a stone’s throw from his family farm and childhood home. “It’s always been very important to me, to be able to stay as close as possible to my family.” Given his deep connection to this community, it only makes sense that his path toward a career in medicine began there. Billigmeier, like his father and grandfather before him, came from agricultural origins, but he knew from an early age that a different professional calling was in his future. “From the beginning, I knew I wanted to stay connected, but I didn’t want to farm,” he said, noting that strength in math and science classes in high school were what caused his initial interest in medicine. Acting on this interest, he took an internship at San

SAN JOAQUIN PHYSICIAN

Joaquin General Hospital and was immediately hooked on the profession. “I found it fascinating; very fulfilling and rewarding,” he said. “I was playing such a tiny, tiny role, but it was enough where I was still very interested.” Following graduation from Linden High School, Billigmeier attended Stanford University and eventually went on to medical school at the University of California, Davis. These years away at school would come to mark the only time he and his high school sweetheart, and now wife, Jimi, lived away from Linden. “We left in body, but not in spirit,” he said. “That connection was always there. We always knew we would be coming home.” After completing his residency, Billigmeier – or “Dr. B” to his patients – began practicing in Stockton with Dr. Carol Cahill, and in 1998 they opened Pediatric Associates of Stockton. The pair continues to practice today, along with Dr. Linda Sakimura and Dr. Erica Waters. With a practice set up nearby, Billigmeier and his wife

SUMMER 2015

Roots Run Deep > Dr. Billigmeier

returned to Linden, purchased some land and built the home where they’ve lived for almost 20 years. While he had been raised in Linden, starting his own family there meant developing an even deeper connection the community, one that has seen him serve as a director of the Linden Educational Foundation, sit on the board of the Linden Little League, and give free annual physicals at Linden High School and hearing exams at Linden Community Preschool. On top of all these engagements, he’s maintained a thriving practice and held multiple professional leadership roles, including six years as chair of Pediatrics at St. Joseph’s Medical Center in Stockton. And, of course, there are always the occasional calls that come with being a physician in a small town. “Oh, I get it all,” he said. “I’ll get texts about fevers and pictures of rashes, and I’m happy to do it. If I didn’t want to do that, I wouldn’t live here.” Asked how he manages to do it all, Billigmeier has a rather simple answer. “That just what you do, especially when you’re in a small community,” he said. “You want the opportunities to be there, not just for your kids, but for all of them.” While examples of his service to the community are many, perhaps none are as important – and potentially lifesaving – as the project he began a few years ago at Linden High School. Billigmeier, like many other parents with high school-age children, had heard stories from across the country of teenagers, often student athletes, going into sudden cardiac arrest while on campus. While these incidents are frightening in their own right, they’re

SUMMER 2015

compounded by the fact that our society is shockingly illequipped to deal with such emergencies. “Less than 20 percent of citizens know CPR,” Billigmeier said. “I thought, ‘That’s a terrible statistic and we need to do something about it.’” Fueled by such statistics, Billigmeier launched a program that would see sophomores and seniors at Linden High School receive both CPR and AED training as part of their health education classes. As a result, these students

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Lodi Memorial Hospital Acute Physical Rehabilitation (APR)

Twenty-four years of specialized, inpatient rehabilitation services for stroke, brain-injury, spinal-cord-injury, multiple-trauma and patients with other neurological conditions

Lodi Health’s team of physical rehabilitation experts.

The county’s only acute, inpatient physical-rehabilitation program, featuring:       

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Emphasis on safe and independent transition home Coordinated physical, occupational, speech and recreational-therapy sessions, minimum of three hours daily State-of-the-art technology for neurologic training 24-hour care by rehabilitation-trained, experienced nurses Minimum of five days of physician visits Outdoor areas for rehabilitation and recreational activities Private rooms and room-service meals for patients and their family members

Lodi Memorial Hospital Acute Physical Rehabilitation Ramnik Clair, MD, Medical Director 209/712-7905 Tel 209/333-3082 Fax 975 S. Fairmont Ave., Lodi, CA 95240

www.lodihealth.org SUMMER 2015

Roots Run Deep > Dr. Billigmeier

would be equipped to deal with a cardiac emergency not only while on campus, but in the larger community, as well. “You don’t want to wait until a tragedy happens to do something about it,” he said. “In Linden, we have a small enough school where we could make it work.” And make it work, he has. Since its inception, the CPR/AED program has trained roughly 1,200 students, and through fundraising, he was able to place four AED machines on campus. Efforts are also underway to include a CPR Day for the greater community in the Fall, joined by American Red Cross Volunteers, with the opportunity for all residents to get CPR & AED trained. In other words, if you’re going to have a cardiac emergency, Linden might be one of the safer places in the nation to do it, thanks in part, to Dr. B. While, by now, having Dr. B around is probably normal to Linden residents, onlookers might find it somewhat strange that a family with such strong agricultural roots would go on to produce a physician. Billigmeier looks at things differently, even seeing parallels between farmers and doctors – pediatricians, in particular. Every year, he explains, farmers plant and care for a new set of crops, raising them from seed to market. At the end of the season, the crops - and with them countless hours of

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a farmer’s’ labor - are harvested and sent out into the world. Next season, the farmers plant anew. For pediatricians, there’s a similar cycle. “We get to see patients from the time they’re babies until they’re ready to head off to college,” Billigmeier said. “We’re almost an

extension of their family.” Inevitably, children grow into adults and no longer see their childhood pediatricians, but there’s a new “crop” of patients headed into the office on a regular basis. “Kids grow up,” he says. “But the cycle continues.”

SAN JOAQUIN PHYSICIAN

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SUMMER 2015

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SUMMER 2015

FROM THE

GROUND

Starting from scratch

can be diﬃcult, but for Dr. Javad Jamshidi, it’s been the true recipe for success. Story by: James Noonan

The word “pioneer” can mean many things to many people.

To some, the title may conjure images of great explorers setting sail for unknown lands, while others may think of more humble citizens, those who set out for a new life beyond the lines of a great frontier. In each of these cases, the people we think of as pioneers possess two key characteristics -- an unwavering belief in themselves and an ability to create something from nothing. Dr. Javad Jamshidi, a pioneer in his own right, sums it up best. “If you want to really do something, you have to start from the bottom from scratch,” he said.

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SAN JOAQUIN PHYSICIAN

From The Ground Up > Dr. Javad Jamshidi

SAN JOAQUIN PHYSICIAN

SUMMER 2015

“I WANTED TO BE A FAMILY MAN” This willingness to start from the bottom -- to build something great – typifies Jamshidi’s career, both as a physician and as a humanitarian. As a result of his labor, countless lives of those in Stockton, the Central Valley and even his native Iran, have been changed for the better. With regard to medicine, Jamshidi’s career began at Tehran University, where he attended medical school. While enrolled, he met his future wife, Mitra, who was also studying to be a physician, and shortly after graduation, the two wed and moved to the United States to begin their residency training. While they were away, things in their home country took a dramatic turn. In early 1979, Iran’s Islamic Revolution broke loose, forever changing the political environment of the nation. When the unrest first began, Jamshidi and his wife took a “wait and see” approach, still entertaining the idea of a return home once he and his wife’s training were complete. Over time, however, careers were launched, children were born and new lives in the United States began to take shape. “Our roots here got stronger and stronger,” Jamshidi said. “Our children went off to school and the idea of going back slowly faded away.” Today, Jamshidi is the archetype of a family man. In the living room of his Stockton home, his eyes light up with pride as he discusses the accomplishments of his daughter, Anahita,

SUMMER 2015

and his two sons Ramin and Neema, both of whom took after their father and are currently practicing physicians. In the past few years, he’s become a grandfather as well, with Ramin and his wife Melissa bringing their daughter Laleh into the world. For a man who cares so deeply for his kin, it’s no surprise that family played such an immense role in not only the decision to remain in the United States, but also what type of medicine to practice. Early on in his medical training, Jamshidi had a strong interest in surgery. The idea of being able to directly intervene in the human body was something that greatly appealed to him, but at the same time, he knew that the demands placed on a surgeon would draw him away from other priorities in life. “I wanted to be a family man,” he said. “The way that the medical system, surgery in particular, was set up would have made that difficult.” Instead, Jamshidi chose radiology, a specialty that, by his own admission, was considered “laid back” in the 1970s. So, after receiving specialty training in both Albany, New York and Washington University in St. Louis’ world-renowned Mallinckrodt Institute of Radiology, Jamshidi interviewed for a position at Stockton Radiology Medical Group, and set down roots in the place he would come to call home.

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From The Ground Up > Dr. Javad Jamshidi

It was then that the true “pioneering” began. When Jamshidi joined Stockton Radiology, his specialty of choice was at the cusp of a technological breakthrough. In 1979, Dr. Godfrey Hounsfield and Dr. Allan Cormack had won a joint Nobel Prize for their development of the CT scan, which for the first time, was allowing physicians to see cross sections of the human body through radiology, something that promised to revolutionize the field. “Before CT, everything we talked about in radiology was two dimensional,” Jamshidi said. “I’ve always been after new adventures, and that was the case with radiology when I started out. It was completely changing the way we practiced medicine.” Before long, CT was being used to supplant the need for traditionally invasive procedures, such as biopsies and angioplasties, and Jamshidi was

helping bring these new developments to the citizens of Stockton. Early in his career he performed the city’s first percutaneous CT-guided organ biopsies. Only a few years later he performed Stockton’s first CTguided angioplasty. “My interest in surgery was, in a way, fulfilled by the advent of interventional radiology,” he said, noting that only a few years earlier, such procedures would have been impossible without a scalpel and operating table. This was a tidal shift in medicine, and Jamshidi illustrates its magnitude by recalling the words 36

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of a career neurosurgeon who had just witnessed the new capabilities of radiological imaging for the first time. “He told me, ‘I’ve been practicing neurosurgery for 35 years and I feel like, the whole time, I’ve been in the dark,” he said. CT and its role in the establishment of interventional radiology had made Jamshidi a household name in Stockton’s medical community – something of a “Mr. Radiology” of the Central Valley. Then came the MRI. Just was the case with CT, the technology behind magnetic resonance imaging was just getting its start in the late ‘70s and early ‘80s, At the beginning of Jamshidi’s medical career, MRI was something that existed mainly in the pages of scientific journals, rather than wings of neighborhood hospitals. Such articles and images, however, immediately caught Jamshidi’s eye, and he knew that this technology had the ability to, once again, turn the field of radiology on its head. At this time, the technology, though incredibly valuable, was prohibitively expensive, and it wasn’t until the Centers for Medicare and Medicaid Services approved reimbursement for MRIs in the 1980s that the procedure truly exploded. “That was the beginning of everything,” he recalls. While the federal government was now willing to reimburse for the cost of the procedure, opening an MRI facility was still an extremely tall order. Between the cost associated with the machine itself, as well as subsequent installation and set-up fees, Jamshidi recalls staring down a more than $2 million hurtle, roughly $5.6 million is today’s value, according the Bureau of Labor Statistics. Despite the costs, Jamshidi knew that the future of the field lay in MRI, and so he decided to build. In 1986, under Jamshidi’s leadership, a SUMMER 2015

Please join us for the

Annual Membership Dinner honoring our

2015 Lifetime Achievement Award Recipient

DR. JAVAD JAMSHIDI Young Physician Award, Steven Billigmeier, MD SUNDAY, JUNE 14, 2015

Cocktail Reception 6:00pm l Dinner 7:00pm

STOCKTON GOLF & COUNTRY CLUB

3800 Country Club Boulevard l Stockton, California Member Physicians and Spouse/Guest – $35 per person Non-Members and Invited Guests – $60 per person Additionally, we will honor the passing of the gavel from Ramin Manshadi, MD to President-Elect John Zeiter, MD

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partnership of three area hospitals -- St. Joseph’s, Dameron and Lodi Memorial -- came together to form San Joaquin Magnetic Resonance Center and cover the costs associated with opening Stockton’s first MRI facility. Jamshidi served as the partnership’s first director and president. While the facility and machine were now at his fingertips, the road to success in the field of MRI was far from over. In the early days of MRI, Jamshidi recalls the field being incredibly fastpaced, one which required physicians conducting MRI procedures to constantly be adapting to the latest developments in the field. “Everything was evolving,” he said. “You’d learn one thing and the next week it would all change.” For five years, Jamshidi led San Joaquin Magnetic Resonance Center, quickly establishing the partnership - as well as himself - as leaders in the field. Then, things evolved once again. In 1991, Jamshidi’s pioneer spirit took hold, and he decided to strike out on his own to open what would eventually become Stockton MRI and Molecular Imaging. In his new, burgeoning facility Jamshidi quickly established himself as being at the top of his field, with Stockton MRI being one of the first facilities in the state to meet the rigorous accreditation

SUMMER 2015

requirements of the American College for Radiology. As time went on, the facility and its staff grew, but Stockton MRI remained where it had been since the onset - on the forefront of a rapidly evolving field. Looking back on the facility’s growth and development into something of a regional institution, Jamshidi sums up success with a simple statement. “If you do something well, you’re going to be rewarded for it,” he said. “If you put your heart in something, you’re going to succeed.” For Jamshidi, this willingness to start anew -this pioneer’s mentality -- is not limited strictly to his professional pursuits, and perhaps there’s no better evidence for this statement than what came about after a trip back to his native Iran in the late 1990s. Following the Iran-Iraq War of the 1980s, Jamshidi’s home nation was reeling economically, as efforts to rebuild from the war were slow to take hold. At the same time, the laws and social structure of the Islamic republic placed the county’s women at an even further disadvantage. “You had a system in place that was suppressing 50 percent of the population,” Jamshidi said, noting that the problem was particularly bad in the county’s rural regions.

SAN JOAQUIN PHYSICIAN

From The Ground Up > Dr. Javad Jamshidi

Just as he had in his professional life, Jamshidi decided that the best way to go about fixing this problem was to roll up his sleeves, get involved and start from the bottom. “We thought the only way to make a difference was to get involved from the grassroots,” he said. “So, let’s educate these ladies and these girls and give them a chance to one day educate their own children.” With this line of thinking, Jamshidi and his wife, Mitra, formed the Jamshidi Family Foundation, with the intent of opening an allfemale high school in one of Iran’s underserved rural areas. Just as it had been with medicine, the process of starting from scratch was anything but easy. For starters, the area where the school was to be built lacked basic infrastructure such as roads, let alone services like electricity that would be needed to form a functioning school. Political circumstances also added to the difficulties,

with the United States government at least once shutting down funding to the project due to economic sanctions being levied against Iran. Through it all, Jamshidi and Mitra persevered, and in 1998, the Dr. Mitra Jamshidinezhad PreUniversity High School, produced its first class of graduates. A few years later, the Jamshidi’s extended their commitment to serve, opening a second school in the heart of Tehran, this time focusing on impoverished youth and adults in need of education. The institution, known as the Adoration and Study Center, runs with volunteer teachers and allows students to drop in for instruction outside of traditional school hours.

“Ignorance is the mother of all vice,” Jamshidi said. “These people, particularly the children, are the best seed for crime, but getting them educated can be difficult because they also need to support their family.” Today, the center offers both basic education for children, as well as vocational and trade programs for adults. Through all these endeavors, both professional and philanthropic, Jamshidi’s willingness to start from scratch, and the success that often followed, is something he says would not have been possible without the make your next meeting support of his wife, Mitra, as well as that of his three children. What I am, and what I have, especially in my adult bundtinis by the dozen • bundtlet towers • decorated bundt cakes life, I owe to having a wife like Mitra,” he said. “I have Stockton been incredibly blessed.” 128 Lincoln Center (Next to Starbucks and Noah’s Bagels) • (209) 957-2253

a Celebration nothingbundtcakes.com 40

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SUMMER 2015

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WINNING FOURSOME

SAN JOAQUIN PHYSICIAN

SUMMER 2015

A NNUA L SAN JOAQUIN MEDICAL SOCIETY

Golf Tournament BENEFITTING THE FIRST TEE OF SA N JOAQUIN A ND DECISION MEDICINE

BY GEORGE KHOURY, MD

Yes it was a great day to play golf. The 6th annual SJMS Golf Tournament benefiting The First Tee of San Joaquin and Decision Medicine. What a great occasion for our medical society and its members, to work with our larger community in providing opportunities to build and expand our youth’s aspirations and futures. The golf course and greens were well manicured and challenging. Thank you to Greg Feddersen and staff at Elkhorn Golf & Country Club for making the tournament run seamlessly. Thank you to all the golfers who participated, San Joaquin Medical society staff; Jessica and Vanessa as well as our executive director Lisa Richmond for their hard work and our sponsors who provided support to the players with drink, food and merriment. Between the sponsors, raff le tickets and registrants we raised $2600 to benefit the First Tee and $4000 for SJMS’ Decision Medicine. SUMMER 2015

FIRST PLACE: DONALD MILLER KIM SMITH, BILL SMITH CHUCK RICHISEN

MOST HONEST TEAM: KATHLEEN GALLUP WENDY TAYLOR ROBERT CLEVELAND KELLI CLEVELAND

CLOSET TO THE PIN: LADIES – KATHLEEN GALLUP MEN – KWABENA ADUBOFOUR

LONGEST DRIVE: LADIES – DEBBIE BOND MEN – ALEX TERRILL

PUTTING CONTEST WINNER: GARY MALLOY SAN JOAQUIN PHYSICIAN

Thank You to our Sponsors George Herron, MD, Lan Quang, MD, Lian and Jerry Soung, MD

The Medical society Golf Committee would like to thank Don Miller, Executive Director of the First Tee of San Joaquin and their Board members who are invaluable in their assistance and guidance with planning and coordinating this tournament.

Kroloﬀ, Belcher, Smart, Perry & Christopherson Crown Enterprises Oak Valley Community Bank Dignity Health Medical Group Stockton East Main Clinic and Stockton Diabetes Intervention Center Stockton Diagnostic Imaging Stone Creek Village Stull Financial Group

The day started with pregame barbecue lunch and Putting Contest. The game was played smoothly without delays or long waiting times using a simple scramble format with all players participating in the team score. The day ended with a delicious dinner and raff le prizes.

University of the Paciﬁc Zeiter Eye Medical Group

Golf Tournament Committee

Daren Primack, MD

George Khoury, MD

Kwabena Adubofour, MD

Peter Garbeﬀ, MD

Lisa Richmond, San Joaquin Medical Society

Ragu Reddy, MD

Cathy Ghan, Oak Valley Community Bank

Lawrence Frank, MD

Donald Miller, The First Tee of San Joaquin Nicole Bojorques, The First Tee of San Joaquin

SAN JOAQUIN PHYSICIAN

SUMMER 2015

SAN JOAQUIN PHYSICIAN

A CHOICE that will change you, and your life forever. Dameron Hospitalâ&#x20AC;&#x2122;s weight loss surgery program is designed for the whole person, mind and body, providing long term weight loss solutions that unveil your complete self. Led by the regionâ&#x20AC;&#x2122;s top bariatric surgeons and devoted expert medical team, patients are guided through a life changing experience from discovery of a customized treatment plan, to pre-operative and post-surgery education and support, as well as wellness workshops and ongoing access to peer groups.

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Medicare > Payment Reform

CONGRESS PASSES MEDICARE PAYMENT REFORM AND ELIMINATES SGR

Last week, the U.S. Senate overwhelmingly passed H.R. 2 with a 92-to-8 vote, which will completely overhaul the Medicare payment program. This move, which follows the U.S. House of Representatives’ near-unanimous vote two weeks ago, is a monumental, bipartisan action taken by Congress that negates the Medicare sustainable growth rate (SGR) formula and extends the Children’s Health Insurance Program (CHIP). President Obama signed it into law on April 16. The California Medical Association (CMA), along with the American Medical Association (AMA) and other health care organizations, have been fighting to end the SGR for 12 years. Without action by Congress, physicians faced a 21 percent cut in Medicare reimbursement the very next day. Senate leaders cleared the way for final passage by allowing votes on several amendments sought by both sides of the aisle. “H.R. 2 is an unprecedented display of bipartisanship on the SGR. After more than a decade of inaction, this is truly a historic moment,” said CMA President Luther F. Cobb, M.D. “This legislation will substantially improve access to care for 5 million California seniors and disabled patients, nearly 1 million military families on TriCare, and nearly 1 million uninsured children.“ CMA applauds this rare bipartisan achievement in a deeply divided Congress. CMA, AMA and more than 780 state and national physician organizations supported the bill. The policy was developed jointly on a bipartisan basis by the three House and Senate health committees. U.S. House of Representatives Speaker John Boehner (R-OH) and Minority Leader Nancy Pelosi (D-CA) are credited with negotiating the budget offsets to fund the final SGR bill. In addition to eliminating the SGR, H.R. 2 includes changes to the payment system. The other major provisions of H.R. 2 include: Providing automatic, stable 0.5 percent updates each year for four years for Medicare Physician Fee Schedule services. In 2019, physicians can choose to participate in one of two SUMMER 2015

payment track options: A fee-for-service track that simplifies and consolidates the existing quality reporting programs, reinstates large bonuses up to 9 percent and reduces current penalties or; An alternative payment model track that provides 5 percent bonus payments and allows physicians to develop the new models, such as primary care/specialty medical homes. Streamlining the Physician Quality Reporting System (PQRS), Meaningful Use (MU) and Value Based Modifier (VBM) quality programs to create the Merit-Based Incentive Program System (MIPS) quality program. Therefore: PQRS, MU and VBM penalties will end in 2019. The maximum MIPS bonuses and penalties will be 4 percent in 2019, 5 percent in 2020, 7 percent in 2021, and 9 percent in 2022 and beyond. Physicians are eligible for additional bonuses of up to 10 percent for exceptional performance. MIPS scores will include quality, resource use, meaningful use and clinical practice improvement activities. The percentages are adjustable for individual physicians or group practices. Quality feedback will be more relative and timely, and targets will be known at the start of each reporting period. Physicians are also required to be involved in defining quality and in developing new payment models that are not specified in the legislation. $125 million in funding to help small practice physicians transition to the alternative models or quality reporting programs Reinstates bundled payments for the 10-day and 90-day global surgical services Provides total cost of care data to help physicians better manage their practices Mandates interoperatibily of electronic health record systems. By December 31, 2018, vendors will no longer be able to block interoperability. SAN JOAQUIN PHYSICIAN

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SUMMER 2015

Ensures that any practice guideline or payment policy in the ACA cannot be construed to be the standard of care for professional liability purposes. H.R. 2 also allows for the release of physician claims data. This same data was released in August 2014 and the Centers for Medicare and Medicaid Services is planning on publishing 2013 physician claims data later this year. CMA is concerned about this provision and is working with AMA to advocate for improvements to this process, such as the ability for physicians to review and correct claims information. For more information, AMA has published two resources, “Highlights of H.R. 2” and an FAQ. The bill represents a significant improvement over the current Medicare program, which mandates penalties of up to 13 percent in the coming years with no opportunities for payment updates or bonuses. By repealing the SGR and providing annual updates, it provides stability to physician practices that allows for longer term planning. Significantly, it allows physicians to design new payment systems that work for themselves and patients instead of government bureaucrats. It also mandates physician involvement in defining and developing quality measures. Moreover, now that the costly SGR is repealed, it will be much easier for physicians to work with Congress to make improvements to the payment system at a lesser cost. The enormous cost of the SGR had been a barrier to making any improvements. The bill also extends the expiring Children’s Health Insurance Program for two years at the higher Affordable Care Act (ACA) funding levels. It covers nearly 1 million children in California who would otherwise lose their insurance. CHIP was formerly known as Healthy Families in California before it was folded into the Medi-Cal program. It also extends the moratorium on recovery audit contractor audits of the hospital two-midnight rule, which helps hospitals and physicians. And, finally, it extends the National Health Service Corps and the ACA teaching health centers primary care residency training programs. Funding Sources: The Congressional Budget Office estimated that the cost of the bill would total $211 billion over 10 years and will not be fully offset with other funding sources. For 12 years, Congress has stopped the SGR payment cuts before they have taken effect; because of that, Speaker Boehner and Leader Pelosi concluded that any federal government savings would be phony and the cost to repeal SGR should be $0. Another $70 billion for the measure will come from deductibles for new MediGap policies starting in 2020. The top 2 percent of high-income seniors will see their premiums increase to 15 percent more for couples making $267,000 to $320,000, and 20 percent more for couples making more than $320,000 in retirement income. There will also be $35 billion in payment cuts to hospitals and other providing post-acute care services. This final cut does not apply to physicians. CMA thanks physicians for their extraordinary efforts to keep fighting to pass this monumental legislation. Fifty-two out of 54 members of the California Congressional delegation supported physicians on this subject. Unity within the physician community helped achieve this stunning victory.

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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.

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SUMMER 2015

Senate President Pro Tem delivers keynote speech to hundreds of health care advocates

ealth care remains a top priority for the California Senate Democratic Caucus and will undoubtedly be a major driver in the state’s continuously recovering economy, according to Senate President Pro Tem Kevin de León. De León was the keynote speaker at the California Medical Association’s (CMA) Legislative Advocacy Day on April 14, where he spoke to an audience of more than 400 physicians, medical students and CMA Alliance members from around the state. He touched on a variety of topics during his address, including the role of health care in a post-recession economy. “We need to make sure that all individuals in the state of California have an opportunity to participate in this economic resurgence,” he said, adding, “we’re in the middle of one of the most transformative eras in the

SUMMER 2015

history of medical health care in the United States. How we do this and how we do this right is going to speak volumes with regards to the economy and also to delivering quality health care to all individuals.” De León highlighted five crucial components of California, or “E’s” that help define the state: economy, education, energy/environment, equity and exceptionality. On the topic of education, de León spoke about the need to provide better access to a college education, as well as the state’s shortage of physicians — particularly in areas hit hardest by the economic recession. “We must continue to invest, and incentivize, the young men and women who enter medical school and want to practice in these areas throughout the state of California,” he said.

De León later acknowledged Senator Richard Pan, M.D., a CMA member who authored a highly debated vaccine bill (SB 277) currently in the legislature, saying it takes “courage to stand up for science and the long-term health of our communities in the face of the threats and misinformation.” He also thanked the health care advocates in the crowd for keeping California healthy and strong. “We know that we are in a very transformative era in America, with regards to delivering health care. It’s not just because we understand that a healthier California is much more prosperous and productive. But it’s also because we want to ensure health care remains one of California’s fastest-growing economic sectors.”

SAN JOAQUIN PHYSICIAN

Public Health

Update

WHAT CAN AND SHOULD PHYSICIANS DO? 1) Suspect TB when you see patients with chronic cough or a pneumonia that just doesnâ&#x20AC;&#x2122;t get better with antibiotics 2) Test for TB infection 3) Treat TB infection 4) Report all suspected or confirmed cases of TB to San Joaquin County Public Health Services within one working day, as required of healthcare providers by state law

Not to be Ignored, TB in San Joaquin County By Julie Vaishampayan, MD, MPH and Alvaro Garza, MD, MPH

It seems most Americans, including physicians, think that tuberculosis (TB) is a disease of the past, eliminated in the US long ago, and only exists in developing countries. But, in fact, there were almost 10,000 cases of TB disease in the U.S. last year and California had more cases (2146) than any other state. When cases are found and reported or outbreaks occur in a community, people inevitably ask, so why is it here?! How could it come back?! Of course, the

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truth is, TB never left. TB has caused more deaths than any other disease in human history and still causes more than one million deaths world-wide each year. Thanks to successful public health campaigns and efforts, TB is a much smaller public health problem in the U.S. today than it was in the early twentieth century. The downside of this wonderful

SUMMER 2015

achievement is that we imagine it’s completely gone and we let down our guard. But letting down our guard gives TB all it needs to spread. In San Joaquin County, Public Health staff are currently responding to three TB outbreaks. The most recent, active and concerning outbreak was identified just last year, with most cases living in the north county. Currently there are 23 TB disease cases genetically and epidemiologically linked to the outbreak; 16 were diagnosed in 2014, the remainder in 2012-13. While having 16 people diagnosed and reported with matching Salmonella strains in a year would not be unusual, it is very unusual for TB. The healthcare system has been significantly affected by this outbreak. Thirteen healthcare facilities have been identified to have had employees exposed to infectious TB disease. While investigation is still ongoing, it suggests that an estimated 30 to 50 healthcare staff will have TB skin test

converted and, thus, have TB infection. Four healthcare workers have been diagnosed with TB disease and linked to this outbreak. Compared to all other counties, San Joaquin had the highest proportion of TB disease reported in healthcare workers in 2014. What can and should physicians do? First, think (suspect) TB when you see patients with chronic cough or a pneumonia that just doesn’t get better with antibiotics. TB in children can present with mild respiratory symptoms; if disease recognition is delayed, disseminated disease may occur. Thinking TB early may save that child’s life. In the present outbreak, three of the 23 cases are children under the age of two years. One child had severe meningitis and is neurologically devastated. Second, test for TB infection. The California TB Controllers Association (CTCA) has developed an adult risk assessment tool for primary care physicians to use to

Percentage of TB Cases in CA Health Care Workers per County in 2014* Percentage health care worker TB cases per county 13.0%

600

12.0%

10.6%

500 400

10.0%

8.5%

7.8%

8.0%

300 4.3%

200

4.2% 1.9%

100 0.0%

0.0%

6.0% 4.0%

2.9% 0.0%

1.9%

2.0%

0.0%

o s A ng el es Or an ge Ri ve rs id e Sa cr am en Sa to n Be rn ar di no Sa n Di eg Sa o n Fr an cis co Sa n Jo aq ui n Sa n M at eo Sa nt a C la ra

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Number of TB Cases

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Number of TB cases per county

County

SUMMER 2015

SAN JOAQUIN PHYSICIAN

identify patients in their practice who are at risk for TB and should be tested. This form can be found on the CTCA website (ctca.org) under the provider tab.

Finally, report all suspected or confirmed cases of TB to San Joaquin County Public Health Services within one working day, as required of healthcare providers by state law.

Third, treat TB infection. The best way to prevent TB disease is early case finding and timely treatment of TB infection. There are three different regimens for treatment of TB infection in adults: nine months of INH daily, four months of rifampin daily, or three months of INH & rifapentine once weekly. The INH/rifapentine regimen requires 12 doses and, at this time, must be observed by a non-family member (directly observed therapy or DOT). Similar to the experience of others, in the San Joaquin County Public Health clinic, treatment completion is 47% for INH, 62% for rifampin, and 81% for INH/rifapentine. Short course treatment of TB infection with either rifampin or INH & rifapentine is preferred as we have significantly greater success with completion of treatment, thus strengthening the prevention of TB disease.

In our busy medical practices, TB is usually not in the forefront of our thoughts. That’s appropriate for most days. But tomorrow a person with TB disease may walk into your office. What will you do? Will you think TB and promptly take the appropriate actions to decrease the risk of transmission to you, your staff, and others in contact with this person? Or will you not think, test for, treat, and report TB, thus missing an opportunity to prevent significant morbidity in our community?

54 SAN JOAQUIN PHYSICIAN 54 SAN JOAQUIN PHYSICIAN

TB is definitely still with us; still in the U.S., still in California, and very much so in San Joaquin County. We, the healthcare community and public health, can stop TB. Let’s not let down our guard, let’s not ignore TB. Thank you for all you do to prevent disease, promote and protect the health of our residents and communities.

SUMMER2015 2015 SPRING

SUMMER 2015 2015 SPRING

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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.

JUNE 10TH, 2015: “COMPLYING WITH HIPAA & CALIFORNIA’S

CONFIDENTIALITY OF MEDICAL INFORMATION ACT” AND “CMA CENTER FOR LEGAL AFFAIRS, NAVIGATING CMA’S HEALTH LAW RESOURCES” 11:00AM to 1:00PM

CMA Legal Counsel will discuss how physician offices can ensure compliance with federal and state laws to protect the confidentiality of patient records, including recent updates to HIPAA and California’s counterpart, the Confidentiality of Medical Information Act, security breaches, enforcement actions and current events related to the privacy of health information. In addition, Legal Center staff will provide an overview of CMA’s Center for Legal Affairs and available educational resources, including how to navigate CMA OnCall, CMA’s online health law library. ~Lisa Matsubara is Legal Counsel in CMA’s Center for Legal Affairs ~Farah Kader, Research Associate for CMA

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ARE YOU READING CPR? CPR contains the latest in Practice Management Resources, Updates and Information.

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CMA Practice Resources (CPR) is a free monthly e-mail bulletin

AUGUST 12TH 2015: TBD

from CMA’s Center for Economic

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SEPTEMBER 9TH 2015: “ARE YOUR EMPLOYEES

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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 BossuatKroloff, Belcher, Smart, Perry & Christopherson

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SUMMER 2015

In Memoriam

In Memoriam Glen Everett Brown, M.D. • Robert W. Westafer M.D. • Douglas B. McGirr, MD

“Dr. Brown found solitude and peace in nature and was an avid fisherman and big game hunter.”

SUMMER 2015

GLEN EVERETT BROWN, M.D. Nov. 11, 1926 - Apr. 20, 2015

Glen Everett Brown, M.D. was born in Kennett, Missouri on November 11, 1926 and died on April 20, 2015 in Ripon, CA. He was an only child and his family survived the Great Depression with entrepreneurial pluck. He and his family moved to California when he was ten years old. At 16, he enlisted in the Marines and was involved in some of the major Pacific Theater battles of WWII. Returning home, he married “the most beautiful girl” he had ever seen and the love of his long life, Alice Kinder, who happened to live across the street from his parents in Salinas, CA. They were married and had a great love for over 68 years. They had two daughters, Betty June Ingell and Mary Ruth Quirit. He built two homes completely from scratch by himself for his young family in those early years. After WWII he became a highly-regarded and sought-after professional pilot owning f lying schools and agricultural crop dusting businesses. He had a lifelong love of aviation, airplanes and f light, owning and restoring many aircraft. His grand adventure was to f ly a sea plane for six weeks in the Alaskan wilderness while hunting large game. Dr. Brown had a restless and pragmatic spirit and in his early 30’s entered and completed college in two years with a Chemistry degree from SF State University. In 1958 he was admitted to medical school at UCSF. Being somewhat older and considerable wiser than his classmates, he became a beloved big brother, mentor and role model for his colleagues. He completed his internship at San Joaquin General Hospital and started a private Family Practice in Manteca in 1963. He stated his goal as a physician was to care for families and grow old with the families of his patients. He was able to complete that goal, delivering multiple generations of babies in some families before his retirement in the late 1990’s. He was a certified diplomat by the American Academy of Family Physician from its inception. He founded Manteca Medical Group in 1963 in Manteca. He provided clinical and administrative leadership through educating interns, residents, family nurse practitioners and physician assistants throughout his career and also served as the Director of the

SAN JOAQUIN PHYSICIAN

In Memoriam

Family Practice Residency Program at San Joaquin General Hospital during the 1980’s. He served on committees of the California State Board of Medical Quality Assurance, as the Medical Director of the Family Nurse Practitioner/ Physician Assistant Program at UC Davis, the Boards of Manteca Hospital/Doctors Hospital of Manteca, the San Joaquin Medical Society, the Foundation for Health Care of San Joaquin County and a number of other professional organizations. Dr. Brown was highly regarded by his colleagues and patients for being a brilliant clinical practitioner, a wise and thoughtful teacher, and a man of deep and abiding kindness and character, and quiet modesty. Dr. Brown found solitude and peace in nature and was an avid fisherman and big game hunter. He and Alice loved to do everything together and they loved exposing their children and grandchildren to these adventures. Like many men of the “Greatest Generation” he had many interests and talents and loved all sports. He refereed high school football, was an expert golfer who won many tournaments in his 20’ and 30’s and was a formidable Bridge player in his retirement years with a highly competitive spirit. In his 80’s, he had solar panels installed on his home and zoomed around in his hybrid cars. Life was a fabulous adventure to be lived at full speed. He will be deeply missed by his devoted wife of 68 years, Alice and daughter Dr. Betty Ingell (Walter) of Ripon, and Mary Quirit (Michael) of Monterey. He leaves a generational legacy of three beautiful and loved granddaughters: Sarah Williams of Napa, Marina Quirit Russo (Marc) of Monterey, and Rachael Romine (Scott) of Woodbridge; as well as four precious great-grandchildren, Amelia Williams, Adelyn (Addy) Romine, Rosemary (Rosie) Romine and Mario Antonio Russo. He was preceded in death by his parents, Adelyn and Paul Brown.

ROBERT W. WESTAFER M.D. May 9, 1942 – March 18, 2015

Physician pioneer in Emergency Medicine and Paramedic Care, Robert Westafer, M.D. passed away on March 18, 2015 in Long Beach, CA. He was born May 9, 1942 in Minneapolis, Minnesota and was raised in the suburbs of St. Louis Park and Hopkins. Bob was the captain of his high school’s 1959 championship football team and co-captain of its 1960 championship basketball team, as well as an honor student. He received an athletic scholarship to Wheaton College in Wheaton, Illinois but a knee injury early in his freshman year that required two subsequent knee surgeries forced him to reconsider competitive athletics and accelerated his interest in attending medical school. Bob graduated from the University of Minnesota Medical

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School in 1967 and after graduation moved to northern California for internship and residency at the University of California Davis Medical Center in Sacramento. He attained the rank of Major while serving as a medical officer in the United States Air Force during the Vietnam War, which included a tour of duty in Southeast Asia. Upon completion of his military service Bob returned to northern California, where as a charter member of the American College of Emergency Physicians he became a physician pioneer in emergency medical care. In 1972 he became a charter member of the American College of Emergency Physicians, and in 1973 he organized the first emergency physicians’ medical group in San Joaquin County, and was the first Director of the Emergency Department and Urgent Care Center at Dameron Hospital, serving as its director for 10 years. In 1975, under the auspices of San Joaquin Delta College, Dr. Westafer developed the course curricula and taught the first Paramedic class and the first Mobile Intensive Care Nurses class in San Joaquin County. Simultaneously he spearheaded improvements in the equipment and staffing of local hospital emergency departments, enabling them to serve as base stations for this new advanced life support capability through the paramedics he was training. In the early 1980’s he was among the first physicians worldwide to become board certified in what had then become the new American Medical Specialty of Emergency Medicine. Bob was also a board certified family physician for 27 years and cared for patients together with his wife, Sharon, a registered nurse, in their private medical office on Grand Canal Boulevard, which they opened in 1983. In 2000, he and Sharon retired from active medical practice, sold their medical office, and subsequently moved to coastal southern California, where among other things he enjoyed the reading, writing, bicycling, world travel and the company of close friends. On May 18, 2015, Bob died from Idiopathic Pulmonary Fibrosis, a devastating, inexorably progressive and fatal lung disease that has little effective treatment and whose cause remains unknown. He is survived by Sharon, his wife and best buddy of 40 years, three children, two grandchildren and his sister, Lois Westafer Carlson. A private memorial was held. Remembrances may be made to St. Mary’s Dining Room in Stockton.

SUMMER 2015

In Memoriam

( Joey); his nieces, Marissa, Ayna, Lei, and Kathleen; and his nephews Michael, JR and Enz. He was devoted to his wife of over 26 years, and he was very proud of his daughters--Samantha graduated from Stanford University in 2011, and Julia will graduate

from Brown University with honors in May. Doug was an avid runner and enjoyed painting and drawing. He was a loving husband, supportive father, dependable brother, fun uncle, compassionate physician, loyal friend, and a good, unassuming person.

DOUGLAS B. MCGIRR, MD March 3, 1950March 22, 2015

Doug was born in Hollywood, California, on March 3, 1950. He graduated from the University of California at Berkeley in 1972, where he was a member of the men’s gymnastics team. He went on to graduate from the University of Nebraska Medical School in 1976. Doug worked for 39 years as a radiologist, including several years as Chief Radiologist at San Joaquin General Hospital and almost 20 years at St. Joseph’s Medical Center. Most recently, he worked at Stockton MRI. His professional research interests included the identification of child abuse through radiology. He also held a patent on a biomedical device. Doug is survived by his wife, Victoria; their two daughters, Samantha and Julia; his brother Scott (Mary); his sister Joan; his brother-in-law Amboy ( Jeannette); his sisters-in-law, Lourdes (Manny) and Lorna

SUMMER 2015

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San Joaquin Medical Society 3031 W. March Lane, Suite 222W Stockton, California 95219-6568

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